	Addendum B.- Final OPPS Payment by HCPCS Code for CY 2021												
	CPT codes and descriptions only are copyright 2020 American Medical Association.  All Rights Reserved.  Applicable FARS/DFARS Apply. Dental codes (D codes) are copyright 2020 American Dental Association.  All Rights Reserved.												
HCPCS Code	Short Descriptor	 CI	 SI	APC 	Relative Weight	Payment Rate 	National Unadjusted Copayment 	Minimum Unadjusted Copayment 	"Note: Actual copayments would be lower due to the cap on copayments at the Inpatient Deductible of $1,484.00"	Drug Pass-Through Expiration during Calendar Year			
0001A	Adm sarscov2 30mcg/0.3ml 1st	NI	S	1492		$15.50	$0.00	$0.00					
0001F	Heart failure composite		E1										
0001U	Rbc dna hea 35 ag 11 bld grp		A										
0002A	Adm sarscov2 30mcg/0.3ml 2nd	NI	S	1493		$25.50	$0.00	$0.00					
0002M	Liver dis 10 assays w/ash		Q4										
0002U	Onc clrct 3 ur metab alg plp		Q4										
0003A	Fee covid-19 vac 1 booster	NI	E1										
0003M	Liver dis 10 assays w/nash		Q4										
0003U	Onc ovar 5 prtn ser alg scor		Q4										
0004A	Fee covid-19 vac 1 res	NI	E1										
0004M	Scoliosis dna alys		A										
0005F	Osteoarthritis composite		E1										
0005U	Onco prst8 3 gene ur alg		Q4										
0006M	Onc hep gene risk classifier		A										
0007M	Onc gastro 51 gene nomogram		A										
0007U	Rx test prsmv ur w/def conf		Q4										
0008U	Hpylori detcj abx rstnc dna		A										
0009U	Onc brst ca erbb2 amp/nonamp		Q4										
00100	Anesth salivary gland		N										
00102	Anesth repair of cleft lip		N										
00103	Anesth blepharoplasty		N										
00104	Anesth electroshock		N										
0010U	Nfct ds strn typ whl gen seq	CH	Q4										
0011A	Adm sarscov2 100mcg/0.5ml1st	NI	S	1492		$15.50	$0.00	$0.00					
0011M	Onc prst8 ca mrna 12 gen alg		A										
0011U	Rx mntr lc-ms/ms oral fluid		Q4										
00120	Anesth ear surgery		N										
00124	Anesth ear exam		N										
00126	Anesth tympanotomy		N										
0012A	Adm sarscov2 100mcg/0.5ml2nd	NI	S	1493		$25.50	$0.00	$0.00					
0012F	Cap bacterial assess		E1										
0012M	Onc mrna 5 gen rsk urthl ca		A										
0012U	Germln do gene reargmt detcj		A										
0013A	Fee covid-19 vac 2 booster	NI	E1										
0013M	Onc mrna 5 gen recr urthl ca		A										
0013U	Onc sld org neo gene reargmt		A										
00140	Anesth procedures on eye		N										
00142	Anesth lens surgery		N										
00144	Anesth corneal transplant		N										
00145	Anesth vitreoretinal surg		N										
00147	Anesth iridectomy		N										
00148	Anesth eye exam		N										
0014A	Fee covid-19 vac 2 res	NI	E1										
0014F	Comp preop assess cat surg		E1										
0014M	Liver ds alys 3 bmrk srm alg	NC	Q4										
0014U	Hem hmtlmf neo gene reargmt		A										
0015F	Melan follow-up complete		E1										
0015M	Adrnl cortcl tum bchm asy 25	NI	Q4										
00160	Anesth nose/sinus surgery		N										
00162	Anesth nose/sinus surgery		N										
00164	Anesth biopsy of nose		N										
0016M	Onc bladder mrna 209 gen alg	NI	A										
0016U	Onc hmtlmf neo rna bcr/abl1		A										
00170	Anesth procedure on mouth		N										
00172	Anesth cleft palate repair		N										
00174	Anesth pharyngeal surgery		N										
00176	Anesth pharyngeal surgery		C										
0017M	Onc dlbcl mrna 20 genes alg	NI	A										
0017U	Onc hmtlmf neo jak2 mut dna		A										
0018U	Onc thyr 10 microrna seq alg		A										
00190	Anesth face/skull bone surg		N										
00192	Anesth facial bone surgery	CH	N										
0019U	Onc rna tiss predict alg		A										
00210	Anesth cranial surg nos		N										
00211	Anesth cran surg hemotoma		C										
00212	Anesth skull drainage		N										
00214	Anesth skull drainage		C										
00215	Anesth skull repair/fract		C										
00216	Anesth head vessel surgery		N										
00218	Anesth special head surgery		N										
0021A	Fee covid-19 vac 3 dose 1	NI	E1										
0021U	Onc prst8 detcj 8 autoantb		Q4										
00220	Anesth intrcrn nerve		N										
00222	Anesth head nerve surgery		N										
0022A	Fee covid-19 vac 3 dose 2	NI	E1										
0022U	Trgt gen seq dna&rna 23 gene		A										
0023A	Fee covid-19 vac 3 booster	NI	E1										
0023U	Onc aml dna detcj/nondetcj		A										
0024A	Fee covid-19 vac 3 res	NI	E1										
0024U	Glyca nuc mr spectrsc quan		Q4										
0025U	Tenofovir liq chrom ur quan		Q4										
0026U	Onc thyr dna&mrna 112 genes		A										
0027U	Jak2 gene trgt seq alys		A										
0029U	Rx metab advrs trgt seq alys		A										
00300	Anesth head/neck/ptrunk		N										
0030U	Rx metab warf trgt seq alys		A										
0031A	Fee covid-19 vac 4 dose 1	NI	E1										
0031U	Cyp1a2 gene		A										
00320	Anesth neck organ 1yr/>		N										
00322	Anesth biopsy of thyroid		N										
00326	Anesth larynx/trach < 1 yr		N										
0032A	Fee covid-19 vac 4 dose 2	NI	E1										
0032U	Comt gene		A										
0033A	Fee covid-19 vac 4 booster	NI	E1										
0033U	Htr2a htr2c genes		A										
0034A	Fee covid-19 vac 4 res	NI	E1										
0034U	Tpmt nudt15 genes		A										
00350	Anesth neck vessel surgery		N										
00352	Anesth neck vessel surgery		N										
0035U	Neuro csf prion prtn qual		Q4										
0036U	Xome tum & nml spec seq alys		A										
0037U	Trgt gen seq dna 324 genes		A										
0038U	Vitamin d srm microsamp quan		Q4										
0039U	Dna antb 2strand hi avidity		Q4										
00400	Anesth skin ext/per/atrunk		N										
00402	Anesth surgery of breast		N										
00404	Anesth surgery of breast		N										
00406	Anesth surgery of breast		N										
0040U	Bcr/abl1 gene major bp quan		A										
00410	Anesth correct heart rhythm		N										
0041A	Fee covid-19 vac 5 dose 1	NI	E1										
0041U	B brgdrferi antb 5 prtn igm		Q4										
0042A	Fee covid-19 vac 5 dose 2	NI	E1										
0042T	Ct perfusion w/contrast cbf		N										
0042U	B brgdrferi antb 12 prtn igg		Q4										
0043A	Fee covid-19 vac 5 booster	NI	E1										
0043U	Tbrf b grp antb 4 prtn igm		Q4										
0044A	Fee covid-19 vac 5 res	NI	E1										
0044U	Tbrf b grp antb 4 prtn igg		Q4										
00450	Anesth surgery of shoulder		N										
00454	Anesth collar bone biopsy		N										
0045U	Onc brst dux carc is 12 gene		A										
0046U	Flt3 gene itd variants quan		A										
00470	Anesth removal of rib		N										
00472	Anesth chest wall repair		N										
00474	Anesth surgery of rib	CH	N										
0047U	Onc prst8 mrna 17 gene alg		A										
0048U	Onc sld org neo dna 468 gene		A										
0049U	Npm1 gene analysis quan		A										
00500	Anesth esophageal surgery		N										
0050U	Trgt gen seq dna 194 genes		A										
0051A	Fee covid-19 vac 6 dose 1	NI	E1										
0051U	Rx mntr lc-ms/ms ur 31 pnl		Q4										
00520	Anesth chest procedure		N										
00522	Anesth chest lining biopsy		N										
00524	Anesth chest drainage		C										
00528	Anes mediascpy & dx thorscpy		N										
00529	Anes medscpy&thorscpy 1 lung		N										
0052A	Fee covid-19 vac 6 dose 2	NI	E1										
0052U	Lpoprtn bld w/5 maj classes		Q4										
00530	Anesth pacemaker insertion		N										
00532	Anesth vascular access		N										
00534	Anesth cardioverter/defib		N										
00537	Anesth cardiac electrophys		N										
00539	Anesth trach-bronch reconst		N										
0053A	Fee covid-19 vac 6 booster	NI	E1										
0053U	Onc prst8 ca fish alys 4 gen		A										
00540	Anesth chest surgery		C										
00541	Anesth one lung ventilation		N										
00542	Anesthesia removal pleura		C										
00546	Anesth lung chest wall surg		C										
00548	Anesth trachea bronchi surg		N										
0054A	Fee covid-19 vac 6 res	NI	E1										
0054T	Bone srgry cmptr fluor image		N										
0054U	Rx mntr 14+ drugs & sbsts		Q4										
00550	Anesth sternal debridement		N										
0055T	Bone srgry cmptr ct/mri imag		N										
0055U	Card hrt trnspl 96 dna seq		A										
00560	Anesth heart surg w/o pump		C										
00561	Anesth heart surg <1 yr		C										
00562	Anesth hrt surg w/pmp age 1+		C										
00563	Anesth heart surg w/arrest		N										
00566	Anesth cabg w/o pump		N										
00567	Anesth cabg w/pump		C										
0056U	Hem aml dna gene reargmt		A										
00580	Anesth heart/lung transplnt		C										
0058T	Cryopreservation ovary tiss	CH	D										
0058U	Onc merkel cll carc srm quan		Q4										
0059U	Onc merkel cll carc srm +/-		Q4										
00600	Anesth spine cord surgery		N										
00604	Anesth sitting procedure	CH	N										
0060U	Twn zyg gen seq alys chrms2		A										
0061A	Fee covid-19 vac 7 dose 1	NI	E1										
0061U	Tc meas 5 bmrk sfdi m-s alys		Q4										
00620	Anesth spine cord surgery		N										
00625	Anes spine tranthor w/o vent		N										
00626	Anes spine transthor w/vent		N										
0062A	Fee covid-19 vac 7 dose 2	NI	E1										
0062U	Ai sle igg&igm alys 80 bmrk		Q4										
00630	Anesth spine cord surgery		N										
00632	Anesth removal of nerves		C										
00635	Anesth lumbar puncture		N										
0063A	Fee covid-19 vac 7 booster	NI	E1										
0063U	Neuro autism 32 amines alg		Q4										
00640	Anesth spine manipulation		N										
0064A	Fee covid-19 vac 7 res	NI	E1										
0064U	Antb tp total&rpr ia qual		Q4										
0065U	Syfls tst nontreponemal antb		Q4										
0066U	Pamg-1 ia cervico-vag fluid		Q4										
00670	Anesth spine cord surgery		N										
0067U	Onc brst imhchem prfl 4 bmrk		A										
0068U	Candida species pnl amp prb		Q4										
0069U	Onc clrct microrna mir-31-3p		A										
00700	Anesth abdominal wall surg		N										
00702	Anesth for liver biopsy		N										
0070U	Cyp2d6 gen com&slct rar vrnt		A										
0071A	Fee covid-19 vac 8 dose 1	NI	E1										
0071T	Us leiomyomata ablate <200		J1	5414	31.6824	"$2,623.21"	.	$524.65					
0071U	Cyp2d6 full gene sequence		A										
0072A	Fee covid-19 vac 8 dose 2	NI	E1										
0072T	Us leiomyomata ablate >200		J1	5414	31.6824	"$2,623.21"	.	$524.65					
0072U	Cyp2d6 gen cyp2d6-2d7 hybrid		A										
00730	Anesth abdominal wall surg		N										
00731	Anes upr gi ndsc px nos		N										
00732	Anes upr gi ndsc px ercp		N										
0073A	Fee covid-19 vac 8 booster	NI	E1										
0073U	Cyp2d6 gen cyp2d7-2d6 hybrid		A										
0074A	Fee covid-19 vac 8 res	NI	E1										
0074U	Cyp2d6 nonduplicated gene		A										
00750	Anesth repair of hernia		N										
00752	Anesth repair of hernia		N										
00754	Anesth repair of hernia		N										
00756	Anesth repair of hernia		N										
0075T	Perq stent/chest vert art		C										
0075U	Cyp2d6 5' gene dup/mlt		A										
0076T	S&i stent/chest vert art		C										
0076U	Cyp2d6 3' gene dup/mlt		A										
00770	Anesth blood vessel repair		N										
0077U	Ig paraprotein qual bld/ur		Q4										
0078U	Pain mgt opi use gnotyp pnl		A										
00790	Anesth surg upper abdomen		N										
00792	Anesth hemorr/excise liver		C										
00794	Anesth pancreas removal		C										
00796	Anesth for liver transplant		C										
00797	Anesth surgery for obesity		N										
0079U	Cmprtv dna alys mlt snps		E1										
00800	Anesth abdominal wall surg		N										
00802	Anesth fat layer removal		N										
0080U	Onc lng 5 clin rsk factr alg		A										
00811	Anes lwr intst ndsc nos		N										
00812	Anes lwr intst scr colsc		N										
00813	Anes upr lwr gi ndsc px		N										
0081A	Fee covid-19 vac 9 dose 1	NI	E1										
00820	Anesth abdominal wall surg		N										
0082A	Fee covid-19 vac 9 dose 2	NI	E1										
0082U	Rx test def 90+ rx/sbsts ur		Q4										
00830	Anesth repair of hernia		N										
00832	Anesth repair of hernia		N										
00834	Anesth hernia repair < 1 yr		N										
00836	Anesth hernia repair preemie		N										
0083A	Fee covid-19 vac 9 booster	NI	E1										
0083U	Onc rspse chemo cntrst tomog		Q4										
00840	Anesth surg lower abdomen		N										
00842	Anesth amniocentesis		N										
00844	Anesth pelvis surgery		C										
00846	Anesth hysterectomy		C										
00848	Anesth pelvic organ surg		C										
0084A	Fee covid-19 vac 9 res	NI	E1										
0084U	Rbc dna gnotyp 10 bld groups		A										
00851	Anesth tubal ligation		N										
0085T	Breath test heart reject	CH	D										
00860	Anesth surgery of abdomen		N										
00862	Anesth kidney/ureter surg		N										
00864	Anesth removal of bladder		C										
00865	Anesth removal of prostate		N										
00866	Anesth removal of adrenal		C										
00868	Anesth kidney transplant		C										
0086U	Nfct ds bact&fng org id 6+	CH	Q4										
00870	Anesth bladder stone surg		N										
00872	Anesth kidney stone destruct		N										
00873	Anesth kidney stone destruct		N										
0087U	Crd hrt trnspl mrna 1283 gen		A										
00880	Anesth abdomen vessel surg		N										
00882	Anesth major vein ligation		C										
0088U	Trnsplj kdn algrft rej 1494		A										
0089U	Onc mlnma prame & linc00518		Q4										
00902	Anesth anorectal surgery		N										
00904	Anesth perineal surgery	CH	N										
00906	Anesth removal of vulva		N										
00908	Anesth removal of prostate		C										
0090U	Onc cutan mlnma mrna 23 gene		A										
00910	Anesth bladder surgery		N										
00912	Anesth bladder tumor surg		N										
00914	Anesth removal of prostate		N										
00916	Anesth bleeding control		N										
00918	Anesth stone removal		N										
0091A	Fee covid-19 vac 10 dose 1	NI	E1										
0091U	Onc clrct scr whl bld alg		E1										
00920	Anesth genitalia surgery		N										
00921	Anesth vasectomy		N										
00922	Anesth sperm duct surgery		N										
00924	Anesth testis exploration		N										
00926	Anesth removal of testis		N										
00928	Anesth removal of testis		N										
0092A	Fee covid-19 vac 10 dose 2	NI	E1										
0092U	Onc lng 3 prtn bmrk plsm alg		Q4										
00930	Anesth testis suspension		N										
00932	Anesth amputation of penis		C										
00934	Anesth penis nodes removal		C										
00936	Anesth penis nodes removal		C										
00938	Anesth insert penis device		N										
0093A	Fee covid-19 vac 10 booster	NI	E1										
0093U	Rx mntr 65 com drugs urine		Q4										
00940	Anesth vaginal procedures		N										
00942	Anesth surg on vag/urethral		N										
00944	Anesth vaginal hysterectomy		N										
00948	Anesth repair of cervix		N										
0094A	Fee covid-19 vac 10 res	NI	E1										
0094U	Genome rapid sequence alys		A										
00950	Anesth vaginal endoscopy		N										
00952	Anesth hysteroscope/graph		N										
0095T	Rmvl artific disc addl crvcl	CH	N										
0095U	Inflm ee elisa alys alg		Q4										
0096U	Hpv hi risk types male urine		Q4										
0097U	Gi pathogen 22 targets		Q4										
0098T	Rev artific disc addl	CH	N										
0098U	Respir pathogen 14 targets		Q4										
0099U	Respir pathogen 20 targets		Q4										
0100T	Prosth retina receive&gen		T	1908		"$152,500.50"	.	"$30,500.10"	*				
0100U	Respir pathogen 21 targets		Q4										
0101A	Fee covid-19 vac 11 dose 1	NI	E1										
0101T	Extracorp shockwv tx hi enrg		J1	5113	34.1848	"$2,830.40"	.	$566.08					
0101U	Hered colon ca do 15 genes		A										
0102A	Fee covid-19 vac 11 dose 2	NI	E1										
0102T	Extracorp shockwv tx anesth		J1	5113	34.1848	"$2,830.40"	.	$566.08					
0102U	Hered brst ca rltd do 17 gen		A										
0103A	Fee covid-19 vac 11 booster	NI	E1										
0103U	Hered ova ca pnl 24 genes		A										
0104A	Fee covid-19 vac 11 res	NI	E1										
0105U	Neph ckd mult eclia tum nec		Q4										
0106T	Touch quant sensory test		Q1	5732	0.4087	$33.84	.	$6.77					
0106U	Gstr emptg 7 timed brth spec		Q4										
0107T	Vibrate quant sensory test		Q1	5732	0.4087	$33.84	.	$6.77					
0107U	C diff tox ag detcj ia stool		Q4										
0108T	Cool quant sensory test		Q1	5733	0.6722	$55.66	.	$11.14					
0108U	Gi barrett esoph 9 prtn bmrk		Q4										
0109T	Heat quant sensory test		Q1	5732	0.4087	$33.84	.	$6.77					
0109U	Id aspergillus dna 4 species	CH	Q4										
0110T	Nos quant sensory test		Q1	5734	1.3521	$111.95	.	$22.39					
0110U	Rx mntr 1+oral onc rx&sbsts		Q4										
01112	Anesth bone aspirate/bx		N										
0111T	Rbc membranes fatty acids	CH	D										
0111U	Onc colon ca kras&nras alys		A										
01120	Anesth pelvis surgery		N										
0112U	Iadi 16s&18s rrna genes		A										
01130	Anesth body cast procedure		N										
0113U	Onc prst8 pca3&tmprss2-erg		A										
01140	Anesth amputation at pelvis	CH	N										
0114U	Gi barretts esoph vim&ccna1		A										
01150	Anesth pelvic tumor surgery	CH	N										
0115U	Respir iadna 18 viral&2 bact	CH	Q4										
01160	Anesth pelvis procedure		N										
0116U	Rx mntr nzm ia 35+oral flu		Q4										
01170	Anesth pelvis surgery		N										
01173	Anesth fx repair pelvis		N										
0117U	Pain mgmt 11 endogenous anal		Q4										
0118U	Trnsplj don-drv cll-fr dna		A										
0119U	Crd ceramides liq chrom plsm		Q4										
01200	Anesth hip joint procedure		N										
01202	Anesth arthroscopy of hip		N										
0120U	Onc b cll lymphm mrna 58 gen		A										
01210	Anesth hip joint surgery		N										
01212	Anesth hip disarticulation	CH	N										
01214	Anesth hip arthroplasty		N										
01215	Anesth revise hip repair		N										
0121U	Sc dis vcam-1 whole blood		Q4										
01220	Anesth procedure on femur		N										
0122U	Sc dis p-selectin whl blood		Q4										
01230	Anesth surgery of femur		N										
01232	Anesth amputation of femur	CH 	N										
01234	Anesth radical femur surg	CH 	N										
0123U	Mchnl fragility rbc prflg		Q4										
01250	Anesth upper leg surgery		N										
01260	Anesth upper leg veins surg		N										
0126T	Chd risk imt study	CH 	D										
01270	Anesth thigh arteries surg		N										
01272	Anesth femoral artery surg		C										
01274	Anesth femoral embolectomy	CH 	N										
0129U	Hered brst ca rltd do panel		A										
0130U	Hered colon ca do mrna pnl		A										
0131U	Hered brst ca rltd do pnl 13		A										
01320	Anesth knee area surgery		N										
0132U	Hered ova ca rltd do pnl 17		A										
0133U	Hered prst8 ca rltd do 11		A										
01340	Anesth knee area procedure		N										
0134U	Hered pan ca mrna pnl 18 gen		A										
0135U	Hered gyn ca mrna pnl 12 gen		A										
01360	Anesth knee area surgery		N										
0136U	Atm mrna seq alys		A										
0137U	Palb2 mrna seq alys		A										
01380	Anesth knee joint procedure		N										
01382	Anesth dx knee arthroscopy		N										
0138U	Brca1 brca2 mrna seq alys		A										
01390	Anesth knee area procedure		N										
01392	Anesth knee area surgery		N										
0139U	Neuro austm meas 6 c metablt		Q4										
01400	Anesth knee joint surgery		N										
01402	Anesth knee arthroplasty		N										
01404	Anesth amputation at knee	CH 	N										
0140U	Nfct ds fungi dna 15 trgt	CH 	Q4										
0141U	Nfct ds bact&fng gram pos	CH 	Q4										
01420	Anesth knee joint casting		N										
0142U	Nfct ds bact&fng gram neg	CH 	Q4										
01430	Anesth knee veins surgery		N										
01432	Anesth knee vessel surg		N										
0143U	Drug assay 120+ rx/metablt		Q4										
01440	Anesth knee arteries surg		N										
01442	Anesth knee artery surg		C										
01444	Anesth knee artery repair		C										
0144U	Drug assay 160+ rx/metablt		Q4										
0145U	Drug assay 65+ rx/metablt		Q4										
01462	Anesth lower leg procedure		N										
01464	Anesth ankle/ft arthroscopy		N										
0146U	Drug assay 80+ rx/metablt		Q4										
01470	Anesth lower leg surgery		N										
01472	Anesth achilles tendon surg		N										
01474	Anesth lower leg surgery		N										
0147U	Drug assay 85+ rx/metablt		Q4										
01480	Anesth lower leg bone surg		N										
01482	Anesth radical leg surgery		N										
01484	Anesth lower leg revision		N										
01486	Anesth ankle replacement	CH 	N										
0148U	Drug assay 100+ rx/metablt		Q4										
01490	Anesth lower leg casting		N										
0149U	Drug assay 60+ rx/metablt		Q4										
01500	Anesth leg arteries surg		N										
01502	Anesth lwr leg embolectomy		C										
0150U	Drug assay 120+ rx/metablt		Q4										
0151U	Nfct bct/vir resp nfctj 33	CH 	Q4										
01520	Anesth lower leg vein surg		N										
01522	Anesth lower leg vein surg		N										
0152U	Nfct ds dna untrgt ngnrj seq	CH 	Q4										
0153U	Onc breast mrna 101 genes		A										
0154U	Onc urthl ca rna fgfr3 gene		A										
0155U	Onc brst ca dna pik3ca gene		A										
0156U	Copy number sequence alys		A										
0157U	Apc mrna seq alys		A  										
0158U	Mlh1 mrna seq alys		A 										
0159U	Msh2 mrna seq alys		A  										
0160U	Msh6 mrna seq alys		A 										
01610	Anesth surgery of shoulder		N										
0161U	Pms2 mrna seq alys		A 										
01620	Anesth shoulder procedure		N										
01622	Anes dx shoulder arthroscopy		N										
0162U	Hered colon ca trgt mrna pnl		A  										
01630	Anesth surgery of shoulder		N										
01634	Anesth shoulder joint amput	CH 	N										
01636	Anesth forequarter amput	CH 	N										
01638	Anesth shoulder replacement	CH 	N										
0163T	Lumb artif diskectomy addl	CH 	N										
0163U	Onc clrct scr 3 prtn alg	NC	E1										
0164T	Remove lumb artif disc addl	CH 	N										
0164U	Gi ibs ia anti-cdtb&vinculin	NC	Q4										
01650	Anesth shoulder artery surg		N										
01652	Anesth shoulder vessel surg		C										
01654	Anesth shoulder vessel surg		C										
01656	Anesth arm-leg vessel surg		C										
0165T	Revise lumb artif disc addl	CH 	N										
0165U	Peanut allg asmt epi	NC	Q4										
0166U	Liver ds 10 biochem asy srm	NC	Q4										
01670	Anesth shoulder vein surg		N										
0167U	Chornc gonadotropin hcg ia	NC	Q4										
01680	Anesth shoulder casting		N										
0168U	Ftl aneuploidy dna seq alys	NC	Q4										
0169U	Nudt15&tpmt gene com vrnt	NC	A										
0170U	Neuro asd rna next gen seq	NC	A										
01710	Anesth elbow area surgery		N										
01712	Anesth uppr arm tendon surg		N										
01714	Anesth uppr arm tendon surg		N										
01716	Anesth biceps tendon repair		N										
0171U	Trgt gen seq alys pnl dna 23	NC	A										
0172U	Onc sld tum alys brca1 brca2	NC	A										
01730	Anesth uppr arm procedure		N										
01732	Anesth dx elbow arthroscopy		N										
0173U	Psyc gen alys panel 14 genes	NC	A										
01740	Anesth upper arm surgery		N										
01742	Anesth humerus surgery		N										
01744	Anesth humerus repair		N										
0174T	Cad cxr with interp		N										
0174U	Onc solid tumor 30 prtn trgt	NC	Q4										
01756	Anesth radical humerus surg	CH	N										
01758	Anesth humeral lesion surg		N										
0175T	Cad cxr remote		N										
0175U	Psyc gen alys panel 15 genes	NC	A										
01760	Anesth elbow replacement		N										
0176U	Cdtb&vinculin igg antb ia	NC	Q4										
01770	Anesth uppr arm artery surg		N										
01772	Anesth uppr arm embolectomy		N										
0177U	Onc brst ca dna pik3ca 11	NC	A										
01780	Anesth upper arm vein surg		N										
01782	Anesth uppr arm vein repair		N										
0178U	Peanut allg asmt epi clin rx	NC	Q4										
0179U	Onc nonsm cll lng ca alys 23	NC	A										
0180U	Abo gnotyp abo 7 exons	NC	A										
01810	Anesth lower arm surgery		N										
0181U	Co gnotyp aqp1 exon 1	NC	A										
01820	Anesth lower arm procedure		N										
01829	Anesth dx wrist arthroscopy		N										
0182U	Crom gnotyp cd55 exons 1-10	NC	A										
01830	Anesth lower arm surgery		N										
01832	Anesth wrist replacement		N										
0183U	Di gnotyp slc4a1 exon 19	NC	A										
01840	Anesth lwr arm artery surg		N										
01842	Anesth lwr arm embolectomy		N										
01844	Anesth vascular shunt surg		N										
0184T	Exc rectal tumor endoscopic		J1	5331	60.7331	"$5,028.52"	.	"$1,005.71"					
0184U	Do gnotyp art4 exon 2	NC	A										
01850	Anesth lower arm vein surg		N										
01852	Anesth lwr arm vein repair		N										
0185U	Fut1 gnotyp fut1 exon 4	NC	A										
01860	Anesth lower arm casting		N										
0186U	Fut2 gnotyp fut2 exon 2	NC	A										
0187U	Fy gnotyp ackr1 exons 1-2	NC	A										
0188U	Ge gnotyp gypc exons 1-4	NC	A										
0189U	Gypa gnotyp ntrns 1 5 exon 2	NC	A										
0190U	Gypb gnotyp ntrns 1 5 seux 3	NC	A										
01916	Anesth dx arteriography		N										
0191T	Insert ant segment drain int		J1	5492	47.3174	"$3,917.74"	.	$783.55					
0191U	In gnotyp cd44 exons 2 3 6	NC	A										
01920	Anesth catheterize heart		N										
01922	Anesth cat or mri scan		N										
01924	Anes ther interven rad artrl		N										
01925	Anes ther interven rad card		N										
01926	Anes tx interv rad hrt/cran		N										
0192U	Jk gnotyp slc14a1 exon 9	NC	A										
01930	Anes ther interven rad vein		N										
01931	Anes ther interven rad tips		N										
01932	Anes tx interv rad th vein		N										
01933	Anes tx interv rad cran vein		N										
01935	Anesth perc img dx sp proc		N										
01936	Anesth perc img tx sp proc		N										
0193U	Jr gnotyp abcg2 exons 2-26	NC	A										
0194U	Kel gnotyp kel exon 8	NC	A										
01951	Anesth burn less 4 percent		N										
01952	Anesth burn 4-9 percent		N										
01953	Anesth burn each 9 percent		N										
01958	Anesth antepartum manipul		N										
0195U	Klf1 targeted sequencing	NC	A										
01960	Anesth vaginal delivery		N										
01961	Anesth cs delivery		N										
01962	Anesth emer hysterectomy		N										
01963	Anesth cs hysterectomy		N										
01965	Anesth inc/missed ab proc		N										
01966	Anesth induced ab procedure		N										
01967	Anesth/analg vag delivery		N										
01968	Anes/analg cs deliver add-on		N										
01969	Anesth/analg cs hyst add-on		N										
0196U	Lu gnotyp bcam exon 3	NC	A										
0197U	Lw gnotyp icam4 exon 1	NC	A										
0198T	Ocular blood flow measure		Q1	5734	1.3521	$111.95	.	$22.39					
0198U	Rhd&rhce gntyp rhd1-10&rhce5	NC	A										
01990	Support for organ donor		C										
01991	Anesth nerve block/inj		N										
01992	Anesth n block/inj prone		N										
01996	Hosp manage cont drug admin		N										
01999	Unlisted anesth procedure		N										
0199U	Sc gnotyp ermap exons 4 12	NC	A										
0200T	Perq sacral augmt unilat inj		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
0200U	Xk gnotyp xk exons 1-3	NC	A										
0201T	Perq sacral augmt bilat inj		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
0201U	Yt gnotyp ache exon 2	NC	A										
0202T	Post vert arthrplst 1 lumbar	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
0202U	Nfct ds 22 trgt sars-cov-2	NC	A										
0203U	Ai ibd mrna xprsn prfl 17	NI	Q4										
0204U	Onc thyr mrna xprsn alys 593	NI	A										
0205U	Oph amd alys 3 gene variants	NI	A										
0206U	Neuro alzheimer cell aggregj	NI	Q4										
0207T	Clear eyelid gland w/heat	CH	Q1	5734	1.3521	$111.95	.	$22.39					
0207U	Neuro alzheimer quan imaging	NI	N										
0208T	Audiometry air only		Q1	5732	0.4087	$33.84	.	$6.77					
0208U	Onc mtc mrna xprsn alys 108	NI	A										
0209T	Audiometry air & bone		Q1	5732	0.4087	$33.84	.	$6.77					
0209U	Cytog const alys interrog	NI	A										
0210T	Speech audiometry threshold		Q1	5732	0.4087	$33.84	.	$6.77					
0210U	Syphilis tst antb ia quan	NI	Q4										
0211T	Speech audiom thresh & recog		Q1	5732	0.4087	$33.84	.	$6.77					
0211U	Onc pan-tum dna&rna gnrj seq	NI	E1										
0212T	Compre audiometry evaluation		Q1	5721	1.6854	$139.55	.	$27.91					
0212U	Rare ds gen dna alys proband	NI	A										
0213T	Njx paravert w/us cer/thor		T	5443	9.9334	$822.46	.	$164.50					
0213U	Rare ds gen dna alys ea comp	NI	A										
0214T	Njx paravert w/us cer/thor		N										
0214U	Rare ds xom dna alys proband	NI	A										
0215T	Njx paravert w/us cer/thor		N										
0215U	Rare ds xom dna alys ea comp	NI	A										
0216T	Njx paravert w/us lumb/sac		T	5443	9.9334	$822.46	.	$164.50					
0216U	Neuro inh ataxia dna 12 com	NI	A										
0217T	Njx paravert w/us lumb/sac		N										
0217U	Neuro inh ataxia dna 51 gene	NI	A										
0218T	Njx paravert w/us lumb/sac		N										
0218U	Neuro musc dys dmd seq alys	NI	A										
0219T	Plmt post facet implt cerv	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
0219U	Nfct agt hiv gnrj seq alys	NI	A										
0220T	Plmt post facet implt thor	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
0220U	Onc brst ca ai assmt 12 feat	NI	Q4										
0221T	Plmt post facet implt lumb		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
0221U	Abo gnotyp next gnrj seq abo	NI	A										
0222T	Plmt post facet implt addl		N										
0222U	Rhd&rhce gntyp next gnrj seq	NI	A										
0223U	Nfct ds 22 trgt sars-cov-2	NC	A										
0224U	Antibody sars-cov-2 titer(s)	NC	A										
0225U	Nfct ds dna&rna 21 sarscov2	NI	A										
0226U	Svnt sarscov2 elisa plsm srm	NI	A										
0227U	Rx asy prsmv 30+rx/metablt	NI	Q4										
0228T	Njx tfrml eprl w/us cer/thor	CH	D										
0228U	Onc prst8 ma molec prfl alg	NI	Q4										
0229T	Njx tfrml eprl w/us cer/thor	CH	D										
0229U	Bcat1 promoter mthyltn alys	NI	A 										
0230T	Njx tfrml eprl w/us lumb/sac	CH	D										
0230U	Ar full sequence analysis	NI	A 										
0231T	Njx tfrml eprl w/us lumb/sac	CH	D										
0231U	Cacna1a full gene analysis	NI	A 										
0232T	Njx platelet plasma		Q1	5735	3.2637	$270.22	.	$54.05					
0232U	Cstb full gene analysis	NI	A 										
0233U	Fxn gene analysis	NI	A 										
0234T	Trluml perip athrc renal art		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
0234U	Mecp2 full gene analysis	NI	A 										
0235T	Trluml perip athrc visceral		C										
0235U	Pten full gene analysis	NI	A 										
0236T	Trluml perip athrc abd aorta		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
0236U	Smn1&smn2 full gene analysis	NI	A 										
0237T	Trluml perip athrc brchiocph		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
0237U	Car ion chnlpthy gen seq pnl	NI	A 										
0238T	Trluml perip athrc iliac art		J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
0238U	Onc lnch syn gen dna seq aly	NI	A 										
0239U	Trgt gen seq alys pnl 311+	NI	A 										
0240U	Nfct ds vir resp rna 3 trgt 	NI	A										
0241U	Nfct ds vir resp rna 4 trgt 	NI	A										
0253T	Insert aqueous drain device		J1	5492	47.3174	"$3,917.74"	.	$783.55					
0263T	Im b1 mrw cel ther cmpl		S	5243	48.7664	"$4,037.71"	.	$807.55					
0264T	Im b1 mrw cel ther xcl hrvst		S	5243	48.7664	"$4,037.71"	.	$807.55					
0265T	Im b1 mrw cel ther hrvst onl		S	5243	48.7664	"$4,037.71"	.	$807.55					
0266T	Implt/rpl crtd sns dev total	CH	J1	5465	355.6230	"$29,444.52"	.	"$5,888.91"	*				
0267T	Implt/rpl crtd sns dev lead		J1	5461	39.5582	"$3,275.30"	.	$655.06					
0268T	Implt/rpl crtd sns dev gen	CH	J1	5465	355.6230	"$29,444.52"	.	"$5,888.91"	*				
0269T	Rev/remvl crtd sns dev total		Q2	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
0270T	Rev/remvl crtd sns dev lead		J1	5461	39.5582	"$3,275.30"	.	$655.06					
0271T	Rev/remvl crtd sns dev gen		J1	5461	39.5582	"$3,275.30"	.	$655.06					
0272T	Interrogate crtd sns dev		S	5721	1.6854	$139.55	.	$27.91					
0273T	Interrogate crtd sns w/pgrmg		S	5721	1.6854	$139.55	.	$27.91					
0274T	Perq lamot/lam crv/thrc		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
0275T	Perq lamot/lam lumbar		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
0278T	Tempr		Q1	5721	1.6854	$139.55	.	$27.91					
0290T	Laser inc for pkp/lkp recip		N										
0295T	Ext ecg complete	CH 	D										
0296T	Ext ecg recording	CH 	D										
0297T	Ext ecg scan w/report	CH 	D										
0298T	Ext ecg review and interp	CH 	D										
0308T	Insj ocular telescope prosth		J1	5495	250.8129	"$20,766.56"	.	"$4,153.32"	*				
0312T	Laps impltj nstim vagus	CH	J1	5465	355.6230	"$29,444.52"	.	"$5,888.91"	*				
0313T	Laps rmvl nstim array vagus		J1	5461	39.5582	"$3,275.30"	.	$655.06					
0314T	Laps rmvl vgl arry&pls gen		J1	5461	39.5582	"$3,275.30"	.	$655.06					
0315T	Rmvl vagus nerve pls gen		J1	5461	39.5582	"$3,275.30"	.	$655.06					
0316T	Replc vagus nerve pls gen	CH	J1	5465	355.6230	"$29,444.52"	.	"$5,888.91"	*				
0317T	Elec alys vagus nrv pls gen		Q1	5741	0.4487	$37.15	.	$7.44					
0329T	Mntr io press 24hrs/> uni/bi		E1										
0330T	Tear film img uni/bi w/i&r		Q1	5732	0.4087	$33.84	.	$6.77					
0331T	Heart symp image plnr		S	5593	15.7728	"$1,305.94"	.	$261.19					
0332T	Heart symp image plnr spect		S	5593	15.7728	"$1,305.94"	.	$261.19					
0333T	Visual ep scr acuity auto		E1										
0335T	Insj sinus tarsi implant		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
0338T	Trnscth renal symp denrv unl		J1	5192	59.8674	"$4,956.84"	.	$991.37					
0339T	Trnscth renal symp denrv bil		J1	5192	59.8674	"$4,956.84"	.	$991.37					
0342T	Thxp apheresis w/hdl delip		S	5243	48.7664	"$4,037.71"	.	$807.55					
0345T	Transcath mtral vlve repair		C										
0347T	Ins bone device for rsa		Q1	5733	0.6722	$55.66	.	$11.14					
0348T	Rsa spine exam		Q1	5522	1.3161	$108.97	.	$21.80					
0349T	Rsa upper extr exam		Q1	5522	1.3161	$108.97	.	$21.80					
0350T	Rsa lower extr exam		Q1	5521	0.9771	$80.90	.	$16.19					
0351T	Intraop oct brst/node spec		N										
0352T	Oct brst/node i&r per spec		B										
0353T	Intraop oct breast cavity		N										
0354T	Oct breast surg cavity i&r		B										
0355T	Gi tract capsule endoscopy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
0356T	Insrt drug device for iop		Q1	5692	0.7485	$61.97	.	$12.40					
0358T	Bia whole body		Q1	5731	0.2980	$24.67	.	$4.94					
0362T	Bhv id suprt assmt ea 15 min		Q3	5821 	0.3168	$26.23	.	$5.25					
0373T	Adapt bhv tx ea 15 min		Q3	5821 	0.3168	$26.23	.	$5.25					
0376T	Insert ant segment drain int		N										
0378T	Visual field assmnt rev/rprt		B										
0379T	Vis field assmnt tech suppt		Q1	5732	0.4087	$33.84	.	$6.77					
0381T	Ext h rate epi sz 14 days	CH 	D										
0382T	Ext h rate sz 14 day ri only	CH 	D										
0383T	Ext h rate sz up to 30 days	CH 	D										
0384T	Ex h rate sz 30 day ri only	CH 	D										
0385T	Ex h rate for sz ovr 30 day	CH 	D										
0386T	Ex h rate sz 30+ day ri only	CH 	D										
0394T	Hdr elctrnc skn surf brchytx		S	5622	2.9190	$241.68	.	$48.34					
0395T	Hdr elctr ntrst/ntrcv brchtx		S	5624	8.5566	$708.46	.	$141.70					
0396T	Intraop kinetic balnce sensr	CH 	D										
0397T	Ercp w/optical endomicroscpy		N										
0398T	Mrgfus strtctc les abltj	CH 	J1	5463	135.7079	"$11,236.21"	.	"$2,247.25"	*				
0400T	Mltispectrl digital les alys	CH 	D										
0401T	Mltispectrl digital les alys	CH 	D										
0402T	Colgn cross-link crn med sep		J1	5503	24.1839	"$2,002.35"	.	$400.48					
0403T	Diabetes prev standard curr		E1										
0404T	Trnscrv uterin fibroid abltj		J1	5416	82.0598	"$6,794.31"	"$1,405.70"	"$1,358.87"					
0405T	Ovrsght xtrcorp liv asst pat	CH 	D										
0408T	Insj/rplc cardiac modulj sys		J1	5231	278.2729	"$23,040.16"	.	"$4,608.04"	*				
0409T	Insj/rplc car modulj pls gn		J1	5231	278.2729	"$23,040.16"	.	"$4,608.04"	*				
0410T	Insj/rplc car modulj atr elt		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
0411T	Insj/rplc car modulj vnt elt		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
0412T	Rmvl cardiac modulj pls gen		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
0413T	Rmvl car modulj tranvns elt		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
0414T	Rmvl & rpl car modulj pls gn		J1	5231	278.2729	"$23,040.16"	.	"$4,608.04"	*				
0415T	Repos car modulj tranvns elt		T	5181	6.5415	$541.62	.	$108.33					
0416T	Reloc skin pocket pls gen		T	5054	20.7177	"$1,715.36"	.	$343.08					
0417T	Prgrmg eval cardiac modulj		Q1	5741	0.4487	$37.15	.	$7.44					
0418T	Interro eval cardiac modulj		Q1	5741	0.4487	$37.15	.	$7.44					
0419T	Dstrj neurofibroma xtnsv		T	5053	6.3308	$524.17	.	$104.84					
0420T	Dstrj neurofibroma xtnsv		T	5053	6.3308	$524.17	.	$104.84					
0421T	Waterjet prostate abltj cmpl		J1	5376	99.7395	"$8,258.13"	.	"$1,651.63"	*				
0422T	Tactile breast img uni/bi		Q1	5521	0.9771	$80.90	.	$16.19					
0423T	Assay secretory type ii pla2		A										
0424T	Insj/rplc nstim apnea compl	CH	J1	5465	355.6230	"$29,444.52"	.	"$5,888.91"	*				
0425T	Insj/rplc nstim apnea sen ld	CH	J1	5463	135.7079	"$11,236.21"	.	"$2,247.25"	*				
0426T	Insj/rplc nstim apnea stm ld		J1	5463	135.7079	"$11,236.21"	.	"$2,247.25"	*				
0427T	Insj/rplc nstim apnea pls gn	CH	J1	5465	355.6230	"$29,444.52"	.	"$5,888.91"	*				
0428T	Rmvl nstim apnea pls gen		J1	5461	39.5582	"$3,275.30"	.	$655.06					
0429T	Rmvl nstim apnea sen ld		J1	5461	39.5582	"$3,275.30"	.	$655.06					
0430T	Rmvl nstim apnea stimj ld		J1	5461	39.5582	"$3,275.30"	.	$655.06					
0431T	Rmvl/rplc nstim apnea pls gn	CH	J1	5465	355.6230	"$29,444.52"	.	"$5,888.91"	*				
0432T	Repos nstim apnea stimj ld		J1	5461	39.5582	"$3,275.30"	.	$655.06					
0433T	Repos nstim apnea sensing ld		J1	5461	39.5582	"$3,275.30"	.	$655.06					
0434T	Interro eval npgs apnea		S	5742	1.2115	$100.31	.	$20.07					
0435T	Prgrmg eval npgs apnea 1 ses		S	5742	1.2115	$100.31	.	$20.07					
0436T	Prgrmg eval npgs apnea study		S	5724	11.1093	$919.82	.	$183.97					
0437T	Impltj synth rnfcmt abdl wal		N										
0439T	Myocrd contrast prfuj echo		N										
0440T	Abltj perc uxtr/perph nrv		J1	5431	21.1890	"$1,754.39"	.	$350.88					
0441T	Abltj perc lxtr/perph nrv		J1	5431	21.1890	"$1,754.39"	.	$350.88					
0442T	Abltj perc plex/trncl nrv		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
0443T	R-t spctrl alys prst8 tiss		N										
0444T	1st plmt drug elut oc ins		N										
0445T	Sbsqt plmt drug elut oc ins		N										
0446T	Insj impltbl glucose sensor	CH	T	5054	20.7177	"$1,715.36"	.	$343.08					
0447T	Rmvl impltbl glucose sensor		Q2	5051	2.1685	$179.55	.	$35.91					
0448T	Remvl insj impltbl gluc sens	CH	T	5054	20.7177	"$1,715.36"	.	$343.08					
0449T	Insj aqueous drain dev 1st		J1	5492	47.3174	"$3,917.74"	.	$783.55					
0450T	Insj aqueous drain dev each		N										
0451T	Insj/rplcmt aortic ventr sys		C										
0452T	Insj/rplcmt dev vasc seal		C										
0453T	Insj/rplcmt mech-elec ntrfce		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
0454T	Insj/rplcmt subq electrode		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
0455T	Remvl aortic ventr cmpl sys		C										
0456T	Remvl aortic dev vasc seal		C										
0457T	Remvl mech-elec skin ntrfce		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
0458T	Remvl subq electrode		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
0459T	Relocaj rplcmt aortic ventr		C										
0460T	Repos aortic ventr dev eltrd		T	5221	41.5519	"$3,440.37"	.	$688.08					
0461T	Repos aortic contrpulsj dev		C										
0462T	Prgrmg eval aortic ventr sys		S	5743	3.2908	$272.47	.	$54.50					
0463T	Interrog aortic ventr sys		S	5743	3.2908	$272.47	.	$54.50					
0464T	Visual ep test for glaucoma		S	5721	1.6854	$139.55	.	$27.91					
0465T	Supchrdl njx rx w/o supply		T	5694	3.7532	$310.75	.	$62.16					
0466T	Insj ch wal respir eltrd/ra		N										
0467T	Revj/rplmnt ch respir eltrd		J1	5461	39.5582	"$3,275.30"	.	$655.06					
0468T	Rmvl ch wal respir eltrd/ra		J1	5461	39.5582	"$3,275.30"	.	$655.06					
0469T	Rta polarize scan oc scr bi		E1										
0470T	Oct skn img acquisj i&r 1st		M										
0471T	Oct skn img acquisj i&r addl		N										
0472T	Prgrmg io rta eltrd ra		Q1	5743	3.2908	$272.47	.	$54.50					
0473T	Reprgrmg io rta eltrd ra		Q1	5742	1.2115	$100.31	.	$20.07					
0474T	Insj aqueous drg dev io rsvr		E1										
0475T	Rec ftl car sgl 3 ch i&r		M										
0476T	Rec ftl car sgl elec tr data		Q1	5734	1.3521	$111.95	.	$22.39					
0477T	Rec ftl car sgl xrtj alys		Q1	5734	1.3521	$111.95	.	$22.39					
0478T	Rec ftl car 3 ch rev i&r		M										
0479T	Fxjl abl lsr 1st 100 sq cm	CH	T	5053	6.3308	$524.17	.	$104.84					
0480T	Fxjl abl lsr ea addl 100sqcm		N										
0481T	Njx autol wbc concentrate		Q1	5735	3.2637	$270.22	.	$54.05					
0483T	Tmvi percutaneous approach		C										
0484T	Tmvi transthoracic exposure		C										
0485T	Oct mid ear i&r unilateral		Q1	5732	0.4087	$33.84	.	$6.77					
0486T	Oct mid ear i&r bilateral		Q1	5732	0.4087	$33.84	.	$6.77					
0487T	Trvg biomchn mapg w/reprt		Q1	5734	1.3521	$111.95	.	$22.39					
0488T	Diabetes prev online/elec		E1										
0489T	Regn cell tx scldr hands		E1										
0490T	Regn cell tx scldr h mlt inj		E1										
0491T	Abl lsr opn wnd 1st 20 sqcm		T	5052	4.1770	$345.84	.	$69.17					
0492T	Abl lsr opn wnd addl 20 sqcm		N										
0493T	Near ifr spectrsc of wounds		N										
0494T	Prep & cannulj cdvr don lung		C										
0495T	Mntr cdvr don lng 1st 2 hrs		C										
0496T	Mntr cdvr don lng ea addl hr		C										
0497T	Xtrnl pt act ecg in-off conn		Q1	5741	0.4487	$37.15	.	$7.44					
0498T	Xtrnl pt act ecg r&i pr 30 d		M										
0499T	Cysto f/urtl strix/stenosis		J1	5374	37.1552	"$3,076.34"	.	$615.27					
0500F	Initial prenatal care visit		E1										
0500T	Hpv 5+ hi risk hpv types		A										
0501F	Prenatal flow sheet		E1										
0501T	Cor ffr derived cor cta data		M										
0502F	Subsequent prenatal care		E1										
0502T	Cor ffr data prep & transmis		N										
0503F	Postpartum care visit		E1										
0503T	Cor ffr alys gnrj ffr mdl		S	1511		$950.50	.	$190.11					
0504T	Cor ffr data review i&r		M										
0505F	Hemodialysis plan docd		E1										
0505T	Ev fempop artl revsc		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
0506T	Mac pgmt opt dns meas hfp		Q1	5733	0.6722	$55.66	.	$11.14					
0507F	Periton dialysis plan docd		E1										
0507T	Near ifr 2img mibmn glnd i&r		Q1	5733	0.6722	$55.66	.	$11.14					
0508T	Pls echo us b1 dns meas tib		S	5522	1.3161	$108.97	.	$21.80					
0509F	Urine incon plan docd		M										
0509T	Pattern erg w/i&r	CH	S	5722	3.1939	$264.45	.	$52.89					
0510T	Rmvl sinus tarsi implant		Q2	5113	34.1848	"$2,830.40"	.	$566.08					
0511T	Rmvl&rinsj sinus tarsi implt		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
0512T	Esw integ wnd hlg 1st wnd	CH	S	5051	2.1685	$179.55	.	$35.91					
0513F	Elev bp plan of care docd		M										
0513T	Esw integ wnd hlg ea addl		N										
0514F	Care plan hgb docd esa pt		E1										
0514T	Intraop vis axis id pt fixj		N 										
0515T	Insj wcs lv compl sys		J1	5231	278.2729	"$23,040.16"	.	"$4,608.04"	*				
0516F	Anemia plan of care docd		E1										
0516T	Insj wcs lv eltrd only		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
0517F	Glaucoma plan of care docd		M										
0517T	Insj wcs lv pg compnt		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
0518F	Fall plan of care docd		M										
0518T	Rmvl pg compnt wcs		T	5221	41.5519	"$3,440.37"	.	$688.08					
0519F	Pland chemo docd b/4 txmnt		E1										
0519T	Rmvl & rplcmt pg compnt wcs		T	5221	41.5519	"$3,440.37"	.	$688.08					
0520F	Rad dos limts b/4 3d rad		M										
0520T	Rmvl&rplcmt pg wcs new eltrd		J1	5231	278.2729	"$23,040.16"	.	"$4,608.04"	*				
0521F	Plan of care 4 pain docd		E1										
0521T	Interrog dev eval wcs ip		Q1	5731	0.2980	$24.67	.	$4.94					
0522T	Prgrmg dev eval wcs ip		Q1	5741	0.4487	$37.15	.	$7.44					
0523T	Ntrapx c ffr w/3d funcjl map		N										
0524T	Ev cath dir chem abltj w/img	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
0525F	Initial visit for episode		E1										
0525T	Insj/rplcmt compl iims		J1	5223	125.6102	"$10,400.15"	.	"$2,080.03"	*				
0526F	Subs visit for episode		M										
0526T	Insj/rplcmt iims eltrd only		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
0527T	Insj/rplcmt iims implt mntr		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
0528F	Rcmnd flw-up 10 yrs docd		M										
0528T	Prgrmg dev eval iims ip		Q1	5741	0.4487	$37.15	.	$7.44					
0529F	Intrvl 3/>yr pts clnscp docd		M										
0529T	Interrog dev eval iims ip		Q1	5741	0.4487	$37.15	.	$7.44					
0530T	Removal complete iims		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
0531T	Removal iims electrode only		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
0532T	Removal iims implt mntr only		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
0533T	Cont rec mvmt do 6-10 days		M										
0534T	Cont rec mvmt do setup&train		Q1	5741	0.4487	$37.15	.	$7.44					
0535F	Dyspnea mngmnt plan docd		E1										
0535T	Cont rec mvmt do reprt cnfig		Q1	5741	0.4487	$37.15	.	$7.44					
0536T	Cont rec mvmt do dl w/i&r		M										
0537T	Bld drv t lymphcyt car-t cll		B										
0538T	Bld drv t lymphcyt prep trns		B										
0539T	Receipt&prep car-t cll admn		B										
0540F	Gluco mngmnt plan docd		M										
0540T	Car-t cll admn autologous		S	5694	3.7532	$310.75	.	$62.16					
0541T	Myocardial imaging mcg		S	5723	5.8913	$487.78	.	$97.56					
0542T	Myocardial imaging mcg i&r		M										
0543T	Ta mv rpr w/artif chord tend		C										
0544T	Tcat mv annulus rcnstj		C										
0545F	Follow up care plan mdd docd		E1										
0545T	Tcat tv annulus rcnstj		C										
0546T	Rf spectrsc ntraop mrgn asmt		N										
0547T	B1 matrl qual tst mcrind tib		E1										
0548T	Tprnl balo cntnc dev bi	CH	J1	5377	138.7492	"$11,488.02"	.	"$2,297.61"	*				
0549T	Tprnl balo cntnc dev uni		J1	5375	53.3099	"$4,413.90"	.	$882.78					
0550F	Cytopath report nongyn spcmn		E1										
0550T	Tprnl balo cntnc dev rmvl ea		J1	5374	37.1552	"$3,076.34"	.	$615.27					
0551F	Cytopath report non routine		E1										
0551T	Tprnl balo cntnc dev adjmt		T	5371	3.2144	$266.14	.	$53.23					
0552T	Low-level laser therapy		M										
0553T	Perq tcat iliac anast implt		E1										
0554T	B1 str & fx rsk analysis		M										
0555F	Symptom mgmnt plan care docd		E1										
0555T	B1 str&fx rsk transmis data		S	5731	0.2980	$24.67	.	$4.94					
0556F	Plan care lipid control docd		E1										
0556T	B1 str & fx rsk assessment		S	5523	2.7794	$230.13	.	$46.03					
0557F	Plan caremng angnl symptdocd		E1										
0557T	B1 str & fx rsk i&r		M										
0558T	Ct scan f/biomchn ct alys		S	5521	0.9771	$80.90	.	$16.19					
0559T	Antmc mdl 3d print 1st cmpnt		Q1	5733	0.6722	$55.66	.	$11.14					
0560T	Antmc mdl 3d print ea addl		N										
0561T	Antmc guide 3d print 1st gd		Q1	5733	0.6722	$55.66	.	$11.14					
0562T	Antmc guide 3d print ea addl		N										
0563T	Evac meibomian glnd heat bi		Q1	5733	0.6722	$55.66	.	$11.14					
0564T	Onc chemo rx cytotox csc 14		Q1	5671	0.6010	$49.76	.	$9.96					
0565T	Autol cell implt adps hrvg		Q1	5733	0.6722	$55.66	.	$11.14					
0566T	Autol cell implt adps njx		T	5441	3.1543	$261.17	.	$52.24					
0567T	Perm flp tube occls w/implt		E1										
0568T	Intro mix saline&air f/ssg		E1										
0569T	Ttvr perq appr 1st prosth		C										
0570T	Ttvr perq ea addl prosth		C										
0571T	Insj/rplcmt icds ss eltrd		J1	5232	396.6193	"$32,838.89"	.	"$6,567.78"	*				
0572T	Insertion ss dfb electrode		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
0573T	Removal ss dfb electrode		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
0574T	Repos prev ss impl dfb eltrd		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
0575F	Hiv rna plan care docd		E1										
0575T	Prgrmg dev eval icds ss ip		Q1	5741	0.4487	$37.15	.	$7.44					
0576T	Interrog dev eval icds ss ip		Q1	5741	0.4487	$37.15	.	$7.44					
0577T	Ephys eval icds ss		J1	5211	13.4398	"$1,112.78"	.	$222.56					
0578T	Rem interrog dev icds phys		M										
0579T	Rem interrog dev icds tech		Q1	5741	0.4487	$37.15	.	$7.44					
0580F	Multidisciplinary care plan		E1										
0580T	Rmvl ss impl dfb pg only		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
0581F	Pt trnsfrd from anesth to cc		M										
0581T	Abltj mal brst tum perq crtx		E1										
0582F	No trnsfr from anesth to cc		E1										
0582T	Trurl abltj mal prst8 tiss		E1										
0583F	Transfer care checklist used		M										
0583T	Tmpst auto tube dlvr sys	CH	J1	5163	16.3386	"$1,352.79"	.	$270.56					
0584F	No transfercare chklist used		E1										
0584T	Perq islet cell transplant		C										
0585T	Laps islet cell transplant		C										
0586T	Open islet cell transplant		C										
0587T	Perq impltj/rplcmt isdns ptn	CH	J1	5462	74.4071	"$6,160.68"	.	"$1,232.14"					
0588T	Revision/removal isdns ptn	CH	J1	5461	39.5582	"$3,275.30"	.	$655.06					
0589T	Elec alys smpl prgrmg iins		S	5742	1.2115	$100.31	.	$20.07					
0590T	Elec alys cplx prgrmg iins		S	5742	1.2115	$100.31	.	$20.07					
0591T	Hlth&wb coaching indiv 1st		E1										
0592T	Hlth&wb coaching indiv f-up		E1										
0593T	Hlth&wb coaching group		E1										
0594T	Osteot hum xtrnl lngth dev	NC	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
0596T	Temp fml iu vlv-pmp 1st insj	NC	T	5372	6.9419	$574.77	.	$114.96					
0597T	Temp fml iu valve-pmp rplcmt	NC	T	5372	6.9419	$574.77	.	$114.96					
0598T	Ncntc r-t fluor wnd img 1st	NC	T	5722	3.1939	$264.45	.	$52.89					
0599T	Ncntc r-t fluor wnd img ea	NC	N										
0600T	Ire abltj 1+tum organ perq	NC	J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
0601T	Ire abltj 1+tumors open	NC	J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
0602T	Transdermal gfr measurements	NC	Q4										
0603T	Transdermal gfr monitoring	NC	Q4										
0604T	Rem oct rta dev setup&educaj	NC	V	5012	1.4341	$118.74	.	$23.75					
0605T	Rem oct rta techl sprt min 8	NC	Q1	5741	0.4487	$37.15	.	$7.44					
0606T	Rem oct rta phys/qhp ea 30d	NC	M										
0607T	Rem mntr pulm flu mntr setup	NC	V	5012	1.4341	$118.74	.	$23.75					
0608T	Rem mntr pulm flu mntr alys	NC	S	5741	0.4487	$37.15	.	$7.44					
0609T	Mrs disc pain acquisj data	NC	Q3	5523	2.7794	$230.13	.	$46.03					
0610T	Mrs disc pain transmis data	NC	N										
0611T	Mrs disc pain alg alys data	NC	S	5523	2.7794	$230.13	.	$46.03					
0612T	Mrs discogenic pain i&r	NC	M										
0613T	Perq tcat intratrl septl sht	NC	E1										
0614T	Rmvl&rplcmt ss impl dfb pg	NC	J1	5231	278.2729	"$23,040.16"	.	"$4,608.04"	*				
0615T	Eye mvmt alys w/o calbrj i&r	NC	Q1	5734	1.3521	$111.95	.	$22.39					
0616T	Insertion of iris prosthesis	NC	J1	5491	25.1115	"$2,079.16"	.	$415.84					
0617T	Insj iris prosth w/rmvl&insj	NC	J1	5492	47.3174	"$3,917.74"	.	$783.55					
0618T	Insj iris prosth sec io lens	NC	J1	5492	47.3174	"$3,917.74"	.	$783.55					
0619T	Cysto w/prst8 commissurotomy	NC	J1	5375	53.3099	"$4,413.90"	.	$882.78					
0620T	Evasc ven artlz tibl/prnl vn	NC	J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
0621T	Trabeculostomy interno laser	NC	E1										
0622T	Trabeculostomy int lsr w/scp	NC	E1										
0623T	Auto quantification c plaque	NC	E1										
0624T	Auto quan c plaq data prep	NC	E1										
0625T	Auto quan c plaq cptr alys	NC	E1										
0626T	Auto quan c plaq i&r	NC	E1										
0627T	Perq njx algc fluor lmbr 1st	NC	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
0628T	Perq njx algc fluor lmbr ea	NC	N										
0629T	Perq njx algc ct lmbr 1st	NC	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
0630T	Perq njx algc ct lmbr ea	NC	N										
0631T	Tc vis lit hyperspectral img	NC	Q1	5731	0.2980	$24.67	.	$4.94					
0632T	Perq tcat us abltj nrv p-art	NC	E1										
0633T	Ct breast w/3d uni c-	NC	Q3	5522	1.3161	$108.97	.	$21.80					
0634T	Ct breast w/3d uni c+	NC	Q3	5571	2.1565	$178.55	.	$35.72					
0635T	Ct breast w/3d uni c-/c+	NC	Q3	5571	2.1565	$178.55	.	$35.72					
0636T	Ct breast w/3d bi c-	NC	Q3	5523	2.7794	$230.13	.	$46.03					
0637T	Ct breast w/3d bi c+	NC	Q3	5572	4.4460	$368.12	.	$73.63					
0638T	Ct breast w/3d bi c-/c+	NC	Q3	5572	4.4460	$368.12	.	$73.63					
0639T	Wrls skn snr anisotropy meas	NC	E1										
10004	Fna bx w/o img gdn ea addl		N										
10005	Fna bx w/us gdn 1st les		T	5071	7.5120	$621.97	.	$124.40					
10006	Fna bx w/us gdn ea addl		N										
10007	Fna bx w/fluor gdn 1st les		T	5071	7.5120	$621.97	.	$124.40					
10008	Fna bx w/fluor gdn ea addl		N										
10009	Fna bx w/ct gdn 1st les		T	5071	7.5120	$621.97	.	$124.40					
1000F	Tobacco use assessed		E1										
10010	Fna bx w/ct gdn ea addl		N										
10011	Fna bx w/mr gdn 1st les		T	5071	7.5120	$621.97	.	$124.40					
10012	Fna bx w/mr gdn ea addl		N										
10021	Fna bx w/o img gdn 1st les		T	5052	4.1770	$345.84	.	$69.17					
1002F	Assess anginal symptom/level		E1										
10030	Guide cathet fluid drainage		T	5071	7.5120	$621.97	.	$124.40					
10035	Perq dev soft tiss 1st imag		T	5071	7.5120	$621.97	.	$124.40					
10036	Perq dev soft tiss add imag		N										
1003F	Level of activity assess		E1										
10040	Acne surgery		Q1	5051	2.1685	$179.55	.	$35.91					
1004F	Clin symp vol ovrld assess		E1										
1005F	Asthma symptoms evaluate		E1										
10060	Drainage of skin abscess		T	5051	2.1685	$179.55	.	$35.91					
10061	Drainage of skin abscess		T	5052	4.1770	$345.84	.	$69.17					
1006F	Osteoarthritis assess		M										
1007F	Anti-inflm/anlgsc otc assess		E1										
10080	Drainage of pilonidal cyst		T	5071	7.5120	$621.97	.	$124.40					
10081	Drainage of pilonidal cyst		T	5071	7.5120	$621.97	.	$124.40					
1008F	Gi/renal risk assess		E1										
1010F	Severity angina by actvty		E1										
1011F	Angina present		E1										
10120	Remove foreign body		T	5052	4.1770	$345.84	.	$69.17					
10121	Remove foreign body		J1	5072	16.9934	"$1,407.00"	.	$281.41					
1012F	Angina absent		E1										
10140	Drainage of hematoma/fluid		J1	5072	16.9934	"$1,407.00"	.	$281.41					
1015F	Copd symptoms assess		E1										
10160	Puncture drainage of lesion		T	5052	4.1770	$345.84	.	$69.17					
10180	Complex drainage wound		J1	5073	28.6243	"$2,370.01"	.	$474.01					
1018F	Assess dyspnea not present		E1										
1019F	Assess dyspnea present		E1										
1022F	Pneumo imm status assess		E1										
1026F	Co-morbid condition assess		E1										
1030F	Influenza imm status assess		E1										
1031F	Smoking & 2nd hand assessed		E1										
1032F	Smoker/exposed 2nd hnd smoke		E1										
1033F	Tobacco nonsmoker nor 2ndhnd		E1										
1034F	Current tobacco smoker		E1										
1035F	Smokeless tobacco user		E1										
1036F	Tobacco non-user		M										
1038F	Persistent asthma		M										
1039F	Intermittent asthma		M										
1040F	Dsm-5 info mdd docd		E1										
1050F	History of mole changes		E1										
1052F	Type location activityassess		E1										
1055F	Visual funct status assess		E1										
1060F	Doc perm/cont/parox atr fib		E1										
1061F	Doc lack perm+cont+parox fib		E1										
1065F	Ischm stroke symp lt3 hrsb/4		E1										
1066F	Ischm stroke symp ge3 hrsb/4		E1										
1070F	Alarm symp assessed-absent		E1										
1071F	Alarm symp assessed-1+ prsnt		E1										
1090F	Pres/absn urine incon assess		M										
1091F	Urine incon characterized		E1										
11000	Debride infected skin		T	5053	6.3308	$524.17	.	$104.84					
11001	Debride infected skin add-on		N										
11004	Debride genitalia & perineum		C										
11005	Debride abdom wall		C										
11006	Debride genit/per/abdom wall		C										
11008	Remove mesh from abd wall		C										
1100F	Ptfalls assess-docd ge2>/yr		M										
11010	Debride skin at fx site		T	5071	7.5120	$621.97	.	$124.40					
11011	Debride skin musc at fx site		T	5071	7.5120	$621.97	.	$124.40					
11012	Deb skin bone at fx site		J1	5073	28.6243	"$2,370.01"	.	$474.01					
1101F	Pt falls assess-docd le1/yr		M										
11042	Deb subq tissue 20 sq cm/<		T	5052	4.1770	$345.84	.	$69.17					
11043	Deb musc/fascia 20 sq cm/<		T	5053	6.3308	$524.17	.	$104.84					
11044	Deb bone 20 sq cm/<		J1	5072	16.9934	"$1,407.00"	.	$281.41					
11045	Deb subq tissue add-on		N										
11046	Deb musc/fascia add-on		N										
11047	Deb bone add-on		N										
11055	Trim skin lesion		Q1	5051	2.1685	$179.55	.	$35.91					
11056	Trim skin lesions 2 to 4		Q1	5051	2.1685	$179.55	.	$35.91					
11057	Trim skin lesions over 4		T	5051	2.1685	$179.55	.	$35.91					
11102	Tangntl bx skin single les		T	5051	2.1685	$179.55	.	$35.91					
11103	Tangntl bx skin ea sep/addl		N										
11104	Punch bx skin single lesion	CH	T	5052	4.1770	$345.84	.	$69.17					
11105	Punch bx skin ea sep/addl		N										
11106	Incal bx skn single les	CH	T	5053	6.3308	$524.17	.	$104.84					
11107	Incal bx skn ea sep/addl		N										
1110F	Pt lft inpt fac w/in 60 days		E1										
1111F	Dschrg med/current med merge		M										
1116F	Auric/peri pain assessed		E1										
1118F	Gerd symps assessed 12 month		E1										
1119F	Init eval for condition		E1										
11200	Removal of skin tags <w/15		Q1	5051	2.1685	$179.55	.	$35.91					
11201	Remove skin tags add-on		N										
1121F	Subs eval for condition		E1										
1123F	Acp discuss/dscn mkr docd		M										
1124F	Acp discuss-no dscnmkr docd		M										
1125F	Amnt pain noted pain prsnt		M										
1126F	Amnt pain noted none prsnt		M										
1127F	New episode for condition		E1										
1128F	Subs episode for condition		E1										
11300	Shave skin lesion 0.5 cm/<	CH	Q1	5052	4.1770	$345.84	.	$69.17					
11301	Shave skin lesion 0.6-1.0 cm		Q1	5051	2.1685	$179.55	.	$35.91					
11302	Shave skin lesion 1.1-2.0 cm		Q1	5051	2.1685	$179.55	.	$35.91					
11303	Shave skin lesion >2.0 cm		Q1	5052	4.1770	$345.84	.	$69.17					
11305	Shave skin lesion 0.5 cm/<		Q1	5051	2.1685	$179.55	.	$35.91					
11306	Shave skin lesion 0.6-1.0 cm		Q1	5051	2.1685	$179.55	.	$35.91					
11307	Shave skin lesion 1.1-2.0 cm		T	5051	2.1685	$179.55	.	$35.91					
11308	Shave skin lesion >2.0 cm		Q1	5052	4.1770	$345.84	.	$69.17					
1130F	Bk pain & fxn assessed		E1										
11310	Shave skin lesion 0.5 cm/<		T	5051	2.1685	$179.55	.	$35.91					
11311	Shave skin lesion 0.6-1.0 cm		T	5051	2.1685	$179.55	.	$35.91					
11312	Shave skin lesion 1.1-2.0 cm		T	5052	4.1770	$345.84	.	$69.17					
11313	Shave skin lesion >2.0 cm		T	5052	4.1770	$345.84	.	$69.17					
1134F	Epsd bk pain for 6 wks/<		E1										
1135F	Epsd bk pain for >6 wks		E1										
1136F	Epsd bk pain for 12 wks/<		E1										
1137F	Epsd bk pain for >12 wks		E1										
11400	Exc tr-ext b9+marg 0.5 cm<		T	5071	7.5120	$621.97	.	$124.40					
11401	Exc tr-ext b9+marg 0.6-1 cm		T	5052	4.1770	$345.84	.	$69.17					
11402	Exc tr-ext b9+marg 1.1-2 cm		T	5071	7.5120	$621.97	.	$124.40					
11403	Exc tr-ext b9+marg 2.1-3cm		T	5071	7.5120	$621.97	.	$124.40					
11404	Exc tr-ext b9+marg 3.1-4 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
11406	Exc tr-ext b9+marg >4.0 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
11420	Exc h-f-nk-sp b9+marg 0.5/<		J1	5072	16.9934	"$1,407.00"	.	$281.41					
11421	Exc h-f-nk-sp b9+marg 0.6-1		T	5071	7.5120	$621.97	.	$124.40					
11422	Exc h-f-nk-sp b9+marg 1.1-2		J1	5072	16.9934	"$1,407.00"	.	$281.41					
11423	Exc h-f-nk-sp b9+marg 2.1-3		J1	5072	16.9934	"$1,407.00"	.	$281.41					
11424	Exc h-f-nk-sp b9+marg 3.1-4		J1	5072	16.9934	"$1,407.00"	.	$281.41					
11426	Exc h-f-nk-sp b9+marg >4 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
11440	Exc face-mm b9+marg 0.5 cm/<		T	5071	7.5120	$621.97	.	$124.40					
11441	Exc face-mm b9+marg 0.6-1 cm		T	5071	7.5120	$621.97	.	$124.40					
11442	Exc face-mm b9+marg 1.1-2 cm		T	5071	7.5120	$621.97	.	$124.40					
11443	Exc face-mm b9+marg 2.1-3 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
11444	Exc face-mm b9+marg 3.1-4 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
11446	Exc face-mm b9+marg >4 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
11450	Removal sweat gland lesion		J1	5073	28.6243	"$2,370.01"	.	$474.01					
11451	Removal sweat gland lesion		J1	5073	28.6243	"$2,370.01"	.	$474.01					
11462	Removal sweat gland lesion		J1	5073	28.6243	"$2,370.01"	.	$474.01					
11463	Removal sweat gland lesion		J1	5073	28.6243	"$2,370.01"	.	$474.01					
11470	Removal sweat gland lesion		J1	5073	28.6243	"$2,370.01"	.	$474.01					
11471	Removal sweat gland lesion		J1	5073	28.6243	"$2,370.01"	.	$474.01					
1150F	Doc pt rsk death w/in 1yr		E1										
1151F	Doc no pt rsk death w/in 1yr		E1										
1152F	Doc advncd dis comfort 1st		E1										
1153F	Doc advncd dis cmfrt not 1st		E1										
1157F	Advnc care plan in rcrd		E1										
1158F	Advnc care plan tlk docd		M										
1159F	Med list docd in rcrd		E1										
11600	Exc tr-ext mal+marg 0.5 cm/<		T	5071	7.5120	$621.97	.	$124.40					
11601	Exc tr-ext mal+marg 0.6-1 cm		T	5071	7.5120	$621.97	.	$124.40					
11602	Exc tr-ext mal+marg 1.1-2 cm		T	5052	4.1770	$345.84	.	$69.17					
11603	Exc tr-ext mal+marg 2.1-3 cm		T	5071	7.5120	$621.97	.	$124.40					
11604	Exc tr-ext mal+marg 3.1-4 cm		T	5071	7.5120	$621.97	.	$124.40					
11606	Exc tr-ext mal+marg >4 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
1160F	Rvw meds by rx/dr in rcrd		E1										
11620	Exc h-f-nk-sp mal+marg 0.5/<		J1	5072	16.9934	"$1,407.00"	.	$281.41					
11621	Exc s/n/h/f/g mal+mrg 0.6-1		T	5071	7.5120	$621.97	.	$124.40					
11622	Exc s/n/h/f/g mal+mrg 1.1-2		T	5071	7.5120	$621.97	.	$124.40					
11623	Exc s/n/h/f/g mal+mrg 2.1-3		J1	5072	16.9934	"$1,407.00"	.	$281.41					
11624	Exc s/n/h/f/g mal+mrg 3.1-4		J1	5072	16.9934	"$1,407.00"	.	$281.41					
11626	Exc s/n/h/f/g mal+mrg >4 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
11640	Exc f/e/e/n/l mal+mrg 0.5cm<		T	5071	7.5120	$621.97	.	$124.40					
11641	Exc f/e/e/n/l mal+mrg 0.6-1		T	5071	7.5120	$621.97	.	$124.40					
11642	Exc f/e/e/n/l mal+mrg 1.1-2		T	5071	7.5120	$621.97	.	$124.40					
11643	Exc f/e/e/n/l mal+mrg 2.1-3		J1	5072	16.9934	"$1,407.00"	.	$281.41					
11644	Exc f/e/e/n/l mal+mrg 3.1-4		J1	5072	16.9934	"$1,407.00"	.	$281.41					
11646	Exc f/e/e/n/l mal+mrg >4 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
1170F	Fxnl status assessed		M										
11719	Trim nail(s) any number		Q1	5733	0.6722	$55.66	.	$11.14					
11720	Debride nail 1-5		Q1	5733	0.6722	$55.66	.	$11.14					
11721	Debride nail 6 or more		Q1	5733	0.6722	$55.66	.	$11.14					
11730	Removal of nail plate		Q1	5051	2.1685	$179.55	.	$35.91					
11732	Remove nail plate add-on		N										
11740	Drain blood from under nail		Q1	5734	1.3521	$111.95	.	$22.39					
11750	Removal of nail bed		T	5052	4.1770	$345.84	.	$69.17					
11755	Biopsy nail unit		T	5071	7.5120	$621.97	.	$124.40					
1175F	Function stat assessed rvwd		E1										
11760	Repair of nail bed		T	5053	6.3308	$524.17	.	$104.84					
11762	Reconstruction of nail bed		T	5054	20.7177	"$1,715.36"	.	$343.08					
11765	Excision of nail fold toe		Q1	5052	4.1770	$345.84	.	$69.17					
11770	Remove pilonidal cyst simple		J1	5073	28.6243	"$2,370.01"	.	$474.01					
11771	Remove pilonidal cyst exten		J1	5073	28.6243	"$2,370.01"	.	$474.01					
11772	Remove pilonidal cyst compl		J1	5073	28.6243	"$2,370.01"	.	$474.01					
1180F	Thromboemb risk assessed		E1										
1181F	Neuropsychia sympts assessed		E1										
1182F	Neuropsychi sympt 1+present		E1										
1183F	Neuropsychiatric symp absent		E1										
11900	Inject skin lesions </w 7		Q1	5051	2.1685	$179.55	.	$35.91					
11901	Inject skin lesions >7		Q1	5051	2.1685	$179.55	.	$35.91					
11920	Correct skin color 6.0 cm/<		T	5053	6.3308	$524.17	.	$104.84					
11921	Correct skn color 6.1-20.0cm		T	5053	6.3308	$524.17	.	$104.84					
11922	Correct skin color ea 20.0cm		N										
11950	Tx contour defects 1 cc/<		T	5051	2.1685	$179.55	.	$35.91					
11951	Tx contour defects 1.1-5.0cc		T	5053	6.3308	$524.17	.	$104.84					
11952	Tx contour defects 5.1-10cc		T	5053	6.3308	$524.17	.	$104.84					
11954	Tx contour defects >10.0 cc	CH	T	5053	6.3308	$524.17	.	$104.84					
11960	Insert tissue expander(s)		T	5055	42.5396	"$3,522.15"	.	$704.44					
11970	Rplcmt tiss xpndr perm implt		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
11971	Rmvl tis xpndr wo insj implt		Q2	5073	28.6243	"$2,370.01"	.	$474.01					
11976	Remove contraceptive capsule		Q2	5071	7.5120	$621.97	.	$124.40					
11980	Implant hormone pellet(s)		Q1	5735	3.2637	$270.22	.	$54.05					
11981	Insert drug implant device		Q1	5734	1.3521	$111.95	.	$22.39					
11982	Remove drug implant device		Q1	5735	3.2637	$270.22	.	$54.05					
11983	Remove/insert drug implant		Q1	5735	3.2637	$270.22	.	$54.05					
12001	Rpr s/n/ax/gen/trnk 2.5cm/<		Q1	5051	2.1685	$179.55	.	$35.91					
12002	Rpr s/n/ax/gen/trnk2.6-7.5cm		Q1	5051	2.1685	$179.55	.	$35.91					
12004	Rpr s/n/ax/gen/trk7.6-12.5cm		Q1	5051	2.1685	$179.55	.	$35.91					
12005	Rpr s/n/a/gen/trk12.6-20.0cm		Q1	5052	4.1770	$345.84	.	$69.17					
12006	Rpr s/n/a/gen/trk20.1-30.0cm		Q2	5052	4.1770	$345.84	.	$69.17					
12007	Rpr s/n/ax/gen/trnk >30.0 cm		T	5051	2.1685	$179.55	.	$35.91					
1200F	Seizure type& frequ docd		E1										
12011	Rpr f/e/e/n/l/m 2.5 cm/<		Q1	5051	2.1685	$179.55	.	$35.91					
12013	Rpr f/e/e/n/l/m 2.6-5.0 cm		Q1	5051	2.1685	$179.55	.	$35.91					
12014	Rpr f/e/e/n/l/m 5.1-7.5 cm		Q1	5051	2.1685	$179.55	.	$35.91					
12015	Rpr f/e/e/n/l/m 7.6-12.5 cm		Q1	5051	2.1685	$179.55	.	$35.91					
12016	Rpr fe/e/en/l/m 12.6-20.0 cm		Q1	5052	4.1770	$345.84	.	$69.17					
12017	Rpr fe/e/en/l/m 20.1-30.0 cm		Q1	5052	4.1770	$345.84	.	$69.17					
12018	Rpr f/e/e/n/l/m >30.0 cm		Q1	5051	2.1685	$179.55	.	$35.91					
12020	Closure of split wound		T	5053	6.3308	$524.17	.	$104.84					
12021	Closure of split wound		T	5052	4.1770	$345.84	.	$69.17					
12031	Intmd rpr s/a/t/ext 2.5 cm/<		T	5052	4.1770	$345.84	.	$69.17					
12032	Intmd rpr s/a/t/ext 2.6-7.5		T	5052	4.1770	$345.84	.	$69.17					
12034	Intmd rpr s/tr/ext 7.6-12.5		T	5052	4.1770	$345.84	.	$69.17					
12035	Intmd rpr s/a/t/ext 12.6-20		T	5052	4.1770	$345.84	.	$69.17					
12036	Intmd rpr s/a/t/ext 20.1-30		T	5053	6.3308	$524.17	.	$104.84					
12037	Intmd rpr s/tr/ext >30.0 cm		T	5054	20.7177	"$1,715.36"	.	$343.08					
12041	Intmd rpr n-hf/genit 2.5cm/<		Q2	5052	4.1770	$345.84	.	$69.17					
12042	Intmd rpr n-hf/genit2.6-7.5		T	5052	4.1770	$345.84	.	$69.17					
12044	Intmd rpr n-hf/genit7.6-12.5		T	5053	6.3308	$524.17	.	$104.84					
12045	Intmd rpr n-hf/genit12.6-20		T	5053	6.3308	$524.17	.	$104.84					
12046	Intmd rpr n-hf/genit20.1-30	CH	T	5053	6.3308	$524.17	.	$104.84					
12047	Intmd rpr n-hf/genit >30.0cm		T	5054	20.7177	"$1,715.36"	.	$343.08					
12051	Intmd rpr face/mm 2.5 cm/<		T	5052	4.1770	$345.84	.	$69.17					
12052	Intmd rpr face/mm 2.6-5.0 cm		T	5052	4.1770	$345.84	.	$69.17					
12053	Intmd rpr face/mm 5.1-7.5 cm		T	5052	4.1770	$345.84	.	$69.17					
12054	Intmd rpr face/mm 7.6-12.5cm		Q2	5052	4.1770	$345.84	.	$69.17					
12055	Intmd rpr face/mm 12.6-20 cm		T	5052	4.1770	$345.84	.	$69.17					
12056	Intmd rpr face/mm 20.1-30.0		Q2	5052	4.1770	$345.84	.	$69.17					
12057	Intmd rpr face/mm >30.0 cm		T	5052	4.1770	$345.84	.	$69.17					
1205F	Epi etiol synd rvwd and docd		E1										
1220F	Pt screened for depression		E1										
13100	Cmplx rpr trunk 1.1-2.5 cm		T	5053	6.3308	$524.17	.	$104.84					
13101	Cmplx rpr trunk 2.6-7.5 cm		T	5053	6.3308	$524.17	.	$104.84					
13102	Cmplx rpr trunk addl 5cm/<		N										
13120	Cmplx rpr s/a/l 1.1-2.5 cm		T	5053	6.3308	$524.17	.	$104.84					
13121	Cmplx rpr s/a/l 2.6-7.5 cm		T	5053	6.3308	$524.17	.	$104.84					
13122	Cmplx rpr s/a/l addl 5 cm/>		N										
13131	Cmplx rpr f/c/c/m/n/ax/g/h/f		T	5052	4.1770	$345.84	.	$69.17					
13132	Cmplx rpr f/c/c/m/n/ax/g/h/f		T	5053	6.3308	$524.17	.	$104.84					
13133	Cmplx rpr f/c/c/m/n/ax/g/h/f		N										
13151	Cmplx rpr e/n/e/l 1.1-2.5 cm		T	5053	6.3308	$524.17	.	$104.84					
13152	Cmplx rpr e/n/e/l 2.6-7.5 cm		T	5053	6.3308	$524.17	.	$104.84					
13153	Cmplx rpr e/n/e/l addl 5cm/<		N										
13160	Late closure of wound		T	5054	20.7177	"$1,715.36"	.	$343.08					
14000	Tis trnfr trunk 10 sq cm/<		T	5054	20.7177	"$1,715.36"	.	$343.08					
14001	Tis trnfr trunk 10.1-30sqcm		T	5054	20.7177	"$1,715.36"	.	$343.08					
1400F	Prkns diag rviewed		E1										
14020	Tis trnfr s/a/l 10 sq cm/<		T	5054	20.7177	"$1,715.36"	.	$343.08					
14021	Tis trnfr s/a/l 10.1-30 sqcm		T	5054	20.7177	"$1,715.36"	.	$343.08					
14040	Tis trnfr f/c/c/m/n/a/g/h/f		T	5054	20.7177	"$1,715.36"	.	$343.08					
14041	Tis trnfr f/c/c/m/n/a/g/h/f		T	5054	20.7177	"$1,715.36"	.	$343.08					
14060	Tis trnfr e/n/e/l 10 sq cm/<		T	5054	20.7177	"$1,715.36"	.	$343.08					
14061	Tis trnfr e/n/e/l10.1-30sqcm		T	5054	20.7177	"$1,715.36"	.	$343.08					
14301	Tis trnfr any 30.1-60 sq cm		T	5055	42.5396	"$3,522.15"	.	$704.44					
14302	Tis trnfr addl 30 sq cm		N										
14350	Filleted finger/toe flap		T	5054	20.7177	"$1,715.36"	.	$343.08					
1450F	Symptoms improved/consist		E1										
1451F	Sympt show clin import drop		E1										
1460F	Qual card diag prior 12 mons		M										
1461F	No qual card diag prior12mon		M										
1490F	Dem severity classified mild		E1										
1491F	Dem severity classified mod		E1										
1493F	Dem severity class severe		E1										
1494F	Cognit assessed and reviewed		E1										
15002	Wound prep trk/arm/leg		T	5054	20.7177	"$1,715.36"	.	$343.08					
15003	Wound prep addl 100 cm		N										
15004	Wound prep f/n/hf/g		T	5053	6.3308	$524.17	.	$104.84					
15005	Wnd prep f/n/hf/g addl cm		N										
1500F	Symptom+sign symm polyneuro		E1										
1501F	Not initial eval for cond		E1										
1502F	Pt queried pain fxn w/ instr		E1										
1503F	Pt queried symp resp insuff		E1										
15040	Harvest cultured skin graft		T	5054	20.7177	"$1,715.36"	.	$343.08					
1504F	Pt has resp insufficiency		E1										
15050	Skin pinch graft		T	5053	6.3308	$524.17	.	$104.84					
1505F	Pt has no resp insufficiency		E1										
15100	Skin splt grft trnk/arm/leg		T	5054	20.7177	"$1,715.36"	.	$343.08					
15101	Skin splt grft t/a/l add-on		N										
15110	Epidrm autogrft trnk/arm/leg		T	5054	20.7177	"$1,715.36"	.	$343.08					
15111	Epidrm autogrft t/a/l add-on		N										
15115	Epidrm a-grft face/nck/hf/g		T	5054	20.7177	"$1,715.36"	.	$343.08					
15116	Epidrm a-grft f/n/hf/g addl		N										
15120	Skn splt a-grft fac/nck/hf/g		T	5055	42.5396	"$3,522.15"	.	$704.44					
15121	Skn splt a-grft f/n/hf/g add		N										
15130	Derm autograft trnk/arm/leg		T	5054	20.7177	"$1,715.36"	.	$343.08					
15131	Derm autograft t/a/l add-on		N										
15135	Derm autograft face/nck/hf/g		T	5055	42.5396	"$3,522.15"	.	$704.44					
15136	Derm autograft f/n/hf/g add		N										
15150	Cult skin grft t/arm/leg		T	5054	20.7177	"$1,715.36"	.	$343.08					
15151	Cult skin grft t/a/l addl		N										
15152	Cult skin graft t/a/l +%		N										
15155	Cult skin graft f/n/hf/g		T	5055	42.5396	"$3,522.15"	.	$704.44					
15156	Cult skin grft f/n/hfg add		N										
15157	Cult epiderm grft f/n/hfg +%		N										
15200	Skin full graft trunk		T	5054	20.7177	"$1,715.36"	.	$343.08					
15201	Skin full graft trunk add-on		N										
15220	Skin full graft sclp/arm/leg		T	5054	20.7177	"$1,715.36"	.	$343.08					
15221	Skin full graft add-on		N										
15240	Skin full grft face/genit/hf		T	5054	20.7177	"$1,715.36"	.	$343.08					
15241	Skin full graft add-on		N										
15260	Skin full graft een & lips		T	5054	20.7177	"$1,715.36"	.	$343.08					
15261	Skin full graft add-on		N										
15271	Skin sub graft trnk/arm/leg		T	5054	20.7177	"$1,715.36"	.	$343.08					
15272	Skin sub graft t/a/l add-on		N										
15273	Skin sub grft t/arm/lg child		T	5055	42.5396	"$3,522.15"	.	$704.44					
15274	Skn sub grft t/a/l child add		N										
15275	Skin sub graft face/nk/hf/g		T	5054	20.7177	"$1,715.36"	.	$343.08					
15276	Skin sub graft f/n/hf/g addl		N										
15277	Skn sub grft f/n/hf/g child		T	5054	20.7177	"$1,715.36"	.	$343.08					
15278	Skn sub grft f/n/hf/g ch add		N										
15570	Skin pedicle flap trunk		T	5054	20.7177	"$1,715.36"	.	$343.08					
15572	Skin pedicle flap arms/legs		T	5055	42.5396	"$3,522.15"	.	$704.44					
15574	Pedcle fh/ch/ch/m/n/ax/g/h/f		T	5054	20.7177	"$1,715.36"	.	$343.08					
15576	Pedicle e/n/e/l/ntroral		T	5054	20.7177	"$1,715.36"	.	$343.08					
15600	Delay flap trunk		T	5055	42.5396	"$3,522.15"	.	$704.44					
15610	Delay flap arms/legs		T	5054	20.7177	"$1,715.36"	.	$343.08					
15620	Delay flap f/c/c/n/ax/g/h/f		T	5054	20.7177	"$1,715.36"	.	$343.08					
15630	Delay flap eye/nos/ear/lip		T	5054	20.7177	"$1,715.36"	.	$343.08					
15650	Transfer skin pedicle flap		T	5054	20.7177	"$1,715.36"	.	$343.08					
15730	Mdfc flap w/prsrv vasc pedcl		T	5055	42.5396	"$3,522.15"	.	$704.44					
15731	Forehead flap w/vasc pedicle		T	5055	42.5396	"$3,522.15"	.	$704.44					
15733	Musc myoq/fscq flp h&n pedcl		T	5055	42.5396	"$3,522.15"	.	$704.44					
15734	Muscle-skin graft trunk		T	5055	42.5396	"$3,522.15"	.	$704.44					
15736	Muscle-skin graft arm		T	5054	20.7177	"$1,715.36"	.	$343.08					
15738	Muscle-skin graft leg		T	5055	42.5396	"$3,522.15"	.	$704.44					
15740	Island pedicle flap graft		T	5054	20.7177	"$1,715.36"	.	$343.08					
15750	Neurovascular pedicle flap		T	5055	42.5396	"$3,522.15"	.	$704.44					
15756	Free myo/skin flap microvasc		C										
15757	Free skin flap microvasc		C										
15758	Free fascial flap microvasc		C										
15760	Composite skin graft		T	5054	20.7177	"$1,715.36"	.	$343.08					
15769	Grfg autol soft tiss dir exc		T	5055	42.5396	"$3,522.15"	.	$704.44					
15770	Derma-fat-fascia graft		T	5055	42.5396	"$3,522.15"	.	$704.44					
15771	Grfg autol fat lipo 50 cc/<		T	5055	42.5396	"$3,522.15"	.	$704.44					
15772	Grfg autol fat lipo ea addl		N										
15773	Grfg autol fat lipo 25 cc/<		T	5054	20.7177	"$1,715.36"	.	$343.08					
15774	Gfrg autol fat lipo ea addl		N										
15775	Hair trnspl 1-15 punch grfts		T	5052	4.1770	$345.84	.	$69.17					
15776	Hair trnspl >15 punch grafts		T	5052	4.1770	$345.84	.	$69.17					
15777	Acellular derm matrix implt		N										
15780	Dermabrasion total face		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15781	Dermabrasion segmental face		T	5071	7.5120	$621.97	.	$124.40					
15782	Dermabrasion other than face		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15783	Dermabrasion suprfl any site		T	5052	4.1770	$345.84	.	$69.17					
15786	Abrasion lesion single		Q1	5051	2.1685	$179.55	.	$35.91					
15787	Abrasion lesions add-on		N										
15788	Chemical peel face epiderm	CH	Q1	5052	4.1770	$345.84	.	$69.17					
15789	Chemical peel face dermal		T	5053	6.3308	$524.17	.	$104.84					
15792	Chemical peel nonfacial	CH	Q1	5053	6.3308	$524.17	.	$104.84					
15793	Chemical peel nonfacial		Q1	5052	4.1770	$345.84	.	$69.17					
15819	Plastic surgery neck		T	5054	20.7177	"$1,715.36"	.	$343.08					
15820	Revision of lower eyelid		T	5054	20.7177	"$1,715.36"	.	$343.08					
15821	Revision of lower eyelid		T	5054	20.7177	"$1,715.36"	.	$343.08					
15822	Revision of upper eyelid		T	5054	20.7177	"$1,715.36"	.	$343.08					
15823	Revision of upper eyelid		T	5054	20.7177	"$1,715.36"	.	$343.08					
15824	Removal of forehead wrinkles		T	5054	20.7177	"$1,715.36"	.	$343.08					
15825	Removal of neck wrinkles		T	5055	42.5396	"$3,522.15"	.	$704.44					
15826	Removal of brow wrinkles		T	5055	42.5396	"$3,522.15"	.	$704.44					
15828	Removal of face wrinkles		T	5055	42.5396	"$3,522.15"	.	$704.44					
15829	Removal of skin wrinkles		T	5055	42.5396	"$3,522.15"	.	$704.44					
15830	Exc skin abd		J1	5092	66.8375	"$5,533.94"	.	"$1,106.79"					
15832	Excise excessive skin thigh		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15833	Excise excessive skin leg		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15834	Excise excessive skin hip		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15835	Excise excessive skin buttck		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15836	Excise excessive skin arm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15837	Excise excess skin arm/hand		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15838	Excise excess skin fat pad		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15839	Excise excess skin & tissue		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15840	Nerve palsy fascial graft		T	5055	42.5396	"$3,522.15"	.	$704.44					
15841	Nerve palsy muscle graft		T	5055	42.5396	"$3,522.15"	.	$704.44					
15842	Nerve palsy microsurg graft		T	5054	20.7177	"$1,715.36"	.	$343.08					
15845	Skin and muscle repair face		T	5055	42.5396	"$3,522.15"	.	$704.44					
15847	Exc skin abd add-on		N										
15850	Remove sutures same surgeon		T	5053	6.3308	$524.17	.	$104.84					
15851	Remove sutures diff surgeon		T	5054	20.7177	"$1,715.36"	.	$343.08					
15852	Dressing change not for burn		Q1	5053	6.3308	$524.17	.	$104.84					
15860	Test for blood flow in graft		Q1	5735	3.2637	$270.22	.	$54.05					
15876	Suction lipectomy head&neck		T	5055	42.5396	"$3,522.15"	.	$704.44					
15877	Suction lipectomy trunk		T	5055	42.5396	"$3,522.15"	.	$704.44					
15878	Suction lipectomy upr extrem		T	5054	20.7177	"$1,715.36"	.	$343.08					
15879	Suction lipectomy lwr extrem		T	5055	42.5396	"$3,522.15"	.	$704.44					
15920	Removal of tail bone ulcer		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15922	Removal of tail bone ulcer		T	5055	42.5396	"$3,522.15"	.	$704.44					
15931	Remove sacrum pressure sore		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15933	Remove sacrum pressure sore		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15934	Remove sacrum pressure sore		T	5055	42.5396	"$3,522.15"	.	$704.44					
15935	Remove sacrum pressure sore		T	5055	42.5396	"$3,522.15"	.	$704.44					
15936	Remove sacrum pressure sore		T	5054	20.7177	"$1,715.36"	.	$343.08					
15937	Remove sacrum pressure sore		T	5054	20.7177	"$1,715.36"	.	$343.08					
15940	Remove hip pressure sore		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15941	Remove hip pressure sore		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15944	Remove hip pressure sore		T	5055	42.5396	"$3,522.15"	.	$704.44					
15945	Remove hip pressure sore		T	5054	20.7177	"$1,715.36"	.	$343.08					
15946	Remove hip pressure sore		T	5054	20.7177	"$1,715.36"	.	$343.08					
15950	Remove thigh pressure sore		J1	5072	16.9934	"$1,407.00"	.	$281.41					
15951	Remove thigh pressure sore		J1	5073	28.6243	"$2,370.01"	.	$474.01					
15952	Remove thigh pressure sore		T	5054	20.7177	"$1,715.36"	.	$343.08					
15953	Remove thigh pressure sore		T	5055	42.5396	"$3,522.15"	.	$704.44					
15956	Remove thigh pressure sore		T	5054	20.7177	"$1,715.36"	.	$343.08					
15958	Remove thigh pressure sore		T	5055	42.5396	"$3,522.15"	.	$704.44					
15999	Removal of pressure sore		T	5071	7.5120	$621.97	.	$124.40					
16000	Initial treatment of burn(s)		Q1	5051	2.1685	$179.55	.	$35.91					
16020	Dress/debrid p-thick burn s		Q1	5051	2.1685	$179.55	.	$35.91					
16025	Dress/debrid p-thick burn m		T	5051	2.1685	$179.55	.	$35.91					
16030	Dress/debrid p-thick burn l		T	5052	4.1770	$345.84	.	$69.17					
16035	Incision of burn scab initi		T	5052	4.1770	$345.84	.	$69.17					
16036	Escharotomy addl incision		C										
17000	Destruct premalg lesion		Q1	5051	2.1685	$179.55	.	$35.91					
17003	Destruct premalg les 2-14		N										
17004	Destroy premal lesions 15/>		T	5052	4.1770	$345.84	.	$69.17					
17106	Destruction of skin lesions		T	5052	4.1770	$345.84	.	$69.17					
17107	Destruction of skin lesions		T	5053	6.3308	$524.17	.	$104.84					
17108	Destruction of skin lesions		T	5054	20.7177	"$1,715.36"	.	$343.08					
17110	Destruct b9 lesion 1-14		Q1	5051	2.1685	$179.55	.	$35.91					
17111	Destruct lesion 15 or more		Q1	5051	2.1685	$179.55	.	$35.91					
17250	Chem caut of granltj tissue		Q1	5051	2.1685	$179.55	.	$35.91					
17260	Destruction of skin lesions		Q1	5051	2.1685	$179.55	.	$35.91					
17261	Destruction of skin lesions		Q1	5051	2.1685	$179.55	.	$35.91					
17262	Destruction of skin lesions		Q1	5051	2.1685	$179.55	.	$35.91					
17263	Destruction of skin lesions		Q1	5051	2.1685	$179.55	.	$35.91					
17264	Destruction of skin lesions		T	5052	4.1770	$345.84	.	$69.17					
17266	Destruction of skin lesions		T	5052	4.1770	$345.84	.	$69.17					
17270	Destruction of skin lesions		T	5051	2.1685	$179.55	.	$35.91					
17271	Destruction of skin lesions		T	5051	2.1685	$179.55	.	$35.91					
17272	Destruction of skin lesions		Q1	5051	2.1685	$179.55	.	$35.91					
17273	Destruction of skin lesions		T	5052	4.1770	$345.84	.	$69.17					
17274	Destruction of skin lesions		T	5052	4.1770	$345.84	.	$69.17					
17276	Destruction of skin lesions		T	5052	4.1770	$345.84	.	$69.17					
17280	Destruction of skin lesions		Q1	5051	2.1685	$179.55	.	$35.91					
17281	Destruction of skin lesions		T	5052	4.1770	$345.84	.	$69.17					
17282	Destruction of skin lesions		T	5052	4.1770	$345.84	.	$69.17					
17283	Destruction of skin lesions		T	5052	4.1770	$345.84	.	$69.17					
17284	Destruction of skin lesions		T	5053	6.3308	$524.17	.	$104.84					
17286	Destruction of skin lesions		T	5053	6.3308	$524.17	.	$104.84					
17311	Mohs 1 stage h/n/hf/g		T	5053	6.3308	$524.17	.	$104.84					
17312	Mohs addl stage		N										
17313	Mohs 1 stage t/a/l		T	5053	6.3308	$524.17	.	$104.84					
17314	Mohs addl stage t/a/l		N										
17315	Mohs surg addl block		N										
17340	Cryotherapy of skin		Q1	5732	0.4087	$33.84	.	$6.77					
17360	Skin peel therapy		Q1	5051	2.1685	$179.55	.	$35.91					
17380	Hair removal by electrolysis		T	5053	6.3308	$524.17	.	$104.84					
17999	Skin tissue procedure		Q1	5051	2.1685	$179.55	.	$35.91					
19000	Drainage of breast lesion		T	5071	7.5120	$621.97	.	$124.40					
19001	Drain breast lesion add-on		N										
19020	Incision of breast lesion		J1	5072	16.9934	"$1,407.00"	.	$281.41					
19030	Injection for breast x-ray		N										
19081	Bx breast 1st lesion strtctc		J1	5072	16.9934	"$1,407.00"	.	$281.41					
19082	Bx breast add lesion strtctc		N										
19083	Bx breast 1st lesion us imag		J1	5072	16.9934	"$1,407.00"	.	$281.41					
19084	Bx breast add lesion us imag		N										
19085	Bx breast 1st lesion mr imag		J1	5072	16.9934	"$1,407.00"	.	$281.41					
19086	Bx breast add lesion mr imag		N										
19100	Bx breast percut w/o image		J1	5072	16.9934	"$1,407.00"	.	$281.41					
19101	Biopsy of breast open		J1	5091	38.1383	"$3,157.74"	.	$631.55					
19105	Cryosurg ablate fa each		J1	5091	38.1383	"$3,157.74"	.	$631.55					
19110	Nipple exploration		J1	5091	38.1383	"$3,157.74"	.	$631.55					
19112	Excise breast duct fistula		J1	5091	38.1383	"$3,157.74"	.	$631.55					
19120	Removal of breast lesion		J1	5091	38.1383	"$3,157.74"	.	$631.55					
19125	Excision breast lesion		J1	5091	38.1383	"$3,157.74"	.	$631.55					
19126	Excision addl breast lesion		N										
19281	Perq device breast 1st imag		Q1	5071	7.5120	$621.97	.	$124.40					
19282	Perq device breast ea imag		N										
19283	Perq dev breast 1st strtctc		Q1	5071	7.5120	$621.97	.	$124.40					
19284	Perq dev breast add strtctc		N										
19285	Perq dev breast 1st us imag		Q1	5071	7.5120	$621.97	.	$124.40					
19286	Perq dev breast add us imag		N										
19287	Perq dev breast 1st mr guide		Q1	5071	7.5120	$621.97	.	$124.40					
19288	Perq dev breast add mr guide		N										
19294	Prep tum cav iort prtl mast		N										
19296	Place po breast cath for rad		J1	5093	107.7339	"$8,920.04"	.	"$1,784.01"	*				
19297	Place breast cath for rad		N										
19298	Place breast rad tube/caths		J1	5092	66.8375	"$5,533.94"	.	"$1,106.79"					
19300	Removal of breast tissue		J1	5091	38.1383	"$3,157.74"	.	$631.55					
19301	Partial mastectomy		J1	5091	38.1383	"$3,157.74"	.	$631.55					
19302	P-mastectomy w/ln removal		J1	5092	66.8375	"$5,533.94"	.	"$1,106.79"					
19303	Mast simple complete		J1	5092	66.8375	"$5,533.94"	.	"$1,106.79"					
19305	Mast radical		C										
19306	Mast rad urban type		C										
19307	Mast mod rad		J1	5092	66.8375	"$5,533.94"	.	"$1,106.79"					
19316	Suspension of breast		J1	5092	66.8375	"$5,533.94"	.	"$1,106.79"					
19318	Breast reduction		J1	5092	66.8375	"$5,533.94"	.	"$1,106.79"					
19324	Enlarge breast	CH	D										
19325	Breast augmentation w/implt		J1	5093	107.7339	"$8,920.04"	.	"$1,784.01"	*				
19328	Rmvl intact breast implant		Q2	5091	38.1383	"$3,157.74"	.	$631.55					
19330	Rmvl ruptured breast implant		Q2	5091	38.1383	"$3,157.74"	.	$631.55					
19340	Insj breast implt sm d mast		J1	5092	66.8375	"$5,533.94"	.	"$1,106.79"					
19342	Insj/rplcmt brst implt sep d		J1	5093	107.7339	"$8,920.04"	.	"$1,784.01"	*				
19350	Breast reconstruction		J1	5091	38.1383	"$3,157.74"	.	$631.55					
19355	Correct inverted nipple(s)		J1	5091	38.1383	"$3,157.74"	.	$631.55					
19357	Tiss xpndr plmt brst rcnstj		J1	5094	180.3049	"$14,928.70"	.	"$2,985.75"	*				
19361	Brst rcnstj latsms drsi flap		C										
19364	Brst rcnstj free flap		C										
19366	Breast reconstruction	CH	D										
19367	Brst rcnstj 1 pdcl tram flap		C										
19368	Brst rcnstj 1pdcl tram anast		C										
19369	Brst rcnstj 2 pdcl tram flap		C										
19370	Revj peri-implt capsule brst		J1	5091	38.1383	"$3,157.74"	.	$631.55					
19371	Peri-implt capslc brst compl		J1	5091	38.1383	"$3,157.74"	.	$631.55					
19380	Revj reconstructed breast		J1	5092	66.8375	"$5,533.94"	.	"$1,106.79"					
19396	Design custom breast implant		J1	5091	38.1383	"$3,157.74"	.	$631.55					
19499	Breast surgery procedure		J1	5091	38.1383	"$3,157.74"	.	$631.55					
2000F	Blood pressure measure		M										
2001F	Weight record		E1										
2002F	Clin sign vol ovrld assess		E1										
2004F	Initial exam involved joints		E1										
20100	Explore wound neck		T	5162	5.4635	$452.36	.	$90.48					
20101	Explore wound chest		T	5054	20.7177	"$1,715.36"	.	$343.08					
20102	Explore wound abdomen		T	5054	20.7177	"$1,715.36"	.	$343.08					
20103	Explore wound extremity		T	5071	7.5120	$621.97	.	$124.40					
2010F	Vital signs recorded		E1										
2014F	Mental status assess		E1										
20150	Excise epiphyseal bar		J1	5113	34.1848	"$2,830.40"	.	$566.08					
2015F	Asthma impairment assessed		E1										
2016F	Asthma risk assessed		E1										
2018F	Hydration status assess		E1										
2019F	Dilated macul exam done		E1										
20200	Muscle biopsy		J1	5072	16.9934	"$1,407.00"	.	$281.41					
20205	Deep muscle biopsy		J1	5073	28.6243	"$2,370.01"	.	$474.01					
20206	Needle biopsy muscle		J1	5072	16.9934	"$1,407.00"	.	$281.41					
2020F	Dilated fundus eval done		E1										
2021F	Dilat macular exam done		E1										
20220	Bone biopsy trocar/needle		J1	5072	16.9934	"$1,407.00"	.	$281.41					
20225	Bone biopsy trocar/needle		J1	5072	16.9934	"$1,407.00"	.	$281.41					
2022F	Dilat rta xm evc rtnopthy		M										
2023F	Dilat rta xm w/o rtnopthy		E1										
20240	Bone biopsy open superficial		J1	5073	28.6243	"$2,370.01"	.	$474.01					
20245	Bone biopsy open deep		J1	5073	28.6243	"$2,370.01"	.	$474.01					
2024F	7 fld rta photo evc rtnopthy		M										
20250	Open bone biopsy		J1	5113	34.1848	"$2,830.40"	.	$566.08					
20251	Open bone biopsy		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
2025F	7 fld rta photo w/o rtnopthy		E1										
2026F	Eye img valid evc rtnopthy		M										
2027F	Optic nerve head eval done		M										
2028F	Foot exam performed		E1										
2029F	Complete phys skin exam done		E1										
2030F	H2o stat docd normal		E1										
2031F	H2o stat docd dehydrated		E1										
2033F	Eye img valid w/o rtnopthy		E1										
2035F	Tymp memb motion examd		E1										
2040F	Bk pn xm on init visit date		E1										
2044F	Doc mntl tst b/4 bk trxmnt		E1										
20500	Injection of sinus tract		J1	5163	16.3386	"$1,352.79"	.	$270.56					
20501	Inject sinus tract for x-ray		N										
2050F	Wound char size etc docd		E1										
20520	Removal of foreign body		J1	5072	16.9934	"$1,407.00"	.	$281.41					
20525	Removal of foreign body		J1	5073	28.6243	"$2,370.01"	.	$474.01					
20526	Ther injection carp tunnel		T	5441	3.1543	$261.17	.	$52.24					
20527	Inj dupuytren cord w/enzyme		T	5441	3.1543	$261.17	.	$52.24					
20550	Inj tendon sheath/ligament		T	5441	3.1543	$261.17	.	$52.24					
20551	Inj tendon origin/insertion		T	5441	3.1543	$261.17	.	$52.24					
20552	Inj trigger point 1/2 muscl		T	5441	3.1543	$261.17	.	$52.24					
20553	Inject trigger points 3/>		T	5441	3.1543	$261.17	.	$52.24					
20555	Place ndl musc/tis for rt		J1	5113	34.1848	"$2,830.40"	.	$566.08					
20560	Ndl insj w/o njx 1 or 2 musc	CH	S	5731	0.2980	$24.67	.	$4.94					
20561	Ndl insj w/o njx 3+ musc	CH	S	5731	0.2980	$24.67	.	$4.94					
20600	Drain/inj joint/bursa w/o us		T	5441	3.1543	$261.17	.	$52.24					
20604	Drain/inj joint/bursa w/us		T	5441	3.1543	$261.17	.	$52.24					
20605	Drain/inj joint/bursa w/o us		T	5441	3.1543	$261.17	.	$52.24					
20606	Drain/inj joint/bursa w/us		T	5442	7.6644	$634.59	.	$126.92					
2060F	Pt talk eval hlthwkr re mdd		E1										
20610	Drain/inj joint/bursa w/o us		T	5441	3.1543	$261.17	.	$52.24					
20611	Drain/inj joint/bursa w/us		T	5441	3.1543	$261.17	.	$52.24					
20612	Aspirate/inj ganglion cyst		T	5441	3.1543	$261.17	.	$52.24					
20615	Treatment of bone cyst		T	5071	7.5120	$621.97	.	$124.40					
20650	Insert and remove bone pin		J1	5113	34.1848	"$2,830.40"	.	$566.08					
20660	Apply rem fixation device		Q2	5112	16.8164	"$1,392.35"	.	$278.47					
20661	Application of head brace	CH	Q1	5113	34.1848	"$2,830.40"	.	$566.08					
20662	Application of pelvis brace		J1	5112	16.8164	"$1,392.35"	.	$278.47					
20663	Application of thigh brace		J1	5113	34.1848	"$2,830.40"	.	$566.08					
20664	Application of halo	CH	Q1	5113	34.1848	"$2,830.40"	.	$566.08					
20665	Removal of fixation device		Q1	5735	3.2637	$270.22	.	$54.05					
20670	Removal of support implant		Q2	5072	16.9934	"$1,407.00"	.	$281.41					
20680	Removal of support implant		Q2	5073	28.6243	"$2,370.01"	.	$474.01					
20690	Apply bone fixation device		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20692	Apply bone fixation device		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
20693	Adjust bone fixation device		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20694	Remove bone fixation device		Q2	5112	16.8164	"$1,392.35"	.	$278.47					
20696	Comp multiplane ext fixation		J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
20697	Comp ext fixate strut change		J1	5112	16.8164	"$1,392.35"	.	$278.47					
20700	Mnl prep&insj dp rx dlvr dev		N										
20701	Rmvl deep rx delivery device		N										
20702	Mnl prep&insj imed rx dev		N										
20703	Rmvl imed rx delivery device		N										
20704	Mnl prep&insj i-artic rx dev		N										
20705	Rmvl i-artic rx delivery dev		N										
20802	Replantation arm complete	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
20805	Replant forearm complete	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
20808	Replantation hand complete	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
20816	Replantation digit complete	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20822	Replantation digit complete		J1	5112	16.8164	"$1,392.35"	.	$278.47					
20824	Replantation thumb complete	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20827	Replantation thumb complete	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20838	Replantation foot complete	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
20900	Removal of bone for graft		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20902	Removal of bone for graft		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20910	Remove cartilage for graft		T	5053	6.3308	$524.17	.	$104.84					
20912	Remove cartilage for graft		T	5055	42.5396	"$3,522.15"	.	$704.44					
20920	Removal of fascia for graft		T	5054	20.7177	"$1,715.36"	.	$343.08					
20922	Removal of fascia for graft		T	5054	20.7177	"$1,715.36"	.	$343.08					
20924	Removal of tendon for graft		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20930	Sp bone algrft morsel add-on		N										
20931	Sp bone algrft struct add-on		N										
20932	Osteoart algrft w/surf & b1		N										
20933	Hemicrt intrclry algrft prtl		N										
20934	Intercalary algrft compl		N										
20936	Sp bone agrft local add-on		N										
20937	Sp bone agrft morsel add-on		N										
20938	Sp bone agrft struct add-on		N										
20939	Bone marrow aspir bone grfg		N										
20950	Fluid pressure muscle		T	5071	7.5120	$621.97	.	$124.40					
20955	Fibula bone graft microvasc	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20956	Iliac bone graft microvasc	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20957	Mt bone graft microvasc	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20962	Other bone graft microvasc	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20969	Bone/skin graft microvasc	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20970	Bone/skin graft iliac crest	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20972	Bone/skin graft metatarsal		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20973	Bone/skin graft great toe		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20974	Electrical bone stimulation		A										
20975	Electrical bone stimulation		N										
20979	Us bone stimulation		Q1	5731	0.2980	$24.67	.	$4.94					
20982	Ablate bone tumor(s) perq		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20983	Ablate bone tumor(s) perq		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
20985	Cptr-asst dir ms px		N										
20999	Musculoskeletal surgery		T	5111	2.4903	$206.19	.	$41.24					
21010	Incision of jaw joint		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21011	Exc face les sc <2 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
21012	Exc face les sbq 2 cm/>		J1	5072	16.9934	"$1,407.00"	.	$281.41					
21013	Exc face tum deep < 2 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
21014	Exc face tum deep 2 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
21015	Resect face/scalp tum < 2 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
21016	Resect face/scalp tum 2 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
21025	Excision of bone lower jaw		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21026	Excision of facial bone(s)		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21029	Contour of face bone lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21030	Excise max/zygoma b9 tumor		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21031	Remove exostosis mandible		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21032	Remove exostosis maxilla		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21034	Excise max/zygoma mal tumor		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21040	Excise mandible lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21044	Removal of jaw bone lesion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21045	Extensive jaw surgery	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21046	Remove mandible cyst complex		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21047	Excise lwr jaw cyst w/repair		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21048	Remove maxilla cyst complex		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21049	Excis uppr jaw cyst w/repair		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21050	Removal of jaw joint		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21060	Remove jaw joint cartilage		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21070	Remove coronoid process		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21073	Mnpj of tmj w/anesth		J1	5163	16.3386	"$1,352.79"	.	$270.56					
21076	Prepare face/oral prosthesis		J1	5163	16.3386	"$1,352.79"	.	$270.56					
21077	Prepare face/oral prosthesis		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21079	Prepare face/oral prosthesis		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21080	Prepare face/oral prosthesis		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21081	Prepare face/oral prosthesis		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21082	Prepare face/oral prosthesis		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21083	Prepare face/oral prosthesis		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21084	Prepare face/oral prosthesis		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21085	Prepare face/oral prosthesis		T	5161	2.5557	$211.60	.	$42.33					
21086	Prepare face/oral prosthesis		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21087	Prepare face/oral prosthesis		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21088	Prepare face/oral prosthesis		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21089	Prepare face/oral prosthesis		T	5161	2.5557	$211.60	.	$42.33					
21100	Maxillofacial fixation		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21110	Interdental fixation		Q2	5163	16.3386	"$1,352.79"	.	$270.56					
21116	Injection jaw joint x-ray		N										
21120	Reconstruction of chin		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21121	Reconstruction of chin		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21122	Reconstruction of chin		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21123	Reconstruction of chin		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21125	Augmentation lower jaw bone		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21127	Augmentation lower jaw bone		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21137	Reduction of forehead		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21138	Reduction of forehead		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21139	Reduction of forehead		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21141	Lefort i-1 piece w/o graft	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21142	Lefort i-2 piece w/o graft	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21143	Lefort i-3/> piece w/o graft	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21145	Lefort i-1 piece w/ graft	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21146	Lefort i-2 piece w/ graft	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21147	Lefort i-3/> piece w/ graft	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21150	Lefort ii anterior intrusion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21151	Lefort ii w/bone grafts	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21154	Lefort iii w/o lefort i	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21155	Lefort iii w/ lefort i	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21159	Lefort iii w/fhdw/o lefort i	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21160	Lefort iii w/fhd w/ lefort i	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21172	Reconstruct orbit/forehead		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21175	Reconstruct orbit/forehead		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21179	Reconstruct entire forehead	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21180	Reconstruct entire forehead	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21181	Contour cranial bone lesion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21182	Reconstruct cranial bone	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21183	Reconstruct cranial bone	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21184	Reconstruct cranial bone	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21188	Reconstruction of midface	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21193	Reconst lwr jaw w/o graft		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21194	Reconst lwr jaw w/graft	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21195	Reconst lwr jaw w/o fixation		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21196	Reconst lwr jaw w/fixation	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21198	Reconstr lwr jaw segment		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21199	Reconstr lwr jaw w/advance		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21206	Reconstruct upper jaw bone		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21208	Augmentation of facial bones		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21209	Reduction of facial bones		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21210	Face bone graft		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21215	Lower jaw bone graft		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21230	Rib cartilage graft		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21235	Ear cartilage graft		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21240	Reconstruction of jaw joint		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21242	Reconstruction of jaw joint		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21243	Reconstruction of jaw joint		J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
21244	Reconstruction of lower jaw		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21245	Reconstruction of jaw		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21246	Reconstruction of jaw		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21247	Reconstruct lower jaw bone	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21248	Reconstruction of jaw		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21249	Reconstruction of jaw		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21255	Reconstruct lower jaw bone	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21256	Reconstruction of orbit		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21260	Revise eye sockets		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21261	Revise eye sockets		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21263	Revise eye sockets		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21267	Revise eye sockets		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21268	Revise eye sockets	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21270	Augmentation cheek bone		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21275	Revision orbitofacial bones		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21280	Revision of eyelid		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21282	Revision of eyelid		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21295	Revision of jaw muscle/bone		J1	5163	16.3386	"$1,352.79"	.	$270.56					
21296	Revision of jaw muscle/bone		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21299	Cranio/maxillofacial surgery		T	5161	2.5557	$211.60	.	$42.33					
21310	Closed tx nose fx w/o manj		T	5111	2.4903	$206.19	.	$41.24					
21315	Closed tx nose fx w/o stablj		J1	5163	16.3386	"$1,352.79"	.	$270.56					
21320	Closed tx nose fx w/ stablj		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21325	Open tx nose fx uncomplicatd		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21330	Open tx nose fx w/skele fixj		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21335	Open tx nose & septal fx		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21336	Open tx septal fx w/wo stabj		J1	5113	34.1848	"$2,830.40"	.	$566.08					
21337	Closed tx septal&nose fx		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21338	Open nasoethmoid fx w/o fixj		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21339	Open nasoethmoid fx w/ fixj		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21340	Perq tx nasoethmoid fx		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21343	Open tx dprsd front sinus fx	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21344	Open tx compl front sinus fx	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21345	Closed tx nose/jaw fx		J1	5163	16.3386	"$1,352.79"	.	$270.56					
21346	Opn tx nasomax fx w/fixj		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21347	Opn tx nasomax fx multple	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21348	Opn tx nasomax fx w/graft	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21355	Perq tx malar fracture		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21356	Opn tx dprsd zygomatic arch		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21360	Opn tx dprsd malar fracture		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21365	Opn tx complx malar fx		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21366	Opn tx complx malar w/grft	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21385	Opn tx orbit fx transantral		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21386	Opn tx orbit fx periorbital		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21387	Opn tx orbit fx combined		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21390	Opn tx orbit periorbtl implt		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21395	Opn tx orbit periorbt w/grft		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21400	Closed tx orbit w/o manipulj		T	5162	5.4635	$452.36	.	$90.48					
21401	Closed tx orbit w/manipulj		J1	5163	16.3386	"$1,352.79"	.	$270.56					
21406	Opn tx orbit fx w/o implant		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21407	Opn tx orbit fx w/implant		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21408	Opn tx orbit fx w/bone grft		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21421	Treat mouth roof fracture		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21422	Treat mouth roof fracture	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21423	Treat mouth roof fracture	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21431	Treat craniofacial fracture	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21432	Treat craniofacial fracture	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21433	Treat craniofacial fracture	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21435	Treat craniofacial fracture	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21436	Treat craniofacial fracture	CH	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21440	Treat dental ridge fracture		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21445	Treat dental ridge fracture		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21450	Treat lower jaw fracture		T	5162	5.4635	$452.36	.	$90.48					
21451	Treat lower jaw fracture		J1	5163	16.3386	"$1,352.79"	.	$270.56					
21452	Treat lower jaw fracture		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21453	Treat lower jaw fracture		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21454	Treat lower jaw fracture		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21461	Treat lower jaw fracture		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21462	Treat lower jaw fracture		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21465	Treat lower jaw fracture		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21470	Treat lower jaw fracture		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21480	Reset dislocated jaw		T	5111	2.4903	$206.19	.	$41.24					
21485	Reset dislocated jaw		J1	5163	16.3386	"$1,352.79"	.	$270.56					
21490	Repair dislocated jaw		J1	5164	33.0494	"$2,736.39"	.	$547.28					
21497	Interdental wiring		J1	5163	16.3386	"$1,352.79"	.	$270.56					
21499	Head surgery procedure		T	5161	2.5557	$211.60	.	$42.33					
21501	Drain neck/chest lesion		J1	5073	28.6243	"$2,370.01"	.	$474.01					
21502	Drain chest lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
21510	Drainage of bone lesion	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21550	Biopsy of neck/chest		J1	5072	16.9934	"$1,407.00"	.	$281.41					
21552	Exc neck les sc 3 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
21554	Exc neck tum deep 5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
21555	Exc neck les sc < 3 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
21556	Exc neck tum deep < 5 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
21557	Resect neck thorax tumor<5cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
21558	Resect neck tumor 5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
21600	Partial removal of rib		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21601	Exc chest wall tumor w/ribs		J1	5073	28.6243	"$2,370.01"	.	$474.01					
21602	Exc ch wal tum w/o lymphadec	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21603	Exc ch wal tum w/lymphadec	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21610	Partial removal of rib		J1	5113	34.1848	"$2,830.40"	.	$566.08					
21615	Removal of rib	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21616	Removal of rib and nerves	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21620	Partial removal of sternum	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21627	Sternal debridement	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21630	Extensive sternum surgery	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21632	Extensive sternum surgery	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21685	Hyoid myotomy & suspension		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
21700	Revision of neck muscle		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21705	Revision of neck muscle/rib	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21720	Revision of neck muscle		J1	5113	34.1848	"$2,830.40"	.	$566.08					
21725	Revision of neck muscle		T	5071	7.5120	$621.97	.	$124.40					
21740	Reconstruction of sternum	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21742	Repair stern/nuss w/o scope		J1	5113	34.1848	"$2,830.40"	.	$566.08					
21743	Repair sternum/nuss w/scope		J1	5113	34.1848	"$2,830.40"	.	$566.08					
21750	Repair of sternum separation	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21811	Optx of rib fx w/fixj scope		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21812	Treatment of rib fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21813	Treatment of rib fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
21820	Treat sternum fracture		T	5111	2.4903	$206.19	.	$41.24					
21825	Treat sternum fracture	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
21899	Neck/chest surgery procedure		T	5161	2.5557	$211.60	.	$42.33					
21920	Biopsy soft tissue of back		J1	5072	16.9934	"$1,407.00"	.	$281.41					
21925	Biopsy soft tissue of back		J1	5072	16.9934	"$1,407.00"	.	$281.41					
21930	Exc back les sc < 3 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
21931	Exc back les sc 3 cm/>		J1	5072	16.9934	"$1,407.00"	.	$281.41					
21932	Exc back tum deep < 5 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
21933	Exc back tum deep 5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
21935	Resect back tum < 5 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
21936	Resect back tum 5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
22010	I&d p-spine c/t/cerv-thor	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22015	I&d abscess p-spine l/s/ls	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22100	Remove part of neck vertebra		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22101	Remove part thorax vertebra		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22102	Remove part lumbar vertebra		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22103	Remove extra spine segment		N										
22110	Remove part of neck vertebra	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22112	Remove part thorax vertebra	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22114	Remove part lumbar vertebra	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22116	Remove extra spine segment	CH	N										
22206	Incis spine 3 column thorac	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22207	Incis spine 3 column lumbar	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22208	Incis spine 3 column adl seg	CH	N										
22210	Incis 1 vertebral seg cerv	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22212	Incis 1 vertebral seg thorac	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22214	Incis 1 vertebral seg lumbar	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22216	Incis addl spine segment	CH	N										
22220	Incis w/discectomy cervical	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22222	Incis w/discectomy thoracic	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22224	Incis w/discectomy lumbar	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22226	Revise extra spine segment	CH	N										
22310	Closed tx vert fx w/o manj		T	5111	2.4903	$206.19	.	$41.24					
22315	Closed tx vert fx w/manj		J1	5113	34.1848	"$2,830.40"	.	$566.08					
22318	Treat odontoid fx w/o graft	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22319	Treat odontoid fx w/graft	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22325	Treat spine fracture	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22326	Treat neck spine fracture	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22327	Treat thorax spine fracture	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22328	Treat each add spine fx	CH	N										
22505	Manipulation of spine		J1	5112	16.8164	"$1,392.35"	.	$278.47					
22510	Perq cervicothoracic inject		J1	5113	34.1848	"$2,830.40"	.	$566.08					
22511	Perq lumbosacral injection		J1	5113	34.1848	"$2,830.40"	.	$566.08					
22512	Vertebroplasty addl inject		N										
22513	Perq vertebral augmentation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22514	Perq vertebral augmentation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
22515	Perq vertebral augmentation		N										
22526	Idet single level		E1										
22527	Idet 1 or more levels		E1										
22532	Lat thorax spine fusion	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22533	Lat lumbar spine fusion	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22534	Lat thor/lumb addl seg	CH	N										
22548	Neck spine fusion	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22551	Neck spine fuse&remov bel c2		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22552	Addl neck spine fusion		N										
22554	Neck spine fusion		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22556	Thorax spine fusion	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22558	Lumbar spine fusion	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22585	Additional spinal fusion		N										
22586	Prescrl fuse w/ instr l5-s1	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22590	Spine & skull spinal fusion	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22595	Neck spinal fusion	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22600	Neck spine fusion	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22610	Thorax spine fusion	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22612	Lumbar spine fusion		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22614	Spine fusion extra segment		N										
22630	Lumbar spine fusion	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22632	Spine fusion extra segment	CH	N										
22633	Lumbar spine fusion combined		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22634	Spine fusion extra segment		N										
22800	Post fusion </6 vert seg	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22802	Post fusion 7-12 vert seg	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22804	Post fusion 13/> vert seg	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22808	Ant fusion 2-3 vert seg	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22810	Ant fusion 4-7 vert seg	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22812	Ant fusion 8/> vert seg	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22818	Kyphectomy 1-2 segments	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22819	Kyphectomy 3 or more	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22830	Exploration of spinal fusion	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22840	Insert spine fixation device		N										
22841	Insert spine fixation device	CH	N										
22842	Insert spine fixation device		N										
22843	Insert spine fixation device	CH	N										
22844	Insert spine fixation device	CH	N										
22845	Insert spine fixation device		N										
22846	Insert spine fixation device	CH	N										
22847	Insert spine fixation device	CH	N										
22848	Insert pelv fixation device	CH	N										
22849	Reinsert spinal fixation	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22850	Remove spine fixation device	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22852	Remove spine fixation device	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22853	Insj biomechanical device		N										
22854	Insj biomechanical device		N										
22855	Remove spine fixation device	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22856	Cerv artific diskectomy		J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22857	Lumbar artif diskectomy	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22858	Second level cer diskectomy		N										
22859	Insj biomechanical device		N										
22861	Revise cerv artific disc	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22862	Revise lumbar artif disc	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22864	Remove cerv artif disc	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22865	Remove lumb artif disc	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22867	Insj stablj dev w/dcmprn		J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
22868	Insj stablj dev w/dcmprn		N										
22869	Insj stablj dev w/o dcmprn		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
22870	Insj stablj dev w/o dcmprn		N										
22899	Spine surgery procedure		T	5111	2.4903	$206.19	.	$41.24					
22900	Exc abdl tum deep < 5 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
22901	Exc abdl tum deep 5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
22902	Exc abd les sc < 3 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
22903	Exc abd les sc 3 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
22904	Radical resect abd tumor<5cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
22905	Rad resect abd tumor 5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
22999	Abdomen surgery procedure		T	5111	2.4903	$206.19	.	$41.24					
23000	Removal of calcium deposits		J1	5073	28.6243	"$2,370.01"	.	$474.01					
23020	Release shoulder joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
23030	Drain shoulder lesion		J1	5073	28.6243	"$2,370.01"	.	$474.01					
23031	Drain shoulder bursa		J1	5073	28.6243	"$2,370.01"	.	$474.01					
23035	Drain shoulder bone lesion		J1	5112	16.8164	"$1,392.35"	.	$278.47					
23040	Exploratory shoulder surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
23044	Exploratory shoulder surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
23065	Biopsy shoulder tissues		J1	5072	16.9934	"$1,407.00"	.	$281.41					
23066	Biopsy shoulder tissues		J1	5073	28.6243	"$2,370.01"	.	$474.01					
23071	Exc shoulder les sc 3 cm/>		J1	5072	16.9934	"$1,407.00"	.	$281.41					
23073	Exc shoulder tum deep 5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
23075	Exc shoulder les sc < 3 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
23076	Exc shoulder tum deep < 5 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
23077	Resect shoulder tumor < 5 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
23078	Resect shoulder tumor 5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
23100	Biopsy of shoulder joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
23101	Shoulder joint surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
23105	Remove shoulder joint lining		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23106	Incision of collarbone joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
23107	Explore treat shoulder joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23120	Partial removal collar bone		J1	5113	34.1848	"$2,830.40"	.	$566.08					
23125	Removal of collar bone		J1	5113	34.1848	"$2,830.40"	.	$566.08					
23130	Remove shoulder bone part		J1	5113	34.1848	"$2,830.40"	.	$566.08					
23140	Removal of bone lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
23145	Removal of bone lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
23146	Removal of bone lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23150	Removal of humerus lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
23155	Removal of humerus lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23156	Removal of humerus lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23170	Remove collar bone lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
23172	Remove shoulder blade lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
23174	Remove humerus lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23180	Remove collar bone lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23182	Remove shoulder blade lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23184	Remove humerus lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23190	Partial removal of scapula		J1	5113	34.1848	"$2,830.40"	.	$566.08					
23195	Removal of head of humerus		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23200	Resect clavicle tumor	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23210	Resect scapula tumor	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23220	Resect prox humerus tumor	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23330	Remove shoulder foreign body		T	5071	7.5120	$621.97	.	$124.40					
23333	Remove shoulder fb deep		J1	5073	28.6243	"$2,370.01"	.	$474.01					
23334	Shoulder prosthesis removal		J1	5073	28.6243	"$2,370.01"	.	$474.01					
23335	Shoulder prosthesis removal	CH	J1	5073	28.6243	"$2,370.01"	.	$474.01					
23350	Injection for shoulder x-ray		N										
23395	Muscle transfer shoulder/arm		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23397	Muscle transfers		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23400	Fixation of shoulder blade		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23405	Incision of tendon & muscle		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23406	Incise tendon(s) & muscle(s)		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23410	Repair rotator cuff acute		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23412	Repair rotator cuff chronic		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23415	Release of shoulder ligament		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23420	Repair of shoulder		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23430	Repair biceps tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23440	Remove/transplant tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23450	Repair shoulder capsule		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23455	Repair shoulder capsule		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23460	Repair shoulder capsule		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23462	Repair shoulder capsule		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23465	Repair shoulder capsule		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23466	Repair shoulder capsule		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23470	Reconstruct shoulder joint		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
23472	Reconstruct shoulder joint	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
23473	Revis reconst shoulder joint		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
23474	Revis reconst shoulder joint	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
23480	Revision of collar bone		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23485	Revision of collar bone		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
23490	Reinforce clavicle		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23491	Reinforce shoulder bones		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
23500	Treat clavicle fracture		T	5111	2.4903	$206.19	.	$41.24					
23505	Treat clavicle fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
23515	Treat clavicle fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23520	Treat clavicle dislocation		J1	5112	16.8164	"$1,392.35"	.	$278.47					
23525	Treat clavicle dislocation		T	5111	2.4903	$206.19	.	$41.24					
23530	Treat clavicle dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23532	Treat clavicle dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23540	Treat clavicle dislocation		T	5111	2.4903	$206.19	.	$41.24					
23545	Treat clavicle dislocation		T	5111	2.4903	$206.19	.	$41.24					
23550	Treat clavicle dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23552	Treat clavicle dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23570	Treat shoulder blade fx		T	5111	2.4903	$206.19	.	$41.24					
23575	Treat shoulder blade fx		J1	5112	16.8164	"$1,392.35"	.	$278.47					
23585	Treat scapula fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23600	Treat humerus fracture		T	5111	2.4903	$206.19	.	$41.24					
23605	Treat humerus fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
23615	Treat humerus fracture		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
23616	Treat humerus fracture		J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
23620	Treat humerus fracture		T	5111	2.4903	$206.19	.	$41.24					
23625	Treat humerus fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
23630	Treat humerus fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23650	Treat shoulder dislocation		T	5111	2.4903	$206.19	.	$41.24					
23655	Treat shoulder dislocation		J1	5112	16.8164	"$1,392.35"	.	$278.47					
23660	Treat shoulder dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23665	Treat dislocation/fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
23670	Treat dislocation/fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23675	Treat dislocation/fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
23680	Treat dislocation/fracture		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
23700	Fixation of shoulder		J1	5112	16.8164	"$1,392.35"	.	$278.47					
23800	Fusion of shoulder joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
23802	Fusion of shoulder joint		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
23900	Amputation of arm & girdle	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
23920	Amputation at shoulder joint	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
23921	Amputation follow-up surgery		T	5054	20.7177	"$1,715.36"	.	$343.08					
23929	Shoulder surgery procedure		T	5111	2.4903	$206.19	.	$41.24					
23930	Drainage of arm lesion		J1	5073	28.6243	"$2,370.01"	.	$474.01					
23931	Drainage of arm bursa		J1	5072	16.9934	"$1,407.00"	.	$281.41					
23935	Drain arm/elbow bone lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24000	Exploratory elbow surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24006	Release elbow joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24065	Biopsy arm/elbow soft tissue		J1	5072	16.9934	"$1,407.00"	.	$281.41					
24066	Biopsy arm/elbow soft tissue		J1	5073	28.6243	"$2,370.01"	.	$474.01					
24071	Exc arm/elbow les sc 3 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
24073	Ex arm/elbow tum deep 5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
24075	Exc arm/elbow les sc < 3 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
24076	Ex arm/elbow tum deep < 5 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
24077	Resect arm/elbow tum < 5 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
24079	Resect arm/elbow tum 5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
24100	Biopsy elbow joint lining		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24101	Explore/treat elbow joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24102	Remove elbow joint lining		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24105	Removal of elbow bursa		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24110	Remove humerus lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24115	Remove/graft bone lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24116	Remove/graft bone lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24120	Remove elbow lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24125	Remove/graft bone lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24126	Remove/graft bone lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24130	Removal of head of radius		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24134	Removal of arm bone lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24136	Remove radius bone lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24138	Remove elbow bone lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24140	Partial removal of arm bone		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24145	Partial removal of radius		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24147	Partial removal of elbow		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24149	Radical resection of elbow		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24150	Resect distal humerus tumor		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24152	Resect radius tumor		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24155	Removal of elbow joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24160	Remove elbow joint implant		Q2	5113	34.1848	"$2,830.40"	.	$566.08					
24164	Remove radius head implant		Q2	5113	34.1848	"$2,830.40"	.	$566.08					
24200	Removal of arm foreign body		J1	5072	16.9934	"$1,407.00"	.	$281.41					
24201	Removal of arm foreign body		J1	5073	28.6243	"$2,370.01"	.	$474.01					
24220	Injection for elbow x-ray		N										
24300	Manipulate elbow w/anesth		J1	5112	16.8164	"$1,392.35"	.	$278.47					
24301	Muscle/tendon transfer		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24305	Arm tendon lengthening		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24310	Revision of arm tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24320	Repair of arm tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24330	Revision of arm muscles		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24331	Revision of arm muscles		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24332	Tenolysis triceps		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24340	Repair of biceps tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24341	Repair arm tendon/muscle		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24342	Repair of ruptured tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24343	Repr elbow lat ligmnt w/tiss		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24344	Reconstruct elbow lat ligmnt		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24345	Repr elbw med ligmnt w/tissu		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24346	Reconstruct elbow med ligmnt		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24357	Repair elbow perc		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24358	Repair elbow w/deb open		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24359	Repair elbow deb/attch open		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24360	Reconstruct elbow joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24361	Reconstruct elbow joint		J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
24362	Reconstruct elbow joint		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24363	Replace elbow joint		J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
24365	Reconstruct head of radius		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24366	Reconstruct head of radius		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24370	Revise reconst elbow joint		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24371	Revise reconst elbow joint		J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
24400	Revision of humerus		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24410	Revision of humerus		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24420	Revision of humerus		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24430	Repair of humerus		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24435	Repair humerus with graft		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24470	Revision of elbow joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24495	Decompression of forearm		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24498	Reinforce humerus		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24500	Treat humerus fracture		T	5111	2.4903	$206.19	.	$41.24					
24505	Treat humerus fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
24515	Treat humerus fracture		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24516	Treat humerus fracture		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24530	Treat humerus fracture		T	5111	2.4903	$206.19	.	$41.24					
24535	Treat humerus fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
24538	Treat humerus fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24545	Treat humerus fracture		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24546	Treat humerus fracture		J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
24560	Treat humerus fracture		T	5111	2.4903	$206.19	.	$41.24					
24565	Treat humerus fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
24566	Treat humerus fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
24575	Treat humerus fracture		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24576	Treat humerus fracture		T	5111	2.4903	$206.19	.	$41.24					
24577	Treat humerus fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
24579	Treat humerus fracture		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24582	Treat humerus fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24586	Treat elbow fracture		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24587	Treat elbow fracture		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24600	Treat elbow dislocation		T	5111	2.4903	$206.19	.	$41.24					
24605	Treat elbow dislocation		J1	5112	16.8164	"$1,392.35"	.	$278.47					
24615	Treat elbow dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24620	Treat elbow fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
24635	Treat elbow fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24640	Treat elbow dislocation		T	5111	2.4903	$206.19	.	$41.24					
24650	Treat radius fracture		T	5111	2.4903	$206.19	.	$41.24					
24655	Treat radius fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
24665	Treat radius fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24666	Treat radius fracture		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24670	Treat ulnar fracture		T	5111	2.4903	$206.19	.	$41.24					
24675	Treat ulnar fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
24685	Treat ulnar fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24800	Fusion of elbow joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24802	Fusion/graft of elbow joint		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24900	Amputation of upper arm	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24920	Amputation of upper arm	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24925	Amputation follow-up surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
24930	Amputation follow-up surgery	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24931	Amputate upper arm & implant	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24935	Revision of amputation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
24940	Revision of upper arm	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
24999	Upper arm/elbow surgery		T	5111	2.4903	$206.19	.	$41.24					
25000	Incision of tendon sheath		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25001	Incise flexor carpi radialis		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25020	Decompress forearm 1 space		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25023	Decompress forearm 1 space		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25024	Decompress forearm 2 spaces		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25025	Decompress forearm 2 spaces		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25028	Drainage of forearm lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25031	Drainage of forearm bursa		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25035	Treat forearm bone lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25040	Explore/treat wrist joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25065	Biopsy forearm soft tissues		J1	5072	16.9934	"$1,407.00"	.	$281.41					
25066	Biopsy forearm soft tissues		J1	5073	28.6243	"$2,370.01"	.	$474.01					
25071	Exc forearm les sc 3 cm/>		J1	5072	16.9934	"$1,407.00"	.	$281.41					
25073	Exc forearm tum deep 3 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
25075	Exc forearm les sc < 3 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
25076	Exc forearm tum deep < 3 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
25077	Resect forearm/wrist tum<3cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
25078	Resect forarm/wrist tum 3cm>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
25085	Incision of wrist capsule		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25100	Biopsy of wrist joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25101	Explore/treat wrist joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25105	Remove wrist joint lining		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25107	Remove wrist joint cartilage		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25109	Excise tendon forearm/wrist		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25110	Remove wrist tendon lesion		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25111	Remove wrist tendon lesion		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25112	Reremove wrist tendon lesion		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25115	Remove wrist/forearm lesion		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25116	Remove wrist/forearm lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25118	Excise wrist tendon sheath		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25119	Partial removal of ulna		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25120	Removal of forearm lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25125	Remove/graft forearm lesion		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25126	Remove/graft forearm lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25130	Removal of wrist lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25135	Remove & graft wrist lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25136	Remove & graft wrist lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25145	Remove forearm bone lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25150	Partial removal of ulna		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25151	Partial removal of radius		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25170	Resect radius/ulnar tumor		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25210	Removal of wrist bone		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25215	Removal of wrist bones		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25230	Partial removal of radius		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25240	Partial removal of ulna		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25246	Injection for wrist x-ray		N										
25248	Remove forearm foreign body		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25250	Removal of wrist prosthesis		Q2	5112	16.8164	"$1,392.35"	.	$278.47					
25251	Removal of wrist prosthesis		Q2	5113	34.1848	"$2,830.40"	.	$566.08					
25259	Manipulate wrist w/anesthes		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25260	Repair forearm tendon/muscle		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25263	Repair forearm tendon/muscle		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25265	Repair forearm tendon/muscle		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25270	Repair forearm tendon/muscle		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25272	Repair forearm tendon/muscle		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25274	Repair forearm tendon/muscle		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25275	Repair forearm tendon sheath		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25280	Revise wrist/forearm tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25290	Incise wrist/forearm tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25295	Release wrist/forearm tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25300	Fusion of tendons at wrist		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25301	Fusion of tendons at wrist		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25310	Transplant forearm tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25312	Transplant forearm tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25315	Revise palsy hand tendon(s)		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25316	Revise palsy hand tendon(s)		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25320	Repair/revise wrist joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25332	Revise wrist joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25335	Realignment of hand		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25337	Reconstruct ulna/radioulnar		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25350	Revision of radius		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25355	Revision of radius		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25360	Revision of ulna		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25365	Revise radius & ulna		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
25370	Revise radius or ulna		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25375	Revise radius & ulna		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25390	Shorten radius or ulna		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25391	Lengthen radius or ulna		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
25392	Shorten radius & ulna		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25393	Lengthen radius & ulna		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25394	Repair carpal bone shorten		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25400	Repair radius or ulna		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25405	Repair/graft radius or ulna		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25415	Repair radius & ulna		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25420	Repair/graft radius & ulna		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25425	Repair/graft radius or ulna		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25426	Repair/graft radius & ulna		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25430	Vasc graft into carpal bone		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25431	Repair nonunion carpal bone		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25440	Repair/graft wrist bone		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25441	Reconstruct wrist joint		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
25442	Reconstruct wrist joint		J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
25443	Reconstruct wrist joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25444	Reconstruct wrist joint		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
25445	Reconstruct wrist joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25446	Wrist replacement		J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
25447	Repair wrist joints		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25449	Remove wrist joint implant		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25450	Revision of wrist joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25455	Revision of wrist joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25490	Reinforce radius		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25491	Reinforce ulna		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
25492	Reinforce radius and ulna		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25500	Treat fracture of radius		T	5111	2.4903	$206.19	.	$41.24					
25505	Treat fracture of radius		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25515	Treat fracture of radius		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25520	Treat fracture of radius		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25525	Treat fracture of radius		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25526	Treat fracture of radius		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25530	Treat fracture of ulna		T	5111	2.4903	$206.19	.	$41.24					
25535	Treat fracture of ulna		T	5111	2.4903	$206.19	.	$41.24					
25545	Treat fracture of ulna		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25560	Treat fracture radius & ulna		T	5111	2.4903	$206.19	.	$41.24					
25565	Treat fracture radius & ulna		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25574	Treat fracture radius & ulna		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25575	Treat fracture radius/ulna		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25600	Treat fracture radius/ulna		T	5111	2.4903	$206.19	.	$41.24					
25605	Treat fracture radius/ulna		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25606	Treat fx distal radial		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25607	Treat fx rad extra-articul		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25608	Treat fx rad intra-articul		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25609	Treat fx radial 3+ frag		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25622	Treat wrist bone fracture		T	5111	2.4903	$206.19	.	$41.24					
25624	Treat wrist bone fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25628	Treat wrist bone fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25630	Treat wrist bone fracture		T	5111	2.4903	$206.19	.	$41.24					
25635	Treat wrist bone fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25645	Treat wrist bone fracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25650	Treat wrist bone fracture		T	5111	2.4903	$206.19	.	$41.24					
25651	Pin ulnar styloid fracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25652	Treat fracture ulnar styloid		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25660	Treat wrist dislocation		T	5111	2.4903	$206.19	.	$41.24					
25670	Treat wrist dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25671	Pin radioulnar dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25675	Treat wrist dislocation		T	5111	2.4903	$206.19	.	$41.24					
25676	Treat wrist dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25680	Treat wrist fracture		T	5111	2.4903	$206.19	.	$41.24					
25685	Treat wrist fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25690	Treat wrist dislocation		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25695	Treat wrist dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25800	Fusion of wrist joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25805	Fusion/graft of wrist joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25810	Fusion/graft of wrist joint		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
25820	Fusion of hand bones		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25825	Fuse hand bones with graft		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25830	Fusion radioulnar jnt/ulna		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25900	Amputation of forearm	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
25905	Amputation of forearm	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
25907	Amputation follow-up surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25909	Amputation follow-up surgery		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25915	Amputation of forearm	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25920	Amputate hand at wrist	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25922	Amputate hand at wrist		J1	5112	16.8164	"$1,392.35"	.	$278.47					
25924	Amputation follow-up surgery	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
25927	Amputation of hand	CH	J1	5113	34.1848	"$2,830.40"	.	$566.08					
25929	Amputation follow-up surgery		T	5054	20.7177	"$1,715.36"	.	$343.08					
25931	Amputation follow-up surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
25999	Forearm or wrist surgery		T	5111	2.4903	$206.19	.	$41.24					
26010	Drainage of finger abscess		T	5051	2.1685	$179.55	.	$35.91					
26011	Drainage of finger abscess		J1	5072	16.9934	"$1,407.00"	.	$281.41					
26020	Drain hand tendon sheath		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26025	Drainage of palm bursa		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26030	Drainage of palm bursas		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26034	Treat hand bone lesion		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26035	Decompress fingers/hand		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26037	Decompress fingers/hand		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26040	Release palm contracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26045	Release palm contracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26055	Incise finger tendon sheath		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26060	Incision of finger tendon		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26070	Explore/treat hand joint		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26075	Explore/treat finger joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26080	Explore/treat finger joint		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26100	Biopsy hand joint lining		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26105	Biopsy finger joint lining		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26110	Biopsy finger joint lining		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26111	Exc hand les sc 1.5 cm/>		J1	5072	16.9934	"$1,407.00"	.	$281.41					
26113	Exc hand tum deep 1.5 cm/>		J1	5072	16.9934	"$1,407.00"	.	$281.41					
26115	Exc hand les sc < 1.5 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
26116	Exc hand tum deep < 1.5 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
26117	Rad resect hand tumor < 3 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
26118	Rad resect hand tumor 3 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
26121	Release palm contracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26123	Release palm contracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26125	Release palm contracture		N										
26130	Remove wrist joint lining		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26135	Revise finger joint each		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26140	Revise finger joint each		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26145	Tendon excision palm/finger		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26160	Remove tendon sheath lesion		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26170	Removal of palm tendon each		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26180	Removal of finger tendon		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26185	Remove finger bone		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26200	Remove hand bone lesion		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26205	Remove/graft bone lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26210	Removal of finger lesion		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26215	Remove/graft finger lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26230	Partial removal of hand bone		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26235	Partial removal finger bone		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26236	Partial removal finger bone		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26250	Extensive hand surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26260	Resect prox finger tumor		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26262	Resect distal finger tumor		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26320	Removal of implant from hand		Q2	5072	16.9934	"$1,407.00"	.	$281.41					
26340	Manipulate finger w/anesth		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26341	Manipulat palm cord post inj		T	5111	2.4903	$206.19	.	$41.24					
26350	Repair finger/hand tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26352	Repair/graft hand tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26356	Repair finger/hand tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26357	Repair finger/hand tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26358	Repair/graft hand tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26370	Repair finger/hand tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26372	Repair/graft hand tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26373	Repair finger/hand tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26390	Revise hand/finger tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26392	Repair/graft hand tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26410	Repair hand tendon		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26412	Repair/graft hand tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26415	Excision hand/finger tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26416	Graft hand or finger tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26418	Repair finger tendon		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26420	Repair/graft finger tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26426	Repair finger/hand tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26428	Repair/graft finger tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26432	Repair finger tendon		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26433	Repair finger tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26434	Repair/graft finger tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26437	Realignment of tendons		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26440	Release palm/finger tendon		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26442	Release palm & finger tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26445	Release hand/finger tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26449	Release forearm/hand tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26450	Incision of palm tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26455	Incision of finger tendon		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26460	Incise hand/finger tendon		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26471	Fusion of finger tendons		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26474	Fusion of finger tendons		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26476	Tendon lengthening		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26477	Tendon shortening		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26478	Lengthening of hand tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26479	Shortening of hand tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26480	Transplant hand tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26483	Transplant/graft hand tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26485	Transplant palm tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26489	Transplant/graft palm tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26490	Revise thumb tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26492	Tendon transfer with graft		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26494	Hand tendon/muscle transfer		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26496	Revise thumb tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26497	Finger tendon transfer		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26498	Finger tendon transfer		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26499	Revision of finger		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26500	Hand tendon reconstruction		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26502	Hand tendon reconstruction		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26508	Release thumb contracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26510	Thumb tendon transfer		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26516	Fusion of knuckle joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26517	Fusion of knuckle joints		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26518	Fusion of knuckle joints		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26520	Release knuckle contracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26525	Release finger contracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26530	Revise knuckle joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26531	Revise knuckle with implant		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26535	Revise finger joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26536	Revise/implant finger joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26540	Repair hand joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26541	Repair hand joint with graft		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26542	Repair hand joint with graft		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26545	Reconstruct finger joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26546	Repair nonunion hand		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26548	Reconstruct finger joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26550	Construct thumb replacement		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26551	Great toe-hand transfer	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26553	Single transfer toe-hand	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26554	Double transfer toe-hand	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26555	Positional change of finger		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26556	Toe joint transfer	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26560	Repair of web finger		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26561	Repair of web finger		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26562	Repair of web finger		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26565	Correct metacarpal flaw		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26567	Correct finger deformity		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26568	Lengthen metacarpal/finger		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26580	Repair hand deformity		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26587	Reconstruct extra finger		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26590	Repair finger deformity		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26591	Repair muscles of hand		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26593	Release muscles of hand		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26596	Excision constricting tissue		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26600	Treat metacarpal fracture		T	5111	2.4903	$206.19	.	$41.24					
26605	Treat metacarpal fracture		T	5111	2.4903	$206.19	.	$41.24					
26607	Treat metacarpal fracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26608	Treat metacarpal fracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26615	Treat metacarpal fracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26641	Treat thumb dislocation		T	5111	2.4903	$206.19	.	$41.24					
26645	Treat thumb fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26650	Treat thumb fracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26665	Treat thumb fracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26670	Treat hand dislocation		T	5111	2.4903	$206.19	.	$41.24					
26675	Treat hand dislocation		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26676	Pin hand dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26685	Treat hand dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26686	Treat hand dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26700	Treat knuckle dislocation		T	5111	2.4903	$206.19	.	$41.24					
26705	Treat knuckle dislocation		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26706	Pin knuckle dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26715	Treat knuckle dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26720	Treat finger fracture each		T	5111	2.4903	$206.19	.	$41.24					
26725	Treat finger fracture each		T	5111	2.4903	$206.19	.	$41.24					
26727	Treat finger fracture each		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26735	Treat finger fracture each		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26740	Treat finger fracture each		T	5111	2.4903	$206.19	.	$41.24					
26742	Treat finger fracture each		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26746	Treat finger fracture each		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26750	Treat finger fracture each		T	5111	2.4903	$206.19	.	$41.24					
26755	Treat finger fracture each		T	5111	2.4903	$206.19	.	$41.24					
26756	Pin finger fracture each		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26765	Treat finger fracture each		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26770	Treat finger dislocation		T	5111	2.4903	$206.19	.	$41.24					
26775	Treat finger dislocation		T	5102	2.9128	$241.17	.	$48.24					
26776	Pin finger dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26785	Treat finger dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26820	Thumb fusion with graft		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26841	Fusion of thumb		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26842	Thumb fusion with graft		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26843	Fusion of hand joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26844	Fusion/graft of hand joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26850	Fusion of knuckle		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26852	Fusion of knuckle with graft		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
26860	Fusion of finger joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26861	Fusion of finger jnt add-on		N										
26862	Fusion/graft of finger joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26863	Fuse/graft added joint		N										
26910	Amputate metacarpal bone		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26951	Amputation of finger/thumb		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26952	Amputation of finger/thumb		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26989	Hand/finger surgery		T	5111	2.4903	$206.19	.	$41.24					
26990	Drainage of pelvis lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
26991	Drainage of pelvis bursa		J1	5112	16.8164	"$1,392.35"	.	$278.47					
26992	Drainage of bone lesion	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27000	Incision of hip tendon		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27001	Incision of hip tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27003	Incision of hip tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27005	Incision of hip tendon	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27006	Incision of hip tendons		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27025	Incision of hip/thigh fascia	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27027	Buttock fasciotomy		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27030	Drainage of hip joint	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27033	Exploration of hip joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27035	Denervation of hip joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27036	Excision of hip joint/muscle	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27040	Biopsy of soft tissues		J1	5072	16.9934	"$1,407.00"	.	$281.41					
27041	Biopsy of soft tissues		J1	5072	16.9934	"$1,407.00"	.	$281.41					
27043	Exc hip pelvis les sc 3 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27045	Exc hip/pelv tum deep 5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27047	Exc hip/pelvis les sc < 3 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27048	Exc hip/pelv tum deep < 5 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27049	Resect hip/pelv tum < 5 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27050	Biopsy of sacroiliac joint		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27052	Biopsy of hip joint		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27054	Removal of hip joint lining	CH	J1	5113	34.1848	"$2,830.40"	.	$566.08					
27057	Buttock fasciotomy w/dbrdmt		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27059	Resect hip/pelv tum 5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27060	Removal of ischial bursa		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27062	Remove femur lesion/bursa		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27065	Remove hip bone les super		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27066	Remove hip bone les deep		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27067	Remove/graft hip bone lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27070	Part remove hip bone super	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27071	Part removal hip bone deep	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27075	Resect hip tumor	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27076	Resect hip tum incl acetabul	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27077	Resect hip tum w/innom bone	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27078	Rsect hip tum incl femur	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27080	Removal of tail bone		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27086	Remove hip foreign body		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27087	Remove hip foreign body		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27090	Removal of hip prosthesis	CH	J1	5073	28.6243	"$2,370.01"	.	$474.01					
27091	Removal of hip prosthesis	CH	J1	5073	28.6243	"$2,370.01"	.	$474.01					
27093	Injection for hip x-ray		N										
27095	Injection for hip x-ray		N										
27096	Inject sacroiliac joint		B										
27097	Revision of hip tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27098	Transfer tendon to pelvis		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27100	Transfer of abdominal muscle		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27105	Transfer of spinal muscle		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27110	Transfer of iliopsoas muscle		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27111	Transfer of iliopsoas muscle		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27120	Reconstruction of hip socket	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27122	Reconstruction of hip socket	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27125	Partial hip replacement	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27130	Total hip arthroplasty		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27132	Total hip arthroplasty	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27134	Revise hip joint replacement	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27137	Revise hip joint replacement	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27138	Revise hip joint replacement	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27140	Transplant femur ridge	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27146	Incision of hip bone	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27147	Revision of hip bone	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27151	Incision of hip bones	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27156	Revision of hip bones	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27158	Revision of pelvis	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27161	Incision of neck of femur	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27165	Incision/fixation of femur	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27170	Repair/graft femur head/neck	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27175	Treat slipped epiphysis	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27176	Treat slipped epiphysis	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27177	Treat slipped epiphysis	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27178	Treat slipped epiphysis	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27179	Revise head/neck of femur		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27181	Treat slipped epiphysis	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27185	Revision of femur epiphysis	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27187	Reinforce hip bones	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27197	Clsd tx pelvic ring fx		T	5111	2.4903	$206.19	.	$41.24					
27198	Clsd tx pelvic ring fx		T	5111	2.4903	$206.19	.	$41.24					
27200	Treat tail bone fracture		T	5111	2.4903	$206.19	.	$41.24					
27202	Treat tail bone fracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27215	Treat pelvic fracture(s)		E1										
27216	Treat pelvic ring fracture		E1										
27217	Treat pelvic ring fracture		E1										
27218	Treat pelvic ring fracture		E1										
27220	Treat hip socket fracture		T	5111	2.4903	$206.19	.	$41.24					
27222	Treat hip socket fracture	CH	T	5111	2.4903	$206.19	.	$41.24					
27226	Treat hip wall fracture	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27227	Treat hip fracture(s)	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27228	Treat hip fracture(s)	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27230	Treat thigh fracture		T	5111	2.4903	$206.19	.	$41.24					
27232	Treat thigh fracture	CH	J1	5112	16.8164	"$1,392.35"	.	$278.47					
27235	Treat thigh fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27236	Treat thigh fracture	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27238	Treat thigh fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27240	Treat thigh fracture	CH	J1	5112	16.8164	"$1,392.35"	.	$278.47					
27244	Treat thigh fracture	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27245	Treat thigh fracture	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27246	Treat thigh fracture		T	5111	2.4903	$206.19	.	$41.24					
27248	Treat thigh fracture	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27250	Treat hip dislocation		T	5111	2.4903	$206.19	.	$41.24					
27252	Treat hip dislocation		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27253	Treat hip dislocation	CH	J1	5113	34.1848	"$2,830.40"	.	$566.08					
27254	Treat hip dislocation	CH	J1	5113	34.1848	"$2,830.40"	.	$566.08					
27256	Treat hip dislocation		T	5111	2.4903	$206.19	.	$41.24					
27257	Treat hip dislocation		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27258	Treat hip dislocation	CH	J1	5113	34.1848	"$2,830.40"	.	$566.08					
27259	Treat hip dislocation	CH	J1	5113	34.1848	"$2,830.40"	.	$566.08					
27265	Treat hip dislocation		T	5111	2.4903	$206.19	.	$41.24					
27266	Treat hip dislocation		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27267	Cltx thigh fx		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27268	Cltx thigh fx w/mnpj	CH	J1	5113	34.1848	"$2,830.40"	.	$566.08					
27269	Optx thigh fx	CH	J1	5112	16.8164	"$1,392.35"	.	$278.47					
27275	Manipulation of hip joint		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27279	Arthrodesis sacroiliac joint		J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
27280	Fusion of sacroiliac joint	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
27282	Fusion of pubic bones	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27284	Fusion of hip joint	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
27286	Fusion of hip joint	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
27290	Amputation of leg at hip	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
27295	Amputation of leg at hip	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
27299	Pelvis/hip joint surgery		T	5111	2.4903	$206.19	.	$41.24					
27301	Drain thigh/knee lesion		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27303	Drainage of bone lesion	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27305	Incise thigh tendon & fascia		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27306	Incision of thigh tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27307	Incision of thigh tendons		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27310	Exploration of knee joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27323	Biopsy thigh soft tissues		J1	5072	16.9934	"$1,407.00"	.	$281.41					
27324	Biopsy thigh soft tissues		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27325	Neurectomy hamstring		J1	5431	21.1890	"$1,754.39"	.	$350.88					
27326	Neurectomy popliteal		J1	5431	21.1890	"$1,754.39"	.	$350.88					
27327	Exc thigh/knee les sc < 3 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
27328	Exc thigh/knee tum deep <5cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27329	Resect thigh/knee tum < 5 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27330	Biopsy knee joint lining		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27331	Explore/treat knee joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27332	Removal of knee cartilage		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27333	Removal of knee cartilage		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27334	Remove knee joint lining		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27335	Remove knee joint lining		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27337	Exc thigh/knee les sc 3 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27339	Exc thigh/knee tum dep 5cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27340	Removal of kneecap bursa		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27345	Removal of knee cyst		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27347	Remove knee cyst		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27350	Removal of kneecap		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27355	Remove femur lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27356	Remove femur lesion/graft		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27357	Remove femur lesion/graft		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27358	Remove femur lesion/fixation		N										
27360	Partial removal leg bone(s)		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27364	Resect thigh/knee tum 5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27365	Resect femur/knee tumor	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27369	Njx cntrst kne arthg/ct/mri		N										
27372	Removal of foreign body		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27380	Repair of kneecap tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27381	Repair/graft kneecap tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27385	Repair of thigh muscle		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27386	Repair/graft of thigh muscle		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27390	Incision of thigh tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27391	Incision of thigh tendons		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27392	Incision of thigh tendons		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27393	Lengthening of thigh tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27394	Lengthening of thigh tendons		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27395	Lengthening of thigh tendons		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27396	Transplant of thigh tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27397	Transplants of thigh tendons		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27400	Revise thigh muscles/tendons		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27403	Repair of knee cartilage		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27405	Repair of knee ligament		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27407	Repair of knee ligament		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27409	Repair of knee ligaments		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27412	Autochondrocyte implant knee		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27415	Osteochondral knee allograft		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27416	Osteochondral knee autograft		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27418	Repair degenerated kneecap		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27420	Revision of unstable kneecap		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27422	Revision of unstable kneecap		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27424	Revision/removal of kneecap		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27425	Lat retinacular release open		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27427	Reconstruction knee		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27428	Reconstruction knee		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27429	Reconstruction knee		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27430	Revision of thigh muscles		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27435	Incision of knee joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27437	Revise kneecap		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27438	Revise kneecap with implant		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27440	Revision of knee joint		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27441	Revision of knee joint		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27442	Revision of knee joint		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27443	Revision of knee joint		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27445	Revision of knee joint	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27446	Revision of knee joint		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27447	Total knee arthroplasty		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27448	Incision of thigh	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27450	Incision of thigh	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27454	Realignment of thigh bone	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27455	Realignment of knee	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27457	Realignment of knee	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27465	Shortening of thigh bone	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27466	Lengthening of thigh bone	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27468	Shorten/lengthen thighs	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27470	Repair of thigh	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27472	Repair/graft of thigh	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27475	Surgery to stop leg growth		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27477	Surgery to stop leg growth		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27479	Surgery to stop leg growth		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27485	Surgery to stop leg growth		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27486	Revise/replace knee joint	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27487	Revise/replace knee joint	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27488	Removal of knee prosthesis	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27495	Reinforce thigh	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27496	Decompression of thigh/knee		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27497	Decompression of thigh/knee		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27498	Decompression of thigh/knee		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27499	Decompression of thigh/knee		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27500	Treatment of thigh fracture		T	5111	2.4903	$206.19	.	$41.24					
27501	Treatment of thigh fracture		T	5111	2.4903	$206.19	.	$41.24					
27502	Treatment of thigh fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27503	Treatment of thigh fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27506	Treatment of thigh fracture	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27507	Treatment of thigh fracture	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27508	Treatment of thigh fracture		T	5111	2.4903	$206.19	.	$41.24					
27509	Treatment of thigh fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27510	Treatment of thigh fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27511	Treatment of thigh fracture	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27513	Treatment of thigh fracture	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27514	Treatment of thigh fracture	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27516	Treat thigh fx growth plate		T	5111	2.4903	$206.19	.	$41.24					
27517	Treat thigh fx growth plate		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27519	Treat thigh fx growth plate	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27520	Treat kneecap fracture		T	5111	2.4903	$206.19	.	$41.24					
27524	Treat kneecap fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27530	Treat knee fracture		T	5111	2.4903	$206.19	.	$41.24					
27532	Treat knee fracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27535	Treat knee fracture	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27536	Treat knee fracture	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27538	Treat knee fracture(s)		T	5111	2.4903	$206.19	.	$41.24					
27540	Treat knee fracture	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27550	Treat knee dislocation		T	5111	2.4903	$206.19	.	$41.24					
27552	Treat knee dislocation		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27556	Treat knee dislocation	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27557	Treat knee dislocation	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27558	Treat knee dislocation	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27560	Treat kneecap dislocation		T	5111	2.4903	$206.19	.	$41.24					
27562	Treat kneecap dislocation		T	5111	2.4903	$206.19	.	$41.24					
27566	Treat kneecap dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27570	Fixation of knee joint		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27580	Fusion of knee	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27590	Amputate leg at thigh	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
27591	Amputate leg at thigh	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
27592	Amputate leg at thigh	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
27594	Amputation follow-up surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27596	Amputation follow-up surgery	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27598	Amputate lower leg at knee	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27599	Leg surgery procedure		T	5111	2.4903	$206.19	.	$41.24					
27600	Decompression of lower leg		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27601	Decompression of lower leg		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27602	Decompression of lower leg		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27603	Drain lower leg lesion		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27604	Drain lower leg bursa		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27605	Incision of achilles tendon		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27606	Incision of achilles tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27607	Treat lower leg bone lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27610	Explore/treat ankle joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27612	Exploration of ankle joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27613	Biopsy lower leg soft tissue		J1	5072	16.9934	"$1,407.00"	.	$281.41					
27614	Biopsy lower leg soft tissue		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27615	Resect leg/ankle tum < 5 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27616	Resect leg/ankle tum 5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27618	Exc leg/ankle tum < 3 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
27619	Exc leg/ankle tum deep <5 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27620	Explore/treat ankle joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27625	Remove ankle joint lining		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27626	Remove ankle joint lining		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27630	Removal of tendon lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27632	Exc leg/ankle les sc 3 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27634	Exc leg/ankle tum dep 5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
27635	Remove lower leg bone lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27637	Remove/graft leg bone lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27638	Remove/graft leg bone lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27640	Partial removal of tibia		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27641	Partial removal of fibula		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27645	Resect tibia tumor	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27646	Resect fibula tumor	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27647	Resect talus/calcaneus tum		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27648	Injection for ankle x-ray		N										
27650	Repair achilles tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27652	Repair/graft achilles tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27654	Repair of achilles tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27656	Repair leg fascia defect		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27658	Repair of leg tendon each		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27659	Repair of leg tendon each		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27664	Repair of leg tendon each		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27665	Repair of leg tendon each		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27675	Repair lower leg tendons		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27676	Repair lower leg tendons		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27680	Release of lower leg tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27681	Release of lower leg tendons		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27685	Revision of lower leg tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27686	Revise lower leg tendons		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27687	Revision of calf tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27690	Revise lower leg tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27691	Revise lower leg tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27692	Revise additional leg tendon		N										
27695	Repair of ankle ligament		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27696	Repair of ankle ligaments		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27698	Repair of ankle ligament		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27700	Revision of ankle joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27702	Reconstruct ankle joint	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27703	Reconstruction ankle joint	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27704	Removal of ankle implant		Q2	5113	34.1848	"$2,830.40"	.	$566.08					
27705	Incision of tibia		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27707	Incision of fibula		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27709	Incision of tibia & fibula		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27712	Realignment of lower leg	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27715	Revision of lower leg	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27720	Repair of tibia		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27722	Repair/graft of tibia		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27724	Repair/graft of tibia	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27725	Repair of lower leg	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27726	Repair fibula nonunion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27727	Repair of lower leg	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27730	Repair of tibia epiphysis		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27732	Repair of fibula epiphysis		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27734	Repair lower leg epiphyses		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27740	Repair of leg epiphyses		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27742	Repair of leg epiphyses		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27745	Reinforce tibia		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27750	Treatment of tibia fracture		T	5111	2.4903	$206.19	.	$41.24					
27752	Treatment of tibia fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27756	Treatment of tibia fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27758	Treatment of tibia fracture		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27759	Treatment of tibia fracture		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27760	Cltx medial ankle fx		T	5111	2.4903	$206.19	.	$41.24					
27762	Cltx med ankle fx w/mnpj		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27766	Optx medial ankle fx		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27767	Cltx post ankle fx		T	5111	2.4903	$206.19	.	$41.24					
27768	Cltx post ankle fx w/mnpj		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27769	Optx post ankle fx		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27780	Treatment of fibula fracture		T	5111	2.4903	$206.19	.	$41.24					
27781	Treatment of fibula fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27784	Treatment of fibula fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27786	Treatment of ankle fracture		T	5111	2.4903	$206.19	.	$41.24					
27788	Treatment of ankle fracture		T	5111	2.4903	$206.19	.	$41.24					
27792	Treatment of ankle fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27808	Treatment of ankle fracture		T	5111	2.4903	$206.19	.	$41.24					
27810	Treatment of ankle fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27814	Treatment of ankle fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27816	Treatment of ankle fracture		T	5111	2.4903	$206.19	.	$41.24					
27818	Treatment of ankle fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27822	Treatment of ankle fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27823	Treatment of ankle fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27824	Treat lower leg fracture		T	5111	2.4903	$206.19	.	$41.24					
27825	Treat lower leg fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27826	Treat lower leg fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27827	Treat lower leg fracture		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27828	Treat lower leg fracture		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27829	Treat lower leg joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27830	Treat lower leg dislocation		T	5111	2.4903	$206.19	.	$41.24					
27831	Treat lower leg dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27832	Treat lower leg dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27840	Treat ankle dislocation		T	5111	2.4903	$206.19	.	$41.24					
27842	Treat ankle dislocation		J1	5112	16.8164	"$1,392.35"	.	$278.47					
27846	Treat ankle dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27848	Treat ankle dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27860	Fixation of ankle joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27870	Fusion of ankle joint open		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27871	Fusion of tibiofibular joint		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27880	Amputation of lower leg	CH	J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
27881	Amputation of lower leg	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27882	Amputation of lower leg	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27884	Amputation follow-up surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27886	Amputation follow-up surgery	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27888	Amputation of foot at ankle	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
27889	Amputation of foot at ankle		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27892	Decompression of leg		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27893	Decompression of leg		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
27894	Decompression of leg		J1	5113	34.1848	"$2,830.40"	.	$566.08					
27899	Leg/ankle surgery procedure		T	5111	2.4903	$206.19	.	$41.24					
28001	Drainage of bursa of foot		J1	5072	16.9934	"$1,407.00"	.	$281.41					
28002	Treatment of foot infection		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28003	Treatment of foot infection		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28005	Treat foot bone lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28008	Incision of foot fascia		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28010	Incision of toe tendon		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28011	Incision of toe tendons		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28020	Exploration of foot joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28022	Exploration of foot joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28024	Exploration of toe joint		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28035	Decompression of tibia nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
28039	Exc foot/toe tum sc 1.5 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
28041	Exc foot/toe tum dep 1.5cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
28043	Exc foot/toe tum sc < 1.5 cm		J1	5072	16.9934	"$1,407.00"	.	$281.41					
28045	Exc foot/toe tum deep <1.5cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
28046	Resect foot/toe tumor < 3 cm		J1	5073	28.6243	"$2,370.01"	.	$474.01					
28047	Resect foot/toe tumor 3 cm/>		J1	5073	28.6243	"$2,370.01"	.	$474.01					
28050	Biopsy of foot joint lining		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28052	Biopsy of foot joint lining		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28054	Biopsy of toe joint lining		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28055	Neurectomy foot		J1	5431	21.1890	"$1,754.39"	.	$350.88					
28060	Partial removal foot fascia		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28062	Removal of foot fascia		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28070	Removal of foot joint lining		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28072	Removal of foot joint lining		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28080	Removal of foot lesion		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28086	Excise foot tendon sheath		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28088	Excise foot tendon sheath		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28090	Removal of foot lesion		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28092	Removal of toe lesions		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28100	Removal of ankle/heel lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28102	Remove/graft foot lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28103	Remove/graft foot lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28104	Removal of foot lesion		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28106	Remove/graft foot lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28107	Remove/graft foot lesion		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28108	Removal of toe lesions		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28110	Part removal of metatarsal		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28111	Part removal of metatarsal		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28112	Part removal of metatarsal		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28113	Part removal of metatarsal		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28114	Removal of metatarsal heads		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28116	Revision of foot		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28118	Removal of heel bone		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28119	Removal of heel spur		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28120	Part removal of ankle/heel		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28122	Partial removal of foot bone		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28124	Partial removal of toe		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28126	Partial removal of toe		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28130	Removal of ankle bone		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28140	Removal of metatarsal		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28150	Removal of toe		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28153	Partial removal of toe		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28160	Partial removal of toe		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28171	Resect tarsal tumor		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28173	Resect metatarsal tumor		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28175	Resect phalanx of toe tumor		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28190	Removal of foot foreign body		T	5071	7.5120	$621.97	.	$124.40					
28192	Removal of foot foreign body		J1	5072	16.9934	"$1,407.00"	.	$281.41					
28193	Removal of foot foreign body		J1	5072	16.9934	"$1,407.00"	.	$281.41					
28200	Repair of foot tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28202	Repair/graft of foot tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28208	Repair of foot tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28210	Repair/graft of foot tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28220	Release of foot tendon		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28222	Release of foot tendons		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28225	Release of foot tendon		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28226	Release of foot tendons		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28230	Incision of foot tendon(s)		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28232	Incision of toe tendon		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28234	Incision of foot tendon		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28238	Revision of foot tendon		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28240	Release of big toe		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28250	Revision of foot fascia		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28260	Release of midfoot joint		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28261	Revision of foot tendon		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28262	Revision of foot and ankle		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28264	Release of midfoot joint		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28270	Release of foot contracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28272	Release of toe joint each		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28280	Fusion of toes		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28285	Repair of hammertoe		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28286	Repair of hammertoe		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28288	Partial removal of foot bone		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28289	Corrj halux rigdus w/o implt		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28291	Corrj halux rigdus w/implt		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28292	Correction hallux valgus		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28295	Correction hallux valgus		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28296	Correction hallux valgus		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28297	Correction hallux valgus		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28298	Correction hallux valgus		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28299	Correction hallux valgus		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28300	Incision of heel bone		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28302	Incision of ankle bone		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28304	Incision of midfoot bones		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28305	Incise/graft midfoot bones		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28306	Incision of metatarsal		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28307	Incision of metatarsal		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28308	Incision of metatarsal		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28309	Incision of metatarsals		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28310	Revision of big toe		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28312	Revision of toe		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28313	Repair deformity of toe		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28315	Removal of sesamoid bone		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28320	Repair of foot bones		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
28322	Repair of metatarsals		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28340	Resect enlarged toe tissue		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28341	Resect enlarged toe		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28344	Repair extra toe(s)		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28345	Repair webbed toe(s)		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28360	Reconstruct cleft foot		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28400	Treatment of heel fracture		T	5111	2.4903	$206.19	.	$41.24					
28405	Treatment of heel fracture		T	5111	2.4903	$206.19	.	$41.24					
28406	Treatment of heel fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28415	Treat heel fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28420	Treat/graft heel fracture		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
28430	Treatment of ankle fracture		T	5111	2.4903	$206.19	.	$41.24					
28435	Treatment of ankle fracture		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28436	Treatment of ankle fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28445	Treat ankle fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28446	Osteochondral talus autogrft		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28450	Treat midfoot fracture each		T	5111	2.4903	$206.19	.	$41.24					
28455	Treat midfoot fracture each		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28456	Treat midfoot fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28465	Treat midfoot fracture each		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28470	Treat metatarsal fracture		T	5111	2.4903	$206.19	.	$41.24					
28475	Treat metatarsal fracture		T	5111	2.4903	$206.19	.	$41.24					
28476	Treat metatarsal fracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28485	Treat metatarsal fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28490	Treat big toe fracture		T	5111	2.4903	$206.19	.	$41.24					
28495	Treat big toe fracture		T	5111	2.4903	$206.19	.	$41.24					
28496	Treat big toe fracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28505	Treat big toe fracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28510	Treatment of toe fracture		T	5111	2.4903	$206.19	.	$41.24					
28515	Treatment of toe fracture		T	5111	2.4903	$206.19	.	$41.24					
28525	Treat toe fracture		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28530	Treat sesamoid bone fracture		T	5111	2.4903	$206.19	.	$41.24					
28531	Treat sesamoid bone fracture		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28540	Treat foot dislocation		T	5111	2.4903	$206.19	.	$41.24					
28545	Treat foot dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28546	Treat foot dislocation		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28555	Repair foot dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28570	Treat foot dislocation		T	5111	2.4903	$206.19	.	$41.24					
28575	Treat foot dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28576	Treat foot dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28585	Repair foot dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28600	Treat foot dislocation		T	5111	2.4903	$206.19	.	$41.24					
28605	Treat foot dislocation		T	5111	2.4903	$206.19	.	$41.24					
28606	Treat foot dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28615	Repair foot dislocation		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28630	Treat toe dislocation		T	5111	2.4903	$206.19	.	$41.24					
28635	Treat toe dislocation		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28636	Treat toe dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28645	Repair toe dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28660	Treat toe dislocation		T	5111	2.4903	$206.19	.	$41.24					
28665	Treat toe dislocation		T	5102	2.9128	$241.17	.	$48.24					
28666	Treat toe dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28675	Repair of toe dislocation		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28705	Fusion of foot bones		J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
28715	Fusion of foot bones		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
28725	Fusion of foot bones		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
28730	Fusion of foot bones		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
28735	Fusion of foot bones		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
28737	Revision of foot bones		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
28740	Fusion of foot bones		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28750	Fusion of big toe joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28755	Fusion of big toe joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28760	Fusion of big toe joint		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
28800	Amputation of midfoot	CH	J1	5113	34.1848	"$2,830.40"	.	$566.08					
28805	Amputation thru metatarsal		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28810	Amputation toe & metatarsal		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28820	Amputation of toe		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28825	Partial amputation of toe		J1	5113	34.1848	"$2,830.40"	.	$566.08					
28890	Hi enrgy eswt plantar fascia		J1	5112	16.8164	"$1,392.35"	.	$278.47					
28899	Foot/toes surgery procedure		T	5111	2.4903	$206.19	.	$41.24					
29000	Application of body cast		T	5102	2.9128	$241.17	.	$48.24					
29010	Application of body cast		T	5102	2.9128	$241.17	.	$48.24					
29015	Application of body cast		T	5102	2.9128	$241.17	.	$48.24					
29035	Application of body cast		T	5102	2.9128	$241.17	.	$48.24					
29040	Application of body cast		T	5102	2.9128	$241.17	.	$48.24					
29044	Application of body cast		T	5101	1.7051	$141.18	.	$28.24					
29046	Application of body cast		T	5102	2.9128	$241.17	.	$48.24					
29049	Application of figure eight		T	5102	2.9128	$241.17	.	$48.24					
29055	Application of shoulder cast		T	5102	2.9128	$241.17	.	$48.24					
29058	Application of shoulder cast		T	5102	2.9128	$241.17	.	$48.24					
29065	Application of long arm cast		T	5102	2.9128	$241.17	.	$48.24					
29075	Application of forearm cast		T	5102	2.9128	$241.17	.	$48.24					
29085	Apply hand/wrist cast		T	5101	1.7051	$141.18	.	$28.24					
29086	Apply finger cast		T	5101	1.7051	$141.18	.	$28.24					
29105	Apply long arm splint		T	5101	1.7051	$141.18	.	$28.24					
29125	Apply forearm splint		Q1	5734	1.3521	$111.95	.	$22.39					
29126	Apply forearm splint		Q1	5734	1.3521	$111.95	.	$22.39					
29130	Application of finger splint	CH	Q1	5734	1.3521	$111.95	.	$22.39					
29131	Application of finger splint		Q1	5733	0.6722	$55.66	.	$11.14					
29200	Strapping of chest		T	5101	1.7051	$141.18	.	$28.24					
29240	Strapping of shoulder		Q1	5734	1.3521	$111.95	.	$22.39					
29260	Strapping of elbow or wrist	CH	Q1	5733	0.6722	$55.66	.	$11.14					
29280	Strapping of hand or finger	CH	Q1	5733	0.6722	$55.66	.	$11.14					
29305	Application of hip cast		T	5102	2.9128	$241.17	.	$48.24					
29325	Application of hip casts		T	5102	2.9128	$241.17	.	$48.24					
29345	Application of long leg cast		T	5102	2.9128	$241.17	.	$48.24					
29355	Application of long leg cast		T	5102	2.9128	$241.17	.	$48.24					
29358	Apply long leg cast brace		T	5102	2.9128	$241.17	.	$48.24					
29365	Application of long leg cast		T	5102	2.9128	$241.17	.	$48.24					
29405	Apply short leg cast		T	5102	2.9128	$241.17	.	$48.24					
29425	Apply short leg cast		T	5102	2.9128	$241.17	.	$48.24					
29435	Apply short leg cast		T	5102	2.9128	$241.17	.	$48.24					
29440	Addition of walker to cast		T	5101	1.7051	$141.18	.	$28.24					
29445	Apply rigid leg cast		T	5102	2.9128	$241.17	.	$48.24					
29450	Application of leg cast		T	5101	1.7051	$141.18	.	$28.24					
29505	Application long leg splint		T	5101	1.7051	$141.18	.	$28.24					
29515	Application lower leg splint		T	5101	1.7051	$141.18	.	$28.24					
29520	Strapping of hip	CH	Q1	5734	1.3521	$111.95	.	$22.39					
29530	Strapping of knee		Q1	5734	1.3521	$111.95	.	$22.39					
29540	Strapping of ankle and/or ft		T	5101	1.7051	$141.18	.	$28.24					
29550	Strapping of toes		Q1	5733	0.6722	$55.66	.	$11.14					
29580	Application of paste boot		T	5101	1.7051	$141.18	.	$28.24					
29581	Apply multlay comprs lwr leg		T	5101	1.7051	$141.18	.	$28.24					
29584	Appl multlay comprs arm/hand		T	5101	1.7051	$141.18	.	$28.24					
29700	Removal/revision of cast		T	5102	2.9128	$241.17	.	$48.24					
29705	Removal/revision of cast		T	5102	2.9128	$241.17	.	$48.24					
29710	Removal/revision of cast		T	5102	2.9128	$241.17	.	$48.24					
29720	Repair of body cast		T	5101	1.7051	$141.18	.	$28.24					
29730	Windowing of cast		T	5101	1.7051	$141.18	.	$28.24					
29740	Wedging of cast		T	5102	2.9128	$241.17	.	$48.24					
29750	Wedging of clubfoot cast		T	5102	2.9128	$241.17	.	$48.24					
29799	Casting/strapping procedure		T	5101	1.7051	$141.18	.	$28.24					
29800	Jaw arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29804	Jaw arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29805	Sho arthrs dx +- synovial bx		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29806	Sho arthrs srg capsulorpaphy		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29807	Sho arthrs srg rpr slap les		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29819	Sho arthrs srg rmvl loose/fb		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29820	Sho arthrs srg prtl synvct		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29821	Sho arthrs srg compl synvct		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29822	Sho arthrs srg lmtd dbrdmt		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29823	Sho arthrs srg xtnsv dbrdmt		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29824	Sho arthrs srg dstl claviclc		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29825	Sho arthrs srg lss&rescj ads		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29826	Sho arthrs srg decompression		N										
29827	Sho arthrs srg rt8tr cuf rpr		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29828	Sho arthrs srg bicp tenodsis		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29830	Elbow arthroscopy		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29834	Elbow arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29835	Elbow arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29836	Elbow arthroscopy/surgery		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29837	Elbow arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29838	Elbow arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29840	Wrist arthroscopy		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29843	Wrist arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29844	Wrist arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29845	Wrist arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29846	Wrist arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29847	Wrist arthroscopy/surgery		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29848	Wrist endoscopy/surgery		J1	5112	16.8164	"$1,392.35"	.	$278.47					
29850	Knee arthroscopy/surgery		J1	5112	16.8164	"$1,392.35"	.	$278.47					
29851	Knee arthroscopy/surgery		J1	5112	16.8164	"$1,392.35"	.	$278.47					
29855	Tibial arthroscopy/surgery		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29856	Tibial arthroscopy/surgery		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
29860	Hip arthroscopy dx		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29861	Hip arthro w/fb removal		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29862	Hip arthr0 w/debridement		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29863	Hip arthr0 w/synovectomy		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29866	Autgrft implnt knee w/scope		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29867	Allgrft implnt knee w/scope		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
29868	Meniscal trnspl knee w/scpe		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29870	Knee arthroscopy dx		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29871	Knee arthroscopy/drainage		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29873	Knee arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29874	Knee arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29875	Knee arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29876	Knee arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29877	Knee arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29879	Knee arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29880	Knee arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29881	Knee arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29882	Knee arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29883	Knee arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29884	Knee arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29885	Knee arthroscopy/surgery		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29886	Knee arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29887	Knee arthroscopy/surgery		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29888	Knee arthroscopy/surgery		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29889	Knee arthroscopy/surgery		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
29891	Ankle arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29892	Ankle arthroscopy/surgery		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29893	Scope plantar fasciotomy		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29894	Ankle arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29895	Ankle arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29897	Ankle arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29898	Ankle arthroscopy/surgery		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29899	Ankle arthroscopy/surgery		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29900	Mcp joint arthroscopy dx		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29901	Mcp joint arthroscopy surg		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29902	Mcp joint arthroscopy surg		J1	5112	16.8164	"$1,392.35"	.	$278.47					
29904	Subtalar arthro w/fb rmvl		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29905	Subtalar arthro w/exc		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29906	Subtalar arthro w/deb		J1	5113	34.1848	"$2,830.40"	.	$566.08					
29907	Subtalar arthro w/fusion		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
29914	Hip arthro w/femoroplasty		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29915	Hip arthro acetabuloplasty		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29916	Hip arthro w/labral repair		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
29999	Arthroscopy of joint		T	5111	2.4903	$206.19	.	$41.24					
30000	Drainage of nose lesion		T	5161	2.5557	$211.60	.	$42.33					
30020	Drainage of nose lesion		T	5162	5.4635	$452.36	.	$90.48					
3006F	Cxr doc rev		E1										
3008F	Body mass index docd		E1										
30100	Intranasal biopsy		J1	5163	16.3386	"$1,352.79"	.	$270.56					
30110	Removal of nose polyp(s)		J1	5163	16.3386	"$1,352.79"	.	$270.56					
30115	Removal of nose polyp(s)		J1	5164	33.0494	"$2,736.39"	.	$547.28					
30117	Removal of intranasal lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
30118	Removal of intranasal lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
3011F	Lipid panel doc rev		E1										
30120	Revision of nose		J1	5164	33.0494	"$2,736.39"	.	$547.28					
30124	Removal of nose lesion		J1	5163	16.3386	"$1,352.79"	.	$270.56					
30125	Removal of nose lesion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
30130	Excise inferior turbinate		J1	5164	33.0494	"$2,736.39"	.	$547.28					
30140	Resect inferior turbinate		J1	5164	33.0494	"$2,736.39"	.	$547.28					
3014F	Screen mammo doc rev		E1										
30150	Partial removal of nose		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
3015F	Cerv cancer screen docd		E1										
30160	Removal of nose		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
3016F	Pt scrnd unhlthy oh use		E1										
3017F	Colorectal ca screen doc rev		M										
3018F	Pre-prxd rsk et al docd		E1										
3019F	Lvef assess planpost dschrge		E1										
30200	Injection treatment of nose		T	5162	5.4635	$452.36	.	$90.48					
3020F	Lvf assess		E1										
30210	Nasal sinus therapy		J1	5163	16.3386	"$1,352.79"	.	$270.56					
3021F	Lvef mod/sever deprs syst		M										
30220	Insert nasal septal button		J1	5163	16.3386	"$1,352.79"	.	$270.56					
3022F	Lvef >/=40% systolic		M										
3023F	Spirom doc rev		M										
3025F	Spirom fev/fvc <70% w/copd		E1										
3027F	Spirom fev/fvc>/=70%/w/ocopd		E1										
3028F	O2 saturation doc rev		E1										
30300	Remove nasal foreign body		Q1	5734	1.3521	$111.95	.	$22.39					
30310	Remove nasal foreign body		J1	5164	33.0494	"$2,736.39"	.	$547.28					
30320	Remove nasal foreign body		J1	5163	16.3386	"$1,352.79"	.	$270.56					
3035F	O2 saturation</=88%/pao</=55		E1										
3037F	O2 saturation >88%/pao>55 hg		E1										
3038F	Pulm fx w/in 12 mon b/4 surg		E1										
30400	Reconstruction of nose		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
3040F	Fev <40% predicted value		E1										
30410	Reconstruction of nose		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
30420	Reconstruction of nose		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
3042F	Fev >/=40% predicted value		E1										
30430	Revision of nose		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
30435	Revision of nose		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
3044F	Hg a1c level lt 7.0%		M										
30450	Revision of nose		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
30460	Revision of nose		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
30462	Revision of nose		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
30465	Repair nasal stenosis		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
30468	Rpr nsl vlv collapse w/implt	NC	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
3046F	Hemoglobin a1c level >9.0%		M										
3048F	Ldl-c <100 mg/dl		E1										
3049F	Ldl-c 100-129 mg/dl		E1										
3050F	Ldl-c >/= 130 mg/dl		E1										
3051F	Hg a1c>equal 7.0%<8.0%		E1										
30520	Repair of nasal septum		J1	5164	33.0494	"$2,736.39"	.	$547.28					
3052F	Hg a1c>equal 8.0%<equal 9.0%		E1										
30540	Repair nasal defect		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
30545	Repair nasal defect		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
3055F	Lvef less than/equal to 35%		E1										
30560	Release of nasal adhesions		T	5162	5.4635	$452.36	.	$90.48					
3056F	Lvef greater than 35%		E1										
30580	Repair upper jaw fistula		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
30600	Repair mouth/nose fistula		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
3060F	Pos microalbuminuria rev		M										
3061F	Neg microalbuminuria rev		M										
30620	Intranasal reconstruction		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
3062F	Pos macroalbuminuria rev		M										
30630	Repair nasal septum defect		J1	5164	33.0494	"$2,736.39"	.	$547.28					
3066F	Nephropathy doc tx		M										
3072F	Low risk for retinopathy		M										
3073F	Pre-surg eye measures docd		E1										
3074F	Syst bp lt 130 mm hg		E1										
3075F	Syst bp ge 130 - 139mm hg		E1										
3077F	Syst bp >/= 140 mm hg		E1										
3078F	Diast bp <80 mm hg		E1										
3079F	Diast bp 80-89 mm hg		E1										
30801	Ablate inf turbinate superf		J1	5163	16.3386	"$1,352.79"	.	$270.56					
30802	Ablate inf turbinate submuc		J1	5163	16.3386	"$1,352.79"	.	$270.56					
3080F	Diast bp >/= 90 mm hg		E1										
3082F	Kt/v <1.2		E1										
3083F	Kt/v =/> 1.2 & <1.7		E1										
3084F	Kt/v >= 1.7		E1										
3085F	Suicide risk assessed		E1										
3088F	Mdd mild		E1										
3089F	Mdd moderate		E1										
30901	Control of nosebleed		Q1	5734	1.3521	$111.95	.	$22.39					
30903	Control of nosebleed		T	5734	1.3521	$111.95	.	$22.39					
30905	Control of nosebleed		T	5734	1.3521	$111.95	.	$22.39					
30906	Repeat control of nosebleed		T	5161	2.5557	$211.60	.	$42.33					
3090F	Mdd severe w/o psych		E1										
30915	Ligation nasal sinus artery		J1	5183	34.5624	"$2,861.66"	.	$572.34					
3091F	Mdd severe w/psych		E1										
30920	Ligation upper jaw artery		J1	5183	34.5624	"$2,861.66"	.	$572.34					
3092F	Mdd in remission		E1										
30930	Ther fx nasal inf turbinate		J1	5164	33.0494	"$2,736.39"	.	$547.28					
3093F	Doc new diag 1st/addl mdd		E1										
3095F	Central dexa results docd		M										
3096F	Central dexa ordered		E1										
30999	Nasal surgery procedure		T	5161	2.5557	$211.60	.	$42.33					
31000	Irrigation maxillary sinus		T	5161	2.5557	$211.60	.	$42.33					
31002	Irrigation sphenoid sinus		J1	5163	16.3386	"$1,352.79"	.	$270.56					
3100F	Image test ref carot diam		M										
31020	Exploration maxillary sinus		J1	5164	33.0494	"$2,736.39"	.	$547.28					
31030	Exploration maxillary sinus		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31032	Explore sinus remove polyps		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31040	Exploration behind upper jaw		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31050	Exploration sphenoid sinus		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31051	Sphenoid sinus surgery		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31070	Exploration of frontal sinus		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31075	Exploration of frontal sinus		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31080	Removal of frontal sinus		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31081	Removal of frontal sinus		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31084	Removal of frontal sinus		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31085	Removal of frontal sinus		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31086	Removal of frontal sinus		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31087	Removal of frontal sinus		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31090	Exploration of sinuses		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
3110F	Pres/absn hmrhg/lesion docd		E1										
3111F	Ct/mri brain done w/in 24hrs		E1										
3112F	Ct/mri brain done 24 hrs		E1										
3115F	Quant results activity &symp		E1										
3117F	Hf assessment tool completed		E1										
3118F	Ny heart assoc class docd		E1										
3119F	No eval activity clin symp		E1										
31200	Removal of ethmoid sinus		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31201	Removal of ethmoid sinus		J1	5163	16.3386	"$1,352.79"	.	$270.56					
31205	Removal of ethmoid sinus		J1	5164	33.0494	"$2,736.39"	.	$547.28					
3120F	12-lead ecg performed		E1										
31225	Removal of upper jaw		C										
31230	Removal of upper jaw		C										
31231	Nasal endoscopy dx		T	5151	1.9855	$164.39	.	$32.88					
31233	Nsl/sins ndsc dx max sinusc		T	5152	4.5474	$376.51	.	$75.31					
31235	Nsl/sins ndsc dx sphn sinusc		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31237	Nasal/sinus endoscopy surg		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31238	Nasal/sinus endoscopy surg		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31239	Nasal/sinus endoscopy surg		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31240	Nasal/sinus endoscopy surg		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31241	Nsl/sins ndsc w/artery lig		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31253	Nsl/sins ndsc total		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31254	Nsl/sins ndsc w/prtl ethmdct		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31255	Nsl/sins ndsc w/tot ethmdct		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31256	Exploration maxillary sinus		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31257	Nsl/sins ndsc tot w/sphendt		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31259	Nsl/sins ndsc sphn tiss rmvl		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31267	Endoscopy maxillary sinus		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
3126F	Esoph bx rprt w/dyspl info		M										
31276	Nsl/sins ndsc frnt tiss rmvl		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31287	Nasal/sinus endoscopy surg		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31288	Nasal/sinus endoscopy surg		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31290	Nasal/sinus endoscopy surg		C										
31291	Nasal/sinus endoscopy surg		C										
31292	Nsl/sins ndsc med/inf dcmprn		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31293	Nsl/sins ndsc med&inf dcmprn		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31294	Nsl/sins ndsc surg on dcmprn		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31295	Nsl/sins ndsc surg max sins		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31296	Nsl/sins ndsc surg frnt sins		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31297	Nsl/sins ndsc surg sphn sins		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31298	Nsl/sins ndsc surg frnt&sphn		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31299	Sinus surgery procedure		T	5161	2.5557	$211.60	.	$42.33					
31300	Removal of larynx lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
3130F	Upper gi endoscopy performed		E1										
3132F	Doc ref upper gi endoscopy		E1										
31360	Removal of larynx		C										
31365	Removal of larynx		C										
31367	Partial removal of larynx		C										
31368	Partial removal of larynx		C										
31370	Partial removal of larynx		C										
31375	Partial removal of larynx		C										
31380	Partial removal of larynx		C										
31382	Partial removal of larynx		C										
31390	Removal of larynx & pharynx		C										
31395	Reconstruct larynx & pharynx		C										
31400	Revision of larynx		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
3140F	Upper gi endo shows barrtts		E1										
3141F	Upper gi endo not barrtts		E1										
31420	Removal of epiglottis		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
3142F	Barium swallow test ordered		E1										
31500	Insert emergency airway		T	5161	2.5557	$211.60	.	$42.33					
31502	Change of windpipe airway		T	5161	2.5557	$211.60	.	$42.33					
31505	Diagnostic laryngoscopy		T	5151	1.9855	$164.39	.	$32.88					
3150F	Forceps esoph biopsy done		E1										
31510	Laryngoscopy with biopsy		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31511	Remove foreign body larynx		T	5151	1.9855	$164.39	.	$32.88					
31512	Removal of larynx lesion		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31513	Injection into vocal cord		T	5152	4.5474	$376.51	.	$75.31					
31515	Laryngoscopy for aspiration		T	5152	4.5474	$376.51	.	$75.31					
31520	Dx laryngoscopy newborn		T	5152	4.5474	$376.51	.	$75.31					
31525	Dx laryngoscopy excl nb		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31526	Dx laryngoscopy w/oper scope		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31527	Laryngoscopy for treatment		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31528	Laryngoscopy and dilation		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31529	Laryngoscopy and dilation		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31530	Laryngoscopy w/fb removal		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31531	Laryngoscopy w/fb & op scope		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31535	Laryngoscopy w/biopsy		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31536	Laryngoscopy w/bx & op scope		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31540	Laryngoscopy w/exc of tumor		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31541	Larynscop w/tumr exc + scope		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31545	Remove vc lesion w/scope		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31546	Remove vc lesion scope/graft		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31551	Laryngoplasty laryngeal sten		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31552	Laryngoplasty laryngeal sten		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31553	Laryngoplasty laryngeal sten		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31554	Laryngoplasty laryngeal sten		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
3155F	Cytogen test marrow b/4 tx		M										
31560	Laryngoscop w/arytenoidectom		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31561	Larynscop remve cart + scop		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31570	Laryngoscope w/vc inj		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31571	Laryngoscop w/vc inj + scope		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31572	Largsc w/laser dstrj les		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31573	Largsc w/ther injection		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31574	Largsc w/njx augmentation		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31575	Diagnostic laryngoscopy		T	5151	1.9855	$164.39	.	$32.88					
31576	Laryngoscopy with biopsy		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31577	Largsc w/rmvl foreign bdy(s)		T	5152	4.5474	$376.51	.	$75.31					
31578	Largsc w/removal lesion		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31579	Laryngoscopy telescopic		T	5152	4.5474	$376.51	.	$75.31					
31580	Laryngoplasty laryngeal web		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31584	Laryngoplasty fx rdctj fixj		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31587	Laryngoplasty cricoid split		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31590	Reinnervate larynx		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31591	Laryngoplasty medialization		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31592	Cricotracheal resection		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31599	Larynx surgery procedure		T	5161	2.5557	$211.60	.	$42.33					
31600	Incision of windpipe		J1	5164	33.0494	"$2,736.39"	.	$547.28					
31601	Incision of windpipe		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31603	Incision of windpipe		J1	5163	16.3386	"$1,352.79"	.	$270.56					
31605	Incision of windpipe		T	5161	2.5557	$211.60	.	$42.33					
3160F	Doc fe+ stores b/4 epo thx		M										
31610	Incision of windpipe		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31611	Surgery/speech prosthesis		J1	5164	33.0494	"$2,736.39"	.	$547.28					
31612	Puncture/clear windpipe		J1	5164	33.0494	"$2,736.39"	.	$547.28					
31613	Repair windpipe opening		J1	5164	33.0494	"$2,736.39"	.	$547.28					
31614	Repair windpipe opening		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31615	Visualization of windpipe		T	5162	5.4635	$452.36	.	$90.48					
31622	Dx bronchoscope/wash		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31623	Dx bronchoscope/brush		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31624	Dx bronchoscope/lavage		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31625	Bronchoscopy w/biopsy(s)		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31626	Bronchoscopy w/markers		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31627	Navigational bronchoscopy		N										
31628	Bronchoscopy/lung bx each		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31629	Bronchoscopy/needle bx each		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31630	Bronchoscopy dilate/fx repr		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31631	Bronchoscopy dilate w/stent		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31632	Bronchoscopy/lung bx addl		N										
31633	Bronchoscopy/needle bx addl		N										
31634	Bronch w/balloon occlusion		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31635	Bronchoscopy w/fb removal		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31636	Bronchoscopy bronch stents		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31637	Bronchoscopy stent add-on		N										
31638	Bronchoscopy revise stent		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31640	Bronchoscopy w/tumor excise		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31641	Bronchoscopy treat blockage		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31643	Diag bronchoscope/catheter		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31645	Brnchsc w/ther aspir 1st		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31646	Brnchsc w/ther aspir sbsq		T	5152	4.5474	$376.51	.	$75.31					
31647	Bronchial valve init insert		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31648	Bronchial valve remov init		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31649	Bronchial valve remov addl		Q2	5153	18.0730	"$1,496.39"	.	$299.28					
31651	Bronchial valve addl insert		N										
31652	Bronch ebus samplng 1/2 node		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31653	Bronch ebus samplng 3/> node		J1	5154	37.4170	"$3,098.02"	.	$619.61					
31654	Bronch ebus ivntj perph les		N										
31660	Bronch thermoplsty 1 lobe		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
31661	Bronch thermoplsty 2/> lobes		J1	5155	70.3257	"$5,822.76"	.	"$1,164.56"					
3170F	Baselin flo cytometry b/4 tx		M										
31717	Bronchial brush biopsy		T	5152	4.5474	$376.51	.	$75.31					
31720	Clearance of airways		Q1	5791	2.2692	$187.88	.	$37.58					
31725	Clearance of airways		C										
31730	Intro windpipe wire/tube		J1	5153	18.0730	"$1,496.39"	.	$299.28					
31750	Repair of windpipe		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31755	Repair of windpipe		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31760	Repair of windpipe		C										
31766	Reconstruction of windpipe		C										
31770	Repair/graft of bronchus		C										
31775	Reconstruct bronchus		C										
31780	Reconstruct windpipe		C										
31781	Reconstruct windpipe		C										
31785	Remove windpipe lesion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
31786	Remove windpipe lesion		C										
31800	Repair of windpipe injury		C										
31805	Repair of windpipe injury		C										
31820	Closure of windpipe lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
31825	Repair of windpipe defect		J1	5164	33.0494	"$2,736.39"	.	$547.28					
31830	Revise windpipe scar		J1	5164	33.0494	"$2,736.39"	.	$547.28					
31899	Airways surgical procedure		T	5151	1.9855	$164.39	.	$32.88					
3200F	Barium swallow test not req		E1										
32035	Thoracostomy w/rib resection		C										
32036	Thoracostomy w/flap drainage		C										
32096	Open wedge/bx lung infiltr		C										
32097	Open wedge/bx lung nodule		C										
32098	Open biopsy of lung pleura		C										
32100	Exploration of chest		C										
3210F	Grp a strep test performed		M										
32110	Explore/repair chest		C										
32120	Re-exploration of chest		C										
32124	Explore chest free adhesions		C										
32140	Removal of lung lesion(s)		C										
32141	Remove/treat lung lesions		C										
32150	Removal of lung lesion(s)		C										
32151	Remove lung foreign body		C										
3215F	Pt immunity to hep a docd		E1										
32160	Open chest heart massage		C										
3216F	Pt immunity to hep b docd		E1										
3218F	Rna tstng hep c docd done		E1										
32200	Drain open lung lesion		C										
3220F	Hep c quant rna tstng docd		E1										
32215	Treat chest lining		C										
32220	Release of lung		C										
32225	Partial release of lung		C										
3230F	Note hring tst w/in 6 mon		E1										
32310	Removal of chest lining		C										
32320	Free/remove chest lining		C										
32400	Needle biopsy chest lining		J1	5072	16.9934	"$1,407.00"	.	$281.41					
32405	Percut bx lung/mediastinum	CH	D										
32408	Core ndl bx lng/med perq	NC	J1	5072	16.9934	"$1,407.00"	.	$281.41					
32440	Remove lung pneumonectomy		C										
32442	Sleeve pneumonectomy		C										
32445	Removal of lung extrapleural		C										
32480	Partial removal of lung		C										
32482	Bilobectomy		C										
32484	Segmentectomy		C										
32486	Sleeve lobectomy		C										
32488	Completion pneumonectomy		C										
32491	Lung volume reduction		C										
32501	Repair bronchus add-on		C										
32503	Resect apical lung tumor		C										
32504	Resect apical lung tum/chest		C										
32505	Wedge resect of lung initial		C										
32506	Wedge resect of lung add-on		C										
32507	Wedge resect of lung diag		C										
3250F	Nonprim loc anat bx site tum		M										
32540	Removal of lung lesion		C										
32550	Insert pleural cath		J1	5341	38.4484	"$3,183.41"	.	$636.69					
32551	Insertion of chest tube		J1	5182	16.9830	"$1,406.14"	.	$281.23					
32552	Remove lung catheter		Q2	5181	6.5415	$541.62	.	$108.33					
32553	Ins mark thor for rt perq		S	5613	15.2443	"$1,262.18"	.	$252.44					
32554	Aspirate pleura w/o imaging		T	5181	6.5415	$541.62	.	$108.33					
32555	Aspirate pleura w/ imaging		T	5181	6.5415	$541.62	.	$108.33					
32556	Insert cath pleura w/o image		J1	5302	19.6265	"$1,625.02"	.	$325.01					
32557	Insert cath pleura w/ image		J1	5182	16.9830	"$1,406.14"	.	$281.23					
32560	Treat pleurodesis w/agent		T	5181	6.5415	$541.62	.	$108.33					
32561	Lyse chest fibrin init day		T	5181	6.5415	$541.62	.	$108.33					
32562	Lyse chest fibrin subq day		T	5181	6.5415	$541.62	.	$108.33					
32601	Thoracoscopy diagnostic		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
32604	Thoracoscopy wbx sac		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
32606	Thoracoscopy w/bx med space		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
32607	Thoracoscopy w/bx infiltrate		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
32608	Thoracoscopy w/bx nodule		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
32609	Thoracoscopy w/bx pleura		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
3260F	Pt cat/pn cat/hist grd docd		M										
32650	Thoracoscopy w/pleurodesis		C										
32651	Thoracoscopy remove cortex		C										
32652	Thoracoscopy rem totl cortex		C										
32653	Thoracoscopy remov fb/fibrin		C										
32654	Thoracoscopy contrl bleeding		C										
32655	Thoracoscopy resect bullae		C										
32656	Thoracoscopy w/pleurectomy		C										
32658	Thoracoscopy w/sac fb remove		C										
32659	Thoracoscopy w/sac drainage		C										
3265F	Rna tstng hepc vir ord/docd		E1										
32661	Thoracoscopy w/pericard exc		C										
32662	Thoracoscopy w/mediast exc		C										
32663	Thoracoscopy w/lobectomy		C										
32664	Thoracoscopy w/ th nrv exc		C										
32665	Thoracoscop w/esoph musc exc		C										
32666	Thoracoscopy w/wedge resect		C										
32667	Thoracoscopy w/w resect addl		C										
32668	Thoracoscopy w/w resect diag		C										
32669	Thoracoscopy remove segment		C										
3266F	Hepc gn tstng docd b/4txmnt		E1										
32670	Thoracoscopy bilobectomy		C										
32671	Thoracoscopy pneumonectomy		C										
32672	Thoracoscopy for lvrs		C										
32673	Thoracoscopy w/thymus resect		C										
32674	Thoracoscopy lymph node exc		C										
3267F	Path rprt w/ pt pn cat et al		M										
3268F	Psa/t/glsc docd b/4 txmnt		E1										
3269F	Bone scn b/4 txmnt/aftr dx		M										
32701	Thorax stereo rad targetw/tx		B										
3270F	No bone scn b/4 txmnt/aftrdx		M										
3271F	Low risk prostate cancer		E1										
3272F	Med risk prostate cancer		E1										
3273F	High risk prostate cancer		E1										
3274F	Prost cncr rsk not lw/md/hgh		E1										
3278F	Serum lvls ca/ipth/lpd ord		E1										
3279F	Hgb lvl >/= 13 g/dl		E1										
32800	Repair lung hernia		C										
3280F	Hgb lvl 11-12.9 g/dl		E1										
32810	Close chest after drainage		C										
32815	Close bronchial fistula		C										
3281F	Hgb lvl <11 g/dl		E1										
32820	Reconstruct injured chest		C										
3284F	Iop down >15% of pre-svc lvl		M										
32850	Donor pneumonectomy		C										
32851	Lung transplant single		C										
32852	Lung transplant with bypass		C										
32853	Lung transplant double		C										
32854	Lung transplant with bypass		C										
32855	Prepare donor lung single		C										
32856	Prepare donor lung double		C										
3285F	Iop down <15% of pre-svc lvl		M										
3288F	Fall risk assessment docd		M										
32900	Removal of rib(s)		C										
32905	Revise & repair chest wall		C										
32906	Revise & repair chest wall		C										
3290F	Pt=d(rh)- and unsensitized		E1										
3291F	Pt=d(rh)+ or sensitized		E1										
3292F	Hiv tstng asked/docd/revwd		E1										
3293F	Abo rh blood typing docd		E1										
32940	Revision of lung		C										
3294F	Grp b strep screening docd		E1										
32960	Therapeutic pneumothorax		T	5181	6.5415	$541.62	.	$108.33					
32994	Ablate pulm tumor perq crybl		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
32997	Total lung lavage		C										
32998	Ablate pulm tumor perq rf		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
32999	Chest surgery procedure		T	5181	6.5415	$541.62	.	$108.33					
3300F	Ajcc stage docd b/4 thxpy		M										
33016	Pericardiocentesis w/imaging		J1	5182	16.9830	"$1,406.14"	.	$281.23					
33017	Prcrd drg 6yr+ w/o cgen car		C										
33018	Prcrd drg 0-5yr or w/anomly		C										
33019	Perq prcrd drg insj cath ct		C										
3301F	Cancer stage docd metast		M										
33020	Incision of heart sac		C										
33025	Incision of heart sac		C										
33030	Partial removal of heart sac		C										
33031	Partial removal of heart sac		C										
33050	Resect heart sac lesion		C										
33120	Removal of heart lesion		C										
33130	Removal of heart lesion		C										
33140	Heart revascularize (tmr)		C										
33141	Heart tmr w/other procedure		C										
3315F	Er+ or pr+ breast cancer		E1										
3316F	Er- or pr- breast cancer		E1										
3317F	Path rpt malig cancer docd		E1										
3318F	Path rpt malig cancer docd		E1										
3319F	X-ray/ct/ultrsnd et al ord		M										
33202	Insert epicard eltrd open		C										
33203	Insert epicard eltrd endo		C										
33206	Insert heart pm atrial		J1	5223	125.6102	"$10,400.15"	.	"$2,080.03"	*				
33207	Insert heart pm ventricular		J1	5223	125.6102	"$10,400.15"	.	"$2,080.03"	*				
33208	Insrt heart pm atrial & vent		J1	5223	125.6102	"$10,400.15"	.	"$2,080.03"	*				
3320F	No xray/ct/ et al ordd		M										
33210	Insert electrd/pm cath sngl		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
33211	Insert card electrodes dual		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
33212	Insert pulse gen sngl lead		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
33213	Insert pulse gen dual leads		J1	5223	125.6102	"$10,400.15"	.	"$2,080.03"	*				
33214	Upgrade of pacemaker system		J1	5223	125.6102	"$10,400.15"	.	"$2,080.03"	*				
33215	Reposition pacing-defib lead		J1	5183	34.5624	"$2,861.66"	.	$572.34					
33216	Insert 1 electrode pm-defib		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
33217	Insert 2 electrode pm-defib		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
33218	Repair lead pace-defib one		T	5221	41.5519	"$3,440.37"	.	$688.08					
3321F	Ajcc cncr 0/ia melan docd		M										
33220	Repair lead pace-defib dual		T	5221	41.5519	"$3,440.37"	.	$688.08					
33221	Insert pulse gen mult leads		J1	5224	224.7818	"$18,611.26"	.	"$3,722.26"	*				
33222	Relocation pocket pacemaker		T	5054	20.7177	"$1,715.36"	.	$343.08					
33223	Relocate pocket for defib		T	5054	20.7177	"$1,715.36"	.	$343.08					
33224	Insert pacing lead & connect		J1	5223	125.6102	"$10,400.15"	.	"$2,080.03"	*				
33225	L ventric pacing lead add-on		N										
33226	Reposition l ventric lead		J1	5183	34.5624	"$2,861.66"	.	$572.34					
33227	Remove&replace pm gen singl		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
33228	Remv&replc pm gen dual lead		J1	5223	125.6102	"$10,400.15"	.	"$2,080.03"	*				
33229	Remv&replc pm gen mult leads		J1	5224	224.7818	"$18,611.26"	.	"$3,722.26"	*				
3322F	Melanomaajcc stage 0 or ia		M										
33230	Insrt pulse gen w/dual leads		J1	5231	278.2729	"$23,040.16"	.	"$4,608.04"	*				
33231	Insrt pulse gen w/mult leads		J1	5232	396.6193	"$32,838.89"	.	"$6,567.78"	*				
33233	Removal of pm generator		Q2	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
33234	Removal of pacemaker system		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
33235	Removal pacemaker electrode		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
33236	Remove electrode/thoracotomy		C										
33237	Remove electrode/thoracotomy		C										
33238	Remove electrode/thoracotomy		C										
3323F	Clin node stgng docdb/4 surg		E1										
33240	Insrt pulse gen w/singl lead		J1	5231	278.2729	"$23,040.16"	.	"$4,608.04"	*				
33241	Remove pulse generator		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
33243	Remove eltrd/thoracotomy		C										
33244	Remove elctrd transvenously		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
33249	Insj/rplcmt defib w/lead(s)		J1	5232	396.6193	"$32,838.89"	.	"$6,567.78"	*				
3324F	Mri ct scan ord rvwd rqstd		E1										
33250	Ablate heart dysrhythm focus		C										
33251	Ablate heart dysrhythm focus		C										
33254	Ablate atria lmtd		C										
33255	Ablate atria w/o bypass ext		C										
33256	Ablate atria w/bypass exten		C										
33257	Ablate atria lmtd add-on		C										
33258	Ablate atria x10sv add-on		C										
33259	Ablate atria w/bypass add-on		C										
3325F	Preop asses 4 cataract surg		E1										
33261	Ablate heart dysrhythm focus		C										
33262	Rmvl& replc pulse gen 1 lead		J1	5231	278.2729	"$23,040.16"	.	"$4,608.04"	*				
33263	Rmvl & rplcmt dfb gen 2 lead		J1	5231	278.2729	"$23,040.16"	.	"$4,608.04"	*				
33264	Rmvl & rplcmt dfb gen mlt ld		J1	5232	396.6193	"$32,838.89"	.	"$6,567.78"	*				
33265	Ablate atria lmtd endo		C										
33266	Ablate atria x10sv endo		C										
33270	Ins/rep subq defibrillator		J1	5232	396.6193	"$32,838.89"	.	"$6,567.78"	*				
33271	Insj subq impltbl dfb elctrd		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
33272	Rmvl of subq defibrillator		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
33273	Repos prev impltbl subq dfb		T	5221	41.5519	"$3,440.37"	.	$688.08					
33274	Tcat insj/rpl perm ldls pm		J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
33275	Tcat rmvl perm ldls pm w/img	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
33285	Insj subq car rhythm mntr		J1	5222	98.4647	"$8,152.58"	.	"$1,630.52"	*				
33286	Rmvl subq car rhythm mntr		Q2	5071	7.5120	$621.97	.	$124.40					
33289	Tcat impl wrls p-art prs snr		J1	5200	348.0247	"$28,815.40"	.	"$5,763.09"	*				
3328F	Prfrmnc docd 2 wks b/4 surg		E1										
33300	Repair of heart wound		C										
33305	Repair of heart wound		C										
3330F	Imaging study ordered (bkp)		E1										
33310	Exploratory heart surgery		C										
33315	Exploratory heart surgery		C										
3331F	Bk imaging tst not ordered		E1										
33320	Repair major blood vessel(s)		C										
33321	Repair major vessel		C										
33322	Repair major blood vessel(s)		C										
33330	Insert major vessel graft		C										
33335	Insert major vessel graft		C										
33340	Perq clsr tcat l atr apndge		C										
33361	Replace aortic valve perq		C										
33362	Replace aortic valve open		C										
33363	Replace aortic valve open		C										
33364	Replace aortic valve open		C										
33365	Replace aortic valve open		C										
33366	Trcath replace aortic valve		C										
33367	Replace aortic valve w/byp		C										
33368	Replace aortic valve w/byp		C										
33369	Replace aortic valve w/byp		C										
33390	Valvuloplasty aortic valve		C										
33391	Valvuloplasty aortic valve		C										
33404	Prepare heart-aorta conduit		C										
33405	Replacement aortic valve opn		C										
33406	Replacement aortic valve opn		C										
3340F	Mammo assess inc xray docd		M										
33410	Replacement aortic valve opn		C										
33411	Replacement of aortic valve		C										
33412	Replacement of aortic valve		C										
33413	Replacement of aortic valve		C										
33414	Repair of aortic valve		C										
33415	Revision subvalvular tissue		C										
33416	Revise ventricle muscle		C										
33417	Repair of aortic valve		C										
33418	Repair tcat mitral valve		C										
33419	Repair tcat mitral valve		N										
3341F	Mammo assess negative docd		M										
33420	Revision of mitral valve		C										
33422	Revision of mitral valve		C										
33425	Repair of mitral valve		C										
33426	Repair of mitral valve		C										
33427	Repair of mitral valve		C										
3342F	Mammo assess bengn docd		M										
33430	Replacement of mitral valve		C										
3343F	Mammo probably bengn docd		M										
33440	Rplcmt a-valve tlcj autol pv		C										
3344F	Mammo assess susp docd		M										
3345F	Mammo assess hghlymalig doc		M										
33460	Revision of tricuspid valve		C										
33463	Valvuloplasty tricuspid		C										
33464	Valvuloplasty tricuspid		C										
33465	Replace tricuspid valve		C										
33468	Revision of tricuspid valve		C										
33470	Revision of pulmonary valve		C										
33471	Valvotomy pulmonary valve		C										
33474	Revision of pulmonary valve		C										
33475	Replacement pulmonary valve		C										
33476	Revision of heart chamber		C										
33477	Implant tcat pulm vlv perq		C										
33478	Revision of heart chamber		C										
33496	Repair prosth valve clot		C										
33500	Repair heart vessel fistula		C										
33501	Repair heart vessel fistula		C										
33502	Coronary artery correction		C										
33503	Coronary artery graft		C										
33504	Coronary artery graft		C										
33505	Repair artery w/tunnel		C										
33506	Repair artery translocation		C										
33507	Repair art intramural		C										
33508	Endoscopic vein harvest		N										
3350F	Mammo bx proven malig docd		M										
33510	Cabg vein single		C										
33511	Cabg vein two		C										
33512	Cabg vein three		C										
33513	Cabg vein four		C										
33514	Cabg vein five		C										
33516	Cabg vein six or more		C										
33517	Cabg artery-vein single		C										
33518	Cabg artery-vein two		C										
33519	Cabg artery-vein three		C										
3351F	Neg scrn dep symp by deptool		E1										
33521	Cabg artery-vein four		C										
33522	Cabg artery-vein five		C										
33523	Cabg art-vein six or more		C										
3352F	No sig dep symp by dep tool		E1										
33530	Coronary artery bypass/reop		C										
33533	Cabg arterial single		C										
33534	Cabg arterial two		C										
33535	Cabg arterial three		C										
33536	Cabg arterial four or more		C										
3353F	Mild-mod dep symp by deptool		E1										
33542	Removal of heart lesion		C										
33545	Repair of heart damage		C										
33548	Restore/remodel ventricle		C										
3354F	Clin sig dep sym by dep tool		E1										
33572	Open coronary endarterectomy		C										
33600	Closure of valve		C										
33602	Closure of valve		C										
33606	Anastomosis/artery-aorta		C										
33608	Repair anomaly w/conduit		C										
33610	Repair by enlargement		C										
33611	Repair double ventricle		C										
33612	Repair double ventricle		C										
33615	Repair modified fontan		C										
33617	Repair single ventricle		C										
33619	Repair single ventricle		C										
33620	Apply r&l pulm art bands		C										
33621	Transthor cath for stent		C										
33622	Redo compl cardiac anomaly		C										
33641	Repair heart septum defect		C										
33645	Revision of heart veins		C										
33647	Repair heart septum defects		C										
33660	Repair of heart defects		C										
33665	Repair of heart defects		C										
33670	Repair of heart chambers		C										
33675	Close mult vsd		C										
33676	Close mult vsd w/resection		C										
33677	Cl mult vsd w/rem pul band		C										
33681	Repair heart septum defect		C										
33684	Repair heart septum defect		C										
33688	Repair heart septum defect		C										
33690	Reinforce pulmonary artery		C										
33692	Repair of heart defects		C										
33694	Repair of heart defects		C										
33697	Repair of heart defects		C										
33702	Repair of heart defects		C										
3370F	Ajcc brst cncr stage 0 docd		E1										
33710	Repair of heart defects		C										
33720	Repair of heart defect		C										
33722	Repair of heart defect		C										
33724	Repair venous anomaly		C										
33726	Repair pul venous stenosis		C										
3372F	Ajcc brst cncr stage 1 docd		E1										
33730	Repair heart-vein defect(s)		C										
33732	Repair heart-vein defect		C										
33735	Revision of heart chamber		C										
33736	Revision of heart chamber		C										
33737	Revision of heart chamber		C										
33741	Tas congenital car anomal	NC	C										
33745	Tis cgen car anomal 1st shnt	NC	C										
33746	Tis cgen car anomal ea addl	NC	C										
3374F	Ajcc brst cncr stage 1 docd		E1										
33750	Major vessel shunt		C										
33755	Major vessel shunt		C										
33762	Major vessel shunt		C										
33764	Major vessel shunt & graft		C										
33766	Major vessel shunt		C										
33767	Major vessel shunt		C										
33768	Cavopulmonary shunting		C										
3376F	Ajcc brstcncr stage 2 docd		E1										
33770	Repair great vessels defect		C										
33771	Repair great vessels defect		C										
33774	Repair great vessels defect		C										
33775	Repair great vessels defect		C										
33776	Repair great vessels defect		C										
33777	Repair great vessels defect		C										
33778	Repair great vessels defect		C										
33779	Repair great vessels defect		C										
33780	Repair great vessels defect		C										
33781	Repair great vessels defect		C										
33782	Nikaidoh proc		C										
33783	Nikaidoh proc w/ostia implt		C										
33786	Repair arterial trunk		C										
33788	Revision of pulmonary artery		C										
3378F	Ajcc brstcncr stage 3 docd		E1										
33800	Aortic suspension		C										
33802	Repair vessel defect		C										
33803	Repair vessel defect		C										
3380F	Ajcc brstcncr stage 4 docd		E1										
33813	Repair septal defect		C										
33814	Repair septal defect		C										
33820	Revise major vessel		C										
33822	Revise major vessel		C										
33824	Revise major vessel		C										
3382F	Ajcc cln cncr stage 0 docd		E1										
33840	Remove aorta constriction		C										
33845	Remove aorta constriction		C										
3384F	Ajcc cln cncr stage 1 docd		E1										
33851	Remove aorta constriction		C										
33852	Repair septal defect		C										
33853	Repair septal defect		C										
33858	As-aort grf f/aortic dsj		C										
33859	As-aort grf f/ds oth/thn dsj		C										
33863	Ascending aortic graft		C										
33864	Ascending aortic graft		C										
33866	Aortic hemiarch graft		N										
3386F	Ajcc cln cncr stage 2 docd		E1										
33871	Transvrs a-arch grf hypthrm		C										
33875	Thoracic aortic graft		C										
33877	Thoracoabdominal graft		C										
33880	Endovasc taa repr incl subcl		C										
33881	Endovasc taa repr w/o subcl		C										
33883	Insert endovasc prosth taa		C										
33884	Endovasc prosth taa add-on		C										
33886	Endovasc prosth delayed		C										
33889	Artery transpose/endovas taa		C										
3388F	Ajcc cln cncr stage 3 docd		E1										
33891	Car-car bp grft/endovas taa		C										
3390F	Ajcc cln cncr stage 4 docd		E1										
33910	Remove lung artery emboli		C										
33915	Remove lung artery emboli		C										
33916	Surgery of great vessel		C										
33917	Repair pulmonary artery		C										
33920	Repair pulmonary atresia		C										
33922	Transect pulmonary artery		C										
33924	Remove pulmonary shunt		C										
33925	Rpr pul art unifocal w/o cpb		C										
33926	Repr pul art unifocal w/cpb		C										
33927	Impltj tot rplcmt hrt sys		C										
33928	Rmvl & rplcmt tot hrt sys		C										
33929	Rmvl rplcmt hrt sys f/trnspl		C										
33930	Removal of donor heart/lung		C										
33933	Prepare donor heart/lung		C										
33935	Transplantation heart/lung		C										
33940	Removal of donor heart		C										
33944	Prepare donor heart		C										
33945	Transplantation of heart		C										
33946	Ecmo/ecls initiation venous		C										
33947	Ecmo/ecls initiation artery		C										
33948	Ecmo/ecls daily mgmt-venous		C										
33949	Ecmo/ecls daily mgmt artery		C										
3394F	Quant her2 ihc eval brst cx		M										
33951	Ecmo/ecls insj prph cannula		C										
33952	Ecmo/ecls insj prph cannula		C										
33953	Ecmo/ecls insj prph cannula		C										
33954	Ecmo/ecls insj prph cannula		C										
33955	Ecmo/ecls insj ctr cannula		C										
33956	Ecmo/ecls insj ctr cannula		C										
33957	Ecmo/ecls repos perph cnula		C										
33958	Ecmo/ecls repos perph cnula		C										
33959	Ecmo/ecls repos perph cnula		C										
3395F	Quant nonher2 ihc brst cx		M										
33962	Ecmo/ecls repos perph cnula		C										
33963	Ecmo/ecls repos perph cnula		C										
33964	Ecmo/ecls repos perph cnula		C										
33965	Ecmo/ecls rmvl perph cannula		C										
33966	Ecmo/ecls rmvl prph cannula		C										
33967	Insert i-aort percut device		C										
33968	Remove aortic assist device		C										
33969	Ecmo/ecls rmvl perph cannula		C										
33970	Aortic circulation assist		C										
33971	Aortic circulation assist		C										
33973	Insert balloon device		C										
33974	Remove intra-aortic balloon		C										
33975	Implant ventricular device		C										
33976	Implant ventricular device		C										
33977	Remove ventricular device		C										
33978	Remove ventricular device		C										
33979	Insert intracorporeal device		C										
33980	Remove intracorporeal device		C										
33981	Replace vad pump ext		C										
33982	Replace vad intra w/o bp		C										
33983	Replace vad intra w/bp		C										
33984	Ecmo/ecls rmvl prph cannula		C										
33985	Ecmo/ecls rmvl ctr cannula		C										
33986	Ecmo/ecls rmvl ctr cannula		C										
33987	Artery expos/graft artery		C										
33988	Insertion of left heart vent		C										
33989	Removal of left heart vent		C										
33990	Insj perq vad l hrt arterial		C										
33991	Insj perq vad l hrt artl&ven		C										
33992	Rmvl perq left heart vad		C										
33993	Reposg perq r/l hrt vad		C										
33995	Insj perq vad r hrt venous	NC	C										
33997	Rmvl perq right heart vad	NC	C										
33999	Cardiac surgery procedure		T	5181	6.5415	$541.62	.	$108.33					
34001	Removal of artery clot		C										
34051	Removal of artery clot		C										
34101	Removal of artery clot		J1	5184	57.6153	"$4,770.37"	.	$954.08					
34111	Removal of arm artery clot		J1	5184	57.6153	"$4,770.37"	.	$954.08					
34151	Removal of artery clot		C										
34201	Removal of artery clot		J1	5184	57.6153	"$4,770.37"	.	$954.08					
34203	Removal of leg artery clot		J1	5184	57.6153	"$4,770.37"	.	$954.08					
34401	Removal of vein clot		C										
34421	Removal of vein clot		J1	5183	34.5624	"$2,861.66"	.	$572.34					
34451	Removal of vein clot		C										
34471	Removal of vein clot		T	5181	6.5415	$541.62	.	$108.33					
34490	Removal of vein clot		J1	5183	34.5624	"$2,861.66"	.	$572.34					
34501	Repair valve femoral vein		J1	5184	57.6153	"$4,770.37"	.	$954.08					
34502	Reconstruct vena cava		C										
3450F	Dyspnea scrnd no-mild dysp		E1										
34510	Transposition of vein valve		J1	5184	57.6153	"$4,770.37"	.	$954.08					
3451F	Dyspnea scrnd mod-high dysp		E1										
34520	Cross-over vein graft		J1	5184	57.6153	"$4,770.37"	.	$954.08					
3452F	Dyspnea not screened		E1										
34530	Leg vein fusion		J1	5183	34.5624	"$2,861.66"	.	$572.34					
3455F	Tb scrng done-interpd 6mon		E1										
34701	Evasc rpr a-ao ndgft		C										
34702	Evasc rpr a-ao ndgft rpt		C										
34703	Evasc rpr a-unilac ndgft		C										
34704	Evasc rpr a-unilac ndgft rpt		C										
34705	Evac rpr a-biiliac ndgft		C										
34706	Evasc rpr a-biiliac rpt		C										
34707	Evasc rpr ilio-iliac ndgft		C										
34708	Evasc rpr ilio-iliac rpt		C										
34709	Plmt xtn prosth evasc rpr		C										
3470F	Ra disease activity low		E1										
34710	Dlyd plmt xtn prosth 1st vsl		C										
34711	Dlyd plmt xtn prosth ea addl		C										
34712	Tcat dlvr enhncd fixj dev		C										
34713	Perq access & clsr fem art		N										
34714	Opn fem art expos cndt crtj		N										
34715	Opn ax/subcla art expos		N										
34716	Opn ax/subcla art expos cndt		N										
34717	Evasc rpr a-iliac ndgft		C										
34718	Evasc rpr n/a a-iliac ndgft		C										
3471F	Ra disease activity mod		E1										
3472F	Ra disease activity high		E1										
3475F	Disease progn ra poor docd		M										
3476F	Disease progn ra good docd		M										
34808	Endovas iliac a device addon		C										
34812	Opn fem art expos		C										
34813	Femoral endovas graft add-on		C										
34820	Opn iliac art expos		C										
34830	Open aortic tube prosth repr		C										
34831	Open aortoiliac prosth repr		C										
34832	Open aortofemor prosth repr		C										
34833	Opn ilac art expos cndt crtj		C										
34834	Opn brach art expos		C										
34839	Plnning pt spec fenest graft		B										
34841	Endovasc visc aorta 1 graft		C										
34842	Endovasc visc aorta 2 graft		C										
34843	Endovasc visc aorta 3 graft		C										
34844	Endovasc visc aorta 4 graft		C										
34845	Visc & infraren abd 1 prosth		C										
34846	Visc & infraren abd 2 prosth		C										
34847	Visc & infraren abd 3 prosth		C										
34848	Visc & infraren abd 4+ prost		C										
3490F	History aids-defining cond		E1										
3491F	Hiv unsure baby of hiv+moms		E1										
3492F	History cd4+ cell count <350		E1										
3493F	No hist cd4+ cell count <350		E1										
3494F	Cd4+cell count <200cells/mm3		E1										
3495F	Cd4+cell cnt 200-499 cells		E1										
3496F	Cd4+ cell count >= 500 cells		E1										
3497F	Cd4+ cell percentage <15%		E1										
3498F	Cd4+ cell =15% (hiv)		E1										
35001	Repair defect of artery		C										
35002	Repair artery rupture neck		C										
35005	Repair defect of artery		C										
3500F	Cd4+cell cnt/% docd as done		E1										
35011	Repair defect of artery		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35013	Repair artery rupture arm		C										
35021	Repair defect of artery		C										
35022	Repair artery rupture chest		C										
3502F	Hiv rna vrl ld <lmts quantif		E1										
3503F	Hiv rna vrl ldnot<lmts quntf		E1										
35045	Repair defect of arm artery		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35081	Repair defect of artery		C										
35082	Repair artery rupture aorta		C										
35091	Repair defect of artery		C										
35092	Repair artery rupture aorta		C										
35102	Repair defect of artery		C										
35103	Repair artery rupture aorta		C										
3510F	Doc tb scrng-rslts interpd		E1										
35111	Repair defect of artery		C										
35112	Repair artery rupture spleen		C										
3511F	Chlmyd/gonrh tsts docd done		E1										
35121	Repair defect of artery		C										
35122	Repair artery rupture belly		C										
3512F	Syph scrng docd as done		E1										
35131	Repair defect of artery		C										
35132	Repair artery rupture groin		C										
3513F	Hep b scrng docd as done		E1										
35141	Repair defect of artery		C										
35142	Repair artery rupture thigh		C										
3514F	Hep c scrng docd as done		E1										
35151	Repair defect of artery		C										
35152	Repair ruptd popliteal art		C										
3515F	Pt has docd immun to hep c		E1										
3517F	Hbv assess&results intrp 1yr		E1										
35180	Repair blood vessel lesion	CH	J1	5182	16.9830	"$1,406.14"	.	$281.23					
35182	Repair blood vessel lesion		C										
35184	Repair blood vessel lesion		J1	5183	34.5624	"$2,861.66"	.	$572.34					
35188	Repair blood vessel lesion		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35189	Repair blood vessel lesion		C										
35190	Repair blood vessel lesion		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35201	Repair blood vessel lesion		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35206	Repair blood vessel lesion		J1	5183	34.5624	"$2,861.66"	.	$572.34					
35207	Repair blood vessel lesion		J1	5183	34.5624	"$2,861.66"	.	$572.34					
3520F	Cdifficile testing performed		E1										
35211	Repair blood vessel lesion		C										
35216	Repair blood vessel lesion		C										
35221	Repair blood vessel lesion		C										
35226	Repair blood vessel lesion		T	5071	7.5120	$621.97	.	$124.40					
35231	Repair blood vessel lesion		J1	5183	34.5624	"$2,861.66"	.	$572.34					
35236	Repair blood vessel lesion		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35241	Repair blood vessel lesion		C										
35246	Repair blood vessel lesion		C										
35251	Repair blood vessel lesion		C										
35256	Repair blood vessel lesion		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35261	Repair blood vessel lesion		J1	5183	34.5624	"$2,861.66"	.	$572.34					
35266	Repair blood vessel lesion		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35271	Repair blood vessel lesion		C										
35276	Repair blood vessel lesion		C										
35281	Repair blood vessel lesion		C										
35286	Repair blood vessel lesion		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35301	Rechanneling of artery		C										
35302	Rechanneling of artery		C										
35303	Rechanneling of artery		C										
35304	Rechanneling of artery		C										
35305	Rechanneling of artery		C										
35306	Rechanneling of artery		C										
35311	Rechanneling of artery		C										
35321	Rechanneling of artery		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35331	Rechanneling of artery		C										
35341	Rechanneling of artery		C										
35351	Rechanneling of artery		C										
35355	Rechanneling of artery		C										
35361	Rechanneling of artery		C										
35363	Rechanneling of artery		C										
35371	Rechanneling of artery		C										
35372	Rechanneling of artery	CH	J1	5184	57.6153	"$4,770.37"	.	$954.08					
35390	Reoperation carotid add-on		C										
35400	Angioscopy		C										
35500	Harvest vein for bypass		N										
35501	Art byp grft ipsilat carotid		C										
35506	Art byp grft subclav-carotid		C										
35508	Art byp grft carotid-vertbrl		C										
35509	Art byp grft contral carotid		C										
3550F	Low rsk thromboembolism		E1										
35510	Art byp grft carotid-brchial		C										
35511	Art byp grft subclav-subclav		C										
35512	Art byp grft subclav-brchial		C										
35515	Art byp grft subclav-vertbrl		C										
35516	Art byp grft subclav-axilary		C										
35518	Art byp grft axillary-axilry		C										
3551F	Intrmed rsk thromboembolism		E1										
35521	Art byp grft axill-femoral		C										
35522	Art byp grft axill-brachial		C										
35523	Art byp grft brchl-ulnr-rdl		C										
35525	Art byp grft brachial-brchl		C										
35526	Art byp grft aor/carot/innom		C										
3552F	Hgh risk for thromboembolism		E1										
35531	Art byp grft aorcel/aormesen		C										
35533	Art byp grft axill/fem/fem		C										
35535	Art byp grft hepatorenal		C										
35536	Art byp grft splenorenal		C										
35537	Art byp grft aortoiliac		C										
35538	Art byp grft aortobi-iliac		C										
35539	Art byp grft aortofemoral		C										
35540	Art byp grft aortbifemoral		C										
35556	Art byp grft fem-popliteal		C										
35558	Art byp grft fem-femoral		C										
3555F	Pt inr measurement performed		E1										
35560	Art byp grft aortorenal		C										
35563	Art byp grft ilioiliac		C										
35565	Art byp grft iliofemoral		C										
35566	Art byp fem-ant-post tib/prl		C										
35570	Art byp tibial-tib/peroneal		C										
35571	Art byp pop-tibl-prl-other		C										
35572	Harvest femoropopliteal vein		N										
35583	Vein byp grft fem-popliteal		C										
35585	Vein byp fem-tibial peroneal		C										
35587	Vein byp pop-tibl peroneal		C										
35600	Harvest art for cabg add-on		C										
35601	Art byp common ipsi carotid		C										
35606	Art byp carotid-subclavian		C										
35612	Art byp subclav-subclavian		C										
35616	Art byp subclav-axillary		C										
35621	Art byp axillary-femoral		C										
35623	Art byp axillary-pop-tibial		C										
35626	Art byp aorsubcl/carot/innom		C										
35631	Art byp aor-celiac-msn-renal		C										
35632	Art byp ilio-celiac		C										
35633	Art byp ilio-mesenteric		C										
35634	Art byp iliorenal		C										
35636	Art byp spenorenal		C										
35637	Art byp aortoiliac		C										
35638	Art byp aortobi-iliac		C										
35642	Art byp carotid-vertebral		C										
35645	Art byp subclav-vertebrl		C										
35646	Art byp aortobifemoral		C										
35647	Art byp aortofemoral		C										
35650	Art byp axillary-axillary		C										
35654	Art byp axill-fem-femoral		C										
35656	Art byp femoral-popliteal		C										
35661	Art byp femoral-femoral		C										
35663	Art byp ilioiliac		C										
35665	Art byp iliofemoral		C										
35666	Art byp fem-ant-post tib/prl		C										
35671	Art byp pop-tibl-prl-other		C										
35681	Composite byp grft pros&vein		C										
35682	Composite byp grft 2 veins		C										
35683	Composite byp grft 3/> segmt		C										
35685	Bypass graft patency/patch		N										
35686	Bypass graft/av fist patency		N										
35691	Art trnsposj vertbrl carotid		C										
35693	Art trnsposj subclavian		C										
35694	Art trnsposj subclav carotid		C										
35695	Art trnsposj carotid subclav		C										
35697	Reimplant artery each		C										
35700	Reoperation bypass graft		C										
35701	Expl n/flwd surg neck art		C										
35702	Expl n/flwd surg uxtr art		C										
35703	Expl n/flwd surg lxtr art		C										
3570F	Rprt bone scint xref w xray		M										
3572F	Pt consid poss risk fx		E1										
3573F	Pt not consid poss risk fx		E1										
35800	Explore neck vessels	CH	J1	5184	57.6153	"$4,770.37"	.	$954.08					
35820	Explore chest vessels		C										
35840	Explore abdominal vessels		C										
35860	Explore limb vessels		J1	5183	34.5624	"$2,861.66"	.	$572.34					
35870	Repair vessel graft defect		C										
35875	Removal of clot in graft		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35876	Removal of clot in graft		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35879	Revise graft w/vein		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35881	Revise graft w/vein		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35883	Revise graft w/nonauto graft		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35884	Revise graft w/vein		J1	5184	57.6153	"$4,770.37"	.	$954.08					
35901	Excision graft neck		C										
35903	Excision graft extremity		J1	5183	34.5624	"$2,861.66"	.	$572.34					
35905	Excision graft thorax		C										
35907	Excision graft abdomen		C										
36000	Place needle in vein		N										
36002	Pseudoaneurysm injection trt		T	5181	6.5415	$541.62	.	$108.33					
36005	Injection ext venography		N										
36010	Place catheter in vein		N										
36011	Place catheter in vein		N										
36012	Place catheter in vein		N										
36013	Place catheter in artery		N										
36014	Place catheter in artery		N										
36015	Place catheter in artery		N										
36100	Establish access to artery		N										
36140	Intro ndl icath upr/lxtr art		N										
36160	Establish access to aorta		N										
36200	Place catheter in aorta		N										
36215	Place catheter in artery		N										
36216	Place catheter in artery		N										
36217	Place catheter in artery		N										
36218	Place catheter in artery		N										
36221	Place cath thoracic aorta		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
36222	Place cath carotid/inom art		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
36223	Place cath carotid/inom art		Q2	5184	57.6153	"$4,770.37"	.	$954.08					
36224	Place cath carotd art		Q2	5184	57.6153	"$4,770.37"	.	$954.08					
36225	Place cath subclavian art		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
36226	Place cath vertebral art		Q2	5184	57.6153	"$4,770.37"	.	$954.08					
36227	Place cath xtrnl carotid		N										
36228	Place cath intracranial art		N										
36245	Ins cath abd/l-ext art 1st		N										
36246	Ins cath abd/l-ext art 2nd		N										
36247	Ins cath abd/l-ext art 3rd		N										
36248	Ins cath abd/l-ext art addl		N										
36251	Ins cath ren art 1st unilat		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
36252	Ins cath ren art 1st bilat		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
36253	Ins cath ren art 2nd+ unilat		Q2	5184	57.6153	"$4,770.37"	.	$954.08					
36254	Ins cath ren art 2nd+ bilat		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
36260	Insertion of infusion pump		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36261	Revision of infusion pump		T	5221	41.5519	"$3,440.37"	.	$688.08					
36262	Removal of infusion pump		Q2	5221	41.5519	"$3,440.37"	.	$688.08					
36299	Vessel injection procedure		N										
36400	Bl draw < 3 yrs fem/jugular		N										
36405	Bl draw <3 yrs scalp vein		N										
36406	Bl draw <3 yrs other vein		N										
36410	Non-routine bl draw 3/> yrs		N										
36415	Routine venipuncture		Q4										
36416	Capillary blood draw		N										
36420	Vein access cutdown < 1 yr	CH	Q1	5734	1.3521	$111.95	.	$22.39					
36425	Vein access cutdown > 1 yr		Q1	5735	3.2637	$270.22	.	$54.05					
36430	Blood transfusion service		S	5241	4.7956	$397.06	.	$79.42					
36440	Bl push transfuse 2 yr/<		S	5241	4.7956	$397.06	.	$79.42					
36450	Bl exchange/transfuse nb		S	5241	4.7956	$397.06	.	$79.42					
36455	Bl exchange/transfuse non-nb		S	5241	4.7956	$397.06	.	$79.42					
36456	Prtl exchange transfuse nb		S	5241	4.7956	$397.06	.	$79.42					
36460	Transfusion service fetal		S	5241	4.7956	$397.06	.	$79.42					
36465	Njx noncmpnd sclrsnt 1 vein		T	5054	20.7177	"$1,715.36"	.	$343.08					
36466	Njx noncmpnd sclrsnt mlt vn		T	5054	20.7177	"$1,715.36"	.	$343.08					
36468	Njx sclrsnt spider veins	CH	Q1	5052	4.1770	$345.84	.	$69.17					
36470	Njx sclrsnt 1 incmptnt vein		T	5052	4.1770	$345.84	.	$69.17					
36471	Njx sclrsnt mlt incmptnt vn		T	5052	4.1770	$345.84	.	$69.17					
36473	Endovenous mchnchem 1st vein		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36474	Endovenous mchnchem add-on		N										
36475	Endovenous rf 1st vein		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36476	Endovenous rf vein add-on		N										
36478	Endovenous laser 1st vein		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36479	Endovenous laser vein addon		N										
36481	Insertion of catheter vein		N										
36482	Endoven ther chem adhes 1st		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36483	Endoven ther chem adhes sbsq		N										
36500	Insertion of catheter vein		N										
3650F	Eeg ordered rvwd reqstd		E1										
36510	Insertion of catheter vein		N										
36511	Apheresis wbc		S	5242	16.4639	"$1,363.16"	.	$272.64					
36512	Apheresis rbc		S	5242	16.4639	"$1,363.16"	.	$272.64					
36513	Apheresis platelets		S	5241	4.7956	$397.06	.	$79.42					
36514	Apheresis plasma		S	5242	16.4639	"$1,363.16"	.	$272.64					
36516	Apheresis immunoads slctv		S	5243	48.7664	"$4,037.71"	.	$807.55					
36522	Photopheresis		S	5243	48.7664	"$4,037.71"	.	$807.55					
36555	Insert non-tunnel cv cath	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
36556	Insert non-tunnel cv cath	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
36557	Insert tunneled cv cath		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36558	Insert tunneled cv cath		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36560	Insert tunneled cv cath		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36561	Insert tunneled cv cath		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36563	Insert tunneled cv cath		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36565	Insert tunneled cv cath		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36566	Insert tunneled cv cath		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36568	Insj picc <5 yr w/o imaging	CH	J1	5182	16.9830	"$1,406.14"	.	$281.23					
36569	Insj picc 5 yr+ w/o imaging		J1	5182	16.9830	"$1,406.14"	.	$281.23					
36570	Insert picvad cath		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36571	Insert picvad cath		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36572	Insj picc rs&i <5 yr		T	5181	6.5415	$541.62	.	$108.33					
36573	Insj picc rs&i 5 yr+		J1	5182	16.9830	"$1,406.14"	.	$281.23					
36575	Repair tunneled cv cath		T	5181	6.5415	$541.62	.	$108.33					
36576	Repair tunneled cv cath		J1	5182	16.9830	"$1,406.14"	.	$281.23					
36578	Replace tunneled cv cath		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36580	Replace cvad cath		J1	5182	16.9830	"$1,406.14"	.	$281.23					
36581	Replace tunneled cv cath		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36582	Replace tunneled cv cath		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36583	Replace tunneled cv cath		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36584	Compl rplcmt picc rs&i		J1	5182	16.9830	"$1,406.14"	.	$281.23					
36585	Replace picvad cath		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36589	Removal tunneled cv cath		Q2	5181	6.5415	$541.62	.	$108.33					
36590	Removal tunneled cv cath	CH	Q2	5182	16.9830	"$1,406.14"	.	$281.23					
36591	Draw blood off venous device		Q1	5734	1.3521	$111.95	.	$22.39					
36592	Collect blood from picc		Q1	5734	1.3521	$111.95	.	$22.39					
36593	Declot vascular device		T	5694	3.7532	$310.75	.	$62.16					
36595	Mech remov tunneled cv cath		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36596	Mech remov tunneled cv cath		J1	5182	16.9830	"$1,406.14"	.	$281.23					
36597	Reposition venous catheter		J1	5182	16.9830	"$1,406.14"	.	$281.23					
36598	Inj w/fluor eval cv device		T	5693	2.4578	$203.50	.	$40.70					
36600	Withdrawal of arterial blood		Q1	5734	1.3521	$111.95	.	$22.39					
36620	Insertion catheter artery		N										
36625	Insertion catheter artery		N										
36640	Insertion catheter artery		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36660	Insertion catheter artery		C										
36680	Insert needle bone cavity		Q1	5735	3.2637	$270.22	.	$54.05					
36800	Insertion of cannula		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36810	Insertion of cannula		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36815	Insertion of cannula		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36818	Av fuse uppr arm cephalic		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36819	Av fuse uppr arm basilic		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36820	Av fusion/forearm vein		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36821	Av fusion direct any site		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36823	Insertion of cannula(s)		C										
36825	Artery-vein autograft		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36830	Artery-vein nonautograft		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36831	Open thrombect av fistula		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36832	Av fistula revision open		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36833	Av fistula revision		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36835	Artery to vein shunt		J1	5183	34.5624	"$2,861.66"	.	$572.34					
36838	Dist revas ligation hemo		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36860	External cannula declotting	CH	J1	5182	16.9830	"$1,406.14"	.	$281.23					
36861	Cannula declotting		J1	5184	57.6153	"$4,770.37"	.	$954.08					
36901	Intro cath dialysis circuit		J1	5182	16.9830	"$1,406.14"	.	$281.23					
36902	Intro cath dialysis circuit		J1	5192	59.8674	"$4,956.84"	.	$991.37					
36903	Intro cath dialysis circuit		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
36904	Thrmbc/nfs dialysis circuit		J1	5192	59.8674	"$4,956.84"	.	$991.37					
36905	Thrmbc/nfs dialysis circuit		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
36906	Thrmbc/nfs dialysis circuit		J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
36907	Balo angiop ctr dialysis seg		N										
36908	Stent plmt ctr dialysis seg		N										
36909	Dialysis circuit embolj		N										
3700F	Psych disorders assessed		E1										
37140	Revision of circulation		C										
37145	Revision of circulation		C										
37160	Revision of circulation		C										
37180	Revision of circulation		C										
37181	Splice spleen/kidney veins		C										
37182	Insert hepatic shunt (tips)	CH	J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
37183	Remove hepatic shunt (tips)		J1	5192	59.8674	"$4,956.84"	.	$991.37					
37184	Prim art m-thrmbc 1st vsl		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
37185	Prim art m-thrmbc sbsq vsl		N										
37186	Sec art thrombectomy add-on		N										
37187	Venous mech thrombectomy	CH	J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
37188	Ven mechnl thrmbc repeat tx		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37191	Ins endovas vena cava filtr		J1	5184	57.6153	"$4,770.37"	.	$954.08					
37192	Redo endovas vena cava filtr		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37193	Rem endovas vena cava filter		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37195	Thrombolytic therapy stroke		T	5694	3.7532	$310.75	.	$62.16					
37197	Remove intrvas foreign body		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37200	Transcatheter biopsy		J1	5184	57.6153	"$4,770.37"	.	$954.08					
3720F	Cognit impairment assessed		M										
37211	Thrombolytic art therapy		J1	5184	57.6153	"$4,770.37"	.	$954.08					
37212	Thrombolytic venous therapy		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37213	Thromblytic art/ven therapy	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
37214	Cessj therapy cath removal	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
37215	Transcath stent cca w/eps		C										
37216	Transcath stent cca w/o eps		E1										
37217	Stent placemt retro carotid		C										
37218	Stent placemt ante carotid		C										
37220	Iliac revasc		J1	5192	59.8674	"$4,956.84"	.	$991.37					
37221	Iliac revasc w/stent		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
37222	Iliac revasc add-on		N										
37223	Iliac revasc w/stent add-on		N										
37224	Fem/popl revas w/tla		J1	5192	59.8674	"$4,956.84"	.	$991.37					
37225	Fem/popl revas w/ather		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
37226	Fem/popl revasc w/stent		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
37227	Fem/popl revasc stnt & ather		J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
37228	Tib/per revasc w/tla		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
37229	Tib/per revasc w/ather		J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
37230	Tib/per revasc w/stent		J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
37231	Tib/per revasc stent & ather		J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
37232	Tib/per revasc add-on		N										
37233	Tibper revasc w/ather add-on		N										
37234	Revsc opn/prq tib/pero stent		N										
37235	Tib/per revasc stnt & ather		N										
37236	Open/perq place stent 1st		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
37237	Open/perq place stent ea add		N										
37238	Open/perq place stent same		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
37239	Open/perq place stent ea add		N										
37241	Vasc embolize/occlude venous		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
37242	Vasc embolize/occlude artery		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
37243	Vasc embolize/occlude organ		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
37244	Vasc embolize/occlude bleed		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
37246	Trluml balo angiop 1st art		J1	5192	59.8674	"$4,956.84"	.	$991.37					
37247	Trluml balo angiop addl art		N										
37248	Trluml balo angiop 1st vein		J1	5192	59.8674	"$4,956.84"	.	$991.37					
37249	Trluml balo angiop addl vein		N										
37252	Intrvasc us noncoronary 1st		N										
37253	Intrvasc us noncoronary addl		N										
3725F	Screen depression performed		M										
37500	Endoscopy ligate perf veins		J1	5184	57.6153	"$4,770.37"	.	$954.08					
37501	Vascular endoscopy procedure		T	5181	6.5415	$541.62	.	$108.33					
3750F	Ptnotrcvngsteroid>/=10mg/day		E1										
3751F	Electrodiag polyneuro 6 mn		E1										
3752F	No electrodiag polyneuro 6mn		E1										
3753F	Pt has symp&signs neuropathy		E1										
3754F	Screening tests dm done		E1										
3755F	Cog&behav imprmnt scrng done		E1										
37565	Ligation of neck vein	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
3756F	Pt w/pseudobulb affect/als		E1										
3757F	Pt w/o pseudobulbaffect/als		E1										
3758F	Pt ref pulm fx test/peakflow		E1										
3759F	Pt scrn dysphag/wt loss/nutr		E1										
37600	Ligation of neck artery		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37605	Ligation of neck artery		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37606	Ligation of neck artery		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37607	Ligation of a-v fistula		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37609	Temporal artery procedure		J1	5072	16.9934	"$1,407.00"	.	$281.41					
3760F	Pt w/ dysphag/wt loss/nutr		E1										
37615	Ligation of neck artery	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
37616	Ligation of chest artery		C										
37617	Ligation of abdomen artery	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
37618	Ligation of extremity artery		C										
37619	Ligation of inf vena cava		J1	5184	57.6153	"$4,770.37"	.	$954.08					
3761F	Pt w/o dysphag/wt loss/nutr		E1										
3762F	Patient is dysarthric		E1										
3763F	Patient is not dysarthric		E1										
37650	Revision of major vein		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37660	Revision of major vein		C										
37700	Revise leg vein		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37718	Ligate/strip short leg vein		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37722	Ligate/strip long leg vein		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37735	Removal of leg veins/lesion		J1	5183	34.5624	"$2,861.66"	.	$572.34					
3775F	Adenoma detected screening		E1										
37760	Ligate leg veins radical		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37761	Ligate leg veins open	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
37765	Stab phleb veins xtr 10-20		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37766	Phleb veins - extrem 20+		J1	5183	34.5624	"$2,861.66"	.	$572.34					
3776F	Adenoma not detect screening		E1										
37780	Revision of leg vein	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
37785	Ligate/divide/excise vein		J1	5183	34.5624	"$2,861.66"	.	$572.34					
37788	Revascularization penis		C										
37790	Penile venous occlusion		J1	5374	37.1552	"$3,076.34"	.	$615.27					
37799	Vascular surgery procedure		T	5181	6.5415	$541.62	.	$108.33					
38100	Removal of spleen total		C										
38101	Removal of spleen partial		C										
38102	Removal of spleen total		C										
38115	Repair of ruptured spleen		C										
38120	Laparoscopy splenectomy		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
38129	Laparoscope proc spleen		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
38200	Injection for spleen x-ray		N										
38204	Bl donor search management		N										
38205	Harvest allogeneic stem cell		B										
38206	Harvest auto stem cells		S	5242	16.4639	"$1,363.16"	.	$272.64					
38207	Cryopreserve stem cells		S	5241	4.7956	$397.06	.	$79.42					
38208	Thaw preserved stem cells		S	5241	4.7956	$397.06	.	$79.42					
38209	Wash harvest stem cells		S	5241	4.7956	$397.06	.	$79.42					
38210	T-cell depletion of harvest		S	5241	4.7956	$397.06	.	$79.42					
38211	Tumor cell deplete of harvst		S	5241	4.7956	$397.06	.	$79.42					
38212	Rbc depletion of harvest		S	5241	4.7956	$397.06	.	$79.42					
38213	Platelet deplete of harvest		S	5241	4.7956	$397.06	.	$79.42					
38214	Volume deplete of harvest		S	5241	4.7956	$397.06	.	$79.42					
38215	Harvest stem cell concentrte		S	5241	4.7956	$397.06	.	$79.42					
38220	Dx bone marrow aspirations		J1	5072	16.9934	"$1,407.00"	.	$281.41					
38221	Dx bone marrow biopsies		J1	5072	16.9934	"$1,407.00"	.	$281.41					
38222	Dx bone marrow bx & aspir		J1	5073	28.6243	"$2,370.01"	.	$474.01					
38230	Bone marrow harvest allogen		S	5242	16.4639	"$1,363.16"	.	$272.64					
38232	Bone marrow harvest autolog		S	5243	48.7664	"$4,037.71"	.	$807.55					
38240	Transplt allo hct/donor		J1	5244	384.5324	"$31,838.13"	.	"$6,367.63"	*				
38241	Transplt autol hct/donor		S	5242	16.4639	"$1,363.16"	.	$272.64					
38242	Transplt allo lymphocytes		S	5242	16.4639	"$1,363.16"	.	$272.64					
38243	Transplj hematopoietic boost		S	5242	16.4639	"$1,363.16"	.	$272.64					
38300	Drainage lymph node lesion		J1	5073	28.6243	"$2,370.01"	.	$474.01					
38305	Drainage lymph node lesion		J1	5073	28.6243	"$2,370.01"	.	$474.01					
38308	Incision of lymph channels		J1	5091	38.1383	"$3,157.74"	.	$631.55					
38380	Thoracic duct procedure		C										
38381	Thoracic duct procedure		C										
38382	Thoracic duct procedure		C										
38500	Biopsy/removal lymph nodes		J1	5091	38.1383	"$3,157.74"	.	$631.55					
38505	Needle biopsy lymph nodes		J1	5072	16.9934	"$1,407.00"	.	$281.41					
38510	Biopsy/removal lymph nodes		J1	5091	38.1383	"$3,157.74"	.	$631.55					
38520	Biopsy/removal lymph nodes		J1	5091	38.1383	"$3,157.74"	.	$631.55					
38525	Biopsy/removal lymph nodes		J1	5091	38.1383	"$3,157.74"	.	$631.55					
38530	Biopsy/removal lymph nodes		J1	5091	38.1383	"$3,157.74"	.	$631.55					
38531	Open bx/exc inguinofem nodes		J1	5091	38.1383	"$3,157.74"	.	$631.55					
38542	Explore deep node(s) neck		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
38550	Removal neck/armpit lesion		J1	5091	38.1383	"$3,157.74"	.	$631.55					
38555	Removal neck/armpit lesion		J1	5092	66.8375	"$5,533.94"	.	"$1,106.79"					
38562	Removal pelvic lymph nodes	CH	J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
38564	Removal abdomen lymph nodes		C										
38570	Laparoscopy lymph node biop		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
38571	Laparoscopy lymphadenectomy		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
38572	Laparoscopy lymphadenectomy		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
38573	Laps pelvic lymphadec		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
38589	Laparoscope proc lymphatic		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
38700	Removal of lymph nodes neck		J1	5092	66.8375	"$5,533.94"	.	"$1,106.79"					
38720	Removal of lymph nodes neck		J1	5093	107.7339	"$8,920.04"	.	"$1,784.01"	*				
38724	Removal of lymph nodes neck		C										
38740	Remove armpit lymph nodes		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
38745	Remove armpit lymph nodes		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
38746	Remove thoracic lymph nodes		C										
38747	Remove abdominal lymph nodes		C										
38760	Remove groin lymph nodes		J1	5092	66.8375	"$5,533.94"	.	"$1,106.79"					
38765	Remove groin lymph nodes		C										
38770	Remove pelvis lymph nodes		C										
38780	Remove abdomen lymph nodes		C										
38790	Inject for lymphatic x-ray		N										
38792	Ra tracer id of sentinl node		Q1	5591	4.5547	$377.12	.	$75.43					
38794	Access thoracic lymph duct		N										
38900	Io map of sent lymph node		N										
38999	Blood/lymph system procedure		S	5241	4.7956	$397.06	.	$79.42					
39000	Exploration of chest		C										
39010	Exploration of chest		C										
39200	Resect mediastinal cyst		C										
39220	Resect mediastinal tumor		C										
39401	Mediastinoscpy w/medstnl bx		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
39402	Mediastinoscpy w/lmph nod bx		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
39499	Chest procedure		C										
39501	Repair diaphragm laceration		C										
39503	Repair of diaphragm hernia		C										
39540	Repair of diaphragm hernia		C										
39541	Repair of diaphragm hernia		C										
39545	Revision of diaphragm		C										
39560	Resect diaphragm simple		C										
39561	Resect diaphragm complex		C										
39599	Diaphragm surgery procedure		C										
4000F	Tobacco use txmnt counseling		E1										
4001F	Tobacco use txmnt pharmacol		E1										
4003F	Pt ed write/oral pts w/ hf		E1										
4004F	Pt tobacco screen rcvd tlk		M										
4005F	Pharm thx for op rxd		E1										
4008F	Beta-blocker therapy rxd/tkn		M										
4010F	Ace/arb therapy rxd/taken		M										
4011F	Oral antiplatelet therapy rx		E1										
4012F	Warfarin therapy rx		E1										
4013F	Statin therapy/currently tkn		E1										
4014F	Written discharge instr prvd		E1										
4015F	Persist asthma medicine ctrl		E1										
4016F	Anti-inflm/anlgsc agent rx		E1										
4017F	Gi prophylaxis for nsaid rx		E1										
4018F	Therapy exercise joint rx		E1										
4019F	Doc recpt counsl vit d/calc+		E1										
4025F	Inhaled bronchodilator rx		E1										
4030F	Oxygen therapy rx		E1										
4033F	Pulmonary rehab rec		E1										
4035F	Influenza imm rec		E1										
4037F	Influenza imm order/admin		E1										
4040F	Pneumoc vac/admin/rcvd		M										
4041F	Doc order cefazolin/cefurox		E1										
4042F	Doc antibio not given		E1										
4043F	Doc order given stop antibio		E1										
4044F	Doc order given vte prophylx		M										
4045F	Empiric antibiotic rx		E1										
4046F	Doc antibio given b/4 surg		E1										
4047F	Doc antibio given b/4 surg		E1										
4048F	Doc antibio given b/4 surg		E1										
40490	Biopsy of lip		T	5161	2.5557	$211.60	.	$42.33					
4049F	Doc order given stop antibio		E1										
40500	Partial excision of lip		J1	5164	33.0494	"$2,736.39"	.	$547.28					
4050F	Ht care plan doc		E1										
40510	Partial excision of lip		J1	5164	33.0494	"$2,736.39"	.	$547.28					
4051F	Referred for an av fistula		E1										
40520	Partial excision of lip		J1	5164	33.0494	"$2,736.39"	.	$547.28					
40525	Reconstruct lip with flap		J1	5164	33.0494	"$2,736.39"	.	$547.28					
40527	Reconstruct lip with flap		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
4052F	Hemodialysis via av fistula		E1										
40530	Partial removal of lip		J1	5164	33.0494	"$2,736.39"	.	$547.28					
4053F	Hemodialysis via av graft		E1										
4054F	Hemodialysis via catheter		E1										
4055F	Pt rcvng periton dialysis		E1										
4056F	Approp oral rehyd recommd		E1										
4058F	Ped gastro ed given caregvr		E1										
4060F	Psych svcs provided		E1										
4062F	Pt referral psych docd		E1										
4063F	Antidepres rxthxpy not rxd		E1										
4064F	Antidepressant rx		E1										
40650	Repair lip		T	5162	5.4635	$452.36	.	$90.48					
40652	Repair lip		T	5162	5.4635	$452.36	.	$90.48					
40654	Repair lip		J1	5163	16.3386	"$1,352.79"	.	$270.56					
4065F	Antipsychotic rx		E1										
4066F	Ect provided		E1										
4067F	Pt referral for ect docd		E1										
4069F	Vte prophylaxis rcvd		E1										
40700	Repair cleft lip/nasal		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
40701	Repair cleft lip/nasal		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
40702	Repair cleft lip/nasal		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
4070F	Dvt prophylx recvd day 2		E1										
40720	Repair cleft lip/nasal		J1	5164	33.0494	"$2,736.39"	.	$547.28					
4073F	Oral antiplat thx rx dischrg		E1										
4075F	Anticoag thx rx at dischrg		E1										
40761	Repair cleft lip/nasal		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
4077F	Doc t-pa admin considered		E1										
40799	Lip surgery procedure		T	5161	2.5557	$211.60	.	$42.33					
4079F	Doc rehab svcs considered		E1										
40800	Drainage of mouth lesion		T	5071	7.5120	$621.97	.	$124.40					
40801	Drainage of mouth lesion		T	5162	5.4635	$452.36	.	$90.48					
40804	Removal foreign body mouth		Q1	5301	9.7781	$809.60	.	$161.92					
40805	Removal foreign body mouth		T	5162	5.4635	$452.36	.	$90.48					
40806	Incision of lip fold		T	5162	5.4635	$452.36	.	$90.48					
40808	Biopsy of mouth lesion		T	5162	5.4635	$452.36	.	$90.48					
40810	Excision of mouth lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
40812	Excise/repair mouth lesion		J1	5163	16.3386	"$1,352.79"	.	$270.56					
40814	Excise/repair mouth lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
40816	Excision of mouth lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
40818	Excise oral mucosa for graft		T	5162	5.4635	$452.36	.	$90.48					
40819	Excise lip or cheek fold		J1	5163	16.3386	"$1,352.79"	.	$270.56					
40820	Treatment of mouth lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
40830	Repair mouth laceration		T	5161	2.5557	$211.60	.	$42.33					
40831	Repair mouth laceration		T	5162	5.4635	$452.36	.	$90.48					
40840	Reconstruction of mouth		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
40842	Reconstruction of mouth		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
40843	Reconstruction of mouth		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
40844	Reconstruction of mouth		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
40845	Reconstruction of mouth		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
4084F	Aspirin recvd w/in 24 hrs		E1										
4086F	Aspirin/clopidogrel rxd		M										
40899	Mouth surgery procedure		T	5161	2.5557	$211.60	.	$42.33					
4090F	Pt rcvng epo thxpy		M										
4095F	Pt not rcvng epo thxpy		E1										
41000	Drainage of mouth lesion		T	5162	5.4635	$452.36	.	$90.48					
41005	Drainage of mouth lesion		T	5161	2.5557	$211.60	.	$42.33					
41006	Drainage of mouth lesion		J1	5163	16.3386	"$1,352.79"	.	$270.56					
41007	Drainage of mouth lesion		J1	5163	16.3386	"$1,352.79"	.	$270.56					
41008	Drainage of mouth lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
41009	Drainage of mouth lesion		T	5162	5.4635	$452.36	.	$90.48					
4100F	Biphos thxpy vein ord/recvd		M										
41010	Incision of tongue fold		J1	5163	16.3386	"$1,352.79"	.	$270.56					
41015	Drainage of mouth lesion		T	5162	5.4635	$452.36	.	$90.48					
41016	Drainage of mouth lesion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
41017	Drainage of mouth lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
41018	Drainage of mouth lesion		J1	5163	16.3386	"$1,352.79"	.	$270.56					
41019	Place needles h&n for rt		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
41100	Biopsy of tongue		T	5162	5.4635	$452.36	.	$90.48					
41105	Biopsy of tongue		J1	5164	33.0494	"$2,736.39"	.	$547.28					
41108	Biopsy of floor of mouth		J1	5072	16.9934	"$1,407.00"	.	$281.41					
4110F	Int mam art used for cabg		M										
41110	Excision of tongue lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
41112	Excision of tongue lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
41113	Excision of tongue lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
41114	Excision of tongue lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
41115	Excision of tongue fold		J1	5163	16.3386	"$1,352.79"	.	$270.56					
41116	Excision of mouth lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
41120	Partial removal of tongue		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
41130	Partial removal of tongue		C										
41135	Tongue and neck surgery		C										
41140	Removal of tongue		C										
41145	Tongue removal neck surgery		C										
41150	Tongue mouth jaw surgery		C										
41153	Tongue mouth neck surgery		C										
41155	Tongue jaw & neck surgery		C										
4115F	Beta blckr admin w/in 24 hrs		M										
4120F	Antibiot rxd/given		M										
4124F	Antibiot not rxd/given		M										
41250	Repair tongue laceration	CH	Q1	5735	3.2637	$270.22	.	$54.05					
41251	Repair tongue laceration		T	5161	2.5557	$211.60	.	$42.33					
41252	Repair tongue laceration		T	5161	2.5557	$211.60	.	$42.33					
4130F	Topical prep rx aoe		M										
4131F	Syst antimicrobial thx rx		M										
4132F	No syst antimicrobial thx rx		M										
4133F	Antihist/decong rx/recom		E1										
4134F	No antihist/decong rx/recom		E1										
4135F	Systemic corticosteroids rx		E1										
4136F	Syst corticosteroids not rx		E1										
4140F	Inhaled corticosteroids rxd		E1										
4142F	Corticoster sparng thrpy rxd		E1										
4144F	Alt long-term cntrl med rxd		E1										
4145F	2+ anti-hyprtnsv agents tkn		E1										
4148F	Hep a vac injxn admin/recvd		E1										
4149F	Hep b vac injxn admin/recvd		E1										
4150F	Pt recvng antivir txmnt hepc		E1										
41510	Tongue to lip surgery		J1	5164	33.0494	"$2,736.39"	.	$547.28					
41512	Tongue suspension		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
4151F	Pt not recvng antiv hep c		E1										
41520	Reconstruction tongue fold		J1	5164	33.0494	"$2,736.39"	.	$547.28					
41530	Tongue base vol reduction		J1	5164	33.0494	"$2,736.39"	.	$547.28					
4153F	Combo pegintf/rib rx		E1										
4155F	Hep a vac series prev recvd		E1										
4157F	Hep b vac series prev recvd		E1										
4158F	Pt edu re alcoh drnkng done		E1										
41599	Tongue and mouth surgery		T	5161	2.5557	$211.60	.	$42.33					
4159F	Contrcp talk b/4 antiv txmnt		E1										
4163F	Pt couns 4 txmnt opt prost		E1										
4164F	Adjv hrmnl thxpy rxd		E1										
4165F	3d-crt/imrt received		E1										
4167F	Hd bed tilted 1st day vent		E1										
4168F	Pt care icu&vent w/in 24hrs		E1										
4169F	No pt care icu/vent in 24hrs		E1										
4171F	Pt rcvng esa thxpy		E1										
4172F	Pt not rcvng esa thxpy		E1										
4174F	Couns potent glauc impct		E1										
4175F	Vis 20/40/> w/in 90 days		M										
4176F	Talk re uv light pt/crgvr		E1										
4177F	Talk pt/crgvr re areds prev		M										
4178F	Antid glbln rcvd w/in 26wks		E1										
4179F	Tamoxifen/ai prescribed		E1										
41800	Drainage of gum lesion		Q1	5734	1.3521	$111.95	.	$22.39					
41805	Removal foreign body gum		J1	5163	16.3386	"$1,352.79"	.	$270.56					
41806	Removal foreign body jawbone		J1	5163	16.3386	"$1,352.79"	.	$270.56					
4180F	Adjv thxpyrxd/rcvd colon ca		E1										
4181F	Conformal radn thxpy rcvd		E1										
41820	Excision gum each quadrant		J1	5164	33.0494	"$2,736.39"	.	$547.28					
41821	Excision of gum flap		J1	5163	16.3386	"$1,352.79"	.	$270.56					
41822	Excision of gum lesion		J1	5163	16.3386	"$1,352.79"	.	$270.56					
41823	Excision of gum lesion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
41825	Excision of gum lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
41826	Excision of gum lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
41827	Excision of gum lesion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
41828	Excision of gum lesion		J1	5163	16.3386	"$1,352.79"	.	$270.56					
4182F	No conformal radn thxpy		E1										
41830	Removal of gum tissue		J1	5164	33.0494	"$2,736.39"	.	$547.28					
41850	Treatment of gum lesion		J1	5163	16.3386	"$1,352.79"	.	$270.56					
4185F	Continuous ppi or h2ra rcvd		E1										
4186F	No cont ppi or h2ra rcvd		E1										
41870	Gum graft		J1	5163	16.3386	"$1,352.79"	.	$270.56					
41872	Repair gum		J1	5164	33.0494	"$2,736.39"	.	$547.28					
41874	Repair tooth socket		J1	5164	33.0494	"$2,736.39"	.	$547.28					
4187F	Anti rheum drugthxpyrxd/gvn		E1										
4188F	Approp ace/arb tstng done		E1										
41899	Dental surgery procedure		T	5161	2.5557	$211.60	.	$42.33					
4189F	Approp digoxin tstng done		E1										
4190F	Approp diuretic tstng done		E1										
4191F	Approp anticonvuls tstng		E1										
4192F	Pt not rcvng glucoco thxpy		M										
4193F	Pt rcvng<10mg daily predniso		M										
4194F	Pt rcvng10mg daily predniso		M										
4195F	Pt rcvng anti-rheum thxpy ra		M										
4196F	Ptnot rcvng anti-rhm thxpyra		M										
42000	Drainage mouth roof lesion		T	5161	2.5557	$211.60	.	$42.33					
4200F	External beam to prost only		E1										
4201F	Extrnl beam other than prost		E1										
42100	Biopsy roof of mouth		J1	5163	16.3386	"$1,352.79"	.	$270.56					
42104	Excision lesion mouth roof		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42106	Excision lesion mouth roof		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42107	Excision lesion mouth roof		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
4210F	Ace/arb thxpy for mos/>		E1										
42120	Remove palate/lesion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42140	Excision of uvula		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42145	Repair palate pharynx/uvula		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42160	Treatment mouth roof lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42180	Repair palate		T	5162	5.4635	$452.36	.	$90.48					
42182	Repair palate		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42200	Reconstruct cleft palate		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42205	Reconstruct cleft palate		J1	5164	33.0494	"$2,736.39"	.	$547.28					
4220F	Digoxin thxpy for 6 mos/>		E1										
42210	Reconstruct cleft palate		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42215	Reconstruct cleft palate		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
4221F	Diuretic thxpy for 6 mos/>		E1										
42220	Reconstruct cleft palate		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42225	Reconstruct cleft palate		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42226	Lengthening of palate		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42227	Lengthening of palate		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42235	Repair palate		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42260	Repair nose to lip fistula		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42280	Preparation palate mold		T	5162	5.4635	$452.36	.	$90.48					
42281	Insertion palate prosthesis		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42299	Palate/uvula surgery		T	5161	2.5557	$211.60	.	$42.33					
42300	Drainage of salivary gland		J1	5163	16.3386	"$1,352.79"	.	$270.56					
42305	Drainage of salivary gland		J1	5164	33.0494	"$2,736.39"	.	$547.28					
4230F	Anticonv thxpy for 6 mos/>		E1										
42310	Drainage of salivary gland		T	5162	5.4635	$452.36	.	$90.48					
42320	Drainage of salivary gland		T	5162	5.4635	$452.36	.	$90.48					
42330	Removal of salivary stone		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42335	Removal of salivary stone		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42340	Removal of salivary stone		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42400	Biopsy of salivary gland		T	5071	7.5120	$621.97	.	$124.40					
42405	Biopsy of salivary gland		J1	5163	16.3386	"$1,352.79"	.	$270.56					
42408	Excision of salivary cyst		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42409	Drainage of salivary cyst		J1	5164	33.0494	"$2,736.39"	.	$547.28					
4240F	Instr xrcz back pain 12 wks		E1										
42410	Excise parotid gland/lesion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42415	Excise parotid gland/lesion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42420	Excise parotid gland/lesion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42425	Excise parotid gland/lesion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42426	Excise parotid gland/lesion		C										
4242F	Sprvsd xrcz back pn >12 wks		E1										
42440	Excise submaxillary gland		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42450	Excise sublingual gland		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
4245F	Pt instr nrml lifest		E1										
4248F	Pt instr no bd rest 4 days/>		E1										
42500	Repair salivary duct		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42505	Repair salivary duct		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42507	Parotid duct diversion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42509	Parotid duct diversion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
4250F	Wrmng 4 surg normothermia		E1										
42510	Parotid duct diversion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42550	Injection for salivary x-ray		N										
4255F	Anesth 60 min/> as docd		M										
4256F	Anesthe <60 min as docd		E1										
42600	Closure of salivary fistula		J1	5164	33.0494	"$2,736.39"	.	$547.28					
4260F	Wound srfc culturetech used		E1										
4261F	Tech other than surfc cultr		E1										
42650	Dilation of salivary duct		J1	5163	16.3386	"$1,352.79"	.	$270.56					
4265F	Wet-dry dressings rx recmd		E1										
42660	Dilation of salivary duct		T	5162	5.4635	$452.36	.	$90.48					
42665	Ligation of salivary duct		J1	5164	33.0494	"$2,736.39"	.	$547.28					
4266F	No wet-dry drssings rx recmd		E1										
4267F	Comprssion thxpy prescribed		E1										
4268F	Pt ed re comp thxpy rcvd		E1										
42699	Salivary surgery procedure		T	5161	2.5557	$211.60	.	$42.33					
4269F	Appropos mthd offloading rxd		E1										
42700	Drainage of tonsil abscess		T	5161	2.5557	$211.60	.	$42.33					
4270F	Pt rcvng anti r-viral thxpy		E1										
4271F	Pt rcvng anti r-viral thxpy		E1										
42720	Drainage of throat abscess		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42725	Drainage of throat abscess		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
4274F	Flu immuno admind rcvd		E1										
4276F	Potent antivir thxpy rxd		E1										
4279F	Pcp prophylaxis rxd		E1										
42800	Biopsy of throat		J1	5163	16.3386	"$1,352.79"	.	$270.56					
42804	Biopsy of upper nose/throat		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42806	Biopsy of upper nose/throat		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42808	Excise pharynx lesion		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42809	Remove pharynx foreign body		Q1	5735	3.2637	$270.22	.	$54.05					
4280F	Pcp prophylax rxd 3mon low %		E1										
42810	Excision of neck cyst		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42815	Excision of neck cyst		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42820	Remove tonsils and adenoids		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42821	Remove tonsils and adenoids		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42825	Removal of tonsils		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42826	Removal of tonsils		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42830	Removal of adenoids		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42831	Removal of adenoids		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42835	Removal of adenoids		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42836	Removal of adenoids		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42842	Extensive surgery of throat		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42844	Extensive surgery of throat		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42845	Extensive surgery of throat		C										
42860	Excision of tonsil tags		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42870	Excision of lingual tonsil		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42890	Partial removal of pharynx		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42892	Revision of pharyngeal walls		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42894	Revision of pharyngeal walls		C										
42900	Repair throat wound		J1	5163	16.3386	"$1,352.79"	.	$270.56					
4290F	Pt scrned for inj drug use		E1										
4293F	Pt scrnd hgh-risk sex behav		E1										
42950	Reconstruction of throat		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
42953	Repair throat esophagus		C										
42955	Surgical opening of throat		J1	5163	16.3386	"$1,352.79"	.	$270.56					
42960	Control throat bleeding		T	5162	5.4635	$452.36	.	$90.48					
42961	Control throat bleeding		C										
42962	Control throat bleeding		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42970	Control nose/throat bleeding		T	5161	2.5557	$211.60	.	$42.33					
42971	Control nose/throat bleeding		C										
42972	Control nose/throat bleeding		J1	5164	33.0494	"$2,736.39"	.	$547.28					
42999	Throat surgery procedure		T	5161	2.5557	$211.60	.	$42.33					
4300F	Pt rcvng warf thxpy		E1										
4301F	Pt not rcvng warf thxpy		E1										
43020	Incision of esophagus		J1	5163	16.3386	"$1,352.79"	.	$270.56					
43030	Throat muscle surgery		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
43045	Incision of esophagus		C										
4305F	Pt ed re ft care inspct rcvd		E1										
4306F	Pt tlk psych & rx opd addic		E1										
43100	Excision of esophagus lesion		C										
43101	Excision of esophagus lesion		C										
43107	Removal of esophagus		C										
43108	Removal of esophagus		C										
43112	Esphg tot w/thrcm		C										
43113	Removal of esophagus		C										
43116	Partial removal of esophagus		C										
43117	Partial removal of esophagus		C										
43118	Partial removal of esophagus		C										
43121	Partial removal of esophagus		C										
43122	Partial removal of esophagus		C										
43123	Partial removal of esophagus		C										
43124	Removal of esophagus		C										
43130	Removal of esophagus pouch		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
43135	Removal of esophagus pouch		C										
43180	Esophagoscopy rigid trnso		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
43191	Esophagoscopy rigid trnso dx		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43192	Esophagoscp rig trnso inject		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43193	Esophagoscp rig trnso biopsy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43194	Esophagoscp rig trnso rem fb		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43195	Esophagoscopy rigid balloon		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43196	Esophagoscp guide wire dilat		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43197	Esophagoscopy flex dx brush		T	5301	9.7781	$809.60	.	$161.92					
43198	Esophagosc flex trnsn biopsy		T	5301	9.7781	$809.60	.	$161.92					
43200	Esophagoscopy flexible brush		T	5301	9.7781	$809.60	.	$161.92					
43201	Esoph scope w/submucous inj		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43202	Esophagoscopy flex biopsy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43204	Esoph scope w/sclerosis inj		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43205	Esophagus endoscopy/ligation		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43206	Esoph optical endomicroscopy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
4320F	Pt talk psychsoc&rx oh dpnd		E1										
43210	Egd esophagogastrc fndoplsty		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
43211	Esophagoscop mucosal resect		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43212	Esophagoscop stent placement		J1	5331	60.7331	"$5,028.52"	.	"$1,005.71"					
43213	Esophagoscopy retro balloon		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43214	Esophagosc dilate balloon 30		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43215	Esophagoscopy flex remove fb		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43216	Esophagoscopy lesion removal		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43217	Esophagoscopy snare les remv		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43220	Esophagoscopy balloon <30mm		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43226	Esoph endoscopy dilation		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43227	Esophagoscopy control bleed		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43229	Esophagoscopy lesion ablate		J1	5303	37.2090	"$3,080.79"	.	$616.16					
4322F	Crgvr prov w/ ed addl rsrcs		M										
43231	Esophagoscop ultrasound exam		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43232	Esophagoscopy w/us needle bx		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43233	Egd balloon dil esoph30 mm/>		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43235	Egd diagnostic brush wash		T	5301	9.7781	$809.60	.	$161.92					
43236	Uppr gi scope w/submuc inj		T	5301	9.7781	$809.60	.	$161.92					
43237	Endoscopic us exam esoph		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43238	Egd us fine needle bx/aspir		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43239	Egd biopsy single/multiple		T	5301	9.7781	$809.60	.	$161.92					
43240	Egd w/transmural drain cyst		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43241	Egd tube/cath insertion		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43242	Egd us fine needle bx/aspir		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43243	Egd injection varices		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43244	Egd varices ligation		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43245	Egd dilate stricture		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43246	Egd place gastrostomy tube		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43247	Egd remove foreign body		T	5301	9.7781	$809.60	.	$161.92					
43248	Egd guide wire insertion		T	5301	9.7781	$809.60	.	$161.92					
43249	Esoph egd dilation <30 mm		J1	5302	19.6265	"$1,625.02"	.	$325.01					
4324F	Pt queried prkns complic		E1										
43250	Egd cautery tumor polyp		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43251	Egd remove lesion snare		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43252	Egd optical endomicroscopy		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43253	Egd us transmural injxn/mark		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43254	Egd endo mucosal resection		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43255	Egd control bleeding any		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43257	Egd w/thrml txmnt gerd		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43259	Egd us exam duodenum/jejunum		J1	5302	19.6265	"$1,625.02"	.	$325.01					
4325F	Med txmnt options rvwd w/pt		M										
43260	Ercp w/specimen collection		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43261	Endo cholangiopancreatograph		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43262	Endo cholangiopancreatograph		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43263	Ercp sphincter pressure meas		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43264	Ercp remove duct calculi		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43265	Ercp lithotripsy calculi		J1	5331	60.7331	"$5,028.52"	.	"$1,005.71"					
43266	Egd endoscopic stent place		J1	5331	60.7331	"$5,028.52"	.	"$1,005.71"					
4326F	Pt asked re symp auto dysfxn		E1										
43270	Egd lesion ablation		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43273	Endoscopic pancreatoscopy		N										
43274	Ercp duct stent placement		J1	5331	60.7331	"$5,028.52"	.	"$1,005.71"					
43275	Ercp remove forgn body duct		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43276	Ercp stent exchange w/dilate		J1	5331	60.7331	"$5,028.52"	.	"$1,005.71"					
43277	Ercp ea duct/ampulla dilate		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43278	Ercp lesion ablate w/dilate		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43279	Lap myotomy heller		C										
43280	Laparoscopy fundoplasty		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
43281	Lap paraesophag hern repair		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
43282	Lap paraesoph her rpr w/mesh		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
43283	Lap esoph lengthening		C										
43284	Laps esophgl sphnctr agmntj		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
43285	Rmvl esophgl sphnctr dev		Q2	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
43286	Esphg tot w/laps moblj		C										
43287	Esphg dstl 2/3 w/laps moblj		C										
43288	Esphg thrsc moblj		C										
43289	Laparoscope proc esoph		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
4328F	Pt asked re sleep disturb		E1										
43300	Repair of esophagus		C										
43305	Repair esophagus and fistula		C										
4330F	Cnslng epi spec sfty issues		E1										
43310	Repair of esophagus		C										
43312	Repair esophagus and fistula		C										
43313	Esophagoplasty congenital		C										
43314	Tracheo-esophagoplasty cong		C										
43320	Fuse esophagus & stomach		C										
43325	Revise esophagus & stomach		C										
43327	Esoph fundoplasty lap		C										
43328	Esoph fundoplasty thor		C										
43330	Esophagomyotomy abdominal		C										
43331	Esophagomyotomy thoracic		C										
43332	Transab esoph hiat hern rpr		C										
43333	Transab esoph hiat hern rpr		C										
43334	Transthor diaphrag hern rpr		C										
43335	Transthor diaphrag hern rpr		C										
43336	Thorabd diaphr hern repair		C										
43337	Thorabd diaphr hern repair		C										
43338	Esoph lengthening		C										
43340	Fuse esophagus & intestine		C										
43341	Fuse esophagus & intestine		C										
43351	Surgical opening esophagus		C										
43352	Surgical opening esophagus		C										
43360	Gastrointestinal repair		C										
43361	Gastrointestinal repair		C										
43400	Ligate esophagus veins		C										
43405	Ligate/staple esophagus		C										
4340F	Cnslng chldbrng women epi		M										
43410	Repair esophagus wound		C										
43415	Repair esophagus wound		C										
43420	Repair esophagus opening		J1	5164	33.0494	"$2,736.39"	.	$547.28					
43425	Repair esophagus opening		C										
43450	Dilate esophagus 1/mult pass		T	5301	9.7781	$809.60	.	$161.92					
43453	Dilate esophagus		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43460	Pressure treatment esophagus		C										
43496	Free jejunum flap microvasc		C										
43499	Esophagus surgery procedure		T	5301	9.7781	$809.60	.	$161.92					
43500	Surgical opening of stomach		C										
43501	Surgical repair of stomach		C										
43502	Surgical repair of stomach		C										
4350F	Cnslng provided symp mngmnt		E1										
43510	Surgical opening of stomach		T	5301	9.7781	$809.60	.	$161.92					
43520	Incision of pyloric muscle		C										
43605	Biopsy of stomach		C										
43610	Excision of stomach lesion		C										
43611	Excision of stomach lesion		C										
43620	Removal of stomach		C										
43621	Removal of stomach		C										
43622	Removal of stomach		C										
43631	Removal of stomach partial		C										
43632	Removal of stomach partial		C										
43633	Removal of stomach partial		C										
43634	Removal of stomach partial		C										
43635	Removal of stomach partial		C										
43640	Vagotomy & pylorus repair		C										
43641	Vagotomy & pylorus repair		C										
43644	Lap gastric bypass/roux-en-y		C										
43645	Lap gastr bypass incl smll i		C										
43647	Lap impl electrode antrum	CH	J1	5463	135.7079	"$11,236.21"	.	"$2,247.25"	*				
43648	Lap revise/remv eltrd antrum		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
43651	Laparoscopy vagus nerve		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
43652	Laparoscopy vagus nerve		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
43653	Laparoscopy gastrostomy		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
43659	Laparoscope proc stom		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
43752	Nasal/orogastric w/tube plmt		Q1	5735	3.2637	$270.22	.	$54.05					
43753	Tx gastro intub w/asp		Q1	5722	3.1939	$264.45	.	$52.89					
43754	Dx gastr intub w/asp spec		Q1	5722	3.1939	$264.45	.	$52.89					
43755	Dx gastr intub w/asp specs		S	5721	1.6854	$139.55	.	$27.91					
43756	Dx duod intub w/asp spec		Q1	5301	9.7781	$809.60	.	$161.92					
43757	Dx duod intub w/asp specs		T	5301	9.7781	$809.60	.	$161.92					
43761	Reposition gastrostomy tube		T	5371	3.2144	$266.14	.	$53.23					
43762	Rplc gtube no revj trc		T	5371	3.2144	$266.14	.	$53.23					
43763	Rplc gtube revj gstrst trc		T	5371	3.2144	$266.14	.	$53.23					
43770	Lap place gastr adj device		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
43771	Lap revise gastr adj device		C										
43772	Lap rmvl gastr adj device		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43773	Lap replace gastr adj device		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
43774	Lap rmvl gastr adj all parts		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43775	Lap sleeve gastrectomy		C										
43800	Reconstruction of pylorus		C										
43810	Fusion of stomach and bowel		C										
43820	Fusion of stomach and bowel		C										
43825	Fusion of stomach and bowel		C										
43830	Place gastrostomy tube		J1	5302	19.6265	"$1,625.02"	.	$325.01					
43831	Place gastrostomy tube		T	5301	9.7781	$809.60	.	$161.92					
43832	Place gastrostomy tube		C										
43840	Repair of stomach lesion	CH	J1	5331	60.7331	"$5,028.52"	.	"$1,005.71"					
43842	V-band gastroplasty		E1										
43843	Gastroplasty w/o v-band		C										
43845	Gastroplasty duodenal switch		C										
43846	Gastric bypass for obesity		C										
43847	Gastric bypass incl small i		C										
43848	Revision gastroplasty		C										
43850	Revise stomach-bowel fusion		C										
43855	Revise stomach-bowel fusion		C										
43860	Revise stomach-bowel fusion		C										
43865	Revise stomach-bowel fusion		C										
43870	Repair stomach opening		J1	5303	37.2090	"$3,080.79"	.	$616.16					
43880	Repair stomach-bowel fistula		C										
43881	Impl/redo electrd antrum		C										
43882	Revise/remove electrd antrum		C										
43886	Revise gastric port open		T	5055	42.5396	"$3,522.15"	.	$704.44					
43887	Remove gastric port open		Q2	5054	20.7177	"$1,715.36"	.	$343.08					
43888	Change gastric port open		T	5055	42.5396	"$3,522.15"	.	$704.44					
43999	Stomach surgery procedure		T	5301	9.7781	$809.60	.	$161.92					
44005	Freeing of bowel adhesion		C										
4400F	Rehab thxpy options w/pt		M										
44010	Incision of small bowel		C										
44015	Insert needle cath bowel		C										
44020	Explore small intestine		C										
44021	Decompress small bowel		C										
44025	Incision of large bowel		C										
44050	Reduce bowel obstruction		C										
44055	Correct malrotation of bowel		C										
44100	Biopsy of bowel		T	5301	9.7781	$809.60	.	$161.92					
44110	Excise intestine lesion(s)		C										
44111	Excision of bowel lesion(s)		C										
44120	Removal of small intestine		C										
44121	Removal of small intestine		C										
44125	Removal of small intestine		C										
44126	Enterectomy w/o taper cong		C										
44127	Enterectomy w/taper cong		C										
44128	Enterectomy cong add-on		C										
44130	Bowel to bowel fusion		C										
44132	Enterectomy cadaver donor		C										
44133	Enterectomy live donor		C										
44135	Intestine transplnt cadaver		C										
44136	Intestine transplant live		C										
44137	Remove intestinal allograft		C										
44139	Mobilization of colon		C										
44140	Partial removal of colon		C										
44141	Partial removal of colon		C										
44143	Partial removal of colon		C										
44144	Partial removal of colon		C										
44145	Partial removal of colon		C										
44146	Partial removal of colon		C										
44147	Partial removal of colon		C										
44150	Removal of colon		C										
44151	Removal of colon/ileostomy		C										
44155	Removal of colon/ileostomy		C										
44156	Removal of colon/ileostomy		C										
44157	Colectomy w/ileoanal anast		C										
44158	Colectomy w/neo-rectum pouch		C										
44160	Removal of colon		C										
44180	Lap enterolysis		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
44186	Lap jejunostomy		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
44187	Lap ileo/jejuno-stomy		C										
44188	Lap colostomy		C										
44202	Lap enterectomy		C										
44203	Lap resect s/intestine addl		C										
44204	Laparo partial colectomy		C										
44205	Lap colectomy part w/ileum		C										
44206	Lap part colectomy w/stoma		C										
44207	L colectomy/coloproctostomy		C										
44208	L colectomy/coloproctostomy		C										
44210	Laparo total proctocolectomy		C										
44211	Lap colectomy w/proctectomy		C										
44212	Laparo total proctocolectomy		C										
44213	Lap mobil splenic fl add-on		C										
44227	Lap close enterostomy		C										
44238	Laparoscope proc intestine		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
44300	Open bowel to skin	CH	J1	5302	19.6265	"$1,625.02"	.	$325.01					
44310	Ileostomy/jejunostomy		C										
44312	Revision of ileostomy		T	5055	42.5396	"$3,522.15"	.	$704.44					
44314	Revision of ileostomy	CH	T	5055	42.5396	"$3,522.15"	.	$704.44					
44316	Devise bowel pouch		C										
44320	Colostomy		C										
44322	Colostomy with biopsies		C										
44340	Revision of colostomy		T	5055	42.5396	"$3,522.15"	.	$704.44					
44345	Revision of colostomy	CH	J1	5341	38.4484	"$3,183.41"	.	$636.69					
44346	Revision of colostomy	CH	J1	5341	38.4484	"$3,183.41"	.	$636.69					
44360	Small bowel endoscopy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
44361	Small bowel endoscopy/biopsy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
44363	Small bowel endoscopy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
44364	Small bowel endoscopy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
44365	Small bowel endoscopy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
44366	Small bowel endoscopy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
44369	Small bowel endoscopy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
44370	Small bowel endoscopy/stent		J1	5331	60.7331	"$5,028.52"	.	"$1,005.71"					
44372	Small bowel endoscopy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
44373	Small bowel endoscopy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
44376	Small bowel endoscopy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
44377	Small bowel endoscopy/biopsy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
44378	Small bowel endoscopy		J1	5302	19.6265	"$1,625.02"	.	$325.01					
44379	S bowel endoscope w/stent		J1	5331	60.7331	"$5,028.52"	.	"$1,005.71"					
44380	Small bowel endoscopy br/wa		T	5301	9.7781	$809.60	.	$161.92					
44381	Small bowel endoscopy br/wa		J1	5302	19.6265	"$1,625.02"	.	$325.01					
44382	Small bowel endoscopy		T	5301	9.7781	$809.60	.	$161.92					
44384	Small bowel endoscopy		J1	5303	37.2090	"$3,080.79"	.	$616.16					
44385	Endoscopy of bowel pouch		T	5311	9.5855	$793.65	.	$158.74					
44386	Endoscopy bowel pouch/biop		T	5311	9.5855	$793.65	.	$158.74					
44388	Colonoscopy thru stoma spx		T	5311	9.5855	$793.65	.	$158.74					
44389	Colonoscopy with biopsy		T	5312	12.5241	"$1,036.96"	.	$207.40					
44390	Colonoscopy for foreign body		T	5311	9.5855	$793.65	.	$158.74					
44391	Colonoscopy for bleeding		T	5312	12.5241	"$1,036.96"	.	$207.40					
44392	Colonoscopy & polypectomy		T	5312	12.5241	"$1,036.96"	.	$207.40					
44394	Colonoscopy w/snare		T	5312	12.5241	"$1,036.96"	.	$207.40					
44401	Colonoscopy with ablation		T	5312	12.5241	"$1,036.96"	.	$207.40					
44402	Colonoscopy w/stent plcmt		J1	5331	60.7331	"$5,028.52"	.	"$1,005.71"					
44403	Colonoscopy w/resection		T	5312	12.5241	"$1,036.96"	.	$207.40					
44404	Colonoscopy w/injection		T	5312	12.5241	"$1,036.96"	.	$207.40					
44405	Colonoscopy w/dilation		T	5312	12.5241	"$1,036.96"	.	$207.40					
44406	Colonoscopy w/ultrasound		T	5312	12.5241	"$1,036.96"	.	$207.40					
44407	Colonoscopy w/ndl aspir/bx		T	5312	12.5241	"$1,036.96"	.	$207.40					
44408	Colonoscopy w/decompression		T	5311	9.5855	$793.65	.	$158.74					
44500	Intro gastrointestinal tube		T	5301	9.7781	$809.60	.	$161.92					
4450F	Self-care ed provided to pt		E1										
44602	Suture small intestine	CH	J1	5303	37.2090	"$3,080.79"	.	$616.16					
44603	Suture small intestine		C										
44604	Suture large intestine		C										
44605	Repair of bowel lesion		C										
44615	Intestinal stricturoplasty		C										
44620	Repair bowel opening		C										
44625	Repair bowel opening		C										
44626	Repair bowel opening		C										
44640	Repair bowel-skin fistula		C										
44650	Repair bowel fistula		C										
44660	Repair bowel-bladder fistula		C										
44661	Repair bowel-bladder fistula		C										
44680	Surgical revision intestine		C										
44700	Suspend bowel w/prosthesis		C										
44701	Intraop colon lavage add-on		N										
44705	Prepare fecal microbiota		B										
4470F	Icd counseling provided		E1										
44715	Prepare donor intestine		C										
44720	Prep donor intestine/venous		C										
44721	Prep donor intestine/artery		C										
44799	Unlisted px small intestine		T	5301 	9.7781	$809.60	.	$161.92					
44800	Excision of bowel pouch		C										
4480F	Pt rcvng ace/arb b-blockertx		E1										
4481F	Pt rcvng ace/arb blker >3mos		E1										
44820	Excision of mesentery lesion		C										
44850	Repair of mesentery		C										
44899	Bowel surgery procedure		C										
44900	Drain appendix abscess open		C										
44950	Appendectomy		J1	5341	38.4484	"$3,183.41"	.	$636.69					
44955	Appendectomy add-on		N										
44960	Appendectomy		C										
44970	Laparoscopy appendectomy		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
44979	Laparoscope proc app		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
45000	Drainage of pelvic abscess		T	5312	12.5241	"$1,036.96"	.	$207.40					
45005	Drainage of rectal abscess		T	5312	12.5241	"$1,036.96"	.	$207.40					
4500F	Ref to outpt card rehab prog		M										
45020	Drainage of rectal abscess		J1	5313	29.5106	"$2,443.39"	.	$488.68					
45100	Biopsy of rectum		J1	5313	29.5106	"$2,443.39"	.	$488.68					
45108	Removal of anorectal lesion		J1	5313	29.5106	"$2,443.39"	.	$488.68					
4510F	Prev cardrehab qualcardevent		M										
45110	Removal of rectum		C										
45111	Partial removal of rectum		C										
45112	Removal of rectum		C										
45113	Partial proctectomy		C										
45114	Partial removal of rectum		C										
45116	Partial removal of rectum		C										
45119	Remove rectum w/reservoir		C										
45120	Removal of rectum		C										
45121	Removal of rectum and colon		C										
45123	Partial proctectomy		C										
45126	Pelvic exenteration		C										
45130	Excision of rectal prolapse		C										
45135	Excision of rectal prolapse		C										
45136	Excise ileoanal reservior		C										
45150	Excision of rectal stricture		T	5312	12.5241	"$1,036.96"	.	$207.40					
45160	Excision of rectal lesion		J1	5313	29.5106	"$2,443.39"	.	$488.68					
45171	Exc rect tum transanal part		J1	5313	29.5106	"$2,443.39"	.	$488.68					
45172	Exc rect tum transanal full		J1	5313	29.5106	"$2,443.39"	.	$488.68					
45190	Destruction rectal tumor		J1	5313	29.5106	"$2,443.39"	.	$488.68					
4525F	Neuropsychia interven order		E1										
4526F	Neuropsychia interven rcvd		E1										
45300	Proctosigmoidoscopy dx		T	5311	9.5855	$793.65	.	$158.74					
45303	Proctosigmoidoscopy dilate		T	5312	12.5241	"$1,036.96"	.	$207.40					
45305	Proctosigmoidoscopy w/bx		T	5312	12.5241	"$1,036.96"	.	$207.40					
45307	Proctosigmoidoscopy fb		J1	5313	29.5106	"$2,443.39"	.	$488.68					
45308	Proctosigmoidoscopy removal		J1	5313	29.5106	"$2,443.39"	.	$488.68					
45309	Proctosigmoidoscopy removal		T	5312	12.5241	"$1,036.96"	.	$207.40					
45315	Proctosigmoidoscopy removal		T	5312	12.5241	"$1,036.96"	.	$207.40					
45317	Proctosigmoidoscopy bleed		T	5312	12.5241	"$1,036.96"	.	$207.40					
45320	Proctosigmoidoscopy ablate		J1	5313	29.5106	"$2,443.39"	.	$488.68					
45321	Proctosigmoidoscopy volvul		J1	5313	29.5106	"$2,443.39"	.	$488.68					
45327	Proctosigmoidoscopy w/stent		J1	5331	60.7331	"$5,028.52"	.	"$1,005.71"					
45330	Diagnostic sigmoidoscopy		T	5311	9.5855	$793.65	.	$158.74					
45331	Sigmoidoscopy and biopsy		T	5311	9.5855	$793.65	.	$158.74					
45332	Sigmoidoscopy w/fb removal		T	5312	12.5241	"$1,036.96"	.	$207.40					
45333	Sigmoidoscopy & polypectomy		T	5311	9.5855	$793.65	.	$158.74					
45334	Sigmoidoscopy for bleeding		T	5312	12.5241	"$1,036.96"	.	$207.40					
45335	Sigmoidoscopy w/submuc inj		T	5311	9.5855	$793.65	.	$158.74					
45337	Sigmoidoscopy & decompress		T	5311	9.5855	$793.65	.	$158.74					
45338	Sigmoidoscopy w/tumr remove		T	5312	12.5241	"$1,036.96"	.	$207.40					
45340	Sig w/tndsc balloon dilation		T	5312	12.5241	"$1,036.96"	.	$207.40					
45341	Sigmoidoscopy w/ultrasound		T	5311	9.5855	$793.65	.	$158.74					
45342	Sigmoidoscopy w/us guide bx		T	5312	12.5241	"$1,036.96"	.	$207.40					
45346	Sigmoidoscopy w/ablation		T	5312	12.5241	"$1,036.96"	.	$207.40					
45347	Sigmoidoscopy w/plcmt stent		J1	5331	60.7331	"$5,028.52"	.	"$1,005.71"					
45349	Sigmoidoscopy w/resection		J1	5313	29.5106	"$2,443.39"	.	$488.68					
45350	Sgmdsc w/band ligation		T	5312	12.5241	"$1,036.96"	.	$207.40					
45378	Diagnostic colonoscopy		T	5311	9.5855	$793.65	.	$158.74					
45379	Colonoscopy w/fb removal		T	5312	12.5241	"$1,036.96"	.	$207.40					
45380	Colonoscopy and biopsy		T	5312	12.5241	"$1,036.96"	.	$207.40					
45381	Colonoscopy submucous njx		T	5312	12.5241	"$1,036.96"	.	$207.40					
45382	Colonoscopy w/control bleed		T	5312	12.5241	"$1,036.96"	.	$207.40					
45384	Colonoscopy w/lesion removal		T	5312	12.5241	"$1,036.96"	.	$207.40					
45385	Colonoscopy w/lesion removal		T	5312	12.5241	"$1,036.96"	.	$207.40					
45386	Colonoscopy w/balloon dilat		T	5312	12.5241	"$1,036.96"	.	$207.40					
45388	Colonoscopy w/ablation		T	5312	12.5241	"$1,036.96"	.	$207.40					
45389	Colonoscopy w/stent plcmt		J1	5331	60.7331	"$5,028.52"	.	"$1,005.71"					
45390	Colonoscopy w/resection		J1	5313	29.5106	"$2,443.39"	.	$488.68					
45391	Colonoscopy w/endoscope us		T	5312	12.5241	"$1,036.96"	.	$207.40					
45392	Colonoscopy w/endoscopic fnb		T	5312	12.5241	"$1,036.96"	.	$207.40					
45393	Colonoscopy w/decompression		T	5312	12.5241	"$1,036.96"	.	$207.40					
45395	Lap removal of rectum		C										
45397	Lap remove rectum w/pouch		C										
45398	Colonoscopy w/band ligation		T	5312	12.5241	"$1,036.96"	.	$207.40					
45399	Unlisted procedure colon		T	5311	9.5855	$793.65	.	$158.74					
45400	Laparoscopic proc		C										
45402	Lap proctopexy w/sig resect		C										
4540F	Disease modif pharmacothxpy		E1										
4541F	Pt offered tx for pseudobulb		E1										
45499	Laparoscope proc rectum		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
45500	Repair of rectum		J1	5313	29.5106	"$2,443.39"	.	$488.68					
45505	Repair of rectum		J1	5313	29.5106	"$2,443.39"	.	$488.68					
4550F	Noninvas resp support talk		E1										
4551F	Nutritional support offered		E1										
45520	Treatment of rectal prolapse		Q1	5311	9.5855	$793.65	.	$158.74					
4552F	Pt ref for speech lang path		E1										
4553F	Pt asst re end life issues		E1										
45540	Correct rectal prolapse		C										
45541	Correct rectal prolapse		J1	5313	29.5106	"$2,443.39"	.	$488.68					
4554F	Pt recvd inhal anesthetic		M										
45550	Repair rectum/remove sigmoid		C										
4555F	Pt recvd no inhal anesthic		E1										
45560	Repair of rectocele		J1	5313	29.5106	"$2,443.39"	.	$488.68					
45562	Exploration/repair of rectum		C										
45563	Exploration/repair of rectum		C										
4556F	Pt w/3+ post-op nausea&vom		M										
4557F	Pt w/o 3+ post-opnausea&vom		E1										
4558F	Pt recvd 2 rx anti-emet agt		E1										
4559F	1 bodytemp >=35.5cw/in 30min		E1										
4560F	Anesth w/o gen/neurax anesth		E1										
4561F	Pt w/ coronary artery stent		E1										
4562F	Pt w/o coronary artery stent		E1										
4563F	Pt recvd aspirin w/in 24 hrs		E1										
45800	Repair rect/bladder fistula		C										
45805	Repair fistula w/colostomy		C										
45820	Repair rectourethral fistula		C										
45825	Repair fistula w/colostomy		C										
45900	Reduction of rectal prolapse		T	5311	9.5855	$793.65	.	$158.74					
45905	Dilation of anal sphincter		T	5312	12.5241	"$1,036.96"	.	$207.40					
45910	Dilation of rectal narrowing		T	5312	12.5241	"$1,036.96"	.	$207.40					
45915	Remove rectal obstruction		T	5312	12.5241	"$1,036.96"	.	$207.40					
45990	Surg dx exam anorectal		J1	5313	29.5106	"$2,443.39"	.	$488.68					
45999	Rectum surgery procedure		T	5311	9.5855	$793.65	.	$158.74					
46020	Placement of seton		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46030	Removal of rectal marker		T	5312	12.5241	"$1,036.96"	.	$207.40					
46040	Incision of rectal abscess		T	5312	12.5241	"$1,036.96"	.	$207.40					
46045	Incision of rectal abscess		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46050	Incision of anal abscess		T	5311	9.5855	$793.65	.	$158.74					
46060	Incision of rectal abscess		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46070	Incision of anal septum		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46080	Incision of anal sphincter		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46083	Incise external hemorrhoid		T	5371	3.2144	$266.14	.	$53.23					
46200	Removal of anal fissure		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46220	Excise anal ext tag/papilla		T	5312	12.5241	"$1,036.96"	.	$207.40					
46221	Ligation of hemorrhoid(s)		T	5311	9.5855	$793.65	.	$158.74					
46230	Removal of anal tags		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46250	Remove ext hem groups 2+		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46255	Remove int/ext hem 1 group		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46257	Remove in/ex hem grp & fiss		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46258	Remove in/ex hem grp w/fistu		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46260	Remove in/ex hem groups 2+		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46261	Remove in/ex hem grps & fiss		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46262	Remove in/ex hem grps w/fist		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46270	Remove anal fist subq		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46275	Remove anal fist inter		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46280	Remove anal fist complex		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46285	Remove anal fist 2 stage		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46288	Repair anal fistula		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46320	Removal of hemorrhoid clot		T	5312	12.5241	"$1,036.96"	.	$207.40					
46500	Injection into hemorrhoid(s)		T	5311	9.5855	$793.65	.	$158.74					
46505	Chemodenervation anal musc		T	5312	12.5241	"$1,036.96"	.	$207.40					
46600	Diagnostic anoscopy spx		Q1	5734	1.3521	$111.95	.	$22.39					
46601	Diagnostic anoscopy		Q1	5734	1.3521	$111.95	.	$22.39					
46604	Anoscopy and dilation		T	5312	12.5241	"$1,036.96"	.	$207.40					
46606	Anoscopy and biopsy		T	5312	12.5241	"$1,036.96"	.	$207.40					
46607	Diagnostic anoscopy & biopsy		T	5312	12.5241	"$1,036.96"	.	$207.40					
46608	Anoscopy remove for body		T	5311	9.5855	$793.65	.	$158.74					
46610	Anoscopy remove lesion		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46611	Anoscopy		T	5311	9.5855	$793.65	.	$158.74					
46612	Anoscopy remove lesions		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46614	Anoscopy control bleeding		T	5312	12.5241	"$1,036.96"	.	$207.40					
46615	Anoscopy		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46700	Repair of anal stricture		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46705	Repair of anal stricture		C										
46706	Repr of anal fistula w/glue		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46707	Repair anorectal fist w/plug		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46710	Repr per/vag pouch sngl proc		C										
46712	Repr per/vag pouch dbl proc		C										
46715	Rep perf anoper fistu		C										
46716	Rep perf anoper/vestib fistu		C										
46730	Construction of absent anus		C										
46735	Construction of absent anus		C										
46740	Construction of absent anus		C										
46742	Repair of imperforated anus		C										
46744	Repair of cloacal anomaly		C										
46746	Repair of cloacal anomaly		C										
46748	Repair of cloacal anomaly		C										
46750	Repair of anal sphincter		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46751	Repair of anal sphincter		C										
46753	Reconstruction of anus		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46754	Removal of suture from anus		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46760	Repair of anal sphincter		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46761	Repair of anal sphincter		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46900	Destruction anal lesion(s)		T	5052	4.1770	$345.84	.	$69.17					
46910	Destruction anal lesion(s)		T	5054	20.7177	"$1,715.36"	.	$343.08					
46916	Cryosurgery anal lesion(s)		T	5051	2.1685	$179.55	.	$35.91					
46917	Laser surgery anal lesions		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46922	Excision of anal lesion(s)		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46924	Destruction anal lesion(s)		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46930	Destroy internal hemorrhoids		T	5312	12.5241	"$1,036.96"	.	$207.40					
46940	Treatment of anal fissure		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46942	Treatment of anal fissure		T	5311	9.5855	$793.65	.	$158.74					
46945	Int hrhc lig 1 hroid w/o img		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46946	Int hrhc lig 2+hroid w/o img		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46947	Hemorrhoidopexy by stapling		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46948	Int hrhc tranal dartlzj 2+		J1	5313	29.5106	"$2,443.39"	.	$488.68					
46999	Anus surgery procedure		T	5311	9.5855	$793.65	.	$158.74					
47000	Needle biopsy of liver		J1	5072	16.9934	"$1,407.00"	.	$281.41					
47001	Needle biopsy liver add-on		N										
47010	Open drainage liver lesion		C										
47015	Inject/aspirate liver cyst		C										
47100	Wedge biopsy of liver		C										
47120	Partial removal of liver		C										
47122	Extensive removal of liver		C										
47125	Partial removal of liver		C										
47130	Partial removal of liver		C										
47133	Removal of donor liver		C										
47135	Transplantation of liver		C										
47140	Partial removal donor liver		C										
47141	Partial removal donor liver		C										
47142	Partial removal donor liver		C										
47143	Prep donor liver whole		C										
47144	Prep donor liver 3-segment		C										
47145	Prep donor liver lobe split		C										
47146	Prep donor liver/venous		C										
47147	Prep donor liver/arterial		C										
47300	Surgery for liver lesion		C										
47350	Repair liver wound		C										
47360	Repair liver wound		C										
47361	Repair liver wound		C										
47362	Repair liver wound		C										
47370	Laparo ablate liver tumor rf		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
47371	Laparo ablate liver cryosurg		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
47379	Laparoscope procedure liver		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
47380	Open ablate liver tumor rf		C										
47381	Open ablate liver tumor cryo		C										
47382	Percut ablate liver rf		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
47383	Perq abltj lvr cryoablation		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
47399	Liver surgery procedure		T	5071	7.5120	$621.97	.	$124.40					
47400	Incision of liver duct		C										
47420	Incision of bile duct		C										
47425	Incision of bile duct		C										
47460	Incise bile duct sphincter		C										
47480	Incision of gallbladder		C										
47490	Incision of gallbladder		J1	5341	38.4484	"$3,183.41"	.	$636.69					
47531	Injection for cholangiogram		Q2	5341	38.4484	"$3,183.41"	.	$636.69					
47532	Injection for cholangiogram		Q2	5341	38.4484	"$3,183.41"	.	$636.69					
47533	Plmt biliary drainage cath		J1	5341	38.4484	"$3,183.41"	.	$636.69					
47534	Plmt biliary drainage cath		J1	5341	38.4484	"$3,183.41"	.	$636.69					
47535	Conversion ext bil drg cath		J1	5341	38.4484	"$3,183.41"	.	$636.69					
47536	Exchange biliary drg cath		J1	5341	38.4484	"$3,183.41"	.	$636.69					
47537	Removal biliary drg cath		Q2	5301	9.7781	$809.60	.	$161.92					
47538	Perq plmt bile duct stent		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
47539	Perq plmt bile duct stent		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
47540	Perq plmt bile duct stent		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
47541	Plmt access bil tree sm bwl		J1	5341	38.4484	"$3,183.41"	.	$636.69					
47542	Dilate biliary duct/ampulla		N										
47543	Endoluminal bx biliary tree		N										
47544	Removal duct glbldr calculi		N										
47550	Bile duct endoscopy add-on		C										
47552	Biliary endo perq dx w/speci		J1	5341	38.4484	"$3,183.41"	.	$636.69					
47553	Biliary endoscopy thru skin		J1	5341	38.4484	"$3,183.41"	.	$636.69					
47554	Biliary endoscopy thru skin		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
47555	Biliary endoscopy thru skin		J1	5341	38.4484	"$3,183.41"	.	$636.69					
47556	Biliary endoscopy thru skin		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
47562	Laparoscopic cholecystectomy		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
47563	Laparo cholecystectomy/graph		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
47564	Laparo cholecystectomy/explr		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
47570	Laparo cholecystoenterostomy		C										
47579	Laparoscope proc biliary		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
47600	Removal of gallbladder		C										
47605	Removal of gallbladder		C										
47610	Removal of gallbladder		C										
47612	Removal of gallbladder		C										
47620	Removal of gallbladder		C										
47700	Exploration of bile ducts		C										
47701	Bile duct revision		C										
47711	Excision of bile duct tumor		C										
47712	Excision of bile duct tumor		C										
47715	Excision of bile duct cyst		C										
47720	Fuse gallbladder & bowel		C										
47721	Fuse upper gi structures		C										
47740	Fuse gallbladder & bowel		C										
47741	Fuse gallbladder & bowel		C										
47760	Fuse bile ducts and bowel		C										
47765	Fuse liver ducts & bowel		C										
47780	Fuse bile ducts and bowel		C										
47785	Fuse bile ducts and bowel		C										
47800	Reconstruction of bile ducts		C										
47801	Placement bile duct support		C										
47802	Fuse liver duct & intestine		C										
47900	Suture bile duct injury		C										
47999	Bile tract surgery procedure		T	5301 	9.7781	$809.60	.	$161.92					
48000	Drainage of abdomen		C										
48001	Placement of drain pancreas		C										
48020	Removal of pancreatic stone		C										
48100	Biopsy of pancreas open		C										
48102	Needle biopsy pancreas		J1	5072	16.9934	"$1,407.00"	.	$281.41					
48105	Resect/debride pancreas		C										
48120	Removal of pancreas lesion		C										
48140	Partial removal of pancreas		C										
48145	Partial removal of pancreas		C										
48146	Pancreatectomy		C										
48148	Removal of pancreatic duct		C										
48150	Partial removal of pancreas		C										
48152	Pancreatectomy		C										
48153	Pancreatectomy		C										
48154	Pancreatectomy		C										
48155	Removal of pancreas		C										
48160	Pancreas removal/transplant		E1										
48400	Injection intraop add-on		C										
48500	Surgery of pancreatic cyst		C										
48510	Drain pancreatic pseudocyst		C										
48520	Fuse pancreas cyst and bowel		C										
48540	Fuse pancreas cyst and bowel		C										
48545	Pancreatorrhaphy		C										
48547	Duodenal exclusion		C										
48548	Fuse pancreas and bowel		C										
48550	Donor pancreatectomy		E1										
48551	Prep donor pancreas		C										
48552	Prep donor pancreas/venous		C										
48554	Transpl allograft pancreas		C										
48556	Removal allograft pancreas		C										
48999	Pancreas surgery procedure		T	5071	7.5120	$621.97	.	$124.40					
49000	Exploration of abdomen		C										
49002	Reopening of abdomen		C										
49010	Exploration behind abdomen	CH	J1	5341	38.4484	"$3,183.41"	.	$636.69					
49013	Prpertl pel pack hemrrg trma		C										
49014	Reexploration pelvic wound		C										
49020	Drainage abdom abscess open		C										
49040	Drain open abdom abscess		C										
49060	Drain open retroperi abscess		C										
49062	Drain to peritoneal cavity		C										
49082	Abd paracentesis		T	5301	9.7781	$809.60	.	$161.92					
49083	Abd paracentesis w/imaging		T	5301	9.7781	$809.60	.	$161.92					
49084	Peritoneal lavage		T	5301	9.7781	$809.60	.	$161.92					
49180	Biopsy abdominal mass		J1	5072	16.9934	"$1,407.00"	.	$281.41					
49185	Sclerotx fluid collection		T	5071	7.5120	$621.97	.	$124.40					
49203	Exc abd tum 5 cm or less		C										
49204	Exc abd tum over 5 cm		C										
49205	Exc abd tum over 10 cm		C										
49215	Excise sacral spine tumor		C										
49220	Multiple surgery abdomen	CH	D										
49250	Excision of umbilicus		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49255	Removal of omentum	CH	J1	5341	38.4484	"$3,183.41"	.	$636.69					
49320	Diag laparo separate proc		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49321	Laparoscopy biopsy		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49322	Laparoscopy aspiration		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49323	Laparo drain lymphocele		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49324	Lap insert tunnel ip cath		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49325	Lap revision perm ip cath		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49326	Lap w/omentopexy add-on		N										
49327	Lap ins device for rt		N										
49329	Laparo proc abdm/per/oment		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49400	Air injection into abdomen		N										
49402	Remove foreign body adbomen		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49405	Image cath fluid colxn visc		J1	5072	16.9934	"$1,407.00"	.	$281.41					
49406	Image cath fluid peri/retro		J1	5072	16.9934	"$1,407.00"	.	$281.41					
49407	Image cath fluid trns/vgnl		J1	5072	16.9934	"$1,407.00"	.	$281.41					
49411	Ins mark abd/pel for rt perq		S	5613	15.2443	"$1,262.18"	.	$252.44					
49412	Ins device for rt guide open		C										
49418	Insert tun ip cath perc		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49419	Insert tun ip cath w/port		J1	5184	57.6153	"$4,770.37"	.	$954.08					
49421	Ins tun ip cath for dial opn		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49422	Remove tunneled ip cath		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
49423	Exchange drainage catheter		J1	5302	19.6265	"$1,625.02"	.	$325.01					
49424	Assess cyst contrast inject		N										
49425	Insert abdomen-venous drain		C										
49426	Revise abdomen-venous shunt		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49427	Injection abdominal shunt		N										
49428	Ligation of shunt		C										
49429	Removal of shunt		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
49435	Insert subq exten to ip cath		N										
49436	Embedded ip cath exit-site		J1	5302	19.6265	"$1,625.02"	.	$325.01					
49440	Place gastrostomy tube perc		J1	5302	19.6265	"$1,625.02"	.	$325.01					
49441	Place duod/jej tube perc		J1	5302	19.6265	"$1,625.02"	.	$325.01					
49442	Place cecostomy tube perc		T	5312	12.5241	"$1,036.96"	.	$207.40					
49446	Change g-tube to g-j perc		J1	5302	19.6265	"$1,625.02"	.	$325.01					
49450	Replace g/c tube perc		T	5301	9.7781	$809.60	.	$161.92					
49451	Replace duod/jej tube perc		T	5301	9.7781	$809.60	.	$161.92					
49452	Replace g-j tube perc		T	5301	9.7781	$809.60	.	$161.92					
49460	Fix g/colon tube w/device		T	5301	9.7781	$809.60	.	$161.92					
49465	Fluoro exam of g/colon tube		Q1	5523	2.7794	$230.13	.	$46.03					
49491	Rpr hern preemie reduc		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49492	Rpr ing hern premie blocked		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49495	Rpr ing hernia baby reduc		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49496	Rpr ing hernia baby blocked		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49500	Rpr ing hernia init reduce		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49501	Rpr ing hernia init blocked		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49505	Prp i/hern init reduc >5 yr		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49507	Prp i/hern init block >5 yr		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49520	Rerepair ing hernia reduce		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49521	Rerepair ing hernia blocked		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49525	Repair ing hernia sliding		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49540	Repair lumbar hernia		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49550	Rpr rem hernia init reduce		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49553	Rpr fem hernia init blocked		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49555	Rerepair fem hernia reduce		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49557	Rerepair fem hernia blocked		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49560	Rpr ventral hern init reduc		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49561	Rpr ventral hern init block		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49565	Rerepair ventrl hern reduce		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49566	Rerepair ventrl hern block		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49568	Hernia repair w/mesh		N										
49570	Rpr epigastric hern reduce		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49572	Rpr epigastric hern blocked		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49580	Rpr umbil hern reduc < 5 yr		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49582	Rpr umbil hern block < 5 yr		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49585	Rpr umbil hern reduc > 5 yr		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49587	Rpr umbil hern block > 5 yr		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49590	Repair spigelian hernia		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49600	Repair umbilical lesion		J1	5341	38.4484	"$3,183.41"	.	$636.69					
49605	Repair umbilical lesion		C										
49606	Repair umbilical lesion		C										
49610	Repair umbilical lesion		C										
49611	Repair umbilical lesion		C										
49650	Lap ing hernia repair init		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49651	Lap ing hernia repair recur		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49652	Lap vent/abd hernia repair		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49653	Lap vent/abd hern proc comp		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49654	Lap inc hernia repair		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
49655	Lap inc hern repair comp		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
49656	Lap inc hernia repair recur		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
49657	Lap inc hern recur comp		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
49659	Laparo proc hernia repair		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
49900	Repair of abdominal wall		C										
49904	Omental flap extra-abdom		C										
49905	Omental flap intra-abdom		C										
49906	Free omental flap microvasc		C										
49999	Abdomen surgery procedure		T	5301 	9.7781	$809.60	.	$161.92					
50010	Exploration of kidney		C										
50020	Renal abscess open drain		J1	5373	21.6552	"$1,792.99"	.	$358.60					
50040	Drainage of kidney		C										
50045	Exploration of kidney		C										
5005F	Pt counsld on exam for moles		E1										
50060	Removal of kidney stone		C										
50065	Incision of kidney		C										
50070	Incision of kidney		C										
50075	Removal of kidney stone		C										
50080	Removal of kidney stone		J1	5376	99.7395	"$8,258.13"	.	"$1,651.63"	*				
50081	Removal of kidney stone		J1	5376	99.7395	"$8,258.13"	.	"$1,651.63"	*				
50100	Revise kidney blood vessels		C										
5010F	Macul result phy/qhp mng dm		M										
50120	Exploration of kidney		C										
50125	Explore and drain kidney		C										
50130	Removal of kidney stone		C										
50135	Exploration of kidney		C										
5015F	Doc fx & test/txmnt for op		M										
50200	Renal biopsy perq		J1	5072	16.9934	"$1,407.00"	.	$281.41					
50205	Renal biopsy open		C										
5020F	Txmnts 2 phys/qhp by 1 mon		E1										
50220	Remove kidney open		C										
50225	Removal kidney open complex		C										
50230	Removal kidney open radical		C										
50234	Removal of kidney & ureter		C										
50236	Removal of kidney & ureter		C										
50240	Partial removal of kidney		C										
50250	Cryoablate renal mass open		C										
50280	Removal of kidney lesion		C										
50290	Removal of kidney lesion		C										
50300	Remove cadaver donor kidney		C										
50320	Remove kidney living donor		C										
50323	Prep cadaver renal allograft		C										
50325	Prep donor renal graft		C										
50327	Prep renal graft/venous		C										
50328	Prep renal graft/arterial		C										
50329	Prep renal graft/ureteral		C										
50340	Removal of kidney		C										
50360	Transplantation of kidney		C										
50365	Transplantation of kidney		C										
50370	Remove transplanted kidney		C										
50380	Reimplantation of kidney		C										
50382	Change ureter stent percut		J1	5373	21.6552	"$1,792.99"	.	$358.60					
50384	Remove ureter stent percut		Q2	5373	21.6552	"$1,792.99"	.	$358.60					
50385	Change stent via transureth		J1	5373	21.6552	"$1,792.99"	.	$358.60					
50386	Remove stent via transureth		Q2	5373	21.6552	"$1,792.99"	.	$358.60					
50387	Change nephroureteral cath		J1	5373	21.6552	"$1,792.99"	.	$358.60					
50389	Remove renal tube w/fluoro		Q2	5372	6.9419	$574.77	.	$114.96					
50390	Drainage of kidney lesion		T	5071	7.5120	$621.97	.	$124.40					
50391	Instll rx agnt into rnal tub		T	5371	3.2144	$266.14	.	$53.23					
50396	Measure kidney pressure		T	5372	6.9419	$574.77	.	$114.96					
50400	Revision of kidney/ureter		C										
50405	Revision of kidney/ureter		C										
50430	Njx px nfrosgrm &/urtrgrm		Q2	5372	6.9419	$574.77	.	$114.96					
50431	Njx px nfrosgrm &/urtrgrm		Q2	5372	6.9419	$574.77	.	$114.96					
50432	Plmt nephrostomy catheter		J1	5373	21.6552	"$1,792.99"	.	$358.60					
50433	Plmt nephroureteral catheter		J1	5374	37.1552	"$3,076.34"	.	$615.27					
50434	Convert nephrostomy catheter		J1	5373	21.6552	"$1,792.99"	.	$358.60					
50435	Exchange nephrostomy cath		J1	5373	21.6552	"$1,792.99"	.	$358.60					
50436	Dilat xst trc ndurlgc px	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
50437	Dilat xst trc new access rcs		J1	5374	37.1552	"$3,076.34"	.	$615.27					
50500	Repair of kidney wound		C										
5050F	Plan 2 main dr by 1 month		M										
50520	Close kidney-skin fistula		C										
50525	Close nephrovisceral fistula		C										
50526	Close nephrovisceral fistula		C										
50540	Revision of horseshoe kidney		C										
50541	Laparo ablate renal cyst		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
50542	Laparo ablate renal mass		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
50543	Laparo partial nephrectomy		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
50544	Laparoscopy pyeloplasty		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
50545	Laparo radical nephrectomy		C										
50546	Laparoscopic nephrectomy		C										
50547	Laparo removal donor kidney		C										
50548	Laparo remove w/ureter		C										
50549	Laparoscope proc renal		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
50551	Kidney endoscopy		J1	5375	53.3099	"$4,413.90"	.	$882.78					
50553	Kidney endoscopy		J1	5375	53.3099	"$4,413.90"	.	$882.78					
50555	Kidney endoscopy & biopsy		J1	5376	99.7395	"$8,258.13"	.	"$1,651.63"	*				
50557	Kidney endoscopy & treatment		J1	5376	99.7395	"$8,258.13"	.	"$1,651.63"	*				
50561	Kidney endoscopy & treatment		J1	5375	53.3099	"$4,413.90"	.	$882.78					
50562	Renal scope w/tumor resect		J1	5376	99.7395	"$8,258.13"	.	"$1,651.63"	*				
50570	Kidney endoscopy		J1	5374	37.1552	"$3,076.34"	.	$615.27					
50572	Kidney endoscopy		T	5372	6.9419	$574.77	.	$114.96					
50574	Kidney endoscopy & biopsy	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
50575	Kidney endoscopy		J1	5375	53.3099	"$4,413.90"	.	$882.78					
50576	Kidney endoscopy & treatment		J1	5375	53.3099	"$4,413.90"	.	$882.78					
50580	Kidney endoscopy & treatment		J1	5375	53.3099	"$4,413.90"	.	$882.78					
50590	Fragmenting of kidney stone		J1	5374	37.1552	"$3,076.34"	.	$615.27					
50592	Perc rf ablate renal tumor		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
50593	Perc cryo ablate renal tum		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
50600	Exploration of ureter		C										
50605	Insert ureteral support		C										
50606	Endoluminal bx urtr rnl plvs		N										
5060F	Fndngs mammo 2pt w/in 3 days		E1										
50610	Removal of ureter stone		C										
50620	Removal of ureter stone		C										
5062F	Mammo result com to pt 5 day		E1										
50630	Removal of ureter stone		C										
50650	Removal of ureter		C										
50660	Removal of ureter		C										
50684	Injection for ureter x-ray		N										
50686	Measure ureter pressure		S	5721	1.6854	$139.55	.	$27.91					
50688	Change of ureter tube/stent		J1	5373	21.6552	"$1,792.99"	.	$358.60					
50690	Injection for ureter x-ray		N										
50693	Plmt ureteral stent prq		J1	5374	37.1552	"$3,076.34"	.	$615.27					
50694	Plmt ureteral stent prq		J1	5374	37.1552	"$3,076.34"	.	$615.27					
50695	Plmt ureteral stent prq		J1	5374	37.1552	"$3,076.34"	.	$615.27					
50700	Revision of ureter		C										
50705	Ureteral embolization/occl		N										
50706	Balloon dilate urtrl strix		N										
50715	Release of ureter		C										
50722	Release of ureter		C										
50725	Release/revise ureter		C										
50727	Revise ureter		J1	5374	37.1552	"$3,076.34"	.	$615.27					
50728	Revise ureter		C										
50740	Fusion of ureter & kidney		C										
50750	Fusion of ureter & kidney		C										
50760	Fusion of ureters		C										
50770	Splicing of ureters		C										
50780	Reimplant ureter in bladder		C										
50782	Reimplant ureter in bladder		C										
50783	Reimplant ureter in bladder		C										
50785	Reimplant ureter in bladder		C										
50800	Implant ureter in bowel		C										
50810	Fusion of ureter & bowel		C										
50815	Urine shunt to intestine		C										
50820	Construct bowel bladder		C										
50825	Construct bowel bladder		C										
50830	Revise urine flow		C										
50840	Replace ureter by bowel		C										
50845	Appendico-vesicostomy		C										
50860	Transplant ureter to skin		C										
50900	Repair of ureter		C										
50920	Closure ureter/skin fistula		C										
50930	Closure ureter/bowel fistula		C										
50940	Release of ureter		C										
50945	Laparoscopy ureterolithotomy		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
50947	Laparo new ureter/bladder		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
50948	Laparo new ureter/bladder		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
50949	Laparoscope proc ureter		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
50951	Endoscopy of ureter		J1	5374	37.1552	"$3,076.34"	.	$615.27					
50953	Endoscopy of ureter		J1	5374	37.1552	"$3,076.34"	.	$615.27					
50955	Ureter endoscopy & biopsy		J1	5375	53.3099	"$4,413.90"	.	$882.78					
50957	Ureter endoscopy & treatment		J1	5375	53.3099	"$4,413.90"	.	$882.78					
50961	Ureter endoscopy & treatment		J1	5375	53.3099	"$4,413.90"	.	$882.78					
50970	Ureter endoscopy		J1	5374	37.1552	"$3,076.34"	.	$615.27					
50972	Ureter endoscopy & catheter		J1	5374	37.1552	"$3,076.34"	.	$615.27					
50974	Ureter endoscopy & biopsy		J1	5375	53.3099	"$4,413.90"	.	$882.78					
50976	Ureter endoscopy & treatment		J1	5375	53.3099	"$4,413.90"	.	$882.78					
50980	Ureter endoscopy & treatment		J1	5375	53.3099	"$4,413.90"	.	$882.78					
5100F	Rsk fx ref w/n 24 hrs xray		E1										
51020	Incise & treat bladder		J1	5374	37.1552	"$3,076.34"	.	$615.27					
51030	Incise & treat bladder		J1	5374	37.1552	"$3,076.34"	.	$615.27					
51040	Incise & drain bladder		J1	5373	21.6552	"$1,792.99"	.	$358.60					
51045	Incise bladder/drain ureter		J1	5373	21.6552	"$1,792.99"	.	$358.60					
51050	Removal of bladder stone		J1	5375	53.3099	"$4,413.90"	.	$882.78					
51060	Removal of ureter stone		J1	5373	21.6552	"$1,792.99"	.	$358.60					
51065	Remove ureter calculus		J1	5374	37.1552	"$3,076.34"	.	$615.27					
51080	Drainage of bladder abscess		J1	5073	28.6243	"$2,370.01"	.	$474.01					
51100	Drain bladder by needle		T	5371	3.2144	$266.14	.	$53.23					
51101	Drain bladder by trocar/cath		S	5724	11.1093	$919.82	.	$183.97					
51102	Drain bl w/cath insertion		J1	5373	21.6552	"$1,792.99"	.	$358.60					
51500	Removal of bladder cyst		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
51520	Removal of bladder lesion		J1	5374	37.1552	"$3,076.34"	.	$615.27					
51525	Removal of bladder lesion		C										
51530	Removal of bladder lesion		C										
51535	Repair of ureter lesion		J1	5374	37.1552	"$3,076.34"	.	$615.27					
51550	Partial removal of bladder		C										
51555	Partial removal of bladder		C										
51565	Revise bladder & ureter(s)		C										
51570	Removal of bladder		C										
51575	Removal of bladder & nodes		C										
51580	Remove bladder/revise tract		C										
51585	Removal of bladder & nodes		C										
51590	Remove bladder/revise tract		C										
51595	Remove bladder/revise tract		C										
51596	Remove bladder/create pouch		C										
51597	Removal of pelvic structures		C										
51600	Injection for bladder x-ray		N										
51605	Preparation for bladder xray		N										
51610	Injection for bladder x-ray		N										
51700	Irrigation of bladder		T	5371	3.2144	$266.14	.	$53.23					
51701	Insert bladder catheter		Q1	5734	1.3521	$111.95	.	$22.39					
51702	Insert temp bladder cath		Q1	5734	1.3521	$111.95	.	$22.39					
51703	Insert bladder cath complex		S	5721	1.6854	$139.55	.	$27.91					
51705	Change of bladder tube		T	5371	3.2144	$266.14	.	$53.23					
51710	Change of bladder tube		T	5372	6.9419	$574.77	.	$114.96					
51715	Endoscopic injection/implant		J1	5374	37.1552	"$3,076.34"	.	$615.27					
51720	Treatment of bladder lesion		T	5371	3.2144	$266.14	.	$53.23					
51725	Simple cystometrogram		T	5371	3.2144	$266.14	.	$53.23					
51726	Complex cystometrogram		T	5371	3.2144	$266.14	.	$53.23					
51727	Cystometrogram w/up		T	5372	6.9419	$574.77	.	$114.96					
51728	Cystometrogram w/vp		T	5372	6.9419	$574.77	.	$114.96					
51729	Cystometrogram w/vp&up		T	5372	6.9419	$574.77	.	$114.96					
51736	Urine flow measurement		Q1	5734	1.3521	$111.95	.	$22.39					
51741	Electro-uroflowmetry first		Q1	5721	1.6854	$139.55	.	$27.91					
51784	Anal/urinary muscle study		S	5721	1.6854	$139.55	.	$27.91					
51785	Anal/urinary muscle study		T	5371	3.2144	$266.14	.	$53.23					
51792	Urinary reflex study		Q1	5733	0.6722	$55.66	.	$11.14					
51797	Intraabdominal pressure test		N										
51798	Us urine capacity measure		Q1	5733	0.6722	$55.66	.	$11.14					
51800	Revision of bladder/urethra		C										
51820	Revision of urinary tract		C										
51840	Attach bladder/urethra	CH	J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
51841	Attach bladder/urethra		C										
51845	Repair bladder neck		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
51860	Repair of bladder wound		J1	5375	53.3099	"$4,413.90"	.	$882.78					
51865	Repair of bladder wound		C										
51880	Repair of bladder opening		J1	5374	37.1552	"$3,076.34"	.	$615.27					
51900	Repair bladder/vagina lesion		C										
51920	Close bladder-uterus fistula		C										
51925	Hysterectomy/bladder repair		C										
51940	Correction of bladder defect		C										
51960	Revision of bladder & bowel		C										
51980	Construct bladder opening		C										
51990	Laparo urethral suspension		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
51992	Laparo sling operation		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
51999	Laparoscope proc bla		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
52000	Cystoscopy		T	5372	6.9419	$574.77	.	$114.96					
52001	Cystoscopy removal of clots		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52005	Cystoscopy & ureter catheter		J1	5373	21.6552	"$1,792.99"	.	$358.60					
52007	Cystoscopy and biopsy		J1	5374	37.1552	"$3,076.34"	.	$615.27					
5200F	Eval appros surg thxpy epi		E1										
52010	Cystoscopy & duct catheter		T	5372	6.9419	$574.77	.	$114.96					
52204	Cystoscopy w/biopsy(s)		J1	5373	21.6552	"$1,792.99"	.	$358.60					
52214	Cystoscopy and treatment	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
52224	Cystoscopy and treatment	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
52234	Cystoscopy and treatment		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52235	Cystoscopy and treatment		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52240	Cystoscopy and treatment		J1	5375	53.3099	"$4,413.90"	.	$882.78					
52250	Cystoscopy and radiotracer		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52260	Cystoscopy and treatment		J1	5373	21.6552	"$1,792.99"	.	$358.60					
52265	Cystoscopy and treatment		J1	5373	21.6552	"$1,792.99"	.	$358.60					
52270	Cystoscopy & revise urethra		J1	5373	21.6552	"$1,792.99"	.	$358.60					
52275	Cystoscopy & revise urethra		J1	5373	21.6552	"$1,792.99"	.	$358.60					
52276	Cystoscopy and treatment		J1	5373	21.6552	"$1,792.99"	.	$358.60					
52277	Cystoscopy and treatment		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52281	Cystoscopy and treatment		J1	5373	21.6552	"$1,792.99"	.	$358.60					
52282	Cystoscopy implant stent		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52283	Cystoscopy and treatment		J1	5373	21.6552	"$1,792.99"	.	$358.60					
52285	Cystoscopy and treatment		T	5372	6.9419	$574.77	.	$114.96					
52287	Cystoscopy chemodenervation		J1	5373	21.6552	"$1,792.99"	.	$358.60					
52290	Cystoscopy and treatment		J1	5373	21.6552	"$1,792.99"	.	$358.60					
52300	Cystoscopy and treatment		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52301	Cystoscopy and treatment		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52305	Cystoscopy and treatment		J1	5375	53.3099	"$4,413.90"	.	$882.78					
52310	Cystoscopy and treatment		J1	5373	21.6552	"$1,792.99"	.	$358.60					
52315	Cystoscopy and treatment		J1	5373	21.6552	"$1,792.99"	.	$358.60					
52317	Remove bladder stone		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52318	Remove bladder stone		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52320	Cystoscopy and treatment		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52325	Cystoscopy stone removal		J1	5375	53.3099	"$4,413.90"	.	$882.78					
52327	Cystoscopy inject material		J1	5375	53.3099	"$4,413.90"	.	$882.78					
52330	Cystoscopy and treatment		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52332	Cystoscopy and treatment		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52334	Create passage to kidney		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52341	Cysto w/ureter stricture tx		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52342	Cysto w/up stricture tx		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52343	Cysto w/renal stricture tx	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
52344	Cysto/uretero stricture tx		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52345	Cysto/uretero w/up stricture		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52346	Cystouretero w/renal strict		J1	5375	53.3099	"$4,413.90"	.	$882.78					
52351	Cystouretero & or pyeloscope		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52352	Cystouretero w/stone remove		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52353	Cystouretero w/lithotripsy		J1	5375	53.3099	"$4,413.90"	.	$882.78					
52354	Cystouretero w/biopsy		J1	5375	53.3099	"$4,413.90"	.	$882.78					
52355	Cystouretero w/excise tumor		J1	5375	53.3099	"$4,413.90"	.	$882.78					
52356	Cysto/uretero w/lithotripsy		J1	5375	53.3099	"$4,413.90"	.	$882.78					
52400	Cystouretero w/congen repr		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52402	Cystourethro cut ejacul duct		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52441	Cystourethro w/implant		B										
52442	Cystourethro w/addl implant		B										
52450	Incision of prostate		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52500	Revision of bladder neck		J1	5374	37.1552	"$3,076.34"	.	$615.27					
5250F	Asthma discharge plan presnt		E1										
52601	Prostatectomy (turp)		J1	5375	53.3099	"$4,413.90"	.	$882.78					
52630	Remove prostate regrowth		J1	5375	53.3099	"$4,413.90"	.	$882.78					
52640	Relieve bladder contracture		J1	5374	37.1552	"$3,076.34"	.	$615.27					
52647	Laser surgery of prostate		J1	5375	53.3099	"$4,413.90"	.	$882.78					
52648	Laser surgery of prostate		J1	5375	53.3099	"$4,413.90"	.	$882.78					
52649	Prostate laser enucleation		J1	5375	53.3099	"$4,413.90"	.	$882.78					
52700	Drainage of prostate abscess		J1	5374	37.1552	"$3,076.34"	.	$615.27					
53000	Incision of urethra		J1	5373	21.6552	"$1,792.99"	.	$358.60					
53010	Incision of urethra		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53020	Incision of urethra		J1	5373	21.6552	"$1,792.99"	.	$358.60					
53025	Incision of urethra		J1	5373	21.6552	"$1,792.99"	.	$358.60					
53040	Drainage of urethra abscess	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
53060	Drainage of urethra abscess		J1	5373	21.6552	"$1,792.99"	.	$358.60					
53080	Drainage of urinary leakage		T	5372	6.9419	$574.77	.	$114.96					
53085	Drainage of urinary leakage		J1	5373	21.6552	"$1,792.99"	.	$358.60					
53200	Biopsy of urethra		J1	5373	21.6552	"$1,792.99"	.	$358.60					
53210	Removal of urethra		J1	5374	37.1552	"$3,076.34"	.	$615.27					
53215	Removal of urethra		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53220	Treatment of urethra lesion		J1	5374	37.1552	"$3,076.34"	.	$615.27					
53230	Removal of urethra lesion		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53235	Removal of urethra lesion		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53240	Surgery for urethra pouch		J1	5374	37.1552	"$3,076.34"	.	$615.27					
53250	Removal of urethra gland		J1	5374	37.1552	"$3,076.34"	.	$615.27					
53260	Treatment of urethra lesion	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
53265	Treatment of urethra lesion		J1	5373	21.6552	"$1,792.99"	.	$358.60					
53270	Removal of urethra gland	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
53275	Repair of urethra defect	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
53400	Revise urethra stage 1		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53405	Revise urethra stage 2		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53410	Reconstruction of urethra		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53415	Reconstruction of urethra		C										
53420	Reconstruct urethra stage 1		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53425	Reconstruct urethra stage 2		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53430	Reconstruction of urethra		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53431	Reconstruct urethra/bladder		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53440	Male sling procedure	CH	J1	5377	138.7492	"$11,488.02"	.	"$2,297.61"	*				
53442	Remove/revise male sling		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53444	Insert tandem cuff	CH	J1	5378	220.5195	"$18,258.35"	.	"$3,651.68"	*				
53445	Insert uro/ves nck sphincter	CH	J1	5378	220.5195	"$18,258.35"	.	"$3,651.68"	*				
53446	Remove uro sphincter		Q2	5375	53.3099	"$4,413.90"	.	$882.78					
53447	Remove/replace ur sphincter	CH	J1	5378	220.5195	"$18,258.35"	.	"$3,651.68"	*				
53448	Remov/replc ur sphinctr comp		C										
53449	Repair uro sphincter		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53450	Revision of urethra		J1	5374	37.1552	"$3,076.34"	.	$615.27					
53460	Revision of urethra		J1	5374	37.1552	"$3,076.34"	.	$615.27					
53500	Urethrlys transvag w/ scope		J1	5374	37.1552	"$3,076.34"	.	$615.27					
53502	Repair of urethra injury		J1	5374	37.1552	"$3,076.34"	.	$615.27					
53505	Repair of urethra injury		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53510	Repair of urethra injury		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53515	Repair of urethra injury		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53520	Repair of urethra defect		J1	5375	53.3099	"$4,413.90"	.	$882.78					
53600	Dilate urethra stricture		T	5371	3.2144	$266.14	.	$53.23					
53601	Dilate urethra stricture		Q1	5734	1.3521	$111.95	.	$22.39					
53605	Dilate urethra stricture	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
53620	Dilate urethra stricture		T	5372	6.9419	$574.77	.	$114.96					
53621	Dilate urethra stricture		T	5371	3.2144	$266.14	.	$53.23					
53660	Dilation of urethra		S	5721	1.6854	$139.55	.	$27.91					
53661	Dilation of urethra		Q1	5734	1.3521	$111.95	.	$22.39					
53665	Dilation of urethra		J1	5373	21.6552	"$1,792.99"	.	$358.60					
53850	Prostatic microwave thermotx		J1	5374	37.1552	"$3,076.34"	.	$615.27					
53852	Prostatic rf thermotx		J1	5374	37.1552	"$3,076.34"	.	$615.27					
53854	Trurl dstrj prst8 tiss rf wv		J1	5373	21.6552	"$1,792.99"	.	$358.60					
53855	Insert prost urethral stent		J1	5373	21.6552	"$1,792.99"	.	$358.60					
53860	Transurethral rf treatment		J1	5373	21.6552	"$1,792.99"	.	$358.60					
53899	Urology surgery procedure		T	5371	3.2144	$266.14	.	$53.23					
54000	Slitting of prepuce		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54001	Slitting of prepuce		J1	5373	21.6552	"$1,792.99"	.	$358.60					
54015	Drain penis lesion		J1	5072	16.9934	"$1,407.00"	.	$281.41					
54050	Destruction penis lesion(s)		Q1	5052	4.1770	$345.84	.	$69.17					
54055	Destruction penis lesion(s)		T	5054	20.7177	"$1,715.36"	.	$343.08					
54056	Cryosurgery penis lesion(s)		Q1	5051	2.1685	$179.55	.	$35.91					
54057	Laser surg penis lesion(s)		T	5054	20.7177	"$1,715.36"	.	$343.08					
54060	Excision of penis lesion(s)		T	5054	20.7177	"$1,715.36"	.	$343.08					
54065	Destruction penis lesion(s)		T	5054	20.7177	"$1,715.36"	.	$343.08					
54100	Biopsy of penis		J1	5072	16.9934	"$1,407.00"	.	$281.41					
54105	Biopsy of penis		J1	5073	28.6243	"$2,370.01"	.	$474.01					
54110	Treatment of penis lesion		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54111	Treat penis lesion graft		J1	5375	53.3099	"$4,413.90"	.	$882.78					
54112	Treat penis lesion graft		J1	5376	99.7395	"$8,258.13"	.	"$1,651.63"	*				
54115	Treatment of penis lesion		J1	5073	28.6243	"$2,370.01"	.	$474.01					
54120	Partial removal of penis		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54125	Removal of penis		C										
54130	Remove penis & nodes		C										
54135	Remove penis & nodes		C										
54150	Circumcision w/regionl block		J1	5373	21.6552	"$1,792.99"	.	$358.60					
54160	Circumcision neonate		T	5372	6.9419	$574.77	.	$114.96					
54161	Circum 28 days or older		J1	5373	21.6552	"$1,792.99"	.	$358.60					
54162	Lysis penil circumic lesion		J1	5373	21.6552	"$1,792.99"	.	$358.60					
54163	Repair of circumcision		J1	5373	21.6552	"$1,792.99"	.	$358.60					
54164	Frenulotomy of penis		J1	5373	21.6552	"$1,792.99"	.	$358.60					
54200	Treatment of penis lesion		T	5371	3.2144	$266.14	.	$53.23					
54205	Treatment of penis lesion		J1	5375	53.3099	"$4,413.90"	.	$882.78					
54220	Treatment of penis lesion		T	5371	3.2144	$266.14	.	$53.23					
54230	Prepare penis study		N										
54231	Dynamic cavernosometry		T	5371	3.2144	$266.14	.	$53.23					
54235	Penile injection		T	5371	3.2144	$266.14	.	$53.23					
54240	Penis study	CH	S	5722	3.1939	$264.45	.	$52.89					
54250	Penis study		T	5371	3.2144	$266.14	.	$53.23					
54300	Revision of penis		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54304	Revision of penis		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54308	Reconstruction of urethra		J1	5375	53.3099	"$4,413.90"	.	$882.78					
54312	Reconstruction of urethra		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54316	Reconstruction of urethra		J1	5375	53.3099	"$4,413.90"	.	$882.78					
54318	Reconstruction of urethra		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54322	Reconstruction of urethra		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54324	Reconstruction of urethra		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54326	Reconstruction of urethra	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
54328	Revise penis/urethra		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54332	Revise penis/urethra		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54336	Revise penis/urethra		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54340	Secondary urethral surgery		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54344	Secondary urethral surgery		J1	5375	53.3099	"$4,413.90"	.	$882.78					
54348	Secondary urethral surgery		J1	5375	53.3099	"$4,413.90"	.	$882.78					
54352	Reconstruct urethra/penis		J1	5375	53.3099	"$4,413.90"	.	$882.78					
54360	Penis plastic surgery		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54380	Repair penis		J1	5373	21.6552	"$1,792.99"	.	$358.60					
54385	Repair penis		J1	5373	21.6552	"$1,792.99"	.	$358.60					
54390	Repair penis and bladder		C										
54400	Insert semi-rigid prosthesis		J1	5377	138.7492	"$11,488.02"	.	"$2,297.61"	*				
54401	Insert self-contd prosthesis	CH	J1	5378	220.5195	"$18,258.35"	.	"$3,651.68"	*				
54405	Insert multi-comp penis pros	CH	J1	5378	220.5195	"$18,258.35"	.	"$3,651.68"	*				
54406	Remove muti-comp penis pros		Q2	5374	37.1552	"$3,076.34"	.	$615.27					
54408	Repair multi-comp penis pros		J1	5375	53.3099	"$4,413.90"	.	$882.78					
54410	Remove/replace penis prosth	CH	J1	5378	220.5195	"$18,258.35"	.	"$3,651.68"	*				
54411	Remov/replc penis pros comp	CH	J1	5378	220.5195	"$18,258.35"	.	"$3,651.68"	*				
54415	Remove self-contd penis pros		Q2	5374	37.1552	"$3,076.34"	.	$615.27					
54416	Remv/repl penis contain pros	CH	J1	5378	220.5195	"$18,258.35"	.	"$3,651.68"	*				
54417	Remv/replc penis pros compl		J1	5377	138.7492	"$11,488.02"	.	"$2,297.61"	*				
54420	Revision of penis	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
54430	Revision of penis		C										
54435	Revision of penis		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54437	Repair corporeal tear		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54438	Replantation of penis		C										
54440	Repair of penis		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54450	Preputial stretching		T	5371	3.2144	$266.14	.	$53.23					
54500	Biopsy of testis		J1	5073	28.6243	"$2,370.01"	.	$474.01					
54505	Biopsy of testis		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54512	Excise lesion testis		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54520	Removal of testis		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54522	Orchiectomy partial		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54530	Removal of testis		J1	5341	38.4484	"$3,183.41"	.	$636.69					
54535	Extensive testis surgery		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54550	Exploration for testis		J1	5341	38.4484	"$3,183.41"	.	$636.69					
54560	Exploration for testis		J1	5373	21.6552	"$1,792.99"	.	$358.60					
54600	Reduce testis torsion		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54620	Suspension of testis		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54640	Orchiopexy ingun/scrot appr		J1	5341	38.4484	"$3,183.41"	.	$636.69					
54650	Orchiopexy (fowler-stephens)		J1	5341	38.4484	"$3,183.41"	.	$636.69					
54660	Revision of testis		J1	5375	53.3099	"$4,413.90"	.	$882.78					
54670	Repair testis injury	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
54680	Relocation of testis(es)		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54690	Laparoscopy orchiectomy		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
54692	Laparoscopy orchiopexy		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
54699	Laparoscope proc testis		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
54700	Drainage of scrotum		J1	5373	21.6552	"$1,792.99"	.	$358.60					
54800	Biopsy of epididymis		J1	5072	16.9934	"$1,407.00"	.	$281.41					
54830	Remove epididymis lesion	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
54840	Remove epididymis lesion		J1	5373	21.6552	"$1,792.99"	.	$358.60					
54860	Removal of epididymis	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
54861	Removal of epididymis		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54865	Explore epididymis		J1	5374	37.1552	"$3,076.34"	.	$615.27					
54900	Fusion of spermatic ducts		J1	5373	21.6552	"$1,792.99"	.	$358.60					
54901	Fusion of spermatic ducts		J1	5374	37.1552	"$3,076.34"	.	$615.27					
55000	Drainage of hydrocele		T	5071	7.5120	$621.97	.	$124.40					
55040	Removal of hydrocele		J1	5341	38.4484	"$3,183.41"	.	$636.69					
55041	Removal of hydroceles		J1	5341	38.4484	"$3,183.41"	.	$636.69					
55060	Repair of hydrocele		J1	5374	37.1552	"$3,076.34"	.	$615.27					
55100	Drainage of scrotum abscess		J1	5072	16.9934	"$1,407.00"	.	$281.41					
55110	Explore scrotum		J1	5374	37.1552	"$3,076.34"	.	$615.27					
55120	Removal of scrotum lesion		J1	5373	21.6552	"$1,792.99"	.	$358.60					
55150	Removal of scrotum		J1	5374	37.1552	"$3,076.34"	.	$615.27					
55175	Revision of scrotum		J1	5374	37.1552	"$3,076.34"	.	$615.27					
55180	Revision of scrotum		J1	5375	53.3099	"$4,413.90"	.	$882.78					
55200	Incision of sperm duct		J1	5374	37.1552	"$3,076.34"	.	$615.27					
55250	Removal of sperm duct(s)		J1	5373	21.6552	"$1,792.99"	.	$358.60					
55300	Prepare sperm duct x-ray		N										
55400	Repair of sperm duct		J1	5374	37.1552	"$3,076.34"	.	$615.27					
55500	Removal of hydrocele		J1	5374	37.1552	"$3,076.34"	.	$615.27					
55520	Removal of sperm cord lesion		J1	5374	37.1552	"$3,076.34"	.	$615.27					
55530	Revise spermatic cord veins		J1	5374	37.1552	"$3,076.34"	.	$615.27					
55535	Revise spermatic cord veins		J1	5341	38.4484	"$3,183.41"	.	$636.69					
55540	Revise hernia & sperm veins		J1	5341	38.4484	"$3,183.41"	.	$636.69					
55550	Laparo ligate spermatic vein		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
55559	Laparo proc spermatic cord		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
55600	Incise sperm duct pouch		J1	5373	21.6552	"$1,792.99"	.	$358.60					
55605	Incise sperm duct pouch		C										
55650	Remove sperm duct pouch		C										
55680	Remove sperm pouch lesion		J1	5374	37.1552	"$3,076.34"	.	$615.27					
55700	Biopsy of prostate		J1	5373	21.6552	"$1,792.99"	.	$358.60					
55705	Biopsy of prostate	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
55706	Prostate saturation sampling		J1	5374	37.1552	"$3,076.34"	.	$615.27					
55720	Drainage of prostate abscess	CH	J1	5374	37.1552	"$3,076.34"	.	$615.27					
55725	Drainage of prostate abscess		J1	5374	37.1552	"$3,076.34"	.	$615.27					
55801	Removal of prostate		C										
55810	Extensive prostate surgery		C										
55812	Extensive prostate surgery		C										
55815	Extensive prostate surgery		C										
55821	Removal of prostate		C										
55831	Removal of prostate		C										
55840	Extensive prostate surgery		C										
55842	Extensive prostate surgery		C										
55845	Extensive prostate surgery		C										
55860	Surgical exposure prostate		J1	5375	53.3099	"$4,413.90"	.	$882.78					
55862	Extensive prostate surgery		C										
55865	Extensive prostate surgery		C										
55866	Laparo radical prostatectomy		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
55870	Electroejaculation		T	5413	7.6501	$633.41	.	$126.69					
55873	Cryoablate prostate		J1	5376	99.7395	"$8,258.13"	.	"$1,651.63"	*				
55874	Tprnl plmt biodegrdabl matrl		T	5375	53.3099	"$4,413.90"	.	$882.78					
55875	Transperi needle place pros		J1	5375	53.3099	"$4,413.90"	.	$882.78					
55876	Place rt device/marker pros		S	5613	15.2443	"$1,262.18"	.	$252.44					
55880	Abltj mal prst8 tiss hifu	NC	J1	5375	53.3099	"$4,413.90"	.	$882.78					
55899	Genital surgery procedure		T	5371	3.2144	$266.14	.	$53.23					
55920	Place needles pelvic for rt		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
55970	Sex transformation m to f		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
55980	Sex transformation f to m		J1	5374	37.1552	"$3,076.34"	.	$615.27					
56405	I & d of vulva/perineum		T	5412	3.3997	$281.48	.	$56.30					
56420	Drainage of gland abscess		T	5411	2.0571	$170.32	.	$34.07					
56440	Surgery for vulva lesion		J1	5414	31.6824	"$2,623.21"	.	$524.65					
56441	Lysis of labial lesion(s)		J1	5414	31.6824	"$2,623.21"	.	$524.65					
56442	Hymenotomy		J1	5414	31.6824	"$2,623.21"	.	$524.65					
56501	Destroy vulva lesions sim		T	5054	20.7177	"$1,715.36"	.	$343.08					
56515	Destroy vulva lesion/s compl		T	5054	20.7177	"$1,715.36"	.	$343.08					
56605	Biopsy of vulva/perineum		T	5413	7.6501	$633.41	.	$126.69					
56606	Biopsy of vulva/perineum		N										
56620	Partial removal of vulva		J1	5414	31.6824	"$2,623.21"	.	$524.65					
56625	Complete removal of vulva		J1	5414	31.6824	"$2,623.21"	.	$524.65					
56630	Extensive vulva surgery	CH	J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
56631	Extensive vulva surgery		C										
56632	Extensive vulva surgery		C										
56633	Extensive vulva surgery		C										
56634	Extensive vulva surgery		C										
56637	Extensive vulva surgery		C										
56640	Extensive vulva surgery		C										
56700	Partial removal of hymen		J1	5414	31.6824	"$2,623.21"	.	$524.65					
56740	Remove vagina gland lesion		J1	5414	31.6824	"$2,623.21"	.	$524.65					
56800	Repair of vagina		J1	5414	31.6824	"$2,623.21"	.	$524.65					
56805	Repair clitoris		J1	5414	31.6824	"$2,623.21"	.	$524.65					
56810	Repair of perineum		J1	5414	31.6824	"$2,623.21"	.	$524.65					
56820	Exam of vulva w/scope		T	5411	2.0571	$170.32	.	$34.07					
56821	Exam/biopsy of vulva w/scope		T	5412	3.3997	$281.48	.	$56.30					
57000	Exploration of vagina		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57010	Drainage of pelvic abscess		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57020	Drainage of pelvic fluid		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57022	I & d vaginal hematoma pp		J1	5073	28.6243	"$2,370.01"	.	$474.01					
57023	I & d vag hematoma non-ob		J1	5073	28.6243	"$2,370.01"	.	$474.01					
57061	Destroy vag lesions simple		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57065	Destroy vag lesions complex		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57100	Biopsy of vagina		T	5413	7.6501	$633.41	.	$126.69					
57105	Biopsy of vagina		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57106	Remove vagina wall partial		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57107	Remove vagina tissue part		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57109	Vaginectomy partial w/nodes		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57110	Remove vagina wall complete		C										
57111	Remove vagina tissue compl		C										
57112	Vaginectomy w/nodes compl	CH	D										
57120	Closure of vagina		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57130	Remove vagina lesion		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57135	Remove vagina lesion		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57150	Treat vagina infection		Q1	5733	0.6722	$55.66	.	$11.14					
57155	Insert uteri tandem/ovoids		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57156	Ins vag brachytx device		T	5412	3.3997	$281.48	.	$56.30					
57160	Insert pessary/other device		T	5411	2.0571	$170.32	.	$34.07					
57170	Fitting of diaphragm/cap		T	5411	2.0571	$170.32	.	$34.07					
57180	Treat vaginal bleeding		T	5411	2.0571	$170.32	.	$34.07					
57200	Repair of vagina		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57210	Repair vagina/perineum		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57220	Revision of urethra		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57230	Repair of urethral lesion		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57240	Anterior colporrhaphy		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57250	Repair rectum & vagina		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57260	Cmbn ant pst colprhy		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57265	Cmbn ap colprhy w/ntrcl rpr		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57267	Insert mesh/pelvic flr addon		N										
57268	Repair of bowel bulge		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57270	Repair of bowel pouch		C										
57280	Suspension of vagina		C										
57282	Colpopexy extraperitoneal		J1	5416	82.0598	"$6,794.31"	"$1,405.70"	"$1,358.87"					
57283	Colpopexy intraperitoneal		J1	5416	82.0598	"$6,794.31"	"$1,405.70"	"$1,358.87"					
57284	Repair paravag defect open		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57285	Repair paravag defect vag		J1	5416	82.0598	"$6,794.31"	"$1,405.70"	"$1,358.87"					
57287	Revise/remove sling repair		Q2	5414	31.6824	"$2,623.21"	.	$524.65					
57288	Repair bladder defect		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57289	Repair bladder & vagina		J1	5416	82.0598	"$6,794.31"	"$1,405.70"	"$1,358.87"					
57291	Construction of vagina		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57292	Construct vagina with graft		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57295	Revise vag graft via vagina		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57296	Revise vag graft open abd		C										
57300	Repair rectum-vagina fistula		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57305	Repair rectum-vagina fistula		C										
57307	Fistula repair & colostomy		C										
57308	Fistula repair transperine		C										
57310	Repair urethrovaginal lesion		J1	5416	82.0598	"$6,794.31"	"$1,405.70"	"$1,358.87"					
57311	Repair urethrovaginal lesion		C										
57320	Repair bladder-vagina lesion		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57330	Repair bladder-vagina lesion		J1	5416	82.0598	"$6,794.31"	"$1,405.70"	"$1,358.87"					
57335	Repair vagina		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57400	Dilation of vagina		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57410	Pelvic examination		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57415	Remove vaginal foreign body		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57420	Exam of vagina w/scope		T	5412	3.3997	$281.48	.	$56.30					
57421	Exam/biopsy of vag w/scope		T	5413	7.6501	$633.41	.	$126.69					
57423	Repair paravag defect lap		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
57425	Laparoscopy surg colpopexy		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
57426	Revise prosth vag graft lap		J1	5416	82.0598	"$6,794.31"	"$1,405.70"	"$1,358.87"					
57452	Exam of cervix w/scope		T	5411	2.0571	$170.32	.	$34.07					
57454	Bx/curett of cervix w/scope		T	5412	3.3997	$281.48	.	$56.30					
57455	Biopsy of cervix w/scope		T	5412	3.3997	$281.48	.	$56.30					
57456	Endocerv curettage w/scope		T	5412	3.3997	$281.48	.	$56.30					
57460	Bx of cervix w/scope leep		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57461	Conz of cervix w/scope leep		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57465	Cam cervix uteri drg colp	NC	N										
57500	Biopsy of cervix		T	5413	7.6501	$633.41	.	$126.69					
57505	Endocervical curettage		T	5413	7.6501	$633.41	.	$126.69					
57510	Cauterization of cervix		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57511	Cryocautery of cervix		T	5412	3.3997	$281.48	.	$56.30					
57513	Laser surgery of cervix		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57520	Conization of cervix		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57522	Conization of cervix		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57530	Removal of cervix		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57531	Removal of cervix radical		C										
57540	Removal of residual cervix		C										
57545	Remove cervix/repair pelvis		C										
57550	Removal of residual cervix		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57555	Remove cervix/repair vagina		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57556	Remove cervix repair bowel		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
57558	D&c of cervical stump		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57700	Revision of cervix		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57720	Revision of cervix		J1	5414	31.6824	"$2,623.21"	.	$524.65					
57800	Dilation of cervical canal		J1	5414	31.6824	"$2,623.21"	.	$524.65					
58100	Biopsy of uterus lining		T	5411	2.0571	$170.32	.	$34.07					
58110	Bx done w/colposcopy add-on		N										
58120	Dilation and curettage		J1	5414	31.6824	"$2,623.21"	.	$524.65					
58140	Myomectomy abdom method		C										
58145	Myomectomy vag method		J1	5414	31.6824	"$2,623.21"	.	$524.65					
58146	Myomectomy abdom complex		C										
58150	Total hysterectomy		C										
58152	Total hysterectomy		C										
58180	Partial hysterectomy		C										
58200	Extensive hysterectomy		C										
58210	Extensive hysterectomy		C										
58240	Removal of pelvis contents		C										
58260	Vaginal hysterectomy		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58262	Vag hyst including t/o		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58263	Vag hyst w/t/o & vag repair		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58267	Vag hyst w/urinary repair		C										
58270	Vag hyst w/enterocele repair		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58275	Hysterectomy/revise vagina		C										
58280	Hysterectomy/revise vagina		C										
58285	Extensive hysterectomy		C										
58290	Vag hyst complex		J1	5416	82.0598	"$6,794.31"	"$1,405.70"	"$1,358.87"					
58291	Vag hyst incl t/o complex		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58292	Vag hyst t/o & repair compl		J1	5416	82.0598	"$6,794.31"	"$1,405.70"	"$1,358.87"					
58293	Vag hyst w/uro repair compl	CH	D										
58294	Vag hyst w/enterocele compl		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58300	Insert intrauterine device		E1										
58301	Remove intrauterine device		Q2	5412	3.3997	$281.48	.	$56.30					
58321	Artificial insemination		T	5412	3.3997	$281.48	.	$56.30					
58322	Artificial insemination		T	5411	2.0571	$170.32	.	$34.07					
58323	Sperm washing		T	5411	2.0571	$170.32	.	$34.07					
58340	Catheter for hysterography		N										
58345	Reopen fallopian tube		J1	5414	31.6824	"$2,623.21"	.	$524.65					
58346	Insert heyman uteri capsule		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58350	Reopen fallopian tube		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58353	Endometr ablate thermal		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58356	Endometrial cryoablation		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58400	Suspension of uterus		C										
58410	Suspension of uterus		C										
58520	Repair of ruptured uterus		C										
58540	Revision of uterus		C										
58541	Lsh uterus 250 g or less		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
58542	Lsh w/t/o ut 250 g or less		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
58543	Lsh uterus above 250 g		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
58544	Lsh w/t/o uterus above 250 g		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
58545	Laparoscopic myomectomy		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
58546	Laparo-myomectomy complex		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
58548	Lap radical hyst		C										
58550	Laparo-asst vag hysterectomy		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
58552	Laparo-vag hyst incl t/o		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
58553	Laparo-vag hyst complex		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
58554	Laparo-vag hyst w/t/o compl		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
58555	Hysteroscopy dx sep proc		J1	5414	31.6824	"$2,623.21"	.	$524.65					
58558	Hysteroscopy biopsy		J1	5414	31.6824	"$2,623.21"	.	$524.65					
58559	Hysteroscopy lysis		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58560	Hysteroscopy resect septum		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58561	Hysteroscopy remove myoma		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58562	Hysteroscopy remove fb		J1	5414	31.6824	"$2,623.21"	.	$524.65					
58563	Hysteroscopy ablation		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58565	Hysteroscopy sterilization		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58570	Tlh uterus 250 g or less		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
58571	Tlh w/t/o 250 g or less		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
58572	Tlh uterus over 250 g		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
58573	Tlh w/t/o uterus over 250 g		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
58575	Laps tot hyst resj mal		C										
58578	Laparo proc uterus		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
58579	Hysteroscope procedure		T	5411	2.0571	$170.32	.	$34.07					
58600	Division of fallopian tube		J1	5414	31.6824	"$2,623.21"	.	$524.65					
58605	Division of fallopian tube		C										
58611	Ligate oviduct(s) add-on		C										
58615	Occlude fallopian tube(s)		J1	5414	31.6824	"$2,623.21"	.	$524.65					
58660	Laparoscopy lysis		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
58661	Laparoscopy remove adnexa		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
58662	Laparoscopy excise lesions		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
58670	Laparoscopy tubal cautery		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
58671	Laparoscopy tubal block		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
58672	Laparoscopy fimbrioplasty		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
58673	Laparoscopy salpingostomy		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
58674	Laps abltj uterine fibroids		J1	5362	107.5843	"$8,907.66"	.	"$1,781.54"	*				
58679	Laparo proc oviduct-ovary		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
58700	Removal of fallopian tube		C										
58720	Removal of ovary/tube(s)		C										
58740	Adhesiolysis tube ovary		C										
58750	Repair oviduct		C										
58752	Revise ovarian tube(s)		C										
58760	Fimbrioplasty		C										
58770	Create new tubal opening		J1	5414	31.6824	"$2,623.21"	.	$524.65					
58800	Drainage of ovarian cyst(s)		J1	5414	31.6824	"$2,623.21"	.	$524.65					
58805	Drainage of ovarian cyst(s)		J1	5414	31.6824	"$2,623.21"	.	$524.65					
58820	Drain ovary abscess open		J1	5414	31.6824	"$2,623.21"	.	$524.65					
58822	Drain ovary abscess percut		C										
58825	Transposition ovary(s)		C										
58900	Biopsy of ovary(s)		J1	5414	31.6824	"$2,623.21"	.	$524.65					
58920	Partial removal of ovary(s)		J1	5416	82.0598	"$6,794.31"	"$1,405.70"	"$1,358.87"					
58925	Removal of ovarian cyst(s)		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
58940	Removal of ovary(s)		C										
58943	Removal of ovary(s)		C										
58950	Resect ovarian malignancy		C										
58951	Resect ovarian malignancy		C										
58952	Resect ovarian malignancy		C										
58953	Tah rad dissect for debulk		C										
58954	Tah rad debulk/lymph remove		C										
58956	Bso omentectomy w/tah		C										
58957	Resect recurrent gyn mal		C										
58958	Resect recur gyn mal w/lym		C										
58960	Exploration of abdomen		C										
58970	Retrieval of oocyte		T	5413	7.6501	$633.41	.	$126.69					
58974	Transfer of embryo		T	5413	7.6501	$633.41	.	$126.69					
58976	Transfer of embryo		T	5412	3.3997	$281.48	.	$56.30					
58999	Genital surgery procedure		T	5411	2.0571	$170.32	.	$34.07					
59000	Amniocentesis diagnostic		T	5413	7.6501	$633.41	.	$126.69					
59001	Amniocentesis therapeutic		T	5412	3.3997	$281.48	.	$56.30					
59012	Fetal cord puncture prenatal		T	5412	3.3997	$281.48	.	$56.30					
59015	Chorion biopsy		T	5413	7.6501	$633.41	.	$126.69					
59020	Fetal contract stress test		T	5411	2.0571	$170.32	.	$34.07					
59025	Fetal non-stress test		T	5411	2.0571	$170.32	.	$34.07					
59030	Fetal scalp blood sample		T	5412	3.3997	$281.48	.	$56.30					
59050	Fetal monitor w/report		M										
59051	Fetal monitor/interpret only		B										
59070	Transabdom amnioinfus w/us		T	5412	3.3997	$281.48	.	$56.30					
59072	Umbilical cord occlud w/us		T	5412	3.3997	$281.48	.	$56.30					
59074	Fetal fluid drainage w/us		T	5412	3.3997	$281.48	.	$56.30					
59076	Fetal shunt placement w/us		T	5412	3.3997	$281.48	.	$56.30					
59100	Remove uterus lesion		J1	5415	53.2572	"$4,409.54"	$902.82	$881.91					
59120	Treat ectopic pregnancy		C										
59121	Treat ectopic pregnancy		C										
59130	Treat ectopic pregnancy		C										
59135	Treat ectopic pregnancy		C										
59136	Treat ectopic pregnancy		C										
59140	Treat ectopic pregnancy		C										
59150	Treat ectopic pregnancy		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
59151	Treat ectopic pregnancy		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
59160	D & c after delivery		J1	5414	31.6824	"$2,623.21"	.	$524.65					
59200	Insert cervical dilator		T	5412	3.3997	$281.48	.	$56.30					
59300	Episiotomy or vaginal repair		J1	5414	31.6824	"$2,623.21"	.	$524.65					
59320	Revision of cervix		J1	5414	31.6824	"$2,623.21"	.	$524.65					
59325	Revision of cervix		C										
59350	Repair of uterus		C										
59400	Obstetrical care		B										
59409	Obstetrical care		J1	5414	31.6824	"$2,623.21"	.	$524.65					
59410	Obstetrical care		B										
59412	Antepartum manipulation		J1	5414	31.6824	"$2,623.21"	.	$524.65					
59414	Deliver placenta		J1	5414	31.6824	"$2,623.21"	.	$524.65					
59425	Antepartum care only		B										
59426	Antepartum care only		B										
59430	Care after delivery		B										
59510	Cesarean delivery		B										
59514	Cesarean delivery only		C										
59515	Cesarean delivery		B										
59525	Remove uterus after cesarean		C										
59610	Vbac delivery		B										
59612	Vbac delivery only		J1	5414	31.6824	"$2,623.21"	.	$524.65					
59614	Vbac care after delivery		B										
59618	Attempted vbac delivery		B										
59620	Attempted vbac delivery only		C										
59622	Attempted vbac after care		B										
59812	Treatment of miscarriage		J1	5414	31.6824	"$2,623.21"	.	$524.65					
59820	Care of miscarriage		J1	5414	31.6824	"$2,623.21"	.	$524.65					
59821	Treatment of miscarriage		J1	5414	31.6824	"$2,623.21"	.	$524.65					
59830	Treat uterus infection		C										
59840	Abortion		J1	5414	31.6824	"$2,623.21"	.	$524.65					
59841	Abortion		J1	5414	31.6824	"$2,623.21"	.	$524.65					
59850	Abortion		C										
59851	Abortion		C										
59852	Abortion		C										
59855	Abortion		C										
59856	Abortion		C										
59857	Abortion		C										
59866	Abortion (mpr)		T	5412	3.3997	$281.48	.	$56.30					
59870	Evacuate mole of uterus		J1	5414	31.6824	"$2,623.21"	.	$524.65					
59871	Remove cerclage suture		Q2	5414	31.6824	"$2,623.21"	.	$524.65					
59897	Fetal invas px w/us		T	5411	2.0571	$170.32	.	$34.07					
59898	Laparo proc ob care/deliver		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
59899	Maternity care procedure		T	5411	2.0571	$170.32	.	$34.07					
60000	Drain thyroid/tongue cyst		J1	5163	16.3386	"$1,352.79"	.	$270.56					
6005F	Care level rationale doc		E1										
60100	Biopsy of thyroid		T	5071	7.5120	$621.97	.	$124.40					
6010F	Dysphag test done b/4 eating		E1										
6015F	Dysphag test done b/4 eating		E1										
60200	Remove thyroid lesion		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
6020F	Npo (nothing-mouth) ordered		E1										
60210	Partial thyroid excision		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
60212	Partial thyroid excision		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
60220	Partial removal of thyroid		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
60225	Partial removal of thyroid		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
60240	Removal of thyroid		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
60252	Removal of thyroid		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
60254	Extensive thyroid surgery		C										
60260	Repeat thyroid surgery		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
60270	Removal of thyroid		C										
60271	Removal of thyroid		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
60280	Remove thyroid duct lesion		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
60281	Remove thyroid duct lesion		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
60300	Aspir/inj thyroid cyst		T	5071	7.5120	$621.97	.	$124.40					
6030F	Max sterile barriers follwd		M										
6040F	Appro rad ds dvcs techs docd		E1										
6045F	Radxps in end rprt4fluro pxd		E1										
60500	Explore parathyroid glands		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
60502	Re-explore parathyroids		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
60505	Explore parathyroid glands		C										
60512	Autotransplant parathyroid		N										
60520	Removal of thymus gland		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
60521	Removal of thymus gland		C										
60522	Removal of thymus gland		C										
60540	Explore adrenal gland		C										
60545	Explore adrenal gland		C										
60600	Remove carotid body lesion		C										
60605	Remove carotid body lesion		C										
60650	Laparoscopy adrenalectomy		C										
60659	Laparo proc endocrine		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
60699	Endocrine surgery procedure		J1	5361	61.1186	"$5,060.44"	.	"$1,012.09"					
6070F	Pt asked/cnsld aed effects		E1										
6080F	Pt/caregiver queried falls		E1										
6090F	Pt/caregiver counsel safety		E1										
61000	Remove cranial cavity fluid		T	5442	7.6644	$634.59	.	$126.92					
61001	Remove cranial cavity fluid		T	5442	7.6644	$634.59	.	$126.92					
6100F	Verify pt site pxd docd		E1										
6101F	Safety counseling dementia		E1										
61020	Remove brain cavity fluid		T	5443	9.9334	$822.46	.	$164.50					
61026	Injection into brain canal		T	5442	7.6644	$634.59	.	$126.92					
6102F	Safety counseling dem order		E1										
61050	Remove brain canal fluid		T	5441	3.1543	$261.17	.	$52.24					
61055	Injection into brain canal		T	5441	3.1543	$261.17	.	$52.24					
61070	Brain canal shunt procedure		T	5442	7.6644	$634.59	.	$126.92					
61105	Twist drill hole		C										
61107	Drill skull for implantation		C										
61108	Drill skull for drainage		C										
6110F	Counsel prov driving risks		E1										
61120	Burr hole for puncture		C										
61140	Pierce skull for biopsy		C										
61150	Pierce skull for drainage		C										
61151	Pierce skull for drainage		C										
61154	Pierce skull & remove clot		C										
61156	Pierce skull for drainage		C										
61210	Pierce skull implant device		C										
61215	Insert brain-fluid device		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
61250	Pierce skull & explore		C										
61253	Pierce skull & explore		C										
61304	Open skull for exploration		C										
61305	Open skull for exploration		C										
61312	Open skull for drainage		C										
61313	Open skull for drainage		C										
61314	Open skull for drainage		C										
61315	Open skull for drainage		C										
61316	Implt cran bone flap to abdo		C										
61320	Open skull for drainage		C										
61321	Open skull for drainage		C										
61322	Decompressive craniotomy		C										
61323	Decompressive lobectomy		C										
61330	Decompress eye socket		J1	5164	33.0494	"$2,736.39"	.	$547.28					
61333	Explore orbit/remove lesion		C										
61340	Subtemporal decompression		C										
61343	Incise skull (press relief)		C										
61345	Relieve cranial pressure		C										
61450	Incise skull for surgery		C										
61458	Incise skull for brain wound		C										
61460	Incise skull for surgery		C										
61500	Removal of skull lesion		C										
61501	Remove infected skull bone		C										
6150F	Pt notrcvng1st antitnf txmnt		E1										
61510	Removal of brain lesion		C										
61512	Remove brain lining lesion		C										
61514	Removal of brain abscess		C										
61516	Removal of brain lesion		C										
61517	Implt brain chemotx add-on		C										
61518	Removal of brain lesion		C										
61519	Remove brain lining lesion		C										
61520	Removal of brain lesion		C										
61521	Removal of brain lesion		C										
61522	Removal of brain abscess		C										
61524	Removal of brain lesion		C										
61526	Removal of brain lesion		C										
61530	Removal of brain lesion		C										
61531	Implant brain electrodes		C										
61533	Implant brain electrodes		C										
61534	Removal of brain lesion		C										
61535	Remove brain electrodes		C										
61536	Removal of brain lesion		C										
61537	Removal of brain tissue		C										
61538	Removal of brain tissue		C										
61539	Removal of brain tissue		C										
61540	Removal of brain tissue		C										
61541	Incision of brain tissue		C										
61543	Removal of brain tissue		C										
61544	Remove & treat brain lesion		C										
61545	Excision of brain tumor		C										
61546	Removal of pituitary gland		C										
61548	Removal of pituitary gland		C										
61550	Release of skull seams		C										
61552	Release of skull seams		C										
61556	Incise skull/sutures		C										
61557	Incise skull/sutures		C										
61558	Excision of skull/sutures		C										
61559	Excision of skull/sutures		C										
61563	Excision of skull tumor		C										
61564	Excision of skull tumor		C										
61566	Removal of brain tissue		C										
61567	Incision of brain tissue		C										
61570	Remove foreign body brain		C										
61571	Incise skull for brain wound		C										
61575	Skull base/brainstem surgery		C										
61576	Skull base/brainstem surgery		C										
61580	Craniofacial approach skull		C										
61581	Craniofacial approach skull		C										
61582	Craniofacial approach skull		C										
61583	Craniofacial approach skull		C										
61584	Orbitocranial approach/skull		C										
61585	Orbitocranial approach/skull		C										
61586	Resect nasopharynx skull		C										
61590	Infratemporal approach/skull		C										
61591	Infratemporal approach/skull		C										
61592	Orbitocranial approach/skull		C										
61595	Transtemporal approach/skull		C										
61596	Transcochlear approach/skull		C										
61597	Transcondylar approach/skull		C										
61598	Transpetrosal approach/skull		C										
61600	Resect/excise cranial lesion		C										
61601	Resect/excise cranial lesion		C										
61605	Resect/excise cranial lesion		C										
61606	Resect/excise cranial lesion		C										
61607	Resect/excise cranial lesion		C										
61608	Resect/excise cranial lesion		C										
61611	Transect artery sinus		C										
61613	Remove aneurysm sinus		C										
61615	Resect/excise lesion skull		C										
61616	Resect/excise lesion skull		C										
61618	Repair dura		C										
61619	Repair dura		C										
61623	Endovasc tempory vessel occl		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
61624	Transcath occlusion cns	CH	J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
61626	Transcath occlusion non-cns		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
61630	Intracranial angioplasty		C										
61635	Intracran angioplsty w/stent		C										
61640	Dilate ic vasospasm init		E1										
61641	Dilat ic vspsm ea vsl sm ter		E1										
61642	Dilat ic vspsm ea diff ter		E1										
61645	Perq art m-thrombect &/nfs		C										
61650	Evasc prlng admn rx agnt 1st		C										
61651	Evasc prlng admn rx agnt add		C										
61680	Intracranial vessel surgery		C										
61682	Intracranial vessel surgery		C										
61684	Intracranial vessel surgery		C										
61686	Intracranial vessel surgery		C										
61690	Intracranial vessel surgery		C										
61692	Intracranial vessel surgery		C										
61697	Brain aneurysm repr complx		C										
61698	Brain aneurysm repr complx		C										
61700	Brain aneurysm repr simple		C										
61702	Inner skull vessel surgery		C										
61703	Clamp neck artery		C										
61705	Revise circulation to head		C										
61708	Revise circulation to head		C										
61710	Revise circulation to head		C										
61711	Fusion of skull arteries		C										
61720	Incise skull/brain surgery		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
61735	Incise skull/brain surgery		C										
61750	Incise skull/brain biopsy		C										
61751	Brain biopsy w/ct/mr guide		C										
61760	Implant brain electrodes		C										
61770	Incise skull for treatment		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
61781	Scan proc cranial intra		N										
61782	Scan proc cranial extra		N										
61783	Scan proc spinal		N										
61790	Treat trigeminal nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
61791	Treat trigeminal tract		J1	5431	21.1890	"$1,754.39"	.	$350.88					
61796	Srs cranial lesion simple		B										
61797	Srs cran les simple addl		B										
61798	Srs cranial lesion complex		B										
61799	Srs cran les complex addl		B										
61800	Apply srs headframe add-on		B										
61850	Implant neuroelectrodes		C										
61860	Implant neuroelectrodes		C										
61863	Implant neuroelectrode		C										
61864	Implant neuroelectrde addl		C										
61867	Implant neuroelectrode		C										
61868	Implant neuroelectrde addl		C										
61870	Implant neuroelectrodes	CH	D										
61880	Revise/remove neuroelectrode		J1	5461	39.5582	"$3,275.30"	.	$655.06					
61885	Insrt/redo neurostim 1 array	CH	J1	5464	247.3493	"$20,479.78"	.	"$4,095.96"	*				
61886	Implant neurostim arrays	CH	J1	5465	355.6230	"$29,444.52"	.	"$5,888.91"	*				
61888	Revise/remove neuroreceiver	CH	J1	5463	135.7079	"$11,236.21"	.	"$2,247.25"	*				
62000	Treat skull fracture		J1	5164	33.0494	"$2,736.39"	.	$547.28					
62005	Treat skull fracture		C										
62010	Treatment of head injury		C										
62100	Repair brain fluid leakage		C										
62115	Reduction of skull defect		C										
62117	Reduction of skull defect		C										
62120	Repair skull cavity lesion		C										
62121	Incise skull repair		C										
62140	Repair of skull defect		C										
62141	Repair of skull defect		C										
62142	Remove skull plate/flap		C										
62143	Replace skull plate/flap		C										
62145	Repair of skull & brain		C										
62146	Repair of skull with graft		C										
62147	Repair of skull with graft		C										
62148	Retr bone flap to fix skull		C										
62160	Neuroendoscopy add-on		N										
62161	Dissect brain w/scope		C										
62162	Remove colloid cyst w/scope		C										
62163	Zneuroendoscopy w/fb removal	CH	D										
62164	Remove brain tumor w/scope		C										
62165	Remove pituit tumor w/scope		C										
62180	Establish brain cavity shunt		C										
62190	Establish brain cavity shunt		C										
62192	Establish brain cavity shunt		C										
62194	Replace/irrigate catheter		J1	5431	21.1890	"$1,754.39"	.	$350.88					
62200	Establish brain cavity shunt		C										
62201	Brain cavity shunt w/scope		C										
62220	Establish brain cavity shunt		C										
62223	Establish brain cavity shunt		C										
62225	Replace/irrigate catheter		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
62230	Replace/revise brain shunt		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
62252	Csf shunt reprogram		S	5743	3.2908	$272.47	.	$54.50					
62256	Remove brain cavity shunt		C										
62258	Replace brain cavity shunt		C										
62263	Epidural lysis mult sessions		T	5443	9.9334	$822.46	.	$164.50					
62264	Epidural lysis on single day		T	5443	9.9334	$822.46	.	$164.50					
62267	Interdiscal perq aspir dx		T	5071	7.5120	$621.97	.	$124.40					
62268	Drain spinal cord cyst		T	5443	9.9334	$822.46	.	$164.50					
62269	Needle biopsy spinal cord		J1	5072	16.9934	"$1,407.00"	.	$281.41					
62270	Dx lmbr spi pnxr		T	5442	7.6644	$634.59	.	$126.92					
62272	Ther spi pnxr drg csf		T	5442	7.6644	$634.59	.	$126.92					
62273	Inject epidural patch		T	5442	7.6644	$634.59	.	$126.92					
62280	Treat spinal cord lesion		T	5443	9.9334	$822.46	.	$164.50					
62281	Treat spinal cord lesion		T	5443	9.9334	$822.46	.	$164.50					
62282	Treat spinal canal lesion		T	5443	9.9334	$822.46	.	$164.50					
62284	Injection for myelogram		N										
62287	Percutaneous diskectomy		J1	5431	21.1890	"$1,754.39"	.	$350.88					
62290	Njx px discography lumbar		N										
62291	Njx px discography crv/thrc		N										
62292	Njx chemonucleolysis lmbr		J1	5431	21.1890	"$1,754.39"	.	$350.88					
62294	Injection into spinal artery		T	5443	9.9334	$822.46	.	$164.50					
62302	Myelography lumbar injection		Q2	5573	8.6377	$715.18	.	$143.04					
62303	Myelography lumbar injection		Q2	5573	8.6377	$715.18	.	$143.04					
62304	Myelography lumbar injection		Q2	5573	8.6377	$715.18	.	$143.04					
62305	Myelography lumbar injection		Q2	5573	8.6377	$715.18	.	$143.04					
62320	Njx interlaminar crv/thrc		T	5442	7.6644	$634.59	.	$126.92					
62321	Njx interlaminar crv/thrc		T	5442	7.6644	$634.59	.	$126.92					
62322	Njx interlaminar lmbr/sac		T	5442	7.6644	$634.59	.	$126.92					
62323	Njx interlaminar lmbr/sac		T	5442	7.6644	$634.59	.	$126.92					
62324	Njx interlaminar crv/thrc		T	5443	9.9334	$822.46	.	$164.50					
62325	Njx interlaminar crv/thrc		T	5443	9.9334	$822.46	.	$164.50					
62326	Njx interlaminar lmbr/sac		T	5443	9.9334	$822.46	.	$164.50					
62327	Njx interlaminar lmbr/sac		T	5443	9.9334	$822.46	.	$164.50					
62328	Dx lmbr spi pnxr w/fluor/ct		T	5442	7.6644	$634.59	.	$126.92					
62329	Ther spi pnxr csf fluor/ct		T	5442	7.6644	$634.59	.	$126.92					
62350	Implant spinal canal cath		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
62351	Implant spinal canal cath		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
62355	Remove spinal canal catheter		Q2	5431	21.1890	"$1,754.39"	.	$350.88					
62360	Insert spine infusion device		J1	5471	205.7067	"$17,031.90"	.	"$3,406.38"	*				
62361	Implant spine infusion pump		J1	5471	205.7067	"$17,031.90"	.	"$3,406.38"	*				
62362	Implant spine infusion pump		J1	5471	205.7067	"$17,031.90"	.	"$3,406.38"	*				
62365	Remove spine infusion device		Q2	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
62367	Analyze spine infus pump		S	5743	3.2908	$272.47	.	$54.50					
62368	Analyze sp inf pump w/reprog		S	5743	3.2908	$272.47	.	$54.50					
62369	Anal sp inf pmp w/reprg&fill		S	5743	3.2908	$272.47	.	$54.50					
62370	Anl sp inf pmp w/mdreprg&fil		S	5743	3.2908	$272.47	.	$54.50					
62380	Ndsc dcmprn 1 ntrspc lumbar		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63001	Remove spine lamina 1/2 crvl		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63003	Remove spine lamina 1/2 thrc		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63005	Remove spine lamina 1/2 lmbr		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63011	Remove spine lamina 1/2 scrl		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63012	Remove lamina/facets lumbar		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63015	Remove spine lamina >2 crvcl		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63016	Remove spine lamina >2 thrc		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63017	Remove spine lamina >2 lmbr		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63020	Neck spine disk surgery		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63030	Low back disk surgery		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63035	Spinal disk surgery add-on		N										
63040	Laminotomy single cervical		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63042	Laminotomy single lumbar		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63043	Laminotomy addl cervical		N										
63044	Laminotomy addl lumbar		N										
63045	Remove spine lamina 1 crvl		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63046	Remove spine lamina 1 thrc		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63047	Remove spine lamina 1 lmbr		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63048	Remove spinal lamina add-on		N										
63050	Cervical laminoplsty 2/> seg		C										
63051	C-laminoplasty w/graft/plate		C										
63055	Decompress spinal cord thrc		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63056	Decompress spinal cord lmbr		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63057	Decompress spine cord add-on		N										
63064	Decompress spinal cord thrc		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63066	Decompress spine cord add-on		N										
63075	Neck spine disk surgery		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63076	Neck spine disk surgery		N										
63077	Spine disk surgery thorax		C										
63078	Spine disk surgery thorax		C										
63081	Remove vert body dcmprn crvl		C										
63082	Remove vertebral body add-on		C										
63085	Remove vert body dcmprn thrc		C										
63086	Remove vertebral body add-on		C										
63087	Remov vertbr dcmprn thrclmbr		C										
63088	Remove vertebral body add-on		C										
63090	Remove vert body dcmprn lmbr		C										
63091	Remove vertebral body add-on		C										
63101	Remove vert body dcmprn thrc		C										
63102	Remove vert body dcmprn lmbr		C										
63103	Remove vertebral body add-on		C										
63170	Incise spinal cord tract(s)		C										
63172	Drainage of spinal cyst		C										
63173	Drainage of spinal cyst		C										
63180	Revise spinal cord ligaments	CH	D										
63182	Revise spinal cord ligaments	CH	D										
63185	Incise spine nrv half segmnt		C										
63190	Incise spine nrv >2 segmnts		C										
63191	Incise spine accessory nerve		C										
63194	Incise spine & cord cervical		C										
63195	Incise spine & cord thoracic		C										
63196	Incise spine&cord 2 trx crvl		C										
63197	Incise spine&cord 2 trx thrc		C										
63198	Incise spin&cord 2 stgs crvl		C										
63199	Incise spin&cord 2 stgs thrc		C										
63200	Release spinal cord lumbar		C										
63250	Revise spinal cord vsls crvl		C										
63251	Revise spinal cord vsls thrc		C										
63252	Revise spine cord vsl thrlmb		C										
63265	Excise intraspinl lesion crv		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63266	Excise intrspinl lesion thrc		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63267	Excise intrspinl lesion lmbr		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63268	Excise intrspinl lesion scrl		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
63270	Excise intrspinl lesion crvl		C										
63271	Excise intrspinl lesion thrc		C										
63272	Excise intrspinl lesion lmbr		C										
63273	Excise intrspinl lesion scrl		C										
63275	Bx/exc xdrl spine lesn crvl		C										
63276	Bx/exc xdrl spine lesn thrc		C										
63277	Bx/exc xdrl spine lesn lmbr		C										
63278	Bx/exc xdrl spine lesn scrl		C										
63280	Bx/exc idrl spine lesn crvl		C										
63281	Bx/exc idrl spine lesn thrc		C										
63282	Bx/exc idrl spine lesn lmbr		C										
63283	Bx/exc idrl spine lesn scrl		C										
63285	Bx/exc idrl imed lesn cervl		C										
63286	Bx/exc idrl imed lesn thrc		C										
63287	Bx/exc idrl imed lesn thrlmb		C										
63290	Bx/exc xdrl/idrl lsn any lvl		C										
63295	Repair laminectomy defect		C										
63300	Remove vert xdrl body crvcl		C										
63301	Remove vert xdrl body thrc		C										
63302	Remove vert xdrl body thrlmb		C										
63303	Remov vert xdrl bdy lmbr/sac		C										
63304	Remove vert idrl body crvcl		C										
63305	Remove vert idrl body thrc		C										
63306	Remov vert idrl bdy thrclmbr		C										
63307	Remov vert idrl bdy lmbr/sac		C										
63308	Remove vertebral body add-on		C										
63600	Remove spinal cord lesion		J1	5431	21.1890	"$1,754.39"	.	$350.88					
63610	Stimulation of spinal cord		J1	5431	21.1890	"$1,754.39"	.	$350.88					
63620	Srs spinal lesion		B										
63621	Srs spinal lesion addl		B										
63650	Implant neuroelectrodes		J1	5462	74.4071	"$6,160.68"	.	"$1,232.14"					
63655	Implant neuroelectrodes	CH	J1	5464	247.3493	"$20,479.78"	.	"$4,095.96"	*				
63661	Remove spine eltrd perq aray		Q2	5431	21.1890	"$1,754.39"	.	$350.88					
63662	Remove spine eltrd plate		J1	5461	39.5582	"$3,275.30"	.	$655.06					
63663	Revise spine eltrd perq aray		J1	5462	74.4071	"$6,160.68"	.	"$1,232.14"					
63664	Revise spine eltrd plate		J1	5463	135.7079	"$11,236.21"	.	"$2,247.25"	*				
63685	Insrt/redo spine n generator	CH	J1	5465	355.6230	"$29,444.52"	.	"$5,888.91"	*				
63688	Revise/remove neuroreceiver		J1	5461	39.5582	"$3,275.30"	.	$655.06					
63700	Repair of spinal herniation		C										
63702	Repair of spinal herniation		C										
63704	Repair of spinal herniation		C										
63706	Repair of spinal herniation		C										
63707	Repair spinal fluid leakage		C										
63709	Repair spinal fluid leakage		C										
63710	Graft repair of spine defect		C										
63740	Install spinal shunt		C										
63741	Install spinal shunt		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
63744	Revision of spinal shunt		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
63746	Removal of spinal shunt		Q2	5431	21.1890	"$1,754.39"	.	$350.88					
64400	Njx aa&/strd trigeminal nrv		T	5441	3.1543	$261.17	.	$52.24					
64405	Njx aa&/strd gr ocpl nrv		T	5441	3.1543	$261.17	.	$52.24					
64408	Njx aa&/strd vagus nrv		T	5441	3.1543	$261.17	.	$52.24					
64415	Njx aa&/strd brach plexus		T	5443	9.9334	$822.46	.	$164.50					
64416	Njx aa&/strd brach plex nfs		T	5443	9.9334	$822.46	.	$164.50					
64417	Njx aa&/strd axillary nrv		T	5443	9.9334	$822.46	.	$164.50					
64418	Njx aa&/strd sprscap nrv		T	5442	7.6644	$634.59	.	$126.92					
64420	Njx aa&/strd ntrcost nrv 1		T	5442	7.6644	$634.59	.	$126.92					
64421	Njx aa&/strd ntrcost nrv ea		T	5443	9.9334	$822.46	.	$164.50					
64425	Njx aa&/strd ii ih nerves		T	5442	7.6644	$634.59	.	$126.92					
64430	Njx aa&/strd pudendal nerve		T	5443	9.9334	$822.46	.	$164.50					
64435	Njx aa&/strd paracrv nrv		T	5442	7.6644	$634.59	.	$126.92					
64445	Njx aa&/strd sciatic nerve		T	5442	7.6644	$634.59	.	$126.92					
64446	Njx aa&/strd sciatic nrv nfs		T	5443	9.9334	$822.46	.	$164.50					
64447	Njx aa&/strd femoral nerve		T	5442	7.6644	$634.59	.	$126.92					
64448	Njx aa&/strd fem nerve nfs		T	5443	9.9334	$822.46	.	$164.50					
64449	Njx aa&/strd lmbr plex nfs		T	5443	9.9334	$822.46	.	$164.50					
64450	Njx aa&/strd other pn/branch		T	5442	7.6644	$634.59	.	$126.92					
64451	Njx aa&/strd nrv nrvtg si jt		T	5442	7.6644	$634.59	.	$126.92					
64454	Njx aa&/strd gnclr nrv brnch		T	5442	7.6644	$634.59	.	$126.92					
64455	Njx aa&/strd pltr com dg nrv		T	5441	3.1543	$261.17	.	$52.24					
64461	Pvb thoracic single inj site		T	5442	7.6644	$634.59	.	$126.92					
64462	Pvb thoracic 2nd+ inj site		N										
64463	Pvb thoracic cont infusion		T	5442	7.6644	$634.59	.	$126.92					
64479	Njx aa&/strd tfrm epi c/t 1		T	5443	9.9334	$822.46	.	$164.50					
64480	Njx aa&/strd tfrm epi c/t ea		N										
64483	Njx aa&/strd tfrm epi l/s 1		T	5443	9.9334	$822.46	.	$164.50					
64484	Njx aa&/strd tfrm epi l/s ea		N										
64486	Tap block unil by injection		N										
64487	Tap block uni by infusion		N										
64488	Tap block bi injection		N										
64489	Tap block bi by infusion		N										
64490	Inj paravert f jnt c/t 1 lev		T	5443	9.9334	$822.46	.	$164.50					
64491	Inj paravert f jnt c/t 2 lev		N										
64492	Inj paravert f jnt c/t 3 lev		N										
64493	Inj paravert f jnt l/s 1 lev		T	5443	9.9334	$822.46	.	$164.50					
64494	Inj paravert f jnt l/s 2 lev		N										
64495	Inj paravert f jnt l/s 3 lev		N										
64505	N block spenopalatine gangl		T	5441	3.1543	$261.17	.	$52.24					
64510	N block stellate ganglion		T	5443	9.9334	$822.46	.	$164.50					
64517	N block inj hypogas plxs		T	5443	9.9334	$822.46	.	$164.50					
64520	N block lumbar/thoracic		T	5443	9.9334	$822.46	.	$164.50					
64530	N block inj celiac pelus		T	5443	9.9334	$822.46	.	$164.50					
64553	Implant neuroelectrodes	CH	J1	5463	135.7079	"$11,236.21"	.	"$2,247.25"	*				
64555	Implant neuroelectrodes		J1	5462	74.4071	"$6,160.68"	.	"$1,232.14"					
64561	Implant neuroelectrodes		J1	5462	74.4071	"$6,160.68"	.	"$1,232.14"					
64566	Neuroeltrd stim post tibial		T	5441	3.1543	$261.17	.	$52.24					
64568	Inc for vagus n elect impl	CH	J1	5465	355.6230	"$29,444.52"	.	"$5,888.91"	*				
64569	Revise/repl vagus n eltrd	CH	J1	5463	135.7079	"$11,236.21"	.	"$2,247.25"	*				
64570	Remove vagus n eltrd		Q2	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64575	Implant neuroelectrodes		J1	5463	135.7079	"$11,236.21"	.	"$2,247.25"	*				
64580	Implant neuroelectrodes	CH	J1	5464	247.3493	"$20,479.78"	.	"$4,095.96"	*				
64581	Implant neuroelectrodes		J1	5462	74.4071	"$6,160.68"	.	"$1,232.14"					
64585	Revise/remove neuroelectrode		J1	5461	39.5582	"$3,275.30"	.	$655.06					
64590	Insrt/redo pn/gastr stimul	CH	J1	5464	247.3493	"$20,479.78"	.	"$4,095.96"	*				
64595	Revise/rmv pn/gastr stimul		J1	5461	39.5582	"$3,275.30"	.	$655.06					
64600	Injection treatment of nerve		T	5443	9.9334	$822.46	.	$164.50					
64605	Injection treatment of nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64610	Injection treatment of nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64611	Chemodenerv saliv glands		T	5441	3.1543	$261.17	.	$52.24					
64612	Destroy nerve face muscle		T	5441	3.1543	$261.17	.	$52.24					
64615	Chemodenerv musc migraine		T	5441	3.1543	$261.17	.	$52.24					
64616	Chemodenerv musc neck dyston		T	5441	3.1543	$261.17	.	$52.24					
64617	Chemodener muscle larynx emg		T	5441	3.1543	$261.17	.	$52.24					
64620	Injection treatment of nerve		T	5443	9.9334	$822.46	.	$164.50					
64624	Dstrj nulyt agt gnclr nrv		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64625	Rf abltj nrv nrvtg si jt		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64630	Injection treatment of nerve		T	5443	9.9334	$822.46	.	$164.50					
64632	N block inj common digit		T	5441	3.1543	$261.17	.	$52.24					
64633	Destroy cerv/thor facet jnt		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64634	Destroy c/th facet jnt addl		N										
64635	Destroy lumb/sac facet jnt		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64636	Destroy l/s facet jnt addl		N										
64640	Injection treatment of nerve		T	5443	9.9334	$822.46	.	$164.50					
64642	Chemodenerv 1 extremity 1-4		T	5442	7.6644	$634.59	.	$126.92					
64643	Chemodenerv 1 extrem 1-4 ea		N										
64644	Chemodenerv 1 extrem 5/> mus		T	5442	7.6644	$634.59	.	$126.92					
64645	Chemodenerv 1 extrem 5/> ea		N										
64646	Chemodenerv trunk musc 1-5		T	5442	7.6644	$634.59	.	$126.92					
64647	Chemodenerv trunk musc 6/>		T	5442	7.6644	$634.59	.	$126.92					
64650	Chemodenerv eccrine glands		T	5441	3.1543	$261.17	.	$52.24					
64653	Chemodenerv eccrine glands		T	5441	3.1543	$261.17	.	$52.24					
64680	Injection treatment of nerve		T	5443	9.9334	$822.46	.	$164.50					
64681	Injection treatment of nerve		T	5443	9.9334	$822.46	.	$164.50					
64702	Revise finger/toe nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64704	Revise hand/foot nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64708	Revise arm/leg nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64712	Revision of sciatic nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64713	Revision of arm nerve(s)		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64714	Revise low back nerve(s)		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64716	Revision of cranial nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64718	Revise ulnar nerve at elbow		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64719	Revise ulnar nerve at wrist		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64721	Carpal tunnel surgery		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64722	Relieve pressure on nerve(s)		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64726	Release foot/toe nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64727	Internal nerve revision		N										
64732	Incision of brow nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64734	Incision of cheek nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64736	Incision of chin nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64738	Incision of jaw nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64740	Incision of tongue nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64742	Incision of facial nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64744	Incise nerve back of head		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64746	Incise diaphragm nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64755	Incision of stomach nerves		C										
64760	Incision of vagus nerve		C										
64763	Incise hip/thigh nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64766	Incise hip/thigh nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64771	Sever cranial nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64772	Incision of spinal nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64774	Remove skin nerve lesion		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64776	Remove digit nerve lesion		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64778	Digit nerve surgery add-on		N										
64782	Remove limb nerve lesion		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64783	Limb nerve surgery add-on		N										
64784	Remove nerve lesion		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64786	Remove sciatic nerve lesion		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64787	Implant nerve end		N										
64788	Remove skin nerve lesion		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64790	Removal of nerve lesion		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64792	Removal of nerve lesion		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64795	Biopsy of nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64802	Sympathectomy cervical		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64804	Remove sympathetic nerves		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64809	Remove sympathetic nerves		C										
64818	Remove sympathetic nerves		C										
64820	Sympathectomy digital artery		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64821	Remove sympathetic nerves		J1	5113	34.1848	"$2,830.40"	.	$566.08					
64822	Remove sympathetic nerves		J1	5113	34.1848	"$2,830.40"	.	$566.08					
64823	Sympathectomy supfc palmar		J1	5113	34.1848	"$2,830.40"	.	$566.08					
64831	Repair of digit nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64832	Repair nerve add-on		N										
64834	Repair of hand or foot nerve		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64835	Repair of hand or foot nerve		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64836	Repair of hand or foot nerve		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64837	Repair nerve add-on		N										
64840	Repair of leg nerve		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64856	Repair/transpose nerve		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64857	Repair arm/leg nerve		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64858	Repair sciatic nerve		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64859	Nerve surgery		N										
64861	Repair of arm nerves		J1	5431	21.1890	"$1,754.39"	.	$350.88					
64862	Repair of low back nerves		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64864	Repair of facial nerve		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64865	Repair of facial nerve		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64866	Fusion of facial/other nerve		C										
64868	Fusion of facial/other nerve		C										
64872	Subsequent repair of nerve		N										
64874	Repair & revise nerve add-on		N										
64876	Repair nerve/shorten bone		N										
64885	Nerve graft head/neck </4 cm		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64886	Nerve graft head/neck >4 cm		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64890	Nerve graft hand/foot </4 cm		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64891	Nerve graft hand/foot >4 cm		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64892	Nerve graft arm/leg <4 cm		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64893	Nerve graft arm/leg >4 cm		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64895	Nerve graft hand/foot </4 cm		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64896	Nerve graft hand/foot >4 cm		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64897	Nerve graft arm/leg </4 cm		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64898	Nerve graft arm/leg >4 cm		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64901	Nerve graft add-on		N										
64902	Nerve graft add-on		N										
64905	Nerve pedicle transfer		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64907	Nerve pedicle transfer		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64910	Nerve repair w/allograft		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64911	Neurorraphy w/vein autograft		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64912	Nrv rpr w/nrv algrft 1st		J1	5432	68.8466	"$5,700.29"	.	"$1,140.06"					
64913	Nrv rpr w/nrv algrft ea addl		N										
64999	Nervous system surgery		T	5441	3.1543	$261.17	.	$52.24					
65091	Revise eye		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65093	Revise eye with implant		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65101	Removal of eye		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65103	Remove eye/insert implant		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65105	Remove eye/attach implant		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65110	Removal of eye		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65112	Remove eye/revise socket		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65114	Remove eye/revise socket		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65125	Revise ocular implant		J1	5503	24.1839	"$2,002.35"	.	$400.48					
65130	Insert ocular implant		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65135	Insert ocular implant		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65140	Attach ocular implant		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65150	Revise ocular implant		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65155	Reinsert ocular implant		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65175	Removal of ocular implant		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65205	Remove foreign body from eye		Q1	5734	1.3521	$111.95	.	$22.39					
65210	Remove foreign body from eye		Q1	5735	3.2637	$270.22	.	$54.05					
65220	Remove foreign body from eye		Q1	5735	3.2637	$270.22	.	$54.05					
65222	Remove foreign body from eye		Q1	5734	1.3521	$111.95	.	$22.39					
65235	Remove foreign body from eye		J1	5491	25.1115	"$2,079.16"	.	$415.84					
65260	Remove foreign body from eye		J1	5491	25.1115	"$2,079.16"	.	$415.84					
65265	Remove foreign body from eye		J1	5491	25.1115	"$2,079.16"	.	$415.84					
65270	Repair of eye wound		J1	5503	24.1839	"$2,002.35"	.	$400.48					
65272	Repair of eye wound		J1	5503	24.1839	"$2,002.35"	.	$400.48					
65273	Repair of eye wound		C										
65275	Repair of eye wound		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65280	Repair of eye wound		J1	5492	47.3174	"$3,917.74"	.	$783.55					
65285	Repair of eye wound		J1	5492	47.3174	"$3,917.74"	.	$783.55					
65286	Repair of eye wound		J1	5491	25.1115	"$2,079.16"	.	$415.84					
65290	Repair of eye socket wound		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65400	Removal of eye lesion		T	5502	9.7774	$809.54	.	$161.91					
65410	Biopsy of cornea		J1	5503	24.1839	"$2,002.35"	.	$400.48					
65420	Removal of eye lesion		J1	5503	24.1839	"$2,002.35"	.	$400.48					
65426	Removal of eye lesion		J1	5503	24.1839	"$2,002.35"	.	$400.48					
65430	Corneal smear		Q1	5735	3.2637	$270.22	.	$54.05					
65435	Curette/treat cornea		T	5502	9.7774	$809.54	.	$161.91					
65436	Curette/treat cornea		J1	5503	24.1839	"$2,002.35"	.	$400.48					
65450	Treatment of corneal lesion		T	5501	3.1557	$261.28	.	$52.26					
65600	Revision of cornea		J1	5503	24.1839	"$2,002.35"	.	$400.48					
65710	Corneal transplant		J1	5492	47.3174	"$3,917.74"	.	$783.55					
65730	Corneal transplant		J1	5492	47.3174	"$3,917.74"	.	$783.55					
65750	Corneal transplant		J1	5492	47.3174	"$3,917.74"	.	$783.55					
65755	Corneal transplant		J1	5492	47.3174	"$3,917.74"	.	$783.55					
65756	Corneal trnspl endothelial		J1	5492	47.3174	"$3,917.74"	.	$783.55					
65757	Prep corneal endo allograft		N										
65760	Revision of cornea		E1										
65765	Revision of cornea		E1										
65767	Corneal tissue transplant		E1										
65770	Revise cornea with implant		J1	5493	88.6006	"$7,335.86"	.	"$1,467.18"					
65771	Radial keratotomy		E1										
65772	Correction of astigmatism		T	5502	9.7774	$809.54	.	$161.91					
65775	Correction of astigmatism		J1	5503	24.1839	"$2,002.35"	.	$400.48					
65778	Cover eye w/membrane		Q2	5502	9.7774	$809.54	.	$161.91					
65779	Cover eye w/membrane suture		Q2	5504	39.9223	"$3,305.45"	.	$661.09					
65780	Ocular reconst transplant		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65781	Ocular reconst transplant		J1	5492	47.3174	"$3,917.74"	.	$783.55					
65782	Ocular reconst transplant		J1	5504	39.9223	"$3,305.45"	.	$661.09					
65785	Impltj ntrstrml crnl rng seg		J1	5492	47.3174	"$3,917.74"	.	$783.55					
65800	Drainage of eye		J1	5491	25.1115	"$2,079.16"	.	$415.84					
65810	Drainage of eye		J1	5491	25.1115	"$2,079.16"	.	$415.84					
65815	Drainage of eye		J1	5491	25.1115	"$2,079.16"	.	$415.84					
65820	Relieve inner eye pressure		J1	5492	47.3174	"$3,917.74"	.	$783.55					
65850	Incision of eye		J1	5491	25.1115	"$2,079.16"	.	$415.84					
65855	Trabeculoplasty laser surg		T	5481	6.0855	$503.86	$100.90	$100.78					
65860	Incise inner eye adhesions		T	5481	6.0855	$503.86	$100.90	$100.78					
65865	Incise inner eye adhesions		J1	5491	25.1115	"$2,079.16"	.	$415.84					
65870	Incise inner eye adhesions		J1	5491	25.1115	"$2,079.16"	.	$415.84					
65875	Incise inner eye adhesions		J1	5491	25.1115	"$2,079.16"	.	$415.84					
65880	Incise inner eye adhesions		J1	5492	47.3174	"$3,917.74"	.	$783.55					
65900	Remove eye lesion		J1	5491	25.1115	"$2,079.16"	.	$415.84					
65920	Remove implant of eye		J1	5491	25.1115	"$2,079.16"	.	$415.84					
65930	Remove blood clot from eye		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66020	Injection treatment of eye		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66030	Injection treatment of eye		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66130	Remove eye lesion		J1	5503	24.1839	"$2,002.35"	.	$400.48					
66150	Glaucoma surgery		J1	5492	47.3174	"$3,917.74"	.	$783.55					
66155	Glaucoma surgery		J1	5492	47.3174	"$3,917.74"	.	$783.55					
66160	Glaucoma surgery		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66170	Glaucoma surgery		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66172	Incision of eye		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66174	Translum dil eye canal		J1	5492	47.3174	"$3,917.74"	.	$783.55					
66175	Trnslum dil eye canal w/stnt		J1	5492	47.3174	"$3,917.74"	.	$783.55					
66179	Aqueous shunt eye w/o graft		J1	5492	47.3174	"$3,917.74"	.	$783.55					
66180	Aqueous shunt eye w/graft		J1	5492	47.3174	"$3,917.74"	.	$783.55					
66183	Insert ant drainage device		J1	5492	47.3174	"$3,917.74"	.	$783.55					
66184	Revision of aqueous shunt		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66185	Revise aqueous shunt eye		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66225	Repair/graft eye lesion		J1	5492	47.3174	"$3,917.74"	.	$783.55					
66250	Follow-up surgery of eye		J1	5503	24.1839	"$2,002.35"	.	$400.48					
66500	Incision of iris		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66505	Incision of iris		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66600	Remove iris and lesion		J1	5492	47.3174	"$3,917.74"	.	$783.55					
66605	Removal of iris		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66625	Removal of iris		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66630	Removal of iris		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66635	Removal of iris		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66680	Repair iris & ciliary body		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66682	Repair iris & ciliary body		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66700	Destruction ciliary body		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66710	Ciliary transsleral therapy		J1	5503	24.1839	"$2,002.35"	.	$400.48					
66711	Ecp ciliary body destruction		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66720	Destruction ciliary body		J1	5503	24.1839	"$2,002.35"	.	$400.48					
66740	Destruction ciliary body		J1	5503	24.1839	"$2,002.35"	.	$400.48					
66761	Revision of iris		T	5481	6.0855	$503.86	$100.90	$100.78					
66762	Revision of iris		T	5481	6.0855	$503.86	$100.90	$100.78					
66770	Removal of inner eye lesion		T	5481	6.0855	$503.86	$100.90	$100.78					
66820	Incision secondary cataract		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66821	After cataract laser surgery		T	5481	6.0855	$503.86	$100.90	$100.78					
66825	Reposition intraocular lens		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66830	Removal of lens lesion		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66840	Removal of lens material		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66850	Removal of lens material		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66852	Removal of lens material		J1	5492	47.3174	"$3,917.74"	.	$783.55					
66920	Extraction of lens		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66930	Extraction of lens		J1	5492	47.3174	"$3,917.74"	.	$783.55					
66940	Extraction of lens		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66982	Xcapsl ctrc rmvl cplx wo ecp		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66983	Cataract surg w/iol 1 stage		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66984	Xcapsl ctrc rmvl w/o ecp		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66985	Insert lens prosthesis		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66986	Exchange lens prosthesis		J1	5491	25.1115	"$2,079.16"	.	$415.84					
66987	Xcapsl ctrc rmvl cplx w/ecp		J1	5492	47.3174	"$3,917.74"	.	$783.55					
66988	Xcapsl ctrc rmvl w/ecp		J1	5492	47.3174	"$3,917.74"	.	$783.55					
66990	Ophthalmic endoscope add-on		N										
66999	Eye surgery procedure		J1	5491	25.1115	"$2,079.16"	.	$415.84					
67005	Partial removal of eye fluid		J1	5491	25.1115	"$2,079.16"	.	$415.84					
67010	Partial removal of eye fluid		J1	5491	25.1115	"$2,079.16"	.	$415.84					
67015	Release of eye fluid		J1	5491	25.1115	"$2,079.16"	.	$415.84					
67025	Replace eye fluid		J1	5491	25.1115	"$2,079.16"	.	$415.84					
67027	Implant eye drug system		J1	5494	181.2793	"$15,009.38"	.	"$3,001.88"	*				
67028	Injection eye drug		S	5694	3.7532	$310.75	.	$62.16					
67030	Incise inner eye strands		J1	5491	25.1115	"$2,079.16"	.	$415.84					
67031	Laser surgery eye strands		T	5481	6.0855	$503.86	$100.90	$100.78					
67036	Removal of inner eye fluid		J1	5492	47.3174	"$3,917.74"	.	$783.55					
67039	Laser treatment of retina		J1	5492	47.3174	"$3,917.74"	.	$783.55					
67040	Laser treatment of retina		J1	5492	47.3174	"$3,917.74"	.	$783.55					
67041	Vit for macular pucker		J1	5492	47.3174	"$3,917.74"	.	$783.55					
67042	Vit for macular hole		J1	5492	47.3174	"$3,917.74"	.	$783.55					
67043	Vit for membrane dissect		J1	5492	47.3174	"$3,917.74"	.	$783.55					
67101	Repair detached retina crtx		J1	5491	25.1115	"$2,079.16"	.	$415.84					
67105	Repair detached retina pc		T	5481	6.0855	$503.86	$100.90	$100.78					
67107	Repair detached retina		J1	5492	47.3174	"$3,917.74"	.	$783.55					
67108	Repair detached retina		J1	5492	47.3174	"$3,917.74"	.	$783.55					
67110	Repair detached retina		J1	5491	25.1115	"$2,079.16"	.	$415.84					
67113	Repair retinal detach cplx		J1	5492	47.3174	"$3,917.74"	.	$783.55					
67115	Release encircling material		J1	5492	47.3174	"$3,917.74"	.	$783.55					
67120	Remove eye implant material		J1	5491	25.1115	"$2,079.16"	.	$415.84					
67121	Remove eye implant material		J1	5491	25.1115	"$2,079.16"	.	$415.84					
67141	Treatment of retina		T	5501	3.1557	$261.28	.	$52.26					
67145	Treatment of retina		T	5481	6.0855	$503.86	$100.90	$100.78					
67208	Treatment of retinal lesion		T	5501	3.1557	$261.28	.	$52.26					
67210	Treatment of retinal lesion		T	5481	6.0855	$503.86	$100.90	$100.78					
67218	Treatment of retinal lesion		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67220	Treatment of choroid lesion		T	5481	6.0855	$503.86	$100.90	$100.78					
67221	Ocular photodynamic ther		T	5481	6.0855	$503.86	$100.90	$100.78					
67225	Eye photodynamic ther add-on		N										
67227	Dstrj extensive retinopathy		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67228	Treatment x10sv retinopathy		T	5481	6.0855	$503.86	$100.90	$100.78					
67229	Tr retinal les preterm inf		T	5481	6.0855	$503.86	$100.90	$100.78					
67250	Reinforce eye wall		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67255	Reinforce/graft eye wall		J1	5491	25.1115	"$2,079.16"	.	$415.84					
67299	Eye surgery procedure		J1	5491	25.1115	"$2,079.16"	.	$415.84					
67311	Revise eye muscle		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67312	Revise two eye muscles		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67314	Revise eye muscle		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67316	Revise two eye muscles		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67318	Revise eye muscle(s)		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67320	Revise eye muscle(s) add-on		N										
67331	Eye surgery follow-up add-on		N										
67332	Rerevise eye muscles add-on		N										
67334	Revise eye muscle w/suture		N										
67335	Eye suture during surgery		N										
67340	Revise eye muscle add-on		N										
67343	Release eye tissue		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67345	Destroy nerve of eye muscle		T	5501	3.1557	$261.28	.	$52.26					
67346	Biopsy eye muscle		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67399	Unlisted px extraocular musc		T	5501	3.1557	$261.28	.	$52.26					
67400	Explore/biopsy eye socket		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67405	Explore/drain eye socket		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67412	Explore/treat eye socket		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67413	Explore/treat eye socket		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67414	Explr/decompress eye socket		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67415	Aspiration orbital contents		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67420	Explore/treat eye socket		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67430	Explore/treat eye socket		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67440	Explore/drain eye socket		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67445	Explr/decompress eye socket		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67450	Explore/biopsy eye socket		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67500	Inject/treat eye socket		T	5501	3.1557	$261.28	.	$52.26					
67505	Inject/treat eye socket		T	5501	3.1557	$261.28	.	$52.26					
67515	Inject/treat eye socket		T	5501	3.1557	$261.28	.	$52.26					
67550	Insert eye socket implant		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67560	Revise eye socket implant		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67570	Decompress optic nerve		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67599	Orbit surgery procedure		T	5501	3.1557	$261.28	.	$52.26					
67700	Drainage of eyelid abscess		T	5501	3.1557	$261.28	.	$52.26					
67710	Incision of eyelid		T	5502	9.7774	$809.54	.	$161.91					
67715	Incision of eyelid fold		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67800	Remove eyelid lesion		T	5501	3.1557	$261.28	.	$52.26					
67801	Remove eyelid lesions		T	5502	9.7774	$809.54	.	$161.91					
67805	Remove eyelid lesions		T	5501	3.1557	$261.28	.	$52.26					
67808	Remove eyelid lesion(s)		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67810	Biopsy eyelid & lid margin		T	5501	3.1557	$261.28	.	$52.26					
67820	Revise eyelashes		Q1	5734	1.3521	$111.95	.	$22.39					
67825	Revise eyelashes		T	5501	3.1557	$261.28	.	$52.26					
67830	Revise eyelashes		T	5502	9.7774	$809.54	.	$161.91					
67835	Revise eyelashes		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67840	Remove eyelid lesion		T	5502	9.7774	$809.54	.	$161.91					
67850	Treat eyelid lesion		T	5502	9.7774	$809.54	.	$161.91					
67875	Closure of eyelid by suture		T	5502	9.7774	$809.54	.	$161.91					
67880	Revision of eyelid		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67882	Revision of eyelid		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67900	Repair brow defect		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67901	Repair eyelid defect		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67902	Repair eyelid defect		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67903	Repair eyelid defect		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67904	Repair eyelid defect		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67906	Repair eyelid defect		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67908	Repair eyelid defect		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67909	Revise eyelid defect		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67911	Revise eyelid defect		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67912	Correction eyelid w/implant		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67914	Repair eyelid defect		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67915	Repair eyelid defect		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67916	Repair eyelid defect		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67917	Repair eyelid defect		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67921	Repair eyelid defect		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67922	Repair eyelid defect		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67923	Repair eyelid defect		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67924	Repair eyelid defect		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67930	Repair eyelid wound		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67935	Repair eyelid wound		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67938	Remove eyelid foreign body		T	5501	3.1557	$261.28	.	$52.26					
67950	Revision of eyelid		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67961	Revision of eyelid		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67966	Revision of eyelid		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67971	Reconstruction of eyelid		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67973	Reconstruction of eyelid		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67974	Reconstruction of eyelid		J1	5504	39.9223	"$3,305.45"	.	$661.09					
67975	Reconstruction of eyelid		J1	5503	24.1839	"$2,002.35"	.	$400.48					
67999	Revision of eyelid		T	5501	3.1557	$261.28	.	$52.26					
68020	Incise/drain eyelid lining		T	5502	9.7774	$809.54	.	$161.91					
68040	Treatment of eyelid lesions		T	5501	3.1557	$261.28	.	$52.26					
68100	Biopsy of eyelid lining		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68110	Remove eyelid lining lesion		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68115	Remove eyelid lining lesion		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68130	Remove eyelid lining lesion		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68135	Remove eyelid lining lesion		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68200	Treat eyelid by injection	CH	Q1	5735	3.2637	$270.22	.	$54.05					
68320	Revise/graft eyelid lining		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68325	Revise/graft eyelid lining		J1	5504	39.9223	"$3,305.45"	.	$661.09					
68326	Revise/graft eyelid lining		J1	5504	39.9223	"$3,305.45"	.	$661.09					
68328	Revise/graft eyelid lining		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68330	Revise eyelid lining		J1	5491	25.1115	"$2,079.16"	.	$415.84					
68335	Revise/graft eyelid lining		J1	5504	39.9223	"$3,305.45"	.	$661.09					
68340	Separate eyelid adhesions		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68360	Revise eyelid lining		J1	5504	39.9223	"$3,305.45"	.	$661.09					
68362	Revise eyelid lining		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68371	Harvest eye tissue alograft		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68399	Eyelid lining surgery		T	5501	3.1557	$261.28	.	$52.26					
68400	Incise/drain tear gland		T	5502	9.7774	$809.54	.	$161.91					
68420	Incise/drain tear sac		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68440	Incise tear duct opening		T	5501	3.1557	$261.28	.	$52.26					
68500	Removal of tear gland		J1	5504	39.9223	"$3,305.45"	.	$661.09					
68505	Partial removal tear gland		J1	5504	39.9223	"$3,305.45"	.	$661.09					
68510	Biopsy of tear gland		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68520	Removal of tear sac		J1	5504	39.9223	"$3,305.45"	.	$661.09					
68525	Biopsy of tear sac		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68530	Clearance of tear duct		T	5501	3.1557	$261.28	.	$52.26					
68540	Remove tear gland lesion		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68550	Remove tear gland lesion		J1	5504	39.9223	"$3,305.45"	.	$661.09					
68700	Repair tear ducts		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68705	Revise tear duct opening		T	5501	3.1557	$261.28	.	$52.26					
68720	Create tear sac drain		J1	5504	39.9223	"$3,305.45"	.	$661.09					
68745	Create tear duct drain		J1	5504	39.9223	"$3,305.45"	.	$661.09					
68750	Create tear duct drain		J1	5504	39.9223	"$3,305.45"	.	$661.09					
68760	Close tear duct opening		T	5501	3.1557	$261.28	.	$52.26					
68761	Close tear duct opening		T	5501	3.1557	$261.28	.	$52.26					
68770	Close tear system fistula		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68801	Dilate tear duct opening		Q1	5735	3.2637	$270.22	.	$54.05					
68810	Probe nasolacrimal duct		T	5501	3.1557	$261.28	.	$52.26					
68811	Probe nasolacrimal duct		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68815	Probe nasolacrimal duct		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68816	Probe nl duct w/balloon		J1	5503	24.1839	"$2,002.35"	.	$400.48					
68840	Explore/irrigate tear ducts		T	5501	3.1557	$261.28	.	$52.26					
68850	Injection for tear sac x-ray		N										
68899	Tear duct system surgery		T	5501	3.1557	$261.28	.	$52.26					
69000	Drain external ear lesion		T	5071	7.5120	$621.97	.	$124.40					
69005	Drain external ear lesion		J1	5072	16.9934	"$1,407.00"	.	$281.41					
69020	Drain outer ear canal lesion		T	5071	7.5120	$621.97	.	$124.40					
69090	Pierce earlobes		E1										
69100	Biopsy of external ear		T	5161	2.5557	$211.60	.	$42.33					
69105	Biopsy of external ear canal		J1	5163	16.3386	"$1,352.79"	.	$270.56					
69110	Remove external ear partial		J1	5073	28.6243	"$2,370.01"	.	$474.01					
69120	Removal of external ear		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69140	Remove ear canal lesion(s)		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69145	Remove ear canal lesion(s)		J1	5073	28.6243	"$2,370.01"	.	$474.01					
69150	Extensive ear canal surgery		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69155	Extensive ear/neck surgery		C										
69200	Clear outer ear canal		Q1	5734	1.3521	$111.95	.	$22.39					
69205	Clear outer ear canal		J1	5072	16.9934	"$1,407.00"	.	$281.41					
69209	Remove impacted ear wax uni		Q1	5733	0.6722	$55.66	.	$11.14					
69210	Remove impacted ear wax uni		Q1	5733	0.6722	$55.66	.	$11.14					
69220	Clean out mastoid cavity		Q1	5051	2.1685	$179.55	.	$35.91					
69222	Clean out mastoid cavity		T	5162	5.4635	$452.36	.	$90.48					
69300	Revise external ear		J1	5164	33.0494	"$2,736.39"	.	$547.28					
69310	Rebuild outer ear canal		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69320	Rebuild outer ear canal		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69399	Outer ear surgery procedure		T	5161	2.5557	$211.60	.	$42.33					
69420	Incision of eardrum		T	5161	2.5557	$211.60	.	$42.33					
69421	Incision of eardrum		J1	5164	33.0494	"$2,736.39"	.	$547.28					
69424	Remove ventilating tube		Q2	5164	33.0494	"$2,736.39"	.	$547.28					
69433	Create eardrum opening		T	5162	5.4635	$452.36	.	$90.48					
69436	Create eardrum opening		J1	5163	16.3386	"$1,352.79"	.	$270.56					
69440	Exploration of middle ear		J1	5164	33.0494	"$2,736.39"	.	$547.28					
69450	Eardrum revision		J1	5164	33.0494	"$2,736.39"	.	$547.28					
69501	Mastoidectomy		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69502	Mastoidectomy		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69505	Remove mastoid structures		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69511	Extensive mastoid surgery		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69530	Extensive mastoid surgery		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69535	Remove part of temporal bone		C										
69540	Remove ear lesion		J1	5163	16.3386	"$1,352.79"	.	$270.56					
69550	Remove ear lesion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69552	Remove ear lesion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69554	Remove ear lesion		C										
69601	Mastoid surgery revision		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69602	Mastoid surgery revision		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69603	Mastoid surgery revision		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69604	Mastoid surgery revision		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69605	Mastoid surgery revision	CH 	D										
69610	Repair of eardrum		J1	5163	16.3386	"$1,352.79"	.	$270.56					
69620	Repair of eardrum		J1	5164	33.0494	"$2,736.39"	.	$547.28					
69631	Repair eardrum structures		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69632	Rebuild eardrum structures		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69633	Rebuild eardrum structures		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69635	Repair eardrum structures		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69636	Rebuild eardrum structures		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69637	Rebuild eardrum structures		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69641	Revise middle ear & mastoid		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69642	Revise middle ear & mastoid		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69643	Revise middle ear & mastoid		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69644	Revise middle ear & mastoid		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69645	Revise middle ear & mastoid		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69646	Revise middle ear & mastoid		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69650	Release middle ear bone		J1	5164	33.0494	"$2,736.39"	.	$547.28					
69660	Revise middle ear bone		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69661	Revise middle ear bone		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69662	Revise middle ear bone		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69666	Repair middle ear structures		J1	5164	33.0494	"$2,736.39"	.	$547.28					
69667	Repair middle ear structures		J1	5164	33.0494	"$2,736.39"	.	$547.28					
69670	Remove mastoid air cells		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69676	Remove middle ear nerve		J1	5164	33.0494	"$2,736.39"	.	$547.28					
69700	Close mastoid fistula		J1	5163	16.3386	"$1,352.79"	.	$270.56					
69705	Nps surg dilat eust tube uni	NC	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69706	Nps surg dilat eust tube bi	NC	J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69710	Implant/replace hearing aid		E1										
69711	Remove/repair hearing aid		J1	5164	33.0494	"$2,736.39"	.	$547.28					
69714	Implant temple bone w/stimul		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
69715	Temple bne implnt w/stimulat		J1	5116	191.6510	"$15,868.13"	.	"$3,173.63"	*				
69717	Temple bone implant revision		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
69718	Revise temple bone implant		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
69720	Release facial nerve		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69725	Release facial nerve		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69740	Repair facial nerve		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69745	Repair facial nerve		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69799	Middle ear surgery procedure		T	5161	2.5557	$211.60	.	$42.33					
69801	Incise inner ear		J1	5163	16.3386	"$1,352.79"	.	$270.56					
69805	Explore inner ear		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69806	Explore inner ear		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69905	Remove inner ear		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69910	Remove inner ear & mastoid		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69915	Incise inner ear nerve		J1	5164	33.0494	"$2,736.39"	.	$547.28					
69930	Implant cochlear device		J1	5166	415.8068	"$34,427.56"	"$7,683.79"	"$6,885.52"	*				
69949	Inner ear surgery procedure		T	5161	2.5557	$211.60	.	$42.33					
69950	Incise inner ear nerve		C										
69955	Release facial nerve		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69960	Release inner ear canal		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69970	Remove inner ear lesion		J1	5165	61.4280	"$5,086.05"	.	"$1,017.22"					
69979	Temporal bone surgery		T	5161	2.5557	$211.60	.	$42.33					
69990	Microsurgery add-on		N										
70010	Contrast x-ray of brain		Q2	5572	4.4460	$368.12	.	$73.63					
70015	Contrast x-ray of brain		Q2	5573	8.6377	$715.18	.	$143.04					
70030	X-ray eye for foreign body		Q1	5521	0.9771	$80.90	.	$16.19					
70100	X-ray exam of jaw <4views		Q1	5521	0.9771	$80.90	.	$16.19					
7010F	Pt info into recall system		M										
70110	X-ray exam of jaw 4/> views		Q1	5522	1.3161	$108.97	.	$21.80					
70120	X-ray exam of mastoids		Q1	5522	1.3161	$108.97	.	$21.80					
70130	X-ray exam of mastoids		Q1	5522	1.3161	$108.97	.	$21.80					
70134	X-ray exam of middle ear		Q1	5524	5.8322	$482.89	.	$96.58					
70140	X-ray exam of facial bones		Q1	5521	0.9771	$80.90	.	$16.19					
70150	X-ray exam of facial bones		Q1	5522	1.3161	$108.97	.	$21.80					
70160	X-ray exam of nasal bones		Q1	5521	0.9771	$80.90	.	$16.19					
70170	X-ray exam of tear duct		Q2	5523	2.7794	$230.13	.	$46.03					
70190	X-ray exam of eye sockets		Q1	5521	0.9771	$80.90	.	$16.19					
70200	X-ray exam of eye sockets		Q1	5522	1.3161	$108.97	.	$21.80					
7020F	Mammo assess cat in dbase		E1										
70210	X-ray exam of sinuses		Q1	5521	0.9771	$80.90	.	$16.19					
70220	X-ray exam of sinuses		Q1	5521	0.9771	$80.90	.	$16.19					
70240	X-ray exam pituitary saddle		Q1	5521	0.9771	$80.90	.	$16.19					
70250	X-ray exam of skull		Q1	5522	1.3161	$108.97	.	$21.80					
7025F	Pt infosys alarm 4 nxt mammo		M										
70260	X-ray exam of skull		Q1	5522	1.3161	$108.97	.	$21.80					
70300	X-ray exam of teeth		Q1	5521	0.9771	$80.90	.	$16.19					
70310	X-ray exam of teeth		Q1	5523	2.7794	$230.13	.	$46.03					
70320	Full mouth x-ray of teeth		Q1	5523	2.7794	$230.13	.	$46.03					
70328	X-ray exam of jaw joint		Q1	5521	0.9771	$80.90	.	$16.19					
70330	X-ray exam of jaw joints		Q1	5521	0.9771	$80.90	.	$16.19					
70332	X-ray exam of jaw joint		Q2	5523	2.7794	$230.13	.	$46.03					
70336	Magnetic image jaw joint		Q3	5523	2.7794	$230.13	.	$46.03					
70350	X-ray head for orthodontia		Q1	5521	0.9771	$80.90	.	$16.19					
70355	Panoramic x-ray of jaws		Q1	5521	0.9771	$80.90	.	$16.19					
70360	X-ray exam of neck		Q1	5521	0.9771	$80.90	.	$16.19					
70370	Throat x-ray & fluoroscopy		Q1	5521	0.9771	$80.90	.	$16.19					
70371	Speech evaluation complex		Q1	5523	2.7794	$230.13	.	$46.03					
70380	X-ray exam of salivary gland		Q1	5521	0.9771	$80.90	.	$16.19					
70390	X-ray exam of salivary duct		Q2	5523	2.7794	$230.13	.	$46.03					
70450	Ct head/brain w/o dye		Q3	5522	1.3161	$108.97	.	$21.80					
70460	Ct head/brain w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
70470	Ct head/brain w/o & w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
70480	Ct orbit/ear/fossa w/o dye		Q3	5522	1.3161	$108.97	.	$21.80					
70481	Ct orbit/ear/fossa w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
70482	Ct orbit/ear/fossa w/o&w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
70486	Ct maxillofacial w/o dye		Q3	5522	1.3161	$108.97	.	$21.80					
70487	Ct maxillofacial w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
70488	Ct maxillofacial w/o & w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
70490	Ct soft tissue neck w/o dye		Q3	5522	1.3161	$108.97	.	$21.80					
70491	Ct soft tissue neck w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
70492	Ct sft tsue nck w/o & w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
70496	Ct angiography head		Q3	5571	2.1565	$178.55	.	$35.72					
70498	Ct angiography neck		Q3	5571	2.1565	$178.55	.	$35.72					
70540	Mri orbit/face/neck w/o dye		Q3	5523	2.7794	$230.13	.	$46.03					
70542	Mri orbit/face/neck w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
70543	Mri orbt/fac/nck w/o &w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
70544	Mr angiography head w/o dye		Q3	5523	2.7794	$230.13	.	$46.03					
70545	Mr angiography head w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
70546	Mr angiograph head w/o&w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
70547	Mr angiography neck w/o dye		Q3	5523	2.7794	$230.13	.	$46.03					
70548	Mr angiography neck w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
70549	Mr angiograph neck w/o&w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
70551	Mri brain stem w/o dye		Q3	5523	2.7794	$230.13	.	$46.03					
70552	Mri brain stem w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
70553	Mri brain stem w/o & w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
70554	Fmri brain by tech		Q3	5523	2.7794	$230.13	.	$46.03					
70555	Fmri brain by phys/psych		S	5523	2.7794	$230.13	.	$46.03					
70557	Mri brain w/o dye		S	5524	5.8322	$482.89	.	$96.58					
70558	Mri brain w/dye		S	5571	2.1565	$178.55	.	$35.72					
70559	Mri brain w/o & w/dye		S	5571	2.1565	$178.55	.	$35.72					
71045	X-ray exam chest 1 view		Q3	5521	0.9771	$80.90	.	$16.19					
71046	X-ray exam chest 2 views		Q3	5521	0.9771	$80.90	.	$16.19					
71047	X-ray exam chest 3 views		Q1	5521	0.9771	$80.90	.	$16.19					
71048	X-ray exam chest 4+ views		Q1	5522	1.3161	$108.97	.	$21.80					
71100	X-ray exam ribs uni 2 views		Q1	5521	0.9771	$80.90	.	$16.19					
71101	X-ray exam unilat ribs/chest		Q1	5522	1.3161	$108.97	.	$21.80					
71110	X-ray exam ribs bil 3 views		Q1	5522	1.3161	$108.97	.	$21.80					
71111	X-ray exam ribs/chest4/> vws		Q1	5522	1.3161	$108.97	.	$21.80					
71120	X-ray exam breastbone 2/>vws		Q1	5521	0.9771	$80.90	.	$16.19					
71130	X-ray strenoclavic jt 3/>vws		Q1	5521	0.9771	$80.90	.	$16.19					
71250	Ct thorax dx c-		Q3	5522	1.3161	$108.97	.	$21.80					
71260	Ct thorax dx c+		Q3	5571	2.1565	$178.55	.	$35.72					
71270	Ct thorax dx c-/c+		Q3	5571	2.1565	$178.55	.	$35.72					
71271	Ct thorax lung cancer scr c-	NC	S	5521	0.9771	$80.90	$0.00	$0.00					
71275	Ct angiography chest		Q3	5571	2.1565	$178.55	.	$35.72					
71550	Mri chest w/o dye		Q3	5523	2.7794	$230.13	.	$46.03					
71551	Mri chest w/dye		Q3	5573	8.6377	$715.18	.	$143.04					
71552	Mri chest w/o & w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
71555	Mri angio chest w or w/o dye		B										
72020	X-ray exam of spine 1 view		Q1	5521	0.9771	$80.90	.	$16.19					
72040	X-ray exam neck spine 2-3 vw		Q1	5521	0.9771	$80.90	.	$16.19					
72050	X-ray exam neck spine 4/5vws		Q1	5522	1.3161	$108.97	.	$21.80					
72052	X-ray exam neck spine 6/>vws		Q1	5522	1.3161	$108.97	.	$21.80					
72070	X-ray exam thorac spine 2vws		Q1	5522	1.3161	$108.97	.	$21.80					
72072	X-ray exam thorac spine 3vws		Q1	5522	1.3161	$108.97	.	$21.80					
72074	X-ray exam thorac spine4/>vw		Q1	5522	1.3161	$108.97	.	$21.80					
72080	X-ray exam thoracolmb 2/> vw		Q1	5521	0.9771	$80.90	.	$16.19					
72081	X-ray exam entire spi 1 vw		Q1	5521	0.9771	$80.90	.	$16.19					
72082	X-ray exam entire spi 2/3 vw		Q1	5522	1.3161	$108.97	.	$21.80					
72083	X-ray exam entire spi 4/5 vw		S	5522	1.3161	$108.97	.	$21.80					
72084	X-ray exam entire spi 6/> vw		S	5522	1.3161	$108.97	.	$21.80					
72100	X-ray exam l-s spine 2/3 vws		Q1	5522	1.3161	$108.97	.	$21.80					
72110	X-ray exam l-2 spine 4/>vws		Q1	5522	1.3161	$108.97	.	$21.80					
72114	X-ray exam l-s spine bending		Q1	5522	1.3161	$108.97	.	$21.80					
72120	X-ray bend only l-s spine		Q1	5522	1.3161	$108.97	.	$21.80					
72125	Ct neck spine w/o dye		Q3	5522	1.3161	$108.97	.	$21.80					
72126	Ct neck spine w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
72127	Ct neck spine w/o & w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
72128	Ct chest spine w/o dye		Q3	5522	1.3161	$108.97	.	$21.80					
72129	Ct chest spine w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
72130	Ct chest spine w/o & w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
72131	Ct lumbar spine w/o dye		Q3	5522	1.3161	$108.97	.	$21.80					
72132	Ct lumbar spine w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
72133	Ct lumbar spine w/o & w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
72141	Mri neck spine w/o dye		Q3	5523	2.7794	$230.13	.	$46.03					
72142	Mri neck spine w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
72146	Mri chest spine w/o dye		Q3	5523	2.7794	$230.13	.	$46.03					
72147	Mri chest spine w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
72148	Mri lumbar spine w/o dye		Q3	5523	2.7794	$230.13	.	$46.03					
72149	Mri lumbar spine w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
72156	Mri neck spine w/o & w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
72157	Mri chest spine w/o & w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
72158	Mri lumbar spine w/o & w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
72159	Mr angio spine w/o&w/dye		B										
72170	X-ray exam of pelvis		Q1	5522	1.3161	$108.97	.	$21.80					
72190	X-ray exam of pelvis		Q1	5522	1.3161	$108.97	.	$21.80					
72191	Ct angiograph pelv w/o&w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
72192	Ct pelvis w/o dye		Q3	5522	1.3161	$108.97	.	$21.80					
72193	Ct pelvis w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
72194	Ct pelvis w/o & w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
72195	Mri pelvis w/o dye		Q3	5523	2.7794	$230.13	.	$46.03					
72196	Mri pelvis w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
72197	Mri pelvis w/o & w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
72198	Mr angio pelvis w/o & w/dye		B										
72200	X-ray exam si joints		Q1	5522	1.3161	$108.97	.	$21.80					
72202	X-ray exam si joints 3/> vws		Q1	5522	1.3161	$108.97	.	$21.80					
72220	X-ray exam sacrum tailbone		Q1	5521	0.9771	$80.90	.	$16.19					
72240	Myelography neck spine		Q2	5573	8.6377	$715.18	.	$143.04					
72255	Myelography thoracic spine		Q2	5573	8.6377	$715.18	.	$143.04					
72265	Myelography l-s spine		Q2	5573	8.6377	$715.18	.	$143.04					
72270	Myelogphy 2/> spine regions		Q2	5573	8.6377	$715.18	.	$143.04					
72275	Epidurography		N										
72285	Discography cerv/thor spine		Q2	5431	21.1890	"$1,754.39"	.	$350.88					
72295	X-ray of lower spine disk		Q2	5431	21.1890	"$1,754.39"	.	$350.88					
73000	X-ray exam of collar bone		Q1	5521	0.9771	$80.90	.	$16.19					
73010	X-ray exam of shoulder blade		Q1	5522	1.3161	$108.97	.	$21.80					
73020	X-ray exam of shoulder		Q1	5521	0.9771	$80.90	.	$16.19					
73030	X-ray exam of shoulder		Q1	5521	0.9771	$80.90	.	$16.19					
73040	Contrast x-ray of shoulder		Q2	5572	4.4460	$368.12	.	$73.63					
73050	X-ray exam of shoulders		Q1	5521	0.9771	$80.90	.	$16.19					
73060	X-ray exam of humerus		Q1	5521	0.9771	$80.90	.	$16.19					
73070	X-ray exam of elbow		Q1	5521	0.9771	$80.90	.	$16.19					
73080	X-ray exam of elbow		Q1	5521	0.9771	$80.90	.	$16.19					
73085	Contrast x-ray of elbow		Q2	5572	4.4460	$368.12	.	$73.63					
73090	X-ray exam of forearm		Q1	5521	0.9771	$80.90	.	$16.19					
73092	X-ray exam of arm infant		Q1	5522	1.3161	$108.97	.	$21.80					
73100	X-ray exam of wrist		Q1	5521	0.9771	$80.90	.	$16.19					
73110	X-ray exam of wrist		Q1	5521	0.9771	$80.90	.	$16.19					
73115	Contrast x-ray of wrist		Q2	5572	4.4460	$368.12	.	$73.63					
73120	X-ray exam of hand		Q1	5522	1.3161	$108.97	.	$21.80					
73130	X-ray exam of hand		Q1	5521	0.9771	$80.90	.	$16.19					
73140	X-ray exam of finger(s)		Q1	5521	0.9771	$80.90	.	$16.19					
73200	Ct upper extremity w/o dye		Q3	5522	1.3161	$108.97	.	$21.80					
73201	Ct upper extremity w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
73202	Ct uppr extremity w/o&w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
73206	Ct angio upr extrm w/o&w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
73218	Mri upper extremity w/o dye		Q3	5523	2.7794	$230.13	.	$46.03					
73219	Mri upper extremity w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
73220	Mri uppr extremity w/o&w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
73221	Mri joint upr extrem w/o dye		Q3	5523	2.7794	$230.13	.	$46.03					
73222	Mri joint upr extrem w/dye		Q3	5573	8.6377	$715.18	.	$143.04					
73223	Mri joint upr extr w/o&w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
73225	Mr angio upr extr w/o&w/dye		B										
73501	X-ray exam hip uni 1 view		Q1	5521	0.9771	$80.90	.	$16.19					
73502	X-ray exam hip uni 2-3 views		Q1	5521	0.9771	$80.90	.	$16.19					
73503	X-ray exam hip uni 4/> views		Q1	5522	1.3161	$108.97	.	$21.80					
73521	X-ray exam hips bi 2 views		Q1	5522	1.3161	$108.97	.	$21.80					
73522	X-ray exam hips bi 3-4 views		Q1	5522	1.3161	$108.97	.	$21.80					
73523	X-ray exam hips bi 5/> views		S	5522	1.3161	$108.97	.	$21.80					
73525	Contrast x-ray of hip		Q2	5572	4.4460	$368.12	.	$73.63					
73551	X-ray exam of femur 1		Q1	5521	0.9771	$80.90	.	$16.19					
73552	X-ray exam of femur 2/>		Q1	5521	0.9771	$80.90	.	$16.19					
73560	X-ray exam of knee 1 or 2		Q1	5521	0.9771	$80.90	.	$16.19					
73562	X-ray exam of knee 3		Q1	5521	0.9771	$80.90	.	$16.19					
73564	X-ray exam knee 4 or more		Q1	5522	1.3161	$108.97	.	$21.80					
73565	X-ray exam of knees		Q1	5521	0.9771	$80.90	.	$16.19					
73580	Contrast x-ray of knee joint		Q2	5572	4.4460	$368.12	.	$73.63					
73590	X-ray exam of lower leg		Q1	5521	0.9771	$80.90	.	$16.19					
73592	X-ray exam of leg infant		Q1	5521	0.9771	$80.90	.	$16.19					
73600	X-ray exam of ankle		Q1	5521	0.9771	$80.90	.	$16.19					
73610	X-ray exam of ankle		Q1	5521	0.9771	$80.90	.	$16.19					
73615	Contrast x-ray of ankle		Q2	5572	4.4460	$368.12	.	$73.63					
73620	X-ray exam of foot		Q1	5521	0.9771	$80.90	.	$16.19					
73630	X-ray exam of foot		Q1	5521	0.9771	$80.90	.	$16.19					
73650	X-ray exam of heel		Q1	5521	0.9771	$80.90	.	$16.19					
73660	X-ray exam of toe(s)		Q1	5521	0.9771	$80.90	.	$16.19					
73700	Ct lower extremity w/o dye		Q3	5522	1.3161	$108.97	.	$21.80					
73701	Ct lower extremity w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
73702	Ct lwr extremity w/o&w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
73706	Ct angio lwr extr w/o&w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
73718	Mri lower extremity w/o dye		Q3	5523	2.7794	$230.13	.	$46.03					
73719	Mri lower extremity w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
73720	Mri lwr extremity w/o&w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
73721	Mri jnt of lwr extre w/o dye		Q3	5523	2.7794	$230.13	.	$46.03					
73722	Mri joint of lwr extr w/dye		Q3	5573	8.6377	$715.18	.	$143.04					
73723	Mri joint lwr extr w/o&w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
73725	Mr ang lwr ext w or w/o dye		B										
74018	X-ray exam abdomen 1 view		Q1	5521	0.9771	$80.90	.	$16.19					
74019	X-ray exam abdomen 2 views		Q1	5522	1.3161	$108.97	.	$21.80					
74021	X-ray exam abdomen 3+ views		Q1	5522	1.3161	$108.97	.	$21.80					
74022	X-ray exam complete abdomen		Q1	5522	1.3161	$108.97	.	$21.80					
74150	Ct abdomen w/o dye		Q3	5522	1.3161	$108.97	.	$21.80					
74160	Ct abdomen w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
74170	Ct abdomen w/o & w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
74174	Ct angio abd&pelv w/o&w/dye		S	5572	4.4460	$368.12	.	$73.63					
74175	Ct angio abdom w/o & w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
74176	Ct abd & pelvis w/o contrast		Q3	5523	2.7794	$230.13	.	$46.03					
74177	Ct abd & pelv w/contrast		Q3	5572	4.4460	$368.12	.	$73.63					
74178	Ct abd & pelv 1/> regns		Q3	5572	4.4460	$368.12	.	$73.63					
74181	Mri abdomen w/o dye		Q3	5523	2.7794	$230.13	.	$46.03					
74182	Mri abdomen w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
74183	Mri abdomen w/o & w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
74185	Mri angio abdom w orw/o dye		B										
74190	X-ray exam of peritoneum		Q2	5524	5.8322	$482.89	.	$96.58					
74210	X-ray xm phrnx&/crv esoph c+		Q1	5571	2.1565	$178.55	.	$35.72					
74220	X-ray xm esophagus 1cntrst		Q1	5571	2.1565	$178.55	.	$35.72					
74221	X-ray xm esophagus 2cntrst		Q1	5571	2.1565	$178.55	.	$35.72					
74230	X-ray xm swlng funcj c+		Q1	5571	2.1565	$178.55	.	$35.72					
74235	Remove esophagus obstruction		N										
74240	X-ray xm upr gi trc 1cntrst		Q1	5571	2.1565	$178.55	.	$35.72					
74246	X-ray xm upr gi trc 2cntrst		Q1	5571	2.1565	$178.55	.	$35.72					
74248	X-ray sm int f-thru std		N 										
74250	X-ray xm sm int 1cntrst std		Q1	5571	2.1565	$178.55	.	$35.72					
74251	X-ray xm sm int 2cntrst std		Q1	5571	2.1565	$178.55	.	$35.72					
74261	Ct colonography dx		Q3	5522	1.3161	$108.97	.	$21.80					
74262	Ct colonography dx w/dye		Q3	5571	2.1565	$178.55	.	$35.72					
74263	Ct colonography screening		E1										
74270	X-ray xm colon 1cntrst std		Q1	5571	2.1565	$178.55	.	$35.72					
74280	X-ray xm colon 2cntrst std		Q1	5571	2.1565	$178.55	.	$35.72					
74283	Ther nma rdctj intus/obstrcj		S	5571	2.1565	$178.55	.	$35.72					
74290	Contrast x-ray gallbladder		Q1	5571	2.1565	$178.55	.	$35.72					
74300	X-ray bile ducts/pancreas		N										
74301	X-rays at surgery add-on		N										
74328	X-ray bile duct endoscopy		N										
74329	X-ray for pancreas endoscopy		N										
74330	X-ray bile/panc endoscopy		N										
74340	X-ray guide for gi tube		N										
74355	X-ray guide intestinal tube		N										
74360	X-ray guide gi dilation		N										
74363	X-ray bile duct dilation		N										
74400	Urography iv +-kub tomog		S	5571	2.1565	$178.55	.	$35.72					
74410	Urography nfs drip&/bolus		S	5571	2.1565	$178.55	.	$35.72					
74415	Urography nfs drip&/bls w/nf		S	5571	2.1565	$178.55	.	$35.72					
74420	Urography rtrgr +-kub		S	5572	4.4460	$368.12	.	$73.63					
74425	Urography antegrade rs&i		Q2	5572	4.4460	$368.12	.	$73.63					
74430	Contrast x-ray bladder		Q2	5572	4.4460	$368.12	.	$73.63					
74440	X-ray male genital tract		Q2	5523	2.7794	$230.13	.	$46.03					
74445	X-ray exam of penis		Q2	5522	1.3161	$108.97	.	$21.80					
74450	X-ray urethra/bladder		Q2	5523	2.7794	$230.13	.	$46.03					
74455	X-ray urethra/bladder		Q2	5523	2.7794	$230.13	.	$46.03					
74470	X-ray exam of kidney lesion		Q2	5524	5.8322	$482.89	.	$96.58					
74485	Dilation urtr/urt rs&i		Q2	5373	21.6552	"$1,792.99"	.	$358.60					
74710	X-ray measurement of pelvis		Q1	5521	0.9771	$80.90	.	$16.19					
74712	Mri fetal sngl/1st gestation		S	5523	2.7794	$230.13	.	$46.03					
74713	Mri fetal ea addl gestation		N										
74740	X-ray female genital tract		Q2	5523	2.7794	$230.13	.	$46.03					
74742	X-ray fallopian tube		N										
74775	X-ray exam of perineum		S	5523	2.7794	$230.13	.	$46.03					
75557	Cardiac mri for morph		Q3	5523	2.7794	$230.13	.	$46.03					
75559	Cardiac mri w/stress img		Q3	5524	5.8322	$482.89	.	$96.58					
75561	Cardiac mri for morph w/dye		Q3	5572	4.4460	$368.12	.	$73.63					
75563	Card mri w/stress img & dye		Q3	5573	8.6377	$715.18	.	$143.04					
75565	Card mri veloc flow mapping		N										
75571	Ct hrt w/o dye w/ca test		Q1	5521	0.9771	$80.90	.	$16.19					
75572	Ct hrt w/3d image		S	5571	2.1565	$178.55	.	$35.72					
75573	Ct hrt w/3d image congen		S	5571	2.1565	$178.55	.	$35.72					
75574	Ct angio hrt w/3d image		S	5571	2.1565	$178.55	.	$35.72					
75600	Contrast exam thoracic aorta		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75605	Contrast exam thoracic aorta		Q2	5184	57.6153	"$4,770.37"	.	$954.08					
75625	Contrast exam abdominl aorta		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75630	X-ray aorta leg arteries		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75635	Ct angio abdominal arteries		Q2	5571	2.1565	$178.55	.	$35.72					
75705	Artery x-rays spine		Q2	5184	57.6153	"$4,770.37"	.	$954.08					
75710	Artery x-rays arm/leg		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75716	Artery x-rays arms/legs		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75726	Artery x-rays abdomen		Q2	5184	57.6153	"$4,770.37"	.	$954.08					
75731	Artery x-rays adrenal gland	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
75733	Artery x-rays adrenals		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75736	Artery x-rays pelvis		Q2	5184	57.6153	"$4,770.37"	.	$954.08					
75741	Artery x-rays lung		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75743	Artery x-rays lungs		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75746	Artery x-rays lung	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
75756	Artery x-rays chest		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75774	Artery x-ray each vessel		N										
75801	Lymph vessel x-ray arm/leg		Q2	5181	6.5415	$541.62	.	$108.33					
75803	Lymph vessel x-ray arms/legs		J1	5182	16.9830	"$1,406.14"	.	$281.23					
75805	Lymph vessel x-ray trunk	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
75807	Lymph vessel x-ray trunk		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75809	Nonvascular shunt x-ray		Q2	5522	1.3161	$108.97	.	$21.80					
75810	Vein x-ray spleen/liver	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
75820	Vein x-ray arm/leg	CH	Q2	5182	16.9830	"$1,406.14"	.	$281.23					
75822	Vein x-ray arms/legs		J1	5182	16.9830	"$1,406.14"	.	$281.23					
75825	Vein x-ray trunk		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75827	Vein x-ray chest	CH	Q2	5182	16.9830	"$1,406.14"	.	$281.23					
75831	Vein x-ray kidney		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75833	Vein x-ray kidneys		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75840	Vein x-ray adrenal gland		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75842	Vein x-ray adrenal glands		Q2	5184	57.6153	"$4,770.37"	.	$954.08					
75860	Vein x-ray neck		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75870	Vein x-ray skull	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
75872	Vein x-ray skull epidural		Q2	5181	6.5415	$541.62	.	$108.33					
75880	Vein x-ray eye socket		Q2	5181	6.5415	$541.62	.	$108.33					
75885	Vein x-ray liver w/hemodynam		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75887	Vein x-ray liver w/o hemodyn	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
75889	Vein x-ray liver w/hemodynam		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75891	Vein x-ray liver		Q2	5183	34.5624	"$2,861.66"	.	$572.34					
75893	Venous sampling by catheter		Q2	5184	57.6153	"$4,770.37"	.	$954.08					
75894	X-rays transcath therapy		N										
75898	Follow-up angiography	CH	J1	5183	34.5624	"$2,861.66"	.	$572.34					
75901	Remove cva device obstruct		N										
75902	Remove cva lumen obstruct		N										
75956	Xray endovasc thor ao repr		C										
75957	Xray endovasc thor ao repr		C										
75958	Xray place prox ext thor ao		C										
75959	Xray place dist ext thor ao		C										
75970	Vascular biopsy		N										
75984	Xray control catheter change		N										
75989	Abscess drainage under x-ray		N										
76000	Fluoroscopy <1 hr phys/qhp		S	5523	2.7794	$230.13	.	$46.03					
76010	X-ray nose to rectum		Q1	5521	0.9771	$80.90	.	$16.19					
76080	X-ray exam of fistula		Q2	5524	5.8322	$482.89	.	$96.58					
76098	X-ray exam surgical specimen		Q2	5524	5.8322	$482.89	.	$96.58					
76100	X-ray exam of body section		Q1	5522	1.3161	$108.97	.	$21.80					
76101	Complex body section x-ray		Q1	5522	1.3161	$108.97	.	$21.80					
76102	Complex body section x-rays		S	5522	1.3161	$108.97	.	$21.80					
76120	Cine/video x-rays		Q1	5522	1.3161	$108.97	.	$21.80					
76125	Cine/video x-rays add-on		N										
76140	X-ray consultation		E1										
76145	Med physic dos eval rad exps	NC	S	5611	1.5323	$126.87	$32.03	$25.38					
76376	3d render w/intrp postproces		N										
76377	3d render w/intrp postproces		N										
76380	Cat scan follow-up study		Q1	5521	0.9771	$80.90	.	$16.19					
76390	Mr spectroscopy	CH	S	5521	0.9771	$80.90	.	$16.19					
76391	Mr elastography		Q3	5523	2.7794	$230.13	.	$46.03					
76496	Fluoroscopic procedure		Q1	5521	0.9771	$80.90	.	$16.19					
76497	Ct procedure		Q1	5521	0.9771	$80.90	.	$16.19					
76498	Mri procedure		S	5521	0.9771	$80.90	.	$16.19					
76499	Radiographic procedure		Q1	5521	0.9771	$80.90	.	$16.19					
76506	Echo exam of head		Q1	5522	1.3161	$108.97	.	$21.80					
76510	Oph us dx b-scan&quan a-scan		Q1	5734	1.3521	$111.95	.	$22.39					
76511	Oph us dx quan a-scan only		Q1	5522	1.3161	$108.97	.	$21.80					
76512	Oph us dx b-scan		Q1	5522	1.3161	$108.97	.	$21.80					
76513	Oph us dx ant sgm us uni/bi		Q1	5522	1.3161	$108.97	.	$21.80					
76514	Echo exam of eye thickness		Q1	5731	0.2980	$24.67	.	$4.94					
76516	Echo exam of eye		Q1	5522	1.3161	$108.97	.	$21.80					
76519	Echo exam of eye		Q1	5522	1.3161	$108.97	.	$21.80					
76529	Echo exam of eye		Q1	5521	0.9771	$80.90	.	$16.19					
76536	Us exam of head and neck		Q1	5522	1.3161	$108.97	.	$21.80					
76604	Us exam chest		Q1	5522	1.3161	$108.97	.	$21.80					
76641	Ultrasound breast complete		Q1	5522	1.3161	$108.97	.	$21.80					
76642	Ultrasound breast limited		Q1	5521	0.9771	$80.90	.	$16.19					
76700	Us exam abdom complete		Q3	5522	1.3161	$108.97	.	$21.80					
76705	Echo exam of abdomen		Q3	5522	1.3161	$108.97	.	$21.80					
76706	Us abdl aorta screen aaa		S	5522	1.3161	$108.97	$0.00	$0.00					
76770	Us exam abdo back wall comp		Q3	5522	1.3161	$108.97	.	$21.80					
76775	Us exam abdo back wall lim		Q1	5522	1.3161	$108.97	.	$21.80					
76776	Us exam k transpl w/doppler		Q3	5522	1.3161	$108.97	.	$21.80					
76800	Us exam spinal canal		Q1	5522	1.3161	$108.97	.	$21.80					
76801	Ob us < 14 wks single fetus		S	5522	1.3161	$108.97	.	$21.80					
76802	Ob us < 14 wks addl fetus		N										
76805	Ob us >= 14 wks sngl fetus		S	5522	1.3161	$108.97	.	$21.80					
76810	Ob us >= 14 wks addl fetus		N										
76811	Ob us detailed sngl fetus		S	5523	2.7794	$230.13	.	$46.03					
76812	Ob us detailed addl fetus		N										
76813	Ob us nuchal meas 1 gest		Q1	5522	1.3161	$108.97	.	$21.80					
76814	Ob us nuchal meas add-on		N										
76815	Ob us limited fetus(s)		Q1	5522	1.3161	$108.97	.	$21.80					
76816	Ob us follow-up per fetus		Q1	5522	1.3161	$108.97	.	$21.80					
76817	Transvaginal us obstetric		Q1	5522	1.3161	$108.97	.	$21.80					
76818	Fetal biophys profile w/nst		S	5522	1.3161	$108.97	.	$21.80					
76819	Fetal biophys profil w/o nst		S	5522	1.3161	$108.97	.	$21.80					
76820	Umbilical artery echo		Q1	5522	1.3161	$108.97	.	$21.80					
76821	Middle cerebral artery echo		Q1	5522	1.3161	$108.97	.	$21.80					
76825	Echo exam of fetal heart		S	5524	5.8322	$482.89	.	$96.58					
76826	Echo exam of fetal heart		S	5523	2.7794	$230.13	.	$46.03					
76827	Echo exam of fetal heart		Q1	5522	1.3161	$108.97	.	$21.80					
76828	Echo exam of fetal heart		Q1	5522	1.3161	$108.97	.	$21.80					
76830	Transvaginal us non-ob		S	5522	1.3161	$108.97	.	$21.80					
76831	Echo exam uterus		Q3	5523	2.7794	$230.13	.	$46.03					
76856	Us exam pelvic complete		Q3	5522	1.3161	$108.97	.	$21.80					
76857	Us exam pelvic limited		Q3	5522	1.3161	$108.97	.	$21.80					
76870	Us exam scrotum		Q1	5522	1.3161	$108.97	.	$21.80					
76872	Us transrectal		S	5522	1.3161	$108.97	.	$21.80					
76873	Echograp trans r pros study		S	5522	1.3161	$108.97	.	$21.80					
76881	Us compl joint r-t w/img		S	5522	1.3161	$108.97	.	$21.80					
76882	Us lmtd jt/nonvasc xtr strux		Q1	5522	1.3161	$108.97	.	$21.80					
76885	Us exam infant hips dynamic		Q1	5521	0.9771	$80.90	.	$16.19					
76886	Us exam infant hips static		Q1	5521	0.9771	$80.90	.	$16.19					
76932	Echo guide for heart biopsy		N										
76936	Echo guide for artery repair		S	5722	3.1939	$264.45	.	$52.89					
76937	Us guide vascular access		N										
76940	Us guide tissue ablation		N										
76941	Echo guide for transfusion		N										
76942	Echo guide for biopsy		N										
76945	Echo guide villus sampling		N										
76946	Echo guide for amniocentesis		N										
76948	Echo guide ova aspiration		N										
76965	Echo guidance radiotherapy		N										
76970	Ultrasound exam follow-up	CH	D										
76975	Gi endoscopic ultrasound		Q2	5523	2.7794	$230.13	.	$46.03					
76977	Us bone density measure		S	5522	1.3161	$108.97	$0.00	$0.00					
76978	Us trgt dyn mbubb 1st les		S	5571	2.1565	$178.55	.	$35.72					
76979	Us trgt dyn mbubb ea addl		N 										
76981	Use parenchyma		Q3	5522	1.3161	$108.97	.	$21.80					
76982	Use 1st target lesion		Q3	5522	1.3161	$108.97	.	$21.80					
76983	Use ea addl target lesion		N 										
76998	Us guide intraop		N										
76999	Echo examination procedure		Q1	5521	0.9771	$80.90	.	$16.19					
77001	Fluoroguide for vein device		N										
77002	Needle localization by xray		N										
77003	Fluoroguide for spine inject		N										
77011	Ct scan for localization		N										
77012	Ct scan for needle biopsy		N										
77013	Ct guide for tissue ablation		N										
77014	Ct scan for therapy guide		N										
77021	Mri guidance ndl plmt rs&i		N										
77022	Mri gdn parnchyma tiss abltj		N										
77046	Mri breast c- unilateral		Q3	5523	2.7794	$230.13	.	$46.03					
77047	Mri breast c- bilateral		Q3	5523	2.7794	$230.13	.	$46.03					
77048	Mri breast c-+ w/cad uni		B										
77049	Mri breast c-+ w/cad bi		B										
77053	X-ray of mammary duct		Q2	5523	2.7794	$230.13	.	$46.03					
77054	X-ray of mammary ducts		Q2	5523	2.7794	$230.13	.	$46.03					
77061	Breast tomosynthesis uni		E1										
77062	Breast tomosynthesis bi		E1										
77063	Breast tomosynthesis bi		A										
77065	Dx mammo incl cad uni		A										
77066	Dx mammo incl cad bi		A										
77067	Scr mammo bi incl cad		A										
77071	X-ray stress view		Q1	5521	0.9771	$80.90	.	$16.19					
77072	X-rays for bone age		Q1	5522	1.3161	$108.97	.	$21.80					
77073	X-rays bone length studies		Q1	5522	1.3161	$108.97	.	$21.80					
77074	X-rays bone survey limited		Q1	5522	1.3161	$108.97	.	$21.80					
77075	X-rays bone survey complete		Q1	5522	1.3161	$108.97	.	$21.80					
77076	X-rays bone survey infant		Q1	5522	1.3161	$108.97	.	$21.80					
77077	Joint survey single view		Q1	5522	1.3161	$108.97	.	$21.80					
77078	Ct bone density axial		S	5521	0.9771	$80.90	$0.00	$0.00					
77080	Dxa bone density axial		S	5522	1.3161	$108.97	$0.00	$0.00					
77081	Dxa bone density/peripheral		S	5521	0.9771	$80.90	$0.00	$0.00					
77084	Magnetic image bone marrow		S	5523	2.7794	$230.13	.	$46.03					
77085	Dxa bone density study		Q1	5522	1.3161	$108.97	$0.00	$0.00					
77086	Fracture assessment via dxa		Q1	5521	0.9771	$80.90	.	$16.19					
77261	Radiation therapy planning		B										
77262	Radiation therapy planning		B										
77263	Radiation therapy planning		B										
77280	Set radiation therapy field		S	5611	1.5323	$126.87	$32.03	$25.38					
77285	Set radiation therapy field		S	5612	4.0905	$338.68	.	$67.74					
77290	Set radiation therapy field		S	5612	4.0905	$338.68	.	$67.74					
77293	Respirator motion mgmt simul		N										
77295	3-d radiotherapy plan		S	5613	15.2443	"$1,262.18"	.	$252.44					
77299	Radiation therapy planning		S	5611	1.5323	$126.87	$32.03	$25.38					
77300	Radiation therapy dose plan		S	5611	1.5323	$126.87	$32.03	$25.38					
77301	Radiotherapy dose plan imrt		S	5613	15.2443	"$1,262.18"	.	$252.44					
77306	Telethx isodose plan simple		S	5612	4.0905	$338.68	.	$67.74					
77307	Telethx isodose plan cplx		S	5612	4.0905	$338.68	.	$67.74					
77316	Brachytx isodose plan simple		S	5612	4.0905	$338.68	.	$67.74					
77317	Brachytx isodose intermed		S	5612	4.0905	$338.68	.	$67.74					
77318	Brachytx isodose complex		S	5612	4.0905	$338.68	.	$67.74					
77321	Special teletx port plan		S	5612	4.0905	$338.68	.	$67.74					
77331	Special radiation dosimetry		S	5611	1.5323	$126.87	$32.03	$25.38					
77332	Radiation treatment aid(s)		S	5611	1.5323	$126.87	$32.03	$25.38					
77333	Radiation treatment aid(s)		S	5611	1.5323	$126.87	$32.03	$25.38					
77334	Radiation treatment aid(s)		S	5612	4.0905	$338.68	.	$67.74					
77336	Radiation physics consult		S	5611	1.5323	$126.87	$32.03	$25.38					
77338	Design mlc device for imrt		S	5612	4.0905	$338.68	.	$67.74					
77370	Radiation physics consult		S	5611	1.5323	$126.87	$32.03	$25.38					
77371	Srs multisource		J1	5627	93.8773	"$7,772.76"	.	"$1,554.56"	*				
77372	Srs linear based		J1	5627	93.8773	"$7,772.76"	.	"$1,554.56"	*				
77373	Sbrt delivery		S	5626	20.9396	"$1,733.74"	.	$346.75					
77385	Ntsty modul rad tx dlvr smpl		S	5623	6.5528	$542.55	.	$108.52					
77386	Ntsty modul rad tx dlvr cplx		S	5623	6.5528	$542.55	.	$108.52					
77387	Guidance for radj tx dlvr		N										
77399	External radiation dosimetry		S	5611	1.5323	$126.87	$32.03	$25.38					
77401	Radiation treatment delivery		S	5621	1.4559	$120.54	.	$24.11					
77402	Radiation treatment delivery		S	5621	1.4559	$120.54	.	$24.11					
77407	Radiation treatment delivery		S	5622	2.9190	$241.68	.	$48.34					
77412	Radiation treatment delivery		S	5622	2.9190	$241.68	.	$48.34					
77417	Radiology port images(s)		N										
77423	Neutron beam tx complex		S	5623	6.5528	$542.55	.	$108.52					
77424	Io rad tx delivery by x-ray		J1	5627	93.8773	"$7,772.76"	.	"$1,554.56"	*				
77425	Io rad tx deliver by elctrns		J1	5627	93.8773	"$7,772.76"	.	"$1,554.56"	*				
77427	Radiation tx management x5		B										
77431	Radiation therapy management		B										
77432	Stereotactic radiation trmt		B										
77435	Sbrt management		N										
77469	Io radiation tx management		B										
77470	Special radiation treatment		S	5623	6.5528	$542.55	.	$108.52					
77499	Radiation therapy management		B										
77520	Proton trmt simple w/o comp		S	5623	6.5528	$542.55	.	$108.52					
77522	Proton trmt simple w/comp		S	5625	15.6759	"$1,297.92"	.	$259.59					
77523	Proton trmt intermediate		S	5625	15.6759	"$1,297.92"	.	$259.59					
77525	Proton treatment complex		S	5625	15.6759	"$1,297.92"	.	$259.59					
77600	Hyperthermia treatment		S	5622	2.9190	$241.68	.	$48.34					
77605	Hyperthermia treatment		S	5624	8.5566	$708.46	.	$141.70					
77610	Hyperthermia treatment		S	5623	6.5528	$542.55	.	$108.52					
77615	Hyperthermia treatment		S	5623	6.5528	$542.55	.	$108.52					
77620	Hyperthermia treatment		S	5623	6.5528	$542.55	.	$108.52					
77750	Infuse radioactive materials		S	5622	2.9190	$241.68	.	$48.34					
77761	Apply intrcav radiat simple		S	5623	6.5528	$542.55	.	$108.52					
77762	Apply intrcav radiat interm		S	5623	6.5528	$542.55	.	$108.52					
77763	Apply intrcav radiat compl		S	5624	8.5566	$708.46	.	$141.70					
77767	Hdr rdncl skn surf brachytx		S	5622	2.9190	$241.68	.	$48.34					
77768	Hdr rdncl skn surf brachytx		S	5622	2.9190	$241.68	.	$48.34					
77770	Hdr rdncl ntrstl/icav brchtx		S	5624	8.5566	$708.46	.	$141.70					
77771	Hdr rdncl ntrstl/icav brchtx		S	5624	8.5566	$708.46	.	$141.70					
77772	Hdr rdncl ntrstl/icav brchtx		S	5624	8.5566	$708.46	.	$141.70					
77778	Apply interstit radiat compl		S	5624	8.5566	$708.46	.	$141.70					
77789	Apply surf ldr radionuclide		S	5621	1.4559	$120.54	.	$24.11					
77790	Radiation handling		N										
77799	Radium/radioisotope therapy		S	5621	1.4559	$120.54	.	$24.11					
78012	Thyroid uptake measurement		S	5591	4.5547	$377.12	.	$75.43					
78013	Thyroid imaging w/blood flow		S	5591	4.5547	$377.12	.	$75.43					
78014	Thyroid imaging w/blood flow		S	5591	4.5547	$377.12	.	$75.43					
78015	Thyroid met imaging		S	5591	4.5547	$377.12	.	$75.43					
78016	Thyroid met imaging/studies		S	5591	4.5547	$377.12	.	$75.43					
78018	Thyroid met imaging body		S	5592	5.9108	$489.40	.	$97.88					
78020	Thyroid met uptake		N										
78070	Parathyroid planar imaging		S	5591	4.5547	$377.12	.	$75.43					
78071	Parathyrd planar w/wo subtrj		S	5591	4.5547	$377.12	.	$75.43					
78072	Parathyrd planar w/spect&ct		S	5592	5.9108	$489.40	.	$97.88					
78075	Adrenal cortex & medulla img		S	5593	15.7728	"$1,305.94"	.	$261.19					
78099	Endocrine nuclear procedure		S	5591	4.5547	$377.12	.	$75.43					
78102	Bone marrow imaging ltd		S	5591	4.5547	$377.12	.	$75.43					
78103	Bone marrow imaging mult		S	5591	4.5547	$377.12	.	$75.43					
78104	Bone marrow imaging body		S	5591	4.5547	$377.12	.	$75.43					
78110	Plasma volume single		S	5593	15.7728	"$1,305.94"	.	$261.19					
78111	Plasma volume multiple		S	5593	15.7728	"$1,305.94"	.	$261.19					
78120	Red cell mass single		S	5591	4.5547	$377.12	.	$75.43					
78121	Red cell mass multiple		S	5592	5.9108	$489.40	.	$97.88					
78122	Blood volume		S	5592	5.9108	$489.40	.	$97.88					
78130	Red cell survival study		S	5591	4.5547	$377.12	.	$75.43					
78135	Red cell survival kinetics	CH	D										
78140	Red cell sequestration		S	5591	4.5547	$377.12	.	$75.43					
78185	Spleen imaging		S	5591	4.5547	$377.12	.	$75.43					
78191	Platelet survival		S	5591	4.5547	$377.12	.	$75.43					
78195	Lymph system imaging		S	5592	5.9108	$489.40	.	$97.88					
78199	Blood/lymph nuclear exam		S	5591	4.5547	$377.12	.	$75.43					
78201	Liver imaging	CH	S	5592	5.9108	$489.40	.	$97.88					
78202	Liver imaging with flow	CH	S	5592	5.9108	$489.40	.	$97.88					
78215	Liver and spleen imaging		S	5591	4.5547	$377.12	.	$75.43					
78216	Liver & spleen image/flow		S	5591	4.5547	$377.12	.	$75.43					
78226	Hepatobiliary system imaging		S	5591	4.5547	$377.12	.	$75.43					
78227	Hepatobil syst image w/drug		S	5592	5.9108	$489.40	.	$97.88					
78230	Salivary gland imaging		S	5591	4.5547	$377.12	.	$75.43					
78231	Serial salivary imaging		S	5591	4.5547	$377.12	.	$75.43					
78232	Salivary gland function exam		S	5591	4.5547	$377.12	.	$75.43					
78258	Esophageal motility study		S	5591	4.5547	$377.12	.	$75.43					
78261	Gastric mucosa imaging		S	5591	4.5547	$377.12	.	$75.43					
78262	Gastroesophageal reflux exam		S	5591	4.5547	$377.12	.	$75.43					
78264	Gastric emptying imag study		S	5591	4.5547	$377.12	.	$75.43					
78265	Gastric emptying imag study		S	5591	4.5547	$377.12	.	$75.43					
78266	Gastric emptying imag study		S	5592	5.9108	$489.40	.	$97.88					
78267	Breath tst attain/anal c-14		A										
78268	Breath test analysis c-14		A										
78278	Acute gi blood loss imaging		S	5591	4.5547	$377.12	.	$75.43					
78282	Gi protein loss exam		S	5591	4.5547	$377.12	.	$75.43					
78290	Meckels divert exam		S	5591	4.5547	$377.12	.	$75.43					
78291	Leveen/shunt patency exam		S	5591	4.5547	$377.12	.	$75.43					
78299	Gi nuclear procedure		S	5591	4.5547	$377.12	.	$75.43					
78300	Bone imaging limited area		S	5591	4.5547	$377.12	.	$75.43					
78305	Bone imaging multiple areas		S	5591	4.5547	$377.12	.	$75.43					
78306	Bone imaging whole body		S	5591	4.5547	$377.12	.	$75.43					
78315	Bone imaging 3 phase		S	5591	4.5547	$377.12	.	$75.43					
78350	Bone mineral single photon		E1										
78351	Bone mineral dual photon		E1										
78399	Musculoskeletal nuclear exam		S	5591	4.5547	$377.12	.	$75.43					
78414	Non-imaging heart function		S	5592	5.9108	$489.40	.	$97.88					
78428	Cardiac shunt imaging		S	5591	4.5547	$377.12	.	$75.43					
78429	Myocrd img pet 1 std w/ct		S	5594	17.8791	"$1,480.34"	.	$296.07					
78430	Myocrd img pet rst/strs w/ct		S	5594	17.8791	"$1,480.34"	.	$296.07					
78431	Myocrd img pet rst&strs ct		S	1522		"$2,250.50"	.	$450.10					
78432	Myocrd img pet 2rtracer		S	1523		"$2,750.50"	.	$550.10					
78433	Myocrd img pet 2rtracer ct		S	1523		"$2,750.50"	.	$550.10					
78434	Aqmbf pet rest & rx stress		N 										
78445	Vascular flow imaging		S	5591	4.5547	$377.12	.	$75.43					
78451	Ht muscle image spect sing		S	5593	15.7728	"$1,305.94"	.	$261.19					
78452	Ht muscle image spect mult		S	5593	15.7728	"$1,305.94"	.	$261.19					
78453	Ht muscle image planar sing		S	5593	15.7728	"$1,305.94"	.	$261.19					
78454	Ht musc image planar mult		S	5593	15.7728	"$1,305.94"	.	$261.19					
78456	Acute venous thrombus image		S	5593	15.7728	"$1,305.94"	.	$261.19					
78457	Venous thrombosis imaging	CH	S	5592	5.9108	$489.40	.	$97.88					
78458	Ven thrombosis images bilat		S	5591	4.5547	$377.12	.	$75.43					
78459	Myocrd img pet single study		S	5593	15.7728	"$1,305.94"	.	$261.19					
78466	Heart infarct image		S	5591	4.5547	$377.12	.	$75.43					
78468	Heart infarct image (ef)		S	5592	5.9108	$489.40	.	$97.88					
78469	Heart infarct image (3d)	CH	S	5592	5.9108	$489.40	.	$97.88					
78472	Gated heart planar single		S	5591	4.5547	$377.12	.	$75.43					
78473	Gated heart multiple		S	5591	4.5547	$377.12	.	$75.43					
78481	Heart first pass single		S	5592	5.9108	$489.40	.	$97.88					
78483	Heart first pass multiple		S	5592	5.9108	$489.40	.	$97.88					
78491	Myocrd img pet 1std rst/strs		S	5594	17.8791	"$1,480.34"	.	$296.07					
78492	Myocrd img pet mlt rst&strs		S	5594	17.8791	"$1,480.34"	.	$296.07					
78494	Heart image spect		S	5591	4.5547	$377.12	.	$75.43					
78496	Heart first pass add-on		N										
78499	Cardiovascular nuclear exam		S	5591	4.5547	$377.12	.	$75.43					
78579	Lung ventilation imaging		S	5591	4.5547	$377.12	.	$75.43					
78580	Lung perfusion imaging		S	5591	4.5547	$377.12	.	$75.43					
78582	Lung ventilat&perfus imaging		S	5592	5.9108	$489.40	.	$97.88					
78597	Lung perfusion differential		S	5591	4.5547	$377.12	.	$75.43					
78598	Lung perf&ventilat diferentl		S	5592	5.9108	$489.40	.	$97.88					
78599	Respiratory nuclear exam		S	5591	4.5547	$377.12	.	$75.43					
78600	Brain image < 4 views		S	5591	4.5547	$377.12	.	$75.43					
78601	Brain image w/flow < 4 views		S	5591	4.5547	$377.12	.	$75.43					
78605	Brain image 4+ views		S	5592	5.9108	$489.40	.	$97.88					
78606	Brain image w/flow 4 + views		S	5592	5.9108	$489.40	.	$97.88					
78608	Brain imaging (pet)		S	5594	17.8791	"$1,480.34"	.	$296.07					
78609	Brain imaging (pet)		E1										
78610	Brain flow imaging only		S	5592	5.9108	$489.40	.	$97.88					
78630	Cerebrospinal fluid scan		S	5592	5.9108	$489.40	.	$97.88					
78635	Csf ventriculography		S	5592	5.9108	$489.40	.	$97.88					
78645	Csf shunt evaluation		S	5592	5.9108	$489.40	.	$97.88					
78650	Csf leakage imaging		S	5593	15.7728	"$1,305.94"	.	$261.19					
78660	Nuclear exam of tear flow		S	5591	4.5547	$377.12	.	$75.43					
78699	Nervous system nuclear exam		S	5591	4.5547	$377.12	.	$75.43					
78700	Kidney imaging morphol		S	5591	4.5547	$377.12	.	$75.43					
78701	Kidney imaging with flow		S	5591	4.5547	$377.12	.	$75.43					
78707	K flow/funct image w/o drug		S	5592	5.9108	$489.40	.	$97.88					
78708	K flow/funct image w/drug		S	5592	5.9108	$489.40	.	$97.88					
78709	K flow/funct image multiple		S	5592	5.9108	$489.40	.	$97.88					
78725	Kidney function study		S	5591	4.5547	$377.12	.	$75.43					
78730	Urinary bladder retention		N										
78740	Ureteral reflux study		S	5591	4.5547	$377.12	.	$75.43					
78761	Testicular imaging w/flow		S	5591	4.5547	$377.12	.	$75.43					
78799	Genitourinary nuclear exam		S	5591	4.5547	$377.12	.	$75.43					
78800	Rp loclzj tum 1 area 1 d img		S	5591	4.5547	$377.12	.	$75.43					
78801	Rp loclzj tum 2+area 1+d img		S	5591	4.5547	$377.12	.	$75.43					
78802	Rp loclzj tum whbdy 1 d img		S	5593	15.7728	"$1,305.94"	.	$261.19					
78803	Rp loclzj tum spect 1 area		S	5593	15.7728	"$1,305.94"	.	$261.19					
78804	Rp loclzj tum whbdy 2+d img		S	5593	15.7728	"$1,305.94"	.	$261.19					
78808	Iv inj ra drug dx study		Q1	5591	4.5547	$377.12	.	$75.43					
78811	Pet image ltd area		S	5593	15.7728	"$1,305.94"	.	$261.19					
78812	Pet image skull-thigh		S	5594	17.8791	"$1,480.34"	.	$296.07					
78813	Pet image full body		S	5594	17.8791	"$1,480.34"	.	$296.07					
78814	Pet image w/ct lmtd		S	5594	17.8791	"$1,480.34"	.	$296.07					
78815	Pet image w/ct skull-thigh		S	5594	17.8791	"$1,480.34"	.	$296.07					
78816	Pet image w/ct full body		S	5594	17.8791	"$1,480.34"	.	$296.07					
78830	Rp loclzj tum spect w/ct 1		S	5593	15.7728	"$1,305.94"	.	$261.19					
78831	Rp loclzj tum spect 2 areas		S	5593	15.7728	"$1,305.94"	.	$261.19					
78832	Rp loclzj tum spect w/ct 2		S	5594	17.8791	"$1,480.34"	.	$296.07					
78835	Rp quan meas single area		N										
78999	Nuclear diagnostic exam		S	5591	4.5547	$377.12	.	$75.43					
79005	Nuclear rx oral admin		S	5661	3.0149	$249.62	.	$49.93					
79101	Nuclear rx iv admin		S	5661	3.0149	$249.62	.	$49.93					
79200	Nuclear rx intracav admin		S	5661	3.0149	$249.62	.	$49.93					
79300	Nuclr rx interstit colloid		S	5661	3.0149	$249.62	.	$49.93					
79403	Hematopoietic nuclear tx		S	5661	3.0149	$249.62	.	$49.93					
79440	Nuclear rx intra-articular		S	5661	3.0149	$249.62	.	$49.93					
79445	Nuclear rx intra-arterial		S	5661	3.0149	$249.62	.	$49.93					
79999	Nuclear medicine therapy		S	5661	3.0149	$249.62	.	$49.93					
80047	Metabolic panel ionized ca		Q4										
80048	Metabolic panel total ca		Q4										
80050	General health panel		E1										
80051	Electrolyte panel		Q4										
80053	Comprehen metabolic panel		Q4										
80055	Obstetric panel		Q4										
80061	Lipid panel		A										
80069	Renal function panel		Q4										
80074	Acute hepatitis panel		Q4										
80076	Hepatic function panel		Q4										
80081	Obstetric panel		Q4										
80143	Drug assay acetaminophen	NC	Q4										
80145	Drug assay adalimumab		Q4										
80150	Assay of amikacin		Q4										
80151	Drug assay amiodarone	NC	Q4										
80155	Drug assay caffeine		Q4										
80156	Assay carbamazepine total		Q4										
80157	Assay carbamazepine free		Q4										
80158	Drug assay cyclosporine		Q4										
80159	Drug assay clozapine		Q4										
80161	"Asy carbamazepin 10,11-epxid"	NC	Q4										
80162	Assay of digoxin total		Q4										
80163	Assay of digoxin free		Q4										
80164	Assay dipropylacetic acd tot		Q4										
80165	Dipropylacetic acid free		Q4										
80167	Drug assay felbamate	NC	Q4										
80168	Assay of ethosuximide		Q4										
80169	Drug assay everolimus		Q4										
80170	Assay of gentamicin		Q4										
80171	Drug screen quant gabapentin		Q4										
80173	Assay of haloperidol		Q4										
80175	Drug screen quan lamotrigine		Q4										
80176	Assay of lidocaine		Q4										
80177	Drug scrn quan levetiracetam		Q4										
80178	Assay of lithium		Q4										
80179	Drug assay salicylate	NC	Q4										
80180	Drug scrn quan mycophenolate		Q4										
80181	Drug assay flecainide	NC	Q4										
80183	Drug scrn quant oxcarbazepin		Q4										
80184	Assay of phenobarbital		Q4										
80185	Assay of phenytoin total		Q4										
80186	Assay of phenytoin free		Q4										
80187	Drug assay posaconazole		Q4										
80188	Assay of primidone		Q4										
80189	Drug assay itraconzaole	NC	Q4										
80190	Assay of procainamide		Q4										
80192	Assay of procainamide		Q4										
80193	Drug assay leflunomide	NC	Q4										
80194	Assay of quinidine		Q4										
80195	Assay of sirolimus		Q4										
80197	Assay of tacrolimus		Q4										
80198	Assay of theophylline		Q4										
80199	Drug screen quant tiagabine		Q4										
80200	Assay of tobramycin		Q4										
80201	Assay of topiramate		Q4										
80202	Assay of vancomycin		Q4										
80203	Drug screen quant zonisamide		Q4										
80204	Drug assay methotrexate	NC	Q4										
80210	Drug assay rufinamide	NC	Q4										
80230	Drug assay infliximab		Q4										
80235	Drug assay lacosamide		Q4										
80280	Drug assay vedolizumab		Q4										
80285	Drug assay voriconazole		Q4										
80299	Quantitative assay drug		Q4										
80305	Drug test prsmv dir opt obs		Q4										
80306	Drug test prsmv instrmnt		Q4										
80307	Drug test prsmv chem anlyzr		Q4										
80320	Drug screen quantalcohols		B										
80321	Alcohols biomarkers 1or 2		B										
80322	Alcohols biomarkers 3/more		B										
80323	Alkaloids nos		B										
80324	Drug screen amphetamines 1/2		B										
80325	Amphetamines 3or 4		B										
80326	Amphetamines 5 or more		B										
80327	Anabolic steroid 1 or 2		B										
80328	Anabolic steroid 3 or more		B										
80329	Analgesics non-opioid 1 or 2		B										
80330	Analgesics non-opioid 3-5		B										
80331	Analgesics non-opioid 6/more		B										
80332	Antidepressants class 1 or 2		B										
80333	Antidepressants class 3-5		B										
80334	Antidepressants class 6/more		B										
80335	Antidepressant tricyclic 1/2		B										
80336	Antidepressant tricyclic 3-5		B										
80337	Tricyclic & cyclicals 6/more		B										
80338	Antidepressant not specified		B										
80339	Antiepileptics nos 1-3		B										
80340	Antiepileptics nos 4-6		B										
80341	Antiepileptics nos 7/more		B										
80342	Antipsychotics nos 1-3		B										
80343	Antipsychotics nos 4-6		B										
80344	Antipsychotics nos 7/more		B										
80345	Drug screening barbiturates		B										
80346	Benzodiazepines1-12		B										
80347	Benzodiazepines 13 or more		B										
80348	Drug screening buprenorphine		B										
80349	Cannabinoids natural		B										
80350	Cannabinoids synthetic 1-3		B										
80351	Cannabinoids synthetic 4-6		B										
80352	Cannabinoid synthetic 7/more		B										
80353	Drug screening cocaine		B										
80354	Drug screening fentanyl		B										
80355	Gabapentin non-blood		B										
80356	Heroin metabolite		B										
80357	Ketamine and norketamine		B										
80358	Drug screening methadone		B										
80359	Methylenedioxyamphetamines		B										
80360	Methylphenidate		B										
80361	Opiates 1 or more		B										
80362	Opioids & opiate analogs 1/2		B										
80363	Opioids & opiate analogs 3/4		B										
80364	Opioid &opiate analog 5/more		B										
80365	Drug screening oxycodone		B										
80366	Drug screening pregabalin		B										
80367	Drug screening propoxyphene		B										
80368	Sedative hypnotics		B										
80369	Skeletal muscle relaxant 1/2		B										
80370	Skel musc relaxant 3 or more		B										
80371	Stimulants synthetic		B										
80372	Drug screening tapentadol		B										
80373	Drug screening tramadol		B										
80374	Stereoisomer analysis		B										
80375	Drug/substance nos 1-3		B										
80376	Drug/substance nos 4-6		B										
80377	Drug/substance nos 7/more		B										
80400	Acth stimulation panel		Q4										
80402	Acth stimulation panel		Q4										
80406	Acth stimulation panel		Q4										
80408	Aldosterone suppression eval		Q4										
80410	Calcitonin stimul panel		Q4										
80412	Crh stimulation panel		Q4										
80414	Testosterone response panel		Q4										
80415	Tot estradiol response panel		Q4										
80416	Renin stimulation panel		Q4										
80417	Renin stimulation panel		Q4										
80418	Pituitary evaluation panel		Q4										
80420	Dexamethasone panel		Q4										
80422	Glucagon tolerance panel		Q4										
80424	Glucagon tolerance panel		Q4										
80426	Gonadotropin hormone panel		Q4										
80428	Growth hormone panel		Q4										
80430	Growth hormone panel		Q4										
80432	Insulin suppression panel		Q4										
80434	Insulin tolerance panel		Q4										
80435	Insulin tolerance panel		Q4										
80436	Metyrapone panel		Q4										
80438	Trh stimulation panel		Q4										
80439	Trh stimulation panel		Q4										
80500	Lab pathology consultation		Q1	5671	0.6010	$49.76	.	$9.96					
80502	Lab pathology consultation	CH 	Q1	5672	1.8015	$149.16	.	$29.84					
81000	Urinalysis nonauto w/scope		Q4										
81001	Urinalysis auto w/scope		Q4										
81002	Urinalysis nonauto w/o scope		Q4										
81003	Urinalysis auto w/o scope		Q4										
81005	Urinalysis		Q4										
81007	Urine screen for bacteria		Q4										
81015	Microscopic exam of urine		Q4										
81020	Urinalysis glass test		Q4										
81025	Urine pregnancy test		Q4										
81050	Urinalysis volume measure		Q4										
81099	Urinalysis test procedure		Q4										
81105	Hpa-1 genotyping		A										
81106	Hpa-2 genotyping		A										
81107	Hpa-3 genotyping		A										
81108	Hpa-4 genotyping		A										
81109	Hpa-5 genotyping		A										
81110	Hpa-6 genotyping		A										
81111	Hpa-9 genotyping		A										
81112	Hpa-15 genotyping		A										
81120	Idh1 common variants		A										
81121	Idh2 common variants		A										
81161	Dmd dup/delet analysis		A										
81162	Brca1&2 gen full seq dup/del		A										
81163	Brca1&2 gene full seq alys		A										
81164	Brca1&2 gen ful dup/del alys		A										
81165	Brca1 gene full seq alys		A										
81166	Brca1 gene full dup/del alys		A										
81167	Brca2 gene full dup/del alys		A										
81168	Ccnd1/igh translocation alys	NC	A										
81170	Abl1 gene		A										
81171	Aff2 gene detc abnor alleles		A										
81172	Aff2 gene charac alleles		A										
81173	Ar gene full gene sequence		A										
81174	Ar gene known famil variant		A										
81175	Asxl1 full gene sequence		A										
81176	Asxl1 gene target seq alys		A										
81177	Atn1 gene detc abnor alleles		A										
81178	Atxn1 gene detc abnor allele		A										
81179	Atxn2 gene detc abnor allele		A										
81180	Atxn3 gene detc abnor allele		A										
81181	Atxn7 gene detc abnor allele		A										
81182	Atxn8os gen detc abnor allel		A										
81183	Atxn10 gene detc abnor allel		A										
81184	Cacna1a gen detc abnor allel		A										
81185	Cacna1a gene full gene seq		A										
81186	Cacna1a gen known famil vrnt		A										
81187	Cnbp gene detc abnor allele		A										
81188	Cstb gene detc abnor allele		A										
81189	Cstb gene full gene sequence		A										
81190	Cstb gene known famil vrnt		A										
81191	Ntrk1 translocation analysis	NC	A										
81192	Ntrk2 translocation analysis	NC	A										
81193	Ntrk3 translocation analysis	NC	A										
81194	Ntrk translocation analysis	NC	A										
81200	Aspa gene		A										
81201	Apc gene full sequence		A										
81202	Apc gene known fam variants		A										
81203	Apc gene dup/delet variants		A										
81204	Ar gene charac alleles		A										
81205	Bckdhb gene		A										
81206	Bcr/abl1 gene major bp		A										
81207	Bcr/abl1 gene minor bp		A										
81208	Bcr/abl1 gene other bp		A										
81209	Blm gene		A										
81210	Braf gene		A										
81212	Brca1&2 185&5385&6174 vrnt		A										
81215	Brca1 gene known famil vrnt		A										
81216	Brca2 gene full seq alys		A										
81217	Brca2 gene known famil vrnt		A										
81218	Cebpa gene full sequence		A										
81219	Calr gene com variants		A										
81220	Cftr gene com variants		A										
81221	Cftr gene known fam variants		A										
81222	Cftr gene dup/delet variants		A										
81223	Cftr gene full sequence		A										
81224	Cftr gene intron poly t		A										
81225	Cyp2c19 gene com variants		A										
81226	Cyp2d6 gene com variants		A										
81227	Cyp2c9 gene com variants		A										
81228	Cytogen micrarray copy nmbr		A										
81229	Cytogen m array copy no&snp		A										
81230	Cyp3a4 gene common variants		A										
81231	Cyp3a5 gene common variants		A										
81232	Dpyd gene common variants		A										
81233	Btk gene common variants		A										
81234	Dmpk gene detc abnor allele		A										
81235	Egfr gene com variants		A										
81236	Ezh2 gene full gene sequence		A										
81237	Ezh2 gene common variants		A										
81238	F9 full gene sequence		A										
81239	Dmpk gene charac alleles		A										
81240	F2 gene		A										
81241	F5 gene		A										
81242	Fancc gene		A										
81243	Fmr1 gene detection		A										
81244	Fmr1 gene charac alleles		A										
81245	Flt3 gene		A										
81246	Flt3 gene analysis		A										
81247	G6pd gene alys cmn variant		A										
81248	G6pd known familial variant		A										
81249	G6pd full gene sequence		A										
81250	G6pc gene		A										
81251	Gba gene		A										
81252	Gjb2 gene full sequence		A										
81253	Gjb2 gene known fam variants		A										
81254	Gjb6 gene com variants		A										
81255	Hexa gene		A										
81256	Hfe gene		A										
81257	Hba1/hba2 gene		A										
81258	Hba1/hba2 gene fam vrnt		A										
81259	Hba1/hba2 full gene sequence		A										
81260	Ikbkap gene		A										
81261	Igh gene rearrange amp meth		A										
81262	Igh gene rearrang dir probe		A										
81263	Igh vari regional mutation		A										
81264	Igk rearrangeabn clonal pop		A										
81265	Str markers specimen anal		A										
81266	Str markers spec anal addl		A										
81267	Chimerism anal no cell selec		A										
81268	Chimerism anal w/cell select		A										
81269	Hba1/hba2 gene dup/del vrnts		A										
81270	Jak2 gene		A										
81271	Htt gene detc abnor alleles		A										
81272	Kit gene targeted seq analys		A										
81273	Kit gene analys d816 variant		A										
81274	Htt gene charac alleles		A										
81275	Kras gene variants exon 2		A										
81276	Kras gene addl variants		A										
81277	Cytogenomic neo microra alys		A										
81278	Igh@/bcl2 translocation alys	NC	A										
81279	Jak2 gene trgt sequence alys	NC	A										
81283	Ifnl3 gene		A										
81284	Fxn gene detc abnor alleles		A										
81285	Fxn gene charac alleles		A										
81286	Fxn gene full gene sequence		A										
81287	Mgmt gene prmtr mthyltn alys		A										
81288	Mlh1 gene		A										
81289	Fxn gene known famil variant		A										
81290	Mcoln1 gene		A										
81291	Mthfr gene		A										
81292	Mlh1 gene full seq		A										
81293	Mlh1 gene known variants		A										
81294	Mlh1 gene dup/delete variant		A										
81295	Msh2 gene full seq		A										
81296	Msh2 gene known variants		A										
81297	Msh2 gene dup/delete variant		A										
81298	Msh6 gene full seq		A										
81299	Msh6 gene known variants		A										
81300	Msh6 gene dup/delete variant		A										
81301	Microsatellite instability		A										
81302	Mecp2 gene full seq		A										
81303	Mecp2 gene known variant		A										
81304	Mecp2 gene dup/delet variant		A										
81305	Myd88 gene p.leu265pro vrnt		A										
81306	Nudt15 gene common variants		A										
81307	Palb2 gene full gene seq		A										
81308	Palb2 gene known famil vrnt		A										
81309	Pik3ca gene trgt seq alys		A										
81310	Npm1 gene		A										
81311	Nras gene variants exon 2&3		A										
81312	Pabpn1 gene detc abnor allel		A										
81313	Pca3/klk3 antigen		A										
81314	Pdgfra gene		A										
81315	Pml/raralpha com breakpoints		A										
81316	Pml/raralpha 1 breakpoint		A										
81317	Pms2 gene full seq analysis		A										
81318	Pms2 known familial variants		A										
81319	Pms2 gene dup/delet variants		A										
81320	Plcg2 gene common variants		A										
81321	Pten gene full sequence		A										
81322	Pten gene known fam variant		A										
81323	Pten gene dup/delet variant		A										
81324	Pmp22 gene dup/delet		A										
81325	Pmp22 gene full sequence		A										
81326	Pmp22 gene known fam variant		A										
81327	Sept9 gen prmtr mthyltn alys		A										
81328	Slco1b1 gene com variants		A										
81329	Smn1 gene dos/deletion alys		A										
81330	Smpd1 gene common variants		A										
81331	Snrpn/ube3a gene		A										
81332	Serpina1 gene		A										
81333	Tgfbi gene common variants		A										
81334	Runx1 gene targeted seq alys		A										
81335	Tpmt gene com variants		A										
81336	Smn1 gene full gene sequence		A										
81337	Smn1 gen nown famil seq vrnt		A										
81338	Mpl gene common variants	NC	A										
81339	Mpl gene seq alys exon 10	NC	A										
81340	Trb@ gene rearrange amplify		A										
81341	Trb@ gene rearrange dirprobe		A										
81342	Trg gene rearrangement anal		A										
81343	Ppp2r2b gen detc abnor allel		A										
81344	Tbp gene detc abnor alleles		A										
81345	Tert gene targeted seq alys		A										
81346	Tyms gene com variants		A										
81347	Sf3b1 gene common variants	NC	A										
81348	Srsf2 gene common variants	NC	A										
81350	Ugt1a1 gene common variants		A										
81351	Tp53 gene full gene sequence	NC	A										
81352	Tp53 gene trgt sequence alys	NC	A										
81353	Tp53 gene known famil vrnt	NC	A										
81355	Vkorc1 gene		A										
81357	U2af1 gene common variants	NC	A										
81360	Zrsr2 gene common variants	NC	A										
81361	Hbb gene com variants		A										
81362	Hbb gene known fam variant		A										
81363	Hbb gene dup/del variants		A										
81364	Hbb full gene sequence		A										
81370	Hla i & ii typing lr		A										
81371	Hla i & ii type verify lr		A										
81372	Hla i typing complete lr		A										
81373	Hla i typing 1 locus lr		A										
81374	Hla i typing 1 antigen lr		A										
81375	Hla ii typing ag equiv lr		A										
81376	Hla ii typing 1 locus lr		A										
81377	Hla ii type 1 ag equiv lr		A										
81378	Hla i & ii typing hr		A										
81379	Hla i typing complete hr		A										
81380	Hla i typing 1 locus hr		A										
81381	Hla i typing 1 allele hr		A										
81382	Hla ii typing 1 loc hr		A										
81383	Hla ii typing 1 allele hr		A										
81400	Mopath procedure level 1		A										
81401	Mopath procedure level 2		A										
81402	Mopath procedure level 3		A										
81403	Mopath procedure level 4		A										
81404	Mopath procedure level 5		A										
81405	Mopath procedure level 6		A										
81406	Mopath procedure level 7		A										
81407	Mopath procedure level 8		A										
81408	Mopath procedure level 9		A										
81410	Aortic dysfunction/dilation		A										
81411	Aortic dysfunction/dilation		A										
81412	Ashkenazi jewish assoc dis		A										
81413	Car ion chnnlpath inc 10 gns		A										
81414	Car ion chnnlpath inc 2 gns		A										
81415	Exome sequence analysis		A										
81416	Exome sequence analysis		A										
81417	Exome re-evaluation		A										
81419	Epilepsy gen seq alys panel	NC	A										
81420	Fetal chrmoml aneuploidy		A										
81422	Fetal chrmoml microdeltj		A										
81425	Genome sequence analysis		A										
81426	Genome sequence analysis		A										
81427	Genome re-evaluation		A										
81430	Hearing loss sequence analys		A										
81431	Hearing loss dup/del analys		A										
81432	Hrdtry brst ca-rlatd dsordrs		A										
81433	Hrdtry brst ca-rlatd dsordrs		A										
81434	Hereditary retinal disorders		A										
81435	Hereditary colon ca dsordrs		A										
81436	Hereditary colon ca dsordrs		A										
81437	Heredtry nurondcrn tum dsrdr		A										
81438	Heredtry nurondcrn tum dsrdr		A										
81439	Hrdtry cardmypy gene panel		A										
81440	Mitochondrial gene		A										
81442	Noonan spectrum disorders		A										
81443	Genetic tstg severe inh cond		A										
81445	Targeted genomic seq analys		A										
81448	Hrdtry perph neurphy panel		A										
81450	Targeted genomic seq analys		A										
81455	Targeted genomic seq analys		A										
81460	Whole mitochondrial genome		A										
81465	Whole mitochondrial genome		A										
81470	X-linked intellectual dblt		A										
81471	X-linked intellectual dblt		A										
81479	Unlisted molecular pathology		A										
81490	Autoimmune rheumatoid arthr	CH	A										
81493	Cor artery disease mrna		A										
81500	Onco (ovar) two proteins	CH	A										
81503	Onco (ovar) five proteins	CH	A										
81504	Oncology tissue of origin		A										
81506	Endo assay seven anal	CH	Q4										
81507	Fetal aneuploidy trisom risk		A										
81508	Ftl cgen abnor two proteins		Q4										
81509	Ftl cgen abnor 3 proteins		Q4										
81510	Ftl cgen abnor three anal		Q4										
81511	Ftl cgen abnor four anal		Q4										
81512	Ftl cgen abnor five anal		Q4										
81513	Nfct ds bv rna vag flu alg	NC	Q4										
81514	Nfct ds bv&vaginitis dna alg	NC	A										
81518	Onc brst mrna 11 genes		A										
81519	Oncology breast mrna		A										
81520	Onc breast mrna 58 genes		A										
81521	Onc breast mrna 70 genes		A										
81522	Onc breast mrna 12 genes		A										
81525	Oncology colon mrna		A										
81528	Oncology colorectal scr		A										
81529	Onc cutan mlnma mrna 31 gene	NC	A										
81535	Oncology gynecologic	CH	A										
81536	Oncology gynecologic	CH	A										
81538	Oncology lung		A										
81539	Oncology prostate prob score	CH	A										
81540	Oncology tum unknown origin		A										
81541	Onc prostate mrna 46 genes		A										
81542	Onc prostate mrna 22 cnt gen		A										
81545	Oncology thyroid	CH	D										
81546	"Onc thyr mrna 10,196 gen alg"	NC	A										
81551	Onc prostate 3 genes		A										
81552	Onc uveal mlnma mrna 15 gene		A										
81554	Pulm ds ipf mrna 190 gen alg	NC	A										
81595	Cardiology hrt trnspl mrna		A										
81596	Nfct ds chrnc hcv 6 assays		A										
81599	Unlisted maaa		A										
82009	Test for acetone/ketones		Q4										
82010	Acetone assay		Q4										
82013	Acetylcholinesterase assay		Q4										
82016	Acylcarnitines qual		Q4										
82017	Acylcarnitines quant		Q4										
82024	Assay of acth		Q4										
82030	Assay of adp & amp		Q4										
82040	Assay of serum albumin		Q4										
82042	Other source albumin quan ea		Q4										
82043	Ur albumin quantitative		Q4										
82044	Ur albumin semiquantitative		Q4										
82045	Albumin ischemia modified		Q4										
82075	Assay of breath ethanol		Q4										
82077	Assay spec xcp ur&breath ia	NC	Q4										
82085	Assay of aldolase		Q4										
82088	Assay of aldosterone		Q4										
82103	Alpha-1-antitrypsin total		Q4										
82104	Alpha-1-antitrypsin pheno		Q4										
82105	Alpha-fetoprotein serum		Q4										
82106	Alpha-fetoprotein amniotic		Q4										
82107	Alpha-fetoprotein l3		Q4										
82108	Assay of aluminum		Q4										
82120	Amines vaginal fluid qual		Q4										
82127	Amino acid single qual		Q4										
82128	Amino acids mult qual		Q4										
82131	Amino acids single quant		Q4										
82135	Assay aminolevulinic acid		Q4										
82136	Amino acids quant 2-5		Q4										
82139	Amino acids quan 6 or more		Q4										
82140	Assay of ammonia		Q4										
82143	Amniotic fluid scan		Q4										
82150	Assay of amylase		Q4										
82154	Androstanediol glucuronide		Q4										
82157	Assay of androstenedione		Q4										
82160	Assay of androsterone		Q4										
82163	Assay of angiotensin ii		Q4										
82164	Angiotensin i enzyme test		Q4										
82172	Assay of apolipoprotein		Q4										
82175	Assay of arsenic		Q4										
82180	Assay of ascorbic acid		Q4										
82190	Atomic absorption		Q4										
82232	Assay of beta-2 protein		Q4										
82239	Bile acids total		Q4										
82240	Bile acids cholylglycine		Q4										
82247	Bilirubin total		Q4										
82248	Bilirubin direct		Q4										
82252	Fecal bilirubin test		Q4										
82261	Assay of biotinidase		Q4										
82270	Occult blood feces		A										
82271	Occult blood other sources		Q4										
82272	Occult bld feces 1-3 tests		Q4										
82274	Assay test for blood fecal		Q4										
82286	Assay of bradykinin		Q4										
82300	Assay of cadmium		Q4										
82306	Vitamin d 25 hydroxy		Q4										
82308	Assay of calcitonin		Q4										
82310	Assay of calcium		Q4										
82330	Assay of calcium		Q4										
82331	Calcium infusion test		Q4										
82340	Assay of calcium in urine		Q4										
82355	Calculus analysis qual		Q4										
82360	Calculus assay quant		Q4										
82365	Calculus spectroscopy		Q4										
82370	X-ray assay calculus		Q4										
82373	Assay c-d transfer measure		Q4										
82374	Assay blood carbon dioxide		Q4										
82375	Assay carboxyhb quant		Q4										
82376	Assay carboxyhb qual		Q4										
82378	Carcinoembryonic antigen		Q4										
82379	Assay of carnitine		Q4										
82380	Assay of carotene		Q4										
82382	Assay urine catecholamines		Q4										
82383	Assay blood catecholamines		Q4										
82384	Assay three catecholamines		Q4										
82387	Assay of cathepsin-d		Q4										
82390	Assay of ceruloplasmin		Q4										
82397	Chemiluminescent assay		Q4										
82415	Assay of chloramphenicol		Q4										
82435	Assay of blood chloride		Q4										
82436	Assay of urine chloride		Q4										
82438	Assay other fluid chlorides		Q4										
82441	Test for chlorohydrocarbons		Q4										
82465	Assay bld/serum cholesterol		A										
82480	Assay serum cholinesterase		Q4										
82482	Assay rbc cholinesterase		Q4										
82485	Assay chondroitin sulfate		Q4										
82495	Assay of chromium		Q4										
82507	Assay of citrate		Q4										
82523	Collagen crosslinks		Q4										
82525	Assay of copper		Q4										
82528	Assay of corticosterone		Q4										
82530	Cortisol free		Q4										
82533	Total cortisol		Q4										
82540	Assay of creatine		Q4										
82542	Col chromotography qual/quan		Q4										
82550	Assay of ck (cpk)		Q4										
82552	Assay of cpk in blood		Q4										
82553	Creatine mb fraction		Q4										
82554	Creatine isoforms		Q4										
82565	Assay of creatinine		Q4										
82570	Assay of urine creatinine		Q4										
82575	Creatinine clearance test		Q4										
82585	Assay of cryofibrinogen		Q4										
82595	Assay of cryoglobulin		Q4										
82600	Assay of cyanide		Q4										
82607	Vitamin b-12		Q4										
82608	B-12 binding capacity		Q4										
82610	Cystatin c		Q4										
82615	Test for urine cystines		Q4										
82626	Dehydroepiandrosterone		Q4										
82627	Dehydroepiandrosterone		Q4										
82633	Desoxycorticosterone		Q4										
82634	Deoxycortisol		Q4										
82638	Assay of dibucaine number		Q4										
82642	Dihydrotestosterone		Q4										
82652	Vit d 1 25-dihydroxy		Q4										
82656	Pancreatic elastase fecal		Q4										
82657	Enzyme cell activity		Q4										
82658	Enzyme cell activity ra		Q4										
82664	Electrophoretic test		Q4										
82668	Assay of erythropoietin		Q4										
82670	Assay of total estradiol		Q4										
82671	Assay of estrogens		Q4										
82672	Assay of estrogen		Q4										
82677	Assay of estriol		Q4										
82679	Assay of estrone		Q4										
82681	Assay dir meas fr estradiol	NC	Q4										
82693	Assay of ethylene glycol		Q4										
82696	Assay of etiocholanolone		Q4										
82705	Fats/lipids feces qual		Q4										
82710	Fats/lipids feces quant		Q4										
82715	Assay of fecal fat		Q4										
82725	Assay of blood fatty acids		Q4										
82726	Long chain fatty acids		Q4										
82728	Assay of ferritin		Q4										
82731	Assay of fetal fibronectin		Q4										
82735	Assay of fluoride		Q4										
82746	Assay of folic acid serum		Q4										
82747	Assay of folic acid rbc		Q4										
82757	Assay of semen fructose		Q4										
82759	Assay of rbc galactokinase		Q4										
82760	Assay of galactose		Q4										
82775	Assay galactose transferase		Q4										
82776	Galactose transferase test		Q4										
82777	Galectin-3		Q4										
82784	Assay iga/igd/igg/igm each		Q4										
82785	Assay of ige		Q4										
82787	Igg 1 2 3 or 4 each		Q4										
82800	Blood ph		Q4										
82803	Blood gases any combination		Q4										
82805	Blood gases w/o2 saturation		Q4										
82810	Blood gases o2 sat only		Q4										
82820	Hemoglobin-oxygen affinity		Q4										
82930	Gastric analy w/ph ea spec		Q4										
82938	Gastrin test		Q4										
82941	Assay of gastrin		Q4										
82943	Assay of glucagon		Q4										
82945	Glucose other fluid		Q4										
82946	Glucagon tolerance test		Q4										
82947	Assay glucose blood quant		A										
82948	Reagent strip/blood glucose		Q4										
82950	Glucose test		A										
82951	Glucose tolerance test (gtt)		A										
82952	Gtt-added samples		Q4										
82955	Assay of g6pd enzyme		Q4										
82960	Test for g6pd enzyme		Q4										
82962	Glucose blood test		Q4										
82963	Assay of glucosidase		Q4										
82965	Assay of gdh enzyme		Q4										
82977	Assay of ggt		Q4										
82978	Assay of glutathione		Q4										
82979	Assay rbc glutathione		Q4										
82985	Assay of glycated protein		Q4										
83001	Assay of gonadotropin (fsh)		Q4										
83002	Assay of gonadotropin (lh)		Q4										
83003	Assay growth hormone (hgh)		Q4										
83006	Growth stimulation gene 2		Q4										
83009	H pylori (c-13) blood		Q4										
83010	Assay of haptoglobin quant		Q4										
83012	Assay of haptoglobins		Q4										
83013	H pylori (c-13) breath		Q4										
83014	H pylori drug admin		Q4										
83015	Heavy metal qual any anal		Q4										
83018	Heavy metal quant each nes		Q4										
83020	Hemoglobin electrophoresis		Q4										
83021	Hemoglobin chromotography		Q4										
83026	Hemoglobin copper sulfate		Q4										
83030	Fetal hemoglobin chemical		Q4										
83033	Fetal hemoglobin assay qual		Q4										
83036	Glycosylated hemoglobin test		Q4										
83037	Glycosylated hb home device		Q4										
83045	Blood methemoglobin test		Q4										
83050	Blood methemoglobin assay		Q4										
83051	Assay of plasma hemoglobin		Q4										
83060	Blood sulfhemoglobin assay		Q4										
83065	Assay of hemoglobin heat		Q4										
83068	Hemoglobin stability screen		Q4										
83069	Assay of urine hemoglobin		Q4										
83070	Assay of hemosiderin qual		Q4										
83080	Assay of b hexosaminidase		Q4										
83088	Assay of histamine		Q4										
83090	Assay of homocystine		Q4										
83150	Assay of homovanillic acid		Q4										
83491	Assay of corticosteroids 17		Q4										
83497	Assay of 5-hiaa		Q4										
83498	Assay of progesterone 17-d		Q4										
83500	Assay free hydroxyproline		Q4										
83505	Assay total hydroxyproline		Q4										
83516	Immunoassay nonantibody		Q4										
83518	Immunoassay dipstick		Q4										
83519	Ria nonantibody		Q4										
83520	Immunoassay quant nos nonab		Q4										
83525	Assay of insulin		Q4										
83527	Assay of insulin		Q4										
83528	Assay of intrinsic factor		Q4										
83540	Assay of iron		Q4										
83550	Iron binding test		Q4										
83570	Assay of idh enzyme		Q4										
83582	Assay of ketogenic steroids		Q4										
83586	Assay 17- ketosteroids		Q4										
83593	Fractionation ketosteroids		Q4										
83605	Assay of lactic acid		Q4										
83615	Lactate (ld) (ldh) enzyme		Q4										
83625	Assay of ldh enzymes		Q4										
83630	Lactoferrin fecal (qual)		Q4										
83631	Lactoferrin fecal (quant)		Q4										
83632	Placental lactogen		Q4										
83633	Test urine for lactose		Q4										
83655	Assay of lead		Q4										
83661	L/s ratio fetal lung		Q4										
83662	Foam stability fetal lung		Q4										
83663	Fluoro polarize fetal lung		Q4										
83664	Lamellar bdy fetal lung		Q4										
83670	Assay of lap enzyme		Q4										
83690	Assay of lipase		Q4										
83695	Assay of lipoprotein(a)		Q4										
83698	Assay lipoprotein pla2		Q4										
83700	Lipopro bld electrophoretic		Q4										
83701	Lipoprotein bld hr fraction		Q4										
83704	Lipoprotein bld quan part		Q4										
83718	Assay of lipoprotein		Q4										
83719	Assay of blood lipoprotein		Q4										
83721	Assay of blood lipoprotein		Q4										
83722	Lipoprtn dir meas sd ldl chl		Q4										
83727	Assay of lrh hormone		Q4										
83735	Assay of magnesium		Q4										
83775	Assay malate dehydrogenase		Q4										
83785	Assay of manganese		Q4										
83789	Mass spectrometry qual/quan		Q4										
83825	Assay of mercury		Q4										
83835	Assay of metanephrines		Q4										
83857	Assay of methemalbumin		Q4										
83861	Microfluid analy tears		Q4										
83864	Mucopolysaccharides		Q4										
83872	Assay synovial fluid mucin		Q4										
83873	Assay of csf protein		Q4										
83874	Assay of myoglobin		Q4										
83876	Assay myeloperoxidase		Q4										
83880	Assay of natriuretic peptide		Q4										
83883	Assay nephelometry not spec		Q4										
83885	Assay of nickel		Q4										
83915	Assay of nucleotidase		Q4										
83916	Oligoclonal bands		Q4										
83918	Organic acids total quant		Q4										
83919	Organic acids qual each		Q4										
83921	Organic acid single quant		Q4										
83930	Assay of blood osmolality		Q4										
83935	Assay of urine osmolality		Q4										
83937	Assay of osteocalcin		Q4										
83945	Assay of oxalate		Q4										
83950	Oncoprotein her-2/neu		Q4										
83951	Oncoprotein dcp		Q4										
83970	Assay of parathormone		Q4										
83986	Assay ph body fluid nos		Q4										
83987	Exhaled breath condensate		Q4										
83992	Assay for phencyclidine		E1										
83993	Assay for calprotectin fecal		Q4										
84030	Assay of blood pku		Q4										
84035	Assay of phenylketones		Q4										
84060	Assay acid phosphatase		Q4										
84066	Assay prostate phosphatase		Q4										
84075	Assay alkaline phosphatase		Q4										
84078	Assay alkaline phosphatase		Q4										
84080	Assay alkaline phosphatases		Q4										
84081	Assay phosphatidylglycerol		Q4										
84085	Assay of rbc pg6d enzyme		Q4										
84087	Assay phosphohexose enzymes		Q4										
84100	Assay of phosphorus		Q4										
84105	Assay of urine phosphorus		Q4										
84106	Test for porphobilinogen		Q4										
84110	Assay of porphobilinogen		Q4										
84112	Eval amniotic fluid protein		Q4										
84119	Test urine for porphyrins		Q4										
84120	Assay of urine porphyrins		Q4										
84126	Assay of feces porphyrins		Q4										
84132	Assay of serum potassium		Q4										
84133	Assay of urine potassium		Q4										
84134	Assay of prealbumin		Q4										
84135	Assay of pregnanediol		Q4										
84138	Assay of pregnanetriol		Q4										
84140	Assay of pregnenolone		Q4										
84143	Assay of 17-hydroxypregneno		Q4										
84144	Assay of progesterone		Q4										
84145	Procalcitonin (pct)		Q4										
84146	Assay of prolactin		Q4										
84150	Assay of prostaglandin		Q4										
84152	Assay of psa complexed		Q4										
84153	Assay of psa total		Q4										
84154	Assay of psa free		Q4										
84155	Assay of protein serum		Q4										
84156	Assay of protein urine		Q4										
84157	Assay of protein other		Q4										
84160	Assay of protein any source		Q4										
84163	Pappa serum		Q4										
84165	Protein e-phoresis serum		Q4										
84166	Protein e-phoresis/urine/csf		Q4										
84181	Western blot test		Q4										
84182	Protein western blot test		Q4										
84202	Assay rbc protoporphyrin		Q4										
84203	Test rbc protoporphyrin		Q4										
84206	Assay of proinsulin		Q4										
84207	Assay of vitamin b-6		Q4										
84210	Assay of pyruvate		Q4										
84220	Assay of pyruvate kinase		Q4										
84228	Assay of quinine		Q4										
84233	Assay of estrogen		Q4										
84234	Assay of progesterone		Q4										
84235	Assay of endocrine hormone		Q4										
84238	Assay nonendocrine receptor		Q4										
84244	Assay of renin		Q4										
84252	Assay of vitamin b-2		Q4										
84255	Assay of selenium		Q4										
84260	Assay of serotonin		Q4										
84270	Assay of sex hormone globul		Q4										
84275	Assay of sialic acid		Q4										
84285	Assay of silica		Q4										
84295	Assay of serum sodium		Q4										
84300	Assay of urine sodium		Q4										
84302	Assay of sweat sodium		Q4										
84305	Assay of somatomedin		Q4										
84307	Assay of somatostatin		Q4										
84311	Spectrophotometry		Q4										
84315	Body fluid specific gravity		Q4										
84375	Chromatogram assay sugars		Q4										
84376	Sugars single qual		Q4										
84377	Sugars multiple qual		Q4										
84378	Sugars single quant		Q4										
84379	Sugars multiple quant		Q4										
84392	Assay of urine sulfate		Q4										
84402	Assay of free testosterone		Q4										
84403	Assay of total testosterone		Q4										
84410	Testosterone bioavailable		Q4										
84425	Assay of vitamin b-1		Q4										
84430	Assay of thiocyanate		Q4										
84431	Thromboxane urine		Q4										
84432	Assay of thyroglobulin		Q4										
84436	Assay of total thyroxine		Q4										
84437	Assay of neonatal thyroxine		Q4										
84439	Assay of free thyroxine		Q4										
84442	Assay of thyroid activity		Q4										
84443	Assay thyroid stim hormone		Q4										
84445	Assay of tsi globulin		Q4										
84446	Assay of vitamin e		Q4										
84449	Assay of transcortin		Q4										
84450	Transferase (ast) (sgot)		Q4										
84460	Alanine amino (alt) (sgpt)		Q4										
84466	Assay of transferrin		Q4										
84478	Assay of triglycerides		A										
84479	Assay of thyroid (t3 or t4)		Q4										
84480	Assay triiodothyronine (t3)		Q4										
84481	Free assay (ft-3)		Q4										
84482	T3 reverse		Q4										
84484	Assay of troponin quant		Q4										
84485	Assay duodenal fluid trypsin		Q4										
84488	Test feces for trypsin		Q4										
84490	Assay of feces for trypsin		Q4										
84510	Assay of tyrosine		Q4										
84512	Assay of troponin qual		Q4										
84520	Assay of urea nitrogen		Q4										
84525	Urea nitrogen semi-quant		Q4										
84540	Assay of urine/urea-n		Q4										
84545	Urea-n clearance test		Q4										
84550	Assay of blood/uric acid		Q4										
84560	Assay of urine/uric acid		Q4										
84577	Assay of feces/urobilinogen		Q4										
84578	Test urine urobilinogen		Q4										
84580	Assay of urine urobilinogen		Q4										
84583	Assay of urine urobilinogen		Q4										
84585	Assay of urine vma		Q4										
84586	Assay of vip		Q4										
84588	Assay of vasopressin		Q4										
84590	Assay of vitamin a		Q4										
84591	Assay of nos vitamin		Q4										
84597	Assay of vitamin k		Q4										
84600	Assay of volatiles		Q4										
84620	Xylose tolerance test		Q4										
84630	Assay of zinc		Q4										
84681	Assay of c-peptide		Q4										
84702	Chorionic gonadotropin test		Q4										
84703	Chorionic gonadotropin assay		Q4										
84704	Hcg free betachain test		Q4										
84830	Ovulation tests		Q4										
84999	Clinical chemistry test		Q4										
85002	Bleeding time test		Q4										
85004	Automated diff wbc count		Q4										
85007	Bl smear w/diff wbc count		Q4										
85008	Bl smear w/o diff wbc count		Q4										
85009	Manual diff wbc count b-coat		Q4										
85013	Spun microhematocrit		Q4										
85014	Hematocrit		Q4										
85018	Hemoglobin		Q4										
85025	Complete cbc w/auto diff wbc		Q4										
85027	Complete cbc automated		Q4										
85032	Manual cell count each		Q4										
85041	Automated rbc count		Q4										
85044	Manual reticulocyte count		Q4										
85045	Automated reticulocyte count		Q4										
85046	Reticyte/hgb concentrate		Q4										
85048	Automated leukocyte count		Q4										
85049	Automated platelet count		Q4										
85055	Reticulated platelet assay		Q4										
85060	Blood smear interpretation		B										
85097	Bone marrow interpretation		Q2	5674	7.9248	$656.15	.	$131.23					
85130	Chromogenic substrate assay		Q4										
85170	Blood clot retraction		Q4										
85175	Blood clot lysis time		Q4										
85210	Clot factor ii prothrom spec		Q4										
85220	Blooc clot factor v test		Q4										
85230	Clot factor vii proconvertin		Q4										
85240	Clot factor viii ahg 1 stage		Q4										
85244	Clot factor viii reltd antgn		Q4										
85245	Clot factor viii vw ristoctn		Q4										
85246	Clot factor viii vw antigen		Q4										
85247	Clot factor viii multimetric		Q4										
85250	Clot factor ix ptc/chrstmas		Q4										
85260	Clot factor x stuart-power		Q4										
85270	Clot factor xi pta		Q4										
85280	Clot factor xii hageman		Q4										
85290	Clot factor xiii fibrin stab		Q4										
85291	Clot factor xiii fibrin scrn		Q4										
85292	Clot factor fletcher fact		Q4										
85293	Clot factor wght kininogen		Q4										
85300	Antithrombin iii activity		Q4										
85301	Antithrombin iii antigen		Q4										
85302	Clot inhibit prot c antigen		Q4										
85303	Clot inhibit prot c activity		Q4										
85305	Clot inhibit prot s total		Q4										
85306	Clot inhibit prot s free		Q4										
85307	Assay activated protein c		Q4										
85335	Factor inhibitor test		Q4										
85337	Thrombomodulin		Q4										
85345	Coagulation time lee & white		Q4										
85347	Coagulation time activated		Q4										
85348	Coagulation time otr method		Q4										
85360	Euglobulin lysis		Q4										
85362	Fibrin degradation products		Q4										
85366	Fibrinogen test		Q4										
85370	Fibrinogen test		Q4										
85378	Fibrin degrade semiquant		Q4										
85379	Fibrin degradation quant		Q4										
85380	Fibrin degradj d-dimer		Q4										
85384	Fibrinogen activity		Q4										
85385	Fibrinogen antigen		Q4										
85390	Fibrinolysins screen i&r		Q4										
85396	Clotting assay whole blood		N										
85397	Clotting funct activity		Q4										
85400	Fibrinolytic plasmin		Q4										
85410	Fibrinolytic antiplasmin		Q4										
85415	Fibrinolytic plasminogen		Q4										
85420	Fibrinolytic plasminogen		Q4										
85421	Fibrinolytic plasminogen		Q4										
85441	Heinz bodies direct		Q4										
85445	Heinz bodies induced		Q4										
85460	Hemoglobin fetal		Q4										
85461	Hemoglobin fetal		Q4										
85475	Hemolysin acid		Q4										
85520	Heparin assay		Q4										
85525	Heparin neutralization		Q4										
85530	Heparin-protamine tolerance		Q4										
85536	Iron stain peripheral blood		Q4										
85540	Wbc alkaline phosphatase		Q4										
85547	Rbc mechanical fragility		Q4										
85549	Muramidase		Q4										
85555	Rbc osmotic fragility		Q4										
85557	Rbc osmotic fragility		Q4										
85576	Blood platelet aggregation		Q4										
85597	Phospholipid pltlt neutraliz		Q4										
85598	Hexagnal phosph pltlt neutrl		Q4										
85610	Prothrombin time		Q4										
85611	Prothrombin test		Q4										
85612	Viper venom prothrombin time		Q4										
85613	Russell viper venom diluted		Q4										
85635	Reptilase test		Q4										
85651	Rbc sed rate nonautomated		Q4										
85652	Rbc sed rate automated		Q4										
85660	Rbc sickle cell test		Q4										
85670	Thrombin time plasma		Q4										
85675	Thrombin time titer		Q4										
85705	Thromboplastin inhibition		Q4										
85730	Thromboplastin time partial		Q4										
85732	Thromboplastin time partial		Q4										
85810	Blood viscosity examination		Q4										
85999	Hematology procedure		Q4										
86000	Agglutinins febrile antigen		Q4										
86001	Allergen specific igg		Q4										
86003	Allg spec ige crude xtrc ea		Q4										
86005	Allg spec ige multiallg scr		Q4										
86008	Allg spec ige recomb ea		Q4										
86021	Wbc antibody identification		Q4										
86022	Platelet antibodies		Q4										
86023	Immunoglobulin assay		Q4										
86038	Antinuclear antibodies		Q4										
86039	Antinuclear antibodies (ana)		Q4										
86060	Antistreptolysin o titer		Q4										
86063	Antistreptolysin o screen		Q4										
86077	Phys blood bank serv xmatch		Q1	5731	0.2980	$24.67	.	$4.94					
86078	Phys blood bank serv reactj		Q1	5672	1.8015	$149.16	.	$29.84					
86079	Phys blood bank serv authrj		Q1	5671	0.6010	$49.76	.	$9.96					
86140	C-reactive protein		Q4										
86141	C-reactive protein hs		Q4										
86146	Beta-2 glycoprotein antibody		Q4										
86147	Cardiolipin antibody ea ig		Q4										
86148	Anti-phospholipid antibody		Q4										
86152	Cell enumeration & id		Q4										
86153	Cell enumeration phys interp		B										
86155	Chemotaxis assay		Q4										
86156	Cold agglutinin screen		Q4										
86157	Cold agglutinin titer		Q4										
86160	Complement antigen		Q4										
86161	Complement/function activity		Q4										
86162	Complement total (ch50)		Q4										
86171	Complement fixation each		Q4										
86200	Ccp antibody		Q4										
86215	Deoxyribonuclease antibody		Q4										
86225	Dna antibody native		Q4										
86226	Dna antibody single strand		Q4										
86235	Nuclear antigen antibody		Q4										
86255	Fluorescent antibody screen		Q4										
86256	Fluorescent antibody titer		Q4										
86277	Growth hormone antibody		Q4										
86280	Hemagglutination inhibition		Q4										
86294	Immunoassay tumor qual		Q4										
86300	Immunoassay tumor ca 15-3		Q4										
86301	Immunoassay tumor ca 19-9		Q4										
86304	Immunoassay tumor ca 125		Q4										
86305	Human epididymis protein 4		Q4										
86308	Heterophile antibody screen		Q4										
86309	Heterophile antibody titer		Q4										
86310	Heterophile antibody absrbj		Q4										
86316	Immunoassay tumor other		Q4										
86317	Immunoassay infectious agent		Q4										
86318	Ia infectious agent antibody		Q4										
86320	Serum immunoelectrophoresis		Q4										
86325	Other immunoelectrophoresis		Q4										
86327	Immunoelectrophoresis assay		Q4										
86328	Ia nfct ab sarscov2 covid19	NC	A 										
86329	Immunodiffusion nes		Q4										
86331	Immunodiffusion ouchterlony		Q4										
86332	Immune complex assay		Q4										
86334	Immunofix e-phoresis serum		Q4										
86335	Immunfix e-phorsis/urine/csf		Q4										
86336	Inhibin a		Q4										
86337	Insulin antibodies		Q4										
86340	Intrinsic factor antibody		Q4										
86341	Islet cell antibody		Q4										
86343	Leukocyte histamine release		Q4										
86344	Leukocyte phagocytosis		Q4										
86352	Cell function assay w/stim		Q4										
86353	Lymphocyte transformation		Q4										
86355	B cells total count		Q4										
86356	Mononuclear cell antigen		Q4										
86357	Nk cells total count		Q4										
86359	T cells total count		Q4										
86360	T cell absolute count/ratio		Q4										
86361	T cell absolute count		Q4										
86367	Stem cells total count		Q4										
86376	Microsomal antibody each		Q4										
86382	Neutralization test viral		Q4										
86384	Nitroblue tetrazolium dye		Q4										
86386	Nuclear matrix protein 22		Q4										
86403	Particle agglut antbdy scrn		Q4										
86406	Particle agglut antbdy titr		Q4										
86408	Neutrlzg antb sarscov2 scr	NI	A										
86409	Neutrlzg antb sarscov2 titer	NI	A										
86413	Sars-cov-2 antb quantitative	NI	A										
86430	Rheumatoid factor test qual		Q4										
86431	Rheumatoid factor quant		Q4										
86480	Tb test cell immun measure		Q4										
86481	Tb ag response t-cell susp		Q4										
86485	Skin test candida		Q1	5731	0.2980	$24.67	.	$4.94					
86486	Skin test nos antigen		Q1	5731	0.2980	$24.67	.	$4.94					
86490	Coccidioidomycosis skin test		Q1	5733	0.6722	$55.66	.	$11.14					
86510	Histoplasmosis skin test		Q1	5733	0.6722	$55.66	.	$11.14					
86580	Tb intradermal test		Q1	5731	0.2980	$24.67	.	$4.94					
86590	Streptokinase antibody		Q4										
86592	Syphilis test non-trep qual		A										
86593	Syphilis test non-trep quant		A										
86602	Antinomyces antibody		Q4										
86603	Adenovirus antibody		Q4										
86606	Aspergillus antibody		Q4										
86609	Bacterium antibody		Q4										
86611	Bartonella antibody		Q4										
86612	Blastomyces antibody		Q4										
86615	Bordetella antibody		Q4										
86617	Lyme disease antibody		Q4										
86618	Lyme disease antibody		Q4										
86619	Borrelia antibody		Q4										
86622	Brucella antibody		Q4										
86625	Campylobacter antibody		Q4										
86628	Candida antibody		Q4										
86631	Chlamydia antibody		A										
86632	Chlamydia igm antibody		A										
86635	Coccidioides antibody		Q4										
86638	Q fever antibody		Q4										
86641	Cryptococcus antibody		Q4										
86644	Cmv antibody		Q4										
86645	Cmv antibody igm		Q4										
86648	Diphtheria antibody		Q4										
86651	Encephalitis californ antbdy		Q4										
86652	Encephaltis east eqne anbdy		Q4										
86653	Encephaltis st louis antbody		Q4										
86654	Encephaltis west eqne antbdy		Q4										
86658	Enterovirus antibody		Q4										
86663	Epstein-barr antibody		Q4										
86664	Epstein-barr nuclear antigen		Q4										
86665	Epstein-barr capsid vca		Q4										
86666	Ehrlichia antibody		Q4										
86668	Francisella tularensis		Q4										
86671	Fungus nes antibody		Q4										
86674	Giardia lamblia antibody		Q4										
86677	Helicobacter pylori antibody		Q4										
86682	Helminth antibody		Q4										
86684	Hemophilus influenza antibdy		Q4										
86687	Htlv-i antibody		Q4										
86688	Htlv-ii antibody		Q4										
86689	Htlv/hiv confirmj antibody		Q4										
86692	Hepatitis delta agent antbdy		Q4										
86694	Herpes simplex nes antbdy		Q4										
86695	Herpes simplex type 1 test		Q4										
86696	Herpes simplex type 2 test		Q4										
86698	Histoplasma antibody		Q4										
86701	Hiv-1antibody		Q4										
86702	Hiv-2 antibody		Q4										
86703	Hiv-1/hiv-2 1 result antbdy		Q4										
86704	Hep b core antibody total		Q4										
86705	Hep b core antibody igm		Q4										
86706	Hep b surface antibody		Q4										
86707	Hepatitis be antibody		Q4										
86708	Hepatitis a antibody		Q4										
86709	Hepatitis a igm antibody		Q4										
86710	Influenza virus antibody		Q4										
86711	John cunningham antibody		Q4										
86713	Legionella antibody		Q4										
86717	Leishmania antibody		Q4										
86720	Leptospira antibody		Q4										
86723	Listeria monocytogenes		Q4										
86727	Lymph choriomeningitis ab		Q4										
86732	Mucormycosis antibody		Q4										
86735	Mumps antibody		Q4										
86738	Mycoplasma antibody		Q4										
86741	Neisseria meningitidis		Q4										
86744	Nocardia antibody		Q4										
86747	Parvovirus antibody		Q4										
86750	Malaria antibody		Q4										
86753	Protozoa antibody nos		Q4										
86756	Respiratory virus antibody		Q4										
86757	Rickettsia antibody		Q4										
86759	Rotavirus antibody		Q4										
86762	Rubella antibody		Q4										
86765	Rubeola antibody		Q4										
86768	Salmonella antibody		Q4										
86769	Sars-cov-2 covid-19 antibody	NC	A										
86771	Shigella antibody		Q4										
86774	Tetanus antibody		Q4										
86777	Toxoplasma antibody		Q4										
86778	Toxoplasma antibody igm		Q4										
86780	Treponema pallidum		A										
86784	Trichinella antibody		Q4										
86787	Varicella-zoster antibody		Q4										
86788	West nile virus ab igm		Q4										
86789	West nile virus antibody		Q4										
86790	Virus antibody nos		Q4										
86793	Yersinia antibody		Q4										
86794	Zika virus igm antibody		Q4										
86800	Thyroglobulin antibody		Q4										
86803	Hepatitis c ab test		Q4										
86804	Hep c ab test confirm		Q4										
86805	Lymphocytotoxicity assay		Q4										
86806	Lymphocytotoxicity assay		Q4										
86807	Cytotoxic antibody screening		Q4										
86808	Cytotoxic antibody screening		Q4										
86812	Hla typing a b or c		Q4										
86813	Hla typing a b or c		Q4										
86816	Hla typing dr/dq		Q4										
86817	Hla typing dr/dq		Q4										
86821	Lymphocyte culture mixed		Q4										
86825	Hla x-math non-cytotoxic		Q4										
86826	Hla x-match noncytotoxc addl		Q4										
86828	Hla class i&ii antibody qual		Q4										
86829	Hla class i/ii antibody qual		Q4										
86830	Hla class i phenotype qual		Q4										
86831	Hla class ii phenotype qual		Q4										
86832	Hla class i high defin qual		Q4										
86833	Hla class ii high defin qual		Q4										
86834	Hla class i semiquant panel		Q4										
86835	Hla class ii semiquant panel		Q4										
86849	Immunology procedure		N										
86850	Rbc antibody screen		Q1	5671	0.6010	$49.76	.	$9.96					
86860	Rbc antibody elution		Q1	5672	1.8015	$149.16	.	$29.84					
86870	Rbc antibody identification		Q2	5673	3.5177	$291.26	.	$58.26					
86880	Coombs test direct	CH	Q1	5733	0.6722	$55.66	.	$11.14					
86885	Coombs test indirect qual		Q1	5672	1.8015	$149.16	.	$29.84					
86886	Coombs test indirect titer		Q1	5672	1.8015	$149.16	.	$29.84					
86890	Autologous blood process		Q1	5672	1.8015	$149.16	.	$29.84					
86891	Autologous blood op salvage		Q1	5674	7.9248	$656.15	.	$131.23					
86900	Blood typing serologic abo		Q1	5734	1.3521	$111.95	.	$22.39					
86901	Blood typing serologic rh(d)		Q1	5732	0.4087	$33.84	.	$6.77					
86902	Blood type antigen donor ea		Q1	5673	3.5177	$291.26	.	$58.26					
86904	Blood typing patient serum		Q1	5732	0.4087	$33.84	.	$6.77					
86905	Blood typing rbc antigens		Q1	5673	3.5177	$291.26	.	$58.26					
86906	Bld typing serologic rh phnt		Q1	5732	0.4087	$33.84	.	$6.77					
86910	Blood typing paternity test		E1										
86911	Blood typing antigen system		E1										
86920	Compatibility test spin		Q1	5672	1.8015	$149.16	.	$29.84					
86921	Compatibility test incubate		Q1	5672	1.8015	$149.16	.	$29.84					
86922	Compatibility test antiglob		Q1	5672	1.8015	$149.16	.	$29.84					
86923	Compatibility test electric		Q1	5672	1.8015	$149.16	.	$29.84					
86927	Plasma fresh frozen		S	5672	1.8015	$149.16	.	$29.84					
86930	Frozen blood prep		Q1	5673	3.5177	$291.26	.	$58.26					
86931	Frozen blood thaw		Q1	5673	3.5177	$291.26	.	$58.26					
86932	Frozen blood freeze/thaw		Q1	5732	0.4087	$33.84	.	$6.77					
86940	Hemolysins/agglutinins auto		Q4										
86941	Hemolysins/agglutinins		Q4										
86945	Blood product/irradiation		Q1	5732	0.4087	$33.84	.	$6.77					
86950	Leukacyte transfusion		Q1	5672	1.8015	$149.16	.	$29.84					
86960	Vol reduction of blood/prod		Q1	5672	1.8015	$149.16	.	$29.84					
86965	Pooling blood platelets		Q1	5672	1.8015	$149.16	.	$29.84					
86970	Rbc pretx incubatj w/chemicl		Q1	5732	0.4087	$33.84	.	$6.77					
86971	Rbc pretx incubatj w/enzymes		Q1	5673	3.5177	$291.26	.	$58.26					
86972	Rbc pretx incubatj w/density		Q1	5672	1.8015	$149.16	.	$29.84					
86975	Rbc serum pretx incubj drugs	CH	Q1	5735	3.2637	$270.22	.	$54.05					
86976	Rbc serum pretx id dilution		Q1	5731	0.2980	$24.67	.	$4.94					
86977	Rbc serum pretx incubj/inhib		Q1	5672	1.8015	$149.16	.	$29.84					
86978	Rbc pretreatment serum		Q1	5732	0.4087	$33.84	.	$6.77					
86985	Split blood or products		Q1	5672	1.8015	$149.16	.	$29.84					
86999	Transfusion procedure		Q1	5731	0.2980	$24.67	.	$4.94					
87003	Small animal inoculation		Q4										
87015	Specimen infect agnt concntj		Q4										
87040	Blood culture for bacteria		Q4										
87045	Feces culture aerobic bact		Q4										
87046	Stool cultr aerobic bact ea		Q4										
87070	Culture othr specimn aerobic		Q4										
87071	Culture aerobic quant other		Q4										
87073	Culture bacteria anaerobic		Q4										
87075	Cultr bacteria except blood		Q4										
87076	Culture anaerobe ident each		Q4										
87077	Culture aerobic identify		Q4										
87081	Culture screen only		Q4										
87084	Culture of specimen by kit		Q4										
87086	Urine culture/colony count		Q4										
87088	Urine bacteria culture		Q4										
87101	Skin fungi culture		Q4										
87102	Fungus isolation culture		Q4										
87103	Blood fungus culture		Q4										
87106	Fungi identification yeast		Q4										
87107	Fungi identification mold		Q4										
87109	Mycoplasma		Q4										
87110	Chlamydia culture	CH	Q4										
87116	Mycobacteria culture		Q4										
87118	Mycobacteric identification		Q4										
87140	Culture type immunofluoresc		Q4										
87143	Culture typing glc/hplc		Q4										
87147	Culture type immunologic		Q4										
87149	Dna/rna direct probe		Q4										
87150	Dna/rna amplified probe		Q4										
87152	Culture type pulse field gel		Q4										
87153	Dna/rna sequencing		Q4										
87158	Culture typing added method		Q4										
87164	Dark field examination		Q4										
87166	Dark field examination		Q4										
87168	Macroscopic exam arthropod		Q4										
87169	Macroscopic exam parasite		Q4										
87172	Pinworm exam		Q4										
87176	Tissue homogenization cultr		Q4										
87177	Ova and parasites smears		Q4										
87181	Microbe susceptible diffuse		Q4										
87184	Microbe susceptible disk		Q4										
87185	Microbe susceptible enzyme		Q4										
87186	Microbe susceptible mic		Q4										
87187	Microbe susceptible mlc		Q4										
87188	Microbe suscept macrobroth		Q4										
87190	Microbe suscept mycobacteri		Q4										
87197	Bactericidal level serum		Q4										
87205	Smear gram stain		Q4										
87206	Smear fluorescent/acid stai		Q4										
87207	Smear special stain		Q4										
87209	Smear complex stain		Q4										
87210	Smear wet mount saline/ink		Q4										
87220	Tissue exam for fungi		Q4										
87230	Assay toxin or antitoxin		Q4										
87250	Virus inoculate eggs/animal		Q4										
87252	Virus inoculation tissue		Q4										
87253	Virus inoculate tissue addl		Q4										
87254	Virus inoculation shell via		Q4										
87255	Genet virus isolate hsv		Q4										
87260	Adenovirus ag if		Q4										
87265	Pertussis ag if		Q4										
87267	Enterovirus antibody dfa		Q4										
87269	Giardia ag if		Q4										
87270	Chlamydia trachomatis ag if	CH	Q4										
87271	Cytomegalovirus dfa		Q4										
87272	Cryptosporidium ag if		Q4										
87273	Herpes simplex 2 ag if		Q4										
87274	Herpes simplex 1 ag if		Q4										
87275	Influenza b ag if		Q4										
87276	Influenza a ag if		Q4										
87278	Legion pneumophilia ag if		Q4										
87279	Parainfluenza ag if		Q4										
87280	Respiratory syncytial ag if		Q4										
87281	Pneumocystis carinii ag if		Q4										
87283	Rubeola ag if		Q4										
87285	Treponema pallidum ag if		Q4										
87290	Varicella zoster ag if		Q4										
87299	Antibody detection nos if		Q4										
87300	Ag detection polyval if		Q4										
87301	Adenovirus ag ia		Q4										
87305	Aspergillus ag ia		Q4										
87320	Chylmd trach ag ia	CH	Q4										
87324	Clostridium ag ia		Q4										
87327	Cryptococcus neoform ag ia		Q4										
87328	Cryptosporidium ag ia		Q4										
87329	Giardia ag ia		Q4										
87332	Cytomegalovirus ag ia		Q4										
87335	E coli 0157 ag ia		Q4										
87336	Entamoeb hist dispr ag ia		Q4										
87337	Entamoeb hist group ag ia		Q4										
87338	Hpylori stool ag ia		Q4										
87339	H pylori ag ia		Q4										
87340	Hepatitis b surface ag ia		Q4										
87341	Hepatitis b surface ag ia	CH	Q4										
87350	Hepatitis be ag ia		Q4										
87380	Hepatitis delta agent ag ia		Q4										
87385	Histoplasma capsul ag ia		Q4										
87389	Hiv-1 ag w/hiv-1&2 ab ag ia		Q4										
87390	Hiv-1 ag ia		Q4										
87391	Hiv-2 ag ia		Q4										
87400	Influenza a/b each ag ia		Q4										
87420	Resp syncytial virus ag ia		Q4										
87425	Rotavirus ag ia		Q4										
87426	Sarscov coronavirus ag ia	NC	A										
87427	Shiga-like toxin ag ia		Q4										
87428	Sarscov & inf vir a&b ag ia 	NI	A										
87430	Strep a ag ia		Q4										
87449	Nos each organism ag ia 		Q4										
87450	Ag detect nos ia single	CH	D										
87451	Polyvalent mult org ea ag ia		Q4										
87471	Bartonella dna amp probe		Q4										
87472	Bartonella dna quant		Q4										
87475	Lyme dis dna dir probe		Q4										
87476	Lyme dis dna amp probe		Q4										
87480	Candida dna dir probe		Q4										
87481	Candida dna amp probe		Q4										
87482	Candida dna quant		Q4										
87483	Cns dna amp probe type 12-25		Q4										
87485	Chylmd pneum dna dir probe		Q4										
87486	Chylmd pneum dna amp probe		Q4										
87487	Chylmd pneum dna quant		Q4										
87490	Chylmd trach dna dir probe		Q4										
87491	Chylmd trach dna amp probe		Q4										
87492	Chylmd trach dna quant		Q4										
87493	C diff amplified probe		Q4										
87495	Cytomeg dna dir probe		Q4										
87496	Cytomeg dna amp probe		Q4										
87497	Cytomeg dna quant		Q4										
87498	Enterovirus probe&revrs trns		Q4										
87500	Vanomycin dna amp probe		Q4										
87501	Influenza dna amp prob 1+		Q4										
87502	Influenza dna amp probe		Q4										
87503	Influenza dna amp prob addl		Q4										
87505	Nfct agent detection gi		Q4										
87506	Iadna-dna/rna probe tq 6-11		Q4										
87507	Iadna-dna/rna probe tq 12-25		Q4										
87510	Gardner vag dna dir probe		Q4										
87511	Gardner vag dna amp probe		Q4										
87512	Gardner vag dna quant		Q4										
87516	Hepatitis b dna amp probe		Q4										
87517	Hepatitis b dna quant		Q4										
87520	Hepatitis c rna dir probe		Q4										
87521	Hepatitis c probe&rvrs trnsc		Q4										
87522	Hepatitis c revrs trnscrpj		Q4										
87525	Hepatitis g dna dir probe		Q4										
87526	Hepatitis g dna amp probe		Q4										
87527	Hepatitis g dna quant		Q4										
87528	Hsv dna dir probe		Q4										
87529	Hsv dna amp probe		Q4										
87530	Hsv dna quant		Q4										
87531	Hhv-6 dna dir probe		Q4										
87532	Hhv-6 dna amp probe		Q4										
87533	Hhv-6 dna quant		Q4										
87534	Hiv-1 dna dir probe		Q4										
87535	Hiv-1 probe&reverse trnscrpj		Q4										
87536	Hiv-1 quant&revrse trnscrpj		Q4										
87537	Hiv-2 dna dir probe		Q4										
87538	Hiv-2 probe&revrse trnscripj		Q4										
87539	Hiv-2 quant&revrse trnscripj		Q4										
87540	Legion pneumo dna dir prob		Q4										
87541	Legion pneumo dna amp prob		Q4										
87542	Legion pneumo dna quant		Q4										
87550	Mycobacteria dna dir probe		Q4										
87551	Mycobacteria dna amp probe		Q4										
87552	Mycobacteria dna quant		Q4										
87555	M.tuberculo dna dir probe		Q4										
87556	M.tuberculo dna amp probe		Q4										
87557	M.tuberculo dna quant		Q4										
87560	M.avium-intra dna dir prob		Q4										
87561	M.avium-intra dna amp prob		Q4										
87562	M.avium-intra dna quant		Q4										
87563	M. genitalium amp probe		Q4										
87580	M.pneumon dna dir probe		Q4										
87581	M.pneumon dna amp probe		Q4										
87582	M.pneumon dna quant		Q4										
87590	N.gonorrhoeae dna dir prob		Q4										
87591	N.gonorrhoeae dna amp prob		Q4										
87592	N.gonorrhoeae dna quant		Q4										
87623	Hpv low-risk types		Q4										
87624	Hpv high-risk types		Q4										
87625	Hpv types 16 & 18 only		Q4										
87631	Resp virus 3-5 targets		Q4										
87632	Resp virus 6-11 targets		Q4										
87633	Resp virus 12-25 targets		Q4										
87634	Rsv dna/rna amp probe		Q4										
87635	Sars-cov-2 covid-19 amp prb	NC	A										
87636	Sarscov2 & inf a&b amp prb	NI 	A										
87637	Sarscov2&inf a&b&rsv amp prb 	NI 	A										
87640	Staph a dna amp probe		Q4										
87641	Mr-staph dna amp probe		Q4										
87650	Strep a dna dir probe		Q4										
87651	Strep a dna amp probe		Q4										
87652	Strep a dna quant		Q4										
87653	Strep b dna amp probe		Q4										
87660	Trichomonas vagin dir probe		Q4										
87661	Trichomonas vaginalis amplif		Q4										
87662	Zika virus dna/rna amp probe		Q4										
87797	Detect agent nos dna dir		Q4										
87798	Detect agent nos dna amp		Q4										
87799	Detect agent nos dna quant		Q4										
87800	Detect agnt mult dna direc		Q4										
87801	Detect agnt mult dna ampli		Q4										
87802	Strep b assay w/optic		Q4										
87803	Clostridium toxin a w/optic		Q4										
87804	Influenza assay w/optic		Q4										
87806	Hiv w/hiv1&2 antb w/optic		Q4										
87807	Rsv assay w/optic		Q4										
87808	Trichomonas assay w/optic		Q4										
87809	Adenovirus assay w/optic		Q4										
87810	Chylmd trach assay w/optic	CH	Q4										
87811	Sars-cov-2 covid19 w/optic	NI	A										
87850	N. gonorrhoeae assay w/optic	CH	Q4										
87880	Strep a assay w/optic		Q4										
87899	Agent nos assay w/optic		Q4										
87900	Phenotype infect agent drug		Q4										
87901	Genotype dna hiv reverse t		Q4										
87902	Genotype dna/rna hep c		Q4										
87903	Phenotype dna hiv w/culture		Q4										
87904	Phenotype dna hiv w/clt add		Q4										
87905	Sialidase enzyme assay		Q4										
87906	Genotype dna/rna hiv		Q4										
87910	Genotype cytomegalovirus		Q4										
87912	Genotype dna hepatitis b		Q4										
87999	Microbiology procedure		N										
88000	Autopsy (necropsy) gross		E1										
88005	Autopsy (necropsy) gross		E1										
88007	Autopsy (necropsy) gross		E1										
88012	Autopsy (necropsy) gross		E1										
88014	Autopsy (necropsy) gross		E1										
88016	Autopsy (necropsy) gross		E1										
88020	Autopsy (necropsy) complete		E1										
88025	Autopsy (necropsy) complete		E1										
88027	Autopsy (necropsy) complete		E1										
88028	Autopsy (necropsy) complete		E1										
88029	Autopsy (necropsy) complete		E1										
88036	Limited autopsy		E1										
88037	Limited autopsy		E1										
88040	Forensic autopsy (necropsy)		E1										
88045	Coroners autopsy (necropsy)		E1										
88099	Necropsy (autopsy) procedure		E1										
88104	Cytopath fl nongyn smears		Q1	5732	0.4087	$33.84	.	$6.77					
88106	Cytopath fl nongyn filter		Q1	5731	0.2980	$24.67	.	$4.94					
88108	Cytopath concentrate tech		Q1	5732	0.4087	$33.84	.	$6.77					
88112	Cytopath cell enhance tech		Q1	5671	0.6010	$49.76	.	$9.96					
88120	Cytp urne 3-5 probes ea spec		Q2	5672	1.8015	$149.16	.	$29.84					
88121	Cytp urine 3-5 probes cmptr		Q1	5673	3.5177	$291.26	.	$58.26					
88125	Forensic cytopathology		Q1	5671	0.6010	$49.76	.	$9.96					
88130	Sex chromatin identification		Q4										
88140	Sex chromatin identification		Q4										
88141	Cytopath c/v interpret		N										
88142	Cytopath c/v thin layer		Q4										
88143	Cytopath c/v thin layer redo		Q4										
88147	Cytopath c/v automated		Q4										
88148	Cytopath c/v auto rescreen		Q4										
88150	Cytopath c/v manual		Q4										
88152	Cytopath c/v auto redo		Q4										
88153	Cytopath c/v redo		Q4										
88155	Cytopath c/v index add-on		Q4										
88160	Cytopath smear other source		Q1	5731	0.2980	$24.67	.	$4.94					
88161	Cytopath smear other source		Q1	5731	0.2980	$24.67	.	$4.94					
88162	Cytopath smear other source		Q1	5671	0.6010	$49.76	.	$9.96					
88164	Cytopath tbs c/v manual		Q4										
88165	Cytopath tbs c/v redo		Q4										
88166	Cytopath tbs c/v auto redo		Q4										
88167	Cytopath tbs c/v select		Q4										
88172	Cytp dx eval fna 1st ea site		Q1	5672	1.8015	$149.16	.	$29.84					
88173	Cytopath eval fna report		Q1	5671	0.6010	$49.76	.	$9.96					
88174	Cytopath c/v auto in fluid		Q4										
88175	Cytopath c/v auto fluid redo		Q4										
88177	Cytp fna eval ea addl		N										
88182	Cell marker study		Q2	5671	0.6010	$49.76	.	$9.96					
88184	Flowcytometry/ tc 1 marker		Q2	5673	3.5177	$291.26	.	$58.26					
88185	Flowcytometry/tc add-on		N										
88187	Flowcytometry/read 2-8		B										
88188	Flowcytometry/read 9-15		B										
88189	Flowcytometry/read 16 & >		B										
88199	Cytopathology procedure		Q1	5671	0.6010	$49.76	.	$9.96					
88230	Tissue culture lymphocyte		Q4										
88233	Tissue culture skin/biopsy		Q4										
88235	Tissue culture placenta		Q4										
88237	Tissue culture bone marrow		Q4										
88239	Tissue culture tumor		Q4										
88240	Cell cryopreserve/storage		Q4										
88241	Frozen cell preparation		Q4										
88245	Chromosome analysis 20-25		Q4										
88248	Chromosome analysis 50-100		Q4										
88249	Chromosome analysis 100		Q4										
88261	Chromosome analysis 5		Q4										
88262	Chromosome analysis 15-20		Q4										
88263	Chromosome analysis 45		Q4										
88264	Chromosome analysis 20-25		Q4										
88267	Chromosome analys placenta		Q4										
88269	Chromosome analys amniotic		Q4										
88271	Cytogenetics dna probe		Q4										
88272	Cytogenetics 3-5		Q4										
88273	Cytogenetics 10-30		Q4										
88274	Cytogenetics 25-99		Q4										
88275	Cytogenetics 100-300		Q4										
88280	Chromosome karyotype study		Q4										
88283	Chromosome banding study		Q4										
88285	Chromosome count additional		Q4										
88289	Chromosome study additional		Q4										
88291	Cyto/molecular report		M										
88299	Cytogenetic study		Q1	5671	0.6010	$49.76	.	$9.96					
88300	Surgical path gross		Q1	5731	0.2980	$24.67	.	$4.94					
88302	Tissue exam by pathologist		Q1	5731	0.2980	$24.67	.	$4.94					
88304	Tissue exam by pathologist		Q1	5671	0.6010	$49.76	.	$9.96					
88305	Tissue exam by pathologist		Q1	5671	0.6010	$49.76	.	$9.96					
88307	Tissue exam by pathologist		Q2	5673	3.5177	$291.26	.	$58.26					
88309	Tissue exam by pathologist		Q2	5674	7.9248	$656.15	.	$131.23					
88311	Decalcify tissue		N										
88312	Special stains group 1		Q1	5671	0.6010	$49.76	.	$9.96					
88313	Special stains group 2		Q1	5732	0.4087	$33.84	.	$6.77					
88314	Histochemical stains add-on		N										
88319	Enzyme histochemistry		Q2	5674	7.9248	$656.15	.	$131.23					
88321	Microslide consultation		Q1	5732	0.4087	$33.84	.	$6.77					
88323	Microslide consultation		Q1	5671	0.6010	$49.76	.	$9.96					
88325	Comprehensive review of data	CH	Q1	5672	1.8015	$149.16	.	$29.84					
88329	Path consult introp		Q1	5732	0.4087	$33.84	.	$6.77					
88331	Path consult intraop 1 bloc		Q1	5672	1.8015	$149.16	.	$29.84					
88332	Path consult intraop addl		N										
88333	Intraop cyto path consult 1		Q2	5674	7.9248	$656.15	.	$131.23					
88334	Intraop cyto path consult 2		N										
88341	Immunohisto antb addl slide		N										
88342	Immunohisto antb 1st stain		Q2	5672	1.8015	$149.16	.	$29.84					
88344	Immunohisto antibody slide		Q1	5673	3.5177	$291.26	.	$58.26					
88346	Immunofluor antb 1st stain		Q2	5673	3.5177	$291.26	.	$58.26					
88348	Electron microscopy		Q2	5674	7.9248	$656.15	.	$131.23					
88350	Immunofluor antb addl stain		N										
88355	Analysis skeletal muscle		Q1	5672	1.8015	$149.16	.	$29.84					
88356	Analysis nerve		Q1	5671	0.6010	$49.76	.	$9.96					
88358	Analysis tumor		Q2	5672	1.8015	$149.16	.	$29.84					
88360	Tumor immunohistochem/manual		Q2	5672	1.8015	$149.16	.	$29.84					
88361	Tumor immunohistochem/comput		Q2	5673	3.5177	$291.26	.	$58.26					
88362	Nerve teasing preparations		Q2	5674	7.9248	$656.15	.	$131.23					
88363	Xm archive tissue molec anal		Q1	5731	0.2980	$24.67	.	$4.94					
88364	Insitu hybridization (fish)		N										
88365	Insitu hybridization (fish)		Q1	5672	1.8015	$149.16	.	$29.84					
88366	Insitu hybridization (fish)		Q1	5673	3.5177	$291.26	.	$58.26					
88367	Insitu hybridization auto		Q2	5673	3.5177	$291.26	.	$58.26					
88368	Insitu hybridization manual		Q2	5673	3.5177	$291.26	.	$58.26					
88369	M/phmtrc alysishquant/semiq		N										
88371	Protein western blot tissue		N										
88372	Protein analysis w/probe		N										
88373	M/phmtrc alys ishquant/semiq		N										
88374	M/phmtrc alys ishquant/semiq		Q1	5672	1.8015	$149.16	.	$29.84					
88375	Optical endomicroscpy interp		B										
88377	M/phmtrc alys ishquant/semiq		Q1	5672	1.8015	$149.16	.	$29.84					
88380	Microdissection laser		N										
88381	Microdissection manual		N										
88387	Tiss exam molecular study		N										
88388	Tiss ex molecul study add-on		N										
88399	Surgical pathology procedure		Q1	5671	0.6010	$49.76	.	$9.96					
88720	Bilirubin total transcut		Q4										
88738	Hgb quant transcutaneous		Q4										
88740	Transcutaneous carboxyhb		Q4										
88741	Transcutaneous methb		Q4										
88749	In vivo lab service		Q4										
89049	Chct for mal hyperthermia		Q1	5672	1.8015	$149.16	.	$29.84					
89050	Body fluid cell count		Q4										
89051	Body fluid cell count		Q4										
89055	Leukocyte assessment fecal		Q4										
89060	Exam synovial fluid crystals		Q4										
89125	Specimen fat stain		Q4										
89160	Exam feces for meat fibers		Q4										
89190	Nasal smear for eosinophils		Q4										
89220	Sputum specimen collection		Q1	5672	1.8015	$149.16	.	$29.84					
89230	Collect sweat for test		Q1	5671	0.6010	$49.76	.	$9.96					
89240	Pathology lab procedure		Q1	5671	0.6010	$49.76	.	$9.96					
89250	Cultr oocyte/embryo <4 days		Q1	5672	1.8015	$149.16	.	$29.84					
89251	Cultr oocyte/embryo <4 days		Q2	5672	1.8015	$149.16	.	$29.84					
89253	Embryo hatching		Q1	5672	1.8015	$149.16	.	$29.84					
89254	Oocyte identification		Q1	5672	1.8015	$149.16	.	$29.84					
89255	Prepare embryo for transfer		Q1	5671	0.6010	$49.76	.	$9.96					
89257	Sperm identification		Q1	5671	0.6010	$49.76	.	$9.96					
89258	Cryopreservation embryo(s)		Q2	5674	7.9248	$656.15	.	$131.23					
89259	Cryopreservation sperm		Q1	5672	1.8015	$149.16	.	$29.84					
89260	Sperm isolation simple		Q1	5671	0.6010	$49.76	.	$9.96					
89261	Sperm isolation complex		Q1	5671	0.6010	$49.76	.	$9.96					
89264	Identify sperm tissue		Q1	5671	0.6010	$49.76	.	$9.96					
89268	Insemination of oocytes		Q1	5672	1.8015	$149.16	.	$29.84					
89272	Extended culture of oocytes		Q2	5674	7.9248	$656.15	.	$131.23					
89280	Assist oocyte fertilization		Q2	5674	7.9248	$656.15	.	$131.23					
89281	Assist oocyte fertilization		Q1	5672	1.8015	$149.16	.	$29.84					
89290	Biopsy oocyte polar body		Q1	5672	1.8015	$149.16	.	$29.84					
89291	Biopsy oocyte polar body		Q1	5672	1.8015	$149.16	.	$29.84					
89300	Semen analysis w/huhner		Q4										
89310	Semen analysis w/count		Q4										
89320	Semen anal vol/count/mot		Q4										
89321	Semen anal sperm detection		Q4										
89322	Semen anal strict criteria		Q4										
89325	Sperm antibody test		Q4										
89329	Sperm evaluation test		Q4										
89330	Evaluation cervical mucus		Q4										
89331	Retrograde ejaculation anal		Q4										
89335	Cryopreserve testicular tiss		Q1	5671	0.6010	$49.76	.	$9.96					
89337	Cryopreservation oocyte(s)		Q1	5672	1.8015	$149.16	.	$29.84					
89342	Storage/year embryo(s)		Q1	5672	1.8015	$149.16	.	$29.84					
89343	Storage/year sperm/semen		Q1	5672	1.8015	$149.16	.	$29.84					
89344	Storage/year reprod tissue		Q1	5672	1.8015	$149.16	.	$29.84					
89346	Storage/year oocyte(s)		Q2	5673	3.5177	$291.26	.	$58.26					
89352	Thawing cryopresrved embryo		Q1	5672	1.8015	$149.16	.	$29.84					
89353	Thawing cryopresrved sperm		Q1	5671	0.6010	$49.76	.	$9.96					
89354	Thaw cryoprsvrd reprod tiss		Q1	5672	1.8015	$149.16	.	$29.84					
89356	Thawing cryopresrved oocyte		Q1	5672	1.8015	$149.16	.	$29.84					
89398	Unlisted reprod med lab proc		Q1	5671	0.6010	$49.76	.	$9.96					
9001F	Aortic aneurysm<5cm diam ct		E1										
9002F	Aortic aneurysm 5-5.4cm diam		E1										
9003F	Aortic anrysm5.5-5.9cm diam		M										
9004F	Aortic anrysm 6/> cm diam		M										
9005F	Asympt carot/vrtbrbas sten		E1										
9006F	Sympt sten-tia/strk<120days		M										
9007F	Other carot sten 120 days/>		M										
90281	Human ig im		E1										
90283	Human ig iv		E1										
90284	Human ig sc		E1										
90287	Botulinum antitoxin		E1										
90288	Botulism ig iv		E1										
90291	Cmv ig iv		E1										
90296	Diphtheria antitoxin	CH 	N										
90371	Hep b ig im		K	1630		$119.087	.	$23.82					
90375	Rabies ig im/sc		K	9133		$273.035	.	$54.61					
90376	Rabies ig heat treated		K	9134		$331.803	.	$66.37					
90377	Rabies ig ht&sol human im/sc	NC	E2										
90378	Rsv mab im 50mg		K	9003		"$1,838.680"	.	$367.74					
90384	Rh ig full-dose im		E1										
90385	Rh ig minidose im	CH 	K	9063		$151.410	.	$30.29					
90386	Rh ig iv		E1										
90389	Tetanus ig im		E1										
90393	Vaccina ig im		E2										
90396	Varicella-zoster ig im		K	9135		"$1,703.971"	.	$340.80					
90399	Immune globulin		E1										
90460	Im admin 1st/only component		B										
90461	Im admin each addl component		B										
90471	Immunization admin		Q1	5692	0.7485	$61.97	.	$12.40					
90472	Immunization admin each add		N										
90473	Immune admin oral/nasal		Q1	5692	0.7485	$61.97	.	$12.40					
90474	Immune admin oral/nasal addl		N										
90476	Adenovirus vaccine type 4		N										
90477	Adenovirus vaccine type 7		M										
90581	Anthrax vaccine sc or im		E2										
90585	Bcg vaccine percut		M										
90586	Bcg vaccine intravesical		B										
90587	Dengue vacc quad 3 dose subq		E1										
90619	Menacwy-tt vaccine im		E1										
90620	Menb-4c vacc 2 dose im		M										
90621	Menb-fhbp vacc 2/3 dose im		M										
90625	Cholera vaccine live oral		E1										
90630	Flu vacc iiv4 no preserv id		L										
90632	Hepa vaccine adult im		N										
90633	Hepa vacc ped/adol 2 dose im		N										
90634	Hepa vacc ped/adol 3 dose		N										
90636	Hep a/hep b vacc adult im		N										
90644	Hib-mency vacc 6wk-18m0 im		M										
90647	Hib prp-omp vacc 3 dose im		N										
90648	Hib prp-t vaccine 4 dose im		N										
90649	4vhpv vaccine 3 dose im		M										
90650	2vhpv vaccine 3 dose im		M										
90651	9vhpv vaccine 2/3 dose im		M										
90653	Iiv adjuvant vaccine im		L										
90654	Flu vacc iiv3 no preserv id		L										
90655	Iiv3 vacc no prsv 0.25 ml im		L										
90656	Iiv3 vacc no prsv 0.5 ml im		L										
90657	Iiv3 vaccine splt 0.25 ml im		L										
90658	Iiv3 vaccine splt 0.5 ml im		E1										
90660	Laiv3 vaccine intranasal		L										
90661	Cciiv3 vac no prsv 0.5 ml im		L										
90662	Iiv no prsv increased ag im		L										
90664	Laiv vacc pandemic intranasl		E1										
90666	Flu vac pandem prsrv free im		E1										
90667	Iiv vacc pandemic adjuvt im		E1										
90668	Iiv vaccine pandemic im		E1										
90670	Pcv13 vaccine im		L										
90672	Laiv4 vaccine intranasal		L										
90673	Riv3 vaccine no preserv im		L										
90674	Cciiv4 vac no prsv 0.5 ml im		L										
90675	Rabies vaccine im		K	9139		$303.241	.	$60.65					
90676	Rabies vaccine id		K	9140		$227.530	.	$45.51					
90680	Rv5 vacc 3 dose live oral		N										
90681	Rv1 vacc 2 dose live oral		M										
90682	Riv4 vacc recombinant dna im		L										
90685	Iiv4 vacc no prsv 0.25 ml im		L										
90686	Iiv4 vacc no prsv 0.5 ml im		L										
90687	Iiv4 vaccine splt 0.25 ml im		L										
90688	Iiv4 vaccine splt 0.5 ml im		L										
90689	Vacc iiv4 no prsrv 0.25ml im		L										
90690	Typhoid vaccine oral		N										
90691	Typhoid vaccine im		N										
90694	Vacc aiiv4 no prsrv 0.5ml im	CH	L										
90696	Dtap-ipv vaccine 4-6 yrs im		N										
90697	Dtap-ipv-hib-hepb vaccine im		M										
90698	Dtap-ipv/hib vaccine im		N										
90700	Dtap vaccine < 7 yrs im		N										
90702	Dt vaccine under 7 yrs im		N										
90707	Mmr vaccine sc		N										
90710	Mmrv vaccine sc		N										
90713	Poliovirus ipv sc/im		N										
90714	Td vacc no presv 7 yrs+ im		N										
90715	Tdap vaccine 7 yrs/> im		N										
90716	Var vaccine live subq		M										
90717	Yellow fever vaccine subq		N										
90723	Dtap-hep b-ipv vaccine im		M										
90732	Ppsv23 vacc 2 yrs+ subq/im		L										
90733	Mpsv4 vaccine subq		M										
90734	Menacwyd/menacwycrm vacc im		M										
90736	Hzv vaccine live subq		M										
90738	Inactivated je vacc im		M										
90739	Hepb vacc 2 dose adult im		F										
90740	Hepb vacc 3 dose immunsup im		F										
90743	Hepb vacc 2 dose adolesc im		F										
90744	Hepb vacc 3 dose ped/adol im		F										
90746	Hepb vaccine 3 dose adult im		F										
90747	Hepb vacc 4 dose immunsup im		F										
90748	Hib-hepb vaccine im		E1										
90749	Vaccine toxoid		N										
90750	Hzv vacc recombinant im		M										
90756	Cciiv4 vacc abx free im		L										
90785	Psytx complex interactive		N										
90791	Psych diagnostic evaluation		Q3	5823	1.6139	$133.63	.	$26.73					
90792	Psych diag eval w/med srvcs		Q3	5823	1.6139	$133.63	.	$26.73					
90832	Psytx w pt 30 minutes		Q3	5823	1.6139	$133.63	.	$26.73					
90833	Psytx w pt w e/m 30 min		N										
90834	Psytx w pt 45 minutes		Q3	5823	1.6139	$133.63	.	$26.73					
90836	Psytx w pt w e/m 45 min		N										
90837	Psytx w pt 60 minutes		Q3	5823	1.6139	$133.63	.	$26.73					
90838	Psytx w pt w e/m 60 min		N										
90839	Psytx crisis initial 60 min		Q3	5823	1.6139	$133.63	.	$26.73					
90840	Psytx crisis ea addl 30 min		N										
90845	Psychoanalysis		Q3	5823	1.6139	$133.63	.	$26.73					
90846	Family psytx w/o pt 50 min		Q3	5823	1.6139	$133.63	.	$26.73					
90847	Family psytx w/pt 50 min		Q3	5823	1.6139	$133.63	.	$26.73					
90849	Multiple family group psytx		Q3	5823	1.6139	$133.63	.	$26.73					
90853	Group psychotherapy		Q3	5822	0.9043	$74.87	.	$14.98					
90863	Pharmacologic mgmt w/psytx		E1										
90865	Narcosynthesis		Q3	5823	1.6139	$133.63	.	$26.73					
90867	Tcranial magn stim tx plan		S	5722	3.1939	$264.45	.	$52.89					
90868	Tcranial magn stim tx deli	CH	S	5722	3.1939	$264.45	.	$52.89					
90869	Tcran magn stim redetemine	CH	S	5722	3.1939	$264.45	.	$52.89					
90870	Electroconvulsive therapy		S	5723	5.8913	$487.78	.	$97.56					
90875	Psychophysiological therapy		E1										
90876	Psychophysiological therapy		E1										
90880	Hypnotherapy		Q3	5822	0.9043	$74.87	.	$14.98					
90882	Environmental manipulation		E1										
90885	Psy evaluation of records		N										
90887	Consultation with family		N										
90889	Preparation of report		N										
90899	Psychiatric service/therapy		Q3	5821	0.3168	$26.23	.	$5.25					
90901	Biofeedback train any meth		A										
90912	Bfb training 1st 15 min		A										
90913	Bfb training ea addl 15 min		A										
90935	Hemodialysis one evaluation		S	5401	7.9030	$654.34	.	$130.87					
90937	Hemodialysis repeated eval		B										
90940	Hemodialysis access study		N										
90945	Dialysis one evaluation		V	5024	4.3931	$363.74	.	$72.75					
90947	Dialysis repeated eval		B										
90951	Esrd serv 4 visits p mo <2yr		M										
90952	Esrd serv 2-3 vsts p mo <2yr		M										
90953	Esrd serv 1 visit p mo <2yrs		M										
90954	Esrd serv 4 vsts p mo 2-11		M										
90955	Esrd srv 2-3 vsts p mo 2-11		M										
90956	Esrd srv 1 visit p mo 2-11		M										
90957	Esrd srv 4 vsts p mo 12-19		M										
90958	Esrd srv 2-3 vsts p mo 12-19		M										
90959	Esrd serv 1 vst p mo 12-19		M										
90960	Esrd srv 4 visits p mo 20+		M										
90961	Esrd srv 2-3 vsts p mo 20+		M										
90962	Esrd serv 1 visit p mo 20+		M										
90963	Esrd home pt serv p mo <2yrs		M										
90964	Esrd home pt serv p mo 2-11		M										
90965	Esrd home pt serv p mo 12-19		M										
90966	Esrd home pt serv p mo 20+		M										
90967	Esrd svc pr day pt <2		M										
90968	Esrd svc pr day pt 2-11		M										
90969	Esrd svc pr day pt 12-19		M										
90970	Esrd svc pr day pt 20+		M										
90989	Dialysis training complete		B										
90993	Dialysis training incompl		B										
90997	Hemoperfusion		B										
90999	Dialysis procedure		B										
91010	Esophagus motility study		S	5723	5.8913	$487.78	.	$97.56					
91013	Esophgl motil w/stim/perfus		N										
91020	Gastric motility studies		S	5723	5.8913	$487.78	.	$97.56					
91022	Duodenal motility study		S	5723	5.8913	$487.78	.	$97.56					
91030	Acid perfusion of esophagus		S	5723	5.8913	$487.78	.	$97.56					
91034	Gastroesophageal reflux test		S	5723	5.8913	$487.78	.	$97.56					
91035	G-esoph reflx tst w/electrod		S	5723	5.8913	$487.78	.	$97.56					
91037	Esoph imped function test		S	5722	3.1939	$264.45	.	$52.89					
91038	Esoph imped funct test > 1hr		S	5723	5.8913	$487.78	.	$97.56					
91040	Esoph balloon distension tst		S	5723	5.8913	$487.78	.	$97.56					
91065	Breath hydrogen/methane test		S	5721	1.6854	$139.55	.	$27.91					
91110	Gi tract capsule endoscopy		T	5301	9.7781	$809.60	.	$161.92					
91111	Esophageal capsule endoscopy		T	5301	9.7781	$809.60	.	$161.92					
91112	Gi wireless capsule measure		T	5301	9.7781	$809.60	.	$161.92					
91117	Colon motility 6 hr study		T	5371	3.2144	$266.14	.	$53.23					
91120	Rectal sensation test	CH	S	5722	3.1939	$264.45	.	$52.89					
91122	Anal pressure record		T	5371	3.2144	$266.14	.	$53.23					
91132	Electrogastrography	CH	S	5722	3.1939	$264.45	.	$52.89					
91133	Electrogastrography w/test		Q1	5734	1.3521	$111.95	.	$22.39					
91200	Liver elastography		Q1	5721	1.6854	$139.55	.	$27.91					
91299	Gastroenterology procedure		S	5721	1.6854	$139.55	.	$27.91					
91300	Sarscov2 vac 30mcg/0.3ml im	NI	L 										
91301	Sarscov2 vac 100mcg/0.5ml im	NI	L 										
91302	Coronavirus vaccine 3	NI	E1										
91303	Coronavirus vaccine 4	NI	E1										
91304	Coronavirus vaccine 5	NI	E1										
91305	Coronavirus vaccine 6	NI	E1										
91306	Coronavirus vaccine 7	NI	E1										
91307	Coronavirus vaccine 8	NI	E1										
91308	Coronavirus vaccine 9	NI	E1										
91309	Coronavirus vaccine 10	NI	E1										
91310	Coronavirus vaccine 11	NI	E1										
92002	Eye exam new patient		V	5012	1.4341	$118.74	.	$23.75					
92004	Eye exam new patient		V	5012	1.4341	$118.74	.	$23.75					
92012	Eye exam establish patient		V	5012	1.4341	$118.74	.	$23.75					
92014	Eye exam&tx estab pt 1/>vst		V	5012	1.4341	$118.74	.	$23.75					
92015	Determine refractive state		E1										
92018	New eye exam & treatment		J1	5503	24.1839	"$2,002.35"	.	$400.48					
92019	Eye exam & treatment		J1	5503	24.1839	"$2,002.35"	.	$400.48					
92020	Special eye evaluation		Q1	5734	1.3521	$111.95	.	$22.39					
92025	Corneal topography		Q1	5733	0.6722	$55.66	.	$11.14					
92060	Special eye evaluation		Q1	5733	0.6722	$55.66	.	$11.14					
92065	Orthoptic/pleoptic training		Q1	5733	0.6722	$55.66	.	$11.14					
92071	Contact lens fitting for tx		N										
92072	Fit contac lens for managmnt		N										
92081	Visual field examination(s)		Q1	5733	0.6722	$55.66	.	$11.14					
92082	Visual field examination(s)		Q1	5733	0.6722	$55.66	.	$11.14					
92083	Visual field examination(s)		Q1	5734	1.3521	$111.95	.	$22.39					
92100	Serial tonometry exam(s)		N										
92132	Cmptr ophth dx img ant segmt		Q1	5733	0.6722	$55.66	.	$11.14					
92133	Cmptr ophth img optic nerve		Q1	5733	0.6722	$55.66	.	$11.14					
92134	Cptr ophth dx img post segmt		Q1	5733	0.6722	$55.66	.	$11.14					
92136	Ophthalmic biometry		Q1	5734	1.3521	$111.95	.	$22.39					
92145	Corneal hysteresis deter		Q1	5732	0.4087	$33.84	.	$6.77					
92201	Opscpy extnd rta draw uni/bi		Q1	5733	0.6722	$55.66	.	$11.14					
92202	Opscpy extnd on/mac draw		Q1	5733	0.6722	$55.66	.	$11.14					
92227	Img rta detcj/mntr ds staff		Q1	5732	0.4087	$33.84	.	$6.77					
92228	Img rta detc/mntr ds phy/qhp		Q1	5732	0.4087	$33.84	.	$6.77					
92229	Img rta detc/mntr ds poc aly	NC	S	5733	0.6722	$55.66	.	$11.14					
92230	Eye exam with photos		Q1	5723	5.8913	$487.78	.	$97.56					
92235	Fluorescein angrph uni/bi		S	5722	3.1939	$264.45	.	$52.89					
92240	Icg angiography uni/bi		S	5722	3.1939	$264.45	.	$52.89					
92242	Fluorescein icg angiography		S	5722	3.1939	$264.45	.	$52.89					
92250	Eye exam with photos		Q1	5734	1.3521	$111.95	.	$22.39					
92260	Ophthalmoscopy/dynamometry		Q1	5732	0.4087	$33.84	.	$6.77					
92265	Eye muscle evaluation		Q1	5733	0.6722	$55.66	.	$11.14					
92270	Electro-oculography		Q1	5734	1.3521	$111.95	.	$22.39					
92273	Full field erg w/i&r		S	5722	3.1939	$264.45	.	$52.89					
92274	Multifocal erg w/i&r		S	5721	1.6854	$139.55	.	$27.91					
92283	Color vision examination		Q1	5733	0.6722	$55.66	.	$11.14					
92284	Dark adaptation eye exam		Q1	5735	3.2637	$270.22	.	$54.05					
92285	Eye photography		Q1	5733	0.6722	$55.66	.	$11.14					
92286	Internal eye photography		Q1	5734	1.3521	$111.95	.	$22.39					
92287	Internal eye photography		Q1	5734	1.3521	$111.95	.	$22.39					
92310	Contact lens fitting		E1										
92311	Contact lens fitting		Q1	5735	3.2637	$270.22	.	$54.05					
92312	Contact lens fitting		Q1	5734	1.3521	$111.95	.	$22.39					
92313	Contact lens fitting		Q1	5734	1.3521	$111.95	.	$22.39					
92314	Prescription of contact lens		E1										
92315	Rx cntact lens aphakia 1 eye		Q1	5734	1.3521	$111.95	.	$22.39					
92316	Rx cntact lens aphakia 2 eye	CH	Q1	5734	1.3521	$111.95	.	$22.39					
92317	Rx corneoscleral cntact lens		Q1	5732	0.4087	$33.84	.	$6.77					
92325	Modification of contact lens		Q1	5734	1.3521	$111.95	.	$22.39					
92326	Replacement of contact lens		Q1	5733	0.6722	$55.66	.	$11.14					
92340	Fit spectacles monofocal		E1										
92341	Fit spectacles bifocal		E1										
92342	Fit spectacles multifocal		E1										
92352	Fit aphakia spectcl monofocl		Q1	5733	0.6722	$55.66	.	$11.14					
92353	Fit aphakia spectcl multifoc		Q1	5733	0.6722	$55.66	.	$11.14					
92354	Fit spectacles single system		Q1	5732	0.4087	$33.84	.	$6.77					
92355	Fit spectacles compound lens		Q1	5732	0.4087	$33.84	.	$6.77					
92358	Aphakia prosth service temp		Q1	5733	0.6722	$55.66	.	$11.14					
92370	Repair & adjust spectacles		E1										
92371	Repair & adjust spectacles		Q1	5733	0.6722	$55.66	.	$11.14					
92499	Eye service or procedure		Q1	5731	0.2980	$24.67	.	$4.94					
92502	Ear and throat examination		T	5162	5.4635	$452.36	.	$90.48					
92504	Ear microscopy examination		N										
92507	Speech/hearing therapy		A										
92508	Speech/hearing therapy		A										
92511	Nasopharyngoscopy		T	5151	1.9855	$164.39	.	$32.88					
92512	Nasal function studies		S	5722	3.1939	$264.45	.	$52.89					
92516	Facial nerve function test	CH	S	5722	3.1939	$264.45	.	$52.89					
92517	Vemp test i&r cervical	NC	S	5721	1.6854	$139.55	.	$27.91					
92518	Vemp test i&r ocular	NC	S	5721	1.6854	$139.55	.	$27.91					
92519	Vemp tst i&r cervical&ocular	NC	S	5722	3.1939	$264.45	.	$52.89					
92520	Laryngeal function studies		Q1	5734	1.3521	$111.95	.	$22.39					
92521	Evaluation of speech fluency		A										
92522	Evaluate speech production		A										
92523	Speech sound lang comprehen		A										
92524	Behavral qualit analys voice		A										
92526	Oral function therapy		A										
92531	Spontaneous nystagmus study		N										
92532	Positional nystagmus test		N										
92533	Caloric vestibular test		N										
92534	Optokinetic nystagmus test		N										
92537	Caloric vstblr test w/rec		S	5721	1.6854	$139.55	.	$27.91					
92538	Caloric vstblr test w/rec		S	5721	1.6854	$139.55	.	$27.91					
92540	Basic vestibular evaluation		S	5721	1.6854	$139.55	.	$27.91					
92541	Spontaneous nystagmus test		Q1	5734	1.3521	$111.95	.	$22.39					
92542	Positional nystagmus test		Q1	5734	1.3521	$111.95	.	$22.39					
92544	Optokinetic nystagmus test		S	5721	1.6854	$139.55	.	$27.91					
92545	Oscillating tracking test	CH	S	5722	3.1939	$264.45	.	$52.89					
92546	Sinusoidal rotational test		S	5721	1.6854	$139.55	.	$27.91					
92547	Supplemental electrical test		N										
92548	Cdp-sot 6 cond w/i&r		Q1	5734	1.3521	$111.95	.	$22.39					
92549	Cdp-sot 6 cond w/i&r mct&adt		Q1	5734	1.3521	$111.95	.	$22.39					
92550	Tympanometry & reflex thresh		Q1	5721	1.6854	$139.55	.	$27.91					
92551	Pure tone hearing test air		E1										
92552	Pure tone audiometry air		Q1	5734	1.3521	$111.95	.	$22.39					
92553	Audiometry air & bone		Q1	5721	1.6854	$139.55	.	$27.91					
92555	Speech threshold audiometry		Q1	5732	0.4087	$33.84	.	$6.77					
92556	Speech audiometry complete	CH	Q1	5733	0.6722	$55.66	.	$11.14					
92557	Comprehensive hearing test		Q1	5721	1.6854	$139.55	.	$27.91					
92558	Evoked auditory test qual		E1										
92559	Group audiometric testing		E1										
92560	Bekesy audiometry screen		E1										
92561	Bekesy audiometry diagnosis		Q1	5734	1.3521	$111.95	.	$22.39					
92562	Loudness balance test		Q1	5721	1.6854	$139.55	.	$27.91					
92563	Tone decay hearing test		Q1	5732	0.4087	$33.84	.	$6.77					
92564	Sisi hearing test		Q1	5731	0.2980	$24.67	.	$4.94					
92565	Stenger test pure tone		Q1	5732	0.4087	$33.84	.	$6.77					
92567	Tympanometry		Q1	5732	0.4087	$33.84	.	$6.77					
92568	Acoustic refl threshold tst		Q1	5732	0.4087	$33.84	.	$6.77					
92570	Acoustic immitance testing		Q1	5721	1.6854	$139.55	.	$27.91					
92571	Filtered speech hearing test		Q1	5732	0.4087	$33.84	.	$6.77					
92572	Staggered spondaic word test		Q1	5721	1.6854	$139.55	.	$27.91					
92575	Sensorineural acuity test		Q1	5732	0.4087	$33.84	.	$6.77					
92576	Synthetic sentence test		Q1	5732	0.4087	$33.84	.	$6.77					
92577	Stenger test speech		Q1	5723	5.8913	$487.78	.	$97.56					
92579	Visual audiometry (vra)		Q1	5721	1.6854	$139.55	.	$27.91					
92582	Conditioning play audiometry		Q1	5721	1.6854	$139.55	.	$27.91					
92583	Select picture audiometry	CH	Q1	5733	0.6722	$55.66	.	$11.14					
92584	Electrocochleography		S	5721	1.6854	$139.55	.	$27.91					
92585	Auditor evoke potent compre	CH	D										
92586	Auditor evoke potent limit	CH	D										
92587	Evoked auditory test limited		S	5722	3.1939	$264.45	.	$52.89					
92588	Evoked auditory tst complete		S	5722	3.1939	$264.45	.	$52.89					
92590	Hearing aid exam one ear		E1										
92591	Hearing aid exam both ears		E1										
92592	Hearing aid check one ear		E1										
92593	Hearing aid check both ears		E1										
92594	Electro hearng aid test one		E1										
92595	Electro hearng aid tst both		E1										
92596	Ear protector evaluation		Q1	5732	0.4087	$33.84	.	$6.77					
92597	Oral speech device eval		A										
92601	Cochlear implt f/up exam <7		S	5721	1.6854	$139.55	.	$27.91					
92602	Reprogram cochlear implt <7		S	5721	1.6854	$139.55	.	$27.91					
92603	Cochlear implt f/up exam 7/>		S	5721	1.6854	$139.55	.	$27.91					
92604	Reprogram cochlear implt 7/>		S	5721	1.6854	$139.55	.	$27.91					
92605	Ex for nonspeech device rx		A										
92606	Non-speech device service		A										
92607	Ex for speech device rx 1hr		A										
92608	Ex for speech device rx addl		A										
92609	Use of speech device service		A										
92610	Evaluate swallowing function		A										
92611	Motion fluoroscopy/swallow		A										
92612	Endoscopy swallow (fees) vid		A										
92613	Endoscopy swallow (fees) i&r		B										
92614	Laryngoscopic sensory vid		A										
92615	Laryngoscopic sensory i&r		E1										
92616	Fees w/laryngeal sense test		A										
92617	Fees w/laryngeal sense i&r		E1										
92618	Ex for nonspeech dev rx add		A										
92620	Auditory function 60 min		Q1	5721	1.6854	$139.55	.	$27.91					
92621	Auditory function + 15 min		N										
92625	Tinnitus assessment		Q1	5721	1.6854	$139.55	.	$27.91					
92626	Eval aud funcj 1st hour		Q1	5721	1.6854	$139.55	.	$27.91					
92627	Eval aud funcj ea addl 15		N										
92630	Aud rehab pre-ling hear loss		E1										
92633	Aud rehab postling hear loss		E1										
92640	Aud brainstem implt programg		S	5721	1.6854	$139.55	.	$27.91					
92650	Aep scr auditory potential	NC	E1										
92651	Aep hearing status deter i&r	NC	S	5721	1.6854	$139.55	.	$27.91					
92652	Aep thrshld est mlt freq i&r	NC	S	5722	3.1939	$264.45	.	$52.89					
92653	Aep neurodiagnostic i&r	NC	S	5722	3.1939	$264.45	.	$52.89					
92700	Ent procedure/service		Q1	5731	0.2980	$24.67	.	$4.94					
92920	Prq cardiac angioplast 1 art		J1	5192	59.8674	"$4,956.84"	.	$991.37					
92921	Prq cardiac angio addl art		N										
92924	Prq card angio/athrect 1 art		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
92925	Prq card angio/athrect addl		N										
92928	Prq card stent w/angio 1 vsl		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
92929	Prq card stent w/angio addl		N										
92933	Prq card stent/ath/angio		J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
92934	Prq card stent/ath/angio		N										
92937	Prq revasc byp graft 1 vsl		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
92938	Prq revasc byp graft addl		N										
92941	Prq card revasc mi 1 vsl		C										
92943	Prq card revasc chronic 1vsl		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
92944	Prq card revasc chronic addl		N										
92950	Heart/lung resuscitation cpr		S	5722	3.1939	$264.45	.	$52.89					
92953	Temporary external pacing		Q3	5781	6.7866	$561.91	.	$112.39					
92960	Cardioversion electric ext		S	5781	6.7866	$561.91	.	$112.39					
92961	Cardioversion electric int		S	5781	6.7866	$561.91	.	$112.39					
92970	Cardioassist internal		C										
92971	Cardioassist external		C										
92973	Prq coronary mech thrombect		N										
92974	Cath place cardio brachytx		N										
92975	Dissolve clot heart vessel		C										
92977	Dissolve clot heart vessel		T	5694	3.7532	$310.75	.	$62.16					
92978	Endoluminl ivus oct c 1st		N										
92979	Endoluminl ivus oct c ea		N										
92986	Revision of aortic valve		J1	5192	59.8674	"$4,956.84"	.	$991.37					
92987	Revision of mitral valve		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
92990	Revision of pulmonary valve		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
92992	Revision of heart chamber	CH	D										
92993	Revision of heart chamber	CH	D										
92997	Pul art balloon repr percut		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
92998	Pul art balloon repr percut		N										
93000	Electrocardiogram complete		M										
93005	Electrocardiogram tracing		Q1	5733	0.6722	$55.66	.	$11.14					
93010	Electrocardiogram report		B										
93015	Cardiovascular stress test		B										
93016	Cardiovascular stress test		B										
93017	Cardiovascular stress test		Q1	5722	3.1939	$264.45	.	$52.89					
93018	Cardiovascular stress test		B										
93024	Cardiac drug stress test		Q1	5735	3.2637	$270.22	.	$54.05					
93025	Microvolt t-wave assess		S	5721	1.6854	$139.55	.	$27.91					
93040	Rhythm ecg with report		B										
93041	Rhythm ecg tracing		Q1	5733	0.6722	$55.66	.	$11.14					
93042	Rhythm ecg report		B										
93050	Art pressure waveform analys		Q1	5731	0.2980	$24.67	.	$4.94					
93224	Ecg monit/reprt up to 48 hrs		M										
93225	Ecg monit/reprt up to 48 hrs		Q1	5734	1.3521	$111.95	.	$22.39					
93226	Ecg monit/reprt up to 48 hrs		Q1	5734	1.3521	$111.95	.	$22.39					
93227	Ecg monit/reprt up to 48 hrs		M										
93228	Remote 30 day ecg rev/report		M										
93229	Remote 30 day ecg tech supp		S	5721	1.6854	$139.55	.	$27.91					
93241	Ext ecg>48hr<7d rec scan a/r	NC	M										
93242	Ext ecg>48hr<7d recording	NC	Q1	5732	0.4087	$33.84	.	$6.77					
93243	Ext ecg>48hr<7d scan a/r	NC	Q1	5733	0.6722	$55.66	.	$11.14					
93244	Ext ecg>48hr<7d rev&interpj	NC	M										
93245	Ext ecg>7d<15d rec scan a/r	NC	M										
93246	Ext ecg>7d<15d recording	NC	Q1	5733	0.6722	$55.66	.	$11.14					
93247	Ext ecg>7d<15d scan a/r	NC	Q1	5734	1.3521	$111.95	.	$22.39					
93248	Ext ecg>7d<15d rev&interpj	NC	M										
93260	Prgrmg dev eval impltbl sys		Q1	5741	0.4487	$37.15	.	$7.44					
93261	Interrogate subq defib		Q1	5741	0.4487	$37.15	.	$7.44					
93264	Rem mntr wrls p-art prs snr		M										
93268	Ecg record/review		M										
93270	Remote 30 day ecg rev/report		Q1	5741	0.4487	$37.15	.	$7.44					
93271	Ecg/monitoring and analysis		S	5742	1.2115	$100.31	.	$20.07					
93272	Ecg/review interpret only		M										
93278	Ecg/signal-averaged		Q1	5733	0.6722	$55.66	.	$11.14					
93279	Prgrmg dev eval pm/ldls pm		Q1	5741	0.4487	$37.15	.	$7.44					
93280	Pm device progr eval dual		Q1	5741	0.4487	$37.15	.	$7.44					
93281	Pm device progr eval multi		Q1	5741	0.4487	$37.15	.	$7.44					
93282	Prgrmg eval implantable dfb		Q1	5741	0.4487	$37.15	.	$7.44					
93283	Prgrmg eval implantable dfb		Q1	5741	0.4487	$37.15	.	$7.44					
93284	Prgrmg eval implantable dfb		Q1	5741	0.4487	$37.15	.	$7.44					
93285	Prgrmg dev eval scrms ip		Q1	5741	0.4487	$37.15	.	$7.44					
93286	Peri-px eval pm/ldls pm ip		N										
93287	Peri-px device eval & prgr		N										
93288	Interrog evl pm/ldls pm ip		Q1	5741	0.4487	$37.15	.	$7.44					
93289	Interrog device eval heart		Q1	5741	0.4487	$37.15	.	$7.44					
93290	Interrog dev eval icpms ip		Q1	5741	0.4487	$37.15	.	$7.44					
93291	Interrog dev eval scrms ip		Q1	5731	0.2980	$24.67	.	$4.94					
93292	Wcd device interrogate		Q1	5741	0.4487	$37.15	.	$7.44					
93293	Pm phone r-strip device eval		Q1	5741	0.4487	$37.15	.	$7.44					
93294	Rem interrog evl pm/ldls pm		M										
93295	Dev interrog remote 1/2/mlt		M										
93296	Rem interrog evl pm/ids		Q1	5741	0.4487	$37.15	.	$7.44					
93297	Rem interrog dev eval icpms		M										
93298	Rem interrog dev eval scrms		M										
93303	Echo transthoracic		S	5524	5.8322	$482.89	.	$96.58					
93304	Echo transthoracic		S	5524	5.8322	$482.89	.	$96.58					
93306	Tte w/doppler complete		S	5524	5.8322	$482.89	.	$96.58					
93307	Tte w/o doppler complete		S	5523	2.7794	$230.13	.	$46.03					
93308	Tte f-up or lmtd		S	5523	2.7794	$230.13	.	$46.03					
93312	Echo transesophageal		S	5524	5.8322	$482.89	.	$96.58					
93313	Echo transesophageal		S	5524	5.8322	$482.89	.	$96.58					
93314	Echo transesophageal		N										
93315	Echo transesophageal		S	5524	5.8322	$482.89	.	$96.58					
93316	Echo transesophageal		S	5524	5.8322	$482.89	.	$96.58					
93317	Echo transesophageal		N										
93318	Echo transesophageal intraop		S	5524	5.8322	$482.89	.	$96.58					
93320	Doppler echo exam heart		N										
93321	Doppler echo exam heart		N										
93325	Doppler color flow add-on		N										
93350	Stress tte only		S	5524	5.8322	$482.89	.	$96.58					
93351	Stress tte complete		S	5524	5.8322	$482.89	.	$96.58					
93352	Admin ecg contrast agent		M										
93355	Echo transesophageal (tee)		N										
93356	Myocrd strain img spckl trck		N										
93451	Right heart cath		J1	5191	35.0136	"$2,899.02"	$864.64	$579.81					
93452	Left hrt cath w/ventrclgrphy		J1	5191	35.0136	"$2,899.02"	$864.64	$579.81					
93453	R&l hrt cath w/ventriclgrphy		J1	5191	35.0136	"$2,899.02"	$864.64	$579.81					
93454	Coronary artery angio s&i		J1	5191	35.0136	"$2,899.02"	$864.64	$579.81					
93455	Coronary art/grft angio s&i		J1	5191	35.0136	"$2,899.02"	$864.64	$579.81					
93456	R hrt coronary artery angio		J1	5191	35.0136	"$2,899.02"	$864.64	$579.81					
93457	R hrt art/grft angio		J1	5191	35.0136	"$2,899.02"	$864.64	$579.81					
93458	L hrt artery/ventricle angio		J1	5191	35.0136	"$2,899.02"	$864.64	$579.81					
93459	L hrt art/grft angio		J1	5191	35.0136	"$2,899.02"	$864.64	$579.81					
93460	R&l hrt art/ventricle angio		J1	5191	35.0136	"$2,899.02"	$864.64	$579.81					
93461	R&l hrt art/ventricle angio		J1	5191	35.0136	"$2,899.02"	$864.64	$579.81					
93462	L hrt cath trnsptl puncture		N										
93463	Drug admin & hemodynmic meas		N										
93464	Exercise w/hemodynamic meas		N										
93503	Insert/place heart catheter		J1	5182	16.9830	"$1,406.14"	.	$281.23					
93505	Biopsy of heart lining		J1	5183	34.5624	"$2,861.66"	.	$572.34					
93530	Rt heart cath congenital		J1	5191	35.0136	"$2,899.02"	$864.64	$579.81					
93531	R & l heart cath congenital		J1	5191	35.0136	"$2,899.02"	$864.64	$579.81					
93532	R & l heart cath congenital		J1	5191	35.0136	"$2,899.02"	$864.64	$579.81					
93533	R & l heart cath congenital		J1	5191	35.0136	"$2,899.02"	$864.64	$579.81					
93561	Cardiac output measurement		N										
93562	Card output measure subsq		N										
93563	Inject congenital card cath		N										
93564	Inject hrt congntl art/grft		N										
93565	Inject l ventr/atrial angio		N										
93566	Inject r ventr/atrial angio		N										
93567	Inject suprvlv aortography		N										
93568	Inject pulm art hrt cath		N										
93571	Heart flow reserve measure		N										
93572	Heart flow reserve measure		N										
93580	Transcath closure of asd		J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
93581	Transcath closure of vsd		J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
93582	Perq transcath closure pda		J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
93583	Perq transcath septal reduxn		C										
93590	Perq transcath cls mitral		J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
93591	Perq transcath cls aortic		J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
93592	Perq transcath closure each		N										
93600	Bundle of his recording		J1	5212	73.4142	"$6,078.48"	.	"$1,215.70"					
93602	Intra-atrial recording		J1	5212	73.4142	"$6,078.48"	.	"$1,215.70"					
93603	Right ventricular recording		J1	5211	13.4398	"$1,112.78"	.	$222.56					
93609	Map tachycardia add-on		N										
93610	Intra-atrial pacing		J1	5212	73.4142	"$6,078.48"	.	"$1,215.70"					
93612	Intraventricular pacing		J1	5212	73.4142	"$6,078.48"	.	"$1,215.70"					
93613	Electrophys map 3d add-on		N										
93615	Esophageal recording		J1	5211	13.4398	"$1,112.78"	.	$222.56					
93616	Esophageal recording		J1	5211	13.4398	"$1,112.78"	.	$222.56					
93618	Heart rhythm pacing		J1	5211	13.4398	"$1,112.78"	.	$222.56					
93619	Electrophysiology evaluation		J1	5212	73.4142	"$6,078.48"	.	"$1,215.70"					
93620	Electrophysiology evaluation		J1	5212	73.4142	"$6,078.48"	.	"$1,215.70"					
93621	Electrophysiology evaluation		N										
93622	Electrophysiology evaluation		N										
93623	Stimulation pacing heart		N										
93624	Electrophysiologic study		J1	5212	73.4142	"$6,078.48"	.	"$1,215.70"					
93631	Heart pacing mapping		N										
93640	Evaluation heart device		N										
93641	Electrophysiology evaluation		N										
93642	Electrophysiology evaluation		J1	5211	13.4398	"$1,112.78"	.	$222.56					
93644	Electrophysiology evaluation		N										
93650	Ablate heart dysrhythm focus		J1	5212	73.4142	"$6,078.48"	.	"$1,215.70"					
93653	Ep & ablate supravent arrhyt		J1	5213	259.2414	"$21,464.41"	.	"$4,292.89"	*				
93654	Ep & ablate ventric tachy		J1	5213	259.2414	"$21,464.41"	.	"$4,292.89"	*				
93655	Ablate arrhythmia add on		N										
93656	Tx atrial fib pulm vein isol		J1	5213	259.2414	"$21,464.41"	.	"$4,292.89"	*				
93657	Tx l/r atrial fib addl		N										
93660	Tilt table evaluation		S	5723	5.8913	$487.78	.	$97.56					
93662	Intracardiac ecg (ice)		N										
93668	Peripheral vascular rehab		S	5733	0.6722	$55.66	.	$11.14					
93701	Bioimpedance cv analysis		Q1	5734	1.3521	$111.95	.	$22.39					
93702	Bis xtracell fluid analysis		S	5721	1.6854	$139.55	.	$27.91					
93724	Analyze pacemaker system		S	5743	3.2908	$272.47	.	$54.50					
93740	Temperature gradient studies		Q1	5721	1.6854	$139.55	.	$27.91					
93745	Set-up cardiovert-defibrill		S	5743	3.2908	$272.47	.	$54.50					
93750	Interrogation vad in person		S	5742	1.2115	$100.31	.	$20.07					
93770	Measure venous pressure		N										
93784	Ambl bp mntr w/software		B										
93786	Ambl bp mntr w/sw rec only		Q1	5734	1.3521	$111.95	.	$22.39					
93788	Ambl bp mntr w/sw a/r		Q1	5734	1.3521	$111.95	.	$22.39					
93790	Ambl bp mntr w/sw i&r		M										
93792	Pt/caregiver traing home inr		B										
93793	Anticoag mgmt pt warfarin		B										
93797	Cardiac rehab		S	5771	1.4018	$116.06	.	$23.22					
93798	Cardiac rehab/monitor		S	5771	1.4018	$116.06	.	$23.22					
93799	Cardiovascular procedure		S	5721	1.6854	$139.55	.	$27.91					
93880	Extracranial bilat study		S	5523	2.7794	$230.13	.	$46.03					
93882	Extracranial uni/ltd study		S	5522	1.3161	$108.97	.	$21.80					
93886	Intracranial complete study		S	5523	2.7794	$230.13	.	$46.03					
93888	Intracranial limited study		S	5522	1.3161	$108.97	.	$21.80					
93890	Tcd vasoreactivity study		Q1	5523	2.7794	$230.13	.	$46.03					
93892	Tcd emboli detect w/o inj		Q1	5522	1.3161	$108.97	.	$21.80					
93893	Tcd emboli detect w/inj		Q1	5522	1.3161	$108.97	.	$21.80					
93895	Carotid intima atheroma eval		E1										
93922	Upr/l xtremity art 2 levels		Q1	5734	1.3521	$111.95	.	$22.39					
93923	Upr/lxtr art stdy 3+ lvls		S	5721	1.6854	$139.55	.	$27.91					
93924	Lwr xtr vasc stdy bilat	CH	S	5722	3.1939	$264.45	.	$52.89					
93925	Lower extremity study		S	5523	2.7794	$230.13	.	$46.03					
93926	Lower extremity study		S	5522	1.3161	$108.97	.	$21.80					
93930	Upper extremity study		S	5523	2.7794	$230.13	.	$46.03					
93931	Upper extremity study		S	5522	1.3161	$108.97	.	$21.80					
93970	Extremity study		S	5523	2.7794	$230.13	.	$46.03					
93971	Extremity study		S	5522	1.3161	$108.97	.	$21.80					
93975	Vascular study		S	5523	2.7794	$230.13	.	$46.03					
93976	Vascular study		S	5522	1.3161	$108.97	.	$21.80					
93978	Vascular study		S	5523	2.7794	$230.13	.	$46.03					
93979	Vascular study		Q1	5522	1.3161	$108.97	.	$21.80					
93980	Penile vascular study		S	5522	1.3161	$108.97	.	$21.80					
93981	Penile vascular study		S	5522	1.3161	$108.97	.	$21.80					
93985	Dup-scan hemo compl bi std		S	5523	2.7794	$230.13	.	$46.03					
93986	Dup-scan hemo compl uni std		S	5522	1.3161	$108.97	.	$21.80					
93990	Doppler flow testing		Q1	5522	1.3161	$108.97	.	$21.80					
93998	Noninvas vasc dx study proc		Q1	5731	0.2980	$24.67	.	$4.94					
94002	Vent mgmt inpat init day		Q3	5801	5.8609	$485.26	.	$97.06					
94003	Vent mgmt inpat subq day		Q3	5801	5.8609	$485.26	.	$97.06					
94004	Vent mgmt nf per day		B										
94005	Home vent mgmt supervision		M										
94010	Breathing capacity test		Q1	5721	1.6854	$139.55	.	$27.91					
94011	Spirometry up to 2 yrs old		Q1	5721	1.6854	$139.55	.	$27.91					
94012	Spirmtry w/brnchdil inf-2 yr		Q1	5722	3.1939	$264.45	.	$52.89					
94013	Meas lung vol thru 2 yrs		S	5723	5.8913	$487.78	.	$97.56					
94014	Patient recorded spirometry		Q1	5735	3.2637	$270.22	.	$54.05					
94015	Patient recorded spirometry		Q1	5722	3.1939	$264.45	.	$52.89					
94016	Review patient spirometry		A										
94060	Evaluation of wheezing		S	5722	3.1939	$264.45	.	$52.89					
94070	Evaluation of wheezing		S	5722	3.1939	$264.45	.	$52.89					
94150	Vital capacity test		Q1	5721	1.6854	$139.55	.	$27.91					
94200	Lung function test (mbc/mvv)		Q1	5733	0.6722	$55.66	.	$11.14					
94250	Expired gas collection	CH	D										
94375	Respiratory flow volume loop		Q1	5722	3.1939	$264.45	.	$52.89					
94400	Co2 breathing response curve	CH	D										
94450	Hypoxia response curve	CH	Q1	5722	3.1939	$264.45	.	$52.89					
94452	Hast w/report		Q1	5734	1.3521	$111.95	.	$22.39					
94453	Hast w/oxygen titrate		Q1	5734	1.3521	$111.95	.	$22.39					
94610	Surfactant admin thru tube		Q1	5791	2.2692	$187.88	.	$37.58					
94617	Exercise tst brncspsm w/ecg		Q1	5734	1.3521	$111.95	.	$22.39					
94618	Pulmonary stress testing		Q1	5734	1.3521	$111.95	.	$22.39					
94619	Exercise tst brncspsm wo ecg	NC	Q1	5733	0.6722	$55.66	.	$11.14					
94621	Cardiopulm exercise testing		S	5722	3.1939	$264.45	.	$52.89					
94640	Airway inhalation treatment		Q1	5791	2.2692	$187.88	.	$37.58					
94642	Aerosol inhalation treatment		Q1	5791	2.2692	$187.88	.	$37.58					
94644	Cbt 1st hour		Q1	5734	1.3521	$111.95	.	$22.39					
94645	Cbt each addl hour		N										
94660	Pos airway pressure cpap		Q1 	5791	2.2692	$187.88	.	$37.58					
94662	Neg press ventilation cnp		Q3	5801	5.8609	$485.26	.	$97.06					
94664	Evaluate pt use of inhaler		Q1	5791	2.2692	$187.88	.	$37.58					
94667	Chest wall manipulation		Q1	5734	1.3521	$111.95	.	$22.39					
94668	Chest wall manipulation		Q1	5734	1.3521	$111.95	.	$22.39					
94669	Mechanical chest wall oscill		Q1	5791	2.2692	$187.88	.	$37.58					
94680	Exhaled air analysis o2		Q1	5721	1.6854	$139.55	.	$27.91					
94681	Exhaled air analysis o2/co2		Q1	5722	3.1939	$264.45	.	$52.89					
94690	Exhaled air analysis	CH	Q1	5733	0.6722	$55.66	.	$11.14					
94726	Pulm funct tst plethysmograp		Q1	5722	3.1939	$264.45	.	$52.89					
94727	Pulm function test by gas		Q1	5721	1.6854	$139.55	.	$27.91					
94728	Airwy resist by oscillometry		Q1	5722	3.1939	$264.45	.	$52.89					
94729	Co/membane diffuse capacity		N										
94750	Pulmonary compliance study	CH	D										
94760	Measure blood oxygen level		N										
94761	Measure blood oxygen level		N										
94762	Measure blood oxygen level		Q3	5721	1.6854	$139.55	.	$27.91					
94770	Exhaled carbon dioxide test	CH	D										
94772	Breath recording infant		S	5723	5.8913	$487.78	.	$97.56					
94774	Ped home apnea rec compl		B										
94775	Ped home apnea rec hk-up		S	5721	1.6854	$139.55	.	$27.91					
94776	Ped home apnea rec downld		S	5721	1.6854	$139.55	.	$27.91					
94777	Ped home apnea rec report		B										
94780	Cars/bd tst inft-12mo 60 min		Q1	5732	0.4087	$33.84	.	$6.77					
94781	Cars/bd tst inft-12mo +30min		N										
94799	Pulmonary service/procedure		Q1	5721	1.6854	$139.55	.	$27.91					
95004	Percut allergy skin tests		Q1	5724	11.1093	$919.82	.	$183.97					
95012	Exhaled nitric oxide meas		Q1	5732	0.4087	$33.84	.	$6.77					
95017	Perq & icut allg test venoms		Q1	5731	0.2980	$24.67	.	$4.94					
95018	Perq&ic allg test drugs/biol		Q1	5732	0.4087	$33.84	.	$6.77					
95024	Icut allergy test drug/bug		Q1	5733	0.6722	$55.66	.	$11.14					
95027	Icut allergy titrate-airborn		Q1	5731	0.2980	$24.67	.	$4.94					
95028	Icut allergy test-delayed		Q1	5732	0.4087	$33.84	.	$6.77					
95044	Allergy patch tests		Q1	5724	11.1093	$919.82	.	$183.97					
95052	Photo patch test	CH	Q1	5733	0.6722	$55.66	.	$11.14					
95056	Photosensitivity tests		Q1	5734	1.3521	$111.95	.	$22.39					
95060	Eye allergy tests		Q1	5734	1.3521	$111.95	.	$22.39					
95065	Nose allergy test		Q1	5732	0.4087	$33.84	.	$6.77					
95070	Bronchial allergy tests		S	5723	5.8913	$487.78	.	$97.56					
95071	Bronchial allergy tests	CH	D										
95076	Ingest challenge ini 120 min		S	5723	5.8913	$487.78	.	$97.56					
95079	Ingest challenge addl 60 min		N										
95115	Immunotherapy one injection		Q1	5691	0.4831	$40.00	.	$8.00					
95117	Immunotherapy injections		Q1	5691	0.4831	$40.00	.	$8.00					
95120	Immunotherapy one injection		E1										
95125	Immunotherapy 2/> injections		E1										
95130	Immntx 1 sting insect		E1										
95131	Immntx 2 sting insects		E1										
95132	Immntx 3 sting insects		E1										
95133	Immntx 4 sting insects		E1										
95134	Immntx 5 sting insects		E1										
95144	Antigen therapy services		Q1	5691	0.4831	$40.00	.	$8.00					
95145	Antigen therapy services		Q1	5691	0.4831	$40.00	.	$8.00					
95146	Antigen therapy services		Q1	5691	0.4831	$40.00	.	$8.00					
95147	Antigen therapy services		Q1	5692	0.7485	$61.97	.	$12.40					
95148	Antigen therapy services		Q1	5692	0.7485	$61.97	.	$12.40					
95149	Antigen therapy services		Q1	5692	0.7485	$61.97	.	$12.40					
95165	Antigen therapy services		Q1	5691	0.4831	$40.00	.	$8.00					
95170	Antigen therapy services		Q1	5691	0.4831	$40.00	.	$8.00					
95180	Rapid desensitization		Q1	5735	3.2637	$270.22	.	$54.05					
95199	Allergy immunology services		Q1	5731	0.2980	$24.67	.	$4.94					
95249	Cont gluc mntr pt prov eqp		S	5733	0.6722	$55.66	.	$11.14					
95250	Cont gluc mntr phys/qhp eqp		V	5012	1.4341	$118.74	.	$23.75					
95251	Cont gluc mntr analysis i&r		B										
95700	Eeg cont rec w/vid eeg tech		S	5722	3.1939	$264.45	.	$52.89					
95705	Eeg w/o vid 2-12 hr unmntr		S	5722	3.1939	$264.45	.	$52.89					
95706	Eeg wo vid 2-12hr intmt mntr		S	5722	3.1939	$264.45	.	$52.89					
95707	Eeg w/o vid 2-12hr cont mntr		S	5722	3.1939	$264.45	.	$52.89					
95708	Eeg wo vid ea 12-26hr unmntr		S	5723	5.8913	$487.78	.	$97.56					
95709	Eeg w/o vid ea 12-26hr intmt		S	5723	5.8913	$487.78	.	$97.56					
95710	Eeg w/o vid ea 12-26hr cont		S	5723	5.8913	$487.78	.	$97.56					
95711	Veeg 2-12 hr unmonitored		S	5722	3.1939	$264.45	.	$52.89					
95712	Veeg 2-12 hr intmt mntr		S	5722	3.1939	$264.45	.	$52.89					
95713	Veeg 2-12 hr cont mntr		S	5723	5.8913	$487.78	.	$97.56					
95714	Veeg ea 12-26 hr unmntr		S	5723	5.8913	$487.78	.	$97.56					
95715	Veeg ea 12-26hr intmt mntr		S	5723	5.8913	$487.78	.	$97.56					
95716	Veeg ea 12-26hr cont mntr		S	5724	11.1093	$919.82	.	$183.97					
95717	Eeg phys/qhp 2-12 hr w/o vid		M										
95718	Eeg phys/qhp 2-12 hr w/veeg		M										
95719	Eeg phys/qhp ea incr w/o vid		M										
95720	Eeg phy/qhp ea incr w/veeg		M										
95721	Eeg phy/qhp>36<60 hr w/o vid		M										
95722	Eeg phy/qhp>36<60 hr w/veeg		M										
95723	Eeg phy/qhp>60<84 hr w/o vid		M										
95724	Eeg phy/qhp>60<84 hr w/veeg		M										
95725	Eeg phy/qhp>84 hr w/o vid		M										
95726	Eeg phy/qhp>84 hr w/veeg		M										
95782	Polysom <6 yrs 4/> paramtrs		S	5724	11.1093	$919.82	.	$183.97					
95783	Polysom <6 yrs cpap/bilvl		S	5724	11.1093	$919.82	.	$183.97					
95800	Slp stdy unattended		S	5721	1.6854	$139.55	.	$27.91					
95801	Slp stdy unatnd w/anal		Q1	5734	1.3521	$111.95	.	$22.39					
95803	Actigraphy testing		Q1	5733	0.6722	$55.66	.	$11.14					
95805	Multiple sleep latency test		S	5723	5.8913	$487.78	.	$97.56					
95806	Sleep study unatt&resp efft		S	5721	1.6854	$139.55	.	$27.91					
95807	Sleep study attended		S	5723	5.8913	$487.78	.	$97.56					
95808	Polysom any age 1-3> param		S	5724	11.1093	$919.82	.	$183.97					
95810	Polysom 6/> yrs 4/> param		S	5724	11.1093	$919.82	.	$183.97					
95811	Polysom 6/>yrs cpap 4/> parm		S	5724	11.1093	$919.82	.	$183.97					
95812	Eeg 41-60 minutes		S	5722	3.1939	$264.45	.	$52.89					
95813	Eeg extnd mntr 61-119 min		S	5722	3.1939	$264.45	.	$52.89					
95816	Eeg awake and drowsy		S	5722	3.1939	$264.45	.	$52.89					
95819	Eeg awake and asleep		S	5722	3.1939	$264.45	.	$52.89					
95822	Eeg coma or sleep only		S	5722	3.1939	$264.45	.	$52.89					
95824	Eeg cerebral death only		S	5723	5.8913	$487.78	.	$97.56					
95829	Surgery electrocorticogram		N										
95830	Insert electrodes for eeg		B										
95836	Ecog impltd brn npgt <30 d		Q1	5741	0.4487	$37.15	.	$7.44					
95851	Range of motion measurements		A										
95852	Range of motion measurements		A										
95857	Cholinesterase challenge		S	5722	3.1939	$264.45	.	$52.89					
95860	Muscle test one limb		Q1	5734	1.3521	$111.95	.	$22.39					
95861	Muscle test 2 limbs		Q1	5734	1.3521	$111.95	.	$22.39					
95863	Muscle test 3 limbs		S	5721	1.6854	$139.55	.	$27.91					
95864	Muscle test 4 limbs		S	5721	1.6854	$139.55	.	$27.91					
95865	Muscle test larynx		Q1	5734	1.3521	$111.95	.	$22.39					
95866	Muscle test hemidiaphragm		Q1	5721	1.6854	$139.55	.	$27.91					
95867	Muscle test cran nerv unilat	CH	S	5722	3.1939	$264.45	.	$52.89					
95868	Muscle test cran nerve bilat	CH	S	5722	3.1939	$264.45	.	$52.89					
95869	Muscle test thor paraspinal		Q1	5721	1.6854	$139.55	.	$27.91					
95870	Muscle test nonparaspinal	CH	Q1	5734	1.3521	$111.95	.	$22.39					
95872	Muscle test one fiber		S	5721	1.6854	$139.55	.	$27.91					
95873	Guide nerv destr elec stim		N										
95874	Guide nerv destr needle emg		N										
95875	Limb exercise test		S	5721	1.6854	$139.55	.	$27.91					
95885	Musc tst done w/nerv tst lim		N										
95886	Musc test done w/n test comp		N										
95887	Musc tst done w/n tst nonext		N										
95905	Motor &/ sens nrve cndj test	CH	Q1	5735	3.2637	$270.22	.	$54.05					
95907	Nvr cndj tst 1-2 studies		S	5721	1.6854	$139.55	.	$27.91					
95908	Nrv cndj tst 3-4 studies		S	5722	3.1939	$264.45	.	$52.89					
95909	Nrv cndj tst 5-6 studies		S	5722	3.1939	$264.45	.	$52.89					
95910	Nrv cndj test 7-8 studies		S	5722	3.1939	$264.45	.	$52.89					
95911	Nrv cndj test 9-10 studies		S	5723	5.8913	$487.78	.	$97.56					
95912	Nrv cndj test 11-12 studies		S	5723	5.8913	$487.78	.	$97.56					
95913	Nrv cndj test 13/> studies		S	5723	5.8913	$487.78	.	$97.56					
95921	Autonomic nrv parasym inervj		S	5721	1.6854	$139.55	.	$27.91					
95922	Autonomic nrv adrenrg inervj		Q1	5734	1.3521	$111.95	.	$22.39					
95923	Autonomic nrv syst funj test		Q1	5734	1.3521	$111.95	.	$22.39					
95924	Ans parasymp & symp w/tilt	CH	S	5722	3.1939	$264.45	.	$52.89					
95925	Somatosensory testing		S	5722	3.1939	$264.45	.	$52.89					
95926	Somatosensory testing		S	5722	3.1939	$264.45	.	$52.89					
95927	Somatosensory testing	CH	S	5722	3.1939	$264.45	.	$52.89					
95928	C motor evoked uppr limbs		S	5724	11.1093	$919.82	.	$183.97					
95929	C motor evoked lwr limbs		S	5723	5.8913	$487.78	.	$97.56					
95930	Visual ep test cns w/i&r	CH	S	5722	3.1939	$264.45	.	$52.89					
95933	Blink reflex test		Q1	5733	0.6722	$55.66	.	$11.14					
95937	Neuromuscular junction test		S	5721	1.6854	$139.55	.	$27.91					
95938	Somatosensory testing		S	5723	5.8913	$487.78	.	$97.56					
95939	C motor evoked upr&lwr limbs		S	5724	11.1093	$919.82	.	$183.97					
95940	Ionm in operatng room 15 min		N										
95941	Ionm remote/>1 pt or per hr		N										
95943	Parasymp&symp hrt rate test		S	5721	1.6854	$139.55	.	$27.91					
95954	Eeg monitoring/giving drugs		S	5723	5.8913	$487.78	.	$97.56					
95955	Eeg during surgery		N										
95957	Eeg digital analysis		N										
95958	Eeg monitoring/function test		S	5724	11.1093	$919.82	.	$183.97					
95961	Electrode stimulation brain		S	5724	11.1093	$919.82	.	$183.97					
95962	Electrode stim brain add-on		N										
95965	Meg spontaneous		S	5724	11.1093	$919.82	.	$183.97					
95966	Meg evoked single		S	5724	11.1093	$919.82	.	$183.97					
95967	Meg evoked each addl		N										
95970	Alys npgt w/o prgrmg		Q1	5734	1.3521	$111.95	.	$22.39					
95971	Alys smpl sp/pn npgt w/prgrm		S	5742	1.2115	$100.31	.	$20.07					
95972	Alys cplx sp/pn npgt w/prgrm		S	5742	1.2115	$100.31	.	$20.07					
95976	Alys smpl cn npgt prgrmg		S	5741	0.4487	$37.15	.	$7.44					
95977	Alys cplx cn npgt prgrmg		S	5742	1.2115	$100.31	.	$20.07					
95980	Io anal gast n-stim init		N										
95981	Io anal gast n-stim subsq		Q1	5734	1.3521	$111.95	.	$22.39					
95982	Io ga n-stim subsq w/reprog		Q1	5741	0.4487	$37.15	.	$7.44					
95983	Alys brn npgt prgrmg 15 min		S	5742	1.2115	$100.31	.	$20.07					
95984	Alys brn npgt prgrmg addl 15		N										
95990	Spin/brain pump refil & main		S	5694	3.7532	$310.75	.	$62.16					
95991	Spin/brain pump refil & main		T	5441	3.1543	$261.17	.	$52.24					
95992	Canalith repositioning proc		A										
95999	Neurological procedure		Q1	5721	1.6854	$139.55	.	$27.91					
96000	Motion analysis video/3d		S	5723	5.8913	$487.78	.	$97.56					
96001	Motion test w/ft press meas		S	5724	11.1093	$919.82	.	$183.97					
96002	Dynamic surface emg		S	5721	1.6854	$139.55	.	$27.91					
96003	Dynamic fine wire emg		Q1	5722	3.1939	$264.45	.	$52.89					
96004	Phys review of motion tests		B										
96020	Functional brain mapping		N										
96040	Genetic counseling 30 min		B										
96105	Assessment of aphasia		A										
96110	Developmental screen w/score		E1										
96112	Devel tst phys/qhp 1st hr	CH	Q3	5722	3.1939	$264.45	.	$52.89					
96113	Devel tst phys/qhp ea addl		N 										
96116	Nubhvl xm phys/qhp 1st hr		Q3	5722	3.1939	$264.45	.	$52.89					
96121	Nubhvl xm phy/qhp ea addl hr		N 										
96125	Cognitive test by hc pro		A										
96127	Brief emotional/behav assmt		Q1	5732	0.4087	$33.84	.	$6.77					
96130	Psycl tst eval phys/qhp 1st	CH	Q3	5722	3.1939	$264.45	.	$52.89					
96131	Psycl tst eval phys/qhp ea		N 										
96132	Nrpsyc tst eval phys/qhp 1st	CH	Q3	5722	3.1939	$264.45	.	$52.89					
96133	Nrpsyc tst eval phys/qhp ea		N 										
96136	Psycl/nrpsyc tst phy/qhp 1st	CH	Q3	5734	1.3521	$111.95	.	$22.39					
96137	Psycl/nrpsyc tst phy/qhp ea		N 										
96138	Psycl/nrpsyc tech 1st	CH	Q3	5735	3.2637	$270.22	.	$54.05					
96139	Psycl/nrpsyc tst tech ea		N										
96146	Psycl/nrpsyc tst auto result		Q3	5731	0.2980	$24.67	.	$4.94					
96156	Hlth bhv assmt/reassessment		Q3	5822	0.9043	$74.87	.	$14.98					
96158	Hlth bhv ivntj indiv 1st 30		Q3	5822	0.9043	$74.87	.	$14.98					
96159	Hlth bhv ivntj indiv ea addl		N										
96160	Pt-focused hlth risk assmt		S	5821	0.3168	$26.23	.	$5.25					
96161	Caregiver health risk assmt		S	5821	0.3168	$26.23	.	$5.25					
96164	Hlth bhv ivntj grp 1st 30		Q3	5821	0.3168	$26.23	.	$5.25					
96165	Hlth bhv ivntj grp ea addl		N										
96167	Hlth bhv ivntj fam 1st 30		Q3	5821	0.3168	$26.23	.	$5.25					
96168	Hlth bhv ivntj fam ea addl		N										
96170	Hlth bhv ivntj fam wo pt 1st		E1										
96171	Hlth bhv ivntj fam w/o pt ea		E1										
96360	Hydration iv infusion init		S	5693	2.4578	$203.50	.	$40.70					
96361	Hydrate iv infusion add-on		S	5691	0.4831	$40.00	.	$8.00					
96365	Ther/proph/diag iv inf init		S	5693	2.4578	$203.50	.	$40.70					
96366	Ther/proph/diag iv inf addon		S	5691	0.4831	$40.00	.	$8.00					
96367	Tx/proph/dg addl seq iv inf		S	5692	0.7485	$61.97	.	$12.40					
96368	Ther/diag concurrent inf		N										
96369	Sc ther infusion up to 1 hr		S	5693	2.4578	$203.50	.	$40.70					
96370	Sc ther infusion addl hr		S	5691	0.4831	$40.00	.	$8.00					
96371	Sc ther infusion reset pump		Q1	5692 	0.7485	$61.97	.	$12.40					
96372	Ther/proph/diag inj sc/im		Q1	5692	0.7485	$61.97	.	$12.40					
96373	Ther/proph/diag inj ia		S	5693	2.4578	$203.50	.	$40.70					
96374	Ther/proph/diag inj iv push		S	5693	2.4578	$203.50	.	$40.70					
96375	Tx/pro/dx inj new drug addon		S	5691	0.4831	$40.00	.	$8.00					
96376	Tx/pro/dx inj same drug adon		N										
96377	Applicaton on-body injector		Q1	5691	0.4831	$40.00	.	$8.00					
96379	Ther/prop/diag inj/inf proc		Q1	5691	0.4831	$40.00	.	$8.00					
96401	Chemo anti-neopl sq/im		Q1	5692	0.7485	$61.97	.	$12.40					
96402	Chemo hormon antineopl sq/im		Q1	5692	0.7485	$61.97	.	$12.40					
96405	Chemo intralesional up to 7		Q1	5692	0.7485	$61.97	.	$12.40					
96406	Chemo intralesional over 7		S	5693	2.4578	$203.50	.	$40.70					
96409	Chemo iv push sngl drug		S	5693	2.4578	$203.50	.	$40.70					
96411	Chemo iv push addl drug		S	5692	0.7485	$61.97	.	$12.40					
96413	Chemo iv infusion 1 hr		S	5694	3.7532	$310.75	.	$62.16					
96415	Chemo iv infusion addl hr		S	5692	0.7485	$61.97	.	$12.40					
96416	Chemo prolong infuse w/pump		S	5694	3.7532	$310.75	.	$62.16					
96417	Chemo iv infus each addl seq		S	5692	0.7485	$61.97	.	$12.40					
96420	Chemo ia push tecnique		S	5694	3.7532	$310.75	.	$62.16					
96422	Chemo ia infusion up to 1 hr		S	5693	2.4578	$203.50	.	$40.70					
96423	Chemo ia infuse each addl hr		S	5691	0.4831	$40.00	.	$8.00					
96425	Chemotherapy infusion method		S	5694	3.7532	$310.75	.	$62.16					
96440	Chemotherapy intracavitary		S	5694	3.7532	$310.75	.	$62.16					
96446	Chemotx admn prtl cavity		S	5694	3.7532	$310.75	.	$62.16					
96450	Chemotherapy into cns		S	5694	3.7532	$310.75	.	$62.16					
96521	Refill/maint portable pump		S	5693	2.4578	$203.50	.	$40.70					
96522	Refill/maint pump/resvr syst		S	5693	2.4578	$203.50	.	$40.70					
96523	Irrig drug delivery device		Q1	5733	0.6722	$55.66	.	$11.14					
96542	Chemotherapy injection		S	5693	2.4578	$203.50	.	$40.70					
96549	Chemotherapy unspecified		Q1	5691	0.4831	$40.00	.	$8.00					
96567	Pdt dstr prmlg les skn		Q1	5051	2.1685	$179.55	.	$35.91					
96570	Photodynmc tx 30 min add-on		N										
96571	Photodynamic tx addl 15 min		N										
96573	Pdt dstr prmlg les phys/qhp		Q1	5051	2.1685	$179.55	.	$35.91					
96574	Dbrdmt prmlg les w/pdt		Q1	5051	2.1685	$179.55	.	$35.91					
96900	Ultraviolet light therapy		Q1	5732	0.4087	$33.84	.	$6.77					
96902	Trichogram		N										
96904	Whole body photography		N										
96910	Photochemotherapy with uv-b		Q1	5733	0.6722	$55.66	.	$11.14					
96912	Photochemotherapy with uv-a		Q1	5733	0.6722	$55.66	.	$11.14					
96913	Photochemotherapy uv-a or b		T	5052	4.1770	$345.84	.	$69.17					
96920	Laser tx skin < 250 sq cm		Q1	5051	2.1685	$179.55	.	$35.91					
96921	Laser tx skin 250-500 sq cm		Q1	5051	2.1685	$179.55	.	$35.91					
96922	Laser tx skin >500 sq cm		Q1	5052	4.1770	$345.84	.	$69.17					
96931	Rcm celulr subcelulr img skn		M										
96932	Rcm celulr subcelulr img skn		N										
96933	Rcm celulr subcelulr img skn		B										
96934	Rcm celulr subcelulr img skn		N										
96935	Rcm celulr subcelulr img skn		N										
96936	Rcm celulr subcelulr img skn		N										
96999	Dermatological procedure		Q1	5051	2.1685	$179.55	.	$35.91					
97010	Hot or cold packs therapy		A										
97012	Mechanical traction therapy		A										
97014	Electric stimulation therapy		E1										
97016	Vasopneumatic device therapy		A										
97018	Paraffin bath therapy		A										
97022	Whirlpool therapy		A										
97024	Diathermy eg microwave		A										
97026	Infrared therapy		A										
97028	Ultraviolet therapy		A										
97032	Electrical stimulation		A										
97033	Electric current therapy		A										
97034	Contrast bath therapy		A										
97035	Ultrasound therapy		A										
97036	Hydrotherapy		A										
97039	Physical therapy treatment		A										
97110	Therapeutic exercises		A										
97112	Neuromuscular reeducation		A										
97113	Aquatic therapy/exercises		A										
97116	Gait training therapy		A										
97124	Massage therapy		A										
97129	Ther ivntj 1st 15 min		A										
97130	Ther ivntj ea addl 15 min		A										
97139	Physical medicine procedure		A										
97140	Manual therapy 1/> regions		A										
97150	Group therapeutic procedures		A										
97151	Bhv id assmt by phys/qhp	CH	Q3	5822	0.9043	$74.87	.	$14.98					
97152	Bhv id suprt assmt by 1 tech	CH	Q3	5822	0.9043	$74.87	.	$14.98					
97153	Adaptive behavior tx by tech	CH	Q3	5822	0.9043	$74.87	.	$14.98					
97154	Grp adapt bhv tx by tech		Q3	5821	0.3168	$26.23	.	$5.25					
97155	Adapt behavior tx phys/qhp	CH	Q3	5822	0.9043	$74.87	.	$14.98					
97156	Fam adapt bhv tx gdn phy/qhp		Q3	5821	0.3168	$26.23	.	$5.25					
97157	Mult fam adapt bhv tx gdn		Q3	5821	0.3168	$26.23	.	$5.25					
97158	Grp adapt bhv tx by phy/qhp		Q3	5821	0.3168	$26.23	.	$5.25					
97161	Pt eval low complex 20 min		A										
97162	Pt eval mod complex 30 min		A										
97163	Pt eval high complex 45 min		A										
97164	Pt re-eval est plan care		A										
97165	Ot eval low complex 30 min		A										
97166	Ot eval mod complex 45 min		A										
97167	Ot eval high complex 60 min		A										
97168	Ot re-eval est plan care		A										
97169	Athletic trn eval low cmplx		E1										
97170	Athletic trn eval mod cmplx		E1										
97171	Athletic trn eval high cmplx		E1										
97172	Athletic trn re-eval plan cr		E1										
97530	Therapeutic activities		A										
97533	Sensory integration		A										
97535	Self care mngment training		A										
97537	Community/work reintegration		A										
97542	Wheelchair mngment training		A										
97545	Work hardening		A										
97546	Work hardening add-on		A										
97597	Rmvl devital tis 20 cm/<		T	5051	2.1685	$179.55	.	$35.91					
97598	Rmvl devital tis addl 20cm/<		N										
97602	Wound(s) care non-selective		Q1	5051	2.1685	$179.55	.	$35.91					
97605	Neg press wound tx <=50 cm		Q1	5051	2.1685	$179.55	.	$35.91					
97606	Neg press wound tx >50 cm		Q1	5052	4.1770	$345.84	.	$69.17					
97607	Neg press wnd tx <=50 sq cm		T	5052	4.1770	$345.84	.	$69.17					
97608	Neg press wound tx >50 cm		T	5052	4.1770	$345.84	.	$69.17					
97610	Low frequency non-thermal us		Q1	5051	2.1685	$179.55	.	$35.91					
97750	Physical performance test		A										
97755	Assistive technology assess		A										
97760	Orthotic mgmt&traing 1st enc		A										
97761	Prosthetic traing 1st enc		A										
97763	Orthc/prostc mgmt sbsq enc		A										
97799	Physical medicine procedure		A										
97802	Medical nutrition indiv in		A										
97803	Med nutrition indiv subseq		A										
97804	Medical nutrition group		A										
97810	Acupunct w/o stimul 15 min	CH	S	5731	0.2980	$24.67	.	$4.94					
97811	Acupunct w/o stimul addl 15m	CH	N 										
97813	Acupunct w/stimul 15 min	CH	S	5731	0.2980	$24.67	.	$4.94					
97814	Acupunct w/stimul addl 15m	CH	N 										
98925	Osteopath manj 1-2 regions		Q1	5811	0.3207	$26.55	.	$5.32					
98926	Osteopath manj 3-4 regions		Q1	5811	0.3207	$26.55	.	$5.32					
98927	Osteopath manj 5-6 regions		Q1	5811	0.3207	$26.55	.	$5.32					
98928	Osteopath manj 7-8 regions		Q1	5811	0.3207	$26.55	.	$5.32					
98929	Osteopath manj 9-10 regions		Q1	5811	0.3207	$26.55	.	$5.32					
98940	Chiropract manj 1-2 regions		Q1	5811	0.3207	$26.55	.	$5.32					
98941	Chiropract manj 3-4 regions		Q1	5811	0.3207	$26.55	.	$5.32					
98942	Chiropractic manj 5 regions		Q1	5811	0.3207	$26.55	.	$5.32					
98943	Chiropract manj xtrspinl 1/>		E1										
98960	Self-mgmt educ & train 1 pt		E1										
98961	Self-mgmt educ/train 2-4 pt		E1										
98962	Self-mgmt educ/train 5-8 pt		E1										
98966	Hc pro phone call 5-10 min	CH	A										
98967	Hc pro phone call 11-20 min	CH	A										
98968	Hc pro phone call 21-30 min	CH	A										
98970	Qnhp ol dig assmt&mgmt 5-10	CH	A										
98971	Qnhp ol dig assmt&mgmt 11-20	CH	A										
98972	Qnhp ol dig assmt&mgmt 21+	CH	A										
99000	Specimen handling office-lab		E1										
99001	Specimen handling pt-lab		E1										
99002	Device handling phys/qhp		B										
99024	Postop follow-up visit		B										
99026	In-hospital on call service		E1										
99027	Out-of-hosp on call service		E1										
99050	Medical services after hrs		B										
99051	Med serv eve/wkend/holiday		B										
99053	Med serv 10pm-8am 24 hr fac		B										
99056	Med service out of office		B										
99058	Office emergency care		B										
99060	Out of office emerg med serv		B										
99070	Special supplies phys/qhp		B										
99071	Patient education materials		B										
99072	Addl supl matrl&staf tm phe 	NI	B										
99075	Medical testimony		E1										
99078	Group health education		N										
99080	Special reports or forms		B										
99082	Unusual physician travel		B										
99091	Collj & interpj data ea 30 d		N										
99100	Special anesthesia service		B										
99116	Anesthesia with hypothermia		B										
99135	Special anesthesia procedure		B										
99140	Emergency anesthesia		B										
99151	Mod sed same phys/qhp <5 yrs		N										
99152	Mod sed same phys/qhp 5/>yrs		N										
99153	Mod sed same phys/qhp ea		N										
99155	Mod sed oth phys/qhp <5 yrs		N										
99156	Mod sed oth phys/qhp 5/>yrs		N										
99157	Mod sed other phys/qhp ea		N										
99170	Anogenital exam child w imag		T	5411	2.0571	$170.32	.	$34.07					
99172	Ocular function screen		E1										
99173	Visual acuity screen		E1										
99174	Ocular instrumnt screen bil		E1										
99175	Induction of vomiting		N										
99177	Ocular instrumnt screen bil		E1										
99183	Hyperbaric oxygen therapy		B										
99184	Hypothermia ill neonate		C										
99188	App topical fluoride varnish		E1										
99190	Special pump services		C										
99191	Special pump services		C										
99192	Special pump services		C										
99195	Phlebotomy		Q1	5734	1.3521	$111.95	.	$22.39					
99199	Special service/proc/report		B										
99201	Office/outpatient visit new	CH	D										
99202	Office o/p new sf 15-29 min		B										
99203	Office o/p new low 30-44 min		B										
99204	Office o/p new mod 45-59 min		B										
99205	Office o/p new hi 60-74 min		B										
99211	Office o/p est minimal prob		B										
99212	Office o/p est sf 10-19 min		B										
99213	Office o/p est low 20-29 min		B										
99214	Office o/p est mod 30-39 min		B										
99215	Office o/p est hi 40-54 min		B										
99217	Observation care discharge		B										
99218	Initial observation care		B										
99219	Initial observation care		B										
99220	Initial observation care		B										
99221	Initial hospital care		B										
99222	Initial hospital care		B										
99223	Initial hospital care		B										
99224	Subsequent observation care		B										
99225	Subsequent observation care		B										
99226	Subsequent observation care		B										
99231	Subsequent hospital care		B										
99232	Subsequent hospital care		B										
99233	Subsequent hospital care		B										
99234	Observ/hosp same date		B										
99235	Observ/hosp same date		B										
99236	Observ/hosp same date		B										
99238	Hospital discharge day		B										
99239	Hospital discharge day		B										
99241	Office consultation		E1										
99242	Office consultation		E1										
99243	Office consultation		E1										
99244	Office consultation		E1										
99245	Office consultation		E1										
99251	Inpatient consultation		E1										
99252	Inpatient consultation		E1										
99253	Inpatient consultation		E1										
99254	Inpatient consultation		E1										
99255	Inpatient consultation		E1										
99281	Emergency dept visit		J2	5021	0.8768	$72.60	.	$14.52					
99282	Emergency dept visit		J2	5022	1.5893	$131.59	.	$26.32					
99283	Emergency dept visit		J2	5023	2.7972	$231.60	.	$46.32					
99284	Emergency dept visit		J2	5024	4.3931	$363.74	.	$72.75					
99285	Emergency dept visit		J2	5025	6.3060	$522.12	.	$104.43					
99288	Direct advanced life support		B										
99291	Critical care first hour		J2	5041	8.3660	$692.68	.	$138.54					
99292	Critical care addl 30 min		N										
99304	Nursing facility care init		B										
99305	Nursing facility care init		B										
99306	Nursing facility care init		B										
99307	Nursing fac care subseq		B										
99308	Nursing fac care subseq		B										
99309	Nursing fac care subseq		B										
99310	Nursing fac care subseq		B										
99315	Nursing fac discharge day		B										
99316	Nursing fac discharge day		B										
99318	Annual nursing fac assessmnt		B										
99324	Domicil/r-home visit new pat		B										
99325	Domicil/r-home visit new pat		B										
99326	Domicil/r-home visit new pat		B										
99327	Domicil/r-home visit new pat		B										
99328	Domicil/r-home visit new pat		B										
99334	Domicil/r-home visit est pat		B										
99335	Domicil/r-home visit est pat		B										
99336	Domicil/r-home visit est pat		B										
99337	Domicil/r-home visit est pat		B										
99339	Domicil/r-home care supervis		B										
99340	Domicil/r-home care supervis		B										
99341	Home visit new patient		B										
99342	Home visit new patient		B										
99343	Home visit new patient		B										
99344	Home visit new patient		B										
99345	Home visit new patient		B										
99347	Home visit est patient		B										
99348	Home visit est patient		B										
99349	Home visit est patient		B										
99350	Home visit est patient		B										
99354	Prolng svc o/p 1st hour		N										
99355	Prolng svc o/p ea addl 30		N										
99356	Prolng svc i/p/obs 1st hour		C										
99357	Prolng svc i/p/obs ea addl		C										
99358	Prolong service w/o contact		N										
99359	Prolong serv w/o contact add		N										
99360	Physician standby services		B										
99366	Team conf w/pat by hc prof		N										
99367	Team conf w/o pat by phys		N										
99368	Team conf w/o pat by hc pro		N										
99374	Home health care supervision		B										
99375	Home health care supervision		E1										
99377	Hospice care supervision		B										
99378	Hospice care supervision		E1										
99379	Nursing fac care supervision		B										
99380	Nursing fac care supervision		B										
99381	Init pm e/m new pat infant		E1										
99382	Init pm e/m new pat 1-4 yrs		E1										
99383	Prev visit new age 5-11		E1										
99384	Prev visit new age 12-17		E1										
99385	Prev visit new age 18-39		E1										
99386	Prev visit new age 40-64		E1										
99387	Init pm e/m new pat 65+ yrs		E1										
99391	Per pm reeval est pat infant		E1										
99392	Prev visit est age 1-4		E1										
99393	Prev visit est age 5-11		E1										
99394	Prev visit est age 12-17		E1										
99395	Prev visit est age 18-39		E1										
99396	Prev visit est age 40-64		E1										
99397	Per pm reeval est pat 65+ yr		E1										
99401	Preventive counseling indiv		E1										
99402	Preventive counseling indiv		E1										
99403	Preventive counseling indiv		E1										
99404	Preventive counseling indiv		E1										
99406	Behav chng smoking 3-10 min		S	5821	0.3168	$26.23	$0.00	$0.00					
99407	Behav chng smoking > 10 min		S	5821	0.3168	$26.23	$0.00	$0.00					
99408	Audit/dast 15-30 min		E1										
99409	Audit/dast over 30 min		E1										
99411	Preventive counseling group		E1										
99412	Preventive counseling group		E1										
99415	Prolng clin staff svc 1st hr	NI	B										
99416	Prolng clin staff svc ea add	NI	B										
99417	Prolng off/op e/m ea 15 min	NC	E1										
99421	Ol dig e/m svc 5-10 min	CH	B										
99422	Ol dig e/m svc 11-20 min	CH	B										
99423	Ol dig e/m svc 21+ min	CH	B										
99429	Unlisted preventive service		E1										
99439	Chrnc care mgmt svc ea addl	NC	N										
99441	Phone e/m phys/qhp 5-10 min	CH	B										
99442	Phone e/m phys/qhp 11-20 min	CH	B										
99443	Phone e/m phys/qhp 21-30 min	CH	B										
99446	Ntrprof ph1/ntrnet/ehr 5-10		M										
99447	Ntrprof ph1/ntrnet/ehr 11-20		M										
99448	Ntrprof ph1/ntrnet/ehr 21-30		M										
99449	Ntrprof ph1/ntrnet/ehr 31/>		M										
99450	Basic life disability exam		E1										
99451	Ntrprof ph1/ntrnet/ehr 5/>		M										
99452	Ntrprof ph1/ntrnet/ehr rfrl		M										
99453	Rem mntr physiol param setup		V	5012	1.4341	$118.74	.	$23.75					
99454	Rem mntr physiol param dev		Q1	5741	0.4487	$37.15	.	$7.44					
99455	Work related disability exam		B										
99456	Disability examination		B										
99457	Rem physiol mntr 1st 20 min	CH	B										
99458	Rem physiol mntr ea addl 20	CH	B										
99460	Init nb em per day hosp		V	5012	1.4341	$118.74	.	$23.75					
99461	Init nb em per day non-fac		M										
99462	Sbsq nb em per day hosp		C										
99463	Same day nb discharge		V	5012	1.4341	$118.74	.	$23.75					
99464	Attendance at delivery		N										
99465	Nb resuscitation		S	5781	6.7866	$561.91	.	$112.39					
99466	Ped crit care transport		N										
99467	Ped crit care transport addl		N										
99468	Neonate crit care initial		C										
99469	Neonate crit care subsq		C										
99471	Ped critical care initial		C										
99472	Ped critical care subsq		C										
99473	Self-meas bp pt educaj/train		Q1	5731	0.2980	$24.67	.	$4.94					
99474	Self-meas bp 2 readg bid 30d	CH	B										
99475	Ped crit care age 2-5 init		C										
99476	Ped crit care age 2-5 subsq		C										
99477	Init day hosp neonate care		C										
99478	Ic lbw inf < 1500 gm subsq		C										
99479	Ic lbw inf 1500-2500 g subsq		C										
99480	Ic inf pbw 2501-5000 g subsq		C										
99483	Assmt & care pln pt cog imp		S	5822	0.9043	$74.87	.	$14.98					
99484	Care mgmt svc bhvl hlth cond		S	5821	0.3168	$26.23	.	$5.25					
99485	Suprv interfacilty transport		B										
99486	Suprv interfac trnsport addl		B										
99487	Cplx chrnc care 1st 60 min	CH	S	5823	1.6139	$133.63	.	$26.73					
99489	Cplx chrnc care ea addl 30		N										
99490	Chrnc care mgmt svc 1st 20		S	5822	0.9043	$74.87	.	$14.98					
99491	Chrnc care mgmt svc 30 min		M										
99492	1st psyc collab care mgmt		S	5822	0.9043	$74.87	.	$14.98					
99493	Sbsq psyc collab care mgmt		S	5822	0.9043	$74.87	.	$14.98					
99494	1st/sbsq psyc collab care		N										
99495	Trans care mgmt 14 day disch		V	5012	1.4341	$118.74	.	$23.75					
99496	Trans care mgmt 7 day disch		V	5012	1.4341	$118.74	.	$23.75					
99497	Advncd care plan 30 min		Q1	5822	0.9043	$74.87	.	$14.98					
99498	Advncd care plan addl 30 min		N										
99499	Unlisted e&m service		B										
99500	Home visit prenatal		E1										
99501	Home visit postnatal		E1										
99502	Home visit nb care		E1										
99503	Home visit resp therapy		E1										
99504	Home visit mech ventilator		E1										
99505	Home visit stoma care		E1										
99506	Home visit im injection		E1										
99507	Home visit cath maintain		E1										
99509	Home visit day life activity		E1										
99510	Home visit sing/m/fam couns		E1										
99511	Home visit fecal/enema mgmt		E1										
99512	Home visit for hemodialysis		E1										
99600	Home visit nos		E1										
99601	Home infusion/visit 2 hrs		E1										
99602	Home infusion each addtl hr		E1										
99605	Mtms by pharm np 15 min		E1										
99606	Mtms by pharm est 15 min		E1										
99607	Mtms by pharm addl 15 min		E1										
A0021	Outside state ambulance serv		E1										
A0080	Noninterest escort in non er		E1										
A0090	Interest escort in non er		E1										
A0100	Nonemergency transport taxi		E1										
A0110	Nonemergency transport bus		E1										
A0120	Noner transport mini-bus		E1										
A0130	Noner transport wheelch van		E1										
A0140	Nonemergency transport air		E1										
A0160	Noner transport case worker		E1										
A0170	Transport parking fees/tolls		E1										
A0180	Noner transport lodgng recip		E1										
A0190	Noner transport meals recip		E1										
A0200	Noner transport lodgng escrt		E1										
A0210	Noner transport meals escort		E1										
A0225	Neonatal emergency transport		E1										
A0380	Basic life support mileage		E1										
A0382	Basic support routine suppls		E1										
A0384	Bls defibrillation supplies		E1										
A0390	Advanced life support mileag		E1										
A0392	Als defibrillation supplies		E1										
A0394	Als iv drug therapy supplies		E1										
A0396	Als esophageal intub suppls		E1										
A0398	Als routine disposble suppls		E1										
A0420	Ambulance waiting 1/2 hr		E1										
A0422	Ambulance 02 life sustaining		E1										
A0424	Extra ambulance attendant		E1										
A0425	Ground mileage		A										
A0426	Als 1		A										
A0427	Als1-emergency		A										
A0428	Bls		A										
A0429	Bls-emergency		A										
A0430	Fixed wing air transport		A										
A0431	Rotary wing air transport		A										
A0432	Pi volunteer ambulance co		A										
A0433	Als 2		A										
A0434	Specialty care transport		A										
A0435	Fixed wing air mileage		A										
A0436	Rotary wing air mileage		A										
A0888	Noncovered ambulance mileage		E1										
A0998	Ambulance response/treatment		E1										
A0999	Unlisted ambulance service		A										
A4206	1 cc sterile syringe&needle		N										
A4207	2 cc sterile syringe&needle		N										
A4208	3 cc sterile syringe&needle		N										
A4209	5+ cc sterile syringe&needle		N										
A4210	Nonneedle injection device		E1										
A4211	Supp for self-adm injections		N										
A4212	Non coring needle or stylet		N										
A4213	20+ cc syringe only		N										
A4215	Sterile needle		N										
A4216	"Sterile water/saline, 10 ml"		N										
A4217	"Sterile water/saline, 500 ml"		N										
A4218	Sterile saline or water		N										
A4220	Infusion pump refill kit		N										
A4221	Supp non-insulin inf cath/wk		N										
A4222	Infusion supplies with pump		N										
A4223	Infusion supplies w/o pump		N										
A4224	Supply insulin inf cath/wk		N										
A4225	Sup/ext insulin inf pump syr		N										
A4226	Weekly supply maint cgs pump		E1										
A4230	Infus insulin pump non needl		N										
A4231	Infusion insulin pump needle		N										
A4232	Syringe w/needle insulin 3cc		E1										
A4233	Alkalin batt for glucose mon		E1										
A4234	J-cell batt for glucose mon		E1										
A4235	Lithium batt for glucose mon		E1										
A4236	Silvr oxide batt glucose mon		E1										
A4244	Alcohol or peroxide per pint		N										
A4245	Alcohol wipes per box		N										
A4246	Betadine/phisohex solution		N										
A4247	Betadine/iodine swabs/wipes		N										
A4248	Chlorhexidine antisept		N										
A4250	Urine reagent strips/tablets		E1										
A4252	Blood ketone test or strip		E1										
A4253	Blood glucose/reagent strips		N										
A4255	Glucose monitor platforms		N										
A4256	Calibrator solution/chips		N										
A4257	Replace lensshield cartridge		E1										
A4258	Lancet device each		N										
A4259	Lancets per box		N										
A4261	Cervical cap contraceptive		E1										
A4262	Temporary tear duct plug		N										
A4263	Permanent tear duct plug		N										
A4264	Intratubal occlusion device		E1										
A4265	Paraffin		N										
A4266	Diaphragm		E1										
A4267	Male condom		E1										
A4268	Female condom		E1										
A4269	Spermicide		E1										
A4270	Disposable endoscope sheath		N										
A4280	Brst prsths adhsv attchmnt		N										
A4281	Replacement breastpump tube		E1										
A4282	Replacement breastpump adpt		E1										
A4283	Replacement breastpump cap		E1										
A4284	Replcmnt breast pump shield		E1										
A4285	Replcmnt breast pump bottle		E1										
A4286	Replcmnt breastpump lok ring		E1										
A4290	Sacral nerve stim test lead		N										
A4300	Cath impl vasc access portal		N										
A4301	Implantable access syst perc		N										
A4305	Drug delivery system >=50 ml		N										
A4306	Drug delivery system <=50 ml		N										
A4310	Insert tray w/o bag/cath		N										
A4311	Catheter w/o bag 2-way latex		N										
A4312	Cath w/o bag 2-way silicone		N										
A4313	Catheter w/bag 3-way		N										
A4314	Cath w/drainage 2-way latex		N										
A4315	Cath w/drainage 2-way silcne		N										
A4316	Cath w/drainage 3-way		N										
A4320	Irrigation tray		N										
A4321	Cath therapeutic irrig agent		N										
A4322	Irrigation syringe		N										
A4326	Male external catheter		N										
A4327	Fem urinary collect dev cup		N										
A4328	Fem urinary collect pouch		N										
A4330	Stool collection pouch		N										
A4331	Extension drainage tubing		N										
A4332	Lube sterile packet		N										
A4333	Urinary cath anchor device		N										
A4334	Urinary cath leg strap		N										
A4335	Incontinence supply		N										
A4336	Urethral insert		N										
A4337	Incontinent rectal insert		N										
A4338	Indwelling catheter latex		N										
A4340	Indwelling catheter special		N										
A4344	Cath indw foley 2 way silicn		N										
A4346	Cath indw foley 3 way		N										
A4349	Disposable male external cat		N										
A4351	Straight tip urine catheter		N										
A4352	Coude tip urinary catheter		N										
A4353	Intermittent urinary cath		N										
A4354	Cath insertion tray w/bag		N										
A4355	Bladder irrigation tubing		N										
A4356	Ext ureth clmp or compr dvc		N										
A4357	Bedside drainage bag		N										
A4358	Urinary leg or abdomen bag		N										
A4360	Disposable ext urethral dev		N										
A4361	Ostomy face plate		N										
A4362	Solid skin barrier		N										
A4363	"Ostomy clamp, replacement"		E1										
A4364	"Adhesive, liquid or equal"		N										
A4366	Ostomy vent		N										
A4367	Ostomy belt		N										
A4368	Ostomy filter		N										
A4369	Skin barrier liquid per oz		N										
A4371	Skin barrier powder per oz		N										
A4372	Skin barrier solid 4x4 equiv		N										
A4373	Skin barrier with flange		N										
A4375	Drainable plastic pch w fcpl		N										
A4376	Drainable rubber pch w fcplt		N										
A4377	Drainable plstic pch w/o fp		N										
A4378	Drainable rubber pch w/o fp		N										
A4379	Urinary plastic pouch w fcpl		N										
A4380	Urinary rubber pouch w fcplt		N										
A4381	Urinary plastic pouch w/o fp		N										
A4382	Urinary hvy plstc pch w/o fp		N										
A4383	Urinary rubber pouch w/o fp		N										
A4384	Ostomy faceplt/silicone ring		N										
A4385	Ost skn barrier sld ext wear		N										
A4387	Ost clsd pouch w att st barr		N										
A4388	Drainable pch w ex wear barr		N										
A4389	Drainable pch w st wear barr		N										
A4390	Drainable pch ex wear convex		N										
A4391	Urinary pouch w ex wear barr		N										
A4392	Urinary pouch w st wear barr		N										
A4393	Urine pch w ex wear bar conv		N										
A4394	Ostomy pouch liq deodorant		N										
A4395	Ostomy pouch solid deodorant		N										
A4396	Peristomal hernia supprt blt		N										
A4397	Irrigation supply sleeve		N										
A4398	Ostomy irrigation bag		N										
A4399	Ostomy irrig cone/cath w brs		N										
A4400	Ostomy irrigation set		N										
A4402	Lubricant per ounce		N										
A4404	Ostomy ring each		N										
A4405	Nonpectin based ostomy paste		N										
A4406	Pectin based ostomy paste		N										
A4407	"Ext wear ost skn barr <=4sq"""		N										
A4408	"Ext wear ost skn barr >4sq"""		N										
A4409	Ost skn barr convex <=4 sq i		N										
A4410	Ost skn barr extnd >4 sq		N										
A4411	Ost skn barr extnd =4sq		N										
A4412	Ost pouch drain high output		N										
A4413	2 pc drainable ost pouch		N										
A4414	Ost sknbar w/o conv<=4 sq in		N										
A4415	Ost skn barr w/o conv >4 sqi		N										
A4416	Ost pch clsd w barrier/filtr		N										
A4417	Ost pch w bar/bltinconv/fltr		N										
A4418	Ost pch clsd w/o bar w filtr		N										
A4419	Ost pch for bar w flange/flt		N										
A4420	Ost pch clsd for bar w lk fl		N										
A4421	Ostomy supply misc		N										
A4422	Ost pouch absorbent material		N										
A4423	Ost pch for bar w lk fl/fltr		N										
A4424	Ost pch drain w bar & filter		N										
A4425	Ost pch drain for barrier fl		N										
A4426	Ost pch drain 2 piece system		N										
A4427	Ost pch drain/barr lk flng/f		N										
A4428	Urine ost pouch w faucet/tap		N										
A4429	Urine ost pouch w bltinconv		N										
A4430	Ost urine pch w b/bltin conv		N										
A4431	Ost pch urine w barrier/tapv		N										
A4432	Os pch urine w bar/fange/tap		N										
A4433	Urine ost pch bar w lock fln		N										
A4434	Ost pch urine w lock flng/ft		N										
A4435	1pc ost pch drain hgh output		N										
A4450	Non-waterproof tape		N										
A4452	Waterproof tape		N										
A4455	Adhesive remover per ounce		N										
A4456	"Adhesive remover, wipes"		N										
A4458	Reusable enema bag		N										
A4459	"Manual pump enema, reusable"		N										
A4461	Surgicl dress hold non-reuse		N										
A4463	Surgical dress holder reuse		N										
A4465	Non-elastic extremity binder		N										
A4467	Belt strap sleev grmnt cover		E1										
A4470	Gravlee jet washer		N										
A4480	Vabra aspirator		N										
A4481	Tracheostoma filter		N										
A4483	Moisture exchanger		N										
A4490	Above knee surgical stocking		E1										
A4495	Thigh length surg stocking		E1										
A4500	Below knee surgical stocking		E1										
A4510	Full length surg stocking		E1										
A4520	Incontinence garment anytype		E1										
A4550	Surgical trays		B										
A4553	"Nondisp underpads, all sizes"		E1										
A4554	Disposable underpads		E1										
A4555	Ca tx e-stim electr/transduc		E1										
A4556	"Electrodes, pair"		N										
A4557	"Lead wires, pair"		N										
A4558	Conductive gel or paste		N										
A4559	Coupling gel or paste		N										
A4561	"Pessary rubber, any type"		N										
A4562	"Pessary, non rubber,any type"		N										
A4563	Vag inser rectal control sys		A										
A4565	Slings		N										
A4566	Should sling/vest/abrestrain		E1										
A4570	Splint		E1										
A4575	Hyperbaric o2 chamber disps		A										
A4580	Cast supplies (plaster)		E1										
A4590	Special casting material		E1										
A4595	Tens suppl 2 lead per month		N										
A4600	"Sleeve, inter limb comp dev"		E1										
A4601	Lith ion non prosth recharge		E1										
A4602	Replace lithium battery 1.5v		N										
A4604	Tubing with heating element		N										
A4605	Trach suction cath close sys		N										
A4606	Oxygen probe used w oximeter		N										
A4608	Transtracheal oxygen cath		N										
A4611	Heavy duty battery		E1										
A4612	Battery cables		E1										
A4613	Battery charger		E1										
A4614	Hand-held pefr meter		N										
A4615	Cannula nasal		N										
A4616	Tubing (oxygen) per foot		N										
A4617	Mouth piece		N										
A4618	Breathing circuits		N										
A4619	Face tent		N										
A4620	Variable concentration mask		N										
A4623	Tracheostomy inner cannula		N										
A4624	Tracheal suction tube		N										
A4625	Trach care kit for new trach		N										
A4626	Tracheostomy cleaning brush		N										
A4627	Spacer bag/reservoir		E1										
A4628	Oropharyngeal suction cath		N										
A4629	Tracheostomy care kit		N										
A4630	Repl bat t.e.n.s. own by pt		E1										
A4633	Uvl replacement bulb		E1										
A4634	Replacement bulb th lightbox		N										
A4635	Underarm crutch pad		E1										
A4636	Handgrip for cane etc		E1										
A4637	Repl tip cane/crutch/walker		E1										
A4638	Repl batt pulse gen sys		E1										
A4639	Infrared ht sys replcmnt pad		E1										
A4640	Alternating pressure pad		E1										
A4641	Radiopharm dx agent noc		N										
A4642	In111 satumomab		N										
A4648	Implantable tissue marker		N										
A4649	Surgical supplies		N										
A4650	Implant radiation dosimeter		N										
A4651	Calibrated microcap tube		N										
A4652	Microcapillary tube sealant		N										
A4653	Pd catheter anchor belt		N										
A4657	Syringe w/wo needle		N										
A4660	Sphyg/bp app w cuff and stet		N										
A4663	Dialysis blood pressure cuff		N										
A4670	"Automatic bp monitor, dial"		E1										
A4671	Disposable cycler set		B										
A4672	"Drainage ext line, dialysis"		B										
A4673	Ext line w easy lock connect		B										
A4674	"Chem/antisept solution, 8oz"		B										
A4680	"Activated carbon filter, ea"		N										
A4690	"Dialyzer, each"		N										
A4706	Bicarbonate conc sol per gal		N										
A4707	Bicarbonate conc pow per pac		N										
A4708	Acetate conc sol per gallon		N										
A4709	Acid conc sol per gallon		N										
A4714	Treated water per gallon		N										
A4719	"""y set"" tubing"		N										
A4720	Dialysat sol fld vol > 249cc		N										
A4721	Dialysat sol fld vol > 999cc		N										
A4722	Dialys sol fld vol > 1999cc		N										
A4723	Dialys sol fld vol > 2999cc		N										
A4724	Dialys sol fld vol > 3999cc		N										
A4725	Dialys sol fld vol > 4999cc		N										
A4726	Dialys sol fld vol > 5999cc		N										
A4728	"Dialysate solution, non-dex"		B										
A4730	"Fistula cannulation set, ea"		N										
A4736	"Topical anesthetic, per gram"		N										
A4737	Inj anesthetic per 10 ml		N										
A4740	Shunt accessory		N										
A4750	Art or venous blood tubing		N										
A4755	Comb art/venous blood tubing		N										
A4760	"Dialysate sol test kit, each"		N										
A4765	Dialysate conc pow per pack		N										
A4766	Dialysate conc sol add 10 ml		N										
A4770	Blood collection tube/vacuum		N										
A4771	Serum clotting time tube		N										
A4772	Blood glucose test strips		N										
A4773	Occult blood test strips		N										
A4774	Ammonia test strips		N										
A4802	Protamine sulfate per 50 mg		N										
A4860	Disposable catheter tips		N										
A4870	Plumb/elec wk hm hemo equip		N										
A4890	Repair/maint cont hemo equip		N										
A4911	Drain bag/bottle		N										
A4913	Misc dialysis supplies noc		N										
A4918	Venous pressure clamp		N										
A4927	Non-sterile gloves		N										
A4928	Surgical mask		N										
A4929	"Tourniquet for dialysis, ea"		N										
A4930	"Sterile, gloves per pair"		N										
A4931	Reusable oral thermometer		N										
A4932	Reusable rectal thermometer		N										
A5051	Pouch clsd w barr attached		N										
A5052	Clsd ostomy pouch w/o barr		N										
A5053	Clsd ostomy pouch faceplate		N										
A5054	Clsd ostomy pouch w/flange		N										
A5055	Stoma cap		N										
A5056	1 pc ost pouch w filter		N										
A5057	1 pc ost pou w built-in conv		N										
A5061	Pouch drainable w barrier at		N										
A5062	Drnble ostomy pouch w/o barr		N										
A5063	Drain ostomy pouch w/flange		N										
A5071	Urinary pouch w/barrier		N										
A5072	Urinary pouch w/o barrier		N										
A5073	Urinary pouch on barr w/flng		N										
A5081	"Stoma plug or seal, any type"		N										
A5082	Continent stoma catheter		N										
A5083	Stoma absorptive cover		N										
A5093	Ostomy accessory convex inse		N										
A5102	Bedside drain btl w/wo tube		N										
A5105	Urinary suspensory		N										
A5112	Urinary leg bag		N										
A5113	Latex leg strap		E1										
A5114	Foam/fabric leg strap		E1										
A5120	"Skin barrier, wipe or swab"		N										
A5121	Solid skin barrier 6x6		N										
A5122	Solid skin barrier 8x8		N										
A5126	Disk/foam pad +or- adhesive		N										
A5131	Appliance cleaner		N										
A5200	Percutaneous catheter anchor		N										
A5500	Diab shoe for density insert		Y										
A5501	Diabetic custom molded shoe		Y										
A5503	Diabetic shoe w/roller/rockr		Y										
A5504	Diabetic shoe with wedge		Y										
A5505	Diab shoe w/metatarsal bar		Y										
A5506	Diabetic shoe w/off set heel		Y										
A5507	Modification diabetic shoe		Y										
A5508	Diabetic deluxe shoe		Y										
A5510	Compression form shoe insert		N										
A5512	Multi den insert direct form		Y										
A5513	Multi den insert custom mold		Y										
A5514	Mult den insert dir carv/cam		Y										
A6000	Wound warming wound cover		E1										
A6010	Collagen based wound filler		N										
A6011	Collagen gel/paste wound fil		N										
A6021	Collagen dressing <=16 sq in		N										
A6022	Collagen drsg>16<=48 sq in		N										
A6023	Collagen dressing >48 sq in		N										
A6024	Collagen dsg wound filler		N										
A6025	"Silicone gel sheet, each"		N										
A6154	Wound pouch each		N										
A6196	Alginate dressing <=16 sq in		N										
A6197	Alginate drsg >16 <=48 sq in		N										
A6198	Alginate dressing > 48 sq in		N										
A6199	Alginate drsg wound filler		N										
A6203	Composite drsg <= 16 sq in		N										
A6204	Composite drsg >16<=48 sq in		N										
A6205	Composite drsg > 48 sq in		N										
A6206	Contact layer <= 16 sq in		N										
A6207	Contact layer >16<= 48 sq in		N										
A6208	Contact layer > 48 sq in		N										
A6209	Foam drsg <=16 sq in w/o bdr		N										
A6210	Foam drg >16<=48 sq in w/o b		N										
A6211	Foam drg > 48 sq in w/o brdr		N										
A6212	Foam drg <=16 sq in w/border		N										
A6213	Foam drg >16<=48 sq in w/bdr		N										
A6214	Foam drg > 48 sq in w/border		N										
A6215	Foam dressing wound filler		N										
A6216	Non-sterile gauze<=16 sq in		N										
A6217	Non-sterile gauze>16<=48 sq		N										
A6218	Non-sterile gauze > 48 sq in		N										
A6219	Gauze <= 16 sq in w/border		N										
A6220	Gauze >16 <=48 sq in w/bordr		N										
A6221	Gauze > 48 sq in w/border		N										
A6222	Gauze <=16 in no w/sal w/o b		N										
A6223	Gauze >16<=48 no w/sal w/o b		N										
A6224	Gauze > 48 in no w/sal w/o b		N										
A6228	Gauze <= 16 sq in water/sal		N										
A6229	Gauze >16<=48 sq in watr/sal		N										
A6230	Gauze > 48 sq in water/salne		N										
A6231	Hydrogel dsg<=16 sq in		N										
A6232	Hydrogel dsg>16<=48 sq in		N										
A6233	Hydrogel dressing >48 sq in		N										
A6234	Hydrocolld drg <=16 w/o bdr		N										
A6235	Hydrocolld drg >16<=48 w/o b		N										
A6236	Hydrocolld drg > 48 in w/o b		N										
A6237	Hydrocolld drg <=16 in w/bdr		N										
A6238	Hydrocolld drg >16<=48 w/bdr		N										
A6239	Hydrocolld drg > 48 in w/bdr		N										
A6240	Hydrocolld drg filler paste		N										
A6241	Hydrocolloid drg filler dry		N										
A6242	Hydrogel drg <=16 in w/o bdr		N										
A6243	Hydrogel drg >16<=48 w/o bdr		N										
A6244	Hydrogel drg >48 in w/o bdr		N										
A6245	Hydrogel drg <= 16 in w/bdr		N										
A6246	Hydrogel drg >16<=48 in w/b		N										
A6247	Hydrogel drg > 48 sq in w/b		N										
A6248	Hydrogel drsg gel filler		N										
A6250	Skin seal protect moisturizr		N										
A6251	Absorpt drg <=16 sq in w/o b		N										
A6252	Absorpt drg >16 <=48 w/o bdr		N										
A6253	Absorpt drg > 48 sq in w/o b		N										
A6254	Absorpt drg <=16 sq in w/bdr		N										
A6255	Absorpt drg >16<=48 in w/bdr		N										
A6256	Absorpt drg > 48 sq in w/bdr		N										
A6257	Transparent film <= 16 sq in		N										
A6258	Transparent film >16<=48 in		N										
A6259	Transparent film > 48 sq in		N										
A6260	Wound cleanser any type/size		N										
A6261	Wound filler gel/paste /oz		N										
A6262	Wound filler dry form / gram		N										
A6266	Impreg gauze no h20/sal/yard		N										
A6402	Sterile gauze <= 16 sq in		N										
A6403	Sterile gauze>16 <= 48 sq in		N										
A6404	Sterile gauze > 48 sq in		N										
A6407	"Packing strips, non-impreg"		N										
A6410	Sterile eye pad		N										
A6411	Non-sterile eye pad		N										
A6412	Occlusive eye patch		N										
A6413	"Adhesive bandage, first-aid"		E1										
A6441	"Pad band w>=3"" <5""/yd"		N										
A6442	"Conform band n/s w<3""/yd"		N										
A6443	"Conform band n/s w>=3""<5""/yd"		N										
A6444	"Conform band n/s w>=5""/yd"		N										
A6445	"Conform band s w <3""/yd"		N										
A6446	"Conform band s w>=3"" <5""/yd"		N										
A6447	"Conform band s w >=5""/yd"		N										
A6448	"Lt compres band <3""/yd"		N										
A6449	"Lt compres band >=3"" <5""/yd"		N										
A6450	"Lt compres band >=5""/yd"		N										
A6451	"Mod compres band w>=3""<5""/yd"		N										
A6452	"High compres band w>=3""<5""yd"		N										
A6453	"Self-adher band w <3""/yd"		N										
A6454	"Self-adher band w>=3"" <5""/yd"		N										
A6455	"Self-adher band >=5""/yd"		N										
A6456	"Zinc paste band w >=3""<5""/yd"		N										
A6457	Tubular dressing		N										
A6460	Synthetic drsg <= 16 sq in		N										
A6461	Synthetic drsg >16<=48 sq in		N										
A6501	Compres burngarment bodysuit		N										
A6502	Compres burngarment chinstrp		N										
A6503	Compres burngarment facehood		N										
A6504	Cmprsburngarment glove-wrist		N										
A6505	Cmprsburngarment glove-elbow		N										
A6506	Cmprsburngrmnt glove-axilla		N										
A6507	Cmprs burngarment foot-knee		N										
A6508	Cmprs burngarment foot-thigh		N										
A6509	Compres burn garment jacket		N										
A6510	Compres burn garment leotard		N										
A6511	Compres burn garment panty		N										
A6512	"Compres burn garment, noc"		N										
A6513	Compress burn mask face/neck		B										
A6530	Compression stocking bk18-30		E1										
A6531	Compression stocking bk30-40		N										
A6532	Compression stocking bk40-50		N										
A6533	Gc stocking thighlngth 18-30		E1										
A6534	Gc stocking thighlngth 30-40		E1										
A6535	Gc stocking thighlngth 40-50		E1										
A6536	Gc stocking full lngth 18-30		E1										
A6537	Gc stocking full lngth 30-40		E1										
A6538	Gc stocking full lngth 40-50		E1										
A6539	Gc stocking waistlngth 18-30		E1										
A6540	Gc stocking waistlngth 30-40		E1										
A6541	Gc stocking waistlngth 40-50		E1										
A6544	Gc stocking garter belt		E1										
A6545	Grad comp non-elastic bk		N										
A6549	G compression stocking		E1										
A6550	Neg pres wound ther drsg set		N										
A7000	Disposable canister for pump		Y										
A7001	Nondisposable pump canister		Y										
A7002	Tubing used w suction pump		Y										
A7003	Nebulizer administration set		Y										
A7004	Disposable nebulizer sml vol		Y										
A7005	Nondisposable nebulizer set		Y										
A7006	Filtered nebulizer admin set		Y										
A7007	Lg vol nebulizer disposable		Y										
A7008	Disposable nebulizer prefill		Y										
A7009	Nebulizer reservoir bottle		Y										
A7010	Disposable corrugated tubing		Y										
A7012	Nebulizer water collec devic		Y										
A7013	Disposable compressor filter		Y										
A7014	Compressor nondispos filter		Y										
A7015	Aerosol mask used w nebulize		Y										
A7016	Nebulizer dome & mouthpiece		Y										
A7017	Nebulizer not used w oxygen		Y										
A7018	Water distilled w/nebulizer		Y										
A7020	"Interface, cough stim device"		Y										
A7025	Replace chest compress vest		N										
A7026	Replace chst cmprss sys hose		Y										
A7027	Combination oral/nasal mask		Y										
A7028	Repl oral cushion combo mask		Y										
A7029	Repl nasal pillow comb mask		Y										
A7030	Cpap full face mask		Y										
A7031	Replacement facemask interfa		Y										
A7032	Replacement nasal cushion		Y										
A7033	Replacement nasal pillows		Y										
A7034	Nasal application device		Y										
A7035	Pos airway press headgear		Y										
A7036	Pos airway press chinstrap		Y										
A7037	Pos airway pressure tubing		Y										
A7038	Pos airway pressure filter		Y										
A7039	"Filter, non disposable w pap"		Y										
A7040	One way chest drain valve		N										
A7041	Water seal drain container		N										
A7044	Pap oral interface		Y										
A7045	Repl exhalation port for pap		Y										
A7046	"Repl water chamber, pap dev"		Y										
A7047	Resp suction oral interface		N										
A7048	Vacuum drain bottle/tube kit		N										
A7501	Tracheostoma valve w diaphra		N										
A7502	Replacement diaphragm/fplate		N										
A7503	Hmes filter holder or cap		N										
A7504	Tracheostoma hmes filter		N										
A7505	Hmes or trach valve housing		N										
A7506	Hmes/trachvalve adhesivedisk		N										
A7507	Integrated filter & holder		N										
A7508	Housing & integrated adhesiv		N										
A7509	Heat & moisture exchange sys		N										
A7520	Trach/laryn tube non-cuffed		N										
A7521	Trach/laryn tube cuffed		N										
A7522	Trach/laryn tube stainless		N										
A7523	Tracheostomy shower protect		N										
A7524	Tracheostoma stent/stud/bttn		N										
A7525	Tracheostomy mask		N										
A7526	Tracheostomy tube collar		N										
A7527	Trach/laryn tube plug/stop		N										
A8000	Soft protect helmet prefab		Y										
A8001	Hard protect helmet prefab		Y										
A8002	Soft protect helmet custom		Y										
A8003	Hard protect helmet custom		Y										
A8004	"Repl soft interface, helmet"		Y										
A9150	Misc/exper non-prescript dru		B										
A9152	Single vitamin nos		E1										
A9153	Multi-vitamin nos		E1										
A9155	Artificial saliva		B										
A9180	"Lice treatment, topical"		E1										
A9270	Non-covered item or service		E1										
A9272	"Disp wound suct, drsg/access"		E1										
A9273	Hot/cold botle/cap/col/wrap		E1										
A9274	Ext amb insulin delivery sys		E1										
A9275	Disp home glucose monitor		E1										
A9276	"Disposable sensor, cgm sys"		E1										
A9277	"External transmitter, cgm"		E1										
A9278	"External receiver, cgm sys"		E1										
A9279	Monitoring feature/devicenoc		E1										
A9280	"Alert device, noc"		E1										
A9281	Reaching/grabbing device		E1										
A9282	Wig any type		E1										
A9283	Foot press off load supp dev		E1										
A9284	Non-electronic spirometer		N										
A9285	Inversion eversion cor devic		A										
A9286	"Any hygienic item, device"		E1										
A9300	Exercise equipment		E1										
A9500	Tc99m sestamibi		N										
A9501	Technetium tc-99m teboroxime		N										
A9502	Tc99m tetrofosmin		N										
A9503	Tc99m medronate		N										
A9504	Tc99m apcitide		N										
A9505	Tl201 thallium		N										
A9507	In111 capromab		N										
A9508	"I131 iodobenguate, dx"		N										
A9509	Iodine i-123 sod iodide mil		N										
A9510	Tc99m disofenin		N										
A9512	Tc99m pertechnetate		N										
A9513	Lutetium lu 177 dotatat ther		G	9067		$266.590	.	$53.32		*			
A9515	Choline c-11		N										
A9516	Iodine i-123 sod iodide mic		N										
A9517	"I131 iodide cap, rx"		K	1064		$20.690	.	$4.14					
A9520	Tc99 tilmanocept diag 0.5mci		N										
A9521	Tc99m exametazime		N										
A9524	"I131 serum albumin, dx"		N										
A9526	Nitrogen n-13 ammonia		N										
A9527	Iodine i-125 sodium iodide		U	2632	0.3228	$26.73	.	$5.35					
A9528	"Iodine i-131 iodide cap, dx"		N										
A9529	"I131 iodide sol, dx"		N										
A9530	"I131 iodide sol, rx"		K	1150		$13.360	.	$2.68					
A9531	I131 max 100uci		N										
A9532	"I125 serum albumin, dx"		N										
A9536	Tc99m depreotide		N										
A9537	Tc99m mebrofenin		N										
A9538	Tc99m pyrophosphate		N										
A9539	Tc99m pentetate		N										
A9540	Tc99m maa		N										
A9541	Tc99m sulfur colloid		N										
A9542	"In111 ibritumomab, dx"		N										
A9543	"Y90 ibritumomab, rx"		K	1643		"$56,746.934"	.	"$11,349.39"	*				
A9546	Co57/58		N										
A9547	In111 oxyquinoline		N										
A9548	In111 pentetate		N										
A9550	Tc99m gluceptate		N										
A9551	Tc99m succimer		N										
A9552	F18 fdg		N										
A9553	Cr51 chromate		N										
A9554	"I125 iothalamate, dx"		N										
A9555	Rb82 rubidium		N										
A9556	Ga67 gallium		N										
A9557	Tc99m bicisate		N										
A9558	Xe133 xenon 10mci		N										
A9559	Co57 cyano		N										
A9560	Tc99m labeled rbc		N										
A9561	Tc99m oxidronate		N										
A9562	Tc99m mertiatide		N										
A9563	P32 na phosphate		K	1675		$449.310	.	$89.87					
A9564	P32 chromic phosphate		E1										
A9566	Tc99m fanolesomab		N										
A9567	Technetium tc-99m aerosol		N										
A9568	Technetium tc99m arcitumomab		N										
A9569	Technetium tc-99m auto wbc		N										
A9570	Indium in-111 auto wbc		N										
A9571	Indium in-111 auto platelet		N										
A9572	Indium in-111 pentetreotide		N										
A9575	Inj gadoterate meglumi 0.1ml		N										
A9576	Inj prohance multipack		N										
A9577	Inj multihance		N										
A9578	Inj multihance multipack		N										
A9579	"Gad-base mr contrast nos,1ml"		N										
A9580	Sodium fluoride f-18		N										
A9581	Gadoxetate disodium inj		N										
A9582	Iodine i-123 iobenguane		N										
A9583	Gadofosveset trisodium inj		N										
A9584	Iodine i-123 ioflupane		N										
A9585	Gadobutrol injection		N										
A9586	Florbetapir f18	CH 	N										
A9587	Gallium ga-68		N										
A9588	Fluciclovine f-18		N										
A9589	Insti hexaminolevulinate hcl		N 										
A9590	Iodine i-131 iobenguane 1mci		G	9339		$320.120	.	$64.03					
A9591	Fluoroestradiol f 18	NI 	G	9370		$626.583	$0.00	$0.00					
A9597	"Pet, dx, for tumor id, noc"		N										
A9598	"Pet dx for non-tumor id, noc"		N										
A9600	Sr89 strontium		K	0701		"$2,045.702"	.	$409.15					
A9604	Sm 153 lexidronam		K	1295		"$17,259.853"	.	"$3,451.98"	*				
A9606	Radium ra223 dichloride ther		K	1745		$140.961	.	$28.20					
A9698	Non-rad contrast materialnoc		N										
A9699	Radiopharm rx agent noc		N										
A9700	Echocardiography contrast		N										
A9900	Supply/accessory/service		Y										
A9901	Delivery/set up/dispensing		A										
A9999	"Dme supply or accessory, nos"		Y										
B4034	Enter feed supkit syr by day		Y										
B4035	Enteral feed supp pump per d		Y										
B4036	Enteral feed sup kit grav by		Y										
B4081	Enteral ng tubing w/ stylet		Y										
B4082	Enteral ng tubing w/o stylet		Y										
B4083	Enteral stomach tube levine		Y										
B4087	"Gastro/jejuno tube, std"		Y										
B4088	"Gastro/jejuno tube, low-pro"		Y										
B4100	Food thickener oral		E1										
B4102	Ef adult fluids and electro		Y										
B4103	Ef ped fluid and electrolyte		Y										
B4104	Additive for enteral formula		E1										
B4105	Enzyme cartridge enteral nut		Y										
B4149	Ef blenderized foods		Y										
B4150	Ef complet w/intact nutrient		Y										
B4152	Ef calorie dense>/=1.5kcal		Y										
B4153	Ef hydrolyzed/amino acids		Y										
B4154	Ef spec metabolic noninherit		Y										
B4155	Ef incomplete/modular		Y										
B4157	Ef special metabolic inherit		Y										
B4158	Ef ped complete intact nut		Y										
B4159	Ef ped complete soy based		Y										
B4160	Ef ped caloric dense>/=0.7kc		Y										
B4161	Ef ped hydrolyzed/amino acid		Y										
B4162	Ef ped specmetabolic inherit		Y										
B4164	Parenteral 50% dextrose solu		Y										
B4168	Parenteral sol amino acid 3.		Y										
B4172	Parenteral sol amino acid 5.		Y										
B4176	Parenteral sol amino acid 7-		Y										
B4178	Parenteral sol amino acid >		Y										
B4180	Parenteral sol carb > 50%		Y										
B4185	Pn soln nos 10 grams lipids		B										
B4187	"Omegaven, 10 grams lipids"		B										
B4189	Parenteral sol amino acid &		Y										
B4193	Parenteral sol 52-73 gm prot		Y										
B4197	Parenteral sol 74-100 gm pro		Y										
B4199	Parenteral sol > 100gm prote		Y										
B4216	Parenteral nutrition additiv		Y										
B4220	Parenteral supply kit premix		Y										
B4222	Parenteral supply kit homemi		Y										
B4224	Parenteral administration ki		Y										
B5000	Parenteral sol renal-amirosy		Y										
B5100	Parenteral solution hepatic		Y										
B5200	Parenteral sol hepatic fream		Y										
B9002	Enter nutr inf pump any type		Y										
B9004	Parenteral infus pump portab		Y										
B9006	Parenteral infus pump statio		Y										
B9998	Enteral supp not otherwise c		Y										
B9999	Parenteral supp not othrws c		Y										
C1052	"Hemostatic agent, gi, topic"	NI	H	2031									
C1062	Intravertebral fx aug impl	NI	H	2032									
C1713	"Anchor/screw bn/bn,tis/bn"		N										
C1714	"Cath, trans atherectomy, dir"		N										
C1715	Brachytherapy needle		N										
C1716	"Brachytx, non-str, gold-198"		U	2645	3.4827	$288.36	.	$57.68					
C1717	"Brachytx, non-str,hdr ir-192"		U	2646	4.0423	$334.69	.	$66.94					
C1719	"Brachytx, ns, non-hdrir-192"		U	2647	3.4112	$282.44	.	$56.49					
C1721	"Aicd, dual chamber"		N										
C1722	"Aicd, single chamber"		N										
C1724	"Cath, trans atherec,rotation"		N										
C1725	"Cath, translumin non-laser"		N										
C1726	"Cath, bal dil, non-vascular"		N										
C1727	"Cath, bal tis dis, non-vas"		N										
C1728	"Cath, brachytx seed adm"		N										
C1729	"Cath, drainage"		N										
C1730	"Cath, ep, 19 or few elect"		N										
C1731	"Cath, ep, 20 or more elec"		N										
C1732	"Cath, ep, diag/abl, 3d/vect"		N										
C1733	"Cath, ep, othr than cool-tip"		N										
C1734	"Orth/devic/drug bn/bn,tis/bn"		H	2026									
C1748	"Endoscope, single, ugi"	NC	H	2029									
C1749	"Endo, colon, retro imaging"		N										
C1750	"Cath, hemodialysis,long-term"		N										
C1751	"Cath, inf, per/cent/midline"		N										
C1752	"Cath,hemodialysis,short-term"		N										
C1753	"Cath, intravas ultrasound"		N										
C1754	"Catheter, intradiscal"		N										
C1755	"Catheter, intraspinal"		N										
C1756	"Cath, pacing, transesoph"		N										
C1757	"Cath, thrombectomy/embolect"		N										
C1758	"Catheter, ureteral"		N										
C1759	"Cath, intra echocardiography"		N										
C1760	"Closure dev, vasc"		N										
C1762	"Conn tiss, human(inc fascia)"		N										
C1763	"Conn tiss, non-human"		N										
C1764	"Event recorder, cardiac"		N										
C1765	Adhesion barrier		N										
C1766	"Intro/sheath,strble,non-peel"		N										
C1767	"Generator, neuro non-recharg"		N										
C1768	"Graft, vascular"		N										
C1769	Guide wire		N										
C1770	"Imaging coil, mr, insertable"		N										
C1771	"Rep dev, urinary, w/sling"		N										
C1772	"Infusion pump, programmable"		N										
C1773	"Ret dev, insertable"		N										
C1776	Joint device (implantable)		N										
C1777	"Lead, aicd, endo single coil"		N										
C1778	"Lead, neurostimulator"		N										
C1779	"Lead, pmkr, transvenous vdd"		N										
C1780	"Lens, intraocular (new tech)"		N										
C1781	Mesh (implantable)		N										
C1782	Morcellator		N										
C1783	"Ocular imp, aqueous drain de"		N										
C1784	"Ocular dev, intraop, det ret"		N										
C1785	"Pmkr, dual, rate-resp"		N										
C1786	"Pmkr, single, rate-resp"		N										
C1787	"Patient progr, neurostim"		N										
C1788	"Port, indwelling, imp"		N										
C1789	"Prosthesis, breast, imp"		N										
C1813	"Prosthesis, penile, inflatab"		N										
C1814	"Retinal tamp, silicone oil"		N										
C1815	"Pros, urinary sph, imp"		N										
C1816	"Receiver/transmitter, neuro"		N										
C1817	Septal defect imp sys		N										
C1818	Integrated keratoprosthesis		N										
C1819	Tissue localization-excision		N										
C1820	Generator neuro rechg bat sy		N										
C1821	Interspinous implant		N										
C1822	"Gen, neuro, hf, rechg bat"		N										
C1823	"Gen, neuro, trans sen/stim"		H	2993									
C1824	"Generator, ccm, implant"		H	2024									
C1825	"Gen, neuro, carot sinus baro"	NI 	H	2030									
C1830	Power bone marrow bx needle		N										
C1839	Iris prosthesis		H	2028									
C1840	Telescopic intraocular lens		N										
C1841	Retinal prosth int/ext comp		N										
C1842	"Retinal prosth, add-on"		E1										
C1849	"Skin substitute, synthetic"	NC	N										
C1874	"Stent, coated/cov w/del sys"		N										
C1875	"Stent, coated/cov w/o del sy"		N										
C1876	"Stent, non-coa/non-cov w/del"		N										
C1877	"Stent, non-coat/cov w/o del"		N										
C1878	Matrl for vocal cord		N										
C1880	Vena cava filter		N										
C1881	Dialysis access system		N										
C1882	"Aicd, other than sing/dual"		N										
C1883	"Adapt/ext, pacing/neuro lead"		N										
C1884	Embolization protect syst		N										
C1885	"Cath, translumin angio laser"		N										
C1886	"Catheter, ablation"		N										
C1887	"Catheter, guiding"		N										
C1888	Endovas non-cardiac abl cath		N										
C1889	"Implant/insert device, noc"		N										
C1890	No device w/dev-intensive px		E1										
C1891	"Infusion pump,non-prog, perm"		N										
C1892	"Intro/sheath,fixed,peel-away"		N										
C1893	"Intro/sheath, fixed,non-peel"		N										
C1894	"Intro/sheath, non-laser"		N										
C1895	"Lead, aicd, endo dual coil"		N										
C1896	"Lead, aicd, non sing/dual"		N										
C1897	"Lead, neurostim test kit"		N										
C1898	"Lead, pmkr, other than trans"		N										
C1899	"Lead, pmkr/aicd combination"		N										
C1900	"Lead, coronary venous"		N										
C1982	"Cath, pressure,valve-occlu"		H	2025									
C2596	"Probe, robotic, water-jet"		H	2027									
C2613	Lung bx plug w/del sys		N										
C2614	"Probe, perc lumb disc"		N										
C2615	"Sealant, pulmonary, liquid"		N										
C2616	"Brachytx, non-str,yttrium-90"		U	2616	210.1240	"$17,397.64"	.	"$3,479.53"	*				
C2617	"Stent, non-cor, tem w/o del"		N										
C2618	"Probe/needle, cryo"		N										
C2619	"Pmkr, dual, non rate-resp"		N										
C2620	"Pmkr, single, non rate-resp"		N										
C2621	"Pmkr, other than sing/dual"		N										
C2622	"Prosthesis, penile, non-inf"		N										
C2623	"Cath, translumin, drug-coat"		N										
C2624	Wireless pressure sensor		N										
C2625	"Stent, non-cor, tem w/del sy"		N										
C2626	"Infusion pump, non-prog,temp"		N										
C2627	"Cath, suprapubic/cystoscopic"		N										
C2628	"Catheter, occlusion"		N										
C2629	"Intro/sheath, laser"		N										
C2630	"Cath, ep, cool-tip"		N										
C2631	"Rep dev, urinary, w/o sling"		N										
C2634	"Brachytx, non-str, ha, i-125"		U	2634	1.7886	$148.09	.	$29.62					
C2635	"Brachytx, non-str, ha, p-103"		U	2635	0.5501	$45.55	.	$9.11					
C2636	"Brachy linear, non-str,p-103"		U	2636	0.3793	$31.40	.	$6.29					
C2637	"Brachy,non-str,ytterbium-169"		B										
C2638	"Brachytx, stranded, i-125"		U	2638	0.4517	$37.40	.	$7.48					
C2639	"Brachytx, non-stranded,i-125"		U	2639	0.4119	$34.10	.	$6.83					
C2640	"Brachytx, stranded, p-103"		U	2640	1.0598	$87.75	.	$17.55					
C2641	"Brachytx, non-stranded,p-103"		U	2641	0.8394	$69.50	.	$13.90					
C2642	"Brachytx, stranded, c-131"		U	2642	0.8679	$71.86	.	$14.38					
C2643	"Brachytx, non-stranded,c-131"		U	2643	0.9705	$80.35	.	$16.08					
C2644	Brachytx cesium-131 chloride		E2										
C2645	"Brachytx planar, p-103"		U	2648	0.0566	$4.69	.	$0.94					
C2698	"Brachytx, stranded, nos"		U	2698	0.4517	$37.40	.	$7.48					
C2699	"Brachytx, non-stranded, nos"		U	2699	0.3793	$31.40	.	$6.29					
C5271	Low cost skin substitute app		T	5053	6.3308	$524.17	.	$104.84					
C5272	Low cost skin substitute app		N										
C5273	Low cost skin substitute app		T	5054	20.7177	"$1,715.36"	.	$343.08					
C5274	Low cost skin substitute app		N										
C5275	Low cost skin substitute app		T	5053	6.3308	$524.17	.	$104.84					
C5276	Low cost skin substitute app		N										
C5277	Low cost skin substitute app		T	5053	6.3308	$524.17	.	$104.84					
C5278	Low cost skin substitute app		N										
C8900	"Mra w/cont, abd"		Q3	5572	4.4460	$368.12	.	$73.63					
C8901	"Mra w/o cont, abd"		Q3	5523	2.7794	$230.13	.	$46.03					
C8902	"Mra w/o fol w/cont, abd"		Q3	5572	4.4460	$368.12	.	$73.63					
C8903	"Mri w/cont, breast,  uni"		Q3	5571	2.1565	$178.55	.	$35.72					
C8905	"Mri w/o fol w/cont, brst, un"		Q3	5572	4.4460	$368.12	.	$73.63					
C8906	"Mri w/cont, breast,  bi"		Q3	5572	4.4460	$368.12	.	$73.63					
C8908	"Mri w/o fol w/cont, breast,"		Q3	5572	4.4460	$368.12	.	$73.63					
C8909	"Mra w/cont, chest"		Q3	5572	4.4460	$368.12	.	$73.63					
C8910	"Mra w/o cont, chest"		Q3	5523	2.7794	$230.13	.	$46.03					
C8911	"Mra w/o fol w/cont, chest"		Q3	5572	4.4460	$368.12	.	$73.63					
C8912	"Mra w/cont, lwr ext"		Q3	5572	4.4460	$368.12	.	$73.63					
C8913	"Mra w/o cont, lwr ext"		Q3	5523	2.7794	$230.13	.	$46.03					
C8914	"Mra w/o fol w/cont, lwr ext"		Q3	5572	4.4460	$368.12	.	$73.63					
C8918	"Mra w/cont, pelvis"		Q3	5572	4.4460	$368.12	.	$73.63					
C8919	"Mra w/o cont, pelvis"		Q3	5523	2.7794	$230.13	.	$46.03					
C8920	"Mra w/o fol w/cont, pelvis"		Q3	5572	4.4460	$368.12	.	$73.63					
C8921	"Tte w or w/o fol w/cont, com"		S	5573	8.6377	$715.18	.	$143.04					
C8922	"Tte w or w/o fol w/cont, f/u"		S	5573	8.6377	$715.18	.	$143.04					
C8923	"2d tte w or w/o fol w/con,co"		S	5573	8.6377	$715.18	.	$143.04					
C8924	"2d tte w or w/o fol w/con,fu"		S	5572	4.4460	$368.12	.	$73.63					
C8925	"2d tee w or w/o fol w/con,in"		S	5573	8.6377	$715.18	.	$143.04					
C8926	"Tee w or w/o fol w/cont,cong"		S	5573	8.6377	$715.18	.	$143.04					
C8927	"Tee w or w/o fol w/cont, mon"		S	5573	8.6377	$715.18	.	$143.04					
C8928	"Tte w or w/o fol w/con,stres"		S	5573	8.6377	$715.18	.	$143.04					
C8929	"Tte w or wo fol wcon,doppler"		S	5573	8.6377	$715.18	.	$143.04					
C8930	"Tte w or w/o contr, cont ecg"		S	5573	8.6377	$715.18	.	$143.04					
C8931	"Mra, w/dye, spinal canal"		Q3	5572	4.4460	$368.12	.	$73.63					
C8932	"Mra, w/o dye, spinal canal"		Q3	5523	2.7794	$230.13	.	$46.03					
C8933	"Mra, w/o&w/dye, spinal canal"		Q3	5572	4.4460	$368.12	.	$73.63					
C8934	"Mra, w/dye, upper extremity"		Q3	5572	4.4460	$368.12	.	$73.63					
C8935	"Mra, w/o dye, upper extr"		Q3	5523	2.7794	$230.13	.	$46.03					
C8936	"Mra, w/o&w/dye, upper extr"		Q3	5572	4.4460	$368.12	.	$73.63					
C8937	Cad breast mri		N										
C8957	"Prolonged iv inf, req pump"		S	5694	3.7532	$310.75	.	$62.16					
C9046	Cocaine hcl nasal solution		G	9307		$1.230	.	$0.25					
C9047	"Injection, caplacizumab-yhdp"		G	9199		$690.680	.	$138.14					
C9060	Fluoroestradiol f18	CH	D										
C9062	Daratumumab hyaluronidase	CH	D										
C9064	Mitomycin pyelocalyceal inst	CH	D										
C9065	Romidepsin non-lyophilized	NI	G	9379		$329.456	.	$65.90					
C9066	Sacituzumab govitecan-hziy	CH	D										
C9067	Gallium ga-68 dotatoc	NI	G	9323		$8.640	$0.00	$0.00					
C9068	"Copper cu-64, dotatate, dx"	NI 	G	9383		$901.250	$0.00	$0.00					
C9069	Belantamab mafodontin-blmf	NI 	G	9384		$42.627	.	$8.53					
C9070	"Injection, tafasitamab-cxix"	NI 	G	9385		$6.180	.	$1.24					
C9071	"Injection, viltolarsen"	NI 	G	9386		$58.092	.	$11.62					
C9072	"Inj, imm glob asceniv"	NI 	G	9392		$481.770	.	$96.36					
C9073	Brexucabtagene autoleucel ca	NI 	G	9391		"$384,190.000"	.	"$76,838.00"	*				
C9113	"Inj pantoprazole sodium, via"		N										
C9122	Mometasone furoate (sinuva)	NC	G	9346		$10.252	.	$2.06					
C9132	"Kcentra, per i.u."		K	9132		$2.091	.	$0.42					
C9248	"Inj, clevidipine butyrate"	CH 	K	9087		$2.870	.	$0.58					
C9250	Artiss fibrin sealant		K	1848		$156.842	.	$31.37					
C9254	"Injection, lacosamide"		N										
C9257	Bevacizumab injection		K	1281		$1.909	.	$0.39					
C9285	"Patch, lidocaine/tetracaine"		N										
C9290	"Inj, bupivacaine liposome"		N										
C9293	"Injection, glucarpidase"	CH 	E2										
C9352	"Neuragen nerve guide, per cm"		N										
C9353	"Neurawrap nerve protector,cm"		N										
C9354	"Veritas collagen matrix, cm2"		N										
C9355	"Neuromatrix nerve cuff, cm"		N										
C9356	"Tenoglide tendon prot, cm2"		N										
C9358	"Surgimend, fetal"		N										
C9359	"Implnt,bon void filler-putty"		N										
C9360	"Surgimend, neonatal"		N										
C9361	Neuromend nerve wrap		N										
C9362	"Implnt,bon void filler-strip"		N										
C9363	Integra meshed bil wound mat		N										
C9364	"Porcine implant, permacol"		N										
C9399	Unclassified drugs or biolog		A										
C9460	"Injection, cangrelor"		K	9460		$15.320	.	$3.07					
C9462	"Injection, delafloxacin"		G	9462		$0.278	.	$0.06		*			
C9482	Sotalol hydrochloride iv		K	9482		$15.999	.	$3.20					
C9488	Conivaptan hcl	CH 	K 	9488		$32.571	.	$6.52					
C9600	Perc drug-el cor stent sing		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
C9601	Perc drug-el cor stent bran		N										
C9602	Perc d-e cor stent ather s		J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
C9603	Perc d-e cor stent ather br		N										
C9604	Perc d-e cor revasc t cabg s		J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
C9605	Perc d-e cor revasc t cabg b		N										
C9606	Perc d-e cor revasc w ami s		C										
C9607	Perc d-e cor revasc chro sin		J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
C9608	Perc d-e cor revasc chro add		N										
C9725	Place endorectal app		T	5311	9.5855	$793.65	.	$158.74					
C9726	Rxt breast appl place/remov		N										
C9727	Insert palate implants		J1	5163	16.3386	"$1,352.79"	.	$270.56					
C9728	"Place device/marker, non pro"		S	5613	15.2443	"$1,262.18"	.	$252.44					
C9733	Non-ophthalmic fva		Q2	5572	4.4460	$368.12	.	$73.63					
C9734	"U/s trtmt, not leiomyomata"		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
C9738	Blue light cysto imag agent		N										
C9739	Cystoscopy prostatic imp 1-3		J1	5375	53.3099	"$4,413.90"	.	$882.78					
C9740	Cysto impl 4 or more		J1	5376	99.7395	"$8,258.13"	.	"$1,651.63"	*				
C9745	Nasal endo eustachian tube	CH	D										
C9747	"Ablation, hifu, prostate"	CH	D										
C9749	Repair nasal stenosis w/imp	CH	D										
C9751	"Microwave bronch, 3d, ebus"	CH	T	1562		"$3,750.50"	.	$750.10					
C9752	Intraosseous des lumb/sacrum		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
C9753	Intraosseous destruct add'l		N										
C9756	Fluorescence lymph map w/icg		N										
C9757	Spine/lumbar disk surgery		J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
C9758	Blind interatrial shunt ide		T	1590		"$17,500.50"	.	"$3,500.11"	*				
C9759	Transcath intraop microinf	NC	N										
C9760	Non-blind interatrial shunt	NC	T	1592		"$27,500.50"	.	"$5,500.11"	*				
C9761	"Cysto, litho, vacuum kidney"	NI	J1	5375	53.3099	"$4,413.90"	.	$882.78					
C9762	Cardiac mri seg dys strain	NC	Q3	5524	5.8322	$482.89	.	$96.58					
C9763	Cardiac mri seg dys stress	NC	Q3	5524	5.8322	$482.89	.	$96.58					
C9764	Revasc intravasc lithotripsy	NC	J1	5192	59.8674	"$4,956.84"	.	$991.37					
C9765	Revasc intra lithotrip-stent	NC	J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
C9766	Revasc intra lithotrip-ather	NC	J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
C9767	Revasc lithotrip-stent-ather	NC	J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
C9768	Endo us-guide hep porto grad	NI	N										
C9769	Cysto w/temp pros implant	NI	J1	5375	53.3099	"$4,413.90"	.	$882.78					
C9770	"Vitrec/mech pars, subret inj"	NC	T	1561		"$3,250.50"	.	$650.11					
C9771	Nsl/sins cryo post nasal tis	NI 	J1	5164	33.0494	"$2,736.39"	.	$547.28					
C9772	Revasc lithotrip tibi/perone	NI 	J1	5193	121.2960	"$10,042.94"	.	"$2,008.59"	*				
C9773	Revasc lithotr-stent tib/per	NI 	J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
C9774	Revasc lithotr-ather tib/per	NI 	J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
C9775	Revasc lith-sten-ath tib/per	NI 	J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
C9803	Hopd covid-19 spec collect	NC	Q1	5731	0.2980	$24.67	.	$4.94					
C9898	Inpnt stay radiolabeled item		N										
C9899	"Inpt implant pros dev,no cov"		A										
D0120	Periodic oral evaluation		E1										
D0140	Limit oral eval problm focus		E1										
D0145	"Oral evaluation, pt < 3yrs"		E1										
D0150	Comprehensve oral evaluation		S	5871	16.8307	"$1,393.53"	.	$278.71					
D0160	Extensv oral eval prob focus		E1										
D0170	"Re-eval,est pt,problem focus"		E1										
D0171	Re-eval post-op visit		E1										
D0180	Comp periodontal evaluation		E1										
D0190	Screening of a patient		E1										
D0191	Assessment of a patient		E1										
D0210	Intraor complete film series		E1										
D0220	Intraoral periapical first		E1										
D0230	Intraoral periapical ea add		E1										
D0240	Intraoral occlusal film		S	5871	16.8307	"$1,393.53"	.	$278.71					
D0250	Extraoral 2d project image		S	5871	16.8307	"$1,393.53"	.	$278.71					
D0251	Extraoral posterior image		Q1	5521	0.9771	$80.90	.	$16.19					
D0270	Dental bitewing single image		S	5871	16.8307	"$1,393.53"	.	$278.71					
D0272	Dental bitewings two images		S	5871	16.8307	"$1,393.53"	.	$278.71					
D0273	Bitewings - three images		E1										
D0274	Bitewings four images		S	5871	16.8307	"$1,393.53"	.	$278.71					
D0277	Vert bitewings 7 to 8 images		S	5871	16.8307	"$1,393.53"	.	$278.71					
D0310	Dental saliography		E1										
D0320	Dental tmj arthrogram incl i		E1										
D0321	Other tmj images by report		E1										
D0322	Dental tomographic survey		E1										
D0330	Panoramic image		E1										
D0340	2d cephalometric image		E1										
D0350	Oral/facial photo images		E1										
D0351	3d photographic image		E1										
D0364	Cone beam ct capt & interp		E1										
D0365	Cone beam ct interprete man		E1										
D0366	Cone beam ct interprete max		E1										
D0367	Cone beam ct interp both jaw		E1										
D0368	Cone beam ct interprete tmj		E1										
D0369	Max mri capture & interprete		E1										
D0370	Max ultrasound capt & interp		E1										
D0371	Sialoendoscopy capt & interp		E1										
D0380	Cone beam ct capture limited		E1										
D0381	Cone beam ct capt mandible		E1										
D0382	Cone beam ct capt maxilla		E1										
D0383	Cone beam ct both jaws		E1										
D0384	Cone beam ct capture tmj		E1										
D0385	Max mri image capture		E1										
D0386	Max ultrasound image capture		E1										
D0391	Imterprete diagnostic image		E1										
D0393	Trtmnt simulation 3d image		E1										
D0394	Digital sub 2 or more images		E1										
D0395	Fusion 2 or more 3d images		E1										
D0411	Hba1c in office testing		E1										
D0412	Blood glucose level test		E1										
D0414	Lab process microbial spec		E1										
D0415	Collection of microorganisms		E1										
D0416	Viral culture		B										
D0417	Collect & prep saliva sample		E1										
D0418	Analysis of saliva sample		E1										
D0419	Assess of salivary flow		E1										
D0422	Collect & prep genetic samp		E1										
D0423	Genetic test spec analysis		E1										
D0425	Caries susceptibility test		E1										
D0431	Diag tst detect mucos abnorm		B										
D0460	Pulp vitality test		S	5871	16.8307	"$1,393.53"	.	$278.71					
D0470	Diagnostic casts		E1										
D0472	"Gross exam, prep & report"		B										
D0473	"Micro exam, prep & report"		B										
D0474	Micro w exam of surg margins		B										
D0475	Decalcification procedure		B										
D0476	Spec stains for microorganis		B										
D0477	Spec stains not for microorg		B										
D0478	Immunohistochemical stains		B										
D0479	Tissue in-situ hybridization		B										
D0480	Cytopath smear prep & report		B										
D0481	Electron microscopy		B										
D0482	Direct immunofluorescence		B										
D0483	Indirect immunofluorescence		B										
D0484	Consult slides prep elsewher		B										
D0485	Consult inc prep of slides		B										
D0486	Access of transep cytol samp		E1										
D0502	Other oral pathology procedu		B										
D0600	Non-ionizing diag proc		S	5871	16.8307	"$1,393.53"	.	$278.71					
D0601	Caries risk assess low risk		E1										
D0602	Caries risk assess mod risk		E1										
D0603	Caries risk assess high risk		E1										
D0604	Antigen test pub hlth pathog	NI 	E1										
D0605	Antibody test pub hlth path	NI 	E1										
D0701	Pano radio image	NI 	E1										
D0702	2d cephal radio image	NI 	E1										
D0703	2d oral/facial photo image	NI 	E1										
D0704	3d photo image capture only	NI 	E1										
D0705	Extra oral post radio image	NI 	E1										
D0706	Intraoral occlus radio image	NI 	E1										
D0707	Intraoral periap radio image	NI 	E1										
D0708	Intraoral bite radio image	NI 	E1										
D0709	Intraoral cmplt radio images	NI 	E1										
D0999	Unspecified diagnostic proce		B										
D1110	Dental prophylaxis adult		E1										
D1120	Dental prophylaxis child		E1										
D1206	Topical fluoride varnish		E1										
D1208	Topical app fluorid ex vrnsh		E1										
D1310	Nutri counsel-control caries		E1										
D1320	Tobacco counseling		E1										
D1321	Couns for high risk sub use	NI 	E1										
D1330	Oral hygiene instruction		E1										
D1351	Dental sealant per tooth		E1										
D1352	"Prev resin rest, perm tooth"		E1										
D1353	Sealant repair per tooth		E1										
D1354	Int caries med app per tooth		E1										
D1355	Caries med app per tooth	NI 	E1										
D1510	Space maintainer fxd unilat		S	5871	16.8307	"$1,393.53"	.	$278.71					
D1516	"Fixed bilat space maint, max"		S	5871	16.8307	"$1,393.53"	.	$278.71					
D1517	"Fixed bilat space maint, man"		S	5871	16.8307	"$1,393.53"	.	$278.71					
D1520	Remove unilat space maintain		S	5871	16.8307	"$1,393.53"	.	$278.71					
D1526	"Remove bilat space main, max"		S	5871	16.8307	"$1,393.53"	.	$278.71					
D1527	"Remove bilat space main, man"		S	5871	16.8307	"$1,393.53"	.	$278.71					
D1551	Recement space maint - max		S	5871	16.8307	"$1,393.53"	.	$278.71					
D1552	Recement space maint - man		S	5871	16.8307	"$1,393.53"	.	$278.71					
D1553	Recement unilat space maint		S	5871	16.8307	"$1,393.53"	.	$278.71					
D1556	Rem fixed unilat space maint		E1										
D1557	Remove fixed bilat maint max		E1										
D1558	Remove fixed bilat man		E1										
D1575	"Dist space maint, fixed unil"		S	5871	16.8307	"$1,393.53"	.	$278.71					
D1999	Unspecified preventive proc		E1										
D2140	Amalgam one surface permanen		E1										
D2150	Amalgam two surfaces permane		E1										
D2160	Amalgam three surfaces perma		E1										
D2161	Amalgam 4 or > surfaces perm		E1										
D2330	Resin one surface-anterior		E1										
D2331	Resin two surfaces-anterior		E1										
D2332	Resin three surfaces-anterio		E1										
D2335	Resin 4/> surf or w incis an		E1										
D2390	Ant resin-based cmpst crown		E1										
D2391	Post 1 srfc resinbased cmpst		E1										
D2392	Post 2 srfc resinbased cmpst		E1										
D2393	Post 3 srfc resinbased cmpst		E1										
D2394	Post >=4srfc resinbase cmpst		E1										
D2410	Dental gold foil one surface		E1										
D2420	Dental gold foil two surface		E1										
D2430	Dental gold foil three surfa		E1										
D2510	Dental inlay metalic 1 surf		E1										
D2520	Dental inlay metallic 2 surf		E1										
D2530	Dental inlay metl 3/more sur		E1										
D2542	Dental onlay metallic 2 surf		E1										
D2543	Dental onlay metallic 3 surf		E1										
D2544	Dental onlay metl 4/more sur		E1										
D2610	Inlay porcelain/ceramic 1 su		E1										
D2620	Inlay porcelain/ceramic 2 su		E1										
D2630	Dental onlay porc 3/more sur		E1										
D2642	Dental onlay porcelin 2 surf		E1										
D2643	Dental onlay porcelin 3 surf		E1										
D2644	Dental onlay porc 4/more sur		E1										
D2650	Inlay composite/resin one su		E1										
D2651	Inlay composite/resin two su		E1										
D2652	Dental inlay resin 3/mre sur		E1										
D2662	Dental onlay resin 2 surface		E1										
D2663	Dental onlay resin 3 surface		E1										
D2664	Dental onlay resin 4/mre sur		E1										
D2710	Crown resin-based indirect		E1										
D2712	Crown 3/4 resin-based compos		E1										
D2720	Crown resin w/ high noble me		E1										
D2721	Crown resin w/ base metal		E1										
D2722	Crown resin w/ noble metal		E1										
D2740	Crown porcelain/ceramic		E1										
D2750	Crown porcelain w/ h noble m		E1										
D2751	Crown porcelain fused base m		E1										
D2752	Crown porcelain w/ noble met		E1										
D2753	Crown porc fused to titanium		E1										
D2780	Crown 3/4 cast hi noble met		E1										
D2781	Crown 3/4 cast base metal		E1										
D2782	Crown 3/4 cast noble metal		E1										
D2783	Crown 3/4 porcelain/ceramic		E1										
D2790	Crown full cast high noble m		E1										
D2791	Crown full cast base metal		E1										
D2792	Crown full cast noble metal		E1										
D2794	Crown-titanium		E1										
D2799	Provisional crown		E1										
D2910	Recement inlay onlay or part		E1										
D2915	Recement cast or prefab post		E1										
D2920	Re-cement or re-bond crown		E1										
D2921	Reattach tooth fragment		E1										
D2928	Prefab porc/cer crown perm	NI	E1										
D2929	Prefab porc/ceram crown pri		E1										
D2930	Prefab stnlss steel crwn pri		E1										
D2931	Prefab stnlss steel crown pe		E1										
D2932	Prefabricated resin crown		E1										
D2933	Prefab stainless steel crown		E1										
D2934	Prefab steel crown primary		E1										
D2940	Protective restoration		E1										
D2941	Int therapeutic restoration		E1										
D2949	Restorative foundation		E1										
D2950	Core build-up incl any pins		E1										
D2951	Tooth pin retention		E1										
D2952	Post and core cast + crown		E1										
D2953	Each addtnl cast post		E1										
D2954	Prefab post/core + crown		E1										
D2955	Post removal		E1										
D2957	Each addtnl prefab post		E1										
D2960	Labial veneer resin direct		E1										
D2961	Labial veneer resin indirect		E1										
D2962	Labial veneer porc indirect		E1										
D2971	Add proc construct new crown		E1										
D2975	Coping		E1										
D2980	Crown repair		E1										
D2981	Inlay repair		E1										
D2982	Onlay repair		E1										
D2983	Veneer repair		E1										
D2990	Resin infiltration of lesion		E1										
D2999	Dental unspec restorative pr		S	5871	16.8307	"$1,393.53"	.	$278.71					
D3110	Pulp cap direct		E1										
D3120	Pulp cap indirect		E1										
D3220	Therapeutic pulpotomy		E1										
D3221	Gross pulpal debridement		E1										
D3222	Part pulp for apexogenesis		E1										
D3230	Pulpal therapy anterior prim		E1										
D3240	Pulpal therapy posterior pri		E1										
D3310	"End thxpy, anterior tooth"		E1										
D3320	"End thxpy, premolar tooth"		E1										
D3330	"End thxpy, molar tooth"		E1										
D3331	Non-surg tx root canal obs		E1										
D3332	Incomplete endodontic tx		E1										
D3333	Internal root repair		E1										
D3346	Retreat root canal anterior		E1										
D3347	Retreat root canal premolar		E1										
D3348	Retreat root canal molar		E1										
D3351	Apexification/recalc initial		E1										
D3352	Apexification/recalc interim		E1										
D3353	Apexification/recalc final		E1										
D3355	Pulpal regeneration initial		E1										
D3356	Pulpal regeneration interim		E1										
D3357	Pulpal regeneration complete		E1										
D3410	Apicoectomy - anterior		E1										
D3421	Root surgery premolar		E1										
D3425	Root surgery molar		E1										
D3426	Root surgery ea add root		E1										
D3427	Periradicular surgery	CH	D										
D3428	Bone graft peri per tooth		E1										
D3429	Bone graft peri each addl		E1										
D3430	Retrograde filling		E1										
D3431	Biological materials		E1										
D3432	Guided tissue regeneration		E1										
D3450	Root amputation		E1										
D3460	Endodontic endosseous implan		S	5871	16.8307	"$1,393.53"	.	$278.71					
D3470	Intentional replantation		E1										
D3471	Surg rep root res anterior	NI 	E1										
D3472	Surg rep root res premolar	NI 	E1										
D3473	Surg rep root res molar	NI 	E1										
D3501	Surg exp root surf anterior	NI 	E1										
D3502	Surg exp root surf premolar	NI 	E1										
D3503	Surg exp root surf molar	NI 	E1										
D3910	Isolation- tooth w rubb dam		E1										
D3920	Tooth splitting		E1										
D3950	Canal prep/fitting of dowel		E1										
D3999	Endodontic procedure		S	5871	16.8307	"$1,393.53"	.	$278.71					
D4210	Gingivectomy/plasty 4 or mor		E1										
D4211	Gingivectomy/plasty 1 to 3		E1										
D4212	Gingivectomy/plasty rest		E1										
D4230	Ana crown exp 4 or> per quad		E1										
D4231	Ana crown exp 1-3 per quad		E1										
D4240	Gingival flap proc w/ planin		E1										
D4241	Gngvl flap w rootplan 1-3 th		E1										
D4245	Apically positioned flap		E1										
D4249	Crown lengthen hard tissue		E1										
D4260	Osseous surgery 4 or more		S	5871	16.8307	"$1,393.53"	.	$278.71					
D4261	Osseous surg 1 to 3 teeth		E1										
D4263	Bone replce graft first site		S	5871	16.8307	"$1,393.53"	.	$278.71					
D4264	Bone replce graft each add		S	5871	16.8307	"$1,393.53"	.	$278.71					
D4265	Bio mtrls to aid soft/os reg		E1										
D4266	Guided tiss regen resorble		E1										
D4267	Guided tiss regen nonresorb		E1										
D4268	Surgical revision procedure		S	5871	16.8307	"$1,393.53"	.	$278.71					
D4270	Pedicle soft tissue graft pr		S	5871	16.8307	"$1,393.53"	.	$278.71					
D4273	Auto tissue graft 1st tooth		S	5871	16.8307	"$1,393.53"	.	$278.71					
D4274	Mesial/distal wedge proc		E1										
D4275	Non-auto graft 1st tooth		E1										
D4276	Con tissue w dble ped graft		E1										
D4277	Soft tissue graft firsttooth		E1										
D4278	Soft tissue graft addl tooth		E1										
D4283	Auto tissue graft addl tooth		E1										
D4285	Non-auto graft addl tooth		E1										
D4320	Provision splnt intracoronal		E1										
D4321	Provisional splint extracoro		E1										
D4341	Periodontal scaling & root		E1										
D4342	Periodontal scaling 1-3teeth		E1										
D4346	Scaling gingiv inflammation		E1										
D4355	Full mouth debridement		S	5871	16.8307	"$1,393.53"	.	$278.71					
D4381	Localized delivery antimicro		S	5871	16.8307	"$1,393.53"	.	$278.71					
D4910	Periodontal maint procedures		E1										
D4920	Unscheduled dressing change		E1										
D4921	Gingival irrigation per quad		E1										
D4999	Unspecified periodontal proc		E1										
D5110	Dentures complete maxillary		E1										
D5120	Dentures complete mandible		E1										
D5130	Dentures immediat maxillary		E1										
D5140	Dentures immediat mandible		E1										
D5211	Dentures maxill part resin		E1										
D5212	Dentures mand part resin		E1										
D5213	Dentures maxill part metal		E1										
D5214	Dentures mandibl part metal		E1										
D5221	Immed max part denture resin		E1										
D5222	Immed man part denture resin		E1										
D5223	Immed max part dent metal		E1										
D5224	Immed mand part dent metal		E1										
D5225	Maxillary part denture flex		E1										
D5226	Mandibular part denture flex		E1										
D5282	"Remove unil part denture,max"		E1										
D5283	"Remove unil part denture,man"		E1										
D5284	Rem unilat dent flex base		E1										
D5286	Rem unilat dent 1 pc resin		E1										
D5410	Dentures adjust cmplt maxil		E1										
D5411	Dentures adjust cmplt mand		E1										
D5421	Dentures adjust part maxill		E1										
D5422	Dentures adjust part mandbl		E1										
D5511	Rep broke comp dent base man		E1										
D5512	Rep broke comp dent base max		E1										
D5520	Replace denture teeth complt		E1										
D5611	Rep resin part dent base man		E1										
D5612	Rep resin part dent base max		E1										
D5621	Rep cast part frame man		E1										
D5622	Rep cast part frame max		E1										
D5630	Rep partial denture clasp		E1										
D5640	Replace part denture teeth		E1										
D5650	Add tooth to partial denture		E1										
D5660	Add clasp to partial denture		E1										
D5670	Replc tth&acrlc on mtl frmwk		E1										
D5671	Replc tth&acrlc mandibular		E1										
D5710	Dentures rebase cmplt maxil		E1										
D5711	Dentures rebase cmplt mand		E1										
D5720	Dentures rebase part maxill		E1										
D5721	Dentures rebase part mandbl		E1										
D5730	Denture reln cmplt max dir		E1										
D5731	Denture reln cmplt mand dir		E1										
D5740	Denture reln part max dir		E1										
D5741	Denture reln part mand dir		E1										
D5750	Denture reln cmplt max indir		E1										
D5751	Denture reln cmplt mand ind		E1										
D5760	Denture reln part max indir		E1										
D5761	Denture reln part mand indir		E1										
D5810	Denture interm cmplt maxill		E1										
D5811	Denture interm cmplt mandbl		E1										
D5820	Denture interm part maxill		E1										
D5821	Denture interm part mandbl		E1										
D5850	Denture tiss conditn maxill		E1										
D5851	Denture tiss condtin mandbl		E1										
D5862	Precision attachment		E1										
D5863	Overdenture complete max		E1										
D5864	Overdenture partial max		E1										
D5865	Overdenture complete mandib		E1										
D5866	Overdenture partial mandib		E1										
D5867	Replacement of precision att		E1										
D5875	Prosthesis modification		E1										
D5876	Add metal sub to acrylc dent		E1										
D5899	Removable prosthodontic proc		E1										
D5911	Facial moulage sectional		S	5871	16.8307	"$1,393.53"	.	$278.71					
D5912	Facial moulage complete		S	5871	16.8307	"$1,393.53"	.	$278.71					
D5913	Nasal prosthesis		E1										
D5914	Auricular prosthesis		E1										
D5915	Orbital prosthesis		E1										
D5916	Ocular prosthesis		E1										
D5919	Facial prosthesis		E1										
D5922	Nasal septal prosthesis		E1										
D5923	Ocular prosthesis interim		E1										
D5924	Cranial prosthesis		E1										
D5925	Facial augmentation implant		E1										
D5926	Replacement nasal prosthesis		E1										
D5927	Auricular replacement		E1										
D5928	Orbital replacement		E1										
D5929	Facial replacement		E1										
D5931	Surgical obturator		E1										
D5932	Postsurgical obturator		E1										
D5933	Refitting of obturator		E1										
D5934	Mandibular flange prosthesis		E1										
D5935	Mandibular denture prosth		E1										
D5936	Temp obturator prosthesis		E1										
D5937	Trismus appliance		E1										
D5951	Feeding aid		E1										
D5952	Pediatric speech aid		E1										
D5953	Adult speech aid		E1										
D5954	Superimposed prosthesis		E1										
D5955	Palatal lift prosthesis		E1										
D5958	Intraoral con def inter plt		E1										
D5959	Intraoral con def mod palat		E1										
D5960	Modify speech aid prosthesis		E1										
D5982	Surgical stent		E1										
D5983	Radiation applicator		S	5871	16.8307	"$1,393.53"	.	$278.71					
D5984	Radiation shield		S	5871	16.8307	"$1,393.53"	.	$278.71					
D5985	Radiation cone locator		S	5871	16.8307	"$1,393.53"	.	$278.71					
D5986	Fluoride applicator		E1										
D5987	Commissure splint		S	5871	16.8307	"$1,393.53"	.	$278.71					
D5988	Surgical splint		E1										
D5991	Vesiculobullous disease carr		E1										
D5992	Adjust max prost appliance		E1										
D5993	Main/clean max prosthesis		E1										
D5994	Peridontal medicament	CH 	D										
D5995	"Peri medicament w/seal, max"	NI 	E1										
D5996	"Peri medicament w/seal, mand"	NI 	E1										
D5999	Maxillofacial prosthesis		E1										
D6010	Odontics endosteal implant		E1										
D6011	Second stage implant surgery		E1										
D6012	Endosteal implant		E1										
D6013	Surgical place mini implant		E1										
D6040	Odontics eposteal implant		E1										
D6050	Odontics transosteal implnt		E1										
D6051	Interim abutment		E1										
D6052	Semi precision attach abut	CH 	D										
D6055	Implant connecting bar		E1										
D6056	Prefabricated abutment		E1										
D6057	Custom abutment		E1										
D6058	Abutment supported crown		E1										
D6059	Abutment supported mtl crown		E1										
D6060	Abutment supported mtl crown		E1										
D6061	Abutment supported mtl crown		E1										
D6062	Abutment supported mtl crown		E1										
D6063	Abutment supported mtl crown		E1										
D6064	Abutment supported mtl crown		E1										
D6065	Implant supported crown		E1										
D6066	Implant supported mtl crown		E1										
D6067	Implant supported mtl crown		E1										
D6068	Abutment supported retainer		E1										
D6069	Abutment supported retainer		E1										
D6070	Abutment supported retainer		E1										
D6071	Abutment supported retainer		E1										
D6072	Abutment supported retainer		E1										
D6073	Abutment supported retainer		E1										
D6074	Abutment supported retainer		E1										
D6075	Implant supported retainer		E1										
D6076	Implant supported retainer		E1										
D6077	Implant supported retainer		E1										
D6080	Implant maintenance		E1										
D6081	"Scale & debride, single imp"		E1										
D6082	Imp crown porc to base alloy		E1										
D6083	Imp crown porc to noble allo		E1										
D6084	Imp crown porc to titanium		E1										
D6085	Provisional implant crown		E1										
D6086	Imp crown base alloys		E1										
D6087	Implant crown noble alloys		E1										
D6088	Imp crown titanium alloys		E1										
D6090	Repair implant		E1										
D6091	Repl semi/precision attach		E1										
D6092	Recement supp crown		E1										
D6093	Recement supp part denture		E1										
D6094	Abut support crown titanium		E1										
D6095	Odontics repr abutment		E1										
D6096	Remove broken imp ret screw		E1										
D6097	Abut crown porc to titanium		E1										
D6098	Imp retain porc to base allo		E1										
D6099	Imp retainer for fpd		E1										
D6100	Removal of implant		E1										
D6101	Debridement of a periimplant		E1										
D6102	Debridement & contouring		E1										
D6103	Bone graft repair perimplant		E1										
D6104	Bone graft time of implant		E1										
D6110	Implnt/abut remov dent max		E1										
D6111	Implnt/abut remov dent mand		E1										
D6112	Imp/abut rem dent part max		E1										
D6113	Imp/abut rem dent part mand		E1										
D6114	Implnt/abut fixed dent max		E1										
D6115	Implnt/abut fixed dent mand		E1										
D6116	Imp/abut fixed dent part max		E1										
D6117	Imp/abut fixed dent part man		E1										
D6118	Imp/abut int fixed dent man		E1										
D6119	Int/abut int fixed dent max		E1										
D6120	Imp retain porc to titanium		E1										
D6121	Retain metal fpd base alloys		E1										
D6122	Retain metal fpd noble alloy		E1										
D6123	Retain metal fpd titanium		E1										
D6190	Radio/surgical implant index		E1										
D6191	Semi precision abutment	NI	E1										
D6192	Semi precision attachment	NI	E1										
D6194	Abut support retainer titani		E1										
D6195	Abut retain porc to titanium		E1										
D6199	Implant procedure		E1										
D6205	Pontic-indirect resin based		E1										
D6210	Prosthodont high noble metal		E1										
D6211	Bridge base metal cast		E1										
D6212	Bridge noble metal cast		E1										
D6214	Pontic titanium		E1										
D6240	Bridge porcelain high noble		E1										
D6241	Bridge porcelain base metal		E1										
D6242	Bridge porcelain nobel metal		E1										
D6243	Pontic porcelain to titanium		E1										
D6245	Bridge porcelain/ceramic		E1										
D6250	Bridge resin w/high noble		E1										
D6251	Bridge resin base metal		E1										
D6252	Bridge resin w/noble metal		E1										
D6253	Provisional pontic		E1										
D6545	Dental retainr cast metl		E1										
D6548	Porcelain/ceramic retainer		E1										
D6549	Resin retainer		E1										
D6600	Porcelain/ceramic inlay 2srf		E1										
D6601	Porc/ceram inlay >= 3 surfac		E1										
D6602	Cst hgh nble mtl inlay 2 srf		E1										
D6603	Cst hgh nble mtl inlay >=3sr		E1										
D6604	Cst bse mtl inlay 2 surfaces		E1										
D6605	Cst bse mtl inlay >= 3 surfa		E1										
D6606	Cast noble metal inlay 2 sur		E1										
D6607	Cst noble mtl inlay >=3 surf		E1										
D6608	Onlay porc/crmc 2 surfaces		E1										
D6609	Onlay porc/crmc >=3 surfaces		E1										
D6610	Onlay cst hgh nbl mtl 2 srfc		E1										
D6611	Onlay cst hgh nbl mtl >=3srf		E1										
D6612	Onlay cst base mtl 2 surface		E1										
D6613	Onlay cst base mtl >=3 surfa		E1										
D6614	Onlay cst nbl mtl 2 surfaces		E1										
D6615	Onlay cst nbl mtl >=3 surfac		E1										
D6624	Inlay titanium		E1										
D6634	Onlay titanium		E1										
D6710	Crown-indirect resin based		E1										
D6720	Retain crown resin w hi nble		E1										
D6721	Crown resin w/base metal		E1										
D6722	Crown resin w/noble metal		E1										
D6740	Crown porcelain/ceramic		E1										
D6750	Crown porcelain high noble		E1										
D6751	Crown porcelain base metal		E1										
D6752	Crown porcelain noble metal		E1										
D6753	Retain crown porc to titaniu		E1										
D6780	Crown 3/4 high noble metal		E1										
D6781	Crown 3/4 cast based metal		E1										
D6782	Crown 3/4 cast noble metal		E1										
D6783	Crown 3/4 porcelain/ceramic		E1										
D6784	Retainer crown 3/4 titanium		E1										
D6790	Crown full high noble metal		E1										
D6791	Crown full base metal cast		E1										
D6792	Crown full noble metal cast		E1										
D6793	Provisional retainer crown		E1										
D6794	Crown titanium		E1										
D6920	Dental connector bar		S	5871	16.8307	"$1,393.53"	.	$278.71					
D6930	Recement/bond part denture		E1										
D6940	Stress breaker		E1										
D6950	Precision attachment		E1										
D6980	Fixed partial repair		E1										
D6985	Pediatric partial denture fx		E1										
D6999	Fixed prosthodontic proc		E1										
D7111	Extraction coronal remnants		S	5871	16.8307	"$1,393.53"	.	$278.71					
D7140	Extraction erupted tooth/exr		S	5871	16.8307	"$1,393.53"	.	$278.71					
D7210	Rem imp tooth w mucoper flp		S	5871	16.8307	"$1,393.53"	.	$278.71					
D7220	Impact tooth remov soft tiss		S	5871	16.8307	"$1,393.53"	.	$278.71					
D7230	Impact tooth remov part bony		S	5871	16.8307	"$1,393.53"	.	$278.71					
D7240	Impact tooth remov comp bony		S	5871	16.8307	"$1,393.53"	.	$278.71					
D7241	Impact tooth rem bony w/comp		S	5871	16.8307	"$1,393.53"	.	$278.71					
D7250	Tooth root removal		S	5871	16.8307	"$1,393.53"	.	$278.71					
D7251	Coronectomy		E1										
D7260	Oral antral fistula closure		S	5871	16.8307	"$1,393.53"	.	$278.71					
D7261	Primary closure sinus perf		S	5871	16.8307	"$1,393.53"	.	$278.71					
D7270	Tooth reimplantation		E1										
D7272	Tooth transplantation		E1										
D7280	Exposure of unerupted tooth		E1										
D7282	Mobilize erupted/malpos toot		E1										
D7283	Place device impacted tooth		B										
D7285	Biopsy of oral tissue hard		E1										
D7286	Biopsy of oral tissue soft		E1										
D7287	Exfoliative cytolog collect		E1										
D7288	Brush biopsy		B										
D7290	Repositioning of teeth		E1										
D7291	Transseptal fiberotomy		S	5871	16.8307	"$1,393.53"	.	$278.71					
D7292	Screw retained plate		E1										
D7293	Temp anchorage dev w flap		E1										
D7294	Temp anchorage dev w/o flap		E1										
D7295	"Bone harvest,auto graft proc"		E1										
D7296	"Corticotomy, 1-3 teeth"		E1										
D7297	"Corticotomy, 4 or more teeth"		E1										
D7310	Alveoplasty w/ extraction		E1										
D7311	Alveoloplasty w/extract 1-3		E1										
D7320	Alveoplasty w/o extraction		E1										
D7321	Alveoloplasty not w/extracts		B										
D7340	Vestibuloplasty ridge extens		E1										
D7350	Vestibuloplasty exten graft		E1										
D7410	Rad exc lesion up to 1.25 cm		E1										
D7411	Excision benign lesion>1.25c		E1										
D7412	Excision benign lesion compl		E1										
D7413	Excision malig lesion<=1.25c		E1										
D7414	Excision malig lesion>1.25cm		E1										
D7415	Excision malig les complicat		E1										
D7440	Malig tumor exc to 1.25 cm		E1										
D7441	Malig tumor > 1.25 cm		E1										
D7450	Rem odontogen cyst to 1.25cm		E1										
D7451	Rem odontogen cyst > 1.25 cm		E1										
D7460	Rem nonodonto cyst to 1.25cm		E1										
D7461	Rem nonodonto cyst > 1.25 cm		E1										
D7465	Lesion destruction		E1										
D7471	Rem exostosis any site		E1										
D7472	Removal of torus palatinus		E1										
D7473	Remove torus mandibularis		E1										
D7485	Surg reduct osseoustuberosit		E1										
D7490	Maxilla or mandible resectio		E1										
D7510	I&d absc intraoral soft tiss		E1										
D7511	Incision/drain abscess intra		B										
D7520	I&d abscess extraoral		E1										
D7521	Incision/drain abscess extra		B										
D7530	Removal fb skin/areolar tiss		E1										
D7540	Removal of fb reaction		E1										
D7550	Removal of sloughed off bone		E1										
D7560	Maxillary sinusotomy		E1										
D7610	Maxilla open reduct simple		E1										
D7620	Clsd reduct simpl maxilla fx		E1										
D7630	Open red simpl mandible fx		E1										
D7640	Clsd red simpl mandible fx		E1										
D7650	Open red simp malar/zygom fx		E1										
D7660	Clsd red simp malar/zygom fx		E1										
D7670	Closd rductn splint alveolus		E1										
D7671	Alveolus open reduction		E1										
D7680	Reduct simple facial bone fx		E1										
D7710	Maxilla open reduct compound		E1										
D7720	Clsd reduct compd maxilla fx		E1										
D7730	Open reduct compd mandble fx		E1										
D7740	Clsd reduct compd mandble fx		E1										
D7750	Open red comp malar/zygma fx		E1										
D7760	Clsd red comp malar/zygma fx		E1										
D7770	Open reduc compd alveolus fx		E1										
D7771	Alveolus clsd reduc stblz te		E1										
D7780	Reduct compnd facial bone fx		E1										
D7810	Tmj open reduct-dislocation		E1										
D7820	Closed tmp manipulation		E1										
D7830	Tmj manipulation under anest		E1										
D7840	Removal of tmj condyle		E1										
D7850	Tmj meniscectomy		E1										
D7852	Tmj repair of joint disc		E1										
D7854	Tmj excisn of joint membrane		E1										
D7856	Tmj cutting of a muscle		E1										
D7858	Tmj reconstruction		E1										
D7860	Tmj cutting into joint		E1										
D7865	Tmj reshaping components		E1										
D7870	Tmj aspiration joint fluid		E1										
D7871	Lysis + lavage w catheters		E1										
D7872	Tmj diagnostic arthroscopy		E1										
D7873	Tmj arthroscopy lysis adhesn		E1										
D7874	Tmj arthroscopy disc reposit		E1										
D7875	Tmj arthroscopy synovectomy		E1										
D7876	Tmj arthroscopy discectomy		E1										
D7877	Tmj arthroscopy debridement		E1										
D7880	Occlusal orthotic appliance		E1										
D7881	Occ orthotic device adjust		E1										
D7899	Tmj unspecified therapy		E1										
D7910	Dent sutur recent wnd to 5cm		E1										
D7911	Dental suture wound to 5 cm		E1										
D7912	Suture complicate wnd > 5 cm		E1										
D7920	Dental skin graft		E1										
D7921	Collect & appl blood product		E1										
D7922	Place intra-socket bio dress		E1										
D7940	Reshaping bone orthognathic		S	5871	16.8307	"$1,393.53"	.	$278.71					
D7941	Bone cutting ramus closed		E1										
D7943	Cutting ramus open w/graft		E1										
D7944	Bone cutting segmented		E1										
D7945	Bone cutting body mandible		E1										
D7946	Reconstruction maxilla total		E1										
D7947	Reconstruct maxilla segment		E1										
D7948	Reconstruct midface no graft		E1										
D7949	Reconstruct midface w/graft		E1										
D7950	Mandible graft		E1										
D7951	Sinus aug w bone or bone sub		E1										
D7952	Sinus augmentation vertical		E1										
D7953	Bone replacement graft		E1										
D7955	Repair maxillofacial defects		E1										
D7960	Frenulectomy/frenectomy	CH 	D										
D7961	Buccal/labial frenectomy	NI 	E1										
D7962	Lingual frenectomy	NI 	E1										
D7963	Frenuloplasty		E1										
D7970	Excision hyperplastic tissue		E1										
D7971	Excision pericoronal gingiva		E1										
D7972	Surg redct fibrous tuberosit		E1										
D7979	Non-surgical sialolithotomy		E1										
D7980	Surgical sialolithotomy		E1										
D7981	Excision of salivary gland		E1										
D7982	Sialodochoplasty		E1										
D7983	Closure of salivary fistula		E1										
D7990	Emergency tracheotomy		E1										
D7991	Dental coronoidectomy		E1										
D7993	Surg place craniofacial impl	NI 	E1										
D7994	Surg place zygomatic impl	NI 	E1										
D7995	Synthetic graft facial bones		E1										
D7996	Implant mandible for augment		E1										
D7997	Appliance removal		E1										
D7998	Intraoral place of fix dev		E1										
D7999	Oral surgery procedure		E1										
D8010	Limited dental tx primary		E1										
D8020	Limited dental tx transition		E1										
D8030	Limited dental tx adolescent		E1										
D8040	Limited dental tx adult		E1										
D8050	Intercep dental tx primary		E1										
D8060	Intercep dental tx transitn		E1										
D8070	Compre dental tx transition		E1										
D8080	Compre dental tx adolescent		E1										
D8090	Compre dental tx adult		E1										
D8210	Orthodontic rem appliance tx		E1										
D8220	Fixed appliance therapy habt		E1										
D8660	Preorthodontic tx visit		E1										
D8670	Periodic orthodontc tx visit		E1										
D8680	Orthodontic retention		E1										
D8681	Removable retainer adjust		E1										
D8690	Orthodontic treatment		E1										
D8695	Remove fixed ortho appliance		E1										
D8696	Rep of ortho appliance max		E1										
D8697	Rep of ortho appliance man		E1										
D8698	Recement fixed retainer max		E1										
D8699	Recement fixed retainer man		E1										
D8701	Repair fixed retainer max		E1										
D8702	Repair of fixed retainer man		E1										
D8703	Replace broken retainer max		E1										
D8704	Replace broken retainer man		E1										
D8999	Orthodontic procedure		E1										
D9110	Tx dental pain minor proc		N										
D9120	Fix partial denture section		E1										
D9130	Temporomandibular joint dysf		E1										
D9210	Dent anesthesia w/o surgery		E1										
D9211	Regional block anesthesia		E1										
D9212	Trigeminal block anesthesia		E1										
D9215	Local anesthesia		E1										
D9219	Eval mod/deep sed/gen anest		E1										
D9222	"Deep anest, 1st 15 min"		E1										
D9223	General anesth ea addl 15 mi		E1										
D9230	Analgesia		N										
D9239	"Iv mod sedation, 1st 15 min"		E1										
D9243	Iv sedation ea addl 15m		E1										
D9248	Sedation (non-iv)		N										
D9310	Dental consultation		E1										
D9311	Consult w/med hlth care prof		E1										
D9410	Dental house call		E1										
D9420	Hospital/asc call		E1										
D9430	Office visit during hours		E1										
D9440	Office visit after hours		E1										
D9450	Case presentation tx plan		E1										
D9610	Dent therapeutic drug inject		E1										
D9612	Thera par drugs 2 or > admin		E1										
D9613	Infiltration thera drug		E1										
D9630	Drugs/meds disp for home use		B										
D9910	Dent appl desensitizing med		E1										
D9911	Appl desensitizing resin		E1										
D9920	Behavior management		E1										
D9930	Treatment of complications		S	5871	16.8307	"$1,393.53"	.	$278.71					
D9932	Clean & inspect rem dent max		E1										
D9933	Clean & inspect rem dent man		E1										
D9934	Clean rem part denture max		E1										
D9935	Clean rem part denture mand		E1										
D9941	Fabrication athletic guard		E1										
D9942	Repair/reline occlusal guard		E1										
D9943	Occlusal guard adjustment		E1										
D9944	"Occ guard, hard, full arch"		S	5871	16.8307	"$1,393.53"	.	$278.71					
D9945	"Occ guard, soft, full arch"		S	5871	16.8307	"$1,393.53"	.	$278.71					
D9946	"Occ guard, hard, part arch"		S	5871	16.8307	"$1,393.53"	.	$278.71					
D9950	Occlusion analysis		S	5871	16.8307	"$1,393.53"	.	$278.71					
D9951	Limited occlusal adjustment		S	5871	16.8307	"$1,393.53"	.	$278.71					
D9952	Complete occlusal adjustment		S	5871	16.8307	"$1,393.53"	.	$278.71					
D9961	Dup/copy patient's records		E1										
D9970	Enamel microabrasion		E1										
D9971	Odontoplasty per tooth		E1										
D9972	Extrnl bleaching per arch		E1										
D9973	Extrnl bleaching per tooth		E1										
D9974	Intrnl bleaching per tooth		E1										
D9975	External bleaching home app		E1										
D9985	Sales tax		E1										
D9986	Missed appointment		E1										
D9987	Cancelled appointment		E1										
D9990	Trans or sign language svcs		E1										
D9991	"Case mgmt, appt barriers"		E1										
D9992	"Case mgmt, care coordination"		E1										
D9993	"Case mgmt, interviewing"		E1										
D9994	"Case mgmt, pt education"		E1										
D9995	Teledentistry real-time		E1										
D9996	Teledentistry dent review		E1										
D9997	Dent case mgmt special needs		E1										
D9999	Adjunctive procedure		E1										
E0100	Cane adjust/fixed with tip		Y										
E0105	Cane adjust/fixed quad/3 pro		Y										
E0110	Crutch forearm pair		Y										
E0111	Crutch forearm each		Y										
E0112	Crutch underarm pair wood		Y										
E0113	Crutch underarm each wood		Y										
E0114	Crutch underarm pair no wood		Y										
E0116	Crutch underarm each no wood		Y										
E0117	Underarm springassist crutch		Y										
E0118	Crutch substitute		E1										
E0130	Walker rigid adjust/fixed ht		Y										
E0135	Walker folding adjust/fixed		Y										
E0140	Walker w trunk support		Y										
E0141	Rigid wheeled walker adj/fix		Y										
E0143	Walker folding wheeled w/o s		Y										
E0144	Enclosed walker w rear seat		Y										
E0147	Walker variable wheel resist		Y										
E0148	Heavyduty walker no wheels		Y										
E0149	Heavy duty wheeled walker		Y										
E0153	Forearm crutch platform atta		Y										
E0154	Walker platform attachment		Y										
E0155	"Walker wheel attachment,pair"		Y										
E0156	Walker seat attachment		Y										
E0157	Walker crutch attachment		Y										
E0158	Walker leg extenders set of4		Y										
E0159	Brake for wheeled walker		Y										
E0160	Sitz type bath or equipment		Y										
E0161	Sitz bath/equipment w/faucet		Y										
E0162	Sitz bath chair		Y										
E0163	Commode chair with fixed arm		Y										
E0165	Commode chair with detacharm		Y										
E0167	Commode chair pail or pan		Y										
E0168	Heavyduty/wide commode chair		Y										
E0170	Commode chair electric		Y										
E0171	Commode chair non-electric		Y										
E0172	Seat lift mechanism toilet		E1										
E0175	Commode chair foot rest		Y										
E0181	Press pad alternating w/ pum		Y										
E0182	"Replace pump, alt press pad"		Y										
E0184	Dry pressure mattress		Y										
E0185	Gel pressure mattress pad		Y										
E0186	Air pressure mattress		Y										
E0187	Water pressure mattress		Y										
E0188	Synthetic sheepskin pad		Y										
E0189	Lambswool sheepskin pad		Y										
E0190	Positioning cushion		E1										
E0191	Protector heel or elbow		Y										
E0193	Powered air flotation bed		Y										
E0194	Air fluidized bed		Y										
E0196	Gel pressure mattress		Y										
E0197	Air pressure pad for mattres		Y										
E0198	Water pressure pad for mattr		Y										
E0199	Dry pressure pad for mattres		Y										
E0200	Heat lamp without stand		Y										
E0202	Phototherapy light w/ photom		Y										
E0203	Therapeutic lightbox tabletp		E1										
E0205	Heat lamp with stand		Y										
E0210	Electric heat pad standard		Y										
E0215	Electric heat pad moist		Y										
E0217	Water circ heat pad w pump		Y										
E0218	Fluid circ cold pad w pump		Y										
E0221	Infrared heating pad system		Y										
E0225	Hydrocollator unit		Y										
E0231	Wound warming device		E1										
E0232	Warming card for nwt		E1										
E0235	Paraffin bath unit portable		Y										
E0236	Pump for water circulating p		Y										
E0239	Hydrocollator unit portable		Y										
E0240	Bath/shower chair		E1										
E0241	Bath tub wall rail		E1										
E0242	Bath tub rail floor		E1										
E0243	Toilet rail		E1										
E0244	Toilet seat raised		E1										
E0245	Tub stool or bench		E1										
E0246	Transfer tub rail attachment		E1										
E0247	Trans bench w/wo comm open		E1										
E0248	Hdtrans bench w/wo comm open		E1										
E0249	Pad water circulating heat u		Y										
E0250	Hosp bed fixed ht w/ mattres		Y										
E0251	Hosp bed fixd ht w/o mattres		Y										
E0255	Hospital bed var ht w/ mattr		Y										
E0256	Hospital bed var ht w/o matt		Y										
E0260	Hosp bed semi-electr w/ matt		Y										
E0261	Hosp bed semi-electr w/o mat		Y										
E0265	Hosp bed total electr w/ mat		Y										
E0266	Hosp bed total elec w/o matt		Y										
E0270	Hospital bed institutional t		E1										
E0271	Mattress innerspring		Y										
E0272	Mattress foam rubber		Y										
E0273	Bed board		E1										
E0274	Over-bed table		E1										
E0275	Bed pan standard		Y										
E0276	Bed pan fracture		Y										
E0277	Powered pres-redu air mattrs		Y										
E0280	Bed cradle		Y										
E0290	Hosp bed fx ht w/o rails w/m		Y										
E0291	Hosp bed fx ht w/o rail w/o		Y										
E0292	Hosp bed var ht no sr w/matt		Y										
E0293	Hosp bed var ht no sr no mat		Y										
E0294	Hosp bed semi-elect w/ mattr		Y										
E0295	Hosp bed semi-elect w/o matt		Y										
E0296	Hosp bed total elect w/ matt		Y										
E0297	Hosp bed total elect w/o mat		Y										
E0300	Enclosed ped crib hosp grade		Y										
E0301	"Hd hosp bed, 350-600 lbs"		Y										
E0302	Ex hd hosp bed > 600 lbs		Y										
E0303	Hosp bed hvy dty xtra wide		Y										
E0304	Hosp bed xtra hvy dty x wide		Y										
E0305	Rails bed side half length		Y										
E0310	Rails bed side full length		Y										
E0315	Bed accessory brd/tbl/supprt		E1										
E0316	Bed safety enclosure		Y										
E0325	Urinal male jug-type		Y										
E0326	Urinal female jug-type		Y										
E0328	"Ped hospital bed, manual"		Y										
E0329	Ped hospital bed semi/elect		Y										
E0350	Control unit bowel system		E1										
E0352	Disposable pack w/bowel syst		E1										
E0370	Air elevator for heel		E1										
E0371	Nonpower mattress overlay		Y										
E0372	Powered air mattress overlay		Y										
E0373	Nonpowered pressure mattress		Y										
E0424	Stationary compressed gas 02		Y										
E0425	Gas system stationary compre		E1										
E0430	Oxygen system gas portable		E1										
E0431	Portable gaseous 02		Y										
E0433	Portable liquid oxygen sys		Y										
E0434	Portable liquid 02		Y										
E0435	Oxygen system liquid portabl		E1										
E0439	Stationary liquid 02		Y										
E0440	Oxygen system liquid station		E1										
E0441	"Stationary o2 contents, gas"		Y										
E0442	"Stationary o2 contents, liq"		Y										
E0443	"Portable 02 contents, gas"		Y										
E0444	"Portable 02 contents, liquid"		Y										
E0445	Oximeter non-invasive		N										
E0446	"Topical ox deliver sys, nos"		A										
E0447	"Port o2 cont, liq over 4 lpm"		Y										
E0455	Oxygen tent excl croup/ped t		Y										
E0457	Chest shell		E1										
E0459	Chest wrap		E1										
E0462	Rocking bed w/ or w/o side r		Y										
E0465	Home vent invasive interface		Y										
E0466	Home vent non-invasive inter		Y										
E0467	Home vent multi-function		Y										
E0470	Rad w/o backup non-inv intfc		Y										
E0471	Rad w/backup non inv intrfc		Y										
E0472	Rad w backup invasive intrfc		Y										
E0480	Percussor elect/pneum home m		Y										
E0481	Intrpulmnry percuss vent sys		E1										
E0482	Cough stimulating device		Y										
E0483	Hi freq chest wall oscil sys		Y										
E0484	Non-elec oscillatory pep dvc		Y										
E0485	Oral device/appliance prefab		Y										
E0486	Oral device/appliance cusfab		Y										
E0487	Electronic spirometer		N										
E0500	Ippb all types		Y										
E0550	Humidif extens supple w ippb		Y										
E0555	Humidifier for use w/ regula		Y										
E0560	Humidifier supplemental w/ i		Y										
E0561	Humidifier nonheated w pap		Y										
E0562	Humidifier heated used w pap		Y										
E0565	Compressor air power source		Y										
E0570	Nebulizer with compression		Y										
E0572	Aerosol compressor adjust pr		Y										
E0574	Ultrasonic generator w svneb		Y										
E0575	Nebulizer ultrasonic		Y										
E0580	Nebulizer for use w/ regulat		Y										
E0585	Nebulizer w/ compressor & he		Y										
E0600	Suction pump portab hom modl		Y										
E0601	Cont airway pressure device		Y										
E0602	Manual breast pump		Y										
E0603	Electric breast pump		N										
E0604	Hosp grade elec breast pump		A										
E0605	Vaporizer room type		Y										
E0606	Drainage board postural		Y										
E0607	Blood glucose monitor home		Y										
E0610	Pacemaker monitr audible/vis		Y										
E0615	Pacemaker monitr digital/vis		Y										
E0616	Cardiac event recorder		N										
E0617	Automatic ext defibrillator		Y										
E0618	Apnea monitor		Y										
E0619	Apnea monitor w recorder		Y										
E0620	Cap bld skin piercing laser		Y										
E0621	Patient lift sling or seat		Y										
E0625	Patient lift bathroom or toi		E1										
E0627	"Seat lift mech, electric any"		Y										
E0629	"Seat lift mech, non-electric"		Y										
E0630	Patient lift hydraulic		Y										
E0635	Patient lift electric		Y										
E0636	Pt support & positioning sys		Y										
E0637	Combination sit to stand sys		E1										
E0638	Standing frame sys		E1										
E0639	Moveable patient lift system		E1										
E0640	Fixed patient lift system		E1										
E0641	Multi-position stnd fram sys		E1										
E0642	Dynamic standing frame		E1										
E0650	Pneuma compresor non-segment		Y										
E0651	Pneum compressor segmental		Y										
E0652	Pneum compres w/cal pressure		Y										
E0655	Pneumatic appliance half arm		Y										
E0656	Segmental pneumatic trunk		Y										
E0657	Segmental pneumatic chest		Y										
E0660	Pneumatic appliance full leg		Y										
E0665	Pneumatic appliance full arm		Y										
E0666	Pneumatic appliance half leg		Y										
E0667	Seg pneumatic appl full leg		Y										
E0668	Seg pneumatic appl full arm		Y										
E0669	Seg pneumatic appli half leg		Y										
E0670	Seg pneum int legs/trunk		Y										
E0671	Pressure pneum appl full leg		Y										
E0672	Pressure pneum appl full arm		Y										
E0673	Pressure pneum appl half leg		Y										
E0675	Pneumatic compression device		Y										
E0676	Inter limb compress dev nos		Y										
E0691	Uvl pnl 2 sq ft or less		Y										
E0692	Uvl sys panel 4 ft		Y										
E0693	Uvl sys panel 6 ft		Y										
E0694	Uvl md cabinet sys 6 ft		Y										
E0700	Safety equipment		E1										
E0705	Transfer device		B										
E0710	Restraints any type		E1										
E0720	Tens two lead		Y										
E0730	Tens four lead		Y										
E0731	Conductive garment for tens/		Y										
E0740	Non-implant pelv flr e-stim		Y										
E0744	Neuromuscular stim for scoli		Y										
E0745	Neuromuscular stim for shock		Y										
E0746	Electromyograph biofeedback		N										
E0747	Elec osteogen stim not spine		Y										
E0748	Elec osteogen stim spinal		Y										
E0749	Elec osteogen stim implanted		N										
E0755	Electronic salivary reflex s		E1										
E0760	Osteogen ultrasound stimltor		Y										
E0761	Nontherm electromgntc device		E1										
E0762	Trans elec jt stim dev sys		B										
E0764	Functional neuromuscularstim		Y										
E0765	Nerve stimulator for tx n&v		Y										
E0766	Elec stim cancer treatment		Y										
E0769	Electric wound treatment dev		B										
E0770	Functional electric stim nos		Y										
E0776	Iv pole		Y										
E0779	Amb infusion pump mechanical		Y										
E0780	Mech amb infusion pump <8hrs		Y										
E0781	External ambulatory infus pu		Y										
E0782	Non-programble infusion pump		N										
E0783	Programmable infusion pump		N										
E0784	Ext amb infusn pump insulin		Y										
E0785	Replacement impl pump cathet		N										
E0786	Implantable pump replacement		N										
E0787	Cgs dose adj insulin inf pmp		E1										
E0791	Parenteral infusion pump sta		Y										
E0830	Ambulatory traction device		N										
E0840	Tract frame attach headboard		Y										
E0849	Cervical pneum trac equip		Y										
E0850	Traction stand free standing		Y										
E0855	Cervical traction equipment		Y										
E0856	Cervic collar w air bladders		Y										
E0860	Tract equip cervical tract		Y										
E0870	Tract frame attach footboard		Y										
E0880	Trac stand free stand extrem		Y										
E0890	Traction frame attach pelvic		Y										
E0900	Trac stand free stand pelvic		Y										
E0910	Trapeze bar attached to bed		Y										
E0911	Hd trapeze bar attach to bed		Y										
E0912	Hd trapeze bar free standing		Y										
E0920	Fracture frame attached to b		Y										
E0930	Fracture frame free standing		Y										
E0935	Cont pas motion exercise dev		Y										
E0936	"Cpm device, other than knee"		E1										
E0940	Trapeze bar free standing		Y										
E0941	Gravity assisted traction de		Y										
E0942	Cervical head harness/halter		Y										
E0944	Pelvic belt/harness/boot		Y										
E0945	Belt/harness extremity		Y										
E0946	Fracture frame dual w cross		Y										
E0947	Fracture frame attachmnts pe		Y										
E0948	Fracture frame attachmnts ce		Y										
E0950	Tray		Y										
E0951	Loop heel		Y										
E0952	"Toe loop/holder, each"		Y										
E0953	W/c lateral thigh/knee sup		Y										
E0954	"Foot box, any type each foot"		Y										
E0955	Cushioned headrest		Y										
E0956	W/c lateral trunk/hip suppor		Y										
E0957	W/c medial thigh support		Y										
E0958	Whlchr att- conv 1 arm drive		Y										
E0959	Amputee adapter		B										
E0960	W/c shoulder harness/straps		Y										
E0961	Wheelchair brake extension		B										
E0966	Wheelchair head rest extensi		B										
E0967	Man wc rim/projection rep ea		Y										
E0968	Wheelchair commode seat		Y										
E0969	Wheelchair narrowing device		Y										
E0970	Wheelchair no. 2 footplates		E1										
E0971	Wheelchair anti-tipping devi		B										
E0973	W/ch access det adj armrest		B										
E0974	W/ch access anti-rollback		B										
E0978	"W/c acc,saf belt pelv strap"		B										
E0980	Wheelchair safety vest		Y										
E0981	"Seat upholstery, replacement"		Y										
E0982	"Back upholstery, replacement"		Y										
E0983	Add pwr joystick		Y										
E0984	Add pwr tiller		Y										
E0985	W/c seat lift mechanism		Y										
E0986	Man w/c push-rim powr system		Y										
E0988	Lever-activated wheel drive		Y										
E0990	Wheelchair elevating leg res		B										
E0992	Wheelchair solid seat insert		B										
E0994	Wheelchair arm rest		Y										
E0995	"Wc calf rest, pad replacemnt"		B										
E1002	Pwr seat tilt		Y										
E1003	Pwr seat recline		Y										
E1004	Pwr seat recline mech		Y										
E1005	Pwr seat recline pwr		Y										
E1006	Pwr seat combo w/o shear		Y										
E1007	Pwr seat combo w/shear		Y										
E1008	Pwr seat combo pwr shear		Y										
E1009	Add mech leg elevation		Y										
E1010	Add pwr leg elevation		Y										
E1011	Ped wc modify width adjustm		Y										
E1012	Ctr mount pwr elev leg rest		Y										
E1014	Reclining back add ped w/c		Y										
E1015	Shock absorber for man w/c		Y										
E1016	Shock absorber for power w/c		Y										
E1017	Hd shck absrbr for hd man wc		Y										
E1018	Hd shck absrber for hd powwc		Y										
E1020	Residual limb support system		Y										
E1028	W/c manual swingaway		Y										
E1029	W/c vent tray fixed		Y										
E1030	W/c vent tray gimbaled		Y										
E1031	Rollabout chair with casters		Y										
E1035	Patient transfer system <300		Y										
E1036	Patient transfer system >300		Y										
E1037	"Transport chair, ped size"		Y										
E1038	Transport chair pt wt<=300lb		Y										
E1039	Transport chair pt wt >300lb		Y										
E1050	Whelchr fxd full length arms		Y										
E1060	Wheelchair detachable arms		Y										
E1070	Wheelchair detachable foot r		Y										
E1083	Hemi-wheelchair fixed arms		Y										
E1084	Hemi-wheelchair detachable a		Y										
E1085	Hemi-wheelchair fixed arms		E1										
E1086	Hemi-wheelchair detachable a		E1										
E1087	Wheelchair lightwt fixed arm		Y										
E1088	Wheelchair lightweight det a		Y										
E1089	Wheelchair lightwt fixed arm		E1										
E1090	Wheelchair lightweight det a		E1										
E1092	Wheelchair wide w/ leg rests		Y										
E1093	Wheelchair wide w/ foot rest		Y										
E1100	Whchr s-recl fxd arm leg res		Y										
E1110	Wheelchair semi-recl detach		Y										
E1130	Whlchr stand fxd arm ft rest		E1										
E1140	Wheelchair standard detach a		E1										
E1150	Wheelchair standard w/ leg r		Y										
E1160	Wheelchair fixed arms		Y										
E1161	Manual adult wc w tiltinspac		Y										
E1170	Whlchr ampu fxd arm leg rest		Y										
E1171	Wheelchair amputee w/o leg r		Y										
E1172	Wheelchair amputee detach ar		Y										
E1180	Wheelchair amputee w/ foot r		Y										
E1190	Wheelchair amputee w/ leg re		Y										
E1195	Wheelchair amputee heavy dut		Y										
E1200	Wheelchair amputee fixed arm		Y										
E1220	Whlchr special size/constrc		Y										
E1221	Wheelchair spec size w foot		Y										
E1222	Wheelchair spec size w/ leg		Y										
E1223	Wheelchair spec size w foot		Y										
E1224	Wheelchair spec size w/ leg		Y										
E1225	Manual semi-reclining back		Y										
E1226	Manual fully reclining back		B										
E1227	Wheelchair spec sz spec ht a		Y										
E1228	Wheelchair spec sz spec ht b		Y										
E1229	Pediatric wheelchair nos		Y										
E1230	Power operated vehicle		Y										
E1231	Rigid ped w/c tilt-in-space		Y										
E1232	Folding ped wc tilt-in-space		Y										
E1233	Rig ped wc tltnspc w/o seat		Y										
E1234	Fld ped wc tltnspc w/o seat		Y										
E1235	Rigid ped wc adjustable		Y										
E1236	Folding ped wc adjustable		Y										
E1237	Rgd ped wc adjstabl w/o seat		Y										
E1238	Fld ped wc adjstabl w/o seat		Y										
E1239	Ped power wheelchair nos		Y										
E1240	Whchr litwt det arm leg rest		Y										
E1250	Wheelchair lightwt fixed arm		E1										
E1260	Wheelchair lightwt foot rest		E1										
E1270	Wheelchair lightweight leg r		Y										
E1280	Whchr h-duty det arm leg res		Y										
E1285	Wheelchair heavy duty fixed		E1										
E1290	Wheelchair hvy duty detach a		E1										
E1295	Wheelchair heavy duty fixed		Y										
E1296	Wheelchair special seat heig		Y										
E1297	Wheelchair special seat dept		Y										
E1298	Wheelchair spec seat depth/w		Y										
E1300	Whirlpool portable		E1										
E1310	Whirlpool non-portable		Y										
E1352	O2 flow reg pos inspir press		Y										
E1353	Oxygen supplies regulator		Y										
E1354	"Wheeled cart, port cyl/conc"		Y										
E1355	Oxygen supplies stand/rack		Y										
E1356	"Batt pack/cart, port conc"		Y										
E1357	"Battery charger, port conc"		Y										
E1358	"Dc power adapter, port conc"		Y										
E1372	Oxy suppl heater for nebuliz		Y										
E1390	Oxygen concentrator		Y										
E1391	"Oxygen concentrator, dual"		Y										
E1392	Portable oxygen concentrator		Y										
E1399	Durable medical equipment mi		Y										
E1405	O2/water vapor enrich w/heat		Y										
E1406	O2/water vapor enrich w/o he		Y										
E1500	Centrifuge		A										
E1510	Kidney dialysate delivry sys		A										
E1520	Heparin infusion pump		A										
E1530	Replacement air bubble detec		A										
E1540	Replacement pressure alarm		A										
E1550	Bath conductivity meter		A										
E1560	Replace blood leak detector		A										
E1570	Adjustable chair for esrd pt		A										
E1575	Transducer protect/fld bar		A										
E1580	Unipuncture control system		A										
E1590	Hemodialysis machine		A										
E1592	Auto interm peritoneal dialy		A										
E1594	Cycler dialysis machine		A										
E1600	Deli/install chrg hemo equip		A										
E1610	Reverse osmosis h2o puri sys		A										
E1615	Deionizer h2o puri system		A										
E1620	Replacement blood pump		A										
E1625	Water softening system		A										
E1630	Reciprocating peritoneal dia		A										
E1632	Wearable artificial kidney		A										
E1634	Peritoneal dialysis clamp		B										
E1635	Compact travel hemodialyzer		A										
E1636	Sorbent cartridges per 10		A										
E1637	"Hemostats for dialysis, each"		A										
E1639	"Scale, each"		A										
E1699	Dialysis equipment noc		A										
E1700	Jaw motion rehab system		Y										
E1701	Repl cushions for jaw motion		Y										
E1702	Repl measr scales jaw motion		Y										
E1800	Adjust elbow ext/flex device		Y										
E1801	Sps elbow device		Y										
E1802	Adjst forearm pro/sup device		Y										
E1805	Adjust wrist ext/flex device		Y										
E1806	Sps wrist device		Y										
E1810	Adjust knee ext/flex device		Y										
E1811	Sps knee device		Y										
E1812	Knee ext/flex w act res ctrl		Y										
E1815	Adjust ankle ext/flex device		Y										
E1816	Sps ankle device		Y										
E1818	Sps forearm device		Y										
E1820	Soft interface material		Y										
E1821	Replacement interface spsd		Y										
E1825	Adjust finger ext/flex devc		Y										
E1830	Adjust toe ext/flex device		Y										
E1831	Static str toe dev ext/flex		Y										
E1840	Adj shoulder ext/flex device		Y										
E1841	Static str shldr dev rom adj		Y										
E1902	Aac non-electronic board		Y										
E2000	Gastric suction pump hme mdl		Y										
E2100	Bld glucose monitor w voice		Y										
E2101	Bld glucose monitor w lance		Y										
E2120	Pulse gen sys tx endolymp fl		Y										
E2201	"Man w/ch acc seat w>=20""<24"""		Y										
E2202	Seat width 24-27 in		Y										
E2203	Frame depth less than 22 in		Y										
E2204	Frame depth 22 to 25 in		Y										
E2205	"Manual wc accessory, handrim"		Y										
E2206	Man wc whl lock comp repl ea		Y										
E2207	Crutch and cane holder		Y										
E2208	Cylinder tank carrier		Y										
E2209	Arm trough each		Y										
E2210	Wheelchair bearings		Y										
E2211	Pneumatic propulsion tire		Y										
E2212	Pneumatic prop tire tube		Y										
E2213	Pneumatic prop tire insert		Y										
E2214	Pneumatic caster tire each		Y										
E2215	Pneumatic caster tire tube		Y										
E2216	Foam filled propulsion tire		Y										
E2217	Foam filled caster tire each		Y										
E2218	Foam propulsion tire each		Y										
E2219	Foam caster tire any size ea		Y										
E2220	"Solid propuls tire, repl, ea"		Y										
E2221	"Solid caster tire repl, each"		Y										
E2222	"Solid caster integ whl, repl"		Y										
E2224	Propulsion whl excl tire rep		Y										
E2225	Caster wheel excludes tire		Y										
E2226	Caster fork replacement only		Y										
E2227	Gear reduction drive wheel		Y										
E2228	"Mwc acc, wheelchair brake"		Y										
E2230	Manual standing system		Y										
E2231	Solid seat support base		Y										
E2291	Planar back for ped size wc		Y										
E2292	Planar seat for ped size wc		Y										
E2293	Contour back for ped size wc		Y										
E2294	Contour seat for ped size wc		Y										
E2295	Ped dynamic seating frame		Y										
E2300	Pwr seat elevation sys		Y										
E2301	Pwr standing		Y										
E2310	Electro connect btw control		Y										
E2311	Electro connect btw 2 sys		Y										
E2312	Mini-prop remote joystick		Y										
E2313	"Pwc harness, expand control"		Y										
E2321	Hand interface joystick		Y										
E2322	Mult mech switches		Y										
E2323	Special joystick handle		Y										
E2324	Chin cup interface		Y										
E2325	Sip and puff interface		Y										
E2326	Breath tube kit		Y										
E2327	Head control interface mech		Y										
E2328	Head/extremity control inter		Y										
E2329	Head control nonproportional		Y										
E2330	Head control proximity switc		Y										
E2331	Attendant control		Y										
E2340	W/c wdth 20-23 in seat frame		Y										
E2341	W/c wdth 24-27 in seat frame		Y										
E2342	W/c dpth 20-21 in seat frame		Y										
E2343	W/c dpth 22-25 in seat frame		Y										
E2351	Electronic sgd interface		Y										
E2358	Gr 34 nonsealed leadacid		Y										
E2359	Gr34 sealed leadacid battery		Y										
E2360	22nf nonsealed leadacid		Y										
E2361	22nf sealed leadacid battery		Y										
E2362	Gr24 nonsealed leadacid		Y										
E2363	Gr24 sealed leadacid battery		Y										
E2364	U1nonsealed leadacid battery		Y										
E2365	U1 sealed leadacid battery		Y										
E2366	"Battery charger, single mode"		Y										
E2367	"Battery charger, dual mode"		Y										
E2368	Pwr wc drivewheel motor repl		Y										
E2369	Pwr wc drivewheel gear repl		Y										
E2370	Pwr wc dr wh motor/gear comb		Y										
E2371	Gr27 sealed leadacid battery		Y										
E2372	Gr27 non-sealed leadacid		Y										
E2373	Hand/chin ctrl spec joystick		Y										
E2374	Hand/chin ctrl std joystick		Y										
E2375	Non-expandable controller		Y										
E2376	"Expandable controller, repl"		Y										
E2377	"Expandable controller, initl"		Y										
E2378	Pw actuator replacement		Y										
E2381	Pneum drive wheel tire		Y										
E2382	"Tube, pneum wheel drive tire"		Y										
E2383	"Insert, pneum wheel drive"		Y										
E2384	Pneumatic caster tire		Y										
E2385	"Tube, pneumatic caster tire"		Y										
E2386	Foam filled drive wheel tire		Y										
E2387	Foam filled caster tire		Y										
E2388	Foam drive wheel tire		Y										
E2389	Foam caster tire		Y										
E2390	Solid drive wheel tire		Y										
E2391	Solid caster tire		Y										
E2392	"Solid caster tire, integrate"		Y										
E2394	Drive wheel excludes tire		Y										
E2395	Caster wheel excludes tire		Y										
E2396	Caster fork		Y										
E2397	"Pwc acc, lith-based battery"		Y										
E2398	Wc dynamic pos back hardware		Y										
E2402	Neg press wound therapy pump		Y										
E2500	Sgd digitized pre-rec <=8min		Y										
E2502	Sgd prerec msg >8min <=20min		Y										
E2504	Sgd prerec msg>20min <=40min		Y										
E2506	Sgd prerec msg > 40 min		Y										
E2508	Sgd spelling phys contact		Y										
E2510	Sgd w multi methods msg/accs		Y										
E2511	Sgd sftwre prgrm for pc/pda		Y										
E2512	"Sgd accessory, mounting sys"		Y										
E2599	Sgd accessory noc		Y										
E2601	Gen w/c cushion wdth < 22 in		Y										
E2602	Gen w/c cushion wdth >=22 in		Y										
E2603	Skin protect wc cus wd <22in		Y										
E2604	Skin protect wc cus wd>=22in		Y										
E2605	Position wc cush wdth <22 in		Y										
E2606	Position wc cush wdth>=22 in		Y										
E2607	Skin pro/pos wc cus wd <22in		Y										
E2608	Skin pro/pos wc cus wd>=22in		Y										
E2609	Custom fabricate w/c cushion		Y										
E2610	Powered w/c cushion		B										
E2611	Gen use back cush wdth <22in		Y										
E2612	Gen use back cush wdth>=22in		Y										
E2613	Position back cush wd <22in		Y										
E2614	Position back cush wd>=22in		Y										
E2615	Pos back post/lat wdth <22in		Y										
E2616	Pos back post/lat wdth>=22in		Y										
E2617	Custom fab w/c back cushion		Y										
E2619	Replace cover w/c seat cush		Y										
E2620	Wc planar back cush wd <22in		Y										
E2621	Wc planar back cush wd>=22in		Y										
E2622	Adj skin pro w/c cus wd<22in		Y										
E2623	Adj skin pro wc cus wd>=22in		Y										
E2624	Adj skin pro/pos cus<22in		Y										
E2625	Adj skin pro/pos wc cus>=22		Y										
E2626	Seo mobile arm sup att to wc		Y										
E2627	Arm supp att to wc rancho ty		Y										
E2628	Mobile arm supports reclinin		Y										
E2629	Friction dampening arm supp		Y										
E2630	Monosuspension arm/hand supp		Y										
E2631	Elevat proximal arm support		Y										
E2632	Offset/lat rocker arm w/ela		Y										
E2633	Mobile arm support supinator		Y										
E8000	Posterior gait trainer		E1										
E8001	Upright gait trainer		E1										
E8002	Anterior gait trainer		E1										
G0008	Admin influenza virus vac		S	5691	0.4831	$40.00	$0.00	$0.00					
G0009	Admin pneumococcal vaccine		S	5691	0.4831	$40.00	$0.00	$0.00					
G0010	Admin hepatitis b vaccine		S	5691	0.4831	$40.00	$0.00	$0.00					
G0027	Semen analysis		Q4										
G0068	Adm iv infusion drug in home		A										
G0069	Adm sq infusion drug in home		A										
G0070	Adm of chemo drug in home		A										
G0071	Comm svcs by rhc/fqhc 5 min		A										
G0076	Care manag h vst new pt 20 m		B										
G0077	Care manag h vst new pt 30 m		B										
G0078	Care manag h vst new pt 45 m		B										
G0079	Care manag h vst new pt 60 m		B										
G0080	Care manag h vst new pt 75 m		B										
G0081	Care man h v ext pt 20 mi		B										
G0082	Care man h v ext pt 30 m		B										
G0083	Care man h v ext pt 45 m		B										
G0084	Care man h v ext pt 60 m		B										
G0085	Care man h v ext pt 75 m		B										
G0086	Care man home care plan 30 m		B										
G0087	Care man home care plan 60 m		B										
G0088	Adm iv drug 1st home visit	NI 	A										
G0089	Adm subq drug 1st home visit	NI 	A										
G0090	Adm iv chemo 1st home visit	NI 	A										
G0101	Ca screen;pelvic/breast exam		S	5822	0.9043	$74.87	$0.00	$0.00					
G0102	Prostate ca screening; dre		N										
G0103	Psa screening		A										
G0104	Ca screen;flexi sigmoidscope		T	5311	9.5855	$793.65	$0.00	$0.00					
G0105	Colorectal scrn; hi risk ind		T	5311	9.5855	$793.65	$0.00	$0.00					
G0106	Colon ca screen;barium enema		S	5571	2.1565	$178.55	$0.00	$0.00					
G0108	Diab manage trn  per indiv		A										
G0109	Diab manage trn ind/group		A										
G0117	Glaucoma scrn hgh risk direc		S	5731	0.2980	$24.67	.	$4.94					
G0118	Glaucoma scrn hgh risk direc		S	5732	0.4087	$33.84	.	$6.77					
G0120	Colon ca scrn; barium enema		S	5572	4.4460	$368.12	$0.00	$0.00					
G0121	Colon ca scrn not hi rsk ind		T	5311	9.5855	$793.65	$0.00	$0.00					
G0122	Colon ca scrn; barium enema		E1										
G0123	Screen cerv/vag thin layer		A										
G0124	Screen c/v thin layer by md		B										
G0127	Trim nail(s)		Q1	5733	0.6722	$55.66	.	$11.14					
G0128	Corf skilled nursing service		B										
G0129	Partial hosp prog service		P										
G0130	Single energy x-ray study		S	5522	1.3161	$108.97	$0.00	$0.00					
G0141	"Scr c/v cyto,autosys and md"		B										
G0143	"Scr c/v cyto,thinlayer,rescr"		A										
G0144	"Scr c/v cyto,thinlayer,rescr"		A										
G0145	"Scr c/v cyto,thinlayer,rescr"		A										
G0147	"Scr c/v cyto, automated sys"		A										
G0148	"Scr c/v cyto, autosys, rescr"		A										
G0151	"Hhcp-serv of pt,ea 15 min"		B										
G0152	"Hhcp-serv of ot,ea 15 min"		B										
G0153	"Hhcp-svs of s/l path,ea 15mn"		B										
G0155	"Hhcp-svs of csw,ea 15 min"		B										
G0156	"Hhcp-svs of aide,ea 15 min"		B										
G0157	Hhc pt assistant ea 15		B										
G0158	Hhc ot assistant ea 15		B										
G0159	Hhc pt maint ea 15 min		B										
G0160	Hhc occup therapy ea 15		B										
G0161	Hhc slp ea 15 min		B										
G0162	"Hhc rn e&m plan svs, 15 min"		B										
G0166	"Extrnl counterpulse, per tx"		Q1	5734	1.3521	$111.95	.	$22.39					
G0168	Wound closure by adhesive		B										
G0175	"Opps service,sched team conf"		V	5024	4.3931	$363.74	.	$72.75					
G0176	Opps/php;activity therapy		P										
G0177	Opps/php; train & educ serv		N										
G0179	Md recertification hha pt		M										
G0180	Md certification hha patient		M										
G0181	Home health care supervision		M										
G0182	Hospice care supervision		M										
G0186	"Dstry eye lesn,fdr vssl tech"		T	5481	6.0855	$503.86	$100.90	$100.78					
G0219	Pet img wholbod melano nonco		E1										
G0235	Pet not otherwise specified	CH 	S	5591	4.5547	$377.12	.	$75.43					
G0237	Therapeutic procd strg endur		S	5731	0.2980	$24.67	.	$4.94					
G0238	"Oth resp proc, indiv"		S	5731	0.2980	$24.67	.	$4.94					
G0239	"Oth resp proc, group"		S	5732	0.4087	$33.84	.	$6.77					
G0245	Initial foot exam pt lops		V	5012	1.4341	$118.74	.	$23.75					
G0246	Followup eval of foot pt lop		V	5012	1.4341	$118.74	.	$23.75					
G0247	Routine footcare pt w lops		Q1	5051	2.1685	$179.55	.	$35.91					
G0248	Demonstrate use home inr mon		V	5012	1.4341	$118.74	.	$23.75					
G0249	Provide inr test mater/equip		V	5012	1.4341	$118.74	.	$23.75					
G0250	Md inr test revie inter mgmt		M										
G0252	Pet imaging initial dx		E1										
G0255	Current percep threshold tst		E1										
G0257	Unsched dialysis esrd pt hos		S	5401	7.9030	$654.34	.	$130.87					
G0259	Inject for sacroiliac joint		N										
G0260	Inj for sacroiliac jt anesth		T	5442	7.6644	$634.59	.	$126.92					
G0268	Removal of impacted wax md		N										
G0269	Occlusive device in vein art		N										
G0270	Mnt subs tx for change dx		A										
G0271	Group mnt 2 or more 30 mins		A										
G0276	Pild/placebo control clin tr		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
G0277	"Hbot, full body chamber, 30m"		S	5061	1.4406	$119.28	.	$23.86					
G0278	"Iliac art angio,cardiac cath"		N										
G0279	"Tomosynthesis, mammo"		A										
G0281	Elec stim unattend for press		A										
G0282	Elect stim wound care not pd		E1										
G0283	Elec stim other than wound		A										
G0288	"Recon, cta for surg plan"		N										
G0289	"Arthro, loose body + chondro"		N										
G0293	"Non-cov surg proc,clin trial"		Q1	5732	0.4087	$33.84	.	$6.77					
G0294	"Non-cov proc, clinical trial"		Q1	5732	0.4087	$33.84	.	$6.77					
G0295	Electromagnetic therapy onc		E1										
G0296	Visit to determ ldct elig		S	5822	0.9043	$74.87	$0.00	$0.00					
G0297	Ldct for lung ca screen	CH	D										
G0299	Hhs/hospice of rn ea 15 min		B										
G0300	Hhs/hospice of lpn ea 15 min		B										
G0302	Pre-op service lvrs complete		S	5723	5.8913	$487.78	.	$97.56					
G0303	Pre-op service lvrs 10-15dos	CH	S	5722	3.1939	$264.45	.	$52.89					
G0304	Pre-op service lvrs 1-9 dos		S	5723	5.8913	$487.78	.	$97.56					
G0305	Post op service lvrs min 6		S	5723	5.8913	$487.78	.	$97.56					
G0306	Cbc/diffwbc w/o platelet		Q4										
G0307	Cbc without platelet		Q4										
G0328	Fecal blood scrn immunoassay		A										
G0329	Electromagntic tx for ulcers		A										
G0333	Dispense fee initial 30 day		M										
G0337	Hospice evaluation preelecti		B										
G0339	"Robot lin-radsurg com, first"		B										
G0340	Robt lin-radsurg fractx 2-5		B										
G0341	Percutaneous islet celltrans		C										
G0342	Laparoscopy islet cell trans		C										
G0343	Laparotomy islet cell transp		C										
G0372	Md service required for pmd		M										
G0378	Hospital observation per hr		N										
G0379	Direct refer hospital observ		J2	5025	6.3060	$522.12	.	$104.43					
G0380	Lev 1 hosp type b ed visit		J2	5031	0.8520	$70.54	.	$14.11					
G0381	Lev 2 hosp type b ed visit		J2	5032	1.1523	$95.41	.	$19.09					
G0382	Lev 3 hosp type b ed visit		J2	5033	2.1857	$180.97	.	$36.20					
G0383	Lev 4 hosp type b ed visit		J2	5034	2.7608	$228.59	.	$45.72					
G0384	Lev 5 hosp type b ed visit		J2	5035	3.8454	$318.39	.	$63.68					
G0390	Trauma respons w/hosp criti		S	5045	11.3852	$942.66	.	$188.54					
G0396	Alcohol/subs interv 15-30mn		S	5821	0.3168	$26.23	.	$5.25					
G0397	Alcohol/subs interv >30 min	CH	S	5823	1.6139	$133.63	.	$26.73					
G0398	Home sleep test/type 2 porta		S	5721	1.6854	$139.55	.	$27.91					
G0399	Home sleep test/type 3 porta		S	5721	1.6854	$139.55	.	$27.91					
G0400	Home sleep test/type 4 porta	CH	S	5722	3.1939	$264.45	.	$52.89					
G0402	Initial preventive exam		V	5012	1.4341	$118.74	$0.00	$0.00					
G0403	Ekg for initial prevent exam		M										
G0404	Ekg tracing for initial prev		S	5731	0.2980	$24.67	.	$4.94					
G0405	Ekg interpret & report preve		B										
G0406	Inpt/tele follow up 15		B										
G0407	Inpt/tele follow up 25		B										
G0408	Inpt/tele follow up 35		B										
G0409	Corf related serv 15 mins ea		B										
G0410	Grp psych partial hosp 45-50		P										
G0411	Inter active grp psych parti		P										
G0412	Open tx iliac spine uni/bil	CH	J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
G0413	Pelvic ring fracture uni/bil		J1	5114	75.6664	"$6,264.95"	.	"$1,253.00"					
G0414	Pelvic ring fx treat int fix	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
G0415	Open tx post pelvic fxcture	CH	J1	5115	148.7344	"$12,314.76"	.	"$2,462.96"	*				
G0416	"Prostate biopsy, any mthd"		Q2	5673	3.5177	$291.26	.	$58.26					
G0420	Ed svc ckd ind per session		A										
G0421	Ed svc ckd grp per session		A										
G0422	Intens cardiac rehab w/exerc		S	5771	1.4018	$116.06	.	$23.22					
G0423	Intens cardiac rehab no exer		S	5771	1.4018	$116.06	.	$23.22					
G0424	Pulmonary rehab w exer		S	5733	0.6722	$55.66	.	$11.14					
G0425	Inpt/ed teleconsult30		B										
G0426	Inpt/ed teleconsult50		B										
G0427	Inpt/ed teleconsult70		B										
G0428	Collagen meniscus implant		E1										
G0429	Dermal filler injection(s)		T	5054	20.7177	"$1,715.36"	.	$343.08					
G0432	Eia hiv-1/hiv-2 screen		A										
G0433	Elisa hiv-1/hiv-2 screen		A										
G0435	Oral hiv-1/hiv-2 screen		A										
G0438	"Ppps, initial visit"		A										
G0439	"Ppps, subseq visit"		A										
G0442	Annual alcohol screen 15 min		S	5821	0.3168	$26.23	$0.00	$0.00					
G0443	Brief alcohol misuse counsel		S	5822	0.9043	$74.87	$0.00	$0.00					
G0444	Depression screen annual		S	5821	0.3168	$26.23	$0.00	$0.00					
G0445	High inten beh couns std 30m		S	5822	0.9043	$74.87	$0.00	$0.00					
G0446	Intens behave ther cardio dx		S	5821	0.3168	$26.23	$0.00	$0.00					
G0447	Behavior counsel obesity 15m		S	5822	0.9043	$74.87	$0.00	$0.00					
G0448	Place perm pacing cardiovert		B										
G0451	Devlopment test interpt&rep		Q3	5822	0.9043	$74.87	.	$14.98					
G0452	Molecular pathology interpr		B										
G0453	Cont intraop neuro monitor		N										
G0454	Md document visit by npp		B										
G0455	Fecal microbiota prep instil		Q1	5301	9.7781	$809.60	.	$161.92					
G0458	Ldr prostate brachy comp rat		B										
G0459	Telehealth inpt pharm mgmt		B										
G0460	Autologous prp for ulcers		T	5054	20.7177	"$1,715.36"	.	$343.08					
G0463	Hospital outpt clinic visit		J2	5012	1.4341	$118.74	.	$23.75					
G0466	Fqhc visit new patient		A										
G0467	"Fqhc visit, estab pt"		A										
G0468	"Fqhc visit, ippe or awv"		A										
G0469	"Fqhc visit, mh new pt"		A										
G0470	"Fqhc visit, mh estab pt"		A										
G0471	Ven blood coll snf/hha		A										
G0472	Hep c screen high risk/other		A										
G0473	Group behave couns 2-10		S	5821	0.3168	$26.23	$0.00	$0.00					
G0475	Hiv combination assay		A										
G0476	Hpv combo assay ca screen		A										
G0480	Drug test def 1-7 classes		Q4										
G0481	Drug test def 8-14 classes		Q4										
G0482	Drug test def 15-21 classes		Q4										
G0483	Drug test def 22+ classes		Q4										
G0490	"Home visit rn, lpn by rhc/fq"		A										
G0491	Dialysis acu kidney no esrd		B										
G0492	Md/oth eval acut kid no esrd		B										
G0493	Rn care ea 15 min hh/hospice		B										
G0494	Lpn care ea 15min hh/hospice		B										
G0495	Rn care train/edu in hh		B										
G0496	Lpn care train/edu in hh		B										
G0498	Chemo extend iv infus w/pump		S	5694	3.7532	$310.75	.	$62.16					
G0499	Hepb screen high risk indiv		A										
G0500	Mod sedat endo service >5yrs		N										
G0501	Resource-inten svc during ov		N										
G0506	Comp asses care plan ccm svc		N										
G0508	Crit care telehea consult 60		B										
G0509	Crit care telehea consult 50		B										
G0511	Ccm/bhi by rhc/fqhc 20min mo		A										
G0512	Cocm by rhc/fqhc 60 min mo		A										
G0513	"Prolong prev svcs, first 30m"		N										
G0514	"Prolong prev svcs, addl 30m"		N										
G0516	"Insert drug del implant, >=4"		Q1	5735	3.2637	$270.22	.	$54.05					
G0517	Remove drug implant		Q1	5735	3.2637	$270.22	.	$54.05					
G0518	Remove w insert drug implant		Q1	5735	3.2637	$270.22	.	$54.05					
G0659	Drug test def simple all cl		Q4										
G0913	Improve visual funct		M										
G0914	Survey not complete		M										
G0915	No improve visual funct		M										
G0916	Satisfy with care		M										
G0917	Satisfy survey not complete		M										
G0918	No satisfy with care		M										
G1001	Cdsm evicore		E1										
G1002	Cdsm medcurrent		E1										
G1003	Cdsm medicalis		E1										
G1004	Cdsm ndsc		E1										
G1005	Cdsm nia	CH	D										
G1006	Cdsm test approp	CH	D										
G1007	Cdsm aim		E1										
G1008	Cdsm cranberry pk		E1										
G1009	Cdsm sage health		E1										
G1010	Cdsm stanson		E1										
G1011	Cdsm qualified nos		E1										
G1012	Cdsm agilemd	NC	E1										
G1013	Cdsm evidencecare	NC	E1										
G1014	Cdsm inveniqa	NC	E1										
G1015	Cdsm reliant	NC	E1										
G1016	Cdsm speed of care	NC	E1										
G1017	Cdsm healthhelp	NC	E1										
G1018	Cdsm infinx	NC	E1										
G1019	Cdsm logicnets	NC	E1										
G1020	Cdsm curbside	NI	E1										
G1021	Cdsm ehealthline	NI	E1										
G1022	Cdsm intermountain	NI	E1										
G1023	Cdsm persivia	NI	E1										
G2000	Blinded conv. tx mdd clin tr		S	5723	5.8913	$487.78	.	$97.56					
G2001	Post d/c h vst new pt 20 m		B										
G2002	Post-d/c h vst new pt 30 m		B										
G2003	Post-d/c h vst new pt 45 m		B										
G2004	Post-d/c h vst new pt 60 m		B										
G2005	Post-d/c h vst new pt 75 m		B										
G2006	Post-d/c h vst ext pt 20 m		B										
G2007	Post-d/c h vst ext pt 30 m		B										
G2008	Post-d/c h vst ext pt 45 m		B										
G2009	Post-d/c h vst ext pt 60 m		B										
G2010	Remot image submit by pt	CH 	B										
G2011	Alcohol/sub misuse assess		S	5731	0.2980	$24.67	.	$4.94					
G2012	Brief check in by md/qhp	CH 	B										
G2013	Post-d/c h vst ext pt 75 m		B										
G2014	Post-d/c care plan overs 30m		B										
G2015	Post-d/c care plan overs 60m		B										
G2021	Hea care pract tx in place		E1										
G2022	"Benef refuses service, mod"		E1										
G2023	Specimen collect covid-19	NC	B										
G2024	Spec coll snf/lab covid-19	NC	B										
G2025	Dis site tele svcs rhc/fqhc	NC	A										
G2058	Ccm add 20min	CH 	D										
G2061	Qual nonmd est pt 5-10m	CH 	D										
G2062	Qual nonmd est pt 11-20m	CH 	D										
G2063	Qual nonmd est pt 21>min	CH 	D										
G2064	Md mang high risk dx 30		M										
G2065	Clin mang h risk dx 30		S	5822	0.9043	$74.87	.	$14.98					
G2066	Inter devc remote 30d		Q1	5741	0.4487	$37.15	.	$7.44					
G2067	Med assist tx meth wk	CH 	A										
G2068	Med assist tx bupre oral	CH 	A										
G2069	Med assist tx inject	CH 	A										
G2070	Med assist tx implant	CH 	A										
G2071	Med tx remove implant	CH 	A										
G2072	Med tx insert/remove imp	CH 	A										
G2073	Med tx naltrexone	CH 	A										
G2074	Med assist tx no drug	CH 	A										
G2075	Med tx meds nos	CH 	A										
G2076	Intake act w/med exam	CH 	A										
G2077	Periodic assessment	CH 	A										
G2078	Take-home meth	CH 	A										
G2079	Take-hom buprenorphine	CH 	A										
G2080	Add 30 mins counsel	CH 	A										
G2081	Pt 66+ snp or ltc pos > 90d		M 										
G2082	Visit esketamine 56m or less		S	1508		$650.50	.	$130.11					
G2083	"Visit esketamine, > 56m"		S	1511		$950.50	.	$190.11					
G2086	Off base opioid tx 70min		S	5823	1.6139	$133.63	.	$26.73					
G2087	"Off base opioid tx, 60 m"		S	5823	1.6139	$133.63	.	$26.73					
G2088	"Off base opioid tx, add30"		N										
G2089	A1c level 7 to 9%	CH	D										
G2090	Pt 66+ frailty and med dem		M 										
G2091	Pt 66+ frailty and adv ill		M 										
G2092	Ace arb arni		M 										
G2093	Med doc rsn no ace arn arni		M 										
G2094	Pt rsn no ace arn arni		M 										
G2095	Sys rsn no ace arn arni		M 										
G2096	No rsn ace arb arni		M 										
G2097	Dx uri 3d after other dx		M 										
G2098	Pt 66+ frailty and med dem		M 										
G2099	Pt 66+ frailty and adv ill		M 										
G2100	Pt 66+ frailty and med dem		M 										
G2101	Pt 66+ frailty and adv ill		M 										
G2102	Dil retinal eye exam	CH	D										
G2103	7 stereo photos interpret	CH	D										
G2104	Eye img valid w/7 stereo	CH	D										
G2105	Pt 66+ snp or ltc pos > 90d		M 										
G2106	Pt 66+ lt ints > 90		M 										
G2107	Pt 66+ frailty and adv ill		M 										
G2108	Pt 66+ snp or ltc pos > 90d		M 										
G2109	Pt 66+ frailty and med dem		M 										
G2110	Pt 66+ frailty and adv ill		M 										
G2112	Pred<=5 mg ra glu <6m		M 										
G2113	"Pred>5 mg >6m, no chg da"		M 										
G2114	Pt 66-80 frailty and med dem	CH	D										
G2115	Pt 66-80 frailty and med dem		M 										
G2116	Pt 66-80 frailty and adv ill		M 										
G2117	Pt 66-80 frailty and adv ill	CH	D										
G2118	Pt 81+ frailty		M 										
G2119	Calc vitd opt	CH 	D										
G2120	No calc vitd opt	CH 	D										
G2121	Psy dep anx ap and icd asse		M 										
G2122	Psy/dep/anx/apandicd noasse		M 										
G2123	Pt 66-80 frailty med dem	CH 	D										
G2124	Pt 66-80 frailty adv ill	CH 	D										
G2125	Pt 81+ frailty		M 										
G2126	Pt 66-80 frailty and adv ill		M 										
G2127	Pt 66-80 frailty and med dem		M 										
G2128	No aspirin med rsn		M 										
G2129	No bp outpt		M 										
G2130	Pt 66+ lt inst > 90	CH 	D										
G2131	Pt 81+ frailty	CH 	D										
G2132	Pt 66-80 frailty and med dem	CH 	D										
G2133	Pt 66-80 frailty and adv ill	CH 	D										
G2134	Pt 66+ frailty and med dem	CH 	D										
G2135	Pt 66+ frailty and adv ill	CH 	D										
G2136	Bk pain vas 6-20wk <= 3		M 										
G2137	Bk pain vas 6-20wk > 3		M 										
G2138	Bk pain vas 9-15mo <= 3		M 										
G2139	Bk pain vas 9-20mo > 3		M 										
G2140	Leg pain vas 6-20wk <= 3		M 										
G2141	Leg pain vas 6-20wk > 3		M 										
G2142	Fs odi 9-15mo postop<= 22		M 										
G2143	Fs odi 9-15mo > 22		M 										
G2144	Fs odi 6-20wk postop <= 22		M 										
G2145	Fsodi 6-20wk >22 or chg 30pt		M 										
G2146	Leg pain vas 9-15mo <= 3		M 										
G2147	Leg pain vas 9-15mo > 3		M 										
G2148	Mpm used		M 										
G2149	No mpm med rsn		M 										
G2150	No mpm		M 										
G2151	Dx degen neuro		M 										
G2152	Res change sc >=0		M 										
G2153	Hosp dur meas pd	CH	D										
G2154	Td 9 yrs start end meas	CH	D										
G2155	Hist contraindications	CH	D										
G2156	No prior td or hx contra	CH	D										
G2157	Pneum vacc 12 mo 60+	CH	D										
G2158	Pneum vacc adv rx	CH	D										
G2159	No pneum vacc 12 mo 60+	CH	D										
G2160	Herpzos 50+	CH	D										
G2161	Adv rx zos	CH	D										
G2162	No herpzos 50+	CH	D										
G2163	Infl vacc 07/01 to 06/30	CH	D										
G2164	Adv rx infl vacc	CH	D										
G2165	No infl vacc 07/01 to 06/30	CH	D										
G2166	No pt adm dx no neck fs prom	CH	D										
G2167	Res change sc < 0		M 										
G2168	Svs by pt in home health	NC	B										
G2169	Svs by ot in home health	NC	B										
G2170	Avf by tissue w thermal e	NC	J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
G2171	Avf use magnetic/art/ven	NC	J1	5194	194.0167	"$16,064.00"	.	"$3,212.81"	*				
G2173	Uri w comorb 12m oth dx	NI	M										
G2174	Uri new rx antibiotic 30d	NI	M										
G2175	Pt comorb dx 12m of epi	NI	M										
G2176	Outpt ed obs w inpt admit	NI	M										
G2177	Bronch w rx antibx 30d	NI	M										
G2178	Pt not elig low neuro ex	NI	M										
G2179	Med doc rsn no low ex	NI	M										
G2180	Inelig footwr eval	NI	M										
G2181	Bmi not doc medrsn ptref	NI	M										
G2182	Pt 1st biolog antirheum	NI	M										
G2183	Doc pt unable comm	NI	M										
G2184	No caregiver	NI	M										
G2185	Caregiver dem trained	NI	M										
G2186	Pt ref app rsrcs	NI	M										
G2187	Clin ind img hd trauma	NI	M										
G2188	Pt 50 yrs w/clin ind hd	NI	M										
G2189	Img hd abnml neuro exam	NI	M										
G2190	Ind img hd rad neck	NI	M										
G2191	Ind img hd pos hd ache	NI	M										
G2192	>55 yrs temp hd ache	NI	M										
G2193	<6yr new onset hd ache	NI	M										
G2194	New hdache ped pt dis	NI	M										
G2195	Occip hdache child	NI	M										
G2196	Screen unhlthy etoh use	NI	M										
G2197	Screen hlthy etoh use	NI	M										
G2198	Med rsn no unhlthy etoh	NI	M										
G2199	Not scrn etoh no rsn	NI	M										
G2200	Unhlthy etoh rcvd couns	NI	M										
G2201	Med rsn no brief couns	NI	M										
G2202	No rsn no brief couns	NI	M										
G2203	Med rsn no etoh couns	NI	M										
G2204	Pt 50-85 w/ scope	NI	M										
G2205	Preg drng adjv trtmt	NI	M										
G2206	Adjv trtmt chemo her2	NI	M										
G2207	Rsn no trtmt chem her2	NI	M										
G2208	No trtmt chemo and her2	NI	M										
G2209	Refused to participate	NI	M										
G2210	No neck fs prom no rsn	NI	M										
G2211	Complex e/m visit add on	NI	B										
G2212	Prolong outpt/office vis	NI	N 										
G2213	Initiat med assist tx in er	NC	N										
G2214	Init/sub psych care m 1st 30	NC	S	5822       	0.9043	$74.87	.	$14.98					
G2215	Home supply nasal naloxone	NC	A										
G2216	Home supply inject naloxon	NC	A										
G2250	"Remot img sub by pt, non e/m"	NI	A 										
G2251	"Brief chkin, 5-10, non-e/m"	NI	A 										
G2252	"Brief chkin by md/qhp, 11-20"	NI	A 										
G6001	Echo guidance radiotherapy		B										
G6002	Stereoscopic x-ray guidance		B										
G6003	Radiation treatment delivery		B										
G6004	Radiation treatment delivery		B										
G6005	Radiation treatment delivery		B										
G6006	Radiation treatment delivery		B										
G6007	Radiation treatment delivery		B										
G6008	Radiation treatment delivery		B										
G6009	Radiation treatment delivery		B										
G6010	Radiation treatment delivery		B										
G6011	Radiation treatment delivery		B										
G6012	Radiation treatment delivery		B										
G6013	Radiation treatment delivery		B										
G6014	Radiation treatment delivery		B										
G6015	Radiation tx delivery imrt		B										
G6016	Delivery comp imrt		B										
G6017	Intrafraction track motion		B										
G8395	Lvef>=40% doc normal or mild		M										
G8396	Lvef not performed		M										
G8397	Dil macula/fundus exam/w doc		M										
G8398	Dil macular/fundus not perfo	CH	D										
G8399	Pt w/dxa results document		M										
G8400	Pt w/dxa no results doc		M										
G8404	Low extemity neur exam docum		M										
G8405	Low extemity neur not perfor		M										
G8410	Eval on foot documented		M										
G8415	Eval on foot not performed		M										
G8416	Pt inelig footwear evaluatio		M										
G8417	Calc bmi abv up param f/u		M										
G8418	Calc bmi blw low param f/u		M										
G8419	Calc bmi out nrm param nof/u		M										
G8420	Calc bmi norm parameters		M										
G8421	Bmi not calculated		M										
G8422	Pt inelig bmi calculation		M										
G8427	Docrev cur meds by elig clin		M										
G8428	Cur meds not document		M										
G8430	Doc med rsn no medrec		M										
G8431	Pos clin depres scrn f/u doc		M										
G8432	"Dep scr not doc, rng"		M										
G8433	Scr for dep not cpt doc rsn		M										
G8442	"Doc pain as nt perf, not elg"	CH	D										
G8450	Beta-bloc rx pt w/abn lvef		M										
G8451	Pt w/abn lvef inelig b-bloc		M										
G8452	Pt w/abn lvef b-bloc no rx		M										
G8465	High risk recurrence pro ca		M										
G8473	Ace/arb thxpy rx'd		M										
G8474	Ace/arb not rx'd; doc reas		M										
G8475	Ace/arb thxpy not rx'd		M										
G8476	Bp sys <140 and dias <90		M										
G8477	Bp sys>=140 and/or dias >=90		M										
G8478	Bp not performed/doc		M										
G8482	Flu immunize order/admin		M										
G8483	Flu imm no admin doc rea		M										
G8484	Flu immunize no admin		M										
G8506	Pt rec ace/arb		M										
G8509	Pos pain assess no f/u doc	CH 	D										
G8510	"Scr dep neg, no plan reqd"		M										
G8511	"Scr dep pos, no plan doc rng"		M										
G8535	Eld maltreatment not doc		M										
G8536	No doc elder mal scrn		M										
G8539	Doc funct and care plan		M										
G8540	Foa not doc as being perf		M										
G8541	No doc cur funct assess		M										
G8542	Doc funct no deficiencies		M										
G8543	Cur funct asses; no care pln		M										
G8559	Pt ref doc oto eval		M										
G8560	Pt hx act drain prev 90 days		M										
G8561	Pt inelig for ref oto eval		M										
G8562	Pt no hx act drain 90 d		M										
G8563	Pt no ref oto reas no spec		M										
G8564	Pt ref oto eval		M										
G8565	Ver doc hear loss		M										
G8566	Pt inelig ref oto eval		M										
G8567	Pt no doc hear loss		M										
G8568	Pt no ref otolo no spec		M										
G8569	Prol intubation req		M										
G8570	No prol intub req		M										
G8571	Ster wd ifx 30 d postop	CH 	D										
G8572	No ster wd ifx	CH 	D										
G8573	Stk cabg	CH 	D										
G8574	No strk cabg	CH 	D										
G8575	Postop ren fail		M										
G8576	No postop ren fail		M										
G8577	Reop req bld grft oth		M										
G8578	No reop req bld grft oth		M										
G8598	Asa/antiplat ther used		M										
G8599	No asa/antiplat ther use rng		M										
G8600	Tpa initi w/in 3 hrs		M										
G8601	No elig tpa init w/in 3 hrs		M										
G8602	No tpa init w/in 3 hrs		M										
G8627	Surg proc w/in 30 days	CH	D										
G8628	No surg proc w/in 30 days	CH	D										
G8633	Pharm ther osteo rx		M										
G8635	No pharm ther osteo rx		M										
G8647	Rafscrs ki scor >= 0		M										
G8648	Rafscrs ki scor < 0		M										
G8650	Rafs crs ki no scor no rsn		M										
G8651	Rafscrs hi scor >=0		M										
G8652	Rafscrs hi scor < 0		M										
G8654	Rafs crs hi no scor no surv		M										
G8655	Rafscrs llfai scor >= 0		M										
G8656	Rafscrs llfai scor < 0		M										
G8658	Rafscrs llfai no scor + surv		M										
G8659	Rafscrs lbi scor >= 0		M										
G8660	Rafscrs lbi scor < 0		M										
G8661	Rafscrs lbi no scor		M										
G8662	Rafs crs lbi no scor no surv		M										
G8663	Rafscrs si scor >= 0		M										
G8664	Rafscrs si scor < 0		M										
G8666	Rafs crs si no scor no surv		M										
G8667	Rafscrs ewh scor >= 0		M										
G8668	Rafscrs ewh scor < 0		M										
G8670	Rafs crs ewh no scor no surv		M										
G8671	Rafscrs goi scor >= 0	CH 	D										
G8672	Rafscrs goi scor < 0	CH 	D										
G8674	"Rafscrs neck, no msr/no foto"	CH 	D										
G8694	Lvef <40%		M										
G8708	Antibiotic not pres		M										
G8709	Uri ep compete diag		M										
G8710	Pt pres antibiotic		M										
G8711	Pres antibiotic		M										
G8712	Not pres antibiotic		M										
G8721	"Pt, pn, hist grade doc"		M										
G8722	"Med reas pt, pn, not doc"		M										
G8723	Spec sit not prim tumor		M										
G8724	"Pt, pn, hist grade not doc"		M										
G8730	Pain doc pos and plan	CH	D										
G8731	Pain neg no plan	CH	D										
G8732	No doc of pain	CH	D										
G8733	Doc pos elder mal scrn plan		M										
G8734	Doc neg elder mal no plan		M										
G8735	Eld mal scrn pos no plan		M										
G8749	No signs melanoma		M										
G8752	Sys bp less 140		M										
G8753	Sys bp > or = 140		M										
G8754	Dias bp less 90		M										
G8755	Dias bp > or = 90		M										
G8756	No bp measure doc		M										
G8783	Bp scrn perf rec interval		M										
G8785	Bp scrn no perf at interval		M										
G8797	Specimen site not esophagus		M										
G8798	Specimen site not prostate		M										
G8806	Perf ultrsnd to lct preg doc		M										
G8807	No ta tv ultrasnd		M										
G8808	"Ultrasound not perf, rng"		M										
G8809	Rh-immunoglobulin order	CH	D										
G8810	Doc reas no rh-immuno	CH	D										
G8811	No rh-immunoglobulin order	CH	D										
G8815	Doc reas no statin therapy		M										
G8816	Statin med pres at disch		M										
G8817	Doc reas no statin med disch		M										
G8818	Pt disch to home by day#7		M										
G8825	Pt not disch to home day#7		M										
G8826	Pt disch home day #2 evar		M										
G8833	Pt not disch home day#2 evar		M										
G8834	Pt disch home day #2 cea		M										
G8838	Not disch home by day #2		M										
G8839	Sleep apnea assess		M										
G8840	Doc reas no sleep apnea		M										
G8841	No sleep apnea assess		M										
G8842	Ahi or rdi initial dx		M										
G8843	Doc reas no ahi or rdi		M										
G8844	No ahi or rdi initial dx		M										
G8845	Pos airway press prescribed		M										
G8846	Mod or severe osa		M										
G8849	Doc reas no pos air press		M										
G8850	No pap prescribed		M										
G8851	Adhere pos air press therapy		M										
G8852	Pos air press prescribe		M										
G8854	Reas no adhere pos air pres		M										
G8855	Pos air press adhere no perf		M										
G8856	Ref for oto eval		M										
G8857	No elig ref for oto eval		M										
G8858	Not ref for oto eval		M										
G8863	No assess bone loss		M										
G8864	Pneumococcal vaccine admin		M										
G8865	Doc med reas no pneumococcal		M										
G8866	Doc pt reas no pneumococcal		M										
G8867	No pneumococcal admin		M										
G8869	Doc immune hep b antitnf		M										
G8872	Intraop image confirm excise	CH	D										
G8873	Specimen not intraop image	CH	D										
G8874	Tissue not image intraop	CH	D										
G8875	Breast cancer dx min invsive		M										
G8876	Doc reas no min inv dx		M										
G8877	No brst cncr dx min invasive		M										
G8878	Sent lymph node biopsy		M										
G8880	Sen lym p node biop not perf		M										
G8881	Brst cncr stage > t1n0m0		M										
G8882	No sent lymph node biopsy		M										
G8883	"Rev, comm, track, doc biopsy"		M										
G8884	Doc reas biopsy not review		M										
G8885	"No rev, comm, track biopsy"		M										
G8907	Pt doc no events on discharg		M										
G8908	Pt doc w burn prior to d/c		M										
G8909	Pt doc no burn prior to d/c		M										
G8910	Pt doc to have fall in asc		M										
G8911	Pt doc no fall in asc		M										
G8912	Pt doc with wrong event		M										
G8913	Pt doc no wrong event		M										
G8914	Pt trans to hosp post d/c		M										
G8915	Pt not trans to hosp at d/c		M										
G8916	Pt w iv ab given on time		M										
G8917	Pt w iv ab not given on time		M										
G8918	Pt w/o preop order iv ab pro		M										
G8923	Lvef < 40% or lvsd		M										
G8924	"Spir fev1/fvc<70%,fev<60%"		M										
G8925	Spir fev1/fvc>=60% & no copd		M										
G8926	Spiro no perf or doc		M										
G8934	Lvef <40% or dep lv sys fcn		M										
G8935	Rx ace or arb therapy		M										
G8936	Pt not eligible ace/arb		M										
G8937	No rx ace/arb therapy		M										
G8938	Bmi doc onl fup nt doc		M										
G8939	"Pain as doc positive, no f/u"	CH	D										
G8941	Eld maltreatment doc as pos		M										
G8942	Doc fcn/care plan w/30 days		M										
G8944	Ajcc mel cnr stg 0 - iic		M										
G8946	Mibm but no dx of breast ca		M										
G8950	"Pre-htn or htn doc, f/u indc"		M										
G8952	"Pre-htn/htn, no f/u, not gvn"		M										
G8955	Most recent assess vol mgmt		M										
G8956	Pt rcv hedia outpt dyls fac		M										
G8958	Assess vol mgmt not doc		M										
G8959	Clin tx mdd comm to tx clin	CH 	D										
G8960	Clin tx mdd not comm	CH 	D										
G8961	Csit lowrisk surg pts preop		M										
G8962	Csit on pt any reas 30 days		M										
G8963	Csi per asx pt w/pci 2 yrs		M										
G8964	Csi any other than pci 2 yr		M										
G8965	Csit perf on low chd rsk		M										
G8966	Csit perf sx or high chd rsk		M										
G8967	Warf or other fda drug presc		M										
G8968	Doc med not presb		M										
G8969	Doc pt rsn no presc warf/fda		M										
G8970	No rsk fac or 1 mod risk te		M										
G8973	Mst rcnt hbb < 10g/dl	CH 	D										
G8974	Hgb not doc rns not gvn	CH 	D										
G8975	"Hgb <10g/dl, med rsn"	CH 	D										
G8976	Hgb >= 10 g/dl	CH 	D										
G9001	"Mccd, initial rate"		B										
G9002	"Mccd,maintenance rate"		B										
G9003	"Mccd, risk adj hi, initial"		B										
G9004	"Mccd, risk adj lo, initial"		B										
G9005	"Mccd, risk adj, maintenance"		B										
G9006	"Mccd, home monitoring"		B										
G9007	"Mccd, sch team conf"		B										
G9008	"Mccd,phys coor-care ovrsght"		B										
G9009	"Mccd, risk adj, level 3"		B										
G9010	"Mccd, risk adj, level 4"		B										
G9011	"Mccd, risk adj, level 5"		B										
G9012	Other specified case mgmt		B										
G9013	Esrd demo bundle level i		E1										
G9014	Esrd demo bundle-level ii		E1										
G9016	Demo-smoking cessation coun		E1										
G9050	Oncology work-up evaluation		E1										
G9051	Oncology tx decision-mgmt		E1										
G9052	Onc surveillance for disease		E1										
G9053	Onc expectant management pt		E1										
G9054	Onc supervision palliative		E1										
G9055	Onc visit unspecified nos		E1										
G9056	Onc prac mgmt adheres guide		E1										
G9057	Onc pract mgmt differs trial		E1										
G9058	Onc prac mgmt disagree w/gui		E1										
G9059	Onc prac mgmt pt opt alterna		E1										
G9060	Onc prac mgmt dif pt comorb		E1										
G9061	Onc prac cond noadd by guide		E1										
G9062	Onc prac guide differs nos		E1										
G9063	Onc dx nsclc stgi no progres		M										
G9064	Onc dx nsclc stg2 no progres		M										
G9065	Onc dx nsclc stg3a no progre		M										
G9066	Onc dx nsclc stg3b-4 metasta		M										
G9067	Onc dx nsclc dx unknown nos		M										
G9068	Onc dx sclc/nsclc limited		M										
G9069	Onc dx sclc/nsclc ext at dx		M										
G9070	Onc dx sclc/nsclc ext unknwn		M										
G9071	"Onc dx brst stg1-2b hr,nopro"		M										
G9072	Onc dx brst stg1-2 noprogres		M										
G9073	"Onc dx brst stg3-hr, no pro"		M										
G9074	Onc dx brst stg3-noprogress		M										
G9075	Onc dx brst metastic/ recur		M										
G9077	Onc dx prostate t1no progres		M										
G9078	Onc dx prostate t2no progres		M										
G9079	Onc dx prostate t3b-t4noprog		M										
G9080	Onc dx prostate w/rise psa		M										
G9083	Onc dx prostate unknwn nos		M										
G9084	"Onc dx colon t1-3,n1-2,no pr"		M										
G9085	"Onc dx colon t4, n0 w/o prog"		M										
G9086	Onc dx colon t1-4 no dx prog		M										
G9087	Onc dx colon metas evid dx		M										
G9088	Onc dx colon metas noevid dx		M										
G9089	Onc dx colon extent unknown		M										
G9090	Onc dx rectal t1-2 no progr		M										
G9091	Onc dx rectal t3 n0 no prog		M										
G9092	"Onc dx rectal t1-3,n1-2noprg"		M										
G9093	"Onc dx rectal t4,n,m0 no prg"		M										
G9094	Onc dx rectal m1 w/mets prog		M										
G9095	Onc dx rectal extent unknwn		M										
G9096	Onc dx esophag t1-t3 noprog		M										
G9097	Onc dx esophageal t4 no prog		M										
G9098	Onc dx esophageal mets recur		M										
G9099	Onc dx esophageal unknown		M										
G9100	Onc dx gastric no recurrence		M										
G9101	Onc dx gastric p r1-r2noprog		M										
G9102	Onc dx gastric unresectable		M										
G9103	Onc dx gastric recurrent		M										
G9104	Onc dx gastric unknown nos		M										
G9105	Onc dx pancreatc p r0 res no		M										
G9106	Onc dx pancreatc p r1/r2 no		M										
G9107	Onc dx pancreatic unresectab		M										
G9108	Onc dx pancreatic unknwn nos		M										
G9109	Onc dx head/neck t1-t2no prg		M										
G9110	Onc dx head/neck t3-4 noprog		M										
G9111	Onc dx head/neck m1 mets rec		M										
G9112	Onc dx head/neck ext unknown		M										
G9113	Onc dx ovarian stg1a-b no pr		M										
G9114	Onc dx ovarian stg1a-b or 2		M										
G9115	Onc dx ovarian stg3/4 noprog		M										
G9116	Onc dx ovarian recurrence		M										
G9117	Onc dx ovarian unknown nos		M										
G9123	Onc dx cml chronic phase		M										
G9124	Onc dx cml acceler phase		M										
G9125	Onc dx cml blast phase		M										
G9126	Onc dx cml remission		M										
G9128	Onc dx multi myeloma stage i		M										
G9129	Onc dx mult myeloma stg2 hig		M										
G9130	Onc dx multi myeloma unknown		M										
G9131	Onc dx brst unknown nos		M										
G9132	Onc dx prostate mets no cast		M										
G9133	Onc dx prostate clinical met		M										
G9134	Onc nhlstg 1-2 no relap no		M										
G9135	Onc dx nhl stg 3-4 not relap		M										
G9136	Onc dx nhl trans to lg bcell		M										
G9137	Onc dx nhl relapse/refractor		M										
G9138	Onc dx nhl stg unknown		M										
G9139	Onc dx cml dx status unknown		M										
G9140	Frontier extended stay demo		A										
G9143	Warfarin respon genetic test		N										
G9147	Outpt iv insulin tx any mea		E1										
G9148	Medical home level 1		M										
G9149	Medical home level ii		M										
G9150	Medical home level iii		M										
G9151	Mapcp demo state		M										
G9152	Mapcp demo community		M										
G9153	Mapcp demo physician		M										
G9156	Evaluation for wheelchair		M										
G9157	Transesoph doppl cardiac mon		B										
G9187	Bpci home visit		E1										
G9188	Beta not given no reason		M										
G9189	Beta pres or already taking		M										
G9190	Medical reason for no beta		M										
G9191	Pt reason for no beta		M										
G9192	System reason for no beta		M										
G9196	Med reason for no ceph		M										
G9197	Order for ceph		M										
G9198	No order for ceph no reason		M										
G9212	Doc of dsm-iv init eval		M										
G9213	No doc of dsm-iv		M										
G9223	Pjp proph ordered cd4 low		M										
G9225	Norsn no foot exam		M										
G9226	3 comp foot exam completed		M										
G9227	"Foa doc, care plan not doc"		M										
G9228	Gc chl syp documented		M										
G9229	Ptrsn no gc chl syp test		M										
G9230	Norsn for gc chl syp test		M										
G9231	Doc esrd dia trans preg		M										
G9232	Ptrsn no comm comorbid	CH 	D										
G9239	Doc rsn hemod & cath acc	CH 	D										
G9240	Doc pt w cath maint dia	CH 	D										
G9241	Doc pt w out cath maint dia	CH 	D										
G9242	Doc viral load >=200		M										
G9243	Doc viral load <200		M										
G9246	No med visit in 24mo		M										
G9247	1 med visit in 24mo		M										
G9250	Doc of pain comfort 48hr		M										
G9251	Doc no pain comfort 48hr		M										
G9254	Doc pt dischg >2d		M										
G9255	Doc pt dischg <=2d		M										
G9256	Doc of pat death after cas	CH 	D										
G9257	Doc of pat stroke after cas	CH 	D										
G9258	Doc of pat stroke after cea	CH 	D										
G9259	Survive/no stroke post cas	CH 	D										
G9260	Doc of pat death after cea	CH 	D										
G9261	Survive/no stroke post cea	CH 	D										
G9262	Doc of death post-aaa repair	CH 	D										
G9263	Doc of disch post-aaa repair	CH 	D										
G9264	Doc rsn hemod w/cath >=90d	CH 	D										
G9265	Doc cath >90d for maint dia	CH 	D										
G9266	Norsn pt cath >=90d	CH 	D										
G9267	Doc comp or mort w in 30d		M										
G9268	Doc comp or mort w in 90d		M										
G9269	Doc no comp or mort w in 30d		M										
G9270	Doc no comp or mort w in 90d		M										
G9273	Sys<140 and dia<90		M										
G9274	Bp out of nrml limits		M										
G9275	Doc of non tobacco user		M										
G9276	Doc of tobacco user		M										
G9277	Doc daily aspirin or contra		M										
G9278	Doc no daily aspirin		M										
G9279	Pne scrn done doc vac done		M										
G9280	Pne not given norsn		M										
G9281	Pne scrn done doc not ind		M										
G9282	Doc medrsn no histo type		M										
G9283	Hist type doc on report		M										
G9284	No hist type doc on report		M										
G9285	Site not small cell lung ca		M										
G9286	Antibio rx w in 10d of sympt		M										
G9287	No antibio w in 10d of sympt		M										
G9288	Doc medrsn no hist type rpt		M										
G9289	Doc type nsm lung ca		M										
G9290	No doc type nsm lung ca		M										
G9291	Not nsm lung ca		M										
G9292	Medrsn no pt category		M										
G9293	No pt category on report		M										
G9294	Pt cat and thck on report		M										
G9295	Non cutaneous loc		M										
G9296	Doc share dec prior proc		M										
G9297	No doc share dec prior proc		M										
G9298	Eval risk vte card 30d prior		M										
G9299	No eval risk vte card prior		M										
G9300	Doc medrsn no compl antibio	CH 	D										
G9301	Doc compl inf antibio	CH 	D										
G9302	Norsn incomp inf antibio	CH 	D										
G9303	Norsn no pros info op rpt	CH 	D										
G9304	Pros info op rpt	CH 	D										
G9305	No interv req for leak		M										
G9306	Interv req for leak		M										
G9307	No ret for surg w in 30d		M										
G9308	Unpl ret or w/compl w/in 30d		M										
G9309	No unplnd hosp readm in 30d		M										
G9310	Unplnd hosp readm in 30d		M										
G9311	No surg site infection		M										
G9312	Surgical site infection		M										
G9313	Amoxic not presc as 1st line		M										
G9314	Norsn not first line amox		M										
G9315	Doc first line amox		M										
G9316	Doc comm risk calc		M										
G9317	No doc comm risk calc		M										
G9318	Image std nomenclature		M										
G9319	Image not std nomenclature		M										
G9321	Doc count of ct in 12mo		M										
G9322	No doc count of ct in 12mo		M										
G9326	"Ct done no rad ds index, nrg"	CH 	D										
G9327	Ct done rad ds index	CH 	D										
G9329	Norsn no dicom format doc	CH 	D										
G9340	Dicom format doc on rpt	CH 	D										
G9341	Srch for ct w in 12 mos		M										
G9342	No srch for ct in 12mo norsn		M										
G9344	Sysrsn no dicom srch		M										
G9345	Follow up pulm nod		M										
G9347	No follow up pulm nod norsn		M										
G9348	Doc rsn for ord ct scan		M										
G9349	Ct within 28 days		M										
G9350	No doc sinus ct 28d or dx		M										
G9351	Doc >1 sinus ct w 90d dx		M										
G9352	Not >1 sinus ct w 90d dx		M										
G9353	Medrsn >1 sinus ct w 90d dx		M										
G9354	1 or no ct sinus w/in 90d dx		M										
G9355	No early ind/delivery		M										
G9356	Early ind/delivery		M										
G9357	Pp eval/edu perf		M										
G9358	Pp eval/edu not perf		M										
G9359	Neg mgd pos tb notact		M										
G9360	No doc of neg or man pos tb		M										
G9361	Doc rsn elect c-sec/induct		M										
G9364	Sinus caus bac inx		M										
G9365	1high risk med ord	CH	D										
G9366	1high risk no ord	CH	D										
G9367	>= 2 same hi-rsk med ord		M										
G9368	>= 2 same hi-rsk med not ord		M										
G9380	Off assis eol iss		M										
G9382	No off assis eol		M										
G9383	Recd scrn hcv infec		M										
G9384	Doc med rsn no hcv scrn		M										
G9385	Doc pt reas not rec hcv srn		M										
G9386	Scrn hcv infec not recd		M										
G9389	Unpln rup post cap	CH 	D										
G9390	No unpln rup post cap	CH 	D										
G9393	Ini phq9 >9 remiss <5		M										
G9394	"Dx bipol, death, nhres, hosp"		M										
G9395	Ini phq9 >9 no remiss >=5		M										
G9396	Ini phq9 >9 not assess		M										
G9399	Doc disc tx choices		M										
G9400	Doc reas no disc tx opt		M										
G9401	No disc tx choices		M										
G9402	Recd f/u w/in 30d disch		M										
G9403	Doc reas no 30 day f/u		M										
G9404	No 30 day f/u		M										
G9405	Recd f/u w/in 7d dc		M										
G9406	Doc reas no 7d f/u		M										
G9407	No 7d f/u		M										
G9408	Card tamp w/in 30d		M										
G9409	No card tamp e/in 30d		M										
G9410	Admit w/in 180d req remov		M										
G9411	No admit w/in 180d req remov		M										
G9412	Admit w/in 180d req surg rev		M										
G9413	No admit req surg rev		M										
G9414	1dose menig vac btwn 11 & 13		M										
G9415	No 1dose meni vac btwn 11&13		M										
G9416	Pt 1 tdap betw 10-13 yrs		M										
G9417	Pt not 1 tdap betw 10-13 yrs		M										
G9418	Lungcx bx rpt docs class		M										
G9419	Med reas not incl histo type		M										
G9420	Spec site no lung		M										
G9421	Lung cx bx rpt no doc class		M										
G9422	Rpt doc class histo type		M										
G9423	Med reas rpt no histo type		M										
G9424	Site no lung or lung cx		M										
G9425	Spec rpt no doc class histo		M										
G9426	Impr med time edarr pain med		M										
G9427	No impro med time pain med		M										
G9428	Patho rpt incl pt ctg		M										
G9429	Doc med rsn no pt cat		M										
G9430	Spec site no cutaneous		M										
G9431	Patho rpt no pt ctg		M										
G9432	Asth controlled		M										
G9434	Asth not controlled		M										
G9448	Born 1945-1965		M										
G9449	Hx bld transf b/f 1992		M										
G9450	Hx injec drug use		M										
G9451	1x scrn hcv infect		M										
G9452	Doc med reas no scrn hcv		M										
G9453	Pt reas no hcv infect		M										
G9454	No scr hcv inf 12 mth rp		M										
G9455	"Abd imag w/us, ct or mri"		M										
G9456	Doc med pt reas no hcc scrn		M										
G9457	Pt no abd img no doc rsn		M										
G9458	Tob user recd cess interv		M										
G9459	Tob non-user		M										
G9460	No tob assess or cess inter		M										
G9468	No recd cortico>=10mg/d >60d		M										
G9469	Rec cortico>90d or 1rx 900mg	CH 	D										
G9470	No rec cortico>60d 1rx 600mg		M										
G9471	W/in 2yr dxa not order		M										
G9473	Chap services at hospice		B										
G9474	Diet counsel at hospice		B										
G9475	Other counselor at hospice		B										
G9476	Volun service at hospice		B										
G9477	Care coord at hospice		B										
G9478	Othe therapist at hospice		B										
G9479	Pharmacist at hospice		B										
G9480	Admission to mccm		B										
G9481	Remote e/m new pt 10mins		B										
G9482	Remote e/m new pt 20mins		B										
G9483	Remote e/m new pt 30mins		B										
G9484	Remote e/m new pt 45mins		B										
G9485	Remote e/m new pt 60mins		B										
G9486	Remote e/m est. pt 10mins		B										
G9487	Remote e/m est. pt 15mins		B										
G9488	Remote e/m est. pt 25mins		B										
G9489	Remote e/m est. pt 40mins		B										
G9490	Cmmi mod home visit		B										
G9497	Rec inst no smoke day surg		M										
G9498	Abx reg prescribed		M										
G9500	Rad expos ind/exp tm doc		M										
G9501	Rad expos ind/exp tm no doc		M										
G9502	Med reas no perf foot exam		M										
G9503	Pt tk tams hcl	CH	D										
G9504	Doc rsn hep b stat not asses		M										
G9505	Abx pres w/in 10 dys of symp		M										
G9506	Bio imm resp mod presc		M										
G9507	Doc reas on statin or contra		M										
G9508	Doc pt not on statin		M										
G9509	Adit mdd dys rem 12 mnths		M										
G9510	Remis12m not phq-9 score <5		M										
G9511	Idx evt dte phq>9 doc 12 mo		M										
G9512	Indiv pdc > 0.8		M										
G9513	Indiv pdc not > 0.8		M										
G9514	Req ret or w/in 90d of surg		M										
G9515	"No reas, no ret or w/in 90d"		M										
G9516	Impr vis acuit w/in 90d		M										
G9517	No impr vis acuit w/in 90d		M										
G9518	Doc active inj drug use		M										
G9519	Final ref +/- 1.0 w/in 90d		M										
G9520	Refract not +/- 1.0 w/in 90d		M										
G9521	Er and ip hosp <2 in 12 mos		M										
G9522	Er/ip hosp =/>2 in 12 mos		M										
G9523	D/c hemo or perit dialysis	CH 	D										
G9524	Refer to hospice	CH 	D										
G9525	Doc pt reas no hospice refer	CH 	D										
G9526	"No reason, no refer hospice"	CH 	D										
G9529	Minor blunt trauma w/head ct		M										
G9530	Pt mbht hd ct ord ec prov		M										
G9531	Pt doc		M										
G9532	Pt hd ct ord	CH 	D										
G9533	Indic for head ct not valid		M										
G9537	Img hd clin trial		M										
G9539	Intent pot remv time placemt		M										
G9540	Pt alive 3 mos post proc		M										
G9541	Filter rem 3 mon plmt		M										
G9542	Doc reass appr remo filt 3ms		M										
G9543	Doc 2x re-assess filt remov		M										
G9544	No filt remov w/in 3mos plcm		M										
G9547	Cys ren les or adren		M										
G9548	No f/u rec image study		M										
G9549	Doc med rsn for f/u imag		M										
G9550	Imag rec		M										
G9551	Imag no les		M										
G9552	Inc thyr node <1.0 in rpt		M										
G9553	Prior thyroid dise dx		M										
G9554	Ct/cta/mri/a chst foll rec		M										
G9555	Doc med rsn for follup image		M										
G9556	Ct/cta/mri/a no follup imag		M										
G9557	Ct/cta/mri/a no thyr <1.0cm		M										
G9558	Tx beta-lactam abx therapy	CH 	D										
G9559	Doc med reas no abx therapy	CH 	D										
G9560	"No beta-lactam abx ther, rng"	CH 	D										
G9561	Presc opiates >6 wks		M										
G9562	Foll-up eval q3mo opiod tx		M										
G9563	No f/u eval q3mo opiod tx		M										
G9573	Adl pt md or dys rem 6 mon	CH 	D										
G9574	Adl pt md dys no rem 6 mon	CH 	D										
G9577	Presc opiates >6 wks		M										
G9578	Doc opioid tx 1x during ther		M										
G9579	No doc opioid tx 1x at ther		M										
G9580	Door to punc time <2hrs		M										
G9582	"Door to punc time >2hr, nrg"		M										
G9583	Presc opiates >6 wks		M										
G9584	Eval opioid use instr/pt int		M										
G9585	No eval opi use instr/intv		M										
G9593	Low pecarn ped head trauma		M										
G9594	Pt mbht hd ct ord ec prov		M										
G9595	Doc shnt/tum/coag		M										
G9596	Ped pt hd ct ord		M										
G9597	No low pecarn ped head traum		M										
G9598	Aor ane 5.5-5.9 cm max diam		M										
G9599	Aor ane >=6.0 cm max diam		M										
G9600	Symp aaa urgent repair	CH 	D										
G9601	Pt dchg home post op day 7	CH 	D										
G9602	Pt no dchg home postop day 7	CH 	D										
G9603	Pt surv improv bsline tx		M										
G9604	Pt surv results not avail		M										
G9605	Surv score no improv w/tx		M										
G9606	Intraop cyst eval trac inj		M										
G9607	Doc med rsn not perf cystosc		M										
G9608	Intraop cyst eval not done		M										
G9609	Doc order anti-plat		M										
G9610	Doc md rsn no antipla		M										
G9611	No doc order anti-plat rng		M										
G9612	Phodoc 2 mr cec lndmk		M										
G9613	Doc post surg anatomy		M										
G9614	Photodoc < 2 cec lndmk		M										
G9615	Pre-op asst doc	CH 	D										
G9616	Doc rsn no preop assmt	CH 	D										
G9617	"Pre-op asst not doc, rng"	CH 	D										
G9618	Doc scr uter mal or us/samp		M										
G9620	No scr utr malig/us/samp rng		M										
G9621	Scr unheal etoh w/counsel		M										
G9622	No unheal etoh user		M										
G9623	Doc med rsn no scr etoh use		M										
G9624	Pt not scrn or no counseling		M										
G9625	Pt bl srg 30 day pst srg		M										
G9626	Med rsn no rpt baldder inj		M										
G9627	Pt no bl srg 30 day pst srg		M										
G9628	Pt bwli srg 30 day pst srg		M										
G9629	Med rsn no rpt bowel inj		M										
G9630	Pt no bwli srg 30 day srg		M										
G9631	Pt ui srg 30 day pst srg		M										
G9632	Med rsn for no rpt uret inj		M										
G9633	Pt no ui srg 30 day pst srg		M										
G9634	Qual life tool 2x same/impr		M										
G9635	No doc rsn do qual life assm		M										
G9636	No life asst 2x same/decr		M										
G9637	Doc >1 dose reduc tech		M										
G9638	No doc >1 dose reduc tech		M										
G9639	Amp no reqd in48h ieler proc		M										
G9640	Doc plan hybrid/stage proc		M										
G9641	Amp reqd w/in 48h ieler proc		M										
G9642	Current smoker		M										
G9643	Elective surgery		M										
G9644	No smok b/4 anes day of surg		M										
G9645	Had smoke b/4 anes day surg		M										
G9646	Pt w/90d mrs 0-2		M										
G9647	No mrs score in 90d followup		M										
G9648	Pt w/90d mrs >2		M										
G9649	Psor as doc spc bm		M										
G9651	Psor as doc no spc bm		M										
G9654	Mon anesth care		M										
G9655	Toc tool incl key elem		M										
G9656	Pt trans from anest to pacu		M										
G9658	Toc tool incl elem not used		M										
G9659	>=86y no hx colo ca/rsn scop		M										
G9660	Doc med rsn scope pt >= 86y		M										
G9661	Pt >= 86  w/ hi risk		M										
G9662	Prior dx/active clin ascvd		M										
G9663	Fast/dir ldl >= 190 mg/dl		M										
G9664	Taking statin or rec'd order		M										
G9665	No statin/no order statin		M										
G9666	Fas/dir ldl 70-189mg/dl mst		M										
G9674	Pt w/clin ascvd dx		M										
G9675	Pt w/fast/dir lab ldl-c >190		M										
G9676	40-75y w/type 1/2 w/ldl-c rs		M										
G9678	Oncology care model service		B										
G9679	Acute care pneumonia		B										
G9680	Acute care congestive heart		B										
G9681	Acute care chronic obstruct		B										
G9682	Acute care skin infection		B										
G9683	Acute fluid/electro disorder		B										
G9684	Acute care urinary tract inf		B										
G9685	Acute nursing facility care		M										
G9687	Hospice anytime msmt per		M										
G9688	Pt w/hosp anytime msmt per		M										
G9689	Inpt elect carotid intervent		M										
G9690	Pt in hos		M										
G9691	Pt hosp dur msmt period		M										
G9692	Hosp recd by pt dur msmt per		M										
G9693	Pt use hosp during msmt per		M										
G9694	Hosp srv used pt in msmt per		M										
G9695	Long act inhal bronchdil pre		M										
G9696	Med rsn no presc bronchdil		M										
G9697	Pt rsn no presc bronchdil		M										
G9698	Sys rsn no presc bronchdil		M										
G9699	Long inhal bronchdil no pres		M										
G9700	Pt is w/hosp during msmt per		M										
G9701	Child anbx 30 prior dx estab	CH	D										
G9702	Pt use hosp during msmt per		M										
G9703	Anbx 30 prior to episode		M										
G9704	Ajcc br ca stg i: t1 mic/t1a		M										
G9705	Ajcc br ca stg ib		M										
G9706	Low recur prost ca		M										
G9707	Pt had hosp dur msmt per		M										
G9708	Bilat mast/hx bi /unilat mas		M										
G9709	Hosp srv used pt in msmt per		M										
G9710	Pt prov hosp srv msmt per		M										
G9711	Pt hx tot col or colon ca		M										
G9712	Doc med rsn presc anbx		M										
G9713	Pt use hosp during msmt per		M										
G9714	Pt is w/hosp during msmt per		M										
G9715	Pt w/hosp anytime msmt per		M										
G9716	Bmi doc onl fup not cmpltd		M										
G9717	Doc pt dx dep/bipol		M										
G9718	Hospice anytime msmt per		M										
G9719	Pt not ambul/immob/wc		M										
G9720	Hospice anytime msmt per		M										
G9721	Pt not ambul/immob/wc		M										
G9722	Doc hx renal fail or cr+ >=4		M										
G9723	Hosp recd by pt dur msmt per		M										
G9724	Pt w/doc use anticoag mst yr		M										
G9725	Pt w/hosp anytime msmt per		M										
G9726	Refused to participate		M										
G9727	Pt unable cmplt lepf prom		M										
G9728	Refused to participate		M										
G9729	Pt unbl cmplt lepf prom		M										
G9730	Refused to participate		M										
G9731	Pt unbl cmplt lepf prom		M										
G9732	Refused to participate		M										
G9733	Pt unbl cmplt lb fs prom		M										
G9734	Refused to participate		M										
G9735	Pt unbl cmplt shld fs prom		M										
G9736	Refused to participate		M										
G9737	Pt unbl cmplt ewh fs prom		M										
G9738	Refused to participate	CH	D										
G9739	Pt unbl cmplt go fs prom	CH	D										
G9740	Hosp srv to pt dur msmt per		M										
G9741	Pt w/hosp anytime msmt per		M										
G9744	Pt not eli d/t act dig htn		M										
G9745	Doc rsn no hbp scrn or f/u		M										
G9746	"Mit sten, valve or trans af"		M										
G9747	Pall dialysis with catheter	CH 	D										
G9748	App transpl lvg kidney donor	CH 	D										
G9749	Pall dialysis with catheter	CH 	D										
G9750	App transpl lvg kidney donor	CH 	D										
G9751	Pt died w/in 24 mos rpt time		M										
G9752	Urgent surgery		M										
G9753	"Doc no dicom, ct other fac"		M										
G9754	Incid pulm nodule		M										
G9755	Doc med rsn no fllw up		M										
G9756	Surg proc w/silicone oil		M										
G9757	Surg proc w/silicone oil		M										
G9758	Pt in hos		M										
G9759	Hx preop post cap rup	CH 	D										
G9760	Pt w/hosp anytime msmt per		M										
G9761	Pt w/hosp anytime msmt per		M										
G9762	Pt had >= 2-3 hpv vaccines		M										
G9763	Pt not have 2-3 hpv vaccines		M										
G9764	Pt treatd w/oral syst or bio		M										
G9765	Doc pat declined therapy		M										
G9766	Cva stroke dx tx transf fac		M										
G9767	Hosp new dx cva consid evst		M										
G9768	Pt w/hosp anytime msmt per		M										
G9769	Bn den 2yr/got ost med/ther		M										
G9770	Perip nerve block		M										
G9771	"Anes end, 1 temp >35.5(95.9)"		M										
G9772	Doc med rsn no temp >= 35.5		M										
G9773	1 bod temp >=35.5		M										
G9774	Pt had hyst		M										
G9775	Recd 2 anti-emet pre/intraop		M										
G9776	Doc med rsn no proph antiem		M										
G9777	Pt no antiemet pre/intraop		M										
G9778	Pts dx w/pregn		M										
G9779	Pts breastfeeding		M										
G9780	Pts dx w/rhabdomyolysis		M										
G9781	Doc rsn no statin		M										
G9782	Hx dx fam/pure hypercholes		M										
G9783	"Doc dx dm, fast <70, no stat"		M										
G9784	Path/derm prov 2nd biop opin		M										
G9785	Path report sent		M										
G9786	Path report not sent		M										
G9787	Pt alive		M										
G9788	Most rct bp </= 140/90		M										
G9789	"Record bp ip, er, urg/self"		M										
G9790	Most rct bp >/= 140/90		M										
G9791	Most rct tob stat free		M										
G9792	Most rct tob stat not free		M										
G9793	Pt on daily asa/antiplat		M										
G9794	Doc med rsn no daily aspirin		M										
G9795	Pt no daily asa/antiplat		M										
G9796	Pt not currently on statin		M										
G9797	Pt currently on statin		M										
G9798	D/c ami btw 7/1-6/30 meas pd	CH 	D										
G9799	Med disp evt indic hx asth	CH 	D										
G9800	Pt id intol/alleg beta-block	CH 	D										
G9801	Nonacut transf from inpt	CH 	D										
G9802	Pt w/hosp anytime msmt per	CH 	D										
G9803	Pt presc 135 day trmt	CH 	D										
G9804	Pt not presc 135 day trmt	CH 	D										
G9805	Pt w/hosp anytime msmt per		M										
G9806	Pt recd cerv cyto/hpv		M										
G9807	Pt no recd cerv cyto/hpv		M										
G9808	Pt no asthm cont med mst per		M										
G9809	Pt w/hosp anytime msmt per		M										
G9810	Pdc 75% w/asth cont med		M										
G9811	No pdc 75% w/asth cont med		M										
G9812	Pt died during inpt/30d aft		M										
G9813	Pt not died w/in 30d of proc		M										
G9814	Death during index hosp	CH 	D										
G9815	Death not during index hosp	CH 	D										
G9816	Death <30 day post discharge	CH 	D										
G9817	No death 30-days post-disch	CH 	D										
G9818	Doc sex activity		M										
G9819	Pt w/hosp anytime msmt per		M										
G9820	Doc chlam scr test w/follow		M										
G9821	No doc chlam scr ts w/follow		M										
G9822	Endo abl proc yr prev ind dt		M										
G9823	Endo smpl/hyst bx res doc		M										
G9824	Endo smpl/hyst bx res no doc		M										
G9825	"Her-2 neg,undoc/unkn"	CH 	D										
G9826	Transf pract aft init chemo	CH 	D										
G9827	Her-2 targ ther no init tx	CH 	D										
G9828	Her-2 targ ther dur init tx	CH 	D										
G9829	Breast adj chemo admin	CH 	D										
G9830	Her-2 pos		M										
G9831	Ajcc stg brt ca dx ii or iii		M										
G9832	"Brt ca dx i, no t1/t1a/t1b"		M										
G9833	Transf pract aft init chemo	CH 	D										
G9834	Pt met dis at dx	CH 	D										
G9835	Trastuz given w/in 12 mos dx	CH 	D										
G9836	Rsn no trast given doc	CH 	D										
G9837	Trastuz not in 12 mos dx	CH 	D										
G9838	Pt met dis at dx		M										
G9839	Anti-egfr mon anti ther		M										
G9840	Gene testing performed		M										
G9841	Gene testing not performed		M										
G9842	Pt met dis at dx		M										
G9843	Kras or nras gene mutation		M										
G9844	Pt no recd anti-egfr ther		M										
G9845	Pt recd anti-egfr ther		M										
G9846	Pt died from cancer		M										
G9847	Pt recd chemo last 14d life		M										
G9848	Pt no chemo last 14d life		M										
G9849	Pt died from cancer	CH 	D										
G9850	1/more ed last 30d life	CH 	D										
G9851	1/no ed visit last 30d life	CH 	D										
G9852	Pt died from cancer		M										
G9853	Icu stay last 30d life		M										
G9854	No icu stay last 30d life		M										
G9855	Pt died from cancer	CH 	D										
G9856	Pt no hospice	CH 	D										
G9857	Pt admit hospice	CH 	D										
G9858	Pt enroll hospice		M										
G9859	Pt died from cancer		M										
G9860	Pt less 3d hospice		M										
G9861	Pt more than 3d hospice		M										
G9862	Doc rsn no 10 yr follow		M										
G9868	Next gen aco model <10min		B										
G9869	Next gen aco model 10-20min		B										
G9870	Next gen aco model >20min		B										
G9873	1 em core session		M										
G9874	4 em core sessions		M										
G9875	9 em core sessions		M										
G9876	2 em core ms mo 7-9 no wl		M										
G9877	2 em core ms mo 10-12 no wl		M										
G9878	2 em core ms mo 7-9 wl		M										
G9879	2 em core ms mo 10-12 wl		M										
G9880	Em 5 percent wl		M										
G9881	Em 9 percent wl		M										
G9882	2 em ongoing ms mo 13-15 wl		M										
G9883	2 em ongoing ms mo 16-18 wl		M										
G9884	2 em ongoing ms mo 19-21 wl		M										
G9885	2 em ongoing ms mo 22-24 wl		M										
G9890	Em bridge payment		M										
G9891	Em session reporting		M										
G9892	Doc pt rsn no dil mac exam		M										
G9893	No mac exam		M										
G9894	Adr dep thrpy prescribed		M										
G9895	Doc med rsn no adr dep thrpy		M										
G9896	Doc pt rsn no adr dep thrpy		M										
G9897	Pt nt prsc adr dep thrpy rng		M										
G9898	Pt 66+ snp or ltc pos > 90d		M										
G9899	Scrn mam perf rslts doc		M										
G9900	Scrn mam perf rslts not doc		M										
G9901	Pt 66+ snp or ltc pos > 90d		M										
G9902	Pt scrn tbco and id as user		M										
G9903	Pt scrn tbco id as non user		M										
G9904	Doc med rsn no tbco scrn		M										
G9905	No pt tbco scrn rng		M										
G9906	Pt recv tbco cess interv		M										
G9907	Doc med rsn no tbco interv		M										
G9908	No pt tbco cess interv rng		M										
G9909	Doc med rsn no tbco interv		M										
G9910	Pt 66+ snp or ltc pos > 90d		M										
G9911	Node neg pre/post syst ther		M										
G9912	Hbv status assesed and int		M										
G9913	No hbv status assesd and int		M										
G9914	Pt receiving anti-tnf agent		M										
G9915	No documntd hbv results rcd		M										
G9916	Funct status past 12 months		M										
G9917	Adv dem crgvr limited		M										
G9918	"No funct stat perf, rsn nos"		M										
G9919	Scrn nd pos nd prov of rec		M										
G9920	Scrning perf and negative		M										
G9921	No or part scrn nd rng or os		M										
G9922	Sfty cncrns scrn nd mit recs		M										
G9923	Safty cncrns scrn and neg		M										
G9924	Doc med rsn no scrn or recs	CH 	D										
G9925	No scrn prov rsn nos		M										
G9926	Sfty cncrns scrn but no recs		M										
G9927	Doc no warf /fda  pt trial		M										
G9928	No warf or fda drug presc		M										
G9929	Trs/rev af		M										
G9930	Com care		M										
G9931	No chad or chad scr 0 or 1		M										
G9932	Doc pt rsn no tb scrn recrds		M										
G9933	Canc detectd during col scrn	CH 	D										
G9934	Doc rsn not detecting cancer	CH 	D										
G9935	Canc not detectd during srcn	CH 	D										
G9936	Pmh plyp/neo co/rect/jun/ans	CH 	D										
G9937	Dig or surv colsco	CH 	D										
G9938	Pt 66+ snp or ltc pos > 90d		M										
G9939	Same path/derm perf biopsy		M										
G9940	Doc reas no statin therapy		M										
G9942	Adtl spine proc on same date		M										
G9943	Bk pn nt msr vas scl pre/pst		M										
G9945	Pt w/cancer scoliosis		M										
G9946	Bk pain no vas		M										
G9948	Adtl spine proc on same date		M										
G9949	Leg pain no vas		M										
G9954	Pt >2 rsk fac post-op vomit		M										
G9955	Inhlnt anesth only for induc		M										
G9956	Combo thrpy of >= 2 prophly		M										
G9957	Doc med rsn no combo thrpy		M										
G9958	No combo prohpyl thrp for pt		M										
G9959	Systemic antimicro not presc		M										
G9960	Med rsn sys antimi nt rx		M										
G9961	Systemic antimicro presc		M										
G9962	Embolization doc separatly		M										
G9963	Embolization not doc separat		M										
G9964	Pt recv >=1 well-chld visit		M										
G9965	No well-chld vist recv by pt		M										
G9966	"Scrn, inter, report child"	CH 	D										
G9967	"No scrn, inter, reprt child"	CH 	D										
G9968	Pt refrd 2 pvdr/spclst in pp		M										
G9969	Pvdr rfrd pt rprt rcvd		M										
G9970	Pvdr rfrd pt no rprt rcvd		M										
G9974	Mac exam perf		M										
G9975	Doc med rsn no dil mac exam		M										
G9978	Remote e/m new pt 10mins		B										
G9979	Remote e/m new pt 20mins		B										
G9980	Remote e/m new pt 30 mins		B										
G9981	Remote e/m new pt 45mins		B										
G9982	Remote e/m new pt 60mins		B										
G9983	Remote e/m est. pt 10mins		B										
G9984	Remote e/m est. pt  15mins		B										
G9985	Remote e/m est. pt 25mins		B										
G9986	Remote e/m est. pt 40mins		B										
G9987	Bpci advanced in home visit		B										
J0120	Tetracyclin injection		N										
J0121	"Inj., omadacycline, 1 mg"		G	9311		$3.147	.	$0.63					
J0122	"Inj., eravacycline, 1 mg"	CH	N										
J0129	Abatacept injection		K	9230		$58.103	.	$11.63					
J0130	Abciximab injection		N										
J0131	Acetaminophen injection		N										
J0132	Acetylcysteine injection		N										
J0133	Acyclovir injection		N										
J0135	Adalimumab injection		K	1083		"$1,430.922"	.	$286.19					
J0153	Adenosine inj 1mg		N										
J0171	Adrenalin epinephrine inject		N										
J0178	Aflibercept injection		K	1420		$928.241	.	$185.65					
J0179	"Inj, brolucizumab-dbll, 1 mg"	CH	G	9340		$311.994	.	$62.40					
J0180	Agalsidase beta injection		K	9208		$188.990	.	$37.80					
J0185	"Inj., aprepitant, 1 mg"		G	9463		$1.732	.	$0.35		*			
J0190	Inj biperiden lactate/5 mg		E2										
J0200	Alatrofloxacin mesylate		E2										
J0202	"Injection, alemtuzumab"		K	1809		"$1,984.320"	.	$396.87					
J0205	Alglucerase injection		E2										
J0207	Amifostine		K	7000		"$1,135.691"	.	$227.14					
J0210	Methyldopate hcl injection	CH	E2										
J0215	Alefacept		E2										
J0220	Alglucosidase alfa injection		K	9234		$73.810	.	$14.77					
J0221	Lumizyme injection		K	1413		$174.488	.	$34.90					
J0222	"Inj., patisiran, 0.1 mg"		G	9180		$97.843	.	$19.57					
J0223	Inj givosiran 0.5 mg	NC	G	9343		$106.875	.	$21.38					
J0256	Alpha 1 proteinase inhibitor		K	0901		$4.358	.	$0.88					
J0257	Glassia injection		K	1415		$4.834	.	$0.97					
J0270	Alprostadil for injection		B										
J0275	Alprostadil urethral suppos		B										
J0278	Amikacin sulfate injection		N										
J0280	Aminophyllin 250 mg inj		N										
J0282	Amiodarone hcl		N										
J0285	Amphotericin b		N										
J0287	Amphotericin b lipid complex		K	9024		$9.358	.	$1.88					
J0288	Ampho b cholesteryl sulfate		E2										
J0289	Amphotericin b liposome inj		K	0736		$26.563	.	$5.32					
J0290	Ampicillin 500 mg inj		N										
J0291	"Inj., plazomicin, 5 mg"		G	9183		$3.105	.	$0.63					
J0295	Ampicillin sulbactam 1.5 gm		N										
J0300	Amobarbital 125 mg inj		K	1341		$95.160	.	$19.04					
J0330	Succinycholine chloride inj		N										
J0348	Anidulafungin injection		N										
J0350	Injection anistreplase 30 u		E2										
J0360	Hydralazine hcl injection		N										
J0364	Apomorphine hydrochloride		E2										
J0365	"Aprotonin, 10,000 kiu"		E2										
J0380	Inj metaraminol bitartrate		E2										
J0390	Chloroquine injection	CH 	K	9352		$165.220	.	$33.05					
J0395	Arbutamine hcl injection		E2										
J0400	Aripiprazole injection		N										
J0401	Inj aripiprazole ext rel 1mg		K	1468		$5.700	.	$1.14					
J0456	Azithromycin		N										
J0461	Atropine sulfate injection		N										
J0470	Dimecaprol injection		N										
J0475	Baclofen 10 mg injection		K	9032		$171.593	.	$34.32					
J0476	Baclofen intrathecal trial		N										
J0480	Basiliximab		K	1683		"$4,005.187"	.	$801.04					
J0485	Belatacept injection		K	9286		$3.775	.	$0.76					
J0490	Belimumab injection		K	1353		$46.179	.	$9.24					
J0500	Dicyclomine injection		N										
J0515	Inj benztropine mesylate		N										
J0517	"Inj., benralizumab, 1 mg"		G	9466		$170.112	.	$34.03		*			
J0520	Bethanechol chloride inject		E2										
J0558	Peng benzathine/procaine inj		K	9088		$11.998	.	$2.40					
J0561	Penicillin g benzathine inj		K	1829		$15.158	.	$3.04					
J0565	"Inj, bezlotoxumab, 10 mg"	CH 	K	9490		$39.645	.	$7.93					
J0567	"Inj., cerliponase alfa 1 mg"	CH 	N										
J0570	Buprenorphine implant 74.2mg		K	9058		"$1,207.160"	.	$241.44					
J0571	Buprenorphine oral 1mg		E1										
J0572	Bupren/nal up to 3mg bupreno		E1										
J0573	Bupren/nal 3.1 to 6mg bupren		E1										
J0574	Bupren/nal 6.1 to 10mg bupre		E1										
J0575	Bupren/nal over 10mg bupreno		E1										
J0583	Bivalirudin		N										
J0584	"Injection, burosumab-twza 1m"		K	9187		$361.895	.	$72.38					
J0585	"Injection,onabotulinumtoxina"		K	0902		$6.077	.	$1.22					
J0586	Abobotulinumtoxina		K	1289		$8.149	.	$1.63					
J0587	"Inj, rimabotulinumtoxinb"		K	9018		$11.929	.	$2.39					
J0588	Incobotulinumtoxin a		K	9278		$5.019	.	$1.01					
J0591	"Inj deoxycholic acid, 1 mg"	NC	E1										
J0592	Buprenorphine hydrochloride		N										
J0593	"Inj., lanadelumab-flyo, 1 mg"	CH	N										
J0594	Busulfan injection		K	1178		$3.405	.	$0.69					
J0595	Butorphanol tartrate 1 mg		N										
J0596	"Injection, ruconest"		K	9445		$29.108	.	$5.83					
J0597	"C-1 esterase, berinert"		K	9269		$54.134	.	$10.83					
J0598	"C-1 esterase, cinryze"		K	9251		$56.199	.	$11.24					
J0599	"Inj., haegarda 10 units"	CH	K	9015		$9.918	.	$1.99					
J0600	Edetate calcium disodium inj		K	1274		"$5,594.422"	.	"$1,118.89"					
J0604	"Cinacalcet, esrd on dialysis"		B										
J0606	"Inj, etelcalcetide, 0.1 mg"	CH	N										
J0610	Calcium gluconate injection		N										
J0620	Calcium glycer & lact/10 ml		N										
J0630	Calcitonin salmon injection		K	1433		"$2,839.223"	.	$567.85					
J0636	Inj calcitriol per 0.1 mcg		N										
J0637	Caspofungin acetate		N										
J0638	Canakinumab injection		K	1311		$113.238	.	$22.65					
J0640	Leucovorin calcium injection		N										
J0641	Inj levoleucovorin nos 0.5mg		K	1236		$0.280	.	$0.06					
J0642	"Injection, khapzory, 0.5 mg"		G	9334		$1.999	.	$0.40					
J0670	Inj mepivacaine hcl/10 ml		N										
J0690	Cefazolin sodium injection		N										
J0691	Inj lefamulin 1 mg	NC	G	9332		$0.724	.	$0.15					
J0692	Cefepime hcl for injection		N										
J0693	"Inj., cefiderocol, 5 mg"	NI 	G	9380		$0.972	.	$0.20					
J0694	Cefoxitin sodium injection		N										
J0695	Inj ceftolozane tazobactam		K	9452		$6.490	.	$1.30					
J0696	Ceftriaxone sodium injection		N										
J0697	Sterile cefuroxime injection		N										
J0698	Cefotaxime sodium injection		N										
J0702	Betamethasone acet&sod phosp		N										
J0706	Caffeine citrate injection		N										
J0710	Cephapirin sodium injection		E2										
J0712	Ceftaroline fosamil inj		K	1824		$3.322	.	$0.67					
J0713	Inj ceftazidime per 500 mg		N										
J0714	Ceftazidime and avibactam		K	1825		$92.002	.	$18.41					
J0715	Ceftizoxime sodium / 500 mg		N										
J0716	Centruroides immune f(ab)		K	1431		"$5,063.557"	.	"$1,012.72"					
J0717	Certolizumab pegol inj 1mg		K	1474		$8.161	.	$1.64					
J0720	Chloramphenicol sodium injec		N										
J0725	Chorionic gonadotropin/1000u		N										
J0735	Clonidine hydrochloride		N										
J0740	Cidofovir injection		K	9033		$666.250	.	$133.25					
J0742	Inj imip 4 cilas 4 releb 2mg	NC	G	9362		$2.255	.	$0.46					
J0743	Cilastatin sodium injection		N										
J0744	Ciprofloxacin iv		N										
J0745	Inj codeine phosphate /30 mg	CH	K	9393		$135.640	.	$27.13					
J0770	Colistimethate sodium inj		N										
J0775	"Collagenase, clost hist inj"		K	1340		$52.388	.	$10.48					
J0780	Prochlorperazine injection		N										
J0791	Inj crizanlizumab-tmca 5mg	NC	G	9359		$122.413	.	$24.49					
J0795	Corticorelin ovine triflutal		K	1684		$9.377	.	$1.88					
J0800	Corticotropin injection	CH 	N										
J0834	"Inj., cosyntropin, 0.25 mg"		N										
J0840	Crotalidae poly immune fab		K	9274		"$3,043.750"	.	$608.75					
J0841	Inj crotalidae im f(ab')2 eq		K	9188		"$1,264.210"	.	$252.85					
J0850	Cytomegalovirus imm iv /vial		K	0903		"$1,496.953"	.	$299.40					
J0875	"Injection, dalbavancin"		K	1823		$15.386	.	$3.08					
J0878	Daptomycin injection	CH 	N										
J0881	"Darbepoetin alfa, non-esrd"		K	1685		$3.716	.	$0.75					
J0882	"Darbepoetin alfa, esrd use"		K	1482		$3.716	.	$0.75					
J0883	Argatroban nonesrd use 1mg		K	1859		$1.307	.	$0.27					
J0884	Argatroban esrd dialysis 1mg		K	9065		$1.307	.	$0.27					
J0885	"Epoetin alfa, non-esrd"		K	1686		$9.109	.	$1.83					
J0887	Epoetin beta esrd use		N										
J0888	Epoetin beta non esrd	CH 	K	9077		$1.544	.	$0.31					
J0890	Peginesatide injection		E1										
J0894	Decitabine injection		K	9231		$4.260	.	$0.86					
J0895	Deferoxamine mesylate inj		N										
J0896	Inj luspatercept-aamt 0.25mg	NC	G	9347		$36.320	.	$7.27					
J0897	Denosumab injection		K	9272		$20.123	.	$4.03					
J0945	Brompheniramine maleate inj		N										
J1000	Depo-estradiol cypionate inj		N										
J1020	Methylprednisolone 20 mg inj		N										
J1030	Methylprednisolone 40 mg inj		N										
J1040	Methylprednisolone 80 mg inj		N										
J1050	Medroxyprogesterone acetate		N										
J1071	Inj testosterone cypionate		N										
J1094	Inj dexamethasone acetate		N										
J1095	"Injection, dexamethasone 9%"		G	9172		$1.106	.	$0.23					
J1096	Dexametha opth insert 0.1 mg		G	9308		$139.547	.	$27.91					
J1097	Phenylep ketorolac opth soln	CH 	N										
J1100	Dexamethasone sodium phos		N										
J1110	Inj dihydroergotamine mesylt		N										
J1120	Acetazolamid sodium injectio		N										
J1130	Inj diclofenac sodium 0.5mg		N										
J1160	Digoxin injection		N										
J1162	Digoxin immune fab (ovine)		K	1687		"$3,972.138"	.	$794.43					
J1165	Phenytoin sodium injection		N										
J1170	Hydromorphone injection		N										
J1180	Dyphylline injection		E2										
J1190	Dexrazoxane hcl injection		K	0726		$199.929	.	$39.99					
J1200	Diphenhydramine hcl injectio		N										
J1201	Inj. cetirizine hcl 0.5mg	NC	G	9361		$15.448	.	$3.09					
J1205	Chlorothiazide sodium inj		N										
J1212	Dimethyl sulfoxide 50% 50 ml		K	1832		$635.667	.	$127.14					
J1230	Methadone injection		N										
J1240	Dimenhydrinate injection		N										
J1245	Dipyridamole injection		N										
J1250	Inj dobutamine hcl/250 mg		N										
J1260	Dolasetron mesylate		N										
J1265	Dopamine injection		N										
J1267	Doripenem injection	CH 	N										
J1270	"Injection, doxercalciferol"		N										
J1290	Ecallantide injection		K	9263		$494.686	.	$98.94					
J1300	Eculizumab injection		K	9236		$230.479	.	$46.10					
J1301	"Injection, edaravone, 1 mg"	CH 	K	9493		$19.892	.	$3.98					
J1303	"Inj., ravulizumab-cwvz 10 mg"		G	9312		$226.275	.	$45.26					
J1320	Amitriptyline injection		N										
J1322	"Elosulfase alfa, injection"		K	1480		$246.196	.	$49.24					
J1324	Enfuvirtide injection		E2										
J1325	Epoprostenol injection		N										
J1327	Eptifibatide injection	CH 	N										
J1330	Ergonovine maleate injection		E2										
J1335	Ertapenem injection		N										
J1364	Erythro lactobionate /500 mg	CH 	K	1669		$76.845	.	$15.37					
J1380	Estradiol valerate 10 mg inj		N										
J1410	Inj estrogen conjugate 25 mg		K	9038		$325.621	.	$65.13					
J1428	"Inj, eteplirsen, 10 mg"	CH 	N										
J1429             	Inj golodirsen 10 mg	NC	G	9356		$166.326	.	$33.27					
J1430	Ethanolamine oleate 100 mg		K	1688		$444.099	.	$88.82					
J1435	Injection estrone per 1 mg		E2										
J1436	Etidronate disodium inj		E1										
J1437	Inj. fe derisomaltose 10 mg	NI	G	9388		$25.382	.	$5.08					
J1438	Etanercept injection		K	1608		$736.295	.	$147.26					
J1439	Inj ferric carboxymaltos 1mg		K	9441		$1.106	.	$0.23					
J1442	Inj filgrastim excl biosimil		K	1469		$0.925	.	$0.19					
J1443	Inj ferric pyrophosphate cit		E2										
J1444	Fe pyro cit pow 0.1 mg iron	CH	E2										
J1447	Inj tbo filgrastim 1 microg		K	1748		$0.470	.	$0.10					
J1450	Fluconazole		N										
J1451	"Fomepizole, 15 mg"		K	1689		$5.326	.	$1.07					
J1452	Intraocular fomivirsen na		E2										
J1453	Fosaprepitant injection		K	9242		$0.785	.	$0.16					
J1454	"Inj fosnetupitant, palonoset"		G	9099		$695.767	.	$139.16		*			
J1455	Foscarnet sodium injection		K	1849		$82.268	.	$16.46					
J1457	Gallium nitrate injection		E2										
J1458	Galsulfase injection		K	9224		$405.755	.	$81.16					
J1459	Inj ivig privigen 500 mg		K	1214		$41.503	.	$8.31					
J1460	Gamma globulin 1 cc inj		K	1850		$42.925	.	$8.59					
J1555	"Inj cuvitru, 100 mg"		K	9034		$14.022	.	$2.81					
J1556	"Inj, imm glob bivigam, 500mg"	CH	K	9130		$70.490	.	$14.10					
J1557	Gammaplex injection		K	9270		$53.662	.	$10.74					
J1558	"Inj. xembify, 100 mg"	NC	K	9372		$14.223	.	$2.85					
J1559	Hizentra injection		K	1312		$10.855	.	$2.18					
J1560	Gamma globulin > 10 cc inj		K	1851		$429.255	.	$85.86					
J1561	Gamunex-c/gammaked		K	0948		$42.186	.	$8.44					
J1562	"Vivaglobin, inj"		E2										
J1566	"Immune globulin, powder"		K	2731		$68.303	.	$13.67					
J1568	Octagam injection		K	0943		$41.229	.	$8.25					
J1569	Gammagard liquid injection		K	0944		$43.201	.	$8.65					
J1570	Ganciclovir sodium injection		N										
J1571	Hepagam b im injection		K	0946		$63.403	.	$12.69					
J1572	Flebogamma injection		K	0947		$40.383	.	$8.08					
J1573	"Hepagam b intravenous, inj"		K	1138		$65.960	.	$13.20					
J1575	Hyqvia 100mg immuneglobulin		K	1826		$14.486	.	$2.90					
J1580	Garamycin gentamicin inj		N										
J1595	Injection glatiramer acetate		K	1015		$157.420	.	$31.49					
J1599	"Ivig non-lyophilized, nos"		N										
J1600	Gold sodium thiomaleate inj		E2										
J1602	Golimumab for iv use 1mg		K	1475		$18.997	.	$3.80					
J1610	Glucagon hydrochloride/1 mg		K	9042		$211.789	.	$42.36					
J1620	Gonadorelin hydroch/ 100 mcg		E2										
J1626	Granisetron hcl injection		N										
J1627	"Inj, granisetron, xr, 0.1 mg"	CH	N										
J1628	"Inj., guselkumab, 1 mg"	CH	K	9029		$93.123	.	$18.63					
J1630	Haloperidol injection		N										
J1631	Haloperidol decanoate inj		N										
J1632	"Inj., brexanolone, 1 mg"	NI	G	9333		$76.909	.	$15.39					
J1640	"Hemin, 1 mg"		K	1690		$24.436	.	$4.89					
J1642	Inj heparin sodium per 10 u		N										
J1644	Inj heparin sodium per 1000u		N										
J1645	Dalteparin sodium		N										
J1650	Inj enoxaparin sodium		N										
J1652	Fondaparinux sodium		N										
J1655	Tinzaparin sodium injection		N										
J1670	Tetanus immune globulin inj		K	1670		$476.569	.	$95.32					
J1675	Histrelin acetate		B										
J1700	Hydrocortisone acetate inj		N										
J1710	Hydrocortisone sodium ph inj		N										
J1720	Hydrocortisone sodium succ i		N										
J1726	"Makena, 10 mg"		K	9074		$15.881	.	$3.18					
J1729	Inj hydroxyprogst capoat nos		K	9318		$10.810	.	$2.17					
J1730	Diazoxide injection		E2										
J1738	Inj. meloxicam 1 mg	NI	G	9371		$3.255	$0.00	$0.00					
J1740	Ibandronate sodium injection		K	9229		$50.999	.	$10.20					
J1741	Ibuprofen injection		N										
J1742	Ibutilide fumarate injection		K	9044		$316.198	.	$63.24					
J1743	Idursulfase injection	CH	N										
J1744	Icatibant injection		K	1443		$276.567	.	$55.32					
J1745	Infliximab not biosimil 10mg		K	7043		$47.620	.	$9.53					
J1746	"Inj., ibalizumab-uiyk, 10 mg"		K	9189		$63.624	.	$12.73					
J1750	Inj iron dextran		K	1237		$15.010	.	$3.01					
J1756	Iron sucrose injection		N										
J1786	Imuglucerase injection		K	1327		$43.377	.	$8.68					
J1790	Droperidol injection		N										
J1800	Propranolol injection		N										
J1810	Droperidol/fentanyl inj		E1										
J1815	Insulin injection		N										
J1817	Insulin for insulin pump use		N										
J1823	"Inj. inebilizumab-cdon, 1 mg"	NI 	K	9394		$449.767	.	$89.96					
J1826	Interferon beta-1a inj		K	1852		"$2,276.610"	.	$455.33					
J1830	Interferon beta-1b / .25 mg		K	0910		$393.833	.	$78.77					
J1833	"Injection, isavuconazonium"		K	9456		$0.783	.	$0.16					
J1835	Itraconazole injection		E2										
J1840	Kanamycin sulfate 500 mg inj		N										
J1850	Kanamycin sulfate 75 mg inj	CH	E2										
J1885	Ketorolac tromethamine inj		N										
J1890	Cephalothin sodium injection		N										
J1930	Lanreotide injection		K	9237		$68.475	.	$13.70					
J1931	Laronidase injection		K	9209		$33.102	.	$6.63					
J1940	Furosemide injection		N										
J1943	"Inj., aristada initio, 1 mg"		G	9179		$2.858	.	$0.58					
J1944	Aripirazole lauroxil 1 mg		K 	9470		$2.847	.	$0.57					
J1945	Lepirudin		E2										
J1950	Leuprolide acetate /3.75 mg		K	0800		"$1,347.559"	.	$269.52					
J1953	Levetiracetam injection		N										
J1955	Inj levocarnitine per 1 gm		B										
J1956	Levofloxacin injection		N										
J1960	Levorphanol tartrate inj		N										
J1980	Hyoscyamine sulfate inj		N										
J1990	Chlordiazepoxide injection		N										
J2001	Lidocaine injection		N										
J2010	Lincomycin injection		N										
J2020	Linezolid injection		N										
J2060	Lorazepam injection		N										
J2062	Loxapine for inhalation 1 mg	CH	E2										
J2150	Mannitol injection		N										
J2170	Mecasermin injection		N										
J2175	Meperidine hydrochl /100 mg		N										
J2180	Meperidine/promethazine inj		N										
J2182	"Injection, mepolizumab, 1mg"		K	9473		$28.704	.	$5.75					
J2185	Meropenem		N										
J2186	"Inj., meropenem, vaborbactam"		K	9178		$1.780	.	$0.36					
J2210	Methylergonovin maleate inj		N										
J2212	Methylnaltrexone injection		N										
J2248	Micafungin sodium injection	CH 	K	9227		$1.180	.	$0.24					
J2250	Inj midazolam hydrochloride		N										
J2260	Inj milrinone lactate / 5 mg		N										
J2265	Minocycline hydrochloride		K	1853		$1.988	.	$0.40					
J2270	Morphine sulfate injection		N										
J2274	Inj morphine pf epid ithc		N										
J2278	Ziconotide injection		K	1694		$8.171	.	$1.64					
J2280	"Inj, moxifloxacin 100 mg"		N										
J2300	Inj nalbuphine hydrochloride		N										
J2310	Inj naloxone hydrochloride		N										
J2315	"Naltrexone, depot form"		K	0759		$3.261	.	$0.66					
J2320	Nandrolone decanoate 50 mg		N										
J2323	Natalizumab injection		K	9126		$21.630	.	$4.33					
J2325	Nesiritide injection	CH 	E1										
J2326	"Inj, nusinersen, 0.1mg"	CH 	K	9489		"$1,122.512"	.	$224.51					
J2350	"Injection, ocrelizumab, 1 mg"	CH 	K	9494		$57.383	.	$11.48					
J2353	"Octreotide injection, depot"		K	1207		$205.878	.	$41.18					
J2354	"Octreotide inj, non-depot"		N										
J2355	Oprelvekin injection	CH 	N										
J2357	Omalizumab injection		K	9300		$37.699	.	$7.54					
J2358	Olanzapine long-acting inj	CH 	K	1331		$2.917	.	$0.59					
J2360	Orphenadrine injection		N										
J2370	Phenylephrine hcl injection		N										
J2400	Chloroprocaine hcl injection		N										
J2405	Ondansetron hcl injection		N										
J2407	"Injection, oritavancin"		K	1660		$23.797	.	$4.76					
J2410	Oxymorphone hcl injection		N										
J2425	Palifermin injection		K	1696		$22.812	.	$4.57					
J2426	Paliperidone palmitate inj		K	9255		$12.102	.	$2.43					
J2430	Pamidronate disodium /30 mg		N										
J2440	Papaverin hcl injection		N										
J2460	Oxytetracycline injection		E2										
J2469	Palonosetron hcl		N										
J2501	Paricalcitol		N										
J2502	"Inj, pasireotide long acting"		K	9454		$332.591	.	$66.52					
J2503	Pegaptanib sodium injection		N										
J2504	"Pegademase bovine, 25 iu"		K	1739		"$1,471.845"	.	$294.37					
J2505	"Injection, pegfilgrastim 6mg"		K	9119		"$3,571.681"	.	$714.34					
J2507	Pegloticase injection		K	9281		"$2,801.076"	.	$560.22					
J2510	Penicillin g procaine inj		N										
J2513	Pentastarch 10% solution		E2										
J2515	Pentobarbital sodium inj		K	1854		$33.926	.	$6.79					
J2540	Penicillin g potassium inj		N										
J2543	Piperacillin/tazobactam		N										
J2545	Pentamidine non-comp unit		B										
J2547	"Injection, peramivir"		K	9451		$1.596	.	$0.32					
J2550	Promethazine hcl injection		N										
J2560	Phenobarbital sodium inj	CH 	K	9069		$47.334	.	$9.47					
J2562	Plerixafor injection		K	9252		$365.294	.	$73.06					
J2590	Oxytocin injection		N										
J2597	Inj desmopressin acetate		K	1440		$10.453	.	$2.10					
J2650	Prednisolone acetate inj		N										
J2670	Totazoline hcl injection		E2										
J2675	Inj progesterone per 50 mg		N										
J2680	Fluphenazine decanoate 25 mg		N										
J2690	Procainamide hcl injection		N										
J2700	Oxacillin sodium injeciton		N										
J2704	"Inj, propofol, 10 mg"		N										
J2710	Neostigmine methylslfte inj		N										
J2720	Inj protamine sulfate/10 mg		N										
J2724	Protein c concentrate		K	1139		$15.064	.	$3.02					
J2725	Inj protirelin per 250 mcg		E2										
J2730	Pralidoxime chloride inj		N										
J2760	Phentolaine mesylate inj		K	1458		$359.137	.	$71.83					
J2765	Metoclopramide hcl injection		N										
J2770	Quinupristin/dalfopristin		K	2770		$458.041	.	$91.61					
J2778	Ranibizumab injection		K	9233		$324.272	.	$64.86					
J2780	Ranitidine hydrochloride inj		N										
J2783	Rasburicase		K	0738		$300.937	.	$60.19					
J2785	Regadenoson injection		N										
J2786	"Injection, reslizumab, 1mg"		K	9481		$9.758	.	$1.96					
J2787	Riboflavin 5'phos opth<=3ml		N										
J2788	Rho d immune globulin 50 mcg		N										
J2790	Rho d immune globulin inj		N										
J2791	Rhophylac injection		N										
J2792	"Rho(d) immune globulin h, sd"		K	1609		$36.366	.	$7.28					
J2793	Rilonacept injection		E2										
J2794	"Inj risperdal consta, 0.5 mg"		K	9125		$10.532	.	$2.11					
J2795	Ropivacaine hcl injection		N										
J2796	Romiplostim injection		K	9245		$78.428	.	$15.69					
J2797	"Inj., rolapitant, 0.5 mg"		E1										
J2798	"Inj., perseris, 0.5 mg"		G	9181		$10.181	.	$2.04					
J2800	Methocarbamol injection		N										
J2805	Sincalide injection		N										
J2810	Inj theophylline per 40 mg		N										
J2820	Sargramostim injection		K	0731		$48.122	.	$9.63					
J2840	Inj sebelipase alfa 1 mg		K	9478		$541.130	.	$108.23					
J2850	Inj secretin synthetic human		K	1700		$34.781	.	$6.96					
J2860	"Injection, siltuximab"		K	9455		$111.935	.	$22.39					
J2910	Aurothioglucose injeciton	CH 	E2										
J2916	Na ferric gluconate complex		N										
J2920	Methylprednisolone injection		N										
J2930	Methylprednisolone injection		N										
J2940	Somatrem injection		E2										
J2941	Somatropin injection		K	9319		$84.130	.	$16.83					
J2950	Promazine hcl injection		N										
J2993	Reteplase injection	CH 	K	9005		"$2,386.298"	.	$477.26					
J2995	Inj streptokinase /250000 iu		E2										
J2997	Alteplase recombinant		K	7048		$87.154	.	$17.44					
J3000	Streptomycin injection		N										
J3010	Fentanyl citrate injection		N										
J3030	Sumatriptan succinate / 6 mg		N										
J3031	"Inj., fremanezumab-vfrm 1 mg"		G	9197		$2.249	.	$0.45					
J3032	Inj. eptinezumab-jjmr 1 mg	NI	G	9357		$15.399	.	$3.08					
J3060	"Inj, taliglucerase alfa 10 u"		K	9294		$40.857	.	$8.18					
J3070	Pentazocine injection		N										
J3090	Inj tedizolid phosphate		K	1662		$1.590	.	$0.32					
J3095	Telavancin injection		K	9258		$5.138	.	$1.03					
J3101	Tenecteplase injection		K	9002		$129.255	.	$25.86					
J3105	Terbutaline sulfate inj		N										
J3110	Teriparatide injection		B										
J3111	Inj. romosozumab-aqqg 1 mg		G	9327		$9.014	.	$1.81					
J3121	Inj testostero enanthate 1mg		N										
J3145	Testosterone undecanoate 1mg		K	9078		$1.543	.	$0.31					
J3230	Chlorpromazine hcl injection		N										
J3240	Thyrotropin injection		K	9108		"$1,740.225"	.	$348.05					
J3241	Inj. teprotumumab-trbw 10 mg	NI	G	9355		$315.880	.	$63.18					
J3243	Tigecycline injection		K	9228		$1.378	.	$0.28					
J3245	"Inj., tildrakizumab, 1 mg"		G	9306		$135.673	.	$27.14					
J3246	Tirofiban hcl		K	7041		$2.191	.	$0.44					
J3250	Trimethobenzamide hcl inj		N										
J3260	Tobramycin sulfate injection		N										
J3262	Tocilizumab injection		K	9264		$5.401	.	$1.09					
J3265	Injection torsemide 10 mg/ml		N										
J3280	Thiethylperazine maleate inj		E2										
J3285	Treprostinil injection		K	1701		$62.806	.	$12.57					
J3300	Triamcinolone a inj prs-free		N										
J3301	Triamcinolone acet inj nos		N										
J3302	Triamcinolone diacetate inj		N										
J3303	Triamcinolone hexacetonl inj		N										
J3304	Inj triamcinolone ace xr 1mg		G	9469		$18.204	.	$3.65		*			
J3305	Inj trimetrexate glucoronate		E2										
J3310	Perphenazine injeciton		N										
J3315	Triptorelin pamoate		K	9122		$385.610	.	$77.13					
J3316	"Inj., triptorelin xr 3.75 mg"	CH	K	9016		"$3,044.011"	.	$608.81					
J3320	Spectinomycn di-hcl inj		E2										
J3350	Urea injection		E2										
J3355	"Urofollitropin, 75 iu"		E2										
J3357	"Ustekinumab sub cu inj, 1 mg"		K	9261		$184.359	.	$36.88					
J3358	"Ustekinumab, iv inject, 1 mg"	CH	K	9487		$12.033	.	$2.41					
J3360	Diazepam injection		N										
J3364	Urokinase 5000 iu injection		N										
J3365	"Urokinase 250,000 iu inj"		E2										
J3370	Vancomycin hcl injection		N										
J3380	"Injection, vedolizumab"		K	1489		$20.297	.	$4.06					
J3385	Velaglucerase alfa		K	9271		$346.147	.	$69.23					
J3396	Verteporfin injection		K	1203		$11.227	.	$2.25					
J3397	"Inj., vestronidase alfa-vjbk"	CH	N										
J3398	Inj luxturna 1 billion vec g		G	9070		"$2,883.200"	.	$576.64		*			
J3399	Inj onase abepar-xioi treat	NC	K	9373		"$2,213,634.284"	.	"$442,726.86"	*				
J3400	Triflupromazine hcl inj		E2										
J3410	Hydroxyzine hcl injection		N										
J3411	Thiamine hcl 100 mg		N										
J3415	Pyridoxine hcl 100 mg		N										
J3420	Vitamin b12 injection		N										
J3430	Vitamin k phytonadione inj		N										
J3465	"Injection, voriconazole"		N										
J3470	Hyaluronidase injection		N										
J3471	"Ovine, up to 999 usp units"		N										
J3472	"Ovine, 1000 usp units"		N										
J3473	Hyaluronidase recombinant		N										
J3475	Inj magnesium sulfate		N										
J3480	Inj potassium chloride		N										
J3485	Zidovudine		N										
J3486	Ziprasidone mesylate		N										
J3489	Zoledronic acid 1mg		N										
J3490	Drugs unclassified injection		N										
J3520	Edetate disodium per 150 mg		E1										
J3530	Nasal vaccine inhalation		N										
J3535	Metered dose inhaler drug		E1										
J3570	Laetrile amygdalin vit b17		E1										
J3590	Unclassified biologics		N										
J3591	Esrd on dialysi drug/bio noc		B										
J7030	Normal saline solution infus		N										
J7040	Normal saline solution infus		N										
J7042	5% dextrose/normal saline		N										
J7050	Normal saline solution infus		N										
J7060	5% dextrose/water		N										
J7070	D5w infusion		N										
J7100	Dextran 40 infusion		N										
J7110	Dextran 75 infusion		N										
J7120	Ringers lactate infusion		N										
J7121	5% dextrose in lac ringers		N										
J7131	Hypertonic saline sol		N										
J7169	"Inj andexxa, 10 mg"	NC	G	9198		$291.500	.	$58.30					
J7170	"Inj., emicizumab-kxwh 0.5 mg"		G	9257		$47.467	.	$9.50		*			
J7175	"Inj, factor x, (human), 1iu"		K	1857		$7.879	.	$1.58					
J7177	"Inj., fibryga, 1 mg"	CH 	N										
J7178	Inj human fibrinogen con nos		K	1478		$1.243	.	$0.25					
J7179	Vonvendi inj 1 iu vwf:rco		K	9059		$1.783	.	$0.36					
J7180	Factor xiii anti-hem factor		K	1416		$8.773	.	$1.76					
J7181	Factor xiii recomb a-subunit		K	1746		$15.526	.	$3.11					
J7182	Factor viii recomb novoeight		K	1856		$1.325	.	$0.27					
J7183	Wilate injection		K	1352		$1.023	.	$0.21					
J7185	Xyntha inj		K	1268		$1.306	.	$0.27					
J7186	Antihemophilic viii/vwf comp		K	1213		$1.136	.	$0.23					
J7187	"Humate-p, inj"		K	1704		$1.207	.	$0.25					
J7188	Factor viii recomb obizur		K	1827		$3.186	.	$0.64					
J7189	Factor viia recomb novoseven		K	1705		$2.250	.	$0.45					
J7190	Factor viii		K	0925		$1.015	.	$0.21					
J7191	Factor viii (porcine)		E2										
J7192	Factor viii recombinant nos		K	0927		$1.378	.	$0.28					
J7193	Factor ix non-recombinant		K	0931		$1.164	.	$0.24					
J7194	Factor ix complex		K	0928		$1.491	.	$0.30					
J7195	Factor ix recombinant nos		K	0932		$1.534	.	$0.31					
J7196	Antithrombin recombinant	CH 	N										
J7197	Antithrombin iii injection		K	1263		$3.504	.	$0.71					
J7198	Anti-inhibitor		K	0929		$2.051	.	$0.42					
J7199	Hemophilia clot factor noc		B										
J7200	Factor ix recombinan rixubis		K	1467		$1.456	.	$0.30					
J7201	Factor ix alprolix recomb		K	1486		$3.252	.	$0.66					
J7202	Factor ix idelvion inj		K	9171		$4.438	.	$0.89					
J7203	Factor ix recomb gly rebinyn		G	9468		$4.009	.	$0.81		*			
J7204	Inj recombin esperoct per iu	NC	G	9354		$2.286	.	$0.46					
J7205	Factor viii fc fusion recomb		K	1656		$2.167	.	$0.44					
J7207	Factor viii pegylated recomb		K	1844		$1.874	.	$0.38					
J7208	Inj. jivi 1 iu		G	9299		$2.020	.	$0.41					
J7209	Factor viii nuwiq recomb 1iu		K	1846		$1.355	.	$0.28					
J7210	"Inj, afstyla, 1 i.u."		K	9043		$1.338	.	$0.27					
J7211	"Inj, kovaltry, 1 i.u."	CH 	K	9075		$1.219	.	$0.25					
J7212	Factor viia recomb sevenfact	NI 	K	9395		$2.585	.	$0.52					
J7296	"Kyleena, 19.5 mg"		E1										
J7297	"Liletta, 52 mg"		E1										
J7298	"Mirena, 52 mg"		E1										
J7300	Intraut copper contraceptive		E1										
J7301	"Skyla, 13.5 mg"		E1										
J7303	Contraceptive vaginal ring		E1										
J7304	Contraceptive hormone patch		E1										
J7306	Levonorgestrel implant sys		E1										
J7307	Etonogestrel implant system		E1										
J7308	Aminolevulinic acid hcl top		K	7308		$394.752	.	$78.96					
J7309	"Methyl aminolevulinate, top"		E2										
J7310	Ganciclovir long act implant		E2										
J7311	"Inj., retisert, 0.01 mg"		K	9225		$340.622	.	$68.13					
J7312	Dexamethasone intra implant		K	9256		$199.756	.	$39.96					
J7313	"Inj., iluvien, 0.01 mg"		K	9450		$490.873	.	$98.18					
J7314	"Inj., yutiq, 0.01 mg"		K	9328		$491.133	.	$98.23					
J7315	Ophthalmic mitomycin		N										
J7316	"Inj, ocriplasmin, 0.125 mg"		K	9298		"$1,046.927"	.	$209.39					
J7318	"Inj, durolane 1 mg"		G	9174		$17.225	.	$3.45		*			
J7320	"Genvisc 850, inj, 1mg"		K	9079		$16.918	.	$3.39					
J7321	Hyalgan or supartz inj dose		N										
J7322	Hymovis injection 1 mg		K	9471		$31.668	.	$6.34					
J7323	Euflexxa inj per dose		K	0875		$140.312	.	$28.07					
J7324	Orthovisc inj per dose		K	0877		$128.409	.	$25.69					
J7325	Synvisc or synvisc-one		K	0874		$10.218	.	$2.05					
J7326	Gel-one		K	1417		"$1,219.000"	.	$243.80					
J7327	Monovisc inj per dose		K	1747		$694.582	.	$138.92					
J7328	Gelsyn-3 injection 0.1 mg	CH	K	1862		$2.177	.	$0.44					
J7329	"Inj, trivisc 1 mg"		K	9196		$7.195	.	$1.44					
J7330	Cultured chondrocytes implnt		B										
J7331	"Synojoynt, inj., 1 mg"	CH 	G	9337		$4.394	.	$0.88					
J7332	"Inj., triluron, 1 mg"	CH 	N 										
J7333	Visco-3 inj dose	NC	N										
J7336	Capsaicin 8% patch		K	9071		$3.250	.	$0.65					
J7340	Carbidopa levodopa ent 100ml		K	9320		$213.095	.	$42.62					
J7342	Ciprofloxacin otic susp 6 mg		K	9479		$29.968	.	$6.00					
J7345	"Aminolevulinic acid, 10% gel"	CH 	K	9301		$1.525	.	$0.31					
J7351	Inj bimatoprost itc imp1mcg	NI	G	9351		$200.850	.	$40.17					
J7352	"Afamelanotide implant, 1 mg"	NI	K	9396		"$3,218.897"	.	$643.78					
J7401	Mometasone furoate sinus imp		N 										
J7500	Azathioprine oral 50mg		N										
J7501	Azathioprine parenteral		K	0887		$227.933	.	$45.59					
J7502	Cyclosporine oral 100 mg		N										
J7503	Tacrol envarsus ex rel oral		N										
J7504	Lymphocyte immune globulin		K	0890		"$2,257.665"	.	$451.54					
J7505	Monoclonal antibodies		N										
J7507	Tacrolimus imme rel oral 1mg		N										
J7508	Tacrol astagraf ex rel oral		N										
J7509	Methylprednisolone oral		N										
J7510	Prednisolone oral per 5 mg		N										
J7511	Antithymocyte globuln rabbit		K	9104		$817.122	.	$163.43					
J7512	Prednisone ir or dr oral 1mg		N										
J7513	"Daclizumab, parenteral"		E2										
J7515	Cyclosporine oral 25 mg		N										
J7516	Cyclosporin parenteral 250mg		N										
J7517	Mycophenolate mofetil oral		N										
J7518	Mycophenolic acid		N										
J7520	"Sirolimus, oral"		N										
J7525	Tacrolimus injection		K	9006		$211.974	.	$42.40					
J7527	Oral everolimus		N										
J7599	Immunosuppressive drug noc		N										
J7604	Acetylcysteine comp unit		M										
J7605	Arformoterol non-comp unit		M										
J7606	"Formoterol fumarate, inh"		M										
J7607	Levalbuterol comp con		M										
J7608	Acetylcysteine non-comp unit		M										
J7609	Albuterol comp unit		M										
J7610	Albuterol comp con		M										
J7611	Albuterol non-comp con		M										
J7612	Levalbuterol non-comp con		M										
J7613	Albuterol non-comp unit		M										
J7614	Levalbuterol non-comp unit		M										
J7615	Levalbuterol comp unit		M										
J7620	Albuterol ipratrop non-comp		M										
J7622	Beclomethasone comp unit		M										
J7624	Betamethasone comp unit		M										
J7626	Budesonide non-comp unit		M										
J7627	Budesonide comp unit		M										
J7628	Bitolterol mesylate comp con		M										
J7629	Bitolterol mesylate comp unt		M										
J7631	Cromolyn sodium noncomp unit		M										
J7632	Cromolyn sodium comp unit		M										
J7633	Budesonide non-comp con		M										
J7634	Budesonide comp con		M										
J7635	Atropine comp con		M										
J7636	Atropine comp unit		M										
J7637	Dexamethasone comp con		M										
J7638	Dexamethasone comp unit		M										
J7639	Dornase alfa non-comp unit		M										
J7640	Formoterol comp unit		E1										
J7641	Flunisolide comp unit		M										
J7642	Glycopyrrolate comp con		M										
J7643	Glycopyrrolate comp unit		M										
J7644	Ipratropium bromide non-comp		M										
J7645	Ipratropium bromide comp		M										
J7647	Isoetharine comp con		M										
J7648	Isoetharine non-comp con		M										
J7649	Isoetharine non-comp unit		M										
J7650	Isoetharine comp unit		M										
J7657	Isoproterenol comp con		M										
J7658	Isoproterenol non-comp con		M										
J7659	Isoproterenol non-comp unit		M										
J7660	Isoproterenol comp unit		M										
J7665	Mannitol for inhaler		N										
J7667	Metaproterenol comp con		M										
J7668	Metaproterenol non-comp con		M										
J7669	Metaproterenol non-comp unit		M										
J7670	Metaproterenol comp unit		M										
J7674	"Methacholine chloride, neb"		N										
J7676	Pentamidine comp unit dose		M										
J7677	Revefenacin inh non-com 1mcg		M										
J7680	Terbutaline sulf comp con		M										
J7681	Terbutaline sulf comp unit		M										
J7682	Tobramycin non-comp unit		M										
J7683	Triamcinolone comp con		M										
J7684	Triamcinolone comp unit		M										
J7685	Tobramycin comp unit		M										
J7686	"Treprostinil, non-comp unit"		M										
J7699	Inhalation solution for dme		M										
J7799	Non-inhalation drug for dme		N										
J7999	"Compounded drug, noc"		N										
J8498	Antiemetic rectal/supp nos		B										
J8499	Oral prescrip drug non chemo		E1										
J8501	Oral aprepitant		N										
J8510	Oral busulfan	CH 	N										
J8515	"Cabergoline, oral 0.25mg"		E1										
J8520	"Capecitabine, oral, 150 mg"		N										
J8521	"Capecitabine, oral, 500 mg"		N										
J8530	Cyclophosphamide oral 25 mg		N										
J8540	Oral dexamethasone		N										
J8560	Etoposide oral 50 mg		K	0802		$75.493	.	$15.10					
J8562	Oral fludarabine phosphate	CH 	E2										
J8565	Gefitinib oral		E2										
J8597	Antiemetic drug oral nos		N										
J8600	Melphalan oral 2 mg		N										
J8610	Methotrexate oral 2.5 mg		N										
J8650	Nabilone oral		E2										
J8655	"Oral netupitant, palonosetro"		K	9448		$270.102	.	$54.03					
J8670	"Rolapitant, oral, 1mg"		K	1761		$2.266	.	$0.46					
J8700	Temozolomide		N										
J8705	Topotecan oral		N										
J8999	Oral prescription drug chemo		B										
J9000	Doxorubicin hcl injection		N										
J9015	Aldesleukin injection		K	0807		"$4,964.616"	.	$992.93					
J9017	Arsenic trioxide injection		K	9012		$22.063	.	$4.42					
J9019	Erwinaze injection		K	9289		$427.269	.	$85.46					
J9020	"Asparaginase, nos"		E2										
J9022	"Inj, atezolizumab,10 mg"		K	9483		$78.279	.	$15.66					
J9023	"Injection, avelumab, 10 mg"	CH 	K	9491		$84.700	.	$16.94					
J9025	Azacitidine injection		K	1709		$0.801	.	$0.17					
J9027	Clofarabine injection		K	1710		$52.637	.	$10.53					
J9030	Bcg live intravesical 1mg	CH 	N										
J9032	"Injection, belinostat, 10mg"		K	1658		$42.794	.	$8.56					
J9033	"Inj., treanda 1 mg"		K	9243		$24.693	.	$4.94					
J9034	"Inj., bendeka 1 mg"		K	1861		$20.273	.	$4.06					
J9035	Bevacizumab injection		K	9214		$76.361	.	$15.28					
J9036	Inj. belrapzo/bendamustine		G	9313		$21.612	.	$4.33					
J9039	"Injection, blinatumomab"		K	9449		$118.586	.	$23.72					
J9040	Bleomycin sulfate injection		N										
J9041	"Inj., velcade 0.1 mg"		K	9207		$44.973	.	$9.00					
J9042	Brentuximab vedotin inj		K	9287		$175.282	.	$35.06					
J9043	Cabazitaxel injection		K	9276		$181.509	.	$36.31					
J9044	"Inj, bortezomib, nos, 0.1 mg"		K	9192		$22.036	.	$4.41					
J9045	Carboplatin injection		N										
J9047	"Injection, carfilzomib, 1 mg"		K	9295		$39.198	.	$7.84					
J9050	Carmustine injection		K	0812		"$2,016.270"	.	$403.26					
J9055	Cetuximab injection		K	9215		$64.286	.	$12.86					
J9057	"Inj., copanlisib, 1 mg"		G	9030		$78.989	.	$15.80		*			
J9060	Cisplatin 10 mg injection		N										
J9065	Inj cladribine per 1 mg		K	0858		$19.573	.	$3.92					
J9070	Cyclophosphamide 100 mg inj		K	1408		$29.672	.	$5.94					
J9098	Cytarabine liposome inj	CH 	N										
J9100	Cytarabine hcl 100 mg inj		N										
J9118	Inj. calaspargase pegol-mknl		E2										
J9119	"Inj., cemiplimab-rwlc, 1 mg"		G	9304		$27.401	.	$5.49					
J9120	Dactinomycin injection		K	0752		"$1,044.534"	.	$208.91					
J9130	Dacarbazine 100 mg inj		N										
J9144	"Daratumumab, hyaluronidase"	NI 	G	9378		$43.340	.	$8.67					
J9145	"Injection, daratumumab 10 mg"		K	9476		$56.286	.	$11.26					
J9150	Daunorubicin injection		K	0820		$43.838	.	$8.77					
J9151	Daunorubicin citrate inj	CH 	E2										
J9153	"Inj daunorubicin, cytarabine"	CH 	K	9302		$197.794	.	$39.56					
J9155	Degarelix injection		K	1296		$3.842	.	$0.77					
J9160	Denileukin diftitox inj		E2										
J9165	Diethylstilbestrol injection		E2										
J9171	Docetaxel injection	CH 	N										
J9173	"Inj., durvalumab, 10 mg"	CH 	K	9492		$76.023	.	$15.21					
J9175	Elliotts b solution per ml		N										
J9176	"Injection, elotuzumab, 1mg"		K	9477		$6.671	.	$1.34					
J9177	Inj enfort vedo-ejfv 0.25mg	NC	G	9364		$27.958	.	$5.60					
J9178	"Inj, epirubicin hcl, 2 mg"		N										
J9179	Eribulin mesylate injection		K	1426		$117.663	.	$23.54					
J9181	Etoposide injection		N										
J9185	Fludarabine phosphate inj		N										
J9190	Fluorouracil injection		N										
J9198	"Inj. infugem, 100 mg"	NC	G	9387		$39.140	.	$7.83					
J9200	Floxuridine injection		N										
J9201	In gemcitabine hcl nos 200mg		N										
J9202	Goserelin acetate implant		K	0810		$503.586	.	$100.72					
J9203	Gemtuzumab ozogamicin 0.1 mg	CH 	K	9495		$205.380	.	$41.08					
J9204	"Inj mogamulizumab-kpkc, 1 mg"		G	9182		$203.883	.	$40.78					
J9205	Inj irinotecan liposome 1 mg		K	9474		$54.331	.	$10.87					
J9206	Irinotecan injection		N										
J9207	Ixabepilone injection		K	9240		$101.189	.	$20.24					
J9208	Ifosfamide injection		N										
J9209	Mesna injection		N										
J9210	"Inj., emapalumab-lzsg, 1 mg"		G	9310		$441.593	.	$88.32					
J9211	Idarubicin hcl injection		N										
J9212	Interferon alfacon-1 inj		E2										
J9213	Interferon alfa-2a inj	CH 	N										
J9214	Interferon alfa-2b inj		K	0836		$34.346	.	$6.87					
J9215	Interferon alfa-n3 inj		E2										
J9216	Interferon gamma 1-b inj		E2										
J9217	Leuprolide acetate suspnsion		K	9217		$224.452	.	$44.90					
J9218	Leuprolide acetate injeciton		N										
J9219	Leuprolide acetate implant		E2										
J9223	"Inj. lurbinectedin, 0.1 mg"	NI 	G	9389		$170.800	.	$34.16					
J9225	Vantas implant		K	1711		"$4,558.133"	.	$911.63					
J9226	Supprelin la implant		K	1142		"$40,237.001"	.	"$8,047.41"	*				
J9227	Inj. isatuximab-irfc 10 mg	NI	G	9377		$66.670	.	$13.34					
J9228	Ipilimumab injection		K	9284		$157.382	.	$31.48					
J9229	Inj inotuzumab ozogam 0.1 mg	CH 	K	9028		"$2,341.499"	.	$468.30					
J9230	Mechlorethamine hcl inj		K	0751		$328.290	.	$65.66					
J9245	Inj melpha hydroch nos 50 mg		K	0840		$260.376	.	$52.08					
J9246	"Inj., evomela, 1 mg"	NC	K	9375		$26.959	.	$5.40					
J9250	Methotrexate sodium inj		N										
J9260	Methotrexate sodium inj		N										
J9261	Nelarabine injection		K	0825		$152.151	.	$30.44					
J9262	"Inj, omacetaxine mep, 0.01mg"		K	9297		$2.976	.	$0.60					
J9263	Oxaliplatin		N										
J9264	Paclitaxel protein bound		K	1712		$13.298	.	$2.66					
J9266	Pegaspargase injection		K	0843		"$19,717.763"	.	"$3,943.56"	*				
J9267	Paclitaxel injection		N										
J9268	Pentostatin injection		K	0844		"$2,060.277"	.	$412.06					
J9269	Inj. tagraxofusp-erzs 10 mcg		G	9309		$270.585	.	$54.12					
J9270	Plicamycin (mithramycin) inj	CH 	K	9093		$115.400	.	$23.08					
J9271	Inj pembrolizumab		K	1490		$50.846	.	$10.17					
J9280	Mitomycin injection		K	1232		$49.879	.	$9.98					
J9281	Mitomycin instillation	NI 	G	9374		$275.216	.	$55.05					
J9285	"Inj, olaratumab, 10 mg"	CH 	K	9485		$52.067	.	$10.42					
J9293	Mitoxantrone hydrochl / 5 mg		K	0864		$28.688	.	$5.74					
J9295	"Injection, necitumumab, 1 mg"		K	9475		$5.731	.	$1.15					
J9299	"Injection, nivolumab"		K	9453		$28.559	.	$5.72					
J9301	Obinutuzumab inj		K	1476		$63.736	.	$12.75					
J9302	Ofatumumab injection		K	9260		$61.942	.	$12.39					
J9303	Panitumumab injection		K	9235		$123.553	.	$24.72					
J9304	"Inj. pemetrexed, 10 mg"	NI	E2										
J9305	Inj. pemetrexed nos 10mg		K	9213		$71.811	.	$14.37					
J9306	"Injection, pertuzumab, 1 mg"		K	1471		$12.945	.	$2.59					
J9307	Pralatrexate injection		K	9259		$311.224	.	$62.25					
J9308	"Injection, ramucirumab"		K	1488		$60.709	.	$12.15					
J9309	"Inj, polatuzumab vedotin 1mg"		G	9331		$110.717	.	$22.15					
J9311	"Inj rituximab, hyaluronidase"		G	9467		$41.140	.	$8.23		*			
J9312	"Inj., rituximab, 10 mg"		K	9186		$92.556	.	$18.52					
J9313	"Inj., lumoxiti, 0.01 mg"		G	9305		$22.460	.	$4.50					
J9315	Romidepsin injection		K	9265		$336.542	.	$67.31					
J9316	"Pertuzu, trastuzu, 10 mg"	NI 	G	9390		$72.709	.	$14.55					
J9317	Sacituzumab govitecan-hziy	NI 	G	9376		$28.790	.	$5.76					
J9320	Streptozocin injection		K	0850		$349.537	.	$69.91					
J9325	Inj talimogene laherparepvec		K	9472		$53.923	.	$10.79					
J9328	Temozolomide injection		K	9253		$10.377	.	$2.08					
J9330	Temsirolimus injection		K	1168		$44.989	.	$9.00					
J9340	Thiotepa injection		K	0851		$475.392	.	$95.08					
J9351	Topotecan injection		N										
J9352	Injection trabectedin 0.1mg		K	9480		$318.927	.	$63.79					
J9354	"Inj, ado-trastuzumab emt 1mg"		K	9131		$32.789	.	$6.56					
J9355	Inj trastuzumab excl biosimi		K	1613		$99.675	.	$19.94					
J9356	"Inj. herceptin hylecta, 10mg"		G	9314		$75.084	.	$15.02					
J9357	Valrubicin injection		K	1235		"$1,403.170"	.	$280.64					
J9358 	Inj fam-trastu deru-nxki 1mg	NC	G	9353		$24.142	.	$4.83					
J9360	Vinblastine sulfate inj		N										
J9370	Vincristine sulfate 1 mg inj		N										
J9371	"Inj, vincristine sul lip 1mg"		K	1466		"$3,320.169"	.	$664.04					
J9390	Vinorelbine tartrate inj		N										
J9395	"Injection, fulvestrant"		K	9120		$52.737	.	$10.55					
J9400	"Inj, ziv-aflibercept, 1mg"		K	9296		$8.073	.	$1.62					
J9600	Porfimer sodium injection		K	0856		"$21,856.352"	.	"$4,371.28"	*				
J9999	Chemotherapy drug		N										
K0001	Standard wheelchair		Y										
K0002	Stnd hemi (low seat) whlchr		Y										
K0003	Lightweight wheelchair		Y										
K0004	High strength ltwt whlchr		Y										
K0005	Ultralightweight wheelchair		Y										
K0006	Heavy duty wheelchair		Y										
K0007	Extra heavy duty wheelchair		Y										
K0008	Cstm manual wheelchair/base		Y										
K0009	Other manual wheelchair/base		Y										
K0010	Stnd wt frame power whlchr		Y										
K0011	Stnd wt pwr whlchr w control		Y										
K0012	Ltwt portbl power whlchr		Y										
K0013	Custom power whlchr base		Y										
K0014	Other power whlchr base		Y										
K0015	Detach non-adj ht armrst rep		Y										
K0017	Detach adjust armrest base		Y										
K0018	Detach adjust armrst upper		Y										
K0019	"Arm pad repl, each"		Y										
K0020	Fixed adjust armrest pair		Y										
K0037	Hi mount flip-up footrest ea		Y										
K0038	Leg strap each		Y										
K0039	Leg strap h style each		Y										
K0040	Adjustable angle footplate		Y										
K0041	Large size footplate each		Y										
K0042	Standard size ftplate rep ea		Y										
K0043	Ftrst lowr exten tube rep ea		Y										
K0044	Ftrst upr hanger brac rep ea		Y										
K0045	Ftrst compl assembly repl ea		Y										
K0046	Elev lgrst lwr exten repl ea		Y										
K0047	Elev legrst upr hangr rep ea		Y										
K0050	Ratchet assembly replacement		Y										
K0051	Cam rel asm ft/legrst rep ea		Y										
K0052	Swingaway detach ftrest repl		Y										
K0053	Elevate footrest articulate		Y										
K0056	Seat ht <17 or >=21 ltwt wc		Y										
K0065	Spoke protectors		Y										
K0069	Rr whl compl sol tire rep ea		Y										
K0070	Rr whl compl pne tire rep ea		Y										
K0071	Fr cstr comp pne tire rep ea		Y										
K0072	Fr cstr semi-pne tire rep ea		Y										
K0073	Caster pin lock each		Y										
K0077	Fr cstr asmb sol tire rep ea		Y										
K0098	"Drive belt for pwc, repl"		Y										
K0105	Iv hanger		Y										
K0108	W/c component-accessory nos		Y										
K0195	Elevating whlchair leg rests		Y										
K0455	Pump uninterrupted infusion		Y										
K0462	Temporary replacement eqpmnt		Y										
K0552	Sup/ext non-ins inf pump syr		Y										
K0553	Ther cgm supply allowance		Y										
K0554	Ther cgm receiver/monitor		Y										
K0601	Repl batt silver oxide 1.5 v		Y										
K0602	Repl batt silver oxide 3 v		Y										
K0603	Repl batt alkaline 1.5 v		Y										
K0604	Repl batt lithium 3.6 v		Y										
K0605	Repl batt lithium 4.5 v		Y										
K0606	Aed garment w elec analysis		Y										
K0607	Repl batt for aed		Y										
K0608	Repl garment for aed		Y										
K0609	Repl electrode for aed		Y										
K0669	Seat/back cus no dmepdac ver		Y										
K0672	Removable soft interface le		A										
K0730	Ctrl dose inh drug deliv sys		Y										
K0733	12-24hr sealed lead acid		Y										
K0738	Portable gas oxygen system		Y										
K0739	Repair/svc dme non-oxygen eq		Y										
K0740	Repair/svc oxygen equipment		E1										
K0743	Portable home suction pump		Y										
K0744	Absorp drg <= 16 suc pump		A										
K0745	Absorp drg >16<=48 suc pump		A										
K0746	Absorp drg >48 suc pump		A										
K0800	Pov group 1 std up to 300lbs		Y										
K0801	Pov group 1 hd 301-450 lbs		Y										
K0802	Pov group 1 vhd 451-600 lbs		Y										
K0806	Pov group 2 std up to 300lbs		Y										
K0807	Pov group 2 hd 301-450 lbs		Y										
K0808	Pov group 2 vhd 451-600 lbs		Y										
K0812	Power operated vehicle noc		Y										
K0813	Pwc gp 1 std port seat/back		Y										
K0814	Pwc gp 1 std port cap chair		Y										
K0815	Pwc gp 1 std seat/back		Y										
K0816	Pwc gp 1 std cap chair		Y										
K0820	Pwc gp 2 std port seat/back		Y										
K0821	Pwc gp 2 std port cap chair		Y										
K0822	Pwc gp 2 std seat/back		Y										
K0823	Pwc gp 2 std cap chair		Y										
K0824	Pwc gp 2 hd seat/back		Y										
K0825	Pwc gp 2 hd cap chair		Y										
K0826	Pwc gp 2 vhd seat/back		Y										
K0827	Pwc gp vhd cap chair		Y										
K0828	Pwc gp 2 xtra hd seat/back		Y										
K0829	Pwc gp 2 xtra hd cap chair		Y										
K0830	Pwc gp2 std seat elevate s/b		Y										
K0831	Pwc gp2 std seat elevate cap		Y										
K0835	Pwc gp2 std sing pow opt s/b		Y										
K0836	Pwc gp2 std sing pow opt cap		Y										
K0837	Pwc gp 2 hd sing pow opt s/b		Y										
K0838	Pwc gp 2 hd sing pow opt cap		Y										
K0839	Pwc gp2 vhd sing pow opt s/b		Y										
K0840	Pwc gp2 xhd sing pow opt s/b		Y										
K0841	Pwc gp2 std mult pow opt s/b		Y										
K0842	Pwc gp2 std mult pow opt cap		Y										
K0843	Pwc gp2 hd mult pow opt s/b		Y										
K0848	Pwc gp 3 std seat/back		Y										
K0849	Pwc gp 3 std cap chair		Y										
K0850	Pwc gp 3 hd seat/back		Y										
K0851	Pwc gp 3 hd cap chair		Y										
K0852	Pwc gp 3 vhd seat/back		Y										
K0853	Pwc gp 3 vhd cap chair		Y										
K0854	Pwc gp 3 xhd seat/back		Y										
K0855	Pwc gp 3 xhd cap chair		Y										
K0856	Pwc gp3 std sing pow opt s/b		Y										
K0857	Pwc gp3 std sing pow opt cap		Y										
K0858	Pwc gp3 hd sing pow opt s/b		Y										
K0859	Pwc gp3 hd sing pow opt cap		Y										
K0860	Pwc gp3 vhd sing pow opt s/b		Y										
K0861	Pwc gp3 std mult pow opt s/b		Y										
K0862	Pwc gp3 hd mult pow opt s/b		Y										
K0863	Pwc gp3 vhd mult pow opt s/b		Y										
K0864	Pwc gp3 xhd mult pow opt s/b		Y										
K0868	Pwc gp 4 std seat/back		Y										
K0869	Pwc gp 4 std cap chair		Y										
K0870	Pwc gp 4 hd seat/back		Y										
K0871	Pwc gp 4 vhd seat/back		Y										
K0877	Pwc gp4 std sing pow opt s/b		Y										
K0878	Pwc gp4 std sing pow opt cap		Y										
K0879	Pwc gp4 hd sing pow opt s/b		Y										
K0880	Pwc gp4 vhd sing pow opt s/b		Y										
K0884	Pwc gp4 std mult pow opt s/b		Y										
K0885	Pwc gp4 std mult pow opt cap		Y										
K0886	Pwc gp4 hd mult pow s/b		Y										
K0890	Pwc gp5 ped sing pow opt s/b		Y										
K0891	Pwc gp5 ped mult pow opt s/b		Y										
K0898	Power wheelchair noc		Y										
K0899	Pow mobil dev no dmepdac		Y										
K0900	Cstm dme other than wheelchr		Y										
K1001	Electronic posa treatment		Y										
K1002	Ces system w/supplies access		E1										
K1003	Whirlpool tub walkin portabl		Y										
K1004	Lo freq us diathermy device		Y										
K1005	Disp col sto bag breast milk		Y										
K1006	Suct pum ext urine mgmt sys	NI	Y										
K1007	Bil hkaf pc s/d micro sensor	NI	Y										
K1009	Speech volume modulation sys	NI	Y										
K1010	Intraurethral drainag device	NI	Y										
K1011	Acti intraurethral drainage	NI	Y										
K1012	Charger base station intraur	NI	Y										
L0112	Cranial cervical orthosis		A										
L0113	Cranial cervical torticollis		A										
L0120	Cerv flex n/adj foam pre ots		A										
L0130	Flex thermoplastic collar mo		A										
L0140	Cervical semi-rigid adjustab		A										
L0150	Cerv semi-rig adj molded chn		A										
L0160	Cerv sr wire occ/man pre ots		A										
L0170	Cervical collar molded to pt		A										
L0172	Cerv col sr foam 2pc pre ots		A										
L0174	Cerv sr 2pc thor ext pre ots		A										
L0180	Cer post col occ/man sup adj		A										
L0190	Cerv collar supp adj cerv ba		A										
L0200	Cerv col supp adj bar & thor		A										
L0220	Thor rib belt custom fabrica		A										
L0450	Tlso flex trunk/thor pre ots		A										
L0452	Tlso flex custom fab thoraci		A										
L0454	Tlso trnk sj-t9 pre cst		A										
L0455	Tlso flex trnk sj-t9 pre ots		A										
L0456	Tlso flex trnk sj-ss pre cst		A										
L0457	Tlso flex trnk sj-ss pre ots		A										
L0458	Tlso 2mod symphis-xipho pre		A										
L0460	Tlso 2 shl symphys-stern cst		A										
L0462	Tlso 3mod sacro-scap pre		A										
L0464	Tlso 4mod sacro-scap pre		A										
L0466	Tlso r fram soft ant pre cst		A										
L0467	Tlso r fram soft pre ots		A										
L0468	Tlso rig fram pelvic pre cst		A										
L0469	Tlso rig fram pelvic pre ots		A										
L0470	Tlso rigid frame pre subclav		A										
L0472	Tlso rigid frame hyperex pre		A										
L0480	Tlso rigid plastic custom fa		A										
L0482	Tlso rigid lined custom fab		A										
L0484	Tlso rigid plastic cust fab		A										
L0486	Tlso rigidlined cust fab two		A										
L0488	Tlso rigid lined pre one pie		A										
L0490	Tlso rigid plastic pre one		A										
L0491	Tlso 2 piece rigid shell		A										
L0492	Tlso 3 piece rigid shell		A										
L0621	Sio flex pelvic/sacr pre ots		A										
L0622	Sio flex pelvisacral custom		A										
L0623	Sio rig pnl pelv/sac pre ots		A										
L0624	Sio panel custom		A										
L0625	Lo flex l1-below l5 pre ots		A										
L0626	Lo sag rig pnl stays pre cst		A										
L0627	Lo sag ri an/pos pnl pre cst		A										
L0628	Lso flex no ri stays pre ots		A										
L0629	Lso flex w/rigid stays cust		A										
L0630	Lso r post pnl sj-t9 pre cst		A										
L0631	Lso sag r an/pos pnl pre cst		A										
L0632	Lso sag rigid frame cust		A										
L0633	Lso sc r pos/lat pnl pre cst		A										
L0634	Lso flexion control custom		A										
L0635	Lso sagit rigid panel prefab		A										
L0636	Lso sagittal rigid panel cus		A										
L0637	Lso sc r ant/pos pnl pre cst		A										
L0638	Lso sag-coronal panel custom		A										
L0639	Lso s/c shell/panel prefab		A										
L0640	Lso s/c shell/panel custom		A										
L0641	Lo rig pos pnl l1-l5 pre ots		A										
L0642	Lo sag ri an/pos pnl pre ots		A										
L0643	Lso sag ctr rigi pos pre ots		A										
L0648	Lso sag r an/pos pnl pre ots		A										
L0649	Lso sc r pos/lat pnl pre ots		A										
L0650	Lso sc r ant/pos pnl pre ots		A										
L0651	Lso sag-co shell pnl pre ots		A										
L0700	Ctlso a-p-l control molded		A										
L0710	Ctlso a-p-l control w/ inter		A										
L0810	Halo cervical into jckt vest		A										
L0820	Halo cervical into body jack		A										
L0830	Halo cerv into milwaukee typ		A										
L0859	Mri compatible system		A										
L0861	Halo repl liner/interface		A										
L0970	Tlso corset front		A										
L0972	Lso corset front		A										
L0974	Tlso full corset		A										
L0976	Lso full corset		A										
L0978	Axillary crutch extension		A										
L0980	Peroneal straps pair pre ots		A										
L0982	Stocking sup grips 4 pre ots		A										
L0984	Protect body sock ea pre ots		A										
L0999	Add to spinal orthosis nos		A										
L1000	Ctlso milwauke initial model		A										
L1001	Ctlso infant immobilizer		A										
L1005	Tension based scoliosis orth		A										
L1010	Ctlso axilla sling		A										
L1020	Kyphosis pad		A										
L1025	Kyphosis pad floating		A										
L1030	Lumbar bolster pad		A										
L1040	Lumbar or lumbar rib pad		A										
L1050	Sternal pad		A										
L1060	Thoracic pad		A										
L1070	Trapezius sling		A										
L1080	Outrigger		A										
L1085	Outrigger bil w/ vert extens		A										
L1090	Lumbar sling		A										
L1100	Ring flange plastic/leather		A										
L1110	Ring flange plas/leather mol		A										
L1120	Covers for upright each		A										
L1200	Furnsh initial orthosis only		A										
L1210	Lateral thoracic extension		A										
L1220	Anterior thoracic extension		A										
L1230	Milwaukee type superstructur		A										
L1240	Lumbar derotation pad		A										
L1250	Anterior asis pad		A										
L1260	Anterior thoracic derotation		A										
L1270	Abdominal pad		A										
L1280	Rib gusset (elastic) each		A										
L1290	Lateral trochanteric pad		A										
L1300	Body jacket mold to patient		A										
L1310	Post-operative body jacket		A										
L1499	Spinal orthosis nos		A										
L1600	Ho flex frejka w/cov pre cst		A										
L1610	Ho frejka cov only pre cst		A										
L1620	Ho flex pavlik harns pre cst		A										
L1630	Abduct control hip semi-flex		A										
L1640	Pelv band/spread bar thigh c		A										
L1650	Ho abduction hip adjustable		A										
L1652	Ho bi thighcuffs w sprdr bar		A										
L1660	Ho abduction static plastic		A										
L1680	Pelvic & hip control thigh c		A										
L1685	Post-op hip abduct custom fa		A										
L1686	Ho post-op hip abduction		A										
L1690	Combination bilateral ho		A										
L1700	Leg perthes orth toronto typ		A										
L1710	Legg perthes orth newington		A										
L1720	Legg perthes orthosis trilat		A										
L1730	Legg perthes orth scottish r		A										
L1755	Legg perthes patten bottom t		A										
L1810	Ko elastic with joints		A										
L1812	Ko elastic w/joints pre ots		A										
L1820	Ko elas w/ condyle pads & jo		A										
L1830	Ko immob canvas long pre ots		A										
L1831	Knee orth pos locking joint		A										
L1832	Ko adj jnt pos r sup pre cst		A										
L1833	Ko adj jnt pos r sup pre ots		A										
L1834	Ko w/0 joint rigid molded to		A										
L1836	Ko rigid w/o joints pre ots		A										
L1840	Ko derot ant cruciate custom		A										
L1843	Ko single upright pre cst		A										
L1844	Ko w/adj jt rot cntrl molded		A										
L1845	Ko double upright pre cst		A										
L1846	Ko w adj flex/ext rotat mold		A										
L1847	Ko dbl upright w/air pre cst		A										
L1848	Ko dbl upright w/air pre ots		A										
L1850	Ko swedish type pre ots		A										
L1851	Ko single upright prefab ots		A										
L1852	Ko double upright prefab ots		A										
L1860	Ko supracondylar socket mold		A										
L1900	Afo sprng wir drsflx calf bd		A										
L1902	Afo ankle gauntlet pre ots		A										
L1904	Afo molded ankle gauntlet		A										
L1906	Afo multilig ank sup pre ots		A										
L1907	Afo supramalleolar custom		A										
L1910	Afo sing bar clasp attach sh		A										
L1920	Afo sing upright w/ adjust s		A										
L1930	Afo plastic		A										
L1932	Afo rig ant tib prefab tcf/=		A										
L1940	Afo molded to patient plasti		A										
L1945	Afo molded plas rig ant tib		A										
L1950	Afo spiral molded to pt plas		A										
L1951	Afo spiral prefabricated		A										
L1960	Afo pos solid ank plastic mo		A										
L1970	Afo plastic molded w/ankle j		A										
L1971	"Afo w/ankle joint, prefab"		A										
L1980	Afo sing solid stirrup calf		A										
L1990	Afo doub solid stirrup calf		A										
L2000	Kafo sing fre stirr thi/calf		A										
L2005	Kafo sng/dbl mechanical act		A										
L2006	Kaf sng/dbl swg/stn mcpr cus		A										
L2010	Kafo sng solid stirrup w/o j		A										
L2020	Kafo dbl solid stirrup band/		A										
L2030	Kafo dbl solid stirrup w/o j		A										
L2034	Kafo pla sin up w/wo k/a cus		A										
L2035	Kafo plastic pediatric size		A										
L2036	Kafo plas doub free knee mol		A										
L2037	Kafo plas sing free knee mol		A										
L2038	Kafo w/o joint multi-axis an		A										
L2040	Hkafo torsion bil rot straps		A										
L2050	Hkafo torsion cable hip pelv		A										
L2060	Hkafo torsion ball bearing j		A										
L2070	Hkafo torsion unilat rot str		A										
L2080	Hkafo unilat torsion cable		A										
L2090	Hkafo unilat torsion ball br		A										
L2106	Afo tib fx cast plaster mold		A										
L2108	Afo tib fx cast molded to pt		A										
L2112	Afo tibial fracture soft		A										
L2114	Afo tib fx semi-rigid		A										
L2116	Afo tibial fracture rigid		A										
L2126	Kafo fem fx cast thermoplas		A										
L2128	Kafo fem fx cast molded to p		A										
L2132	Kafo femoral fx cast soft		A										
L2134	Kafo fem fx cast semi-rigid		A										
L2136	Kafo femoral fx cast rigid		A										
L2180	Plas shoe insert w ank joint		A										
L2182	Drop lock knee		A										
L2184	Limited motion knee joint		A										
L2186	Adj motion knee jnt lerman t		A										
L2188	Quadrilateral brim		A										
L2190	Waist belt		A										
L2192	Pelvic band & belt thigh fla		A										
L2200	Limited ankle motion ea jnt		A										
L2210	Dorsiflexion assist each joi		A										
L2220	Dorsi & plantar flex ass/res		A										
L2230	Split flat caliper stirr & p		A										
L2232	"Rocker bottom, contact afo"		A										
L2240	Round caliper and plate atta		A										
L2250	Foot plate molded stirrup at		A										
L2260	Reinforced solid stirrup		A										
L2265	Long tongue stirrup		A										
L2270	Varus/valgus strap padded/li		A										
L2275	Plastic mod low ext pad/line		A										
L2280	Molded inner boot		A										
L2300	Abduction bar jointed adjust		A										
L2310	Abduction bar-straight		A										
L2320	Non-molded lacer		A										
L2330	Lacer molded to patient mode		A										
L2335	Anterior swing band		A										
L2340	Pre-tibial shell molded to p		A										
L2350	Prosthetic type socket molde		A										
L2360	Extended steel shank		A										
L2370	Patten bottom		A										
L2375	Torsion ank & half solid sti		A										
L2380	Torsion straight knee joint		A										
L2385	Straight knee joint heavy du		A										
L2387	Add le poly knee custom kafo		A										
L2390	Offset knee joint each		A										
L2395	Offset knee joint heavy duty		A										
L2397	Suspension sleeve lower ext		A										
L2405	Knee joint drop lock ea jnt		A										
L2415	Knee joint cam lock each joi		A										
L2425	Knee disc/dial lock/adj flex		A										
L2430	Knee jnt ratchet lock ea jnt		A										
L2492	Knee lift loop drop lock rin		A										
L2500	Thi/glut/ischia wgt bearing		A										
L2510	Th/wght bear quad-lat brim m		A										
L2520	Th/wght bear quad-lat brim c		A										
L2525	Th/wght bear nar m-l brim mo		A										
L2526	Th/wght bear nar m-l brim cu		A										
L2530	Thigh/wght bear lacer non-mo		A										
L2540	Thigh/wght bear lacer molded		A										
L2550	Thigh/wght bear high roll cu		A										
L2570	Hip clevis type 2 posit jnt		A										
L2580	Pelvic control pelvic sling		A										
L2600	Hip clevis/thrust bearing fr		A										
L2610	Hip clevis/thrust bearing lo		A										
L2620	Pelvic control hip heavy dut		A										
L2622	Hip joint adjustable flexion		A										
L2624	Hip adj flex ext abduct cont		A										
L2627	Plastic mold recipro hip & c		A										
L2628	Metal frame recipro hip & ca		A										
L2630	Pelvic control band & belt u		A										
L2640	Pelvic control band & belt b		A										
L2650	Pelv & thor control gluteal		A										
L2660	Thoracic control thoracic ba		A										
L2670	Thorac cont paraspinal uprig		A										
L2680	Thorac cont lat support upri		A										
L2750	Plating chrome/nickel pr bar		A										
L2755	Carbon graphite lamination		A										
L2760	Extension per extension per		A										
L2768	Ortho sidebar disconnect		A										
L2780	Non-corrosive finish		A										
L2785	Drop lock retainer each		A										
L2795	Knee control full kneecap		A										
L2800	Knee cap medial or lateral p		A										
L2810	Knee control condylar pad		A										
L2820	Soft interface below knee se		A										
L2830	Soft interface above knee se		A										
L2840	Tibial length sock fx or equ		A										
L2850	Femoral lgth sock fx or equa		A										
L2861	Torsion mechanism knee/ankle		E1										
L2999	Lower extremity orthosis nos		A										
L3000	Ft insert ucb berkeley shell		A										
L3001	Foot insert remov molded spe		A										
L3002	Foot insert plastazote or eq		A										
L3003	Foot insert silicone gel eac		A										
L3010	Foot longitudinal arch suppo		A										
L3020	Foot longitud/metatarsal sup		A										
L3030	Foot arch support remov prem		A										
L3031	Foot lamin/prepreg composite		A										
L3040	Ft arch suprt premold longit		A										
L3050	Foot arch supp premold metat		A										
L3060	Foot arch supp longitud/meta		A										
L3070	Arch suprt att to sho longit		A										
L3080	Arch supp att to shoe metata		A										
L3090	Arch supp att to shoe long/m		A										
L3100	Hallus-valgus nt dyn pre ots		A										
L3140	Abduction rotation bar shoe		A										
L3150	Abduct rotation bar w/o shoe		A										
L3160	Shoe styled positioning dev		A										
L3170	Foot plas heel stabi pre ots		A										
L3201	Oxford w supinat/pronat inf		A										
L3202	Oxford w/ supinat/pronator c		A										
L3203	Oxford w/ supinator/pronator		A										
L3204	Hightop w/ supp/pronator inf		A										
L3206	Hightop w/ supp/pronator chi		A										
L3207	Hightop w/ supp/pronator jun		A										
L3208	Surgical boot each infant		A										
L3209	Surgical boot each child		A										
L3211	Surgical boot each junior		A										
L3212	Benesch boot pair infant		A										
L3213	Benesch boot pair child		A										
L3214	Benesch boot pair junior		A										
L3215	Orthopedic ftwear ladies oxf		E1										
L3216	Orthoped ladies shoes dpth i		E1										
L3217	Ladies shoes hightop depth i		E1										
L3219	Orthopedic mens shoes oxford		E1										
L3221	Orthopedic mens shoes dpth i		E1										
L3222	Mens shoes hightop depth inl		E1										
L3224	Woman's shoe oxford brace		A										
L3225	Man's shoe oxford brace		A										
L3230	Custom shoes depth inlay		A										
L3250	Custom mold shoe remov prost		A										
L3251	Shoe molded to pt silicone s		A										
L3252	Shoe molded plastazote cust		A										
L3253	Shoe molded plastazote cust		A										
L3254	Orth foot non-stndard size/w		A										
L3255	Orth foot non-standard size/		A										
L3257	Orth foot add charge split s		A										
L3260	Ambulatory surgical boot eac		E1										
L3265	Plastazote sandal each		A										
L3300	Sho lift taper to metatarsal		A										
L3310	Shoe lift elev heel/sole neo		A										
L3320	Shoe lift elev heel/sole cor		A										
L3330	Lifts elevation metal extens		A										
L3332	Shoe lifts tapered to one-ha		A										
L3334	Shoe lifts elevation heel /i		A										
L3340	Shoe wedge sach		A										
L3350	Shoe heel wedge		A										
L3360	Shoe sole wedge outside sole		A										
L3370	Shoe sole wedge between sole		A										
L3380	Shoe clubfoot wedge		A										
L3390	Shoe outflare wedge		A										
L3400	Shoe metatarsal bar wedge ro		A										
L3410	Shoe metatarsal bar between		A										
L3420	Full sole/heel wedge btween		A										
L3430	Sho heel count plast reinfor		A										
L3440	Heel leather reinforced		A										
L3450	Shoe heel sach cushion type		A										
L3455	Shoe heel new leather standa		A										
L3460	Shoe heel new rubber standar		A										
L3465	Shoe heel thomas with wedge		A										
L3470	Shoe heel thomas extend to b		A										
L3480	Shoe heel pad & depress for		A										
L3485	Shoe heel pad removable for		A										
L3500	Ortho shoe add leather insol		A										
L3510	Orthopedic shoe add rub insl		A										
L3520	O shoe add felt w leath insl		A										
L3530	Ortho shoe add half sole		A										
L3540	Ortho shoe add full sole		A										
L3550	O shoe add standard toe tap		A										
L3560	O shoe add horseshoe toe tap		A										
L3570	O shoe add instep extension		A										
L3580	O shoe add instep velcro clo		A										
L3590	O shoe convert to sof counte		A										
L3595	Ortho shoe add march bar		A										
L3600	Trans shoe calip plate exist		A										
L3610	Trans shoe caliper plate new		A										
L3620	Trans shoe solid stirrup exi		A										
L3630	Trans shoe solid stirrup new		A										
L3640	Shoe dennis browne splint bo		A										
L3649	Orthopedic shoe modifica nos		A										
L3650	So 8 abd restraint pre ots		A										
L3660	So 8 ab rstr can/web pre ots		A										
L3670	So acro/clav can web pre ots		A										
L3671	So cap design w/o jnts cf		A										
L3674	So airplane w/wo joint cf		A										
L3675	So vest canvas/web pre ots		A										
L3677	So hard plas stabili pre cst		A										
L3678	So hard plas stabili pre ots		A										
L3702	Eo w/o joints cf		A										
L3710	Eo elas w/metal jnts pre ots		A										
L3720	Forearm/arm cuffs free motio		A										
L3730	Forearm/arm cuffs ext/flex a		A										
L3740	Cuffs adj lock w/ active con		A										
L3760	Eo adj jt prefab custom fit		A										
L3761	"Eo, adj lock joint prefab ot"		A										
L3762	Eo rigid w/o joints pre ots		A										
L3763	Ewho rigid w/o jnts cf		A										
L3764	Ewho w/joint(s) cf		A										
L3765	Ewhfo rigid w/o jnts cf		A										
L3766	Ewhfo w/joint(s) cf		A										
L3806	Whfo w/joint(s) custom fab		A										
L3807	Whfo w/o joints pre cst		A										
L3808	"Whfo, rigid w/o joints"		A										
L3809	Whfo w/o joints pre ots		A										
L3891	Torsion mechanism wrist/elbo		E1										
L3900	Hinge extension/flex wrist/f		A										
L3901	Hinge ext/flex wrist finger		A										
L3904	Whfo electric custom fitted		A										
L3905	Who w/nontorsion jnt(s) cf		A										
L3906	Who w/o joints cf		A										
L3908	Who cock-up nonmolde pre ots		A										
L3912	Hfo flexion glove pre ots		A										
L3913	Hfo w/o joints cf		A										
L3915	Who nontorsion jnts pre cst		A										
L3916	Who nontorsion jnts pre ots		A										
L3917	Metacarp fx orthosis pre cst		A										
L3918	Metacarp fx orthosis pre ots		A										
L3919	Ho w/o joints cf		A										
L3921	Hfo w/joint(s) cf		A										
L3923	Hfo without joints pre cst		A										
L3924	Hfo without joints pre ots		A										
L3925	Fo pip dip jnt/sprng pre ots		A										
L3927	Fo pip dip no jt spr pre ots		A										
L3929	Hfo nontorsion jnts pre cst		A										
L3930	Hfo nontorsion jnts pre ots		A										
L3931	Whfo nontorsion joint prefab		A										
L3933	Fo w/o joints cf		A										
L3935	Fo nontorsion joint cf		A										
L3956	Add joint upper ext orthosis		A										
L3960	Sewho airplan desig abdu pos		A										
L3961	Sewho cap design w/o jnts cf		A										
L3962	Sewho erbs palsey design abd		A										
L3967	Sewho airplane w/o jnts cf		A										
L3971	Sewho cap design w/jnt(s) cf		A										
L3973	Sewho airplane w/jnt(s) cf		A										
L3975	Sewhfo cap design w/o jnt cf		A										
L3976	Sewhfo airplane w/o jnts cf		A										
L3977	Sewhfo cap desgn w/jnt(s) cf		A										
L3978	Sewhfo airplane w/jnt(s) cf		A										
L3980	Up ext fx orthos humeral nos		A										
L3981	Ue fx orth shoul cap forearm		A										
L3982	Upper ext fx orthosis rad/ul		A										
L3984	Upper ext fx orthosis wrist		A										
L3995	Sock fracture or equal each		A										
L3999	Upper limb orthosis nos		A										
L4000	Repl girdle milwaukee orth		A										
L4002	"Replace strap, any orthosis"		A										
L4010	Replace trilateral socket br		A										
L4020	Replace quadlat socket brim		A										
L4030	Replace socket brim cust fit		A										
L4040	Replace molded thigh lacer		A										
L4045	Replace non-molded thigh lac		A										
L4050	Replace molded calf lacer		A										
L4055	Replace non-molded calf lace		A										
L4060	Replace high roll cuff		A										
L4070	Replace prox & dist upright		A										
L4080	Repl met band kafo-afo prox		A										
L4090	Repl met band kafo-afo calf/		A										
L4100	Repl leath cuff kafo prox th		A										
L4110	Repl leath cuff kafo-afo cal		A										
L4130	Replace pretibial shell		A										
L4205	Ortho dvc repair per 15 min		A										
L4210	Orth dev repair/repl minor p		A										
L4350	Ankle control ortho pre ots		A										
L4360	Pneumat walking boot pre cst		A										
L4361	Pneuma/vac walk boot pre ots		A										
L4370	Pneum full leg splnt pre ots		A										
L4386	Non-pneum walk boot pre cst		A										
L4387	Non-pneum walk boot pre ots		A										
L4392	Replace afo soft interface		A										
L4394	Replace foot drop spint		A										
L4396	Static or dynami afo pre cst		A										
L4397	Static or dynami afo pre ots		A										
L4398	Foot drop splint pre ots		A										
L4631	"Afo, walk boot type, cus fab"		A										
L5000	Sho insert w arch toe filler		A										
L5010	Mold socket ank hgt w/ toe f		A										
L5020	Tibial tubercle hgt w/ toe f		A										
L5050	Ank symes mold sckt sach ft		A										
L5060	Symes met fr leath socket ar		A										
L5100	Molded socket shin sach foot		A										
L5105	Plast socket jts/thgh lacer		A										
L5150	Mold sckt ext knee shin sach		A										
L5160	Mold socket bent knee shin s		A										
L5200	Kne sing axis fric shin sach		A										
L5210	No knee/ankle joints w/ ft b		A										
L5220	No knee joint with artic ali		A										
L5230	Fem focal defic constant fri		A										
L5250	Hip canad sing axi cons fric		A										
L5270	Tilt table locking hip sing		A										
L5280	Hemipelvect canad sing axis		A										
L5301	Bk mold socket sach ft endo		A										
L5312	"Knee disart, sach ft, endo"		A										
L5321	Ak open end sach		A										
L5331	Hip disart canadian sach ft		A										
L5341	Hemipelvectomy canadian sach		A										
L5400	Postop dress & 1 cast chg bk		A										
L5410	Postop dsg bk ea add cast ch		A										
L5420	Postop dsg & 1 cast chg ak/d		A										
L5430	Postop dsg ak ea add cast ch		A										
L5450	Postop app non-wgt bear dsg		A										
L5460	Postop app non-wgt bear dsg		A										
L5500	Init bk ptb plaster direct		A										
L5505	Init ak ischal plstr direct		A										
L5510	Prep bk ptb plaster molded		A										
L5520	Perp bk ptb thermopls direct		A										
L5530	Prep bk ptb thermopls molded		A										
L5535	Prep bk ptb open end socket		A										
L5540	Prep bk ptb laminated socket		A										
L5560	Prep ak ischial plast molded		A										
L5570	Prep ak ischial direct form		A										
L5580	Prep ak ischial thermo mold		A										
L5585	Prep ak ischial open end		A										
L5590	Prep ak ischial laminated		A										
L5595	Hip disartic sach thermopls		A										
L5600	Hip disart sach laminat mold		A										
L5610	Above knee hydracadence		A										
L5611	Ak 4 bar link w/fric swing		A										
L5613	Ak 4 bar ling w/hydraul swig		A										
L5614	4-bar link above knee w/swng		A										
L5616	Ak univ multiplex sys frict		A										
L5617	Ak/bk self-aligning unit ea		A										
L5618	Test socket symes		A										
L5620	Test socket below knee		A										
L5622	Test socket knee disarticula		A										
L5624	Test socket above knee		A										
L5626	Test socket hip disarticulat		A										
L5628	Test socket hemipelvectomy		A										
L5629	Below knee acrylic socket		A										
L5630	Syme typ expandabl wall sckt		A										
L5631	Ak/knee disartic acrylic soc		A										
L5632	Symes type ptb brim design s		A										
L5634	Symes type poster opening so		A										
L5636	Symes type medial opening so		A										
L5637	Below knee total contact		A										
L5638	Below knee leather socket		A										
L5639	Below knee wood socket		A										
L5640	Knee disarticulat leather so		A										
L5642	Above knee leather socket		A										
L5643	Hip flex inner socket ext fr		A										
L5644	Above knee wood socket		A										
L5645	Bk flex inner socket ext fra		A										
L5646	Below knee cushion socket		A										
L5647	Below knee suction socket		A										
L5648	Above knee cushion socket		A										
L5649	Isch containmt/narrow m-l so		A										
L5650	Tot contact ak/knee disart s		A										
L5651	Ak flex inner socket ext fra		A										
L5652	Suction susp ak/knee disart		A										
L5653	Knee disart expand wall sock		A										
L5654	Socket insert symes		A										
L5655	Socket insert below knee		A										
L5656	Socket insert knee articulat		A										
L5658	Socket insert above knee		A										
L5661	Multi-durometer symes		A										
L5665	Multi-durometer below knee		A										
L5666	Below knee cuff suspension		A										
L5668	Bk molded distal cushion		A										
L5670	Bk molded supracondylar susp		A										
L5671	Bk/ak locking mechanism		A										
L5672	Bk removable medial brim sus		A										
L5673	Socket insert w lock mech		A										
L5676	Bk knee joints single axis p		A										
L5677	Bk knee joints polycentric p		A										
L5678	Bk joint covers pair		A										
L5679	Socket insert w/o lock mech		A										
L5680	Bk thigh lacer non-molded		A										
L5681	Intl custm cong/latyp insert		A										
L5682	Bk thigh lacer glut/ischia m		A										
L5683	Initial custom socket insert		A										
L5684	Bk fork strap		A										
L5685	Below knee sus/seal sleeve		A										
L5686	Bk back check		A										
L5688	Bk waist belt webbing		A										
L5690	Bk waist belt padded and lin		A										
L5692	Ak pelvic control belt light		A										
L5694	Ak pelvic control belt pad/l		A										
L5695	Ak sleeve susp neoprene/equa		A										
L5696	Ak/knee disartic pelvic join		A										
L5697	Ak/knee disartic pelvic band		A										
L5698	Ak/knee disartic silesian ba		A										
L5699	Shoulder harness		A										
L5700	Replace socket below knee		A										
L5701	Replace socket above knee		A										
L5702	Replace socket hip		A										
L5703	Symes ankle w/o (sach) foot		A										
L5704	Custom shape cover bk		A										
L5705	Custom shape cover ak		A										
L5706	Custom shape cvr knee disart		A										
L5707	Custom shape cvr hip disart		A										
L5710	Kne-shin exo sng axi mnl loc		A										
L5711	Knee-shin exo mnl lock ultra		A										
L5712	Knee-shin exo frict swg & st		A										
L5714	Knee-shin exo variable frict		A										
L5716	Knee-shin exo mech stance ph		A										
L5718	Knee-shin exo frct swg & sta		A										
L5722	Knee-shin pneum swg frct exo		A										
L5724	Knee-shin exo fluid swing ph		A										
L5726	Knee-shin ext jnts fld swg e		A										
L5728	Knee-shin fluid swg & stance		A										
L5780	Knee-shin pneum/hydra pneum		A										
L5781	Lower limb pros vacuum pump		A										
L5782	Hd low limb pros vacuum pump		A										
L5785	Exoskeletal bk ultralt mater		A										
L5790	Exoskeletal ak ultra-light m		A										
L5795	Exoskel hip ultra-light mate		A										
L5810	Endoskel knee-shin mnl lock		A										
L5811	Endo knee-shin mnl lck ultra		A										
L5812	Endo knee-shin frct swg & st		A										
L5814	Endo knee-shin hydral swg ph		A										
L5816	Endo knee-shin polyc mch sta		A										
L5818	Endo knee-shin frct swg & st		A										
L5822	Endo knee-shin pneum swg frc		A										
L5824	Endo knee-shin fluid swing p		A										
L5826	Miniature knee joint		A										
L5828	Endo knee-shin fluid swg/sta		A										
L5830	Endo knee-shin pneum/swg pha		A										
L5840	Multi-axial knee/shin system		A										
L5845	Knee-shin sys stance flexion		A										
L5848	Knee-shin sys hydraul stance		A										
L5850	Endo ak/hip knee extens assi		A										
L5855	Mech hip extension assist		A										
L5856	Elec knee-shin swing/stance		A										
L5857	Elec knee-shin swing only		A										
L5858	Stance phase only		A										
L5859	Knee-shin pro flex/ext cont		A										
L5910	Endo below knee alignable sy		A										
L5920	Endo ak/hip alignable system		A										
L5925	Above knee manual lock		A										
L5930	High activity knee frame		A										
L5940	Endo bk ultra-light material		A										
L5950	Endo ak ultra-light material		A										
L5960	Endo hip ultra-light materia		A										
L5961	"Endo poly hip, pneu/hyd/rot"		A										
L5962	Below knee flex cover system		A										
L5964	Above knee flex cover system		A										
L5966	Hip flexible cover system		A										
L5968	Multiaxial ankle w dorsiflex		A										
L5969	Ak/ft power asst incl motors		A										
L5970	Foot external keel sach foot		A										
L5971	"Sach foot, replacement"		A										
L5972	Flexible keel foot		A										
L5973	Ank-foot sys dors-plant flex		A										
L5974	Foot single axis ankle/foot		A										
L5975	Combo ankle/foot prosthesis		A										
L5976	Energy storing foot		A										
L5978	Ft prosth multiaxial ankl/ft		A										
L5979	Multi-axial ankle/ft prosth		A										
L5980	Flex foot system		A										
L5981	Flex-walk sys low ext prosth		A										
L5982	Exoskeletal axial rotation u		A										
L5984	Endoskeletal axial rotation		A										
L5985	Lwr ext dynamic prosth pylon		A										
L5986	Multi-axial rotation unit		A										
L5987	Shank ft w vert load pylon		A										
L5988	Vertical shock reducing pylo		A										
L5990	User adjustable heel height		A										
L5999	Lowr extremity prosthes nos		A										
L6000	Part hand thumb rem		A										
L6010	Part hand little/ring		A										
L6020	Part hand no fingers		A										
L6026	Part hand myo exclu term dev		A										
L6050	Wrst mld sck flx hng tri pad		A										
L6055	Wrst mold sock w/exp interfa		A										
L6100	Elb mold sock flex hinge pad		A										
L6110	Elbow mold sock suspension t		A										
L6120	Elbow mold doub splt soc ste		A										
L6130	Elbow stump activated lock h		A										
L6200	Elbow mold outsid lock hinge		A										
L6205	Elbow molded w/ expand inter		A										
L6250	Elbow inter loc elbow forarm		A										
L6300	Shlder disart int lock elbow		A										
L6310	Shoulder passive restor comp		A										
L6320	Shoulder passive restor cap		A										
L6350	Thoracic intern lock elbow		A										
L6360	Thoracic passive restor comp		A										
L6370	Thoracic passive restor cap		A										
L6380	Postop dsg cast chg wrst/elb		A										
L6382	Postop dsg cast chg elb dis/		A										
L6384	Postop dsg cast chg shlder/t		A										
L6386	Postop ea cast chg & realign		A										
L6388	Postop applicat rigid dsg on		A										
L6400	Below elbow prosth tiss shap		A										
L6450	Elb disart prosth tiss shap		A										
L6500	Above elbow prosth tiss shap		A										
L6550	Shldr disar prosth tiss shap		A										
L6570	Scap thorac prosth tiss shap		A										
L6580	Wrist/elbow bowden cable mol		A										
L6582	Wrist/elbow bowden cbl dir f		A										
L6584	Elbow fair lead cable molded		A										
L6586	Elbow fair lead cable dir fo		A										
L6588	Shdr fair lead cable molded		A										
L6590	Shdr fair lead cable direct		A										
L6600	Polycentric hinge pair		A										
L6605	Single pivot hinge pair		A										
L6610	Flexible metal hinge pair		A										
L6611	"Additional switch, ext power"		A										
L6615	Disconnect locking wrist uni		A										
L6616	Disconnect insert locking wr		A										
L6620	Flexion/extension wrist unit		A										
L6621	Flex/ext wrist w/wo friction		A										
L6623	Spring-ass rot wrst w/ latch		A										
L6624	Flex/ext/rotation wrist unit		A										
L6625	Rotation wrst w/ cable lock		A										
L6628	Quick disconn hook adapter o		A										
L6629	Lamination collar w/ couplin		A										
L6630	Stainless steel any wrist		A										
L6632	Latex suspension sleeve each		A										
L6635	Lift assist for elbow		A										
L6637	Nudge control elbow lock		A										
L6638	Elec lock on manual pw elbow		A										
L6640	Shoulder abduction joint pai		A										
L6641	Excursion amplifier pulley t		A										
L6642	Excursion amplifier lever ty		A										
L6645	Shoulder flexion-abduction j		A										
L6646	Multipo locking shoulder jnt		A										
L6647	Shoulder lock actuator		A										
L6648	Ext pwrd shlder lock/unlock		A										
L6650	Shoulder universal joint		A										
L6655	Standard control cable extra		A										
L6660	Heavy duty control cable		A										
L6665	Teflon or equal cable lining		A										
L6670	Hook to hand cable adapter		A										
L6672	Harness chest/shlder saddle		A										
L6675	Harness figure of 8 sing con		A										
L6676	Harness figure of 8 dual con		A										
L6677	Ue triple control harness		A										
L6680	Test sock wrist disart/bel e		A										
L6682	Test sock elbw disart/above		A										
L6684	Test socket shldr disart/tho		A										
L6686	Suction socket		A										
L6687	Frame typ socket bel elbow/w		A										
L6688	Frame typ sock above elb/dis		A										
L6689	Frame typ socket shoulder di		A										
L6690	Frame typ sock interscap-tho		A										
L6691	Removable insert each		A										
L6692	Silicone gel insert or equal		A										
L6693	Lockingelbow forearm cntrbal		A										
L6694	Elbow socket ins use w/lock		A										
L6695	Elbow socket ins use w/o lck		A										
L6696	Cus elbo skt in for con/atyp		A										
L6697	Cus elbo skt in not con/atyp		A										
L6698	Below/above elbow lock mech		A										
L6703	"Term dev, passive hand mitt"		A										
L6704	"Term dev, sport/rec/work att"		A										
L6706	Term dev mech hook vol open		A										
L6707	Term dev mech hook vol close		A										
L6708	Term dev mech hand vol open		A										
L6709	Term dev mech hand vol close		A										
L6711	"Ped term dev, hook, vol open"		A										
L6712	"Ped term dev, hook, vol clos"		A										
L6713	"Ped term dev, hand, vol open"		A										
L6714	"Ped term dev, hand, vol clos"		A										
L6715	"Term device, multi art digit"		A										
L6721	"Hook/hand, hvy dty, vol open"		A										
L6722	"Hook/hand, hvy dty, vol clos"		A										
L6805	Term dev modifier wrist unit		A										
L6810	Term dev precision pinch dev		A										
L6880	Elec hand ind art digits		A										
L6881	Term dev auto grasp feature		A										
L6882	Microprocessor control uplmb		A										
L6883	Replc sockt below e/w disa		A										
L6884	Replc sockt above elbow disa		A										
L6885	Replc sockt shldr dis/interc		A										
L6890	Prefab glove for term device		A										
L6895	Custom glove for term device		A										
L6900	Hand restorat thumb/1 finger		A										
L6905	Hand restoration multiple fi		A										
L6910	Hand restoration no fingers		A										
L6915	Hand restoration replacmnt g		A										
L6920	Wrist disarticul switch ctrl		A										
L6925	Wrist disart myoelectronic c		A										
L6930	Below elbow switch control		A										
L6935	Below elbow myoelectronic ct		A										
L6940	Elbow disarticulation switch		A										
L6945	Elbow disart myoelectronic c		A										
L6950	Above elbow switch control		A										
L6955	Above elbow myoelectronic ct		A										
L6960	Shldr disartic switch contro		A										
L6965	Shldr disartic myoelectronic		A										
L6970	Interscapular-thor switch ct		A										
L6975	Interscap-thor myoelectronic		A										
L7007	Adult electric hand		A										
L7008	Pediatric electric hand		A										
L7009	Adult electric hook		A										
L7040	Prehensile actuator		A										
L7045	Pediatric electric hook		A										
L7170	Electronic elbow hosmer swit		A										
L7180	Electronic elbow sequential		A										
L7181	Electronic elbo simultaneous		A										
L7185	Electron elbow adolescent sw		A										
L7186	Electron elbow child switch		A										
L7190	Elbow adolescent myoelectron		A										
L7191	Elbow child myoelectronic ct		A										
L7259	Electronic wrist rotator any		A										
L7360	Six volt bat otto bock/eq ea		A										
L7362	Battery chrgr six volt otto		A										
L7364	Twelve volt battery utah/equ		A										
L7366	Battery chrgr 12 volt utah/e		A										
L7367	Replacemnt lithium ionbatter		A										
L7368	Lithium ion battery charger		A										
L7400	"Add ue prost be/wd, ultlite"		A										
L7401	Add ue prost a/e ultlite mat		A										
L7402	Add ue prost s/d ultlite mat		A										
L7403	Add ue prost b/e acrylic		A										
L7404	Add ue prost a/e acrylic		A										
L7405	Add ue prost s/d acrylic		A										
L7499	Upper extremity prosthes nos		A										
L7510	Prosthetic device repair rep		A										
L7520	Repair prosthesis per 15 min		A										
L7600	Prosthetic donning sleeve		E1										
L7700	Pros soc insert gasket/seal		A										
L7900	Male vacuum erection system		E1										
L7902	"Tension ring, vac erect dev"		E1										
L8000	Mastectomy bra		A										
L8001	Breast prosthesis bra & form		A										
L8002	Brst prsth bra & bilat form		A										
L8010	Mastectomy sleeve		A										
L8015	Ext breastprosthesis garment		A										
L8020	Mastectomy form		A										
L8030	Breast prosthes w/o adhesive		A										
L8031	Breast prosthesis w adhesive		A										
L8032	Reusable nipple prosthesis		A										
L8033	"Nipple prosthesis custom, ea"		A										
L8035	Custom breast prosthesis		A										
L8039	Breast prosthesis nos		A										
L8040	Nasal prosthesis		A										
L8041	Midfacial prosthesis		A										
L8042	Orbital prosthesis		A										
L8043	Upper facial prosthesis		A										
L8044	Hemi-facial prosthesis		A										
L8045	Auricular prosthesis		A										
L8046	Partial facial prosthesis		A										
L8047	Nasal septal prosthesis		A										
L8048	Unspec maxillofacial prosth		A										
L8049	Repair maxillofacial prosth		A										
L8300	Truss single w/ standard pad		A										
L8310	Truss double w/ standard pad		A										
L8320	Truss addition to std pad wa		A										
L8330	Truss add to std pad scrotal		A										
L8400	Sheath below knee		A										
L8410	Sheath above knee		A										
L8415	Sheath upper limb		A										
L8417	Pros sheath/sock w gel cushn		A										
L8420	Prosthetic sock multi ply bk		A										
L8430	Prosthetic sock multi ply ak		A										
L8435	Pros sock multi ply upper lm		A										
L8440	Shrinker below knee		A										
L8460	Shrinker above knee		A										
L8465	Shrinker upper limb		A										
L8470	Pros sock single ply bk		A										
L8480	Pros sock single ply ak		A										
L8485	Pros sock single ply upper l		A										
L8499	Unlisted misc prosthetic ser		A										
L8500	Artificial larynx		A										
L8501	Tracheostomy speaking valve		A										
L8505	"Artificial larynx, accessory"		A										
L8507	Trach-esoph voice pros pt in		A										
L8509	Trach-esoph voice pros md in		A										
L8510	Voice amplifier		A										
L8511	Indwelling trach insert		A										
L8512	Gel cap for trach voice pros		A										
L8513	Trach pros cleaning device		A										
L8514	Repl trach puncture dilator		A										
L8515	Gel cap app device for trach		A										
L8600	Implant breast silicone/eq		N										
L8603	Collagen imp urinary 2.5 ml		N										
L8604	Dextranomer/hyaluronic acid		N										
L8605	Inj bulking agent anal canal		N										
L8606	Synthetic implnt urinary 1ml		N										
L8607	Inj vocal cord bulking agent		N										
L8608	Arg ii ext com/sup/acc misc		N										
L8609	Artificial cornea		N										
L8610	Ocular implant		N										
L8612	Aqueous shunt prosthesis		N										
L8613	Ossicular implant		N										
L8614	Cochlear device		N										
L8615	Coch implant headset replace		A										
L8616	Coch implant microphone repl		A										
L8617	Coch implant trans coil repl		A										
L8618	Coch implant tran cable repl		A										
L8619	Coch imp ext proc/contr rplc		A										
L8621	Repl zinc air battery		A										
L8622	Repl alkaline battery		A										
L8623	"Lith ion batt cid,non-earlvl"		A										
L8624	"Lith ion batt cid, ear level"		A										
L8625	Charger coch impl/aoi battry		A										
L8627	Cid ext speech process repl		A										
L8628	Cid ext controller repl		A										
L8629	Cid transmit coil and cable		A										
L8630	Metacarpophalangeal implant		N										
L8631	Mcp joint repl 2 pc or more		N										
L8641	Metatarsal joint implant		N										
L8642	Hallux implant		N										
L8658	Interphalangeal joint spacer		N										
L8659	Interphalangeal joint repl		N										
L8670	"Vascular graft, synthetic"		N										
L8679	Imp neurosti pls gn any type		N										
L8680	Implt neurostim elctr each		E1										
L8681	Pt prgrm for implt neurostim		A										
L8682	Implt neurostim radiofq rec		N										
L8683	Radiofq trsmtr for implt neu		A										
L8684	Radiof trsmtr implt scrl neu		A										
L8685	Implt nrostm pls gen sng rec		E1										
L8686	Implt nrostm pls gen sng non		E1										
L8687	Implt nrostm pls gen dua rec		E1										
L8688	Implt nrostm pls gen dua non		E1										
L8689	External recharg sys intern		A										
L8690	"Aud osseo dev, int/ext comp"		N										
L8691	Aoi snd proc repl excl actua		A										
L8692	Non-osseointegrated snd proc		E1										
L8693	"Aud osseo dev, abutment"		A										
L8694	Aoi transducer/actuator repl		A										
L8695	External recharg sys extern		A										
L8696	Ext antenna phren nerve stim		A										
L8698	Misc used with tot art heart		A										
L8699	Prosthetic implant nos		N										
L8701	Ewh s/d uprt micro sensor		A										
L8702	Ewhf s/d uprt micro sensor		A										
L9900	O&p supply/accessory/service		N										
M0075	Cellular therapy		E1										
M0076	Prolotherapy		E1										
M0100	Intragastric hypothermia		E1										
M0239	Bamlanivimab-xxxx infusion	NI 	S	5694	3.7532	$310.75	$0.00	$0.00					
M0243	Casirivi and imdevi infusion	NI 	S	5694	3.7532	$310.75	$0.00	$0.00					
M0300	Iv chelationtherapy		E1										
M0301	Fabric wrapping of aneurysm		E1										
M1003	Tb scr 12 mo pri fst bio dz		M										
M1004	Doc med rsn no srn tb		M										
M1005	Tb scr no perf		M										
M1006	"Dz not ases, no rsn"		M										
M1007	>=50% total pt outpt ra enct		M										
M1008	<50% total pt outpt ra encts		M										
M1009	Dc eoc doc med rec		M										
M1010	Dc eoc doc med rec		M										
M1011	Dc eoc doc med rec		M										
M1012	Dc eoc doc med rec		M										
M1013	Dc eoc doc med rec		M										
M1014	Dc epi care doc medrec		M										
M1015	Dc eoc doc med rec	CH	D										
M1016	Pt dx meop or sur steri		M										
M1017	Pt admt to palitve serv		M										
M1018	Pt dx hst cr pt sk lg cr scr		M										
M1019	Adl pt mj dep ds rs 12 phq<5		M										
M1020	Adl pt mj dep ds no rs 12 mo		M										
M1021	Pt uc in pp		M										
M1022	Pt hospice during perf pd		M										
M1023	Adl pt mj dep ds rs 6 phq<5	CH 	D										
M1024	Adl pt mj dep ds no rs 6 mo	CH 	D										
M1025	Pt hospice during perf pd		M										
M1026	Pt hospice during perf pd		M										
M1027	Img head (ct or mri) obtnd		M										
M1028	Doc of pt prm hda dx and otr		M										
M1029	Doc sysm rsn img hd		M										
M1031	Pt clin ind img hd		M										
M1032	Adt tkng pharmthry for oud		M										
M1033	Pharmthry for oud afr 6.30	CH 	D										
M1034	Adt 180 dys pharmthry oud		M										
M1035	Adt pd out mat pr 180 dys tx		M										
M1036	Adt no 180 dys pharmthry oud		M										
M1037	Pt dx lum sp reg cacr		M										
M1038	Pt dx lum sp reg fract		M										
M1039	Pt dx lum sp reg inf		M										
M1040	Pt dx lum idi or cong scol		M										
M1041	Pt cr ft inf lm or pt id sl		M										
M1043	Fs no odi 9-15mo		M										
M1045	Fs oks 9-15mo >= 37 >= 71		M										
M1046	Fs oks 9-15mo < 37 < 71		M										
M1049	Fs wth scr no odi pre and p		M										
M1051	Pt w/cancer scoliosis		M										
M1052	Lg pn not meas w/ vas 1yr po		M										
M1054	Pt uc in pp		M										
M1055	Aspirin used		M										
M1056	Presc antico med in pp		M										
M1057	"Aspirin not used, no rsn"		M										
M1058	Pt prm nurs hm res in pp		M										
M1059	Pt no prm nurs hm res in pp		M										
M1060	Pt died in pp		M										
M1061	Pt preg	CH 	D										
M1062	Pt imcomprmd	CH 	D										
M1063	Pt rec hg dos imsup thpy	CH 	D										
M1064	Shing vac doc adm or pv rec	CH 	D										
M1065	Shing vac no adm clinc rsn	CH 	D										
M1066	Shing vac no doc no rsn	CH 	D										
M1067	Hspc pt prv time meam per		M										
M1068	Pt not ambulatory		M										
M1069	Pt scr ft fall rsk		M										
M1070	Pt not scrn fut fall no rsn		M										
M1071	Pt had add'l sp pcr perf		M										
M1106	Start eoc doc med rec		M										
M1107	Docu dx degen neuro		M										
M1108	Oc ni pt home prog		M										
M1109	Oc ni pt dc		M										
M1110	Oc not p pt selfdc		M										
M1111	Start eoc doc med rec		M										
M1112	Docu dx degen neuro		M										
M1113	Oc ni pt home prog		M										
M1114	Oc ni pt dc		M										
M1115	Oc ni pt selfdc		M										
M1116	Start eoc doc med rec		M										
M1117	Docu dx degen neuro		M										
M1118	Oc ni pt home prog		M										
M1119	Oc ni pt dc		M										
M1120	Oc ni pt selfdc		M										
M1121	Start eoc doc med rec		M										
M1122	Docu dx degen neuro		M										
M1123	Oc ni pt home prog		M										
M1124	Oc ni pt dc 1-2 vis		M										
M1125	Oc ni pt selfdc 1-2 vis		M										
M1126	Start eoc doc med rec		M										
M1127	Docu dx degen neuro		M										
M1128	Oc ni pt home prog		M										
M1129	Oc ni pt dc		M										
M1130	Oc ni pt selfdc		M										
M1131	Docu dx degen neuro		M										
M1132	Oc ni pt home prog		M										
M1133	Oc ni pt dc		M										
M1134	Oc ni pt selfdc		M										
M1135	Start eoc doc med rec		M										
M1136	Start eoc doc med rec	CH	D										
M1137	Docu dx degen neuro	CH	D										
M1138	Oc ni pt 1-2 vis	CH	D										
M1139	Oc ni pt self dc 1-2 vis	CH	D										
M1140	Oc ni pt dc 1-2 vis	CH	D										
M1141	Fs no oks		M										
M1142	Emerge cases		M										
M1143	Ni rehab med chiro		M										
M1144	Oc no ind pt 1-2 vis	CH	D										
M1145	"MFN drug add-on, per dose"	NI	E1										
M1146	Ongoing care not ind	NI	M										
M1147	Care not poss med rsn	NI	M										
M1148	Pt self dschg	NI	M										
M1149	No neck fs prom incap	NI	M										
P2028	Cephalin floculation test		A										
P2029	Congo red blood test		A										
P2031	Hair analysis		E1										
P2033	Blood thymol turbidity		A										
P2038	Blood mucoprotein		A										
P3000	Screen pap by tech w md supv		A										
P3001	Screening pap smear by phys		B										
P7001	Culture bacterial urine		E1										
P9010	Whole blood for transfusion		R	9510	1.8134	$150.14	.	$30.03					
P9011	Blood split unit		R	9520	1.7824	$147.58	.	$29.52					
P9012	Cryoprecipitate each unit		R	9511	0.9644	$79.85	.	$15.97					
P9016	Rbc leukocytes reduced		R	9512	2.2768	$188.51	.	$37.71					
P9017	Plasma 1 donor frz w/in 8 hr		R	9508	0.9984	$82.66	.	$16.54					
P9019	"Platelets, each unit"		R	9515	0.8610	$71.29	.	$14.26					
P9020	Plaelet rich plasma unit		R	9516	2.4156	$200.00	.	$40.01					
P9021	Red blood cells unit		R	9517	1.6623	$137.63	.	$27.53					
P9022	Washed red blood cells unit		R	9518	4.5878	$379.86	.	$75.98					
P9023	"Frozen plasma, pooled, sd"		R	9509	1.0767	$89.15	.	$17.83					
P9031	Platelets leukocytes reduced		R	9526	1.8107	$149.92	.	$29.99					
P9032	"Platelets, irradiated"		R	9500	1.7113	$141.69	.	$28.34					
P9033	Platelets leukoreduced irrad		R	9521	2.5748	$213.19	.	$42.64					
P9034	"Platelets, pheresis"		R	9507	3.9131	$323.99	.	$64.80					
P9035	Platelet pheres leukoreduced		R	9501	5.8794	$486.80	.	$97.36					
P9036	Platelet pheresis irradiated		R	9502	7.3057	$604.89	.	$120.98					
P9037	Plate pheres leukoredu irrad		R	9530	7.4560	$617.33	.	$123.47					
P9038	Rbc irradiated		R	9505	2.0449	$169.31	.	$33.87					
P9039	Rbc deglycerolized		R	9504	5.2738	$436.65	.	$87.34					
P9040	Rbc leukoreduced irradiated		R	9522	3.1468	$260.55	.	$52.11					
P9041	"Albumin (human),5%, 50ml"		K	0961		$10.490	.	$2.10					
P9043	"Plasma protein fract,5%,50ml"		R	9514	0.0965	$7.99	.	$1.60					
P9044	Cryoprecipitatereducedplasma		R	9523	0.7935	$65.70	.	$13.14					
P9045	"Albumin (human), 5%, 250 ml"		K	0963		$52.450	.	$10.49					
P9046	"Albumin (human), 25%, 20 ml"		K	0964		$20.980	.	$4.20					
P9047	"Albumin (human), 25%, 50ml"		K	0965		$52.450	.	$10.49					
P9048	"Plasmaprotein fract,5%,250ml"		R	9519	1.9366	$160.34	.	$32.07					
P9050	"Granulocytes, pheresis unit"		E2										
P9051	"Blood, l/r, cmv-neg"		R	9524	2.5632	$212.23	.	$42.45					
P9052	"Platelets, hla-m, l/r, unit"		R	9525	9.7248	$805.18	.	$161.04					
P9053	"Plt, pher, l/r cmv-neg, irr"		R	9531	5.4025	$447.31	.	$89.47					
P9054	"Blood, l/r, froz/degly/wash"		R	9527	3.7525	$310.70	.	$62.14					
P9055	"Plt, aph/pher, l/r, cmv-neg"		R	9528	5.7978	$480.04	.	$96.01					
P9056	"Blood, l/r, irradiated"		R	9529	1.8619	$154.16	.	$30.84					
P9057	"Rbc, frz/deg/wsh, l/r, irrad"		R	9532	3.1473	$260.59	.	$52.12					
P9058	"Rbc, l/r, cmv-neg, irrad"		R	9533	2.9454	$243.87	.	$48.78					
P9059	"Plasma, frz between 8-24hour"		R	9513	0.8593	$71.15	.	$14.23					
P9060	Fr frz plasma donor retested		R	9503	0.7860	$65.08	.	$13.02					
P9070	Pathogen reduced plasma pool		R	9534	0.6413	$53.10	.	$10.62					
P9071	Pathogen reduced plasma sing		R	9535	1.4834	$122.82	.	$24.57					
P9073	Platelets pheresis path redu		R	9536	7.0518	$583.87	.	$116.78					
P9099	Blood component/product noc	CH	R	9537	0.0965	$7.99		$1.60					
P9100	Pathogen test for platelets	CH	S	5732	0.4087	$33.84	.	$6.77					
P9603	One-way allow prorated miles		A										
P9604	One-way allow prorated trip		A										
P9612	Catheterize for urine spec		A										
P9615	Urine specimen collect mult		N										
Q0035	Cardiokymography		Q1	5732	0.4087	$33.84	.	$6.77					
Q0081	Infusion ther other than che		B										
Q0083	Chemo by other than infusion		B										
Q0084	Chemotherapy by infusion		B										
Q0085	Chemo by both infusion and o		B										
Q0091	Obtaining screen pap smear		S	5731	0.2980	$24.67	$0.00	$0.00					
Q0092	Set up port xray equipment		N										
Q0111	Wet mounts/ w preparations		A										
Q0112	Potassium hydroxide preps		A										
Q0113	Pinworm examinations		A										
Q0114	Fern test		A										
Q0115	Post-coital mucous exam		A										
Q0138	"Ferumoxytol, non-esrd"		K	1297		$0.983	.	$0.20					
Q0139	"Ferumoxytol, esrd use"		K	1485		$0.983	.	$0.20					
Q0144	"Azithromycin dihydrate, oral"		E1										
Q0161	Chlorpromazine hcl 5mg oral		N										
Q0162	Ondansetron oral		N										
Q0163	Diphenhydramine hcl 50mg		N										
Q0164	Prochlorperazine maleate 5mg		N										
Q0166	Granisetron hcl 1 mg oral		N										
Q0167	Dronabinol 2.5mg oral		N										
Q0169	Promethazine hcl 12.5mg oral		N										
Q0173	Trimethobenzamide hcl 250mg		N										
Q0174	Thiethylperazine maleate10mg		E2										
Q0175	Perphenazine 4mg oral		N										
Q0177	Hydroxyzine pamoate 25mg		N										
Q0180	Dolasetron mesylate oral		N										
Q0181	Unspecified oral anti-emetic		N										
Q0239	Bamlanivimab-xxxx	NI 	L										
Q0243	Casirivimab and imdevimab	NI 	L										
Q0477	Pwr module pt cable lvad rpl		A										
Q0478	"Power adapter, combo vad"		A										
Q0479	"Power module combo vad, rep"		A										
Q0480	"Driver pneumatic vad, rep"		A										
Q0481	"Microprcsr cu elec vad, rep"		A										
Q0482	"Microprcsr cu combo vad, rep"		A										
Q0483	"Monitor elec vad, rep"		A										
Q0484	Monitor elec or comb vad rep		A										
Q0485	"Monitor cable elec vad, rep"		A										
Q0486	Mon cable elec/pneum vad rep		A										
Q0487	"Leads any type vad, rep only"		A										
Q0488	"Pwr pack base elec vad, rep"		A										
Q0489	"Pwr pck base combo vad, rep"		A										
Q0490	"Emr pwr source elec vad, rep"		A										
Q0491	Emr pwr source combo vad rep		A										
Q0492	"Emr pwr cbl elec vad, rep"		A										
Q0493	"Emr pwr cbl combo vad, rep"		A										
Q0494	"Emr hd pmp elec/combo, rep"		A										
Q0495	"Charger elec/combo vad, rep"		A										
Q0496	"Battery elec/combo vad, rep"		A										
Q0497	"Bat clps elec/comb vad, rep"		A										
Q0498	"Holster elec/combo vad, rep"		A										
Q0499	Belt/vest elec/combo vad rep		A										
Q0500	"Filters elec/combo vad, rep"		A										
Q0501	"Shwr cov elec/combo vad, rep"		A										
Q0502	"Mobility cart pneum vad, rep"		A										
Q0503	Battery pneum vad replacemnt		A										
Q0504	"Pwr adpt pneum vad, rep veh"		A										
Q0506	Lith-ion batt elec/pneum vad		A										
Q0507	Misc sup/acc ext vad		A										
Q0508	Mis sup/acc imp vad		A										
Q0509	Mis sup/ac imp vad nopay med		A										
Q0510	Dispens fee immunosupressive		B										
Q0511	"Sup fee antiem,antica,immuno"		B										
Q0512	Px sup fee anti-can sub pres		B										
Q0513	Disp fee inhal drugs/30 days		B										
Q0514	Disp fee inhal drugs/90 days		B										
Q0515	Sermorelin acetate injection		E2										
Q1004	Ntiol category 4		E1										
Q1005	Ntiol category 5		E1										
Q2004	Bladder calculi irrig sol		N										
Q2009	Fosphenytoin inj pe	CH 	N										
Q2017	"Teniposide, 50 mg"		K	7035		"$2,645.707"	.	$529.15					
Q2026	Radiesse injection		K	9094		$222.090	.	$44.42					
Q2028	"Inj, sculptra, 0.5mg"		K	9095		$3.190	.	$0.64					
Q2034	Agriflu vaccine		L										
Q2035	"Afluria vacc, 3 yrs & >, im"		L										
Q2036	"Flulaval vacc, 3 yrs & >, im"		L										
Q2037	"Fluvirin vacc, 3 yrs & >, im"		L										
Q2038	"Fluzone vacc, 3 yrs & >, im"		L										
Q2039	"Influenza virus vaccine, nos"		L										
Q2041	Axicabtagene ciloleucel car+		G	9035		"$395,380.000"	.	"$79,076.00"	*	*			
Q2042	Tisagenlecleucel car-pos t		G	9194		"$429,813.310"	.	"$85,962.67"	*	*			
Q2043	Sipuleucel-t auto cd54+		K	9273		"$49,671.772"	.	"$9,934.36"	*				
Q2049	Imported lipodox inj		K	1421		$482.060	.	$96.42					
Q2050	Doxorubicin inj 10mg		K	7046		$315.731	.	$63.15					
Q2052	"Ivig demo, services/supplies"		E1										
Q3001	Brachytherapy radioelements		B										
Q3014	Telehealth facility fee		A										
Q3027	Inj beta interferon im 1 mcg		K	1472		$54.322	.	$10.87					
Q3028	Inj beta interferon sq 1 mcg		E1										
Q3031	Collagen skin test		N										
Q4001	Cast sup body cast plaster		B										
Q4002	Cast sup body cast fiberglas		B										
Q4003	Cast sup shoulder cast plstr		B										
Q4004	Cast sup shoulder cast fbrgl		B										
Q4005	Cast sup long arm adult plst		B										
Q4006	Cast sup long arm adult fbrg		B										
Q4007	Cast sup long arm ped plster		B										
Q4008	Cast sup long arm ped fbrgls		B										
Q4009	Cast sup sht arm adult plstr		B										
Q4010	Cast sup sht arm adult fbrgl		B										
Q4011	Cast sup sht arm ped plaster		B										
Q4012	Cast sup sht arm ped fbrglas		B										
Q4013	Cast sup gauntlet plaster		B										
Q4014	Cast sup gauntlet fiberglass		B										
Q4015	Cast sup gauntlet ped plster		B										
Q4016	Cast sup gauntlet ped fbrgls		B										
Q4017	Cast sup lng arm splint plst		B										
Q4018	Cast sup lng arm splint fbrg		B										
Q4019	Cast sup lng arm splnt ped p		B										
Q4020	Cast sup lng arm splnt ped f		B										
Q4021	Cast sup sht arm splint plst		B										
Q4022	Cast sup sht arm splint fbrg		B										
Q4023	Cast sup sht arm splnt ped p		B										
Q4024	Cast sup sht arm splnt ped f		B										
Q4025	Cast sup hip spica plaster		B										
Q4026	Cast sup hip spica fiberglas		B										
Q4027	Cast sup hip spica ped plstr		B										
Q4028	Cast sup hip spica ped fbrgl		B										
Q4029	Cast sup long leg plaster		B										
Q4030	Cast sup long leg fiberglass		B										
Q4031	Cast sup lng leg ped plaster		B										
Q4032	Cast sup lng leg ped fbrgls		B										
Q4033	Cast sup lng leg cylinder pl		B										
Q4034	Cast sup lng leg cylinder fb		B										
Q4035	Cast sup lngleg cylndr ped p		B										
Q4036	Cast sup lngleg cylndr ped f		B										
Q4037	Cast sup shrt leg plaster		B										
Q4038	Cast sup shrt leg fiberglass		B										
Q4039	Cast sup shrt leg ped plster		B										
Q4040	Cast sup shrt leg ped fbrgls		B										
Q4041	Cast sup lng leg splnt plstr		B										
Q4042	Cast sup lng leg splnt fbrgl		B										
Q4043	Cast sup lng leg splnt ped p		B										
Q4044	Cast sup lng leg splnt ped f		B										
Q4045	Cast sup sht leg splnt plstr		B										
Q4046	Cast sup sht leg splnt fbrgl		B										
Q4047	Cast sup sht leg splnt ped p		B										
Q4048	Cast sup sht leg splnt ped f		B										
Q4049	"Finger splint, static"		B										
Q4050	Cast supplies unlisted		B										
Q4051	Splint supplies misc		B										
Q4074	Iloprost non-comp unit dose		Y										
Q4081	"Epoetin alfa, 100 units esrd"		N										
Q4082	Drug/bio noc part b drug cap		B										
Q4100	"Skin substitute, nos"		N										
Q4101	Apligraf		N										
Q4102	Oasis wound matrix		N										
Q4103	Oasis burn matrix		N										
Q4104	Integra bmwd		N										
Q4105	Integra drt or omnigraft		N										
Q4106	Dermagraft		N										
Q4107	Graftjacket		N										
Q4108	Integra matrix		N										
Q4110	Primatrix		N										
Q4111	Gammagraft		N										
Q4112	Cymetra injectable		N										
Q4113	Graftjacket xpress		N										
Q4114	Integra flowable wound matri		N										
Q4115	Alloskin		N										
Q4116	Alloderm		N										
Q4117	Hyalomatrix		N										
Q4118	Matristem micromatrix		N										
Q4121	Theraskin		N										
Q4122	"Dermacell, awm, porous sq cm"		N										
Q4123	Alloskin		N										
Q4124	Oasis tri-layer wound matrix		N										
Q4125	Arthroflex		N										
Q4126	Memoderm/derma/tranz/integup		N										
Q4127	Talymed		N										
Q4128	Flexhd/allopatchhd/matrixhd		N										
Q4130	Strattice tm		N										
Q4132	"Grafix core, grafixpl core"		N										
Q4133	Grafix stravix prime pl sqcm		N										
Q4134	Hmatrix		N										
Q4135	Mediskin		N										
Q4136	Ezderm		N										
Q4137	Amnioexcel biodexcel 1sq cm		N										
Q4138	"Biodfence dryflex, 1cm"		N										
Q4139	"Amnio or biodmatrix, inj 1cc"		N										
Q4140	Biodfence 1cm		N										
Q4141	"Alloskin ac, 1 cm"		N										
Q4142	Xcm biologic tiss matrix 1cm		N										
Q4143	"Repriza, 1cm"		N										
Q4145	"Epifix, inj, 1mg"		N										
Q4146	"Tensix, 1cm"		N										
Q4147	Architect ecm px fx 1 sq cm		N										
Q4148	Neox neox rt or clarix cord		N										
Q4149	"Excellagen, 0.1 cc"		N										
Q4150	Allowrap ds or dry 1 sq cm		N										
Q4151	"Amnioband, guardian 1 sq cm"		N										
Q4152	Dermapure 1 square cm		N										
Q4153	"Dermavest, plurivest sq cm"		N										
Q4154	Biovance 1 square cm		N										
Q4155	Neoxflo or clarixflo 1 mg		N										
Q4156	Neox 100 or clarix 100		N										
Q4157	Revitalon 1 square cm		N										
Q4158	"Kerecis omega3, per sq cm"		N										
Q4159	Affinity1 square cm		N										
Q4160	Nushield 1 square cm		N										
Q4161	Bio-connekt per square cm		N										
Q4162	"Wndex flw, bioskn flw, 0.5cc"		N										
Q4163	"Woundex, bioskin, per sq cm"		N										
Q4164	"Helicoll, per square cm"		N										
Q4165	"Keramatrix, kerasorb sq cm"		N										
Q4166	"Cytal, per square centimeter"		N										
Q4167	"Truskin, per sq centimeter"		N										
Q4168	"Amnioband, 1 mg"		N										
Q4169	"Artacent wound, per sq cm"		N										
Q4170	"Cygnus, per sq cm"		N										
Q4171	"Interfyl, 1 mg"		N										
Q4173	Palingen or palingen xplus		N										
Q4174	Palingen or promatrx		N										
Q4175	Miroderm		N										
Q4176	"Neopatch or therion, 1 sq cm"		N										
Q4177	"Floweramnioflo, 0.1 cc"		N										
Q4178	"Floweramniopatch, per sq cm"		N										
Q4179	"Flowerderm, per sq cm"		N										
Q4180	"Revita, per sq cm"		N										
Q4181	"Amnio wound, per square cm"		N										
Q4182	"Transcyte, per sq centimeter"		N										
Q4183	"Surgigraft, 1 sq cm"		N										
Q4184	Cellesta or duo per sq cm		N										
Q4185	Cellesta flowab amnion 0.5cc		N										
Q4186	Epifix 1 sq cm		N										
Q4187	Epicord 1 sq cm		N										
Q4188	Amnioarmor 1 sq cm		N										
Q4189	"Artacent ac, 1 mg"		N										
Q4190	Artacent ac 1 sq cm		N										
Q4191	Restorigin 1 sq cm		N										
Q4192	"Restorigin, 1 cc"		N										
Q4193	Coll-e-derm 1 sq cm		N										
Q4194	Novachor 1 sq cm		N										
Q4195	Puraply 1 sq cm	CH	N										
Q4196	Puraply am 1 sq cm	CH	N										
Q4197	Puraply xt 1 sq cm		N										
Q4198	Genesis amnio membrane 1sqcm		N										
Q4200	Skin te 1 sq cm		N										
Q4201	Matrion 1 sq cm		N										
Q4202	"Keroxx (2.5g/cc), 1cc"		N										
Q4203	"Derma-gide, 1 sq cm"		N										
Q4204	Xwrap 1 sq cm		N										
Q4205	Membrane graft or wrap sq cm		N										
Q4206	Fluid flow or fluid gf 1 cc		N										
Q4208	Novafix per sq cm		N										
Q4209	Surgraft per sq cm		N										
Q4210	Axolotl graf dualgraf sq cm		N										
Q4211	Amnion bio or axobio sq cm		N										
Q4212	"Allogen, per cc"		N										
Q4213	"Ascent, 0.5 mg"		N										
Q4214	Cellesta cord per sq cm		N										
Q4215	"Axolotl ambient, cryo 0.1 mg"		N										
Q4216	Artacent cord per sq cm		N										
Q4217	Woundfix biowound plus xplus		N										
Q4218	Surgicord per sq cm		N										
Q4219	Surgigraft dual per sq cm		N										
Q4220	"Bellacell hd, surederm sq cm"		N										
Q4221	Amniowrap2 per sq cm		N										
Q4222	"Progenamatrix, per sq cm"		N										
Q4226	Myown harv prep proc sq cm		N										
Q4227	Amniocore per sq cm	NC	N										
Q4228	"Bionextpatch, per sq cm"	NC	N										
Q4229	Cogenex amnio memb per sq cm	NC	N										
Q4230	Cogenex flow amnion 0.5 cc	NC	N										
Q4231	"Corplex p, per cc"	NC	N										
Q4232	"Corplex, per sq cm"	NC	N										
Q4233	Surfactor /nudyn per 0.5 cc	NC	N										
Q4234	"Xcellerate, per sq cm"	NC	N										
Q4235	Amniorepair or altiply sq cm	NC	N										
Q4236	Carepatch per sq cm	NC	N										
Q4237	"Cryo-cord, per sq cm"	NC	N										
Q4238	"Derm-maxx, per sq cm"	NC	N										
Q4239	Amnio-maxx or lite per sq cm	NC	N										
Q4240	Corecyte topical only 0.5 cc	NC	N										
Q4241	"Polycyte, topical only 0.5cc"	NC	N										
Q4242	"Amniocyte plus, per 0.5 cc"	NC	N										
Q4244	"Procenta, per 200 mg"	NC	N										
Q4245	"Amniotext, per cc"	NC	N										
Q4246	"Coretext or protext, per cc"	NC	N										
Q4247	"Amniotext patch, per sq cm"	NC	N										
Q4248	Dermacyte amn mem allo sq cm	NC	N										
Q4249	"Amniply, per sq cm"	NI	N										
Q4250	Amnioamp-mp per sq cm	NI	N										
Q4254	Novafix dl per sq cm	NI	N										
Q4255	"Reguard, topical use per sq"	NI	N										
Q5001	Hospice or home hlth in home		B										
Q5002	Hospice/home hlth in asst lv		B										
Q5003	Hospice in lt/non-skilled nf		B										
Q5004	Hospice in snf		B										
Q5005	"Hospice, inpatient hospital"		B										
Q5006	Hospice in hospice facility		B										
Q5007	Hospice in ltch		B										
Q5008	Hospice in inpatient psych		B										
Q5009	"Hospice/home hlth, place nos"		B										
Q5010	Hospice home care in hospice		B										
Q5101	"Injection, zarxio"		K	1822		$0.468	.	$0.10					
Q5103	"Injection, inflectra"	CH 	K	1847		$43.724	.	$8.75					
Q5104	"Injection, renflexis"		G	9036		$44.547	.	$8.91		*			
Q5105	Inj retacrit esrd on dialysi		G	9096		$0.861	.	$0.18		*			
Q5106	Inj retacrit non-esrd use		G	9097		$8.612	.	$1.73		*			
Q5107	Inj mvasi 10 mg		G	9329		$60.939	.	$12.19					
Q5108	"Injection, fulphila"		G	9173		$269.041	.	$53.81					
Q5109	"Injection, ixifi, 10 mg"		E2										
Q5110	Nivestym		G	9193		$0.621	.	$0.13					
Q5111	"Injection, udenyca 0.5 mg"		G	9195		$286.674	.	$57.34					
Q5112	Inj ontruzant 10 mg	CH 	G	9382		$92.296	.	$18.46					
Q5113	Inj herzuma 10 mg	CH 	G	9349		$91.523	.	$18.31					
Q5114	Inj ogivri 10 mg	CH 	G	9341		$76.407	.	$15.29					
Q5115	Inj truxima 10 mg	CH 	G	9336		$68.799	.	$13.76					
Q5116	"Inj., trazimera, 10 mg"	CH 	G	9350		$83.104	.	$16.63					
Q5117	"Inj., kanjinti, 10 mg"		G	9330		$78.723	.	$15.75					
Q5118	"Inj., zirabev, 10 mg"	CH 	G	9348		$62.235	.	$12.45					
Q5119	"Inj ruxience, 10 mg"	NC	G	9367		$70.900	.	$14.18					
Q5120	Inj pegfilgrastim-bmez 0.5mg	NC	G	9345		$305.552	.	$61.12					
Q5121	"Inj. avsola, 10 mg"	NC	G	9381		$51.500	.	$10.30					
Q5122	"Inj, nyvepria"	NI 	E2										
Q9001	Va chaplain assessment	NI	E1										
Q9002	Va chaplain counsel individu	NI	E1										
Q9003	Va chaplain counsel group	NI	E1										
Q9950	Inj sulf hexa lipid microsph	CH 	N										
Q9951	"Locm >= 400 mg/ml iodine,1ml"		N										
Q9953	"Inj fe-based mr contrast,1ml"		N										
Q9954	"Oral mr contrast, 100 ml"		N										
Q9955	"Inj perflexane lip micros,ml"		N										
Q9956	"Inj octafluoropropane mic,ml"		N										
Q9957	"Inj perflutren lip micros,ml"		N										
Q9958	"Hocm <=149 mg/ml iodine, 1ml"		N										
Q9959	"Hocm 150-199mg/ml iodine,1ml"		N										
Q9960	"Hocm 200-249mg/ml iodine,1ml"		N										
Q9961	"Hocm 250-299mg/ml iodine,1ml"		N										
Q9962	"Hocm 300-349mg/ml iodine,1ml"		N										
Q9963	"Hocm 350-399mg/ml iodine,1ml"		N										
Q9964	"Hocm>= 400mg/ml iodine, 1ml"		N										
Q9965	"Locm 100-199mg/ml iodine,1ml"		N										
Q9966	"Locm 200-299mg/ml iodine,1ml"		N										
Q9967	"Locm 300-399mg/ml iodine,1ml"		N										
Q9968	Visualization adjunct		K	1446		$7.552	.	$1.52					
Q9969	Non-heu tc-99m add-on/dose		K	1442		$10.000	.	$2.00					
Q9982	Flutemetamol f18 diagnostic	CH 	N										
Q9983	Florbetaben f18 diagnostic	CH 	N										
Q9991	Buprenorph xr 100 mg or less		G	9073		"$1,743.482"	.	$348.70		*			
Q9992	Buprenorphine xr over 100 mg		G	9239		"$1,743.482"	.	$348.70		*			
R0070	Transport portable x-ray		B										
R0075	Transport port x-ray multipl		B										
R0076	Transport portable ekg		B										
U0001	2019-ncov diagnostic p	NC	A										
U0002	Covid-19 lab test non-cdc	NC	A										
U0003	Cov-19 amp prb hgh thruput		A										
U0004	Cov-19 test non-cdc hgh thru		A										
U0005	Infec agen detec ampli probe	NI	A										
V2020	Vision svcs frames purchases		A										
V2025	Eyeglasses delux frames		E1										
V2100	Lens spher single plano 4.00		A										
V2101	Single visn sphere 4.12-7.00		A										
V2102	Singl visn sphere 7.12-20.00		A										
V2103	Spherocylindr 4.00d/12-2.00d		A										
V2104	Spherocylindr 4.00d/2.12-4d		A										
V2105	Spherocylinder 4.00d/4.25-6d		A										
V2106	Spherocylinder 4.00d/>6.00d		A										
V2107	Spherocylinder 4.25d/12-2d		A										
V2108	Spherocylinder 4.25d/2.12-4d		A										
V2109	Spherocylinder 4.25d/4.25-6d		A										
V2110	Spherocylinder 4.25d/over 6d		A										
V2111	Spherocylindr 7.25d/.25-2.25		A										
V2112	Spherocylindr 7.25d/2.25-4d		A										
V2113	Spherocylindr 7.25d/4.25-6d		A										
V2114	Spherocylinder over 12.00d		A										
V2115	Lens lenticular bifocal		A										
V2118	Lens aniseikonic single		A										
V2121	"Lenticular lens, single"		A										
V2199	Lens single vision not oth c		A										
V2200	Lens spher bifoc plano 4.00d		A										
V2201	Lens sphere bifocal 4.12-7.0		A										
V2202	Lens sphere bifocal 7.12-20.		A										
V2203	Lens sphcyl bifocal 4.00d/.1		A										
V2204	Lens sphcy bifocal 4.00d/2.1		A										
V2205	Lens sphcy bifocal 4.00d/4.2		A										
V2206	Lens sphcy bifocal 4.00d/ove		A										
V2207	Lens sphcy bifocal 4.25-7d/.		A										
V2208	Lens sphcy bifocal 4.25-7/2.		A										
V2209	Lens sphcy bifocal 4.25-7/4.		A										
V2210	Lens sphcy bifocal 4.25-7/ov		A										
V2211	Lens sphcy bifo 7.25-12/.25-		A										
V2212	Lens sphcyl bifo 7.25-12/2.2		A										
V2213	Lens sphcyl bifo 7.25-12/4.2		A										
V2214	Lens sphcyl bifocal over 12.		A										
V2215	Lens lenticular bifocal		A										
V2218	Lens aniseikonic bifocal		A										
V2219	Lens bifocal seg width over		A										
V2220	Lens bifocal add over 3.25d		A										
V2221	"Lenticular lens, bifocal"		A										
V2299	Lens bifocal speciality		A										
V2300	Lens sphere trifocal 4.00d		A										
V2301	Lens sphere trifocal 4.12-7.		A										
V2302	Lens sphere trifocal 7.12-20		A										
V2303	Lens sphcy trifocal 4.0/.12-		A										
V2304	Lens sphcy trifocal 4.0/2.25		A										
V2305	Lens sphcy trifocal 4.0/4.25		A										
V2306	Lens sphcyl trifocal 4.00/>6		A										
V2307	Lens sphcy trifocal 4.25-7/.		A										
V2308	Lens sphc trifocal 4.25-7/2.		A										
V2309	Lens sphc trifocal 4.25-7/4.		A										
V2310	Lens sphc trifocal 4.25-7/>6		A										
V2311	Lens sphc trifo 7.25-12/.25-		A										
V2312	Lens sphc trifo 7.25-12/2.25		A										
V2313	Lens sphc trifo 7.25-12/4.25		A										
V2314	Lens sphcyl trifocal over 12		A										
V2315	Lens lenticular trifocal		A										
V2318	Lens aniseikonic trifocal		A										
V2319	Lens trifocal seg width > 28		A										
V2320	Lens trifocal add over 3.25d		A										
V2321	"Lenticular lens, trifocal"		A										
V2399	Lens trifocal speciality		A										
V2410	Lens variab asphericity sing		A										
V2430	Lens variable asphericity bi		A										
V2499	Variable asphericity lens		A										
V2500	Contact lens pmma spherical		A										
V2501	Cntct lens pmma-toric/prism		A										
V2502	Contact lens pmma bifocal		A										
V2503	Cntct lens pmma color vision		A										
V2510	Cntct gas permeable sphericl		A										
V2511	Cntct toric prism ballast		A										
V2512	Cntct lens gas permbl bifocl		A										
V2513	Contact lens extended wear		A										
V2520	Contact lens hydrophilic		A										
V2521	Cntct lens hydrophilic toric		A										
V2522	Cntct lens hydrophil bifocl		A										
V2523	Cntct lens hydrophil extend		A										
V2524	Cntct lens hydrophil photoch	NI	A										
V2530	Contact lens gas impermeable		A										
V2531	Contact lens gas permeable		A										
V2599	Contact lens/es other type		A										
V2600	Hand held low vision aids		A										
V2610	Single lens spectacle mount		A										
V2615	Telescop/othr compound lens		A										
V2623	Plastic eye prosth custom		A										
V2624	Polishing artifical eye		A										
V2625	Enlargemnt of eye prosthesis		A										
V2626	Reduction of eye prosthesis		A										
V2627	Scleral cover shell		A										
V2628	Fabrication & fitting		A										
V2629	Prosthetic eye other type		A										
V2630	Anter chamber intraocul lens		N										
V2631	Iris support intraoclr lens		N										
V2632	Post chmbr intraocular lens		N										
V2700	Balance lens		A										
V2702	Deluxe lens feature		E1										
V2710	Glass/plastic slab off prism		A										
V2715	Prism lens/es		A										
V2718	Fresnell prism press-on lens		A										
V2730	Special base curve		A										
V2744	Tint photochromatic lens/es		A										
V2745	"Tint, any color/solid/grad"		A										
V2750	Anti-reflective coating		A										
V2755	Uv lens/es		A										
V2756	Eye glass case		E1										
V2760	Scratch resistant coating		E1										
V2761	Mirror coating		B										
V2762	"Polarization, any lens"		E1										
V2770	Occluder lens/es		A										
V2780	Oversize lens/es		A										
V2781	Progressive lens per lens		B										
V2782	"Lens, 1.54-1.65 p/1.60-1.79g"		A										
V2783	"Lens, >= 1.66 p/>=1.80 g"		A										
V2784	Lens polycarb or equal		A										
V2785	Corneal tissue processing		F										
V2786	Occupational multifocal lens		E1										
V2787	Astigmatism-correct function		E1										
V2788	Presbyopia-correct function		E1										
V2790	Amniotic membrane		N										
V2797	Vis item/svc in other code		E1										
V2799	Misc vision item or service		A										
V5008	Hearing screening		E1										
V5010	Assessment for hearing aid		E1										
V5011	Hearing aid fitting/checking		E1										
V5014	Hearing aid repair/modifying		E1										
V5020	Conformity evaluation		E1										
V5030	Body-worn hearing aid air		E1										
V5040	Body-worn hearing aid bone		E1										
V5050	Hearing aid monaural in ear		E1										
V5060	Behind ear hearing aid		E1										
V5070	Glasses air conduction		E1										
V5080	Glasses bone conduction		E1										
V5090	Hearing aid dispensing fee		E1										
V5095	Implant mid ear hearing pros		E1										
V5100	Body-worn bilat hearing aid		E1										
V5110	Hearing aid dispensing fee		E1										
V5120	Body-worn binaur hearing aid		E1										
V5130	In ear binaural hearing aid		E1										
V5140	Behind ear binaur hearing ai		E1										
V5150	Glasses binaural hearing aid		E1										
V5160	Dispensing fee binaural		E1										
V5171	Hearing aid monaural ite		E1										
V5172	Hearing aid monaural itc		E1										
V5181	Hearing aid monaural bte		E1										
V5190	Hearing aid monaural glasses		E1										
V5200	Disp fee contralateral monau		E1										
V5211	Hearing aid binaural ite/ite		E1										
V5212	Hearing aid binaural ite/itc		E1										
V5213	Hearing aid binaural ite/bte		E1										
V5214	Hearing aid binaural itc/itc		E1										
V5215	Hearing aid binaural itc/bte		E1										
V5221	Hearing aid binaural bte/bte		E1										
V5230	Hearing aid binaural glasses		E1										
V5240	Disp fee contralateral binau		E1										
V5241	"Dispensing fee, monaural"		E1										
V5242	"Hearing aid, monaural, cic"		E1										
V5243	"Hearing aid, monaural, itc"		E1										
V5244	"Hearing aid, prog, mon, cic"		E1										
V5245	"Hearing aid, prog, mon, itc"		E1										
V5246	"Hearing aid, prog, mon, ite"		E1										
V5247	"Hearing aid, prog, mon, bte"		E1										
V5248	"Hearing aid, binaural, cic"		E1										
V5249	"Hearing aid, binaural, itc"		E1										
V5250	"Hearing aid, prog, bin, cic"		E1										
V5251	"Hearing aid, prog, bin, itc"		E1										
V5252	"Hearing aid, prog, bin, ite"		E1										
V5253	"Hearing aid, prog, bin, bte"		E1										
V5254	"Hearing id, digit, mon, cic"		E1										
V5255	"Hearing aid, digit, mon, itc"		E1										
V5256	"Hearing aid, digit, mon, ite"		E1										
V5257	"Hearing aid, digit, mon, bte"		E1										
V5258	"Hearing aid, digit, bin, cic"		E1										
V5259	"Hearing aid, digit, bin, itc"		E1										
V5260	"Hearing aid, digit, bin, ite"		E1										
V5261	"Hearing aid, digit, bin, bte"		E1										
V5262	"Hearing aid, disp, monaural"		E1										
V5263	"Hearing aid, disp, binaural"		E1										
V5264	Ear mold/insert		E1										
V5265	"Ear mold/insert, disp"		E1										
V5266	Battery for hearing device		E1										
V5267	Hearing aid sup/access/dev		E1										
V5268	Ald telephone amplifier		E1										
V5269	"Alerting device, any type"		E1										
V5270	"Ald, tv amplifier, any type"		E1										
V5271	"Ald, tv caption decoder"		E1										
V5272	Tdd		E1										
V5273	Ald for cochlear implant		E1										
V5274	Ald unspecified		E1										
V5275	Ear impression		E1										
V5281	"Ald fm/dm system, monaural"		E1										
V5282	Ald fm/dm system binaural		E1										
V5283	"Ald neck, loop ind receiver"		E1										
V5284	Ald fm/dm ear level receiver		E1										
V5285	Ald fm/dm aud input receiver		E1										
V5286	Ald blu tooth fm/dm receiver		E1										
V5287	"Ald fm/dm receiver, nos"		E1										
V5288	Ald fm/dm transmitter ald		E1										
V5289	Ald fm/dm adapt/boot couplin		E1										
V5290	Ald transmitter microphone		E1										
V5298	Hearing aid noc		E1										
V5299	Hearing service		B										
V5336	Repair communication device		E1										
V5362	Speech screening		E1										
V5363	Language screening		E1										
V5364	Dysphagia screening		E1										
