		Addendum C. - Final HCPCS Codes Payable Under the 2021 OPPS by APC								
		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.								
APC	HCPCS	Group Title	Short Descriptor	SI	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
0701		Sr89 strontium		K		"$2,045.702"	.	$409.15		
0701	A9600		Sr89 strontium							
0726		Dexrazoxane HCl injection		K		$199.929	.	$39.99		
0726	J1190		Dexrazoxane hcl injection							
0731		Sargramostim injection		K		$48.122	.	$9.63		
0731	J2820		Sargramostim injection							
0736		Amphotericin b liposome inj		K		$26.563	.	$5.32		
0736	J0289		Amphotericin b liposome inj							
0738		Rasburicase		K		$300.937	.	$60.19		
0738	J2783		Rasburicase							
0751		Mechlorethamine hcl inj		K		$328.290	.	$65.66		
0751	J9230		Mechlorethamine hcl inj							
0752		Dactinomycin injection		K		"$1,044.534"	.	$208.91		
0752	J9120		Dactinomycin injection							
0759		"Naltrexone, depot form"		K		$3.261	.	$0.66		
0759	J2315		"Naltrexone, depot form"							
0800		Leuprolide acetate		K		"$1,347.559"	.	$269.52		
0800	J1950		Leuprolide acetate /3.75 mg							
0802		Etoposide oral		K		$75.493	.	$15.10		
0802	J8560		Etoposide oral 50 mg							
0807		Aldesleukin injection		K		"$4,964.616"	.	$992.93		
0807	J9015		Aldesleukin injection							
0810		Goserelin acetate implant		K		$503.586	.	$100.72		
0810	J9202		Goserelin acetate implant							
0812		Carmustine injection		K		"$2,016.270"	.	$403.26		
0812	J9050		Carmustine injection							
0820		Daunorubicin injection		K		$43.838	.	$8.77		
0820	J9150		Daunorubicin injection							
0825		Nelarabine injection		K		$152.151	.	$30.44		
0825	J9261		Nelarabine injection							
0836		Interferon alfa-2b inj		K		$34.346	.	$6.87		
0836	J9214		Interferon alfa-2b inj							
0840		Inj melphalan hydrochl 50 mg		K		$260.376	.	$52.08		
0840	J9245		Inj melphalan hydrochl 50 mg							
0843		Pegaspargase injection		K		"$19,717.763"	.	"$3,943.56"	*	
0843	J9266		Pegaspargase injection							
0844		Pentostatin injection		K		"$2,060.277"	.	$412.06		
0844	J9268		Pentostatin injection							
0850		Streptozocin injection		K		$349.537	.	$69.91		
0850	J9320		Streptozocin injection							
0851		Thiotepa injection		K		$475.392	.	$95.08		
0851	J9340		Thiotepa injection							
0856		Porfimer sodium injection		K		"$21,856.352"	.	"$4,371.28"	*	
0856	J9600		Porfimer sodium injection							
0858		Inj cladribine		K		$19.573	.	$3.92		
0858	J9065		Inj cladribine per 1 mg							
0864		Mitoxantrone hydrochl		K		$28.688	.	$5.74		
0864	J9293		Mitoxantrone hydrochl / 5 m							
0874		Synvisc or synvisc-one		K		$10.218	.	$2.05		
0874	J7325		Synvisc or synvisc-one							
0875		Euflexxa inj per dose		K		$140.312	.	$28.07		
0875	J7323		Euflexxa inj per dose							
0877		Orthovisc inj per dose		K		$128.409	.	$25.69		
0877	J7324		Orthovisc inj per dose							
0887		Azathioprine parenteral		K		$227.933	.	$45.59		
0887	J7501		Azathioprine parenteral							
0890		Lymphocyte immune globulin		K		"$2,257.665"	.	$451.54		
0890	J7504		Lymphocyte immune globulin							
0901		Alpha 1 proteinase inhibitor		K		$4.358	.	$0.88		
0901	J0256		Alpha 1 proteinase inhibito							
0902		"Injection,onabotulinumtoxinA"		K		$6.077	.	$1.22		
0902	J0585		"Injection,onabotulinumtoxin"							
0903		Cytomegalovirus imm IV /vial		K		"$1,496.953"	.	$299.40		
0903	J0850		Cytomegalovirus imm iv /via							
0910		Interferon beta-1b / .25 MG		K		$393.833	.	$78.77		
0910	J1830		Interferon beta-1b / .25 mg							
0925		Factor viii		K		$1.015	.	$0.21		
0925	J7190		Factor viii							
0927		Factor viii recombinant		K		$1.378	.	$0.28		
0927	J7192		Factor viii recombinant nos							
0928		Factor ix complex		K		$1.491	.	$0.30		
0928	J7194		Factor ix complex							
0929		Anti-inhibitor		K		$2.051	.	$0.42		
0929	J7198		Anti-inhibitor							
0931		Factor IX non-recombinant		K		$1.164	.	$0.24		
0931	J7193		Factor ix non-recombinant							
0932		Factor ix recombinant nos		K		$1.534	.	$0.31		
0932	J7195		Factor ix recombinant nos							
0943		Octagam injection		K		$41.229	.	$8.25		
0943	J1568		Octagam injection							
0944		Gammagard liquid injection		K		$43.201	.	$8.65		
0944	J1569		Gammagard liquid injection							
0946		Hepagam b im injection		K		$63.403	.	$12.69		
0946	J1571		Hepagam b im injection							
0947		Flebogamma injection		K		$40.383	.	$8.08		
0947	J1572		Flebogamma injection							
0948		Gamunex-C/Gammaked		K		$42.186	.	$8.44		
0948	J1561		Gamunex-c/gammaked							
0961		"Albumin (human),5%, 50ml"		K		$10.490	.	$2.10		
0961	P9041		"Albumin (human),5%, 50ml"							
0963		"Albumin (human), 5%, 250 ml"		K		$52.450	.	$10.49		
0963	P9045		"Albumin (human), 5%, 250 ml"							
0964		"Albumin (human), 25%, 20 ml"		K		$20.980	.	$4.20		
0964	P9046		"Albumin (human), 25%, 20 ml"							
0965		"Albumin (human), 25%, 50ml"		K		$52.450	.	$10.49		
0965	P9047		"Albumin (human), 25%, 50ml"							
1015		Injection glatiramer acetate		K		$157.420	.	$31.49		
1015	J1595		Injection glatiramer acetat							
1064		"I131 iodide cap, rx"		K		$20.690	.	$4.14		
1064	A9517		"I131 iodide cap, rx"							
1083		Adalimumab injection		K		"$1,430.922"	.	$286.19		
1083	J0135		Adalimumab injection							
1138		"Hepagam b intravenous, inj"		K		$65.960	.	$13.20		
1138	J1573		"Hepagam b intravenous, inj"							
1139		Protein c concentrate		K		$15.064	.	$3.02		
1139	J2724		Protein c concentrate							
1142		Supprelin LA implant		K		"$40,237.001"	.	"$8,047.41"	*	
1142	J9226		Supprelin la implant							
1150		"I131 iodide sol, rx"		K		$13.360	.	$2.68		
1150	A9530		"I131 iodide sol, rx"							
1168		"Inj, temsirolimus"		K		$44.989	.	$9.00		
1168	J9330		Temsirolimus injection							
1178		Busulfan injection		K		$3.405	.	$0.69		
1178	J0594		Busulfan injection							
1203		Verteporfin injection		K		$11.227	.	$2.25		
1203	J3396		Verteporfin injection							
1207		"Octreotide injection, depot"		K		$205.878	.	$41.18		
1207	J2353		"Octreotide injection, depot"							
1213		Antihemophilic viii/vwf comp		K		$1.136	.	$0.23		
1213	J7186		Antihemophilic viii/vwf com							
1214		Inj IVIG privigen 500 mg		K		$41.503	.	$8.31		
1214	J1459		Inj ivig privigen 500 mg							
1232		Mitomycin injection		K		$49.879	.	$9.98		
1232	J9280		Mitomycin injection							
1235		Valrubicin injection		K		"$1,403.170"	.	$280.64		
1235	J9357		Valrubicin injection							
1236		Inj levoleucovorin nos 0.5mg		K		$0.280	.	$0.06		
1236	J0641		Inj levoleucovorin nos 0.5m							
1237		Inj iron dextran		K		$15.010	.	$3.01		
1237	J1750		Inj iron dextran							
1263		Antithrombin iii injection		K		$3.504	.	$0.71		
1263	J7197		Antithrombin iii injection							
1268		Xyntha inj		K		$1.306	.	$0.27		
1268	J7185		Xyntha inj							
1274		Edetate calcium disodium inj		K		"$5,594.422"	.	"$1,118.89"		
1274	J0600		Edetate calcium disodium in							
1281		Bevacizumab injection		K		$1.909	.	$0.39		
1281	C9257		Bevacizumab injection							
1289		AbobotulinumtoxinA		K		$8.149	.	$1.63		
1289	J0586		Abobotulinumtoxina							
1295		Sm 153 lexidronam		K		"$17,259.853"	.	"$3,451.98"	*	
1295	A9604		Sm 153 lexidronam							
1296		Degarelix injection		K		$3.842	.	$0.77		
1296	J9155		Degarelix injection							
1297		"Ferumoxytol, non-esrd"		K		$0.983	.	$0.20		
1297	Q0138		"Ferumoxytol, non-esrd"							
1311		Canakinumab injection		K		$113.238	.	$22.65		
1311	J0638		Canakinumab injection							
1312		Hizentra injection		K		$10.855	.	$2.18		
1312	J1559		Hizentra injection							
1327		Imiglucerase injection		K		$43.377	.	$8.68		
1327	J1786		Imuglucerase injection							
1331		Olanzapine long-acting inj		K		$2.917	.	$0.59		
1331	J2358		Olanzapine long-acting inj							
1340		"Collagenase, clost hist inj"		K		$52.388	.	$10.48		
1340	J0775		"Collagenase, clost hist inj"							
1341		Amobarbital 125 MG inj		K		$95.160	.	$19.04		
1341	J0300		Amobarbital 125 mg inj							
1352		Wilate injection		K		$1.023	.	$0.21		
1352	J7183		Wilate injection							
1353		Belimumab injection		K		$46.179	.	$9.24		
1353	J0490		Belimumab injection							
1408		Cyclophosphamide 100 MG inj		K		$29.672	.	$5.94		
1408	J9070		Cyclophosphamide 100 mg inj							
1413		Lumizyme injection		K		$174.488	.	$34.90		
1413	J0221		Lumizyme injection							
1415		Glassia injection		K		$4.834	.	$0.97		
1415	J0257		Glassia injection							
1416		Factor xiii anti-hem factor		K		$8.773	.	$1.76		
1416	J7180		Factor xiii anti-hem factor							
1417		Gel-one		K		"$1,219.000"	.	$243.80		
1417	J7326		Gel-one							
1420		Aflibercept injection		K		$928.241	.	$185.65		
1420	J0178		Aflibercept injection							
1421		Imported lipodox inj		K		$482.060	.	$96.42		
1421	Q2049		Imported lipodox inj							
1426		Eribulin mesylate injection		K		$117.663	.	$23.54		
1426	J9179		Eribulin mesylate injection							
1431		Centruroides immune f(ab)		K		"$5,063.557"	.	"$1,012.72"		
1431	J0716		Centruroides immune f(ab)							
1433		Calcitonin salmon injection		K		"$2,839.223"	.	$567.85		
1433	J0630		Calcitonin salmon injection							
1440		Inj desmopressin acetate		K		$10.453	.	$2.10		
1440	J2597		Inj desmopressin acetate							
1442		Non-HEU TC-99M add-on/dose		K		$10.000	.	$2.00		
1442	Q9969		Non-heu tc-99m add-on/dose							
1443		Icatibant injection		K		$276.567	.	$55.32		
1443	J1744		Icatibant injection							
1446		Visualization adjunct		K		$7.552	.	$1.52		
1446	Q9968		Visualization adjunct							
1458		Phentolaine mesylate inj		K		$359.137	.	$71.83		
1458	J2760		Phentolaine mesylate inj							
1466		"Inj, vincristine sul lip 1mg"		K		"$3,320.169"	.	$664.04		
1466	J9371		"Inj, vincristine sul lip 1m"							
1467		Factor ix recombinan rixubis		K		$1.456	.	$0.30		
1467	J7200		Factor ix recombinan rixubi							
1468		Inj Aripiprazole Ext Rel 1mg		K		$5.700	.	$1.14		
1468	J0401		Inj aripiprazole ext rel 1m							
1469		Inj filgrastim excl biosimil		K		$0.925	.	$0.19		
1469	J1442		Inj filgrastim excl biosimi							
1471		"Injection, Pertuzumab, 1 mg"		K		$12.945	.	$2.59		
1471	J9306		"Injection, pertuzumab, 1 mg"							
1472		Inj beta interferon im 1 mcg		K		$54.322	.	$10.87		
1472	Q3027		Inj beta interferon im 1 mc							
1474		Certolizumab pegol inj 1mg		K		$8.161	.	$1.64		
1474	J0717		Certolizumab pegol inj 1mg							
1475		Golimumab for iv use 1mg		K		$18.997	.	$3.80		
1475	J1602		Golimumab for iv use 1mg							
1476		Obinutuzumab inj		K		$63.736	.	$12.75		
1476	J9301		Obinutuzumab inj							
1478		Inj human fibrinogen con nos		K		$1.243	.	$0.25		
1478	J7178		Inj human fibrinogen con no							
1480		"Elosulfase alfa, injection"		K		$246.196	.	$49.24		
1480	J1322		"Elosulfase alfa, injection"							
1482		"Darbepoetin alfa, esrd use"		K		$3.716	.	$0.75		
1482	J0882		"Darbepoetin alfa, esrd use"							
1485		"Ferumoxytol, esrd use"		K		$0.983	.	$0.20		
1485	Q0139		"Ferumoxytol, esrd use"							
1486		Factor ix fc fusion recomb		K		$3.252	.	$0.66		
1486	J7201		Factor ix alprolix recomb							
1488		"Injection, ramucirumab"		K		$60.709	.	$12.15		
1488	J9308		"Injection, ramucirumab"							
1489		"Injection, vedolizumab"		K		$20.297	.	$4.06		
1489	J3380		"Injection, vedolizumab"							
1490		Inj pembrolizumab		K		$50.846	.	$10.17		
1490	J9271		Inj pembrolizumab							
1492		New Technology  - Level 1B ($11-$20)		S		$15.50		$3.10		
1492	0001A		Adm sarscov2 30mcg/0.3ml 1st				$0.00	$0.00		
1492	0011A		Adm sarscov2 100mcg/0.5ml1st				$0.00	$0.00		
1493		New Technology  - Level 1C ($21-$30)		S		$25.50	.	$5.11		
1493	0002A		Adm sarscov2 30mcg/0.3ml 2nd				$0.00	$0.00		
1493	0012A		Adm sarscov2 100mcg/0.5ml2nd				$0.00	$0.00		
1508		New Technology - Level 8 ($601 - $700)		S		$650.50	.	$130.11		
1508	G2082		Visit esketamine 56m or les							
1511		New Technology - Level 11 ($901 - $1000)		S		$950.50	.	$190.11		
1511	0503T		Cor ffr alys gnrj ffr mdl							
1511	G2083		"Visit esketamine, > 56m"							
1522		New Technology - Level 22 ($2001-$2500)		S		"$2,250.50"	.	$450.10		
1522	78431		Myocrd img pet rst&strs ct							
1523		New Technology - Level 23 ($2501-$3000)		S		"$2,750.50"	.	$550.10		
1523	78432		Myocrd img pet 2rtracer							
1523	78433		Myocrd img pet 2rtracer ct							
1561		New Technology - Level 24 ($3001-$3500)		T		"$3,250.50"	.	$650.11		
1561	C9770		"Vitrec/mech pars, subret in"							
1562		New Technology - Level 25 ($3501-$4000)		T		"$3,750.50"	.	$750.10		
1562	C9751		"Microwave bronch, 3d, ebus"							
1590		"New Technology - Level 39 ($15,001-$20,000)"		T		"$17,500.50"	.	"$3,500.11"	*	
1590	C9758		Interatrial shunt ide							
1592		"New Technology - Level 41 ($25,001-$30,000)"		T		"$27,500.50"	.	"$5,500.11"	*	
1592	C9760		Non-blind interatrial shunt							
1608		Etanercept injection		K		$736.295	.	$147.26		
1608	J1438		Etanercept injection							
1609		"Rho(D) immune globulin h, sd"		K		$36.366	.	$7.28		
1609	J2792		"Rho(d) immune globulin h, s"							
1613		Inj trastuzumab excl biosimi		K		$99.675	.	$19.94		
1613	J9355		Inj trastuzumab excl biosimi							
1630		"Hep b ig, im"		K		$119.087	.	$23.82		
1630	90371		Hep b ig im							
1643		"Y90 ibritumomab, rx"		K		"$56,746.934"	.	"$11,349.39"	*	
1643	A9543		"Y90 ibritumomab, rx"							
1656		Factor viii fc fusion recomb		K		$2.167	.	$0.44		
1656	J7205		Factor viii fc fusion recom							
1658		"Injection, belinostat, 10mg"		K		$42.794	.	$8.56		
1658	J9032		"Injection, belinostat, 10mg"							
1660		"Injection, oritavancin"		K		$23.797	.	$4.76		
1660	J2407		"Injection, oritavancin"							
1662		Inj tedizolid phosphate		K		$1.590	.	$0.32		
1662	J3090		Inj tedizolid phosphate							
1669		Erythro lactobionate /500 mg		K		$76.845	.	$15.37		
1669	J1364		Erythro lactobionate /500 m							
1670		Tetanus immune globulin inj		K		$476.569	.	$95.32		
1670	J1670		Tetanus immune globulin inj							
1675		P32 Na phosphate		K		$449.310	.	$89.87		
1675	A9563		P32 na phosphate							
1683		Basiliximab		K		"$4,005.187"	.	$801.04		
1683	J0480		Basiliximab							
1684		Corticorelin ovine triflutal		K		$9.377	.	$1.88		
1684	J0795		Corticorelin ovine trifluta							
1685		"Darbepoetin alfa, non-esrd"		K		$3.716	.	$0.75		
1685	J0881		"Darbepoetin alfa, non-esrd"							
1686		"Epoetin alfa, non-esrd"		K		$9.109	.	$1.83		
1686	J0885		"Epoetin alfa, non-esrd"							
1687		Digoxin immune fab (ovine)		K		"$3,972.138"	.	$794.43		
1687	J1162		Digoxin immune fab (ovine)							
1688		Ethanolamine oleate		K		$444.099	.	$88.82		
1688	J1430		Ethanolamine oleate 100 mg							
1689		Fomepizole		K		$5.326	.	$1.07		
1689	J1451		"Fomepizole, 15 mg"							
1690		Hemin		K		$24.436	.	$4.89		
1690	J1640		"Hemin, 1 mg"							
1694		Ziconotide injection		K		$8.171	.	$1.64		
1694	J2278		Ziconotide injection							
1696		Palifermin injection		K		$22.812	.	$4.57		
1696	J2425		Palifermin injection							
1700		Inj secretin synthetic human		K		$34.781	.	$6.96		
1700	J2850		Inj secretin synthetic huma							
1701		Treprostinil injection		K		$62.806	.	$12.57		
1701	J3285		Treprostinil injection							
1704		"Humate-P, inj"		K		$1.207	.	$0.25		
1704	J7187		"Humate-p, inj"							
1705		Factor viia recomb novoseven		K		$2.250	.	$0.45		
1705	J7189		Factor viia recomb novoseve							
1709		Azacitidine injection		K		$0.801	.	$0.17		
1709	J9025		Azacitidine injection							
1710		Clofarabine injection		K		$52.637	.	$10.53		
1710	J9027		Clofarabine injection							
1711		Vantas implant		K		"$4,558.133"	.	$911.63		
1711	J9225		Vantas implant							
1712		Paclitaxel protein bound		K		$13.298	.	$2.66		
1712	J9264		Paclitaxel protein bound							
1739		"Pegademase bovine, 25 iu"		K		"$1,471.845"	.	$294.37		
1739	J2504		"Pegademase bovine, 25 iu"							
1745		Radium ra223 dichloride ther		K		$140.961	.	$28.20		
1745	A9606		Radium ra223 dichloride the							
1746		Factor xiii recomb a-subunit		K		$15.526	.	$3.11		
1746	J7181		Factor xiii recomb a-subuni							
1747		Monovisc inj per dose		K		$694.582	.	$138.92		
1747	J7327		Monovisc inj per dose							
1748		Inj tbo filgrastim 1 microg		K		$0.470	.	$0.10		
1748	J1447		Inj tbo filgrastim 1 microg							
1761		"Rolapitant, oral, 1mg"		K		$2.266	.	$0.46		
1761	J8670		"Rolapitant, oral, 1mg"							
1809		"Injection, alemtuzumab"		K		"$1,984.320"	.	$396.87		
1809	J0202		"Injection, alemtuzumab"							
1822		"Injection, zarxio"		K		$0.468	.	$0.10		
1822	Q5101		"Injection, zarxio"							
1823		"Injection, dalbavancin"		K		$15.386	.	$3.08		
1823	J0875		"Injection, dalbavancin"							
1824		Ceftaroline fosamil inj		K		$3.322	.	$0.67		
1824	J0712		Ceftaroline fosamil inj							
1825		Ceftazidime and avibactam		K		$92.002	.	$18.41		
1825	J0714		Ceftazidime and avibactam							
1826		Hyqvia 100mg immuneglobulin		K		$14.486	.	$2.90		
1826	J1575		Hyqvia 100mg immuneglobulin							
1827		Factor viii recomb obizur		K		$3.186	.	$0.64		
1827	J7188		Factor viii recomb obizur							
1829		Penicillin g benzathine inj		K		$15.158	.	$3.04		
1829	J0561		Penicillin g benzathine inj							
1832		Dimethyl sulfoxide 50% 50 ml		K		$635.667	.	$127.14		
1832	J1212		Dimethyl sulfoxide 50% 50 m							
1844		Factor viii pegylated recomb		K		$1.874	.	$0.38		
1844	J7207		Factor viii pegylated recom							
1846		Factor viii nuwiq recomb 1iu		K		$1.355	.	$0.28		
1846	J7209		Factor viii nuwiq recomb 1i							
1847		"Injection, inflectra"		K		$43.724	.	$8.75		
1847	Q5103		"Injection, inflectra"							
1848		Artiss fibrin sealant		K		$156.842	.	$31.37		
1848	C9250		Artiss fibrin sealant							
1849		Foscarnet sodium injection		K		$82.268	.	$16.46		
1849	J1455		Foscarnet sodium injection							
1850		Gamma globulin 1 cc inj		K		$42.925	.	$8.59		
1850	J1460		Gamma globulin 1 cc inj							
1851		Gamma globulin > 10 cc inj		K		$429.255	.	$85.86		
1851	J1560		Gamma globulin > 10 cc inj							
1852		Interferon beta-1a inj		K		"$2,276.610"	.	$455.33		
1852	J1826		Interferon beta-1a inj							
1853		Minocycline hydrochloride		K		$1.988	.	$0.40		
1853	J2265		Minocycline hydrochloride							
1854		Pentobarbital sodium inj		K		$33.926	.	$6.79		
1854	J2515		Pentobarbital sodium inj							
1856		Factor viii recomb novoeight		K		$1.325	.	$0.27		
1856	J7182		Factor viii recomb novoeigh							
1857		"Inj, factor x, (human), 1iu"		K		$7.879	.	$1.58		
1857	J7175		"Inj, factor x, (human), 1iu"							
1859		Argatroban nonesrd use 1mg		K		$1.307	.	$0.27		
1859	J0883		Argatroban nonesrd use 1mg							
1861		"Inj., bendeka 1 mg"		K		$20.273	.	$4.06		
1861	J9034		"Inj., bendeka 1 mg"							
1862		Gelsyn-3 injection 0.1 mg		K		$2.177	.	$0.44		
1862	J7328		Gelsyn-3 injection 0.1 mg							
1908		"New Technology - Level 52 ($145,001-$160,000)"		T		"$152,500.50"	.	"$30,500.10"	*	
1908	0100T		Prosth retina receive&gen							
2024		"Generator, CCM, implant"		H						
2024	C1824		"Generator, CCM, implant"							
2025		"Cath, pressure,valve-occlu"		H						
2025	C1982		"Cath, pressure,valve-occlu"							
2026		"Orth/devic/drug bn/bn,tis/bn"		H						
2026	C1734		"'Orth/devic/drug bn/bn,tis/"							
2027		"Probe, robotic, water-jet"		H						
2027	C2596		"Probe, robotic, water-jet"							
2028		Iris prosthesis		H						
2028	C1839		Iris prosthesis							
2029		"Endoscope, single, UGI"		H						
2029	C1748		"'Endoscope, single, ugi'"							
2030		"Gen, neuro, carot sinus baro"		H						
2030	C1825		"Gen, neuro, carot sinus bar"							
2031		"Hemostatic agent, GI, topic"		H						
2031	C1052		"Hemostatic agent, GI, topic"							
2032		Intravertebral fx aug impl		H						
2032	C1062		Intravertebral fx aug impl							
2616		"Brachytx, non-str,Yttrium-90"		U	210.124	"$17,397.64"	.	"$3,479.53"	*	
2616	C2616		"Brachytx, non-str,yttrium-9"							
2632		Iodine I-125 sodium iodide		U	0.3228	$26.73	.	$5.35		
2632	A9527		Iodine i-125 sodium iodide							
2634		"Brachytx, non-str, HA, I-125"		U	1.7886	$148.09	.	$29.62		
2634	C2634		"Brachytx, non-str, ha, i-12"							
2635		"Brachytx, non-str, HA, P-103"		U	0.5501	$45.55	.	$9.11		
2635	C2635		"Brachytx, non-str, ha, p-10"							
2636		"Brachy linear, non-str,P-103"		U	0.3793	$31.41	.	$6.29		
2636	C2636		"Brachy linear, non-str,p-10"							
2638		"Brachytx, stranded, I-125"		U	0.4517	$37.40	.	$7.48		
2638	C2638		"Brachytx, stranded, i-125"							
2639		"Brachytx, non-stranded,I-125"		U	0.4119	$34.10	.	$6.83		
2639	C2639		"Brachytx, non-stranded,i-12"							
2640		"Brachytx, stranded, P-103"		U	1.0598	$87.75	.	$17.55		
2640	C2640		"Brachytx, stranded, p-103"							
2641		"Brachytx, non-stranded,P-103"		U	0.8394	$69.50	.	$13.90		
2641	C2641		"Brachytx, non-stranded,p-10"							
2642		"Brachytx, stranded, C-131"		U	0.8679	$71.86	.	$14.38		
2642	C2642		"Brachytx, stranded, c-131"							
2643		"Brachytx, non-stranded,C-131"		U	0.9705	$80.35	.	$16.08		
2643	C2643		"Brachytx, non-stranded,c-13"							
2645		"Brachytx, non-str, Gold-198"		U	3.4827	$288.36	.	$57.68		
2645	C1716		"Brachytx, non-str, gold-198"							
2646		"Brachytx, non-str, HDR Ir-192"		U	4.0423	$334.69	.	$66.94		
2646	C1717		"Brachytx, non-str,hdr ir-19"							
2647		"Brachytx, NS, Non-HDRIr-192"		U	3.4112	$282.44	.	$56.49		
2647	C1719		"Brachytx, ns, non-hdrir-192"							
2648		"Brachytx planar, p-103"		U	0.0566	$4.69	.	$0.94		
2648	C2645		"Brachytx planar, p-103"							
2698		"Brachytx, stranded, NOS"		U	0.4517	$37.40	.	$7.48		
2698	C2698		"Brachytx, stranded, nos"							
2699		"Brachytx, non-stranded, NOS"		U	0.3793	$31.41	.	$6.29		
2699	C2699		"Brachytx, non-stranded, nos"							
2731		"Immune globulin, powder"		K		$68.303	.	$13.67		
2731	J1566		"Immune globulin, powder"							
2770		Quinupristin/dalfopristin		K		$458.041	.	$91.61		
2770	J2770		Quinupristin/dalfopristin							
2993		"Gen, neuro, trans sen/stim"		H						
2993	C1823		"Gen, neuro, trans sen/stim"							
5012		Clinic Visits and Related Services		V	1.4341	$118.74	.	$23.75		
5012	0604T		Rem oct rta dev setup&educa							
5012	0607T		Rem mntr pulm flu mntr setu							
5012	92002		Eye exam new patient							
5012	92004		Eye exam new patient							
5012	92012		Eye exam establish patient							
5012	92014		Eye exam&tx estab pt 1/>vst							
5012	95250		Cont gluc mntr phys/qhp eqp							
5012	99453		Rem mntr physiol param setu							
5012	99460		Init nb em per day hosp							
5012	99463		Same day nb discharge							
5012	99495		Trans care mgmt 14 day disc							
5012	99496		Trans care mgmt 7 day disch							
5012	G0245		Initial foot exam pt lops							
5012	G0246		Followup eval of foot pt lo							
5012	G0248		Demonstrate use home inr mo							
5012	G0249		Provide inr test mater/equi							
5522	76706		Us abdl aorta screen aaa				$0.00	$0.00		
5012	G0463		Hospital outpt clinic visit							
5021		Level 1 Type A ED Visits		V	0.8768	$72.60	.	$14.52		
5021	99281		Emergency dept visit							
5022		Level 2 Type A ED Visits		V	1.5893	$131.59	.	$26.32		
5022	99282		Emergency dept visit							
5023		Level 3 Type A ED Visits		V	2.7972	$231.60	.	$46.32		
5023	99283		Emergency dept visit							
5024		Level 4 Type A ED Visits		V	4.3931	$363.74	.	$72.75		
5024	90945		Dialysis one evaluation							
5024	99284		Emergency dept visit							
5024	G0175		"Opps service,sched team con"							
5025		Level 5 Type A ED Visits		V	6.306	$522.12	.	$104.43		
5025	99285		Emergency dept visit							
5025	G0379		Direct refer hospital obser							
5031		Level 1 Type B ED Visits		V	0.852	$70.54	.	$14.11		
5031	G0380		Lev 1 hosp type b ed visit							
5032		Level 2 Type B ED Visits		V	1.1523	$95.41	.	$19.09		
5032	G0381		Lev 2 hosp type b ed visit							
5033		Level 3 Type B ED Visits		V	2.1857	$180.97	.	$36.20		
5033	G0382		Lev 3 hosp type b ed visit							
5034		Level 4 Type B ED Visits		V	2.7608	$228.59	.	$45.72		
5034	G0383		Lev 4 hosp type b ed visit							
5035		Level 5 Type B ED Visits		V	3.8454	$318.39	.	$63.68		
5035	G0384		Lev 5 hosp type b ed visit							
5041		Critical Care		S	8.366	$692.68	.	$138.54		
5041	99291		Critical care first hour							
5045		Trauma Response with Critical Care		S	11.3852	$942.66	.	$188.54		
5045	G0390		Trauma respons w/hosp criti							
5051		Level 1 Skin Procedures		T	2.1685	$179.55	.	$35.91		
5051	0447T		Rmvl impltbl glucose sensor							
5051	0512T		Esw integ wnd hlg 1st wnd							
5051	10040		Acne surgery							
5051	10060		Drainage of skin abscess							
5051	11055		Trim skin lesion							
5051	11056		Trim skin lesions 2 to 4							
5051	11057		Trim skin lesions over 4							
5051	11102		Tangntl bx skin single les							
5051	11200		Removal of skin tags <w/15							
5051	11301		Shave skin lesion 0.6-1.0 c							
5051	11302		Shave skin lesion 1.1-2.0 c							
5051	11305		Shave skin lesion 0.5 cm/<							
5051	11306		Shave skin lesion 0.6-1.0 c							
5051	11307		Shave skin lesion 1.1-2.0 c							
5051	11310		Shave skin lesion 0.5 cm/<							
5051	11311		Shave skin lesion 0.6-1.0 c							
5051	11730		Removal of nail plate							
5051	11900		Inject skin lesions </w 7							
5051	11901		Inject skin lesions >7							
5051	11950		Tx contour defects 1 cc/<							
5051	12001		Rpr s/n/ax/gen/trnk 2.5cm/<							
5051	12002		Rpr s/n/ax/gen/trnk2.6-7.5c							
5051	12004		Rpr s/n/ax/gen/trk7.6-12.5c							
5051	12007		Rpr s/n/ax/gen/trnk >30.0 c							
5051	12011		Rpr f/e/e/n/l/m 2.5 cm/<							
5051	12013		Rpr f/e/e/n/l/m 2.6-5.0 cm							
5051	12014		Rpr f/e/e/n/l/m 5.1-7.5 cm							
5051	12015		Rpr f/e/e/n/l/m 7.6-12.5 cm							
5051	12018		Rpr f/e/e/n/l/m >30.0 cm							
5051	15786		Abrasion lesion single							
5051	16000		Initial treatment of burn(s							
5051	16020		Dress/debrid p-thick burn s							
5051	16025		Dress/debrid p-thick burn m							
5051	17000		Destruct premalg lesion							
5051	17110		Destruct b9 lesion 1-14							
5051	17111		Destruct lesion 15 or more							
5051	17250		Chem caut of granltj tissue							
5051	17260		Destruction of skin lesions							
5051	17261		Destruction of skin lesions							
5051	17262		Destruction of skin lesions							
5051	17263		Destruction of skin lesions							
5051	17270		Destruction of skin lesions							
5051	17271		Destruction of skin lesions							
5051	17272		Destruction of skin lesions							
5051	17280		Destruction of skin lesions							
5051	17360		Skin peel therapy							
5051	17999		Skin tissue procedure							
5051	26010		Drainage of finger abscess							
5051	46916		Cryosurgery anal lesion(s)							
5051	54056		Cryosurgery penis lesion(s)							
5051	69220		Clean out mastoid cavity							
5051	96567		Pdt dstr prmlg les skn							
5051	96573		Pdt dstr prmlg les phys/qhp							
5051	96574		Dbrdmt prmlg les w/pdt							
5051	96920		Laser tx skin < 250 sq cm							
5051	96921		Laser tx skin 250-500 sq cm							
5051	96999		Dermatological procedure							
5051	97597		Rmvl devital tis 20 cm/<							
5051	97602		Wound(s) care non-selective							
5051	97605		Neg press wound tx <=50 cm							
5051	97610		Low frequency non-thermal u							
5051	G0247		Routine footcare pt w lops							
5052		Level 2 Skin Procedures		T	4.177	$345.84	.	$69.17		
5052	0491T		Abl lsr opn wnd 1st 20 sqcm							
5052	10021		Fna bx w/o img gdn 1st les							
5052	10061		Drainage of skin abscess							
5052	10120		Remove foreign body							
5052	10160		Puncture drainage of lesion							
5052	11042		Deb subq tissue 20 sq cm/<							
5052	11104		Punch bx skin single lesion							
5052	11300		Shave skin lesion 0.5 cm/<							
5052	11303		Shave skin lesion >2.0 cm							
5052	11308		Shave skin lesion >2.0 cm							
5052	11312		Shave skin lesion 1.1-2.0 c							
5052	11313		Shave skin lesion >2.0 cm							
5052	11401		Exc tr-ext b9+marg 0.6-1 cm							
5052	11602		Exc tr-ext mal+marg 1.1-2 c							
5052	11750		Removal of nail bed							
5052	11765		Excision of nail fold toe							
5052	12005		Rpr s/n/a/gen/trk12.6-20.0c							
5052	12006		Rpr s/n/a/gen/trk20.1-30.0c							
5052	12016		Rpr fe/e/en/l/m 12.6-20.0 c							
5052	12017		Rpr fe/e/en/l/m 20.1-30.0 c							
5052	12021		Closure of split wound							
5052	12031		Intmd rpr s/a/t/ext 2.5 cm/							
5052	12032		Intmd rpr s/a/t/ext 2.6-7.5							
5052	12034		Intmd rpr s/tr/ext 7.6-12.5							
5052	12035		Intmd rpr s/a/t/ext 12.6-20							
5052	12041		Intmd rpr n-hf/genit 2.5cm/							
5052	12042		Intmd rpr n-hf/genit2.6-7.5							
5052	12051		Intmd rpr face/mm 2.5 cm/<							
5052	12052		Intmd rpr face/mm 2.6-5.0 c							
5052	12053		Intmd rpr face/mm 5.1-7.5 c							
5052	12054		Intmd rpr face/mm 7.6-12.5c							
5052	12055		Intmd rpr face/mm 12.6-20 c							
5052	12056		Intmd rpr face/mm 20.1-30.0							
5052	12057		Intmd rpr face/mm >30.0 cm							
5052	13131		Cmplx rpr f/c/c/m/n/ax/g/h/							
5052	15775		Hair trnspl 1-15 punch grft							
5052	15776		Hair trnspl >15 punch graft							
5052	15783		Dermabrasion suprfl any sit							
5052	15788		Chemical peel face epiderm							
5052	15793		Chemical peel nonfacial							
5052	16030		Dress/debrid p-thick burn l							
5052	16035		Incision of burn scab initi							
5052	17004		Destroy premal lesions 15/>							
5052	17106		Destruction of skin lesions							
5052	17264		Destruction of skin lesions							
5052	17266		Destruction of skin lesions							
5052	17273		Destruction of skin lesions							
5052	17274		Destruction of skin lesions							
5052	17276		Destruction of skin lesions							
5052	17281		Destruction of skin lesions							
5052	17282		Destruction of skin lesions							
5052	17283		Destruction of skin lesions							
5052	36468		Njx sclrsnt spider veins							
5052	36470		Njx sclrsnt 1 incmptnt vein							
5052	36471		Njx sclrsnt mlt incmptnt vn							
5052	46900		Destruction anal lesion(s)							
5052	54050		Destruction penis lesion(s)							
5052	96913		Photochemotherapy uv-a or b							
5052	96922		Laser tx skin >500 sq cm							
5052	97606		Neg press wound tx >50 cm							
5052	97607		Neg press wnd tx <=50 sq cm							
5052	97608		Neg press wound tx >50 cm							
5053		Level 3 Skin Procedures		T	6.3308	$524.17	.	$104.84		
5053	0419T		Dstrj neurofibroma xtnsv							
5053	0420T		Dstrj neurofibroma xtnsv							
5053	0479T		Fxjl abl lsr 1st 100 sq cm							
5053	11000		Debride infected skin							
5053	11043		Deb musc/fascia 20 sq cm/<							
5053	11106		Incal bx skn single les							
5053	11760		Repair of nail bed							
5053	11920		Correct skin color 6.0 cm/<							
5053	11921		Correct skn color 6.1-20.0c							
5053	11951		Tx contour defects 1.1-5.0c							
5053	11952		Tx contour defects 5.1-10cc							
5053	11954		Tx contour defects >10.0 cc							
5053	12020		Closure of split wound							
5053	12036		Intmd rpr s/a/t/ext 20.1-30							
5053	12044		Intmd rpr n-hf/genit7.6-12.							
5053	12045		Intmd rpr n-hf/genit12.6-20							
5053	12046		Intmd rpr n-hf/genit20.1-30							
5053	13100		Cmplx rpr trunk 1.1-2.5 cm							
5053	13101		Cmplx rpr trunk 2.6-7.5 cm							
5053	13120		Cmplx rpr s/a/l 1.1-2.5 cm							
5053	13121		Cmplx rpr s/a/l 2.6-7.5 cm							
5053	13132		Cmplx rpr f/c/c/m/n/ax/g/h/							
5053	13151		Cmplx rpr e/n/e/l 1.1-2.5 c							
5053	13152		Cmplx rpr e/n/e/l 2.6-7.5 c							
5053	15004		Wound prep f/n/hf/g							
5053	15050		Skin pinch graft							
5053	15789		Chemical peel face dermal							
5053	15792		Chemical peel nonfacial							
5053	15850		Remove sutures same surgeon							
5053	15852		Dressing change not for bur							
5053	17107		Destruction of skin lesions							
5053	17284		Destruction of skin lesions							
5053	17286		Destruction of skin lesions							
5053	17311		Mohs 1 stage h/n/hf/g							
5053	17313		Mohs 1 stage t/a/l							
5053	17380		Hair removal by electrolysi							
5053	20910		Remove cartilage for graft							
5053	C5271		Low cost skin substitute ap							
5053	C5275		Low cost skin substitute ap							
5053	C5277		Low cost skin substitute ap							
5054		Level 4 Skin Procedures		T	20.7177	"$1,715.36"	.	$343.08		
5054	0416T		Reloc skin pocket pls gen							
5054	0446T		Insj impltbl glucose sensor							
5054	0448T		Remvl insj impltbl gluc sen							
5054	11762		Reconstruction of nail bed							
5054	12037		Intmd rpr s/tr/ext >30.0 cm							
5054	12047		Intmd rpr n-hf/genit >30.0c							
5054	13160		Late closure of wound							
5054	14000		Tis trnfr trunk 10 sq cm/<							
5054	14001		Tis trnfr trunk 10.1-30sqcm							
5054	14020		Tis trnfr s/a/l 10 sq cm/<							
5054	14021		Tis trnfr s/a/l 10.1-30 sqc							
5054	14040		Tis trnfr f/c/c/m/n/a/g/h/f							
5054	14041		Tis trnfr f/c/c/m/n/a/g/h/f							
5054	14060		Tis trnfr e/n/e/l 10 sq cm/							
5054	14061		Tis trnfr e/n/e/l10.1-30sqc							
5054	14350		Filleted finger/toe flap							
5054	15002		Wound prep trk/arm/leg							
5054	15040		Harvest cultured skin graft							
5054	15100		Skin splt grft trnk/arm/leg							
5054	15110		Epidrm autogrft trnk/arm/le							
5054	15115		Epidrm a-grft face/nck/hf/g							
5054	15130		Derm autograft trnk/arm/leg							
5054	15150		Cult skin grft t/arm/leg							
5054	15200		Skin full graft trunk							
5054	15220		Skin full graft sclp/arm/le							
5054	15240		Skin full grft face/genit/h							
5054	15260		Skin full graft een & lips							
5054	15271		Skin sub graft trnk/arm/leg							
5054	15275		Skin sub graft face/nk/hf/g							
5054	15277		Skn sub grft f/n/hf/g child							
5054	15570		Skin pedicle flap trunk							
5054	15574		Pedcle fh/ch/ch/m/n/ax/g/h/							
5054	15576		Pedicle e/n/e/l/ntroral							
5054	15610		Delay flap arms/legs							
5054	15620		Delay flap f/c/c/n/ax/g/h/f							
5054	15630		Delay flap eye/nos/ear/lip							
5054	15650		Transfer skin pedicle flap							
5054	15736		Muscle-skin graft arm							
5054	15740		Island pedicle flap graft							
5054	15760		Composite skin graft							
5054	15773		Grfg autol fat lipo 25 cc/<							
5054	15819		Plastic surgery neck							
5054	15820		Revision of lower eyelid							
5054	15821		Revision of lower eyelid							
5054	15822		Revision of upper eyelid							
5054	15823		Revision of upper eyelid							
5054	15824		Removal of forehead wrinkle							
5054	15842		Nerve palsy microsurg graft							
5054	15851		Remove sutures diff surgeon							
5054	15878		Suction lipectomy upr extre							
5054	15936		Remove sacrum pressure sore							
5054	15937		Remove sacrum pressure sore							
5054	15945		Remove hip pressure sore							
5054	15946		Remove hip pressure sore							
5054	15952		Remove thigh pressure sore							
5054	15956		Remove thigh pressure sore							
5054	17108		Destruction of skin lesions							
5054	20101		Explore wound chest							
5054	20102		Explore wound abdomen							
5054	20920		Removal of fascia for graft							
5054	20922		Removal of fascia for graft							
5054	23921		Amputation follow-up surger							
5054	25929		Amputation follow-up surger							
5054	33222		Relocation pocket pacemaker							
5054	33223		Relocate pocket for defib							
5054	36465		Njx noncmpnd sclrsnt 1 vein							
5054	36466		Njx noncmpnd sclrsnt mlt vn							
5054	43887		Remove gastric port open							
5054	46910		Destruction anal lesion(s)							
5054	54055		Destruction penis lesion(s)							
5054	54057		Laser surg penis lesion(s)							
5054	54060		Excision of penis lesion(s)							
5054	54065		Destruction penis lesion(s)							
5054	56501		Destroy vulva lesions sim							
5054	56515		Destroy vulva lesion/s comp							
5054	C5273		Low cost skin substitute ap							
5054	G0429		Dermal filler injection(s)							
5054	G0460		Autologous prp for ulcers							
5055		Level 5 Skin Procedures		T	42.5396	"$3,522.15"	.	$704.44		
5055	11960		Insert tissue expander(s)							
5055	14301		Tis trnfr any 30.1-60 sq cm							
5055	15120		Skn splt a-grft fac/nck/hf/							
5055	15135		Derm autograft face/nck/hf/							
5055	15155		Cult skin graft f/n/hf/g							
5055	15273		Skin sub grft t/arm/lg chil							
5055	15572		Skin pedicle flap arms/legs							
5055	15600		Delay flap trunk							
5055	15730		Mdfc flap w/prsrv vasc pedc							
5055	15731		Forehead flap w/vasc pedicl							
5055	15733		Musc myoq/fscq flp h&n pedc							
5055	15734		Muscle-skin graft trunk							
5055	15738		Muscle-skin graft leg							
5055	15750		Neurovascular pedicle flap							
5055	15769		Grfg autol soft tiss dir ex							
5055	15770		Derma-fat-fascia graft							
5055	15771		Grfg autol fat lipo 50 cc/<							
5055	15825		Removal of neck wrinkles							
5055	15826		Removal of brow wrinkles							
5055	15828		Removal of face wrinkles							
5055	15829		Removal of skin wrinkles							
5055	15840		Nerve palsy fascial graft							
5055	15841		Nerve palsy muscle graft							
5055	15845		Skin and muscle repair face							
5055	15876		Suction lipectomy head&neck							
5055	15877		Suction lipectomy trunk							
5055	15879		Suction lipectomy lwr extre							
5055	15922		Removal of tail bone ulcer							
5055	15934		Remove sacrum pressure sore							
5055	15935		Remove sacrum pressure sore							
5055	15944		Remove hip pressure sore							
5055	15953		Remove thigh pressure sore							
5055	15958		Remove thigh pressure sore							
5055	20912		Remove cartilage for graft							
5055	43886		Revise gastric port open							
5055	43888		Change gastric port open							
5055	44312		Revision of ileostomy							
5055	44314		Revision of ileostomy							
5055	44340		Revision of colostomy							
5061		Hyperbaric Oxygen		S	1.4406	$119.28	.	$23.86		
5061	G0277		"Hbot, full body chamber, 30"							
5071		Level 1 Excision/ Biopsy/ Incision and Drainage		T	7.512	$621.97	.	$124.40		
5071	10005		Fna bx w/us gdn 1st les							
5071	10007		Fna bx w/fluor gdn 1st les							
5071	10009		Fna bx w/ct gdn 1st les							
5071	10011		Fna bx w/mr gdn 1st les							
5071	10030		Guide cathet fluid drainage							
5071	10035		Perq dev soft tiss 1st imag							
5071	10080		Drainage of pilonidal cyst							
5071	10081		Drainage of pilonidal cyst							
5071	11010		Debride skin at fx site							
5071	11011		Debride skin musc at fx sit							
5071	11400		Exc tr-ext b9+marg 0.5 cm<							
5071	11402		Exc tr-ext b9+marg 1.1-2 cm							
5071	11403		Exc tr-ext b9+marg 2.1-3cm							
5071	11421		Exc h-f-nk-sp b9+marg 0.6-1							
5071	11440		Exc face-mm b9+marg 0.5 cm/							
5071	11441		Exc face-mm b9+marg 0.6-1 c							
5071	11442		Exc face-mm b9+marg 1.1-2 c							
5071	11600		Exc tr-ext mal+marg 0.5 cm/							
5071	11601		Exc tr-ext mal+marg 0.6-1 c							
5071	11603		Exc tr-ext mal+marg 2.1-3 c							
5071	11604		Exc tr-ext mal+marg 3.1-4 c							
5071	11621		Exc s/n/h/f/g mal+mrg 0.6-1							
5071	11622		Exc s/n/h/f/g mal+mrg 1.1-2							
5071	11640		Exc f/e/e/n/l mal+mrg 0.5cm							
5071	11641		Exc f/e/e/n/l mal+mrg 0.6-1							
5071	11642		Exc f/e/e/n/l mal+mrg 1.1-2							
5071	11755		Biopsy nail unit							
5071	11976		Remove contraceptive capsul							
5071	15781		Dermabrasion segmental face							
5071	15999		Removal of pressure sore							
5071	19000		Drainage of breast lesion							
5071	19281		Perq device breast 1st imag							
5071	19283		Perq dev breast 1st strtctc							
5071	19285		Perq dev breast 1st us imag							
5071	19287		Perq dev breast 1st mr guid							
5071	20103		Explore wound extremity							
5071	20615		Treatment of bone cyst							
5071	20950		Fluid pressure muscle							
5071	21725		Revision of neck muscle							
5071	23330		Remove shoulder foreign bod							
5071	28190		Removal of foot foreign bod							
5071	33286		Rmvl subq car rhythm mntr							
5071	35226		Repair blood vessel lesion							
5071	40800		Drainage of mouth lesion							
5071	42400		Biopsy of salivary gland							
5071	47399		Liver surgery procedure							
5071	48999		Pancreas surgery procedure							
5071	49185		Sclerotx fluid collection							
5071	50390		Drainage of kidney lesion							
5071	55000		Drainage of hydrocele							
5071	60100		Biopsy of thyroid							
5071	60300		Aspir/inj thyroid cyst							
5071	62267		Interdiscal perq aspir dx							
5071	69000		Drain external ear lesion							
5071	69020		Drain outer ear canal lesio							
5072		Level 2 Excision/ Biopsy/ Incision and Drainage		J1	16.9934	"$1,407.00"	.	$281.41		
5072	10121		Remove foreign body							
5072	10140		Drainage of hematoma/fluid							
5072	11044		Deb bone 20 sq cm/<							
5072	11404		Exc tr-ext b9+marg 3.1-4 cm							
5072	11406		Exc tr-ext b9+marg >4.0 cm							
5072	11420		Exc h-f-nk-sp b9+marg 0.5/<							
5072	11422		Exc h-f-nk-sp b9+marg 1.1-2							
5072	11423		Exc h-f-nk-sp b9+marg 2.1-3							
5072	11424		Exc h-f-nk-sp b9+marg 3.1-4							
5072	11443		Exc face-mm b9+marg 2.1-3 c							
5072	11444		Exc face-mm b9+marg 3.1-4 c							
5072	11606		Exc tr-ext mal+marg >4 cm							
5072	11620		Exc h-f-nk-sp mal+marg 0.5/							
5072	11623		Exc s/n/h/f/g mal+mrg 2.1-3							
5072	11624		Exc s/n/h/f/g mal+mrg 3.1-4							
5072	11643		Exc f/e/e/n/l mal+mrg 2.1-3							
5072	11644		Exc f/e/e/n/l mal+mrg 3.1-4							
5072	15950		Remove thigh pressure sore							
5072	19020		Incision of breast lesion							
5072	19081		Bx breast 1st lesion strtct							
5072	19083		Bx breast 1st lesion us ima							
5072	19085		Bx breast 1st lesion mr ima							
5072	19100		Bx breast percut w/o image							
5072	20200		Muscle biopsy							
5072	20206		Needle biopsy muscle							
5072	20220		Bone biopsy trocar/needle							
5072	20225		Bone biopsy trocar/needle							
5072	20520		Removal of foreign body							
5072	20670		Removal of support implant							
5072	21011		Exc face les sc <2 cm							
5072	21012		Exc face les sbq 2 cm/>							
5072	21013		Exc face tum deep < 2 cm							
5072	21550		Biopsy of neck/chest							
5072	21555		Exc neck les sc < 3 cm							
5072	21920		Biopsy soft tissue of back							
5072	21925		Biopsy soft tissue of back							
5072	21930		Exc back les sc < 3 cm							
5072	21931		Exc back les sc 3 cm/>							
5072	22902		Exc abd les sc < 3 cm							
5072	23065		Biopsy shoulder tissues							
5072	23071		Exc shoulder les sc 3 cm/>							
5072	23075		Exc shoulder les sc < 3 cm							
5072	23931		Drainage of arm bursa							
5072	24065		Biopsy arm/elbow soft tissu							
5072	24075		Exc arm/elbow les sc < 3 cm							
5072	24200		Removal of arm foreign body							
5072	25065		Biopsy forearm soft tissues							
5072	25071		Exc forearm les sc 3 cm/>							
5072	25075		Exc forearm les sc < 3 cm							
5072	25076		Exc forearm tum deep < 3 cm							
5072	26011		Drainage of finger abscess							
5072	26111		Exc hand les sc 1.5 cm/>							
5072	26113		Exc hand tum deep 1.5 cm/>							
5072	26115		Exc hand les sc < 1.5 cm							
5072	26116		Exc hand tum deep < 1.5 cm							
5072	26320		Removal of implant from han							
5072	27040		Biopsy of soft tissues							
5072	27041		Biopsy of soft tissues							
5072	27323		Biopsy thigh soft tissues							
5072	27327		Exc thigh/knee les sc < 3 c							
5072	27613		Biopsy lower leg soft tissu							
5072	27618		Exc leg/ankle tum < 3 cm							
5072	28001		Drainage of bursa of foot							
5072	28043		Exc foot/toe tum sc < 1.5 c							
5072	28192		Removal of foot foreign bod							
5072	28193		Removal of foot foreign bod							
5072	32400		Needle biopsy chest lining							
5072	32408		Core ndl bx lng/med perq							
5072	37609		Temporal artery procedure							
5072	38220		Dx bone marrow aspirations							
5072	38221		Dx bone marrow biopsies							
5072	38505		Needle biopsy lymph nodes							
5072	41108		Biopsy of floor of mouth							
5072	47000		Needle biopsy of liver							
5072	48102		Needle biopsy pancreas							
5072	49180		Biopsy abdominal mass							
5072	49405		Image cath fluid colxn visc							
5072	49406		Image cath fluid peri/retro							
5072	49407		Image cath fluid trns/vgnl							
5072	50200		Renal biopsy perq							
5072	54015		Drain penis lesion							
5072	54100		Biopsy of penis							
5072	54800		Biopsy of epididymis							
5072	55100		Drainage of scrotum abscess							
5072	62269		Needle biopsy spinal cord							
5072	69005		Drain external ear lesion							
5072	69205		Clear outer ear canal							
5073		Level 3 Excision/ Biopsy/ Incision and Drainage		J1	28.6243	"$2,370.01"	.	$474.01		
5073	10180		Complex drainage wound							
5073	11012		Deb skin bone at fx site							
5073	11426		Exc h-f-nk-sp b9+marg >4 cm							
5073	11446		Exc face-mm b9+marg >4 cm							
5073	11450		Removal sweat gland lesion							
5073	11451		Removal sweat gland lesion							
5073	11462		Removal sweat gland lesion							
5073	11463		Removal sweat gland lesion							
5073	11470		Removal sweat gland lesion							
5073	11471		Removal sweat gland lesion							
5073	11626		Exc s/n/h/f/g mal+mrg >4 cm							
5073	11646		Exc f/e/e/n/l mal+mrg >4 cm							
5073	11770		Remove pilonidal cyst simpl							
5073	11771		Remove pilonidal cyst exten							
5073	11772		Remove pilonidal cyst compl							
5073	11971		Remove tissue expander(s)							
5073	15780		Dermabrasion total face							
5073	15782		Dermabrasion other than fac							
5073	15832		Excise excessive skin thigh							
5073	15833		Excise excessive skin leg							
5073	15834		Excise excessive skin hip							
5073	15835		Excise excessive skin buttc							
5073	15836		Excise excessive skin arm							
5073	15837		Excise excess skin arm/hand							
5073	15838		Excise excess skin fat pad							
5073	15839		Excise excess skin & tissue							
5073	15920		Removal of tail bone ulcer							
5073	15931		Remove sacrum pressure sore							
5073	15933		Remove sacrum pressure sore							
5073	15940		Remove hip pressure sore							
5073	15941		Remove hip pressure sore							
5073	15951		Remove thigh pressure sore							
5073	20205		Deep muscle biopsy							
5073	20240		Bone biopsy open superficia							
5073	20245		Bone biopsy open deep							
5073	20525		Removal of foreign body							
5073	20680		Removal of support implant							
5073	21014		Exc face tum deep 2 cm/>							
5073	21015		Resect face/scalp tum < 2 c							
5073	21016		Resect face/scalp tum 2 cm/							
5073	21501		Drain neck/chest lesion							
5073	21552		Exc neck les sc 3 cm/>							
5073	21554		Exc neck tum deep 5 cm/>							
5073	21556		Exc neck tum deep < 5 cm							
5073	21557		Resect neck thorax tumor<5c							
5073	21558		Resect neck tumor 5 cm/>							
5073	21601		Exc chest wall tumor w/ribs							
5073	21932		Exc back tum deep < 5 cm							
5073	21933		Exc back tum deep 5 cm/>							
5073	21935		Resect back tum < 5 cm							
5073	21936		Resect back tum 5 cm/>							
5073	22900		Exc abdl tum deep < 5 cm							
5073	22901		Exc abdl tum deep 5 cm/>							
5073	22903		Exc abd les sc 3 cm/>							
5073	22904		Radical resect abd tumor<5c							
5073	22905		Rad resect abd tumor 5 cm/>							
5073	23000		Removal of calcium deposits							
5073	23030		Drain shoulder lesion							
5073	23031		Drain shoulder bursa							
5073	23066		Biopsy shoulder tissues							
5073	23073		Exc shoulder tum deep 5 cm/							
5073	23076		Exc shoulder tum deep < 5 c							
5073	23077		Resect shoulder tumor < 5 c							
5073	23078		Resect shoulder tumor 5 cm/							
5073	23333		Remove shoulder fb deep							
5073	23334		Shoulder prosthesis removal							
5073	23335		Shoulder prosthesis removal							
5073	23930		Drainage of arm lesion							
5073	24066		Biopsy arm/elbow soft tissu							
5073	24071		Exc arm/elbow les sc 3 cm/>							
5073	24073		Ex arm/elbow tum deep 5 cm/							
5073	24076		Ex arm/elbow tum deep < 5 c							
5073	24077		Resect arm/elbow tum < 5 cm							
5073	24079		Resect arm/elbow tum 5 cm/>							
5073	24201		Removal of arm foreign body							
5073	25066		Biopsy forearm soft tissues							
5073	25073		Exc forearm tum deep 3 cm/>							
5073	25077		Resect forearm/wrist tum<3c							
5073	25078		Resect forarm/wrist tum 3cm							
5073	26117		Rad resect hand tumor < 3 c							
5073	26118		Rad resect hand tumor 3 cm/							
5073	27043		Exc hip pelvis les sc 3 cm/							
5073	27045		Exc hip/pelv tum deep 5 cm/							
5073	27047		Exc hip/pelvis les sc < 3 c							
5073	27048		Exc hip/pelv tum deep < 5 c							
5073	27049		Resect hip/pelv tum < 5 cm							
5073	27059		Resect hip/pelv tum 5 cm/>							
5073	27086		Remove hip foreign body							
5073	27090		Removal of hip prosthesis							
5073	27091		Removal of hip prosthesis							
5073	27301		Drain thigh/knee lesion							
5073	27324		Biopsy thigh soft tissues							
5073	27328		Exc thigh/knee tum deep <5c							
5073	27329		Resect thigh/knee tum < 5 c							
5073	27337		Exc thigh/knee les sc 3 cm/							
5073	27339		Exc thigh/knee tum dep 5cm/							
5073	27364		Resect thigh/knee tum 5 cm/							
5073	27372		Removal of foreign body							
5073	27603		Drain lower leg lesion							
5073	27614		Biopsy lower leg soft tissu							
5073	27615		Resect leg/ankle tum < 5 cm							
5073	27616		Resect leg/ankle tum 5 cm/>							
5073	27619		Exc leg/ankle tum deep <5 c							
5073	27632		Exc leg/ankle les sc 3 cm/>							
5073	27634		Exc leg/ankle tum dep 5 cm/							
5073	28039		Exc foot/toe tum sc 1.5 cm/							
5073	28041		Exc foot/toe tum dep 1.5cm/							
5073	28045		Exc foot/toe tum deep <1.5c							
5073	28046		Resect foot/toe tumor < 3 c							
5073	28047		Resect foot/toe tumor 3 cm/							
5073	38222		Dx bone marrow bx & aspir							
5073	38300		Drainage lymph node lesion							
5073	38305		Drainage lymph node lesion							
5073	51080		Drainage of bladder abscess							
5073	54105		Biopsy of penis							
5073	54115		Treatment of penis lesion							
5073	54500		Biopsy of testis							
5073	57022		I & d vaginal hematoma pp							
5073	57023		I & d vag hematoma non-ob							
5073	69110		Remove external ear partial							
5073	69145		Remove ear canal lesion(s)							
5091		Level 1 Breast/Lymphatic Surgery and Related Procedures		J1	38.1383	"$3,157.74"	.	$631.55		
5091	19101		Biopsy of breast open							
5091	19105		Cryosurg ablate fa each							
5091	19110		Nipple exploration							
5091	19112		Excise breast duct fistula							
5091	19120		Removal of breast lesion							
5091	19125		Excision breast lesion							
5091	19300		Removal of breast tissue							
5091	19301		Partial mastectomy							
5091	19328		Removal of breast implant							
5091	19330		Removal of implant material							
5091	19350		Breast reconstruction							
5091	19355		Correct inverted nipple(s)							
5091	19370		Surgery of breast capsule							
5091	19371		Removal of breast capsule							
5091	19396		Design custom breast implan							
5091	19499		Breast surgery procedure							
5091	38308		Incision of lymph channels							
5091	38500		Biopsy/removal lymph nodes							
5091	38510		Biopsy/removal lymph nodes							
5091	38520		Biopsy/removal lymph nodes							
5091	38525		Biopsy/removal lymph nodes							
5091	38530		Biopsy/removal lymph nodes							
5091	38531		Open bx/exc inguinofem node							
5091	38550		Removal neck/armpit lesion							
5092		Level 2 Breast/Lymphatic Surgery and Related Procedures		J1	66.8375	"$5,533.94"	.	"$1,106.79"		
5092	15830		Exc skin abd							
5092	19298		Place breast rad tube/caths							
5092	19302		P-mastectomy w/ln removal							
5092	19303		Mast simple complete							
5092	19307		Mast mod rad							
5092	19316		Suspension of breast							
5092	19318		Reduction of large breast							
5092	19340		Immediate breast prosthesis							
5092	19380		Revise breast reconstruction							
5092	38555		Removal neck/armpit lesion							
5092	38700		Removal of lymph nodes neck							
5092	38760		Remove groin lymph nodes							
5093		Level 3 Breast/Lymphatic Surgery and Related Procedures		J1	107.7339	"$8,920.04"	.	"$1,784.01"	*	
5093	19296		Place po breast cath for ra							
5093	19325		Enlarge breast with implant							
5093	19342		Delayed breast prosthesis							
5093	38720		Removal of lymph nodes neck							
5094		Level 4 Breast/Lymphatic Surgery and Related Procedures		J1	180.3049	"$14,928.71"	.	"$2,985.75"	*	
5094	19357		Breast reconstruction							
5101		Level 1 Strapping and Cast Application		T	1.7051	$141.18	.	$28.24		
5101	29044		Application of body cast							
5101	29085		Apply hand/wrist cast							
5101	29086		Apply finger cast							
5101	29105		Apply long arm splint							
5101	29200		Strapping of chest							
5101	29440		Addition of walker to cast							
5101	29450		Application of leg cast							
5101	29505		Application long leg splint							
5101	29515		Application lower leg splin							
5101	29540		Strapping of ankle and/or f							
5101	29580		Application of paste boot							
5101	29581		Apply multlay comprs lwr le							
5101	29584		Appl multlay comprs arm/han							
5101	29720		Repair of body cast							
5101	29730		Windowing of cast							
5101	29799		Casting/strapping procedure							
5102		Level 2 Strapping and Cast Application		T	2.9128	$241.17	.	$48.24		
5102	26775		Treat finger dislocation							
5102	28665		Treat toe dislocation							
5102	29000		Application of body cast							
5102	29010		Application of body cast							
5102	29015		Application of body cast							
5102	29035		Application of body cast							
5102	29040		Application of body cast							
5102	29046		Application of body cast							
5102	29049		Application of figure eight							
5102	29055		Application of shoulder cas							
5102	29058		Application of shoulder cas							
5102	29065		Application of long arm cas							
5102	29075		Application of forearm cast							
5102	29305		Application of hip cast							
5102	29325		Application of hip casts							
5102	29345		Application of long leg cas							
5102	29355		Application of long leg cas							
5102	29358		Apply long leg cast brace							
5102	29365		Application of long leg cas							
5102	29405		Apply short leg cast							
5102	29425		Apply short leg cast							
5102	29435		Apply short leg cast							
5102	29445		Apply rigid leg cast							
5102	29700		Removal/revision of cast							
5102	29705		Removal/revision of cast							
5102	29710		Removal/revision of cast							
5102	29740		Wedging of cast							
5102	29750		Wedging of clubfoot cast							
5111		Level 1 Musculoskeletal Procedures		T	2.4903	$206.19	.	$41.24		
5111	20999		Musculoskeletal surgery							
5111	21310		Closed tx nose fx w/o manj							
5111	21480		Reset dislocated jaw							
5111	21820		Treat sternum fracture							
5111	22310		Closed tx vert fx w/o manj							
5111	22899		Spine surgery procedure							
5111	22999		Abdomen surgery procedure							
5111	23500		Treat clavicle fracture							
5111	23525		Treat clavicle dislocation							
5111	23540		Treat clavicle dislocation							
5111	23545		Treat clavicle dislocation							
5111	23570		Treat shoulder blade fx							
5111	23600		Treat humerus fracture							
5111	23620		Treat humerus fracture							
5111	23650		Treat shoulder dislocation							
5111	23929		Shoulder surgery procedure							
5111	24500		Treat humerus fracture							
5111	24530		Treat humerus fracture							
5111	24560		Treat humerus fracture							
5111	24576		Treat humerus fracture							
5111	24600		Treat elbow dislocation							
5111	24640		Treat elbow dislocation							
5111	24650		Treat radius fracture							
5111	24670		Treat ulnar fracture							
5111	24999		Upper arm/elbow surgery							
5111	25500		Treat fracture of radius							
5111	25530		Treat fracture of ulna							
5111	25535		Treat fracture of ulna							
5111	25560		Treat fracture radius & uln							
5111	25600		Treat fracture radius/ulna							
5111	25622		Treat wrist bone fracture							
5111	25630		Treat wrist bone fracture							
5111	25650		Treat wrist bone fracture							
5111	25660		Treat wrist dislocation							
5111	25675		Treat wrist dislocation							
5111	25680		Treat wrist fracture							
5111	25999		Forearm or wrist surgery							
5111	26341		Manipulat palm cord post in							
5111	26600		Treat metacarpal fracture							
5111	26605		Treat metacarpal fracture							
5111	26641		Treat thumb dislocation							
5111	26670		Treat hand dislocation							
5111	26700		Treat knuckle dislocation							
5111	26720		Treat finger fracture each							
5111	26725		Treat finger fracture each							
5111	26740		Treat finger fracture each							
5111	26750		Treat finger fracture each							
5111	26755		Treat finger fracture each							
5111	26770		Treat finger dislocation							
5111	26989		Hand/finger surgery							
5111	27197		Clsd tx pelvic ring fx							
5111	27198		Clsd tx pelvic ring fx							
5111	27200		Treat tail bone fracture							
5111	27220		Treat hip socket fracture							
5111	27222		Treat hip socket fracture							
5111	27230		Treat thigh fracture							
5111	27246		Treat thigh fracture							
5111	27250		Treat hip dislocation							
5111	27256		Treat hip dislocation							
5111	27265		Treat hip dislocation							
5111	27299		Pelvis/hip joint surgery							
5111	27500		Treatment of thigh fracture							
5111	27501		Treatment of thigh fracture							
5111	27508		Treatment of thigh fracture							
5111	27516		Treat thigh fx growth plate							
5111	27520		Treat kneecap fracture							
5111	27530		Treat knee fracture							
5111	27538		Treat knee fracture(s)							
5111	27550		Treat knee dislocation							
5111	27560		Treat kneecap dislocation							
5111	27562		Treat kneecap dislocation							
5111	27599		Leg surgery procedure							
5111	27750		Treatment of tibia fracture							
5111	27760		Cltx medial ankle fx							
5111	27767		Cltx post ankle fx							
5111	27780		Treatment of fibula fractur							
5111	27786		Treatment of ankle fracture							
5111	27788		Treatment of ankle fracture							
5111	27808		Treatment of ankle fracture							
5111	27816		Treatment of ankle fracture							
5111	27824		Treat lower leg fracture							
5111	27830		Treat lower leg dislocation							
5111	27840		Treat ankle dislocation							
5111	27899		Leg/ankle surgery procedure							
5111	28400		Treatment of heel fracture							
5111	28405		Treatment of heel fracture							
5111	28430		Treatment of ankle fracture							
5111	28450		Treat midfoot fracture each							
5111	28470		Treat metatarsal fracture							
5111	28475		Treat metatarsal fracture							
5111	28490		Treat big toe fracture							
5111	28495		Treat big toe fracture							
5111	28510		Treatment of toe fracture							
5111	28515		Treatment of toe fracture							
5111	28530		Treat sesamoid bone fractur							
5111	28540		Treat foot dislocation							
5111	28570		Treat foot dislocation							
5111	28600		Treat foot dislocation							
5111	28605		Treat foot dislocation							
5111	28630		Treat toe dislocation							
5111	28660		Treat toe dislocation							
5111	28899		Foot/toes surgery procedure							
5111	29999		Arthroscopy of joint							
5112		Level 2 Musculoskeletal Procedures		J1	16.8164	"$1,392.35"	.	$278.47		
5112	20660		Apply rem fixation device							
5112	20662		Application of pelvis brace							
5112	20694		Remove bone fixation device							
5112	20697		Comp ext fixate strut chang							
5112	20822		Replantation digit complete							
5112	21813		Treatment of rib fracture							
5112	22505		Manipulation of spine							
5112	23035		Drain shoulder bone lesion							
5112	23505		Treat clavicle fracture							
5112	23520		Treat clavicle dislocation							
5112	23575		Treat shoulder blade fx							
5112	23605		Treat humerus fracture							
5112	23625		Treat humerus fracture							
5112	23655		Treat shoulder dislocation							
5112	23665		Treat dislocation/fracture							
5112	23675		Treat dislocation/fracture							
5112	23700		Fixation of shoulder							
5112	24300		Manipulate elbow w/anesth							
5112	24505		Treat humerus fracture							
5112	24535		Treat humerus fracture							
5112	24565		Treat humerus fracture							
5112	24566		Treat humerus fracture							
5112	24577		Treat humerus fracture							
5112	24605		Treat elbow dislocation							
5112	24620		Treat elbow fracture							
5112	24655		Treat radius fracture							
5112	24675		Treat ulnar fracture							
5112	25000		Incision of tendon sheath							
5112	25020		Decompress forearm 1 space							
5112	25025		Decompress forearm 2 spaces							
5112	25031		Drainage of forearm bursa							
5112	25110		Remove wrist tendon lesion							
5112	25111		Remove wrist tendon lesion							
5112	25112		Reremove wrist tendon lesio							
5112	25115		Remove wrist/forearm lesion							
5112	25118		Excise wrist tendon sheath							
5112	25125		Remove/graft forearm lesion							
5112	25248		Remove forearm foreign body							
5112	25250		Removal of wrist prosthesis							
5112	25259		Manipulate wrist w/anesthes							
5112	25505		Treat fracture of radius							
5112	25520		Treat fracture of radius							
5112	25565		Treat fracture radius & uln							
5112	25605		Treat fracture radius/ulna							
5112	25624		Treat wrist bone fracture							
5112	25635		Treat wrist bone fracture							
5112	25690		Treat wrist dislocation							
5112	25922		Amputate hand at wrist							
5112	26034		Treat hand bone lesion							
5112	26040		Release palm contracture							
5112	26055		Incise finger tendon sheath							
5112	26060		Incision of finger tendon							
5112	26070		Explore/treat hand joint							
5112	26080		Explore/treat finger joint							
5112	26110		Biopsy finger joint lining							
5112	26140		Revise finger joint each							
5112	26145		Tendon excision palm/finger							
5112	26160		Remove tendon sheath lesion							
5112	26170		Removal of palm tendon each							
5112	26180		Removal of finger tendon							
5112	26185		Remove finger bone							
5112	26200		Remove hand bone lesion							
5112	26210		Removal of finger lesion							
5112	26235		Partial removal finger bone							
5112	26236		Partial removal finger bone							
5112	26262		Resect distal finger tumor							
5112	26340		Manipulate finger w/anesth							
5112	26410		Repair hand tendon							
5112	26418		Repair finger tendon							
5112	26432		Repair finger tendon							
5112	26440		Release palm/finger tendon							
5112	26455		Incision of finger tendon							
5112	26460		Incise hand/finger tendon							
5112	26474		Fusion of finger tendons							
5112	26525		Release finger contracture							
5112	26560		Repair of web finger							
5112	26590		Repair finger deformity							
5112	26645		Treat thumb fracture							
5112	26675		Treat hand dislocation							
5112	26705		Treat knuckle dislocation							
5112	26742		Treat finger fracture each							
5112	26991		Drainage of pelvis bursa							
5112	27000		Incision of hip tendon							
5112	27050		Biopsy of sacroiliac joint							
5112	27052		Biopsy of hip joint							
5112	27057		Buttock fasciotomy w/dbrdmt							
5112	27232		Treat thigh fracture							
5112	27238		Treat thigh fracture							
5112	27240		Treat thigh fracture							
5112	27252		Treat hip dislocation							
5112	27257		Treat hip dislocation							
5112	27266		Treat hip dislocation							
5112	27269		Optx thigh fx							
5112	27275		Manipulation of hip joint							
5112	27498		Decompression of thigh/knee							
5112	27502		Treatment of thigh fracture							
5112	27503		Treatment of thigh fracture							
5112	27510		Treatment of thigh fracture							
5112	27517		Treat thigh fx growth plate							
5112	27552		Treat knee dislocation							
5112	27570		Fixation of knee joint							
5112	27605		Incision of achilles tendon							
5112	27752		Treatment of tibia fracture							
5112	27762		Cltx med ankle fx w/mnpj							
5112	27768		Cltx post ankle fx w/mnpj							
5112	27781		Treatment of fibula fractur							
5112	27810		Treatment of ankle fracture							
5112	27818		Treatment of ankle fracture							
5112	27825		Treat lower leg fracture							
5112	27842		Treat ankle dislocation							
5112	28002		Treatment of foot infection							
5112	28010		Incision of toe tendon							
5112	28011		Incision of toe tendons							
5112	28024		Exploration of toe joint							
5112	28080		Removal of foot lesion							
5112	28090		Removal of foot lesion							
5112	28092		Removal of toe lesions							
5112	28108		Removal of toe lesions							
5112	28175		Resect phalanx of toe tumor							
5112	28220		Release of foot tendon							
5112	28230		Incision of foot tendon(s)							
5112	28232		Incision of toe tendon							
5112	28234		Incision of foot tendon							
5112	28261		Revision of foot tendon							
5112	28264		Release of midfoot joint							
5112	28272		Release of toe joint each							
5112	28345		Repair webbed toe(s)							
5112	28435		Treatment of ankle fracture							
5112	28455		Treat midfoot fracture each							
5112	28546		Treat foot dislocation							
5112	28635		Treat toe dislocation							
5112	28890		Hi enrgy eswt plantar fasci							
5112	29848		Wrist endoscopy/surgery							
5112	29850		Knee arthroscopy/surgery							
5112	29851		Knee arthroscopy/surgery							
5112	29902		Mcp joint arthroscopy surg							
5113		Level 3 Musculoskeletal Procedures		J1	34.1848	"$2,830.40"	.	$566.08		
5113	0101T		Extracorp shockwv tx hi enr							
5113	0102T		Extracorp shockwv tx anesth							
5113	0510T		Rmvl sinus tarsi implant							
5113	20150		Excise epiphyseal bar							
5113	20250		Open bone biopsy							
5113	20555		Place ndl musc/tis for rt							
5113	20650		Insert and remove bone pin							
5113	20661		Application of head brace							
5113	20663		Application of thigh brace							
5113	20664		Application of halo							
5113	21336		Open tx septal fx w/wo stab							
5113	21502		Drain chest lesion							
5113	21610		Partial removal of rib							
5113	21720		Revision of neck muscle							
5113	21742		Repair stern/nuss w/o scope							
5113	21743		Repair sternum/nuss w/scope							
5113	22315		Closed tx vert fx w/manj							
5113	22510		Perq cervicothoracic inject							
5113	22511		Perq lumbosacral injection							
5113	23020		Release shoulder joint							
5113	23040		Exploratory shoulder surger							
5113	23044		Exploratory shoulder surger							
5113	23100		Biopsy of shoulder joint							
5113	23101		Shoulder joint surgery							
5113	23106		Incision of collarbone join							
5113	23120		Partial removal collar bone							
5113	23125		Removal of collar bone							
5113	23130		Remove shoulder bone part							
5113	23140		Removal of bone lesion							
5113	23145		Removal of bone lesion							
5113	23150		Removal of humerus lesion							
5113	23170		Remove collar bone lesion							
5113	23172		Remove shoulder blade lesio							
5113	23190		Partial removal of scapula							
5113	23935		Drain arm/elbow bone lesion							
5113	24000		Exploratory elbow surgery							
5113	24006		Release elbow joint							
5113	24100		Biopsy elbow joint lining							
5113	24101		Explore/treat elbow joint							
5113	24102		Remove elbow joint lining							
5113	24105		Removal of elbow bursa							
5113	24110		Remove humerus lesion							
5113	24120		Remove elbow lesion							
5113	24125		Remove/graft bone lesion							
5113	24130		Removal of head of radius							
5113	24136		Remove radius bone lesion							
5113	24140		Partial removal of arm bone							
5113	24147		Partial removal of elbow							
5113	24155		Removal of elbow joint							
5113	24160		Remove elbow joint implant							
5113	24164		Remove radius head implant							
5113	24305		Arm tendon lengthening							
5113	24310		Revision of arm tendon							
5113	24332		Tenolysis triceps							
5113	24343		Repr elbow lat ligmnt w/tis							
5113	24357		Repair elbow perc							
5113	24358		Repair elbow w/deb open							
5113	24359		Repair elbow deb/attch open							
5113	24470		Revision of elbow joint							
5113	24925		Amputation follow-up surger							
5113	25001		Incise flexor carpi radiali							
5113	25023		Decompress forearm 1 space							
5113	25024		Decompress forearm 2 spaces							
5113	25028		Drainage of forearm lesion							
5113	25040		Explore/treat wrist joint							
5113	25085		Incision of wrist capsule							
5113	25100		Biopsy of wrist joint							
5113	25101		Explore/treat wrist joint							
5113	25105		Remove wrist joint lining							
5113	25107		Remove wrist joint cartilag							
5113	25109		Excise tendon forearm/wrist							
5113	25116		Remove wrist/forearm lesion							
5113	25119		Partial removal of ulna							
5113	25120		Removal of forearm lesion							
5113	25126		Remove/graft forearm lesion							
5113	25130		Removal of wrist lesion							
5113	25145		Remove forearm bone lesion							
5113	25150		Partial removal of ulna							
5113	25151		Partial removal of radius							
5113	25210		Removal of wrist bone							
5113	25215		Removal of wrist bones							
5113	25230		Partial removal of radius							
5113	25240		Partial removal of ulna							
5113	25251		Removal of wrist prosthesis							
5113	25260		Repair forearm tendon/muscl							
5113	25265		Repair forearm tendon/muscl							
5113	25270		Repair forearm tendon/muscl							
5113	25272		Repair forearm tendon/muscl							
5113	25274		Repair forearm tendon/muscl							
5113	25275		Repair forearm tendon sheat							
5113	25280		Revise wrist/forearm tendon							
5113	25290		Incise wrist/forearm tendon							
5113	25295		Release wrist/forearm tendo							
5113	25300		Fusion of tendons at wrist							
5113	25301		Fusion of tendons at wrist							
5113	25310		Transplant forearm tendon							
5113	25312		Transplant forearm tendon							
5113	25332		Revise wrist joint							
5113	25335		Realignment of hand							
5113	25355		Revision of radius							
5113	25370		Revise radius or ulna							
5113	25375		Revise radius & ulna							
5113	25394		Repair carpal bone shorten							
5113	25426		Repair/graft radius & ulna							
5113	25430		Vasc graft into carpal bone							
5113	25447		Repair wrist joints							
5113	25450		Revision of wrist joint							
5113	25455		Revision of wrist joint							
5113	25492		Reinforce radius and ulna							
5113	25606		Treat fx distal radial							
5113	25645		Treat wrist bone fracture							
5113	25651		Pin ulnar styloid fracture							
5113	25671		Pin radioulnar dislocation							
5113	25907		Amputation follow-up surger							
5113	25927		Amputation of hand							
5113	25931		Amputation follow-up surger							
5113	26020		Drain hand tendon sheath							
5113	26025		Drainage of palm bursa							
5113	26030		Drainage of palm bursas							
5113	26035		Decompress fingers/hand							
5113	26037		Decompress fingers/hand							
5113	26045		Release palm contracture							
5113	26075		Explore/treat finger joint							
5113	26100		Biopsy hand joint lining							
5113	26105		Biopsy finger joint lining							
5113	26121		Release palm contracture							
5113	26123		Release palm contracture							
5113	26130		Remove wrist joint lining							
5113	26135		Revise finger joint each							
5113	26215		Remove/graft finger lesion							
5113	26230		Partial removal of hand bon							
5113	26250		Extensive hand surgery							
5113	26260		Resect prox finger tumor							
5113	26350		Repair finger/hand tendon							
5113	26356		Repair finger/hand tendon							
5113	26357		Repair finger/hand tendon							
5113	26370		Repair finger/hand tendon							
5113	26373		Repair finger/hand tendon							
5113	26412		Repair/graft hand tendon							
5113	26415		Excision hand/finger tendon							
5113	26416		Graft hand or finger tendon							
5113	26420		Repair/graft finger tendon							
5113	26426		Repair finger/hand tendon							
5113	26428		Repair/graft finger tendon							
5113	26433		Repair finger tendon							
5113	26434		Repair/graft finger tendon							
5113	26437		Realignment of tendons							
5113	26442		Release palm & finger tendo							
5113	26445		Release hand/finger tendon							
5113	26449		Release forearm/hand tendon							
5113	26450		Incision of palm tendon							
5113	26471		Fusion of finger tendons							
5113	26476		Tendon lengthening							
5113	26477		Tendon shortening							
5113	26478		Lengthening of hand tendon							
5113	26479		Shortening of hand tendon							
5113	26480		Transplant hand tendon							
5113	26483		Transplant/graft hand tendo							
5113	26485		Transplant palm tendon							
5113	26489		Transplant/graft palm tendo							
5113	26490		Revise thumb tendon							
5113	26492		Tendon transfer with graft							
5113	26494		Hand tendon/muscle transfer							
5113	26496		Revise thumb tendon							
5113	26497		Finger tendon transfer							
5113	26498		Finger tendon transfer							
5113	26499		Revision of finger							
5113	26502		Hand tendon reconstruction							
5113	26508		Release thumb contracture							
5113	26510		Thumb tendon transfer							
5113	26516		Fusion of knuckle joint							
5113	26517		Fusion of knuckle joints							
5113	26520		Release knuckle contracture							
5113	26535		Revise finger joint							
5113	26540		Repair hand joint							
5113	26541		Repair hand joint with graf							
5113	26542		Repair hand joint with graf							
5113	26545		Reconstruct finger joint							
5113	26548		Reconstruct finger joint							
5113	26550		Construct thumb replacement							
5113	26561		Repair of web finger							
5113	26562		Repair of web finger							
5113	26565		Correct metacarpal flaw							
5113	26567		Correct finger deformity							
5113	26580		Repair hand deformity							
5113	26587		Reconstruct extra finger							
5113	26591		Repair muscles of hand							
5113	26593		Release muscles of hand							
5113	26596		Excision constricting tissu							
5113	26607		Treat metacarpal fracture							
5113	26608		Treat metacarpal fracture							
5113	26615		Treat metacarpal fracture							
5113	26650		Treat thumb fracture							
5113	26665		Treat thumb fracture							
5113	26676		Pin hand dislocation							
5113	26685		Treat hand dislocation							
5113	26686		Treat hand dislocation							
5113	26706		Pin knuckle dislocation							
5113	26715		Treat knuckle dislocation							
5113	26727		Treat finger fracture each							
5113	26735		Treat finger fracture each							
5113	26746		Treat finger fracture each							
5113	26756		Pin finger fracture each							
5113	26765		Treat finger fracture each							
5113	26776		Pin finger dislocation							
5113	26785		Treat finger dislocation							
5113	26860		Fusion of finger joint							
5113	26862		Fusion/graft of finger join							
5113	26910		Amputate metacarpal bone							
5113	26951		Amputation of finger/thumb							
5113	26952		Amputation of finger/thumb							
5113	26990		Drainage of pelvis lesion							
5113	27001		Incision of hip tendon							
5113	27006		Incision of hip tendons							
5113	27035		Denervation of hip joint							
5113	27054		Removal of hip joint lining							
5113	27062		Remove femur lesion/bursa							
5113	27066		Remove hip bone les deep							
5113	27080		Removal of tail bone							
5113	27087		Remove hip foreign body							
5113	27097		Revision of hip tendon							
5113	27098		Transfer tendon to pelvis							
5113	27105		Transfer of spinal muscle							
5113	27111		Transfer of iliopsoas muscl							
5113	27202		Treat tail bone fracture							
5113	27253		Treat hip dislocation							
5113	27254		Treat hip dislocation							
5113	27258		Treat hip dislocation							
5113	27259		Treat hip dislocation							
5113	27267		Cltx thigh fx							
5113	27268		Cltx thigh fx w/mnpj							
5113	27305		Incise thigh tendon & fasci							
5113	27306		Incision of thigh tendon							
5113	27307		Incision of thigh tendons							
5113	27310		Exploration of knee joint							
5113	27330		Biopsy knee joint lining							
5113	27331		Explore/treat knee joint							
5113	27332		Removal of knee cartilage							
5113	27333		Removal of knee cartilage							
5113	27334		Remove knee joint lining							
5113	27340		Removal of kneecap bursa							
5113	27345		Removal of knee cyst							
5113	27347		Remove knee cyst							
5113	27355		Remove femur lesion							
5113	27360		Partial removal leg bone(s)							
5113	27390		Incision of thigh tendon							
5113	27391		Incision of thigh tendons							
5113	27392		Incision of thigh tendons							
5113	27395		Lengthening of thigh tendon							
5113	27425		Lat retinacular release ope							
5113	27435		Incision of knee joint							
5113	27496		Decompression of thigh/knee							
5113	27497		Decompression of thigh/knee							
5113	27532		Treat knee fracture							
5113	27594		Amputation follow-up surger							
5113	27600		Decompression of lower leg							
5113	27601		Decompression of lower leg							
5113	27602		Decompression of lower leg							
5113	27604		Drain lower leg bursa							
5113	27606		Incision of achilles tendon							
5113	27607		Treat lower leg bone lesion							
5113	27610		Explore/treat ankle joint							
5113	27612		Exploration of ankle joint							
5113	27620		Explore/treat ankle joint							
5113	27625		Remove ankle joint lining							
5113	27626		Remove ankle joint lining							
5113	27630		Removal of tendon lesion							
5113	27635		Remove lower leg bone lesio							
5113	27640		Partial removal of tibia							
5113	27641		Partial removal of fibula							
5113	27647		Resect talus/calcaneus tum							
5113	27656		Repair leg fascia defect							
5113	27658		Repair of leg tendon each							
5113	27675		Repair lower leg tendons							
5113	27680		Release of lower leg tendon							
5113	27681		Release of lower leg tendon							
5113	27685		Revision of lower leg tendo							
5113	27686		Revise lower leg tendons							
5113	27687		Revision of calf tendon							
5113	27704		Removal of ankle implant							
5113	27707		Incision of fibula							
5113	27730		Repair of tibia epiphysis							
5113	27732		Repair of fibula epiphysis							
5113	27734		Repair lower leg epiphyses							
5113	27740		Repair of leg epiphyses							
5113	27742		Repair of leg epiphyses							
5113	27831		Treat lower leg dislocation							
5113	27860		Fixation of ankle joint							
5113	27884		Amputation follow-up surger							
5113	27892		Decompression of leg							
5113	27894		Decompression of leg							
5113	28003		Treatment of foot infection							
5113	28005		Treat foot bone lesion							
5113	28008		Incision of foot fascia							
5113	28020		Exploration of foot joint							
5113	28022		Exploration of foot joint							
5113	28050		Biopsy of foot joint lining							
5113	28052		Biopsy of foot joint lining							
5113	28054		Biopsy of toe joint lining							
5113	28060		Partial removal foot fascia							
5113	28062		Removal of foot fascia							
5113	28072		Removal of foot joint linin							
5113	28086		Excise foot tendon sheath							
5113	28088		Excise foot tendon sheath							
5113	28100		Removal of ankle/heel lesio							
5113	28104		Removal of foot lesion							
5113	28110		Part removal of metatarsal							
5113	28111		Part removal of metatarsal							
5113	28112		Part removal of metatarsal							
5113	28113		Part removal of metatarsal							
5113	28114		Removal of metatarsal heads							
5113	28116		Revision of foot							
5113	28118		Removal of heel bone							
5113	28119		Removal of heel spur							
5113	28120		Part removal of ankle/heel							
5113	28122		Partial removal of foot bon							
5113	28124		Partial removal of toe							
5113	28126		Partial removal of toe							
5113	28140		Removal of metatarsal							
5113	28150		Removal of toe							
5113	28153		Partial removal of toe							
5113	28160		Partial removal of toe							
5113	28171		Resect tarsal tumor							
5113	28173		Resect metatarsal tumor							
5113	28200		Repair of foot tendon							
5113	28208		Repair of foot tendon							
5113	28222		Release of foot tendons							
5113	28225		Release of foot tendon							
5113	28226		Release of foot tendons							
5113	28240		Release of big toe							
5113	28250		Revision of foot fascia							
5113	28260		Release of midfoot joint							
5113	28270		Release of foot contracture							
5113	28280		Fusion of toes							
5113	28285		Repair of hammertoe							
5113	28286		Repair of hammertoe							
5113	28288		Partial removal of foot bon							
5113	28289		Corrj halux rigdus w/o impl							
5113	28292		Correction hallux valgus							
5113	28295		Correction hallux valgus							
5113	28296		Correction hallux valgus							
5113	28308		Incision of metatarsal							
5113	28312		Revision of toe							
5113	28313		Repair deformity of toe							
5113	28315		Removal of sesamoid bone							
5113	28340		Resect enlarged toe tissue							
5113	28341		Resect enlarged toe							
5113	28344		Repair extra toe(s)							
5113	28476		Treat metatarsal fracture							
5113	28496		Treat big toe fracture							
5113	28505		Treat big toe fracture							
5113	28525		Treat toe fracture							
5113	28545		Treat foot dislocation							
5113	28575		Treat foot dislocation							
5113	28606		Treat foot dislocation							
5113	28636		Treat toe dislocation							
5113	28645		Repair toe dislocation							
5113	28666		Treat toe dislocation							
5113	28675		Repair of toe dislocation							
5113	28800		Amputation of midfoot							
5113	28805		Amputation thru metatarsal							
5113	28810		Amputation toe & metatarsal							
5113	28820		Amputation of toe							
5113	28825		Partial amputation of toe							
5113	29800		Jaw arthroscopy/surgery							
5113	29804		Jaw arthroscopy/surgery							
5113	29805		Sho arthrs dx +- synovial b							
5113	29819		Sho arthrs srg rmvl loose/f							
5113	29821		Sho arthrs srg compl synvct							
5113	29822		Shoulder arthroscopy/surgery							
5113	29823		Shoulder arthroscopy/surgery							
5113	29824		Sho arthrs srg dstl clavicl							
5113	29825		Sho arthrs srg lss&rescj ad							
5113	29830		Elbow arthroscopy							
5113	29834		Elbow arthroscopy/surgery							
5113	29835		Elbow arthroscopy/surgery							
5113	29837		Elbow arthroscopy/surgery							
5113	29838		Elbow arthroscopy/surgery							
5113	29840		Wrist arthroscopy							
5113	29843		Wrist arthroscopy/surgery							
5113	29844		Wrist arthroscopy/surgery							
5113	29845		Wrist arthroscopy/surgery							
5113	29846		Wrist arthroscopy/surgery							
5113	29863		Hip arthr0 w/synovectomy							
5113	29870		Knee arthroscopy dx							
5113	29871		Knee arthroscopy/drainage							
5113	29873		Knee arthroscopy/surgery							
5113	29874		Knee arthroscopy/surgery							
5113	29875		Knee arthroscopy/surgery							
5113	29876		Knee arthroscopy/surgery							
5113	29877		Knee arthroscopy/surgery							
5113	29879		Knee arthroscopy/surgery							
5113	29880		Knee arthroscopy/surgery							
5113	29881		Knee arthroscopy/surgery							
5113	29882		Knee arthroscopy/surgery							
5113	29883		Knee arthroscopy/surgery							
5113	29884		Knee arthroscopy/surgery							
5113	29886		Knee arthroscopy/surgery							
5113	29891		Ankle arthroscopy/surgery							
5113	29893		Scope plantar fasciotomy							
5113	29894		Ankle arthroscopy/surgery							
5113	29895		Ankle arthroscopy/surgery							
5113	29897		Ankle arthroscopy/surgery							
5113	29898		Ankle arthroscopy/surgery							
5113	29900		Mcp joint arthroscopy dx							
5113	29901		Mcp joint arthroscopy surg							
5113	29904		Subtalar arthro w/fb rmvl							
5113	29906		Subtalar arthro w/deb							
5113	64821		Remove sympathetic nerves							
5113	64822		Remove sympathetic nerves							
5113	64823		Sympathectomy supfc palmar							
5114		Level 4 Musculoskeletal Procedures		J1	75.6664	"$6,264.95"	.	"$1,253.00"		
5114	0200T		Perq sacral augmt unilat in							
5114	0201T		Perq sacral augmt bilat inj							
5114	0221T		Plmt post facet implt lumb							
5114	0274T		Perq lamot/lam crv/thrc							
5114	0275T		Perq lamot/lam lumbar							
5114	0335T		Insj sinus tarsi implant							
5114	0511T		Rmvl&rinsj sinus tarsi impl							
5114	0594T		Osteot hum xtrnl lngth dev							
5114	11970		Replace tissue expander							
5114	20251		Open bone biopsy							
5114	20690		Apply bone fixation device							
5114	20693		Adjust bone fixation device							
5114	20816		Replantation digit complete							
5114	20824		Replantation thumb complete							
5114	20827		Replantation thumb complete							
5114	20900		Removal of bone for graft							
5114	20902		Removal of bone for graft							
5114	20924		Removal of tendon for graft							
5114	20955		Fibula bone graft microvasc							
5114	20956		Iliac bone graft microvasc							
5114	20957		Mt bone graft microvasc							
5114	20962		Other bone graft microvasc							
5114	20969		Bone/skin graft microvasc							
5114	20970		Bone/skin graft iliac crest							
5114	20972		Bone/skin graft metatarsal							
5114	20973		Bone/skin graft great toe							
5114	20982		Ablate bone tumor(s) perq							
5114	20983		Ablate bone tumor(s) perq							
5114	21510		Drainage of bone lesion							
5114	21600		Partial removal of rib							
5114	21602		Exc ch wal tum w/o lymphade							
5114	21603		Exc ch wal tum w/lymphadec							
5114	21615		Removal of rib							
5114	21616		Removal of rib and nerves							
5114	21620		Partial removal of sternum							
5114	21627		Sternal debridement							
5114	21630		Extensive sternum surgery							
5114	21632		Extensive sternum surgery							
5114	21700		Revision of neck muscle							
5114	21705		Revision of neck muscle/rib							
5114	21740		Reconstruction of sternum							
5114	21750		Repair of sternum separatio							
5114	21811		Optx of rib fx w/fixj scope							
5114	21812		Treatment of rib fracture							
5114	21825		Treat sternum fracture							
5114	22010		I&d p-spine c/t/cerv-thor							
5114	22015		I&d abscess p-spine l/s/ls							
5114	22100		Remove part of neck vertebr							
5114	22101		Remove part thorax vertebra							
5114	22102		Remove part lumbar vertebra							
5114	22110		Remove part of neck vertebr							
5114	22112		Remove part thorax vertebra							
5114	22114		Remove part lumbar vertebra							
5114	22206		Incis spine 3 column thorac							
5114	22207		Incis spine 3 column lumbar							
5114	22210		Incis 1 vertebral seg cerv							
5114	22212		Incis 1 vertebral seg thora							
5114	22214		Incis 1 vertebral seg lumba							
5114	22220		Incis w/discectomy cervical							
5114	22222		Incis w/discectomy thoracic							
5114	22224		Incis w/discectomy lumbar							
5114	22513		Perq vertebral augmentation							
5114	22514		Perq vertebral augmentation							
5114	23105		Remove shoulder joint linin							
5114	23107		Explore treat shoulder join							
5114	23146		Removal of bone lesion							
5114	23155		Removal of humerus lesion							
5114	23156		Removal of humerus lesion							
5114	23174		Remove humerus lesion							
5114	23180		Remove collar bone lesion							
5114	23182		Remove shoulder blade lesio							
5114	23184		Remove humerus lesion							
5114	23195		Removal of head of humerus							
5114	23200		Resect clavicle tumor							
5114	23210		Resect scapula tumor							
5114	23220		Resect prox humerus tumor							
5114	23395		Muscle transfer shoulder/ar							
5114	23397		Muscle transfers							
5114	23400		Fixation of shoulder blade							
5114	23405		Incision of tendon & muscle							
5114	23406		Incise tendon(s) & muscle(s							
5114	23410		Repair rotator cuff acute							
5114	23412		Repair rotator cuff chronic							
5114	23415		Release of shoulder ligamen							
5114	23420		Repair of shoulder							
5114	23430		Repair biceps tendon							
5114	23440		Remove/transplant tendon							
5114	23450		Repair shoulder capsule							
5114	23455		Repair shoulder capsule							
5114	23460		Repair shoulder capsule							
5114	23462		Repair shoulder capsule							
5114	23465		Repair shoulder capsule							
5114	23466		Repair shoulder capsule							
5114	23480		Revision of collar bone							
5114	23490		Reinforce clavicle							
5114	23515		Treat clavicle fracture							
5114	23530		Treat clavicle dislocation							
5114	23532		Treat clavicle dislocation							
5114	23550		Treat clavicle dislocation							
5114	23552		Treat clavicle dislocation							
5114	23585		Treat scapula fracture							
5114	23630		Treat humerus fracture							
5114	23660		Treat shoulder dislocation							
5114	23670		Treat dislocation/fracture							
5114	23800		Fusion of shoulder joint							
5114	24115		Remove/graft bone lesion							
5114	24116		Remove/graft bone lesion							
5114	24126		Remove/graft bone lesion							
5114	24134		Removal of arm bone lesion							
5114	24138		Remove elbow bone lesion							
5114	24145		Partial removal of radius							
5114	24149		Radical resection of elbow							
5114	24150		Resect distal humerus tumor							
5114	24152		Resect radius tumor							
5114	24301		Muscle/tendon transfer							
5114	24320		Repair of arm tendon							
5114	24330		Revision of arm muscles							
5114	24331		Revision of arm muscles							
5114	24340		Repair of biceps tendon							
5114	24341		Repair arm tendon/muscle							
5114	24342		Repair of ruptured tendon							
5114	24344		Reconstruct elbow lat ligmn							
5114	24345		Repr elbw med ligmnt w/tiss							
5114	24360		Reconstruct elbow joint							
5114	24400		Revision of humerus							
5114	24420		Revision of humerus							
5114	24495		Decompression of forearm							
5114	24538		Treat humerus fracture							
5114	24582		Treat humerus fracture							
5114	24615		Treat elbow dislocation							
5114	24635		Treat elbow fracture							
5114	24665		Treat radius fracture							
5114	24685		Treat ulnar fracture							
5114	24800		Fusion of elbow joint							
5114	24930		Amputation follow-up surger							
5114	24935		Revision of amputation							
5114	25035		Treat forearm bone lesion							
5114	25135		Remove & graft wrist lesion							
5114	25136		Remove & graft wrist lesion							
5114	25170		Resect radius/ulnar tumor							
5114	25263		Repair forearm tendon/muscl							
5114	25315		Revise palsy hand tendon(s)							
5114	25316		Revise palsy hand tendon(s)							
5114	25320		Repair/revise wrist joint							
5114	25337		Reconstruct ulna/radioulnar							
5114	25350		Revision of radius							
5114	25360		Revision of ulna							
5114	25390		Shorten radius or ulna							
5114	25392		Shorten radius & ulna							
5114	25393		Lengthen radius & ulna							
5114	25400		Repair radius or ulna							
5114	25405		Repair/graft radius or ulna							
5114	25415		Repair radius & ulna							
5114	25420		Repair/graft radius & ulna							
5114	25425		Repair/graft radius or ulna							
5114	25431		Repair nonunion carpal bone							
5114	25440		Repair/graft wrist bone							
5114	25443		Reconstruct wrist joint							
5114	25445		Reconstruct wrist joint							
5114	25449		Remove wrist joint implant							
5114	25490		Reinforce radius							
5114	25515		Treat fracture of radius							
5114	25525		Treat fracture of radius							
5114	25526		Treat fracture of radius							
5114	25545		Treat fracture of ulna							
5114	25574		Treat fracture radius & uln							
5114	25575		Treat fracture radius/ulna							
5114	25607		Treat fx rad extra-articul							
5114	25608		Treat fx rad intra-articul							
5114	25609		Treat fx radial 3+ frag							
5114	25628		Treat wrist bone fracture							
5114	25652		Treat fracture ulnar styloi							
5114	25670		Treat wrist dislocation							
5114	25676		Treat wrist dislocation							
5114	25685		Treat wrist fracture							
5114	25695		Treat wrist dislocation							
5114	25800		Fusion of wrist joint							
5114	25805		Fusion/graft of wrist joint							
5114	25820		Fusion of hand bones							
5114	25825		Fuse hand bones with graft							
5114	25830		Fusion radioulnar jnt/ulna							
5114	25909		Amputation follow-up surger							
5114	25915		Amputation of forearm							
5114	25920		Amputate hand at wrist							
5114	25924		Amputation follow-up surger							
5114	26205		Remove/graft bone lesion							
5114	26352		Repair/graft hand tendon							
5114	26358		Repair/graft hand tendon							
5114	26372		Repair/graft hand tendon							
5114	26390		Revise hand/finger tendon							
5114	26392		Repair/graft hand tendon							
5114	26500		Hand tendon reconstruction							
5114	26518		Fusion of knuckle joints							
5114	26530		Revise knuckle joint							
5114	26531		Revise knuckle with implant							
5114	26536		Revise/implant finger joint							
5114	26546		Repair nonunion hand							
5114	26551		Great toe-hand transfer							
5114	26553		Single transfer toe-hand							
5114	26554		Double transfer toe-hand							
5114	26555		Positional change of finger							
5114	26556		Toe joint transfer							
5114	26568		Lengthen metacarpal/finger							
5114	26820		Thumb fusion with graft							
5114	26841		Fusion of thumb							
5114	26842		Thumb fusion with graft							
5114	26843		Fusion of hand joint							
5114	26844		Fusion/graft of hand joint							
5114	26850		Fusion of knuckle							
5114	26852		Fusion of knuckle with graf							
5114	26992		Drainage of bone lesion							
5114	27003		Incision of hip tendon							
5114	27005		Incision of hip tendon							
5114	27025		Incision of hip/thigh fasci							
5114	27027		Buttock fasciotomy							
5114	27030		Drainage of hip joint							
5114	27033		Exploration of hip joint							
5114	27036		Excision of hip joint/muscl							
5114	27060		Removal of ischial bursa							
5114	27065		Remove hip bone les super							
5114	27067		Remove/graft hip bone lesio							
5114	27070		Part remove hip bone super							
5114	27071		Part removal hip bone deep							
5114	27075		Resect hip tumor							
5114	27076		Resect hip tum incl acetabu							
5114	27100		Transfer of abdominal muscl							
5114	27110		Transfer of iliopsoas muscl							
5114	27146		Incision of hip bone							
5114	27147		Revision of hip bone							
5114	27151		Incision of hip bones							
5114	27156		Revision of hip bones							
5114	27158		Revision of pelvis							
5114	27161		Incision of neck of femur							
5114	27165		Incision/fixation of femur							
5114	27170		Repair/graft femur head/nec							
5114	27175		Treat slipped epiphysis							
5114	27177		Treat slipped epiphysis							
5114	27178		Treat slipped epiphysis							
5114	27179		Revise head/neck of femur							
5114	27181		Treat slipped epiphysis							
5114	27185		Revision of femur epiphysis							
5114	27187		Reinforce hip bones							
5114	27226		Treat hip wall fracture							
5114	27227		Treat hip fracture(s)							
5114	27228		Treat hip fracture(s)							
5114	27235		Treat thigh fracture							
5114	27236		Treat thigh fracture							
5114	27244		Treat thigh fracture							
5114	27245		Treat thigh fracture							
5114	27248		Treat thigh fracture							
5114	27303		Drainage of bone lesion							
5114	27335		Remove knee joint lining							
5114	27350		Removal of kneecap							
5114	27357		Remove femur lesion/graft							
5114	27365		Resect femur/knee tumor							
5114	27380		Repair of kneecap tendon							
5114	27381		Repair/graft kneecap tendon							
5114	27385		Repair of thigh muscle							
5114	27386		Repair/graft of thigh muscl							
5114	27393		Lengthening of thigh tendon							
5114	27394		Lengthening of thigh tendon							
5114	27396		Transplant of thigh tendon							
5114	27397		Transplants of thigh tendon							
5114	27400		Revise thigh muscles/tendon							
5114	27403		Repair of knee cartilage							
5114	27405		Repair of knee ligament							
5114	27407		Repair of knee ligament							
5114	27409		Repair of knee ligaments							
5114	27412		Autochondrocyte implant kne							
5114	27416		Osteochondral knee autograf							
5114	27418		Repair degenerated kneecap							
5114	27420		Revision of unstable kneeca							
5114	27422		Revision of unstable kneeca							
5114	27424		Revision/removal of kneecap							
5114	27427		Reconstruction knee							
5114	27430		Revision of thigh muscles							
5114	27437		Revise kneecap							
5114	27448		Incision of thigh							
5114	27450		Incision of thigh							
5114	27454		Realignment of thigh bone							
5114	27455		Realignment of knee							
5114	27457		Realignment of knee							
5114	27465		Shortening of thigh bone							
5114	27466		Lengthening of thigh bone							
5114	27468		Shorten/lengthen thighs							
5114	27470		Repair of thigh							
5114	27472		Repair/graft of thigh							
5114	27475		Surgery to stop leg growth							
5114	27477		Surgery to stop leg growth							
5114	27479		Surgery to stop leg growth							
5114	27485		Surgery to stop leg growth							
5114	27488		Removal of knee prosthesis							
5114	27495		Reinforce thigh							
5114	27499		Decompression of thigh/knee							
5114	27506		Treatment of thigh fracture							
5114	27507		Treatment of thigh fracture							
5114	27509		Treatment of thigh fracture							
5114	27511		Treatment of thigh fracture							
5114	27513		Treatment of thigh fracture							
5114	27514		Treatment of thigh fracture							
5114	27519		Treat thigh fx growth plate							
5114	27524		Treat kneecap fracture							
5114	27535		Treat knee fracture							
5114	27536		Treat knee fracture							
5114	27540		Treat knee fracture							
5114	27556		Treat knee dislocation							
5114	27557		Treat knee dislocation							
5114	27558		Treat knee dislocation							
5114	27566		Treat kneecap dislocation							
5114	27596		Amputation follow-up surger							
5114	27637		Remove/graft leg bone lesio							
5114	27638		Remove/graft leg bone lesio							
5114	27645		Resect tibia tumor							
5114	27646		Resect fibula tumor							
5114	27650		Repair achilles tendon							
5114	27652		Repair/graft achilles tendo							
5114	27654		Repair of achilles tendon							
5114	27659		Repair of leg tendon each							
5114	27664		Repair of leg tendon each							
5114	27665		Repair of leg tendon each							
5114	27676		Repair lower leg tendons							
5114	27690		Revise lower leg tendon							
5114	27691		Revise lower leg tendon							
5114	27695		Repair of ankle ligament							
5114	27696		Repair of ankle ligaments							
5114	27698		Repair of ankle ligament							
5114	27700		Revision of ankle joint							
5114	27705		Incision of tibia							
5114	27720		Repair of tibia							
5114	27722		Repair/graft of tibia							
5114	27724		Repair/graft of tibia							
5114	27725		Repair of lower leg							
5114	27726		Repair fibula nonunion							
5114	27727		Repair of lower leg							
5114	27745		Reinforce tibia							
5114	27756		Treatment of tibia fracture							
5114	27766		Optx medial ankle fx							
5114	27769		Optx post ankle fx							
5114	27784		Treatment of fibula fractur							
5114	27792		Treatment of ankle fracture							
5114	27814		Treatment of ankle fracture							
5114	27822		Treatment of ankle fracture							
5114	27823		Treatment of ankle fracture							
5114	27826		Treat lower leg fracture							
5114	27829		Treat lower leg joint							
5114	27832		Treat lower leg dislocation							
5114	27846		Treat ankle dislocation							
5114	27848		Treat ankle dislocation							
5114	27881		Amputation of lower leg							
5114	27882		Amputation of lower leg							
5114	27886		Amputation follow-up surger							
5114	27889		Amputation of foot at ankle							
5114	27893		Decompression of leg							
5114	28070		Removal of foot joint linin							
5114	28102		Remove/graft foot lesion							
5114	28103		Remove/graft foot lesion							
5114	28106		Remove/graft foot lesion							
5114	28107		Remove/graft foot lesion							
5114	28130		Removal of ankle bone							
5114	28202		Repair/graft of foot tendon							
5114	28210		Repair/graft of foot tendon							
5114	28238		Revision of foot tendon							
5114	28262		Revision of foot and ankle							
5114	28291		Corrj halux rigdus w/implt							
5114	28297		Correction hallux valgus							
5114	28298		Correction hallux valgus							
5114	28299		Correction hallux valgus							
5114	28300		Incision of heel bone							
5114	28302		Incision of ankle bone							
5114	28304		Incision of midfoot bones							
5114	28305		Incise/graft midfoot bones							
5114	28306		Incision of metatarsal							
5114	28307		Incision of metatarsal							
5114	28309		Incision of metatarsals							
5114	28310		Revision of big toe							
5114	28322		Repair of metatarsals							
5114	28360		Reconstruct cleft foot							
5114	28406		Treatment of heel fracture							
5114	28415		Treat heel fracture							
5114	28436		Treatment of ankle fracture							
5114	28445		Treat ankle fracture							
5114	28446		Osteochondral talus autogrf							
5114	28456		Treat midfoot fracture							
5114	28465		Treat midfoot fracture each							
5114	28485		Treat metatarsal fracture							
5114	28531		Treat sesamoid bone fractur							
5114	28555		Repair foot dislocation							
5114	28576		Treat foot dislocation							
5114	28585		Repair foot dislocation							
5114	28615		Repair foot dislocation							
5114	28740		Fusion of foot bones							
5114	28750		Fusion of big toe joint							
5114	28755		Fusion of big toe joint							
5114	28760		Fusion of big toe joint							
5114	29806		Sho arthrs srg capsulorpaph							
5114	29807		Sho arthrs srg rpr slap les							
5114	29820		Sho arthrs srg prtl synvct							
5114	29827		Sho arthrs srg rt8tr cuf rp							
5114	29828		Sho arthrs srg bicp tenodsi							
5114	29836		Elbow arthroscopy/surgery							
5114	29847		Wrist arthroscopy/surgery							
5114	29855		Tibial arthroscopy/surgery							
5114	29860		Hip arthroscopy dx							
5114	29861		Hip arthro w/fb removal							
5114	29862		Hip arthr0 w/debridement							
5114	29866		Autgrft implnt knee w/scope							
5114	29868		Meniscal trnspl knee w/scpe							
5114	29885		Knee arthroscopy/surgery							
5114	29887		Knee arthroscopy/surgery							
5114	29888		Knee arthroscopy/surgery							
5114	29892		Ankle arthroscopy/surgery							
5114	29899		Ankle arthroscopy/surgery							
5114	29905		Subtalar arthro w/exc							
5114	29914		Hip arthro w/femoroplasty							
5114	29915		Hip arthro acetabuloplasty							
5114	29916		Hip arthro w/labral repair							
5114	62351		Implant spinal canal cath							
5114	62380		Ndsc dcmprn 1 ntrspc lumbar							
5114	63001		Remove spine lamina 1/2 crv							
5114	63003		Remove spine lamina 1/2 thr							
5114	63005		Remove spine lamina 1/2 lmb							
5114	63011		Remove spine lamina 1/2 scr							
5114	63012		Remove lamina/facets lumbar							
5114	63015		Remove spine lamina >2 crvc							
5114	63016		Remove spine lamina >2 thrc							
5114	63017		Remove spine lamina >2 lmbr							
5114	63020		Neck spine disk surgery							
5114	63030		Low back disk surgery							
5114	63040		Laminotomy single cervical							
5114	63042		Laminotomy single lumbar							
5114	63045		Remove spine lamina 1 crvl							
5114	63046		Remove spine lamina 1 thrc							
5114	63047		Remove spine lamina 1 lmbr							
5114	63055		Decompress spinal cord thrc							
5114	63056		Decompress spinal cord lmbr							
5114	63064		Decompress spinal cord thrc							
5114	63075		Neck spine disk surgery							
5114	63265		Excise intraspinl lesion cr							
5114	63266		Excise intrspinl lesion thr							
5114	63267		Excise intrspinl lesion lmb							
5114	63268		Excise intrspinl lesion scr							
5114	69717		Temple bone implant revisio							
5114	G0276		Pild/placebo control clin t							
5114	G0412		Open tx iliac spine uni/bil							
5114	G0413		Pelvic ring fracture uni/bi							
5115		Level 5 Musculoskeletal Procedures		J1	148.7344	"$12,314.76"	.	"$2,462.96"	*	
5115	0202T		Post vert arthrplst 1 lumba							
5115	0219T		Plmt post facet implt cerv							
5115	0220T		Plmt post facet implt thor							
5115	0627T		Perq njx algc fluor lmbr 1s							
5115	0629T		Perq njx algc ct lmbr 1st							
5115	20692		Apply bone fixation device							
5115	22318		Treat odontoid fx w/o graft							
5115	22319		Treat odontoid fx w/graft							
5115	22325		Treat spine fracture							
5115	22326		Treat neck spine fracture							
5115	22327		Treat thorax spine fracture							
5115	22551		Neck spine fuse&remov bel c							
5115	22554		Neck spine fusion							
5115	22612		Lumbar spine fusion							
5115	22633		Lumbar spine fusion combine							
5115	22830		Exploration of spinal fusio							
5115	22850		Remove spine fixation devic							
5115	22852		Remove spine fixation devic							
5115	22855		Remove spine fixation devic							
5115	22864		Remove cerv artif disc							
5115	22865		Remove lumb artif disc							
5115	22869		Insj stablj dev w/o dcmprn							
5115	23470		Reconstruct shoulder joint							
5115	23472		Reconstruct shoulder joint							
5115	23473		Revis reconst shoulder join							
5115	23474		Revis reconst shoulder join							
5115	23485		Revision of collar bone							
5115	23491		Reinforce shoulder bones							
5115	23615		Treat humerus fracture							
5115	23680		Treat dislocation/fracture							
5115	23802		Fusion of shoulder joint							
5115	23900		Amputation of arm & girdle							
5115	23920		Amputation at shoulder join							
5115	24346		Reconstruct elbow med ligmn							
5115	24362		Reconstruct elbow joint							
5115	24365		Reconstruct head of radius							
5115	24366		Reconstruct head of radius							
5115	24370		Revise reconst elbow joint							
5115	24410		Revision of humerus							
5115	24430		Repair of humerus							
5115	24435		Repair humerus with graft							
5115	24498		Reinforce humerus							
5115	24515		Treat humerus fracture							
5115	24516		Treat humerus fracture							
5115	24545		Treat humerus fracture							
5115	24575		Treat humerus fracture							
5115	24579		Treat humerus fracture							
5115	24586		Treat elbow fracture							
5115	24587		Treat elbow fracture							
5115	24666		Treat radius fracture							
5115	24802		Fusion/graft of elbow joint							
5115	24900		Amputation of upper arm							
5115	24920		Amputation of upper arm							
5115	24931		Amputate upper arm & implan							
5115	24940		Revision of upper arm							
5115	25365		Revise radius & ulna							
5115	25391		Lengthen radius or ulna							
5115	25441		Reconstruct wrist joint							
5115	25444		Reconstruct wrist joint							
5115	25491		Reinforce ulna							
5115	25810		Fusion/graft of wrist joint							
5115	25900		Amputation of forearm							
5115	25905		Amputation of forearm							
5115	27077		Resect hip tum w/innom bone							
5115	27078		Rsect hip tum incl femur							
5115	27120		Reconstruction of hip socke							
5115	27122		Reconstruction of hip socke							
5115	27125		Partial hip replacement							
5115	27130		Total hip arthroplasty							
5115	27132		Total hip arthroplasty							
5115	27134		Revise hip joint replacemen							
5115	27137		Revise hip joint replacemen							
5115	27138		Revise hip joint replacemen							
5115	27140		Transplant femur ridge							
5115	27176		Treat slipped epiphysis							
5115	27282		Fusion of pubic bones							
5115	27356		Remove femur lesion/graft							
5115	27415		Osteochondral knee allograf							
5115	27428		Reconstruction knee							
5115	27429		Reconstruction knee							
5115	27438		Revise kneecap with implant							
5115	27440		Revision of knee joint							
5115	27441		Revision of knee joint							
5115	27442		Revision of knee joint							
5115	27443		Revision of knee joint							
5115	27445		Revision of knee joint							
5115	27446		Revision of knee joint							
5115	27447		Total knee arthroplasty							
5115	27486		Revise/replace knee joint							
5115	27487		Revise/replace knee joint							
5115	27580		Fusion of knee							
5115	27598		Amputate lower leg at knee							
5115	27702		Reconstruct ankle joint							
5115	27703		Reconstruction ankle joint							
5115	27709		Incision of tibia & fibula							
5115	27712		Realignment of lower leg							
5115	27715		Revision of lower leg							
5115	27758		Treatment of tibia fracture							
5115	27759		Treatment of tibia fracture							
5115	27827		Treat lower leg fracture							
5115	27828		Treat lower leg fracture							
5115	27870		Fusion of ankle joint open							
5115	27871		Fusion of tibiofibular join							
5115	27888		Amputation of foot at ankle							
5115	28320		Repair of foot bones							
5115	28420		Treat/graft heel fracture							
5115	28715		Fusion of foot bones							
5115	28725		Fusion of foot bones							
5115	28730		Fusion of foot bones							
5115	28735		Fusion of foot bones							
5115	28737		Revision of foot bones							
5115	29856		Tibial arthroscopy/surgery							
5115	29867		Allgrft implnt knee w/scope							
5115	29889		Knee arthroscopy/surgery							
5115	29907		Subtalar arthro w/fusion							
5115	69714		Implant temple bone w/stimu							
5115	69718		Revise temple bone implant							
5115	C9734		"U/s trtmt, not leiomyomata"							
5115	C9752		Intraosseous des lumb/sacru							
5115	C9757		Spine/lumbar disk surgery							
5115	G0414		Pelvic ring fx treat int fi							
5115	G0415		Open tx post pelvic fxcture							
5116		Level 6 Musculoskeletal Procedures		J1	191.651	"$15,868.13"	.	"$3,173.63"	*	
5116	20696		Comp multiplane ext fixatio							
5116	20802		Replantation arm complete							
5116	20805		Replant forearm complete							
5116	20808		Replantation hand complete							
5116	20838		Replantation foot complete							
5116	21243		Reconstruction of jaw joint							
5116	22532		Lat thorax spine fusion							
5116	22533		Lat lumbar spine fusion							
5116	22548		Neck spine fusion							
5116	22556		Thorax spine fusion							
5116	22558		Lumbar spine fusion							
5116	22586		Prescrl fuse w/ instr l5-s1							
5116	22590		Spine & skull spinal fusion							
5116	22595		Neck spinal fusion							
5116	22600		Neck spine fusion							
5116	22610		Thorax spine fusion							
5116	22630		Lumbar spine fusion							
5116	22800		Post fusion </6 vert seg							
5116	22802		Post fusion 7-12 vert seg							
5116	22804		Post fusion 13/> vert seg							
5116	22808		Ant fusion 2-3 vert seg							
5116	22810		Ant fusion 4-7 vert seg							
5116	22812		Ant fusion 8/> vert seg							
5116	22818		Kyphectomy 1-2 segments							
5116	22819		Kyphectomy 3 or more							
5116	22849		Reinsert spinal fixation							
5116	22856		Cerv artific diskectomy							
5116	22857		Lumbar artif diskectomy							
5116	22861		Revise cerv artific disc							
5116	22862		Revise lumbar artif disc							
5116	22867		Insj stablj dev w/dcmprn							
5116	23616		Treat humerus fracture							
5116	24361		Reconstruct elbow joint							
5116	24363		Replace elbow joint							
5116	24371		Revise reconst elbow joint							
5116	24546		Treat humerus fracture							
5116	25442		Reconstruct wrist joint							
5116	25446		Wrist replacement							
5116	27279		Arthrodesis sacroiliac join							
5116	27280		Fusion of sacroiliac joint							
5116	27284		Fusion of hip joint							
5116	27286		Fusion of hip joint							
5116	27290		Amputation of leg at hip							
5116	27295		Amputation of leg at hip							
5116	27590		Amputate leg at thigh							
5116	27591		Amputate leg at thigh							
5116	27592		Amputate leg at thigh							
5116	27880		Amputation of lower leg							
5116	28705		Fusion of foot bones							
5116	69715		Temple bne implnt w/stimula							
5151		Level 1 Airway Endoscopy		T	1.9855	$164.39	.	$32.88		
5151	31231		Nasal endoscopy dx							
5151	31505		Diagnostic laryngoscopy							
5151	31511		Remove foreign body larynx							
5151	31575		Diagnostic laryngoscopy							
5151	31899		Airways surgical procedure							
5151	92511		Nasopharyngoscopy							
5152		Level 2 Airway Endoscopy		T	4.5474	$376.51	.	$75.31		
5152	31233		Nsl/sins ndsc dx max sinusc							
5152	31513		Injection into vocal cord							
5152	31515		Laryngoscopy for aspiration							
5152	31520		Dx laryngoscopy newborn							
5152	31577		Largsc w/rmvl foreign bdy(s							
5152	31579		Laryngoscopy telescopic							
5152	31646		Brnchsc w/ther aspir sbsq							
5152	31717		Bronchial brush biopsy							
5153		Level 3 Airway Endoscopy		J1	18.073	"$1,496.39"	.	$299.28		
5153	31235		Nsl/sins ndsc dx sphn sinus							
5153	31237		Nasal/sinus endoscopy surg							
5153	31238		Nasal/sinus endoscopy surg							
5153	31240		Nasal/sinus endoscopy surg							
5153	31241		Nsl/sins ndsc w/artery lig							
5153	31525		Dx laryngoscopy excl nb							
5153	31526		Dx laryngoscopy w/oper scop							
5153	31530		Laryngoscopy w/fb removal							
5153	31573		Largsc w/ther injection							
5153	31574		Largsc w/njx augmentation							
5153	31576		Laryngoscopy with biopsy							
5153	31622		Dx bronchoscope/wash							
5153	31623		Dx bronchoscope/brush							
5153	31624		Dx bronchoscope/lavage							
5153	31625		Bronchoscopy w/biopsy(s)							
5153	31635		Bronchoscopy w/fb removal							
5153	31643		Diag bronchoscope/catheter							
5153	31645		Brnchsc w/ther aspir 1st							
5153	31649		Bronchial valve remov addl							
5153	31730		Intro windpipe wire/tube							
5154		Level 4 Airway Endoscopy		J1	37.417	"$3,098.02"	.	$619.61		
5154	31239		Nasal/sinus endoscopy surg							
5154	31256		Exploration maxillary sinus							
5154	31510		Laryngoscopy with biopsy							
5154	31512		Removal of larynx lesion							
5154	31527		Laryngoscopy for treatment							
5154	31528		Laryngoscopy and dilation							
5154	31529		Laryngoscopy and dilation							
5154	31531		Laryngoscopy w/fb & op scop							
5154	31535		Laryngoscopy w/biopsy							
5154	31536		Laryngoscopy w/bx & op scop							
5154	31540		Laryngoscopy w/exc of tumor							
5154	31541		Larynscop w/tumr exc + scop							
5154	31545		Remove vc lesion w/scope							
5154	31570		Laryngoscope w/vc inj							
5154	31571		Laryngoscop w/vc inj + scop							
5154	31572		Largsc w/laser dstrj les							
5154	31578		Largsc w/removal lesion							
5154	31628		Bronchoscopy/lung bx each							
5154	31629		Bronchoscopy/needle bx each							
5154	31630		Bronchoscopy dilate/fx repr							
5154	31640		Bronchoscopy w/tumor excise							
5154	31641		Bronchoscopy treat blockage							
5154	31648		Bronchial valve remov init							
5154	31652		Bronch ebus samplng 1/2 nod							
5154	31653		Bronch ebus samplng 3/> nod							
5155		Level 5 Airway Endoscopy		J1	70.3257	"$5,822.76"	.	"$1,164.56"		
5155	31253		Nsl/sins ndsc total							
5155	31254		Nsl/sins ndsc w/prtl ethmdc							
5155	31255		Nsl/sins ndsc w/tot ethmdct							
5155	31257		Nsl/sins ndsc tot w/sphendt							
5155	31259		Nsl/sins ndsc sphn tiss rmv							
5155	31267		Endoscopy maxillary sinus							
5155	31276		Nsl/sins ndsc frnt tiss rmv							
5155	31287		Nasal/sinus endoscopy surg							
5155	31288		Nasal/sinus endoscopy surg							
5155	31292		Nsl/sins ndsc med/inf dcmpr							
5155	31293		Nsl/sins ndsc med&inf dcmpr							
5155	31294		Nsl/sins ndsc surg on dcmpr							
5155	31295		Nsl/sins ndsc surg max sins							
5155	31296		Nsl/sins ndsc surg frnt sin							
5155	31297		Nsl/sins ndsc surg sphn sin							
5155	31298		Nsl/sins ndsc surg frnt&sph							
5155	31546		Remove vc lesion scope/graf							
5155	31560		Laryngoscop w/arytenoidecto							
5155	31561		Larynscop remve cart + scop							
5155	31626		Bronchoscopy w/markers							
5155	31631		Bronchoscopy dilate w/stent							
5155	31634		Bronch w/balloon occlusion							
5155	31636		Bronchoscopy bronch stents							
5155	31638		Bronchoscopy revise stent							
5155	31647		Bronchial valve init insert							
5155	31660		Bronch thermoplsty 1 lobe							
5155	31661		Bronch thermoplsty 2/> lobe							
5161		Level 1 ENT Procedures		T	2.5557	$211.60	.	$42.33		
5161	21085		Prepare face/oral prosthesi							
5161	21089		Prepare face/oral prosthesi							
5161	21299		Cranio/maxillofacial surger							
5161	21499		Head surgery procedure							
5161	21899		Neck/chest surgery procedur							
5161	30000		Drainage of nose lesion							
5161	30906		Repeat control of nosebleed							
5161	30999		Nasal surgery procedure							
5161	31000		Irrigation maxillary sinus							
5161	31299		Sinus surgery procedure							
5161	31500		Insert emergency airway							
5161	31502		Change of windpipe airway							
5161	31599		Larynx surgery procedure							
5161	31605		Incision of windpipe							
5161	40490		Biopsy of lip							
5161	40799		Lip surgery procedure							
5161	40830		Repair mouth laceration							
5161	40899		Mouth surgery procedure							
5161	41005		Drainage of mouth lesion							
5161	41251		Repair tongue laceration							
5161	41252		Repair tongue laceration							
5161	41599		Tongue and mouth surgery							
5161	41899		Dental surgery procedure							
5161	42000		Drainage mouth roof lesion							
5161	42299		Palate/uvula surgery							
5161	42699		Salivary surgery procedure							
5161	42700		Drainage of tonsil abscess							
5161	42970		Control nose/throat bleedin							
5161	42999		Throat surgery procedure							
5161	69100		Biopsy of external ear							
5161	69399		Outer ear surgery procedure							
5161	69420		Incision of eardrum							
5161	69799		Middle ear surgery procedur							
5161	69949		Inner ear surgery procedure							
5161	69979		Temporal bone surgery							
5162		Level 2 ENT Procedures		T	5.4635	$452.36	.	$90.48		
5162	20100		Explore wound neck							
5162	21400		Closed tx orbit w/o manipul							
5162	21450		Treat lower jaw fracture							
5162	30020		Drainage of nose lesion							
5162	30200		Injection treatment of nose							
5162	30560		Release of nasal adhesions							
5162	31615		Visualization of windpipe							
5162	40650		Repair lip							
5162	40652		Repair lip							
5162	40801		Drainage of mouth lesion							
5162	40805		Removal foreign body mouth							
5162	40806		Incision of lip fold							
5162	40808		Biopsy of mouth lesion							
5162	40818		Excise oral mucosa for graf							
5162	40831		Repair mouth laceration							
5162	41000		Drainage of mouth lesion							
5162	41009		Drainage of mouth lesion							
5162	41015		Drainage of mouth lesion							
5162	41100		Biopsy of tongue							
5162	42180		Repair palate							
5162	42280		Preparation palate mold							
5162	42310		Drainage of salivary gland							
5162	42320		Drainage of salivary gland							
5162	42660		Dilation of salivary duct							
5162	42960		Control throat bleeding							
5162	69222		Clean out mastoid cavity							
5162	69433		Create eardrum opening							
5162	92502		Ear and throat examination							
5163		Level 3 ENT Procedures		J1	16.3386	"$1,352.79"	.	$270.56		
5163	0583T		Tmpst auto tube dlvr sys							
5163	20500		Injection of sinus tract							
5163	21073		Mnpj of tmj w/anesth							
5163	21076		Prepare face/oral prosthesi							
5163	21110		Interdental fixation							
5163	21295		Revision of jaw muscle/bone							
5163	21315		Closed tx nose fx w/o stabl							
5163	21345		Closed tx nose/jaw fx							
5163	21401		Closed tx orbit w/manipulj							
5163	21451		Treat lower jaw fracture							
5163	21485		Reset dislocated jaw							
5163	21497		Interdental wiring							
5163	30100		Intranasal biopsy							
5163	30110		Removal of nose polyp(s)							
5163	30124		Removal of nose lesion							
5163	30210		Nasal sinus therapy							
5163	30220		Insert nasal septal button							
5163	30320		Remove nasal foreign body							
5163	30801		Ablate inf turbinate superf							
5163	30802		Ablate inf turbinate submuc							
5163	31002		Irrigation sphenoid sinus							
5163	31201		Removal of ethmoid sinus							
5163	31603		Incision of windpipe							
5163	40654		Repair lip							
5163	40812		Excise/repair mouth lesion							
5163	40819		Excise lip or cheek fold							
5163	41006		Drainage of mouth lesion							
5163	41007		Drainage of mouth lesion							
5163	41010		Incision of tongue fold							
5163	41018		Drainage of mouth lesion							
5163	41115		Excision of tongue fold							
5163	41805		Removal foreign body gum							
5163	41806		Removal foreign body jawbon							
5163	41821		Excision of gum flap							
5163	41822		Excision of gum lesion							
5163	41828		Excision of gum lesion							
5163	41850		Treatment of gum lesion							
5163	41870		Gum graft							
5163	42100		Biopsy roof of mouth							
5163	42300		Drainage of salivary gland							
5163	42405		Biopsy of salivary gland							
5163	42650		Dilation of salivary duct							
5163	42800		Biopsy of throat							
5163	42900		Repair throat wound							
5163	42955		Surgical opening of throat							
5163	43020		Incision of esophagus							
5163	60000		Drain thyroid/tongue cyst							
5163	69105		Biopsy of external ear cana							
5163	69436		Create eardrum opening							
5163	69540		Remove ear lesion							
5163	69610		Repair of eardrum							
5163	69700		Close mastoid fistula							
5163	69801		Incise inner ear							
5163	C9727		Insert palate implants							
5164		Level 4 ENT Procedures		J1	33.0494	"$2,736.39"	.	$547.28		
5164	21010		Incision of jaw joint							
5164	21029		Contour of face bone lesion							
5164	21031		Remove exostosis mandible							
5164	21032		Remove exostosis maxilla							
5164	21040		Excise mandible lesion							
5164	21079		Prepare face/oral prosthesi							
5164	21080		Prepare face/oral prosthesi							
5164	21082		Prepare face/oral prosthesi							
5164	21083		Prepare face/oral prosthesi							
5164	21084		Prepare face/oral prosthesi							
5164	21086		Prepare face/oral prosthesi							
5164	21088		Prepare face/oral prosthesi							
5164	21121		Reconstruction of chin							
5164	21123		Reconstruction of chin							
5164	21137		Reduction of forehead							
5164	21280		Revision of eyelid							
5164	21282		Revision of eyelid							
5164	21296		Revision of jaw muscle/bone							
5164	21320		Closed tx nose fx w/ stablj							
5164	21325		Open tx nose fx uncomplicat							
5164	21335		Open tx nose & septal fx							
5164	21337		Closed tx septal&nose fx							
5164	21340		Perq tx nasoethmoid fx							
5164	21355		Perq tx malar fracture							
5164	21421		Treat mouth roof fracture							
5164	21440		Treat dental ridge fracture							
5164	21490		Repair dislocated jaw							
5164	30115		Removal of nose polyp(s)							
5164	30117		Removal of intranasal lesio							
5164	30118		Removal of intranasal lesio							
5164	30120		Revision of nose							
5164	30130		Excise inferior turbinate							
5164	30140		Resect inferior turbinate							
5164	30310		Remove nasal foreign body							
5164	30520		Repair of nasal septum							
5164	30630		Repair nasal septum defect							
5164	30930		Ther fx nasal inf turbinate							
5164	31020		Exploration maxillary sinus							
5164	31205		Removal of ethmoid sinus							
5164	31300		Removal of larynx lesion							
5164	31600		Incision of windpipe							
5164	31611		Surgery/speech prosthesis							
5164	31612		Puncture/clear windpipe							
5164	31613		Repair windpipe opening							
5164	31820		Closure of windpipe lesion							
5164	31825		Repair of windpipe defect							
5164	31830		Revise windpipe scar							
5164	40500		Partial excision of lip							
5164	40510		Partial excision of lip							
5164	40520		Partial excision of lip							
5164	40525		Reconstruct lip with flap							
5164	40530		Partial removal of lip							
5164	40720		Repair cleft lip/nasal							
5164	40810		Excision of mouth lesion							
5164	40814		Excise/repair mouth lesion							
5164	40816		Excision of mouth lesion							
5164	40820		Treatment of mouth lesion							
5164	41008		Drainage of mouth lesion							
5164	41017		Drainage of mouth lesion							
5164	41105		Biopsy of tongue							
5164	41110		Excision of tongue lesion							
5164	41112		Excision of tongue lesion							
5164	41113		Excision of tongue lesion							
5164	41114		Excision of tongue lesion							
5164	41116		Excision of mouth lesion							
5164	41510		Tongue to lip surgery							
5164	41520		Reconstruction tongue fold							
5164	41530		Tongue base vol reduction							
5164	41820		Excision gum each quadrant							
5164	41825		Excision of gum lesion							
5164	41826		Excision of gum lesion							
5164	41830		Removal of gum tissue							
5164	41872		Repair gum							
5164	41874		Repair tooth socket							
5164	42104		Excision lesion mouth roof							
5164	42106		Excision lesion mouth roof							
5164	42140		Excision of uvula							
5164	42160		Treatment mouth roof lesion							
5164	42205		Reconstruct cleft palate							
5164	42305		Drainage of salivary gland							
5164	42330		Removal of salivary stone							
5164	42335		Removal of salivary stone							
5164	42340		Removal of salivary stone							
5164	42408		Excision of salivary cyst							
5164	42409		Drainage of salivary cyst							
5164	42510		Parotid duct diversion							
5164	42600		Closure of salivary fistula							
5164	42665		Ligation of salivary duct							
5164	42720		Drainage of throat abscess							
5164	42804		Biopsy of upper nose/throat							
5164	42806		Biopsy of upper nose/throat							
5164	42808		Excise pharynx lesion							
5164	42810		Excision of neck cyst							
5164	42821		Remove tonsils and adenoids							
5164	42826		Removal of tonsils							
5164	42830		Removal of adenoids							
5164	42831		Removal of adenoids							
5164	42835		Removal of adenoids							
5164	42836		Removal of adenoids							
5164	42860		Excision of tonsil tags							
5164	42962		Control throat bleeding							
5164	42972		Control nose/throat bleedin							
5164	43420		Repair esophagus opening							
5164	61330		Decompress eye socket							
5164	62000		Treat skull fracture							
5164	69300		Revise external ear							
5164	69421		Incision of eardrum							
5164	69424		Remove ventilating tube							
5164	69440		Exploration of middle ear							
5164	69450		Eardrum revision							
5164	69620		Repair of eardrum							
5164	69650		Release middle ear bone							
5164	69666		Repair middle ear structure							
5164	69667		Repair middle ear structure							
5164	69676		Remove middle ear nerve							
5164	69711		Remove/repair hearing aid							
5164	69915		Incise inner ear nerve							
5164	C9771		Nsl/sins cryo post nasal ti							
5165		Level 5 ENT Procedures		J1	61.428	"$5,086.05"	.	"$1,017.22"		
5165	21025		Excision of bone lower jaw							
5165	21026		Excision of facial bone(s)							
5165	21030		Excise max/zygoma b9 tumor							
5165	21034		Excise max/zygoma mal tumor							
5165	21044		Removal of jaw bone lesion							
5165	21045		Extensive jaw surgery							
5165	21046		Remove mandible cyst comple							
5165	21047		Excise lwr jaw cyst w/repai							
5165	21048		Remove maxilla cyst complex							
5165	21049		Excis uppr jaw cyst w/repai							
5165	21050		Removal of jaw joint							
5165	21060		Remove jaw joint cartilage							
5165	21070		Remove coronoid process							
5165	21077		Prepare face/oral prosthesi							
5165	21081		Prepare face/oral prosthesi							
5165	21087		Prepare face/oral prosthesi							
5165	21100		Maxillofacial fixation							
5165	21120		Reconstruction of chin							
5165	21122		Reconstruction of chin							
5165	21125		Augmentation lower jaw bone							
5165	21127		Augmentation lower jaw bone							
5165	21138		Reduction of forehead							
5165	21139		Reduction of forehead							
5165	21141		Lefort i-1 piece w/o graft							
5165	21142		Lefort i-2 piece w/o graft							
5165	21143		Lefort i-3/> piece w/o graf							
5165	21145		Lefort i-1 piece w/ graft							
5165	21146		Lefort i-2 piece w/ graft							
5165	21147		Lefort i-3/> piece w/ graft							
5165	21150		Lefort ii anterior intrusio							
5165	21151		Lefort ii w/bone grafts							
5165	21154		Lefort iii w/o lefort i							
5165	21155		Lefort iii w/ lefort i							
5165	21159		Lefort iii w/fhdw/o lefort							
5165	21160		Lefort iii w/fhd w/ lefort							
5165	21172		Reconstruct orbit/forehead							
5165	21175		Reconstruct orbit/forehead							
5165	21179		Reconstruct entire forehead							
5165	21180		Reconstruct entire forehead							
5165	21181		Contour cranial bone lesion							
5165	21182		Reconstruct cranial bone							
5165	21183		Reconstruct cranial bone							
5165	21184		Reconstruct cranial bone							
5165	21188		Reconstruction of midface							
5165	21193		Reconst lwr jaw w/o graft							
5165	21194		Reconst lwr jaw w/graft							
5165	21195		Reconst lwr jaw w/o fixatio							
5165	21196		Reconst lwr jaw w/fixation							
5165	21198		Reconstr lwr jaw segment							
5165	21199		Reconstr lwr jaw w/advance							
5165	21206		Reconstruct upper jaw bone							
5165	21208		Augmentation of facial bone							
5165	21209		Reduction of facial bones							
5165	21210		Face bone graft							
5165	21215		Lower jaw bone graft							
5165	21230		Rib cartilage graft							
5165	21235		Ear cartilage graft							
5165	21240		Reconstruction of jaw joint							
5165	21242		Reconstruction of jaw joint							
5165	21244		Reconstruction of lower jaw							
5165	21245		Reconstruction of jaw							
5165	21246		Reconstruction of jaw							
5165	21247		Reconstruct lower jaw bone							
5165	21248		Reconstruction of jaw							
5165	21249		Reconstruction of jaw							
5165	21255		Reconstruct lower jaw bone							
5165	21256		Reconstruction of orbit							
5165	21260		Revise eye sockets							
5165	21261		Revise eye sockets							
5165	21263		Revise eye sockets							
5165	21267		Revise eye sockets							
5165	21268		Revise eye sockets							
5165	21270		Augmentation cheek bone							
5165	21275		Revision orbitofacial bones							
5165	21330		Open tx nose fx w/skele fix							
5165	21338		Open nasoethmoid fx w/o fix							
5165	21339		Open nasoethmoid fx w/ fixj							
5165	21343		Open tx dprsd front sinus f							
5165	21344		Open tx compl front sinus f							
5165	21346		Opn tx nasomax fx w/fixj							
5165	21347		Opn tx nasomax fx multple							
5165	21348		Opn tx nasomax fx w/graft							
5165	21356		Opn tx dprsd zygomatic arch							
5165	21360		Opn tx dprsd malar fracture							
5165	21365		Opn tx complx malar fx							
5165	21366		Opn tx complx malar w/grft							
5165	21385		Opn tx orbit fx transantral							
5165	21386		Opn tx orbit fx periorbital							
5165	21387		Opn tx orbit fx combined							
5165	21390		Opn tx orbit periorbtl impl							
5165	21395		Opn tx orbit periorbt w/grf							
5165	21406		Opn tx orbit fx w/o implant							
5165	21407		Opn tx orbit fx w/implant							
5165	21408		Opn tx orbit fx w/bone grft							
5165	21422		Treat mouth roof fracture							
5165	21423		Treat mouth roof fracture							
5165	21431		Treat craniofacial fracture							
5165	21432		Treat craniofacial fracture							
5165	21433		Treat craniofacial fracture							
5165	21435		Treat craniofacial fracture							
5165	21436		Treat craniofacial fracture							
5165	21445		Treat dental ridge fracture							
5165	21452		Treat lower jaw fracture							
5165	21453		Treat lower jaw fracture							
5165	21454		Treat lower jaw fracture							
5165	21461		Treat lower jaw fracture							
5165	21462		Treat lower jaw fracture							
5165	21465		Treat lower jaw fracture							
5165	21470		Treat lower jaw fracture							
5165	21685		Hyoid myotomy & suspension							
5165	30125		Removal of nose lesion							
5165	30150		Partial removal of nose							
5165	30160		Removal of nose							
5165	30400		Reconstruction of nose							
5165	30410		Reconstruction of nose							
5165	30420		Reconstruction of nose							
5165	30430		Revision of nose							
5165	30435		Revision of nose							
5165	30450		Revision of nose							
5165	30460		Revision of nose							
5165	30462		Revision of nose							
5165	30465		Repair nasal stenosis							
5165	30468		Rpr nsl vlv collapse w/impl							
5165	30540		Repair nasal defect							
5165	30545		Repair nasal defect							
5165	30580		Repair upper jaw fistula							
5165	30600		Repair mouth/nose fistula							
5165	30620		Intranasal reconstruction							
5165	31030		Exploration maxillary sinus							
5165	31032		Explore sinus remove polyps							
5165	31040		Exploration behind upper ja							
5165	31050		Exploration sphenoid sinus							
5165	31051		Sphenoid sinus surgery							
5165	31070		Exploration of frontal sinu							
5165	31075		Exploration of frontal sinu							
5165	31080		Removal of frontal sinus							
5165	31081		Removal of frontal sinus							
5165	31084		Removal of frontal sinus							
5165	31085		Removal of frontal sinus							
5165	31086		Removal of frontal sinus							
5165	31087		Removal of frontal sinus							
5165	31090		Exploration of sinuses							
5165	31200		Removal of ethmoid sinus							
5165	31400		Revision of larynx							
5165	31420		Removal of epiglottis							
5165	31551		Laryngoplasty laryngeal ste							
5165	31552		Laryngoplasty laryngeal ste							
5165	31553		Laryngoplasty laryngeal ste							
5165	31554		Laryngoplasty laryngeal ste							
5165	31580		Laryngoplasty laryngeal web							
5165	31584		Laryngoplasty fx rdctj fixj							
5165	31587		Laryngoplasty cricoid split							
5165	31590		Reinnervate larynx							
5165	31591		Laryngoplasty medialization							
5165	31592		Cricotracheal resection							
5165	31601		Incision of windpipe							
5165	31610		Incision of windpipe							
5165	31614		Repair windpipe opening							
5165	31750		Repair of windpipe							
5165	31755		Repair of windpipe							
5165	31785		Remove windpipe lesion							
5165	40527		Reconstruct lip with flap							
5165	40700		Repair cleft lip/nasal							
5165	40701		Repair cleft lip/nasal							
5165	40702		Repair cleft lip/nasal							
5165	40761		Repair cleft lip/nasal							
5165	40840		Reconstruction of mouth							
5165	40842		Reconstruction of mouth							
5165	40843		Reconstruction of mouth							
5165	40844		Reconstruction of mouth							
5165	40845		Reconstruction of mouth							
5165	41016		Drainage of mouth lesion							
5165	41019		Place needles h&n for rt							
5165	41120		Partial removal of tongue							
5165	41512		Tongue suspension							
5165	41823		Excision of gum lesion							
5165	41827		Excision of gum lesion							
5165	42107		Excision lesion mouth roof							
5165	42120		Remove palate/lesion							
5165	42145		Repair palate pharynx/uvula							
5165	42182		Repair palate							
5165	42200		Reconstruct cleft palate							
5165	42210		Reconstruct cleft palate							
5165	42215		Reconstruct cleft palate							
5165	42220		Reconstruct cleft palate							
5165	42225		Reconstruct cleft palate							
5165	42226		Lengthening of palate							
5165	42227		Lengthening of palate							
5165	42235		Repair palate							
5165	42260		Repair nose to lip fistula							
5165	42281		Insertion palate prosthesis							
5165	42410		Excise parotid gland/lesion							
5165	42415		Excise parotid gland/lesion							
5165	42420		Excise parotid gland/lesion							
5165	42425		Excise parotid gland/lesion							
5165	42440		Excise submaxillary gland							
5165	42450		Excise sublingual gland							
5165	42500		Repair salivary duct							
5165	42505		Repair salivary duct							
5165	42507		Parotid duct diversion							
5165	42509		Parotid duct diversion							
5165	42725		Drainage of throat abscess							
5165	42815		Excision of neck cyst							
5165	42820		Remove tonsils and adenoids							
5165	42825		Removal of tonsils							
5165	42842		Extensive surgery of throat							
5165	42844		Extensive surgery of throat							
5165	42870		Excision of lingual tonsil							
5165	42890		Partial removal of pharynx							
5165	42892		Revision of pharyngeal wall							
5165	42950		Reconstruction of throat							
5165	43030		Throat muscle surgery							
5165	43130		Removal of esophagus pouch							
5165	43180		Esophagoscopy rigid trnso							
5165	60252		Removal of thyroid							
5165	60260		Repeat thyroid surgery							
5165	60271		Removal of thyroid							
5165	60500		Explore parathyroid glands							
5165	60502		Re-explore parathyroids							
5165	60520		Removal of thymus gland							
5165	69120		Removal of external ear							
5165	69140		Remove ear canal lesion(s)							
5165	69150		Extensive ear canal surgery							
5165	69310		Rebuild outer ear canal							
5165	69320		Rebuild outer ear canal							
5165	69501		Mastoidectomy							
5165	69502		Mastoidectomy							
5165	69505		Remove mastoid structures							
5165	69511		Extensive mastoid surgery							
5165	69530		Extensive mastoid surgery							
5165	69550		Remove ear lesion							
5165	69552		Remove ear lesion							
5165	69601		Mastoid surgery revision							
5165	69602		Mastoid surgery revision							
5165	69603		Mastoid surgery revision							
5165	69604		Mastoid surgery revision							
5165	69631		Repair eardrum structures							
5165	69632		Rebuild eardrum structures							
5165	69633		Rebuild eardrum structures							
5165	69635		Repair eardrum structures							
5165	69636		Rebuild eardrum structures							
5165	69637		Rebuild eardrum structures							
5165	69641		Revise middle ear & mastoid							
5165	69642		Revise middle ear & mastoid							
5165	69643		Revise middle ear & mastoid							
5165	69644		Revise middle ear & mastoid							
5165	69645		Revise middle ear & mastoid							
5165	69646		Revise middle ear & mastoid							
5165	69660		Revise middle ear bone							
5165	69661		Revise middle ear bone							
5165	69662		Revise middle ear bone							
5165	69670		Remove mastoid air cells							
5165	69705		Nps surg dilat eust tube un							
5165	69706		Nps surg dilat eust tube bi							
5165	69720		Release facial nerve							
5165	69725		Release facial nerve							
5165	69740		Repair facial nerve							
5165	69745		Repair facial nerve							
5165	69805		Explore inner ear							
5165	69806		Explore inner ear							
5165	69905		Remove inner ear							
5165	69910		Remove inner ear & mastoid							
5165	69955		Release facial nerve							
5165	69960		Release inner ear canal							
5165	69970		Remove inner ear lesion							
5166		Cochlear Implant Procedure		J1	415.8068	"$34,427.56"	"$7,683.79"	"$6,885.52"	*	
5166	69930		Implant cochlear device							
5181		Level 1 Vascular Procedures		T	6.5415	$541.62	.	$108.33		
5181	0415T		Repos car modulj tranvns el							
5181	32552		Remove lung catheter							
5181	32554		Aspirate pleura w/o imaging							
5181	32555		Aspirate pleura w/ imaging							
5181	32560		Treat pleurodesis w/agent							
5181	32561		Lyse chest fibrin init day							
5181	32562		Lyse chest fibrin subq day							
5181	32960		Therapeutic pneumothorax							
5181	32999		Chest surgery procedure							
5181	33999		Cardiac surgery procedure							
5181	34471		Removal of vein clot							
5181	36002		Pseudoaneurysm injection tr							
5181	36572		Insj picc rs&i <5 yr							
5181	36575		Repair tunneled cv cath							
5181	36589		Removal tunneled cv cath							
5181	37501		Vascular endoscopy procedur							
5181	37799		Vascular surgery procedure							
5181	75801		Lymph vessel x-ray arm/leg							
5181	75872		Vein x-ray skull epidural							
5181	75880		Vein x-ray eye socket							
5182		Level 2 Vascular Procedures		J1	16.983	"$1,406.14"	.	$281.23		
5182	32551		Insertion of chest tube							
5182	32557		Insert cath pleura w/ image							
5182	33016		Pericardiocentesis w/imagin							
5182	35180		Repair blood vessel lesion							
5182	36568		Insj picc <5 yr w/o imaging							
5182	36569		Insj picc 5 yr+ w/o imaging							
5182	36573		Insj picc rs&i 5 yr+							
5182	36576		Repair tunneled cv cath							
5182	36580		Replace cvad cath							
5182	36584		Compl rplcmt picc rs&i							
5182	36590		Removal tunneled cv cath							
5182	36596		Mech remov tunneled cv cath							
5182	36597		Reposition venous catheter							
5182	36860		External cannula declotting							
5182	36901		Intro cath dialysis circuit							
5182	75803		Lymph vessel x-ray arms/leg							
5182	75820		Vein x-ray arm/leg							
5182	75822		Vein x-ray arms/legs							
5182	75827		Vein x-ray chest							
5182	93503		Insert/place heart catheter							
5183		Level 3 Vascular Procedures		J1	34.5624	"$2,861.66"	.	$572.34		
5183	0524T		Ev cath dir chem abltj w/im							
5183	30915		Ligation nasal sinus artery							
5183	30920		Ligation upper jaw artery							
5183	33215		Reposition pacing-defib lea							
5183	33226		Reposition l ventric lead							
5183	33275		Tcat rmvl perm ldls pm w/im							
5183	34421		Removal of vein clot							
5183	34490		Removal of vein clot							
5183	34530		Leg vein fusion							
5183	35184		Repair blood vessel lesion							
5183	35206		Repair blood vessel lesion							
5183	35207		Repair blood vessel lesion							
5183	35231		Repair blood vessel lesion							
5183	35261		Repair blood vessel lesion							
5183	35860		Explore limb vessels							
5183	35903		Excision graft extremity							
5183	36221		Place cath thoracic aorta							
5183	36222		Place cath carotid/inom art							
5183	36225		Place cath subclavian art							
5183	36251		Ins cath ren art 1st unilat							
5183	36252		Ins cath ren art 1st bilat							
5183	36254		Ins cath ren art 2nd+ bilat							
5183	36473		Endovenous mchnchem 1st vei							
5183	36475		Endovenous rf 1st vein							
5183	36478		Endovenous laser 1st vein							
5183	36555		Insert non-tunnel cv cath							
5183	36556		Insert non-tunnel cv cath							
5183	36558		Insert tunneled cv cath							
5183	36560		Insert tunneled cv cath							
5183	36561		Insert tunneled cv cath							
5183	36565		Insert tunneled cv cath							
5183	36570		Insert picvad cath							
5183	36571		Insert picvad cath							
5183	36578		Replace tunneled cv cath							
5183	36581		Replace tunneled cv cath							
5183	36582		Replace tunneled cv cath							
5183	36585		Replace picvad cath							
5183	36595		Mech remov tunneled cv cath							
5183	36640		Insertion catheter artery							
5183	36810		Insertion of cannula							
5183	36821		Av fusion direct any site							
5183	36835		Artery to vein shunt							
5183	37188		Ven mechnl thrmbc repeat tx							
5183	37192		Redo endovas vena cava filt							
5183	37193		Rem endovas vena cava filte							
5183	37197		Remove intrvas foreign body							
5183	37212		Thrombolytic venous therapy							
5183	37213		Thromblytic art/ven therapy							
5183	37214		Cessj therapy cath removal							
5183	37565		Ligation of neck vein							
5183	37600		Ligation of neck artery							
5183	37605		Ligation of neck artery							
5183	37606		Ligation of neck artery							
5183	37607		Ligation of a-v fistula							
5183	37615		Ligation of neck artery							
5183	37617		Ligation of abdomen artery							
5183	37650		Revision of major vein							
5183	37700		Revise leg vein							
5183	37718		Ligate/strip short leg vein							
5183	37722		Ligate/strip long leg vein							
5183	37735		Removal of leg veins/lesion							
5183	37760		Ligate leg veins radical							
5183	37761		Ligate leg veins open							
5183	37765		Stab phleb veins xtr 10-20							
5183	37766		Phleb veins - extrem 20+							
5183	37780		Revision of leg vein							
5183	37785		Ligate/divide/excise vein							
5183	49422		Remove tunneled ip cath							
5183	49429		Removal of shunt							
5183	75600		Contrast exam thoracic aort							
5183	75625		Contrast exam abdominl aort							
5183	75630		X-ray aorta leg arteries							
5183	75710		Artery x-rays arm/leg							
5183	75716		Artery x-rays arms/legs							
5183	75731		Artery x-rays adrenal gland							
5183	75733		Artery x-rays adrenals							
5183	75741		Artery x-rays lung							
5183	75743		Artery x-rays lungs							
5183	75746		Artery x-rays lung							
5183	75756		Artery x-rays chest							
5183	75805		Lymph vessel x-ray trunk							
5183	75807		Lymph vessel x-ray trunk							
5183	75810		Vein x-ray spleen/liver							
5183	75825		Vein x-ray trunk							
5183	75831		Vein x-ray kidney							
5183	75833		Vein x-ray kidneys							
5183	75840		Vein x-ray adrenal gland							
5183	75860		Vein x-ray neck							
5183	75870		Vein x-ray skull							
5183	75885		Vein x-ray liver w/hemodyna							
5183	75887		Vein x-ray liver w/o hemody							
5183	75889		Vein x-ray liver w/hemodyna							
5183	75891		Vein x-ray liver							
5183	75898		Follow-up angiography							
5183	93505		Biopsy of heart lining							
5184		Level 4 Vascular Procedures		J1	57.6153	"$4,770.37"	.	$954.08		
5184	34101		Removal of artery clot							
5184	34111		Removal of arm artery clot							
5184	34201		Removal of artery clot							
5184	34203		Removal of leg artery clot							
5184	34501		Repair valve femoral vein							
5184	34510		Transposition of vein valve							
5184	34520		Cross-over vein graft							
5184	35011		Repair defect of artery							
5184	35045		Repair defect of arm artery							
5184	35188		Repair blood vessel lesion							
5184	35190		Repair blood vessel lesion							
5184	35201		Repair blood vessel lesion							
5184	35236		Repair blood vessel lesion							
5184	35256		Repair blood vessel lesion							
5184	35266		Repair blood vessel lesion							
5184	35286		Repair blood vessel lesion							
5184	35321		Rechanneling of artery							
5184	35372		Rechanneling of artery							
5184	35800		Explore neck vessels							
5184	35875		Removal of clot in graft							
5184	35876		Removal of clot in graft							
5184	35879		Revise graft w/vein							
5184	35881		Revise graft w/vein							
5184	35883		Revise graft w/nonauto graf							
5184	35884		Revise graft w/vein							
5184	36223		Place cath carotid/inom art							
5184	36224		Place cath carotd art							
5184	36226		Place cath vertebral art							
5184	36253		Ins cath ren art 2nd+ unila							
5184	36260		Insertion of infusion pump							
5184	36482		Endoven ther chem adhes 1st							
5184	36557		Insert tunneled cv cath							
5184	36563		Insert tunneled cv cath							
5184	36566		Insert tunneled cv cath							
5184	36583		Replace tunneled cv cath							
5184	36800		Insertion of cannula							
5184	36815		Insertion of cannula							
5184	36818		Av fuse uppr arm cephalic							
5184	36819		Av fuse uppr arm basilic							
5184	36820		Av fusion/forearm vein							
5184	36825		Artery-vein autograft							
5184	36830		Artery-vein nonautograft							
5184	36831		Open thrombect av fistula							
5184	36832		Av fistula revision open							
5184	36833		Av fistula revision							
5184	36838		Dist revas ligation hemo							
5184	36861		Cannula declotting							
5184	37191		Ins endovas vena cava filtr							
5184	37200		Transcatheter biopsy							
5184	37211		Thrombolytic art therapy							
5184	37500		Endoscopy ligate perf veins							
5184	37619		Ligation of inf vena cava							
5184	49419		Insert tun ip cath w/port							
5184	75605		Contrast exam thoracic aort							
5184	75705		Artery x-rays spine							
5184	75726		Artery x-rays abdomen							
5184	75736		Artery x-rays pelvis							
5184	75842		Vein x-ray adrenal glands							
5184	75893		Venous sampling by catheter							
5191		Level 1 Endovascular Procedures		J1	35.0136	"$2,899.02"	$864.64	$579.81		
5191	93451		Right heart cath							
5191	93452		Left hrt cath w/ventrclgrph							
5191	93453		R&l hrt cath w/ventriclgrph							
5191	93454		Coronary artery angio s&i							
5191	93455		Coronary art/grft angio s&i							
5191	93456		R hrt coronary artery angio							
5191	93457		R hrt art/grft angio							
5191	93458		L hrt artery/ventricle angi							
5191	93459		L hrt art/grft angio							
5191	93460		R&l hrt art/ventricle angio							
5191	93461		R&l hrt art/ventricle angio							
5191	93530		Rt heart cath congenital							
5191	93531		R & l heart cath congenital							
5191	93532		R & l heart cath congenital							
5191	93533		R & l heart cath congenital							
5192		Level 2 Endovascular Procedures		J1	59.8674	"$4,956.84"	.	$991.37		
5192	0338T		Trnscth renal symp denrv un							
5192	0339T		Trnscth renal symp denrv bi							
5192	36902		Intro cath dialysis circuit							
5192	36904		Thrmbc/nfs dialysis circuit							
5192	37183		Remove hepatic shunt (tips)							
5192	37220		Iliac revasc							
5192	37224		Fem/popl revas w/tla							
5192	37246		Trluml balo angiop 1st art							
5192	37248		Trluml balo angiop 1st vein							
5192	92920		Prq cardiac angioplast 1 ar							
5192	92986		Revision of aortic valve							
5192	C9764		Revasc intravasc lithotrips							
5193		Level 3 Endovascular Procedures		J1	121.296	"$10,042.95"	.	"$2,008.59"	*	
5193	0234T		Trluml perip athrc renal ar							
5193	0236T		Trluml perip athrc abd aort							
5193	0237T		Trluml perip athrc brchiocp							
5193	0505T		Ev fempop artl revsc							
5193	36903		Intro cath dialysis circuit							
5193	36905		Thrmbc/nfs dialysis circuit							
5193	37182		Insert hepatic shunt (tips)							
5193	37184		Prim art m-thrmbc 1st vsl							
5193	37187		Venous mech thrombectomy							
5193	37221		Iliac revasc w/stent							
5193	37225		Fem/popl revas w/ather							
5193	37226		Fem/popl revasc w/stent							
5193	37228		Tib/per revasc w/tla							
5193	37236		Open/perq place stent 1st							
5193	37238		Open/perq place stent same							
5193	37241		Vasc embolize/occlude venou							
5193	37242		Vasc embolize/occlude arter							
5193	37243		Vasc embolize/occlude organ							
5193	37244		Vasc embolize/occlude bleed							
5193	61623		Endovasc tempory vessel occ							
5193	61626		Transcath occlusion non-cns							
5193	92924		Prq card angio/athrect 1 ar							
5193	92928		Prq card stent w/angio 1 vs							
5193	92937		Prq revasc byp graft 1 vsl							
5193	92943		Prq card revasc chronic 1vs							
5193	92987		Revision of mitral valve							
5193	92990		Revision of pulmonary valve							
5193	92997		Pul art balloon repr percut							
5193	C9600		Perc drug-el cor stent sing							
5193	C9604		Perc d-e cor revasc t cabg							
5193	C9765		Revasc intra lithotrip-sten							
5193	C9766		Revasc intra lithotrip-athe							
5193	C9772		Revasc lithotrip tibi/peron							
5194		Level 4 Endovascular Procedures		J1	194.0167	"$16,064.00"	.	"$3,212.81"	*	
5194	0238T		Trluml perip athrc iliac ar							
5194	0620T		Evasc ven artlz tibl/prnl v							
5194	33274		Tcat insj/rpl perm ldls pm							
5194	36906		Thrmbc/nfs dialysis circuit							
5194	37227		Fem/popl revasc stnt & athe							
5194	37229		Tib/per revasc w/ather							
5194	37230		Tib/per revasc w/stent							
5194	37231		Tib/per revasc stent & athe							
5194	61624		Transcath occlusion cns							
5194	92933		Prq card stent/ath/angio							
5194	93580		Transcath closure of asd							
5194	93581		Transcath closure of vsd							
5194	93582		Perq transcath closure pda							
5194	93590		Perq transcath cls mitral							
5194	93591		Perq transcath cls aortic							
5194	C9602		Perc d-e cor stent ather s							
5194	C9607		Perc d-e cor revasc chro si							
5194	C9767		Revasc lithotrip-stent-athe							
5194	C9773		Revasc lithotr-stent tib/pe							
5194	C9774		Revasc lithotr-ather tib/pe							
5194	C9775		Revasc lith-sten-ath tib/pe							
5194	G2170		Avf by tissue w thermal e							
5194	G2171		Avf use magnetic/art/ven							
5200		Implantation Wireless PA Pressure Monitor		J1	348.0247	"$28,815.40"	.	"$5,763.09"	*	
5200	33289		Tcat impl wrls p-art prs sn							
5211		Level 1 Electrophysiologic Procedures		J1	13.4398	"$1,112.78"	.	$222.56		
5211	0577T		Ephys eval icds ss							
5211	93603		Right ventricular recording							
5211	93615		Esophageal recording							
5211	93616		Esophageal recording							
5211	93618		Heart rhythm pacing							
5211	93642		Electrophysiology evaluatio							
5212		Level 2 Electrophysiologic Procedures		J1	73.4142	"$6,078.48"	.	"$1,215.70"		
5212	93600		Bundle of his recording							
5212	93602		Intra-atrial recording							
5212	93610		Intra-atrial pacing							
5212	93612		Intraventricular pacing							
5212	93619		Electrophysiology evaluatio							
5212	93620		Electrophysiology evaluatio							
5212	93624		Electrophysiologic study							
5212	93650		Ablate heart dysrhythm focu							
5213		Level 3 Electrophysiologic Procedures		J1	259.2414	"$21,464.41"	.	"$4,292.89"	*	
5213	93653		Ep & ablate supravent arrhy							
5213	93654		Ep & ablate ventric tachy							
5213	93656		Tx atrial fib pulm vein iso							
5221		Level1 Pacemaker and Similar Procedures		T	41.5519	"$3,440.37"	.	$688.08		
5221	0412T		Rmvl cardiac modulj pls gen							
5221	0413T		Rmvl car modulj tranvns elt							
5221	0457T		Remvl mech-elec skin ntrfce							
5221	0458T		Remvl subq electrode							
5221	0460T		Repos aortic ventr dev eltr							
5221	0518T		Rmvl pg compnt wcs							
5221	0519T		Rmvl & rplcmt pg compnt wcs							
5221	0530T		Removal complete iims							
5221	0531T		Removal iims electrode only							
5221	0532T		Removal iims implt mntr onl							
5221	0573T		Removal ss dfb electrode							
5221	0574T		Repos prev ss impl dfb eltr							
5221	0580T		Rmvl ss impl dfb pg only							
5221	33218		Repair lead pace-defib one							
5221	33220		Repair lead pace-defib dual							
5221	33234		Removal of pacemaker system							
5221	33235		Removal pacemaker electrode							
5221	33241		Remove pulse generator							
5221	33244		Remove elctrd transvenously							
5221	33272		Rmvl of subq defibrillator							
5221	33273		Repos prev impltbl subq dfb							
5221	36261		Revision of infusion pump							
5221	36262		Removal of infusion pump							
5222		Level 2 Pacemaker and Similar Procedures		J1	98.4647	"$8,152.58"	.	"$1,630.52"	*	
5222	0410T		Insj/rplc car modulj atr el							
5222	0411T		Insj/rplc car modulj vnt el							
5222	0453T		Insj/rplcmt mech-elec ntrfc							
5222	0454T		Insj/rplcmt subq electrode							
5222	0516T		Insj wcs lv eltrd only							
5222	0517T		Insj wcs lv pg compnt							
5222	0526T		Insj/rplcmt iims eltrd only							
5222	0527T		Insj/rplcmt iims implt mntr							
5222	0572T		Insertion ss dfb electrode							
5222	33210		Insert electrd/pm cath sngl							
5222	33211		Insert card electrodes dual							
5222	33212		Insert pulse gen sngl lead							
5222	33216		Insert 1 electrode pm-defib							
5222	33217		Insert 2 electrode pm-defib							
5222	33227		Remove&replace pm gen singl							
5222	33233		Removal of pm generator							
5222	33271		Insj subq impltbl dfb elctr							
5222	33285		Insj subq car rhythm mntr							
5223		Level 3 Pacemaker and Similar Procedures		J1	125.6102	"$10,400.15"	.	"$2,080.03"	*	
5223	0525T		Insj/rplcmt compl iims							
5223	33206		Insert heart pm atrial							
5223	33207		Insert heart pm ventricular							
5223	33208		Insrt heart pm atrial & ven							
5223	33213		Insert pulse gen dual leads							
5223	33214		Upgrade of pacemaker system							
5223	33224		Insert pacing lead & connec							
5223	33228		Remv&replc pm gen dual lead							
5224		Level 4 Pacemaker and Similar Procedures		J1	224.7818	"$18,611.26"	.	"$3,722.26"	*	
5224	33221		Insert pulse gen mult leads							
5224	33229		Remv&replc pm gen mult lead							
5231		Level 1 ICD and Similar Procedures		J1	278.2729	"$23,040.16"	.	"$4,608.04"	*	
5231	0408T		Insj/rplc cardiac modulj sy							
5231	0409T		Insj/rplc car modulj pls gn							
5231	0414T		Rmvl & rpl car modulj pls g							
5231	0515T		Insj wcs lv compl sys							
5231	0520T		Rmvl&rplcmt pg wcs new eltr							
5231	0614T		Rmvl&rplcmt ss impl dfb pg							
5231	33230		Insrt pulse gen w/dual lead							
5231	33240		Insrt pulse gen w/singl lea							
5231	33262		Rmvl& replc pulse gen 1 lea							
5231	33263		Rmvl & rplcmt dfb gen 2 lea							
5232		Level 2 ICD and Similar Procedures		J1	396.6193	"$32,838.89"	.	"$6,567.78"	*	
5232	0571T		Insj/rplcmt icds ss eltrd							
5232	33231		Insrt pulse gen w/mult lead							
5232	33249		Insj/rplcmt defib w/lead(s)							
5232	33264		Rmvl & rplcmt dfb gen mlt l							
5232	33270		Ins/rep subq defibrillator							
5241		Level 1 Blood Product Exchange and Related Services		S	4.7956	$397.06	.	$79.42		
5241	36430		Blood transfusion service							
5241	36440		Bl push transfuse 2 yr/<							
5241	36450		Bl exchange/transfuse nb							
5241	36455		Bl exchange/transfuse non-n							
5241	36456		Prtl exchange transfuse nb							
5241	36460		Transfusion service fetal							
5241	36513		Apheresis platelets							
5241	38207		Cryopreserve stem cells							
5241	38208		Thaw preserved stem cells							
5241	38209		Wash harvest stem cells							
5241	38210		T-cell depletion of harvest							
5241	38211		Tumor cell deplete of harvs							
5241	38212		Rbc depletion of harvest							
5241	38213		Platelet deplete of harvest							
5241	38214		Volume deplete of harvest							
5241	38215		Harvest stem cell concentrt							
5241	38999		Blood/lymph system procedur							
5242		Level 2 Blood Product Exchange and Related Services		S	16.4639	"$1,363.16"	.	$272.64		
5242	36511		Apheresis wbc							
5242	36512		Apheresis rbc							
5242	36514		Apheresis plasma							
5242	38206		Harvest auto stem cells							
5242	38230		Bone marrow harvest allogen							
5242	38241		Transplt autol hct/donor							
5242	38242		Transplt allo lymphocytes							
5242	38243		Transplj hematopoietic boos							
5243		Level 3 Blood Product Exchange and Related Services		S	48.7664	"$4,037.71"	.	$807.55		
5243	0263T		Im b1 mrw cel ther cmpl							
5243	0264T		Im b1 mrw cel ther xcl hrvs							
5243	0265T		Im b1 mrw cel ther hrvst on							
5243	0342T		Thxp apheresis w/hdl delip							
5243	36516		Apheresis immunoads slctv							
5243	36522		Photopheresis							
5243	38232		Bone marrow harvest autolog							
5244		Level 4 Blood Product Exchange and Related Services		J1	384.5324	"$31,838.13"	.	"$6,367.63"	*	
5244	38240		Transplt allo hct/donor							
5301		Level 1 Upper GI Procedures		T	9.7781	$809.60	.	$161.92		
5301	40804		Removal foreign body mouth							
5301	43197		Esophagoscopy flex dx brush							
5301	43198		Esophagosc flex trnsn biops							
5301	43200		Esophagoscopy flexible brus							
5301	43235		Egd diagnostic brush wash							
5301	43236		Uppr gi scope w/submuc inj							
5301	43239		Egd biopsy single/multiple							
5301	43247		Egd remove foreign body							
5301	43248		Egd guide wire insertion							
5301	43450		Dilate esophagus 1/mult pas							
5301	43499		Esophagus surgery procedure							
5301	43510		Surgical opening of stomach							
5301	43756		Dx duod intub w/asp spec							
5301	43757		Dx duod intub w/asp specs							
5301	43831		Place gastrostomy tube							
5301	43999		Stomach surgery procedure							
5301	44100		Biopsy of bowel							
5301	44380		Small bowel endoscopy br/wa							
5301	44382		Small bowel endoscopy							
5301	44500		Intro gastrointestinal tube							
5301	44799		Unlisted px small intestine							
5301	47537		Removal biliary drg cath							
5301	47999		Bile tract surgery procedur							
5301	49082		Abd paracentesis							
5301	49083		Abd paracentesis w/imaging							
5301	49084		Peritoneal lavage							
5301	49450		Replace g/c tube perc							
5301	49451		Replace duod/jej tube perc							
5301	49452		Replace g-j tube perc							
5301	49460		Fix g/colon tube w/device							
5301	49999		Abdomen surgery procedure							
5301	91110		Gi tract capsule endoscopy							
5301	91111		Esophageal capsule endoscop							
5301	91112		Gi wireless capsule measure							
5301	G0455		Fecal microbiota prep insti							
5302		Level 2 Upper GI Procedures		J1	19.6265	"$1,625.02"	.	$325.01		
5302	0355T		Gi tract capsule endoscopy							
5302	32556		Insert cath pleura w/o imag							
5302	43191		Esophagoscopy rigid trnso d							
5302	43192		Esophagoscp rig trnso injec							
5302	43193		Esophagoscp rig trnso biops							
5302	43194		Esophagoscp rig trnso rem f							
5302	43201		Esoph scope w/submucous inj							
5302	43202		Esophagoscopy flex biopsy							
5302	43204		Esoph scope w/sclerosis inj							
5302	43205		Esophagus endoscopy/ligatio							
5302	43206		Esoph optical endomicroscop							
5302	43211		Esophagoscop mucosal resect							
5302	43213		Esophagoscopy retro balloon							
5302	43214		Esophagosc dilate balloon 3							
5302	43215		Esophagoscopy flex remove f							
5302	43216		Esophagoscopy lesion remova							
5302	43217		Esophagoscopy snare les rem							
5302	43220		Esophagoscopy balloon <30mm							
5302	43226		Esoph endoscopy dilation							
5302	43227		Esophagoscopy control bleed							
5302	43231		Esophagoscop ultrasound exa							
5302	43232		Esophagoscopy w/us needle b							
5302	43233		Egd balloon dil esoph30 mm/							
5302	43237		Endoscopic us exam esoph							
5302	43238		Egd us fine needle bx/aspir							
5302	43241		Egd tube/cath insertion							
5302	43242		Egd us fine needle bx/aspir							
5302	43243		Egd injection varices							
5302	43244		Egd varices ligation							
5302	43245		Egd dilate stricture							
5302	43246		Egd place gastrostomy tube							
5302	43249		Esoph egd dilation <30 mm							
5302	43250		Egd cautery tumor polyp							
5302	43251		Egd remove lesion snare							
5302	43253		Egd us transmural injxn/mar							
5302	43254		Egd endo mucosal resection							
5302	43255		Egd control bleeding any							
5302	43259		Egd us exam duodenum/jejunu							
5302	43270		Egd lesion ablation							
5302	43453		Dilate esophagus							
5302	43830		Place gastrostomy tube							
5302	44300		Open bowel to skin							
5302	44360		Small bowel endoscopy							
5302	44361		Small bowel endoscopy/biops							
5302	44363		Small bowel endoscopy							
5302	44364		Small bowel endoscopy							
5302	44365		Small bowel endoscopy							
5302	44366		Small bowel endoscopy							
5302	44369		Small bowel endoscopy							
5302	44372		Small bowel endoscopy							
5302	44373		Small bowel endoscopy							
5302	44376		Small bowel endoscopy							
5302	44377		Small bowel endoscopy/biops							
5302	44378		Small bowel endoscopy							
5302	44381		Small bowel endoscopy br/wa							
5302	49423		Exchange drainage catheter							
5302	49436		Embedded ip cath exit-site							
5302	49440		Place gastrostomy tube perc							
5302	49441		Place duod/jej tube perc							
5302	49446		Change g-tube to g-j perc							
5303		Level 3 Upper GI Procedures		J1	37.209	"$3,080.79"	.	$616.16		
5303	43195		Esophagoscopy rigid balloon							
5303	43196		Esophagoscp guide wire dila							
5303	43229		Esophagoscopy lesion ablate							
5303	43240		Egd w/transmural drain cyst							
5303	43252		Egd optical endomicroscopy							
5303	43257		Egd w/thrml txmnt gerd							
5303	43260		Ercp w/specimen collection							
5303	43261		Endo cholangiopancreatograp							
5303	43262		Endo cholangiopancreatograp							
5303	43263		Ercp sphincter pressure mea							
5303	43264		Ercp remove duct calculi							
5303	43275		Ercp remove forgn body duct							
5303	43277		Ercp ea duct/ampulla dilate							
5303	43278		Ercp lesion ablate w/dilate							
5303	43772		Lap rmvl gastr adj device							
5303	43774		Lap rmvl gastr adj all part							
5303	43870		Repair stomach opening							
5303	44384		Small bowel endoscopy							
5303	44602		Suture small intestine							
5311		Level 1 Lower GI Procedures		T	9.5855	$793.65	.	$158.74		
5311	44385		Endoscopy of bowel pouch							
5311	44386		Endoscopy bowel pouch/biop							
5311	44388		Colonoscopy thru stoma spx							
5311	44390		Colonoscopy for foreign bod							
5311	44408		Colonoscopy w/decompression							
5311	45300		Proctosigmoidoscopy dx							
5311	45330		Diagnostic sigmoidoscopy							
5311	45331		Sigmoidoscopy and biopsy							
5311	45333		Sigmoidoscopy & polypectomy							
5311	45335		Sigmoidoscopy w/submuc inj							
5311	45337		Sigmoidoscopy & decompress							
5311	45341		Sigmoidoscopy w/ultrasound							
5311	45378		Diagnostic colonoscopy							
5311	45399		Unlisted procedure colon							
5311	45520		Treatment of rectal prolaps							
5311	45900		Reduction of rectal prolaps							
5311	45999		Rectum surgery procedure							
5311	46050		Incision of anal abscess							
5311	46221		Ligation of hemorrhoid(s)							
5311	46500		Injection into hemorrhoid(s							
5311	46608		Anoscopy remove for body							
5311	46611		Anoscopy							
5311	46942		Treatment of anal fissure							
5311	46999		Anus surgery procedure							
5311	C9725		Place endorectal app							
5522	76977		Us bone density measure				$0.00	$0.00		
5521	77078		Ct bone density axial				$0.00	$0.00		
5522	77080		Dxa bone density axial				$0.00	$0.00		
5312		Level 2 Lower GI Procedures		T	12.5241	"$1,036.96"	.	$207.40		
5312	44389		Colonoscopy with biopsy							
5312	44391		Colonoscopy for bleeding							
5312	44392		Colonoscopy & polypectomy							
5312	44394		Colonoscopy w/snare							
5312	44401		Colonoscopy with ablation							
5312	44403		Colonoscopy w/resection							
5312	44404		Colonoscopy w/injection							
5312	44405		Colonoscopy w/dilation							
5312	44406		Colonoscopy w/ultrasound							
5312	44407		Colonoscopy w/ndl aspir/bx							
5312	45000		Drainage of pelvic abscess							
5312	45005		Drainage of rectal abscess							
5312	45150		Excision of rectal strictur							
5312	45303		Proctosigmoidoscopy dilate							
5312	45305		Proctosigmoidoscopy w/bx							
5312	45309		Proctosigmoidoscopy removal							
5312	45315		Proctosigmoidoscopy removal							
5312	45317		Proctosigmoidoscopy bleed							
5312	45332		Sigmoidoscopy w/fb removal							
5312	45334		Sigmoidoscopy for bleeding							
5312	45338		Sigmoidoscopy w/tumr remove							
5312	45340		Sig w/tndsc balloon dilatio							
5312	45342		Sigmoidoscopy w/us guide bx							
5312	45346		Sigmoidoscopy w/ablation							
5312	45350		Sgmdsc w/band ligation							
5312	45379		Colonoscopy w/fb removal							
5312	45380		Colonoscopy and biopsy							
5312	45381		Colonoscopy submucous njx							
5312	45382		Colonoscopy w/control bleed							
5312	45384		Colonoscopy w/lesion remova							
5312	45385		Colonoscopy w/lesion remova							
5312	45386		Colonoscopy w/balloon dilat							
5312	45388		Colonoscopy w/ablation							
5312	45391		Colonoscopy w/endoscope us							
5312	45392		Colonoscopy w/endoscopic fn							
5312	45393		Colonoscopy w/decompression							
5312	45398		Colonoscopy w/band ligation							
5312	45905		Dilation of anal sphincter							
5312	45910		Dilation of rectal narrowin							
5312	45915		Remove rectal obstruction							
5312	46030		Removal of rectal marker							
5312	46040		Incision of rectal abscess							
5312	46220		Excise anal ext tag/papilla							
5312	46320		Removal of hemorrhoid clot							
5312	46505		Chemodenervation anal musc							
5312	46604		Anoscopy and dilation							
5312	46606		Anoscopy and biopsy							
5312	46607		Diagnostic anoscopy & biops							
5312	46614		Anoscopy control bleeding							
5312	46930		Destroy internal hemorrhoid							
5312	49442		Place cecostomy tube perc							
5313		Level 3 Lower GI Procedures		J1	29.5106	"$2,443.39"	.	$488.68		
5313	45020		Drainage of rectal abscess							
5313	45100		Biopsy of rectum							
5313	45108		Removal of anorectal lesion							
5313	45160		Excision of rectal lesion							
5313	45171		Exc rect tum transanal part							
5313	45172		Exc rect tum transanal full							
5313	45190		Destruction rectal tumor							
5313	45307		Proctosigmoidoscopy fb							
5313	45308		Proctosigmoidoscopy removal							
5313	45320		Proctosigmoidoscopy ablate							
5313	45321		Proctosigmoidoscopy volvul							
5313	45349		Sigmoidoscopy w/resection							
5313	45390		Colonoscopy w/resection							
5313	45500		Repair of rectum							
5313	45505		Repair of rectum							
5313	45541		Correct rectal prolapse							
5313	45560		Repair of rectocele							
5313	45990		Surg dx exam anorectal							
5313	46020		Placement of seton							
5313	46045		Incision of rectal abscess							
5313	46060		Incision of rectal abscess							
5313	46070		Incision of anal septum							
5313	46080		Incision of anal sphincter							
5313	46200		Removal of anal fissure							
5313	46230		Removal of anal tags							
5313	46250		Remove ext hem groups 2+							
5313	46255		Remove int/ext hem 1 group							
5313	46257		Remove in/ex hem grp & fiss							
5313	46258		Remove in/ex hem grp w/fist							
5313	46260		Remove in/ex hem groups 2+							
5313	46261		Remove in/ex hem grps & fis							
5313	46262		Remove in/ex hem grps w/fis							
5313	46270		Remove anal fist subq							
5313	46275		Remove anal fist inter							
5313	46280		Remove anal fist complex							
5313	46285		Remove anal fist 2 stage							
5313	46288		Repair anal fistula							
5313	46610		Anoscopy remove lesion							
5313	46612		Anoscopy remove lesions							
5313	46615		Anoscopy							
5313	46700		Repair of anal stricture							
5313	46706		Repr of anal fistula w/glue							
5313	46707		Repair anorectal fist w/plu							
5313	46750		Repair of anal sphincter							
5313	46753		Reconstruction of anus							
5313	46754		Removal of suture from anus							
5313	46760		Repair of anal sphincter							
5313	46761		Repair of anal sphincter							
5313	46917		Laser surgery anal lesions							
5313	46922		Excision of anal lesion(s)							
5313	46924		Destruction anal lesion(s)							
5313	46940		Treatment of anal fissure							
5313	46945		Int hrhc lig 1 hroid w/o im							
5313	46946		Int hrhc lig 2+hroid w/o im							
5313	46947		Hemorrhoidopexy by stapling							
5313	46948		Int hrhc tranal dartlzj 2+							
5331		Complex GI Procedures		J1	60.7331	"$5,028.52"	.	"$1,005.71"		
5331	0184T		Exc rectal tumor endoscopic							
5331	43212		Esophagoscop stent placemen							
5331	43265		Ercp lithotripsy calculi							
5331	43266		Egd endoscopic stent place							
5331	43274		Ercp duct stent placement							
5331	43276		Ercp stent exchange w/dilat							
5331	43840		Repair of stomach lesion							
5331	44370		Small bowel endoscopy/stent							
5331	44379		S bowel endoscope w/stent							
5331	44402		Colonoscopy w/stent plcmt							
5331	45327		Proctosigmoidoscopy w/stent							
5331	45347		Sigmoidoscopy w/plcmt stent							
5331	45389		Colonoscopy w/stent plcmt							
5341		Abdominal/Peritoneal/Biliary and Related Procedures		J1	38.4484	"$3,183.41"	.	$636.69		
5341	32550		Insert pleural cath							
5341	44345		Revision of colostomy							
5341	44346		Revision of colostomy							
5341	44950		Appendectomy							
5341	47490		Incision of gallbladder							
5341	47531		Injection for cholangiogram							
5341	47532		Injection for cholangiogram							
5341	47533		Plmt biliary drainage cath							
5341	47534		Plmt biliary drainage cath							
5341	47535		Conversion ext bil drg cath							
5341	47536		Exchange biliary drg cath							
5341	47541		Plmt access bil tree sm bwl							
5341	47552		Biliary endo perq dx w/spec							
5341	47553		Biliary endoscopy thru skin							
5341	47555		Biliary endoscopy thru skin							
5341	49010		Exploration behind abdomen							
5341	49250		Excision of umbilicus							
5341	49255		Removal of omentum							
5341	49402		Remove foreign body adbomen							
5341	49418		Insert tun ip cath perc							
5341	49421		Ins tun ip cath for dial op							
5341	49426		Revise abdomen-venous shunt							
5341	49492		Rpr ing hern premie blocked							
5341	49495		Rpr ing hernia baby reduc							
5341	49496		Rpr ing hernia baby blocked							
5341	49500		Rpr ing hernia init reduce							
5341	49501		Rpr ing hernia init blocked							
5341	49505		Prp i/hern init reduc >5 yr							
5341	49507		Prp i/hern init block >5 yr							
5341	49520		Rerepair ing hernia reduce							
5341	49521		Rerepair ing hernia blocked							
5341	49525		Repair ing hernia sliding							
5341	49550		Rpr rem hernia init reduce							
5341	49553		Rpr fem hernia init blocked							
5341	49555		Rerepair fem hernia reduce							
5341	49557		Rerepair fem hernia blocked							
5341	49560		Rpr ventral hern init reduc							
5341	49561		Rpr ventral hern init block							
5341	49570		Rpr epigastric hern reduce							
5341	49572		Rpr epigastric hern blocked							
5341	49580		Rpr umbil hern reduc < 5 yr							
5341	49582		Rpr umbil hern block < 5 yr							
5341	49585		Rpr umbil hern reduc > 5 yr							
5341	49587		Rpr umbil hern block > 5 yr							
5341	49590		Repair spigelian hernia							
5341	49600		Repair umbilical lesion							
5341	54530		Removal of testis							
5341	54550		Exploration for testis							
5341	54640		Orchiopexy ingun/scrot appr							
5341	54650		Orchiopexy (fowler-stephens							
5341	55040		Removal of hydrocele							
5341	55041		Removal of hydroceles							
5341	55535		Revise spermatic cord veins							
5341	55540		Revise hernia & sperm veins							
5361		Level 1 Laparoscopy and Related Services		J1	61.1186	"$5,060.44"	.	"$1,012.09"		
5361	32601		Thoracoscopy diagnostic							
5361	32604		Thoracoscopy wbx sac							
5361	32606		Thoracoscopy w/bx med space							
5361	32607		Thoracoscopy w/bx infiltrat							
5361	32608		Thoracoscopy w/bx nodule							
5361	32609		Thoracoscopy w/bx pleura							
5361	32994		Ablate pulm tumor perq cryb							
5361	32998		Ablate pulm tumor perq rf							
5361	38129		Laparoscope proc spleen							
5361	38542		Explore deep node(s) neck							
5361	38570		Laparoscopy lymph node biop							
5361	38589		Laparoscope proc lymphatic							
5361	38740		Remove armpit lymph nodes							
5361	38745		Remove armpit lymph nodes							
5361	39401		Mediastinoscpy w/medstnl bx							
5361	39402		Mediastinoscpy w/lmph nod b							
5361	43285		Rmvl esophgl sphnctr dev							
5361	43289		Laparoscope proc esoph							
5361	43648		Lap revise/remv eltrd antru							
5361	43651		Laparoscopy vagus nerve							
5361	43652		Laparoscopy vagus nerve							
5361	43653		Laparoscopy gastrostomy							
5361	43659		Laparoscope proc stom							
5361	43773		Lap replace gastr adj devic							
5361	44180		Lap enterolysis							
5361	44186		Lap jejunostomy							
5361	44238		Laparoscope proc intestine							
5361	44970		Laparoscopy appendectomy							
5361	44979		Laparoscope proc app							
5361	45499		Laparoscope proc rectum							
5361	47379		Laparoscope procedure liver							
5361	47382		Percut ablate liver rf							
5361	47383		Perq abltj lvr cryoablation							
5361	47538		Perq plmt bile duct stent							
5361	47539		Perq plmt bile duct stent							
5361	47540		Perq plmt bile duct stent							
5361	47554		Biliary endoscopy thru skin							
5361	47556		Biliary endoscopy thru skin							
5361	47562		Laparoscopic cholecystectom							
5361	47563		Laparo cholecystectomy/grap							
5361	47564		Laparo cholecystectomy/expl							
5361	47579		Laparoscope proc biliary							
5361	49320		Diag laparo separate proc							
5361	49321		Laparoscopy biopsy							
5361	49322		Laparoscopy aspiration							
5361	49323		Laparo drain lymphocele							
5361	49324		Lap insert tunnel ip cath							
5361	49325		Lap revision perm ip cath							
5361	49329		Laparo proc abdm/per/oment							
5361	49491		Rpr hern preemie reduc							
5361	49540		Repair lumbar hernia							
5361	49565		Rerepair ventrl hern reduce							
5361	49566		Rerepair ventrl hern block							
5361	49650		Lap ing hernia repair init							
5361	49651		Lap ing hernia repair recur							
5361	49652		Lap vent/abd hernia repair							
5361	49653		Lap vent/abd hern proc comp							
5361	49659		Laparo proc hernia repair							
5361	50541		Laparo ablate renal cyst							
5361	50549		Laparoscope proc renal							
5361	50592		Perc rf ablate renal tumor							
5361	50945		Laparoscopy ureterolithotom							
5361	50947		Laparo new ureter/bladder							
5361	50949		Laparoscope proc ureter							
5361	51500		Removal of bladder cyst							
5361	51990		Laparo urethral suspension							
5361	51992		Laparo sling operation							
5361	51999		Laparoscope proc bla							
5361	54690		Laparoscopy orchiectomy							
5361	54692		Laparoscopy orchiopexy							
5361	54699		Laparoscope proc testis							
5361	55550		Laparo ligate spermatic vei							
5361	55559		Laparo proc spermatic cord							
5361	58541		Lsh uterus 250 g or less							
5361	58545		Laparoscopic myomectomy							
5361	58550		Laparo-asst vag hysterectom							
5361	58578		Laparo proc uterus							
5361	58660		Laparoscopy lysis							
5361	58661		Laparoscopy remove adnexa							
5361	58662		Laparoscopy excise lesions							
5361	58670		Laparoscopy tubal cautery							
5361	58671		Laparoscopy tubal block							
5361	58672		Laparoscopy fimbrioplasty							
5361	58673		Laparoscopy salpingostomy							
5361	58679		Laparo proc oviduct-ovary							
5361	59150		Treat ectopic pregnancy							
5361	59151		Treat ectopic pregnancy							
5361	59898		Laparo proc ob care/deliver							
5361	60200		Remove thyroid lesion							
5361	60210		Partial thyroid excision							
5361	60212		Partial thyroid excision							
5361	60220		Partial removal of thyroid							
5361	60225		Partial removal of thyroid							
5361	60240		Removal of thyroid							
5361	60280		Remove thyroid duct lesion							
5361	60281		Remove thyroid duct lesion							
5361	60659		Laparo proc endocrine							
5361	60699		Endocrine surgery procedure							
5362		Level 2 Laparoscopy and Related Services		J1	107.5843	"$8,907.66"	.	"$1,781.54"	*	
5362	0600T		Ire abltj 1+tum organ perq							
5362	0601T		Ire abltj 1+tumors open							
5362	38120		Laparoscopy splenectomy							
5362	38562		Removal pelvic lymph nodes							
5362	38571		Laparoscopy lymphadenectomy							
5362	38572		Laparoscopy lymphadenectomy							
5362	38573		Laps pelvic lymphadec							
5362	43210		Egd esophagogastrc fndoplst							
5362	43280		Laparoscopy fundoplasty							
5362	43281		Lap paraesophag hern repair							
5362	43282		Lap paraesoph her rpr w/mes							
5362	43284		Laps esophgl sphnctr agmntj							
5362	43770		Lap place gastr adj device							
5362	47370		Laparo ablate liver tumor r							
5362	47371		Laparo ablate liver cryosur							
5362	49654		Lap inc hernia repair							
5362	49655		Lap inc hern repair comp							
5362	49656		Lap inc hernia repair recur							
5362	49657		Lap inc hern recur comp							
5362	50542		Laparo ablate renal mass							
5362	50543		Laparo partial nephrectomy							
5362	50544		Laparoscopy pyeloplasty							
5362	50593		Perc cryo ablate renal tum							
5362	50948		Laparo new ureter/bladder							
5362	55866		Laparo radical prostatectom							
5362	57423		Repair paravag defect lap							
5362	57425		Laparoscopy surg colpopexy							
5362	58542		Lsh w/t/o ut 250 g or less							
5362	58543		Lsh uterus above 250 g							
5362	58544		Lsh w/t/o uterus above 250							
5362	58546		Laparo-myomectomy complex							
5362	58552		Laparo-vag hyst incl t/o							
5362	58553		Laparo-vag hyst complex							
5362	58554		Laparo-vag hyst w/t/o compl							
5362	58570		Tlh uterus 250 g or less							
5362	58571		Tlh w/t/o 250 g or less							
5362	58572		Tlh uterus over 250 g							
5362	58573		Tlh w/t/o uterus over 250 g							
5362	58674		Laps abltj uterine fibroids							
5371		Level 1 Urology and Related Services		T	3.2144	$266.14	.	$53.23		
5371	0551T		Tprnl balo cntnc dev adjmt							
5371	43761		Reposition gastrostomy tube							
5371	43762		Rplc gtube no revj trc							
5371	43763		Rplc gtube revj gstrst trc							
5371	46083		Incise external hemorrhoid							
5371	50391		Instll rx agnt into rnal tu							
5371	51100		Drain bladder by needle							
5371	51700		Irrigation of bladder							
5371	51705		Change of bladder tube							
5371	51720		Treatment of bladder lesion							
5371	51725		Simple cystometrogram							
5371	51726		Complex cystometrogram							
5371	51785		Anal/urinary muscle study							
5371	53600		Dilate urethra stricture							
5371	53621		Dilate urethra stricture							
5371	53899		Urology surgery procedure							
5371	54200		Treatment of penis lesion							
5371	54220		Treatment of penis lesion							
5371	54231		Dynamic cavernosometry							
5371	54235		Penile injection							
5371	54250		Penis study							
5371	54450		Preputial stretching							
5371	55899		Genital surgery procedure							
5371	91117		Colon motility 6 hr study							
5371	91122		Anal pressure record							
5372		Level 2 Urology and Related Services		T	6.9419	$574.77	.	$114.96		
5372	0596T		Temp fml iu vlv-pmp 1st ins							
5372	0597T		Temp fml iu valve-pmp rplcm							
5372	50389		Remove renal tube w/fluoro							
5372	50396		Measure kidney pressure							
5372	50430		Njx px nfrosgrm &/urtrgrm							
5372	50431		Njx px nfrosgrm &/urtrgrm							
5372	50572		Kidney endoscopy							
5372	51710		Change of bladder tube							
5372	51727		Cystometrogram w/up							
5372	51728		Cystometrogram w/vp							
5372	51729		Cystometrogram w/vp&up							
5372	52000		Cystoscopy							
5372	52010		Cystoscopy & duct catheter							
5372	52285		Cystoscopy and treatment							
5372	53080		Drainage of urinary leakage							
5372	53620		Dilate urethra stricture							
5372	54160		Circumcision neonate							
5373		Level 3 Urology and Related Services		J1	21.6552	"$1,792.99"	.	$358.60		
5373	50020		Renal abscess open drain							
5373	50382		Change ureter stent percut							
5373	50384		Remove ureter stent percut							
5373	50385		Change stent via transureth							
5373	50386		Remove stent via transureth							
5373	50387		Change nephroureteral cath							
5373	50432		Plmt nephrostomy catheter							
5373	50434		Convert nephrostomy cathete							
5373	50435		Exchange nephrostomy cath							
5373	50688		Change of ureter tube/stent							
5373	51040		Incise & drain bladder							
5373	51045		Incise bladder/drain ureter							
5373	51060		Removal of ureter stone							
5373	51102		Drain bl w/cath insertion							
5373	52005		Cystoscopy & ureter cathete							
5373	52204		Cystoscopy w/biopsy(s)							
5373	52260		Cystoscopy and treatment							
5373	52265		Cystoscopy and treatment							
5373	52270		Cystoscopy & revise urethra							
5373	52275		Cystoscopy & revise urethra							
5373	52276		Cystoscopy and treatment							
5373	52281		Cystoscopy and treatment							
5373	52283		Cystoscopy and treatment							
5373	52287		Cystoscopy chemodenervation							
5373	52290		Cystoscopy and treatment							
5373	52310		Cystoscopy and treatment							
5373	52315		Cystoscopy and treatment							
5373	53000		Incision of urethra							
5373	53020		Incision of urethra							
5373	53025		Incision of urethra							
5373	53060		Drainage of urethra abscess							
5373	53085		Drainage of urinary leakage							
5373	53200		Biopsy of urethra							
5373	53265		Treatment of urethra lesion							
5373	53665		Dilation of urethra							
5373	53854		Trurl dstrj prst8 tiss rf w							
5373	53855		Insert prost urethral stent							
5373	53860		Transurethral rf treatment							
5373	54001		Slitting of prepuce							
5373	54150		Circumcision w/regionl bloc							
5373	54161		Circum 28 days or older							
5373	54162		Lysis penil circumic lesion							
5373	54163		Repair of circumcision							
5373	54164		Frenulotomy of penis							
5373	54380		Repair penis							
5373	54385		Repair penis							
5373	54560		Exploration for testis							
5373	54700		Drainage of scrotum							
5373	54840		Remove epididymis lesion							
5373	54900		Fusion of spermatic ducts							
5373	55120		Removal of scrotum lesion							
5373	55250		Removal of sperm duct(s)							
5373	55600		Incise sperm duct pouch							
5373	55700		Biopsy of prostate							
5373	74485		Dilation urtr/urt rs&i							
5374		Level 4 Urology and Related Services		J1	37.1552	"$3,076.34"	.	$615.27		
5374	0499T		Cysto f/urtl strix/stenosis							
5374	0550T		Tprnl balo cntnc dev rmvl e							
5374	37790		Penile venous occlusion							
5374	50433		Plmt nephroureteral cathete							
5374	50436		Dilat xst trc ndurlgc px							
5374	50437		Dilat xst trc new access rc							
5374	50570		Kidney endoscopy							
5374	50574		Kidney endoscopy & biopsy							
5374	50590		Fragmenting of kidney stone							
5374	50693		Plmt ureteral stent prq							
5374	50694		Plmt ureteral stent prq							
5374	50695		Plmt ureteral stent prq							
5374	50727		Revise ureter							
5374	50951		Endoscopy of ureter							
5374	50953		Endoscopy of ureter							
5374	50970		Ureter endoscopy							
5374	50972		Ureter endoscopy & catheter							
5374	51020		Incise & treat bladder							
5374	51030		Incise & treat bladder							
5374	51065		Remove ureter calculus							
5374	51520		Removal of bladder lesion							
5374	51535		Repair of ureter lesion							
5374	51715		Endoscopic injection/implan							
5374	51880		Repair of bladder opening							
5374	52001		Cystoscopy removal of clots							
5374	52007		Cystoscopy and biopsy							
5374	52214		Cystoscopy and treatment							
5374	52224		Cystoscopy and treatment							
5374	52234		Cystoscopy and treatment							
5374	52235		Cystoscopy and treatment							
5374	52250		Cystoscopy and radiotracer							
5374	52277		Cystoscopy and treatment							
5374	52282		Cystoscopy implant stent							
5374	52300		Cystoscopy and treatment							
5374	52301		Cystoscopy and treatment							
5374	52317		Remove bladder stone							
5374	52318		Remove bladder stone							
5374	52320		Cystoscopy and treatment							
5374	52330		Cystoscopy and treatment							
5374	52332		Cystoscopy and treatment							
5374	52334		Create passage to kidney							
5374	52341		Cysto w/ureter stricture tx							
5374	52342		Cysto w/up stricture tx							
5374	52343		Cysto w/renal stricture tx							
5374	52344		Cysto/uretero stricture tx							
5374	52345		Cysto/uretero w/up strictur							
5374	52351		Cystouretero & or pyeloscop							
5374	52352		Cystouretero w/stone remove							
5374	52400		Cystouretero w/congen repr							
5374	52402		Cystourethro cut ejacul duc							
5374	52450		Incision of prostate							
5374	52500		Revision of bladder neck							
5374	52640		Relieve bladder contracture							
5374	52700		Drainage of prostate absces							
5374	53040		Drainage of urethra abscess							
5374	53210		Removal of urethra							
5374	53220		Treatment of urethra lesion							
5374	53240		Surgery for urethra pouch							
5374	53250		Removal of urethra gland							
5374	53260		Treatment of urethra lesion							
5374	53270		Removal of urethra gland							
5374	53275		Repair of urethra defect							
5374	53450		Revision of urethra							
5374	53460		Revision of urethra							
5374	53500		Urethrlys transvag w/ scope							
5374	53502		Repair of urethra injury							
5374	53605		Dilate urethra stricture							
5374	53850		Prostatic microwave thermot							
5374	53852		Prostatic rf thermotx							
5374	54000		Slitting of prepuce							
5374	54110		Treatment of penis lesion							
5374	54120		Partial removal of penis							
5374	54300		Revision of penis							
5374	54304		Revision of penis							
5374	54312		Reconstruction of urethra							
5374	54318		Reconstruction of urethra							
5374	54322		Reconstruction of urethra							
5374	54324		Reconstruction of urethra							
5374	54326		Reconstruction of urethra							
5374	54328		Revise penis/urethra							
5374	54332		Revise penis/urethra							
5374	54336		Revise penis/urethra							
5374	54340		Secondary urethral surgery							
5374	54360		Penis plastic surgery							
5374	54406		Remove muti-comp penis pros							
5374	54415		Remove self-contd penis pro							
5374	54420		Revision of penis							
5374	54435		Revision of penis							
5374	54437		Repair corporeal tear							
5374	54440		Repair of penis							
5374	54505		Biopsy of testis							
5374	54512		Excise lesion testis							
5374	54520		Removal of testis							
5374	54522		Orchiectomy partial							
5374	54535		Extensive testis surgery							
5374	54600		Reduce testis torsion							
5374	54620		Suspension of testis							
5374	54670		Repair testis injury							
5374	54680		Relocation of testis(es)							
5374	54830		Remove epididymis lesion							
5374	54860		Removal of epididymis							
5374	54861		Removal of epididymis							
5374	54865		Explore epididymis							
5374	54901		Fusion of spermatic ducts							
5374	55060		Repair of hydrocele							
5374	55110		Explore scrotum							
5374	55150		Removal of scrotum							
5374	55175		Revision of scrotum							
5374	55200		Incision of sperm duct							
5374	55400		Repair of sperm duct							
5374	55500		Removal of hydrocele							
5374	55520		Removal of sperm cord lesio							
5374	55530		Revise spermatic cord veins							
5374	55680		Remove sperm pouch lesion							
5374	55705		Biopsy of prostate							
5374	55706		Prostate saturation samplin							
5374	55720		Drainage of prostate absces							
5374	55725		Drainage of prostate absces							
5374	55980		Sex transformation f to m							
5375		Level 5 Urology and Related Services		J1	53.3099	"$4,413.90"	.	$882.78		
5375	0549T		Tprnl balo cntnc dev uni							
5375	0619T		Cysto w/prst8 commissurotom							
5375	50551		Kidney endoscopy							
5375	50553		Kidney endoscopy							
5375	50561		Kidney endoscopy & treatmen							
5375	50575		Kidney endoscopy							
5375	50576		Kidney endoscopy & treatmen							
5375	50580		Kidney endoscopy & treatmen							
5375	50955		Ureter endoscopy & biopsy							
5375	50957		Ureter endoscopy & treatmen							
5375	50961		Ureter endoscopy & treatmen							
5375	50974		Ureter endoscopy & biopsy							
5375	50976		Ureter endoscopy & treatmen							
5375	50980		Ureter endoscopy & treatmen							
5375	51050		Removal of bladder stone							
5375	51860		Repair of bladder wound							
5375	52240		Cystoscopy and treatment							
5375	52305		Cystoscopy and treatment							
5375	52325		Cystoscopy stone removal							
5375	52327		Cystoscopy inject material							
5375	52346		Cystouretero w/renal strict							
5375	52353		Cystouretero w/lithotripsy							
5375	52354		Cystouretero w/biopsy							
5375	52355		Cystouretero w/excise tumor							
5375	52356		Cysto/uretero w/lithotripsy							
5375	52601		Prostatectomy (turp)							
5375	52630		Remove prostate regrowth							
5375	52647		Laser surgery of prostate							
5375	52648		Laser surgery of prostate							
5375	52649		Prostate laser enucleation							
5375	53010		Incision of urethra							
5375	53215		Removal of urethra							
5375	53230		Removal of urethra lesion							
5375	53235		Removal of urethra lesion							
5375	53400		Revise urethra stage 1							
5375	53405		Revise urethra stage 2							
5375	53410		Reconstruction of urethra							
5375	53420		Reconstruct urethra stage 1							
5375	53425		Reconstruct urethra stage 2							
5375	53430		Reconstruction of urethra							
5375	53431		Reconstruct urethra/bladder							
5375	53442		Remove/revise male sling							
5375	53446		Remove uro sphincter							
5375	53449		Repair uro sphincter							
5375	53505		Repair of urethra injury							
5375	53510		Repair of urethra injury							
5375	53515		Repair of urethra injury							
5375	53520		Repair of urethra defect							
5375	54111		Treat penis lesion graft							
5375	54205		Treatment of penis lesion							
5375	54308		Reconstruction of urethra							
5375	54316		Reconstruction of urethra							
5375	54344		Secondary urethral surgery							
5375	54348		Secondary urethral surgery							
5375	54352		Reconstruct urethra/penis							
5375	54408		Repair multi-comp penis pro							
5375	54660		Revision of testis							
5375	55180		Revision of scrotum							
5375	55860		Surgical exposure prostate							
5375	55874		Tprnl plmt biodegrdabl matr							
5375	55875		Transperi needle place pros							
5375	55880		Abltj mal prst8 tiss hifu							
5375	C9739		Cystoscopy prostatic imp 1-							
5375	C9761		"Cysto, litho, vacuum kidney"							
5375	C9769		Cysto w/temp pros implant							
5376		Level 6 Urology and Related Services		J1	99.7395	"$8,258.13"	.	"$1,651.63"	*	
5376	0421T		Waterjet prostate abltj cmp							
5376	50080		Removal of kidney stone							
5376	50081		Removal of kidney stone							
5376	50555		Kidney endoscopy & biopsy							
5376	50557		Kidney endoscopy & treatmen							
5376	50562		Renal scope w/tumor resect							
5376	54112		Treat penis lesion graft							
5376	55873		Cryoablate prostate							
5376	C9740		Cysto impl 4 or more							
5377		Level 7 Urology and Related Services		J1	138.7492	"$11,488.02"	.	"$2,297.61"	*	
5377	0548T		Tprnl balo cntnc dev bi							
5377	53440		Male sling procedure							
5377	54400		Insert semi-rigid prosthesi							
5377	54417		Remv/replc penis pros compl							
5378		Level 8 Urology and Related Services		J1	220.5195	"$18,258.35"	.	"$3,651.68"	*	
5378	53444		Insert tandem cuff							
5378	53445		Insert uro/ves nck sphincte							
5378	53447		Remove/replace ur sphincter							
5378	54401		Insert self-contd prosthesi							
5378	54405		Insert multi-comp penis pro							
5378	54410		Remove/replace penis prosth							
5378	54411		Remov/replc penis pros comp							
5378	54416		Remv/repl penis contain pro							
5401		Dialysis		S	7.903	$654.35	.	$130.87		
5401	90935		Hemodialysis one evaluation							
5401	G0257		Unsched dialysis esrd pt ho							
5411		Level 1 Gynecologic Procedures		T	2.0571	$170.32	.	$34.07		
5411	56420		Drainage of gland abscess							
5411	56820		Exam of vulva w/scope							
5411	57160		Insert pessary/other device							
5411	57170		Fitting of diaphragm/cap							
5411	57180		Treat vaginal bleeding							
5411	57452		Exam of cervix w/scope							
5411	58100		Biopsy of uterus lining							
5411	58322		Artificial insemination							
5411	58323		Sperm washing							
5411	58579		Hysteroscope procedure							
5411	58999		Genital surgery procedure							
5411	59020		Fetal contract stress test							
5411	59025		Fetal non-stress test							
5411	59897		Fetal invas px w/us							
5411	59899		Maternity care procedure							
5411	99170		Anogenital exam child w ima							
5412		Level 2 Gynecologic Procedures		T	3.3997	$281.49	.	$56.30		
5412	56405		I & d of vulva/perineum							
5412	56821		Exam/biopsy of vulva w/scop							
5412	57156		Ins vag brachytx device							
5412	57420		Exam of vagina w/scope							
5412	57454		Bx/curett of cervix w/scope							
5412	57455		Biopsy of cervix w/scope							
5412	57456		Endocerv curettage w/scope							
5412	57511		Cryocautery of cervix							
5412	58301		Remove intrauterine device							
5412	58321		Artificial insemination							
5412	58976		Transfer of embryo							
5412	59001		Amniocentesis therapeutic							
5412	59012		Fetal cord puncture prenata							
5412	59030		Fetal scalp blood sample							
5412	59070		Transabdom amnioinfus w/us							
5412	59072		Umbilical cord occlud w/us							
5412	59074		Fetal fluid drainage w/us							
5412	59076		Fetal shunt placement w/us							
5412	59200		Insert cervical dilator							
5412	59866		Abortion (mpr)							
5413		Level 3 Gynecologic Procedures		T	7.6501	$633.41	.	$126.69		
5413	55870		Electroejaculation							
5413	56605		Biopsy of vulva/perineum							
5413	57100		Biopsy of vagina							
5413	57421		Exam/biopsy of vag w/scope							
5413	57500		Biopsy of cervix							
5413	57505		Endocervical curettage							
5413	58970		Retrieval of oocyte							
5413	58974		Transfer of embryo							
5413	59000		Amniocentesis diagnostic							
5413	59015		Chorion biopsy							
5414		Level 4 Gynecologic Procedures		J1	31.6824	"$2,623.21"	.	$524.65		
5414	0071T		Us leiomyomata ablate <200							
5414	0072T		Us leiomyomata ablate >200							
5414	56440		Surgery for vulva lesion							
5414	56441		Lysis of labial lesion(s)							
5414	56442		Hymenotomy							
5414	56620		Partial removal of vulva							
5414	56625		Complete removal of vulva							
5414	56700		Partial removal of hymen							
5414	56740		Remove vagina gland lesion							
5414	56800		Repair of vagina							
5414	56805		Repair clitoris							
5414	56810		Repair of perineum							
5414	57000		Exploration of vagina							
5414	57010		Drainage of pelvic abscess							
5414	57061		Destroy vag lesions simple							
5414	57065		Destroy vag lesions complex							
5414	57105		Biopsy of vagina							
5414	57106		Remove vagina wall partial							
5414	57107		Remove vagina tissue part							
5414	57109		Vaginectomy partial w/nodes							
5414	57130		Remove vagina lesion							
5414	57135		Remove vagina lesion							
5414	57200		Repair of vagina							
5414	57210		Repair vagina/perineum							
5414	57230		Repair of urethral lesion							
5414	57287		Revise/remove sling repair							
5414	57295		Revise vag graft via vagina							
5414	57300		Repair rectum-vagina fistul							
5414	57400		Dilation of vagina							
5414	57410		Pelvic examination							
5414	57415		Remove vaginal foreign body							
5414	57460		Bx of cervix w/scope leep							
5414	57461		Conz of cervix w/scope leep							
5414	57510		Cauterization of cervix							
5414	57513		Laser surgery of cervix							
5414	57520		Conization of cervix							
5414	57522		Conization of cervix							
5414	57558		D&c of cervical stump							
5414	57700		Revision of cervix							
5414	57720		Revision of cervix							
5414	57800		Dilation of cervical canal							
5414	58120		Dilation and curettage							
5414	58145		Myomectomy vag method							
5414	58345		Reopen fallopian tube							
5414	58555		Hysteroscopy dx sep proc							
5414	58558		Hysteroscopy biopsy							
5414	58562		Hysteroscopy remove fb							
5414	58600		Division of fallopian tube							
5414	58615		Occlude fallopian tube(s)							
5414	58770		Create new tubal opening							
5414	58800		Drainage of ovarian cyst(s)							
5414	58805		Drainage of ovarian cyst(s)							
5414	58820		Drain ovary abscess open							
5414	58900		Biopsy of ovary(s)							
5414	59160		D & c after delivery							
5414	59300		Episiotomy or vaginal repai							
5414	59320		Revision of cervix							
5414	59409		Obstetrical care							
5414	59412		Antepartum manipulation							
5414	59414		Deliver placenta							
5414	59612		Vbac delivery only							
5414	59812		Treatment of miscarriage							
5414	59820		Care of miscarriage							
5414	59821		Treatment of miscarriage							
5414	59840		Abortion							
5414	59841		Abortion							
5414	59870		Evacuate mole of uterus							
5414	59871		Remove cerclage suture							
5415		Level 5 Gynecologic Procedures		J1	53.2572	"$4,409.54"	$902.82	$881.91		
5415	51840		Attach bladder/urethra							
5415	51845		Repair bladder neck							
5415	55920		Place needles pelvic for rt							
5415	55970		Sex transformation m to f							
5415	56630		Extensive vulva surgery							
5415	57020		Drainage of pelvic fluid							
5415	57120		Closure of vagina							
5415	57155		Insert uteri tandem/ovoids							
5415	57220		Revision of urethra							
5415	57240		Anterior colporrhaphy							
5415	57250		Repair rectum & vagina							
5415	57260		Cmbn ant pst colprhy							
5415	57265		Cmbn ap colprhy w/ntrcl rpr							
5415	57268		Repair of bowel bulge							
5415	57284		Repair paravag defect open							
5415	57288		Repair bladder defect							
5415	57291		Construction of vagina							
5415	57292		Construct vagina with graft							
5415	57320		Repair bladder-vagina lesio							
5415	57335		Repair vagina							
5415	57530		Removal of cervix							
5415	57550		Removal of residual cervix							
5415	57555		Remove cervix/repair vagina							
5415	57556		Remove cervix repair bowel							
5415	58260		Vaginal hysterectomy							
5415	58262		Vag hyst including t/o							
5415	58263		Vag hyst w/t/o & vag repair							
5415	58270		Vag hyst w/enterocele repai							
5415	58291		Vag hyst incl t/o complex							
5415	58294		Vag hyst w/enterocele compl							
5415	58346		Insert heyman uteri capsule							
5415	58350		Reopen fallopian tube							
5415	58353		Endometr ablate thermal							
5415	58356		Endometrial cryoablation							
5415	58559		Hysteroscopy lysis							
5415	58560		Hysteroscopy resect septum							
5415	58561		Hysteroscopy remove myoma							
5415	58563		Hysteroscopy ablation							
5415	58565		Hysteroscopy sterilization							
5415	58925		Removal of ovarian cyst(s)							
5415	59100		Remove uterus lesion							
5416		Level 6 Gynecologic Procedures		J1	82.0598	"$6,794.31"	"$1,405.70"	"$1,358.87"		
5416	0404T		Trnscrv uterin fibroid ablt							
5416	57282		Colpopexy extraperitoneal							
5416	57283		Colpopexy intraperitoneal							
5416	57285		Repair paravag defect vag							
5416	57289		Repair bladder & vagina							
5416	57310		Repair urethrovaginal lesio							
5416	57330		Repair bladder-vagina lesio							
5416	57426		Revise prosth vag graft lap							
5416	58290		Vag hyst complex							
5416	58292		Vag hyst t/o & repair compl							
5416	58920		Partial removal of ovary(s)							
5431		Level 1 Nerve Procedures		J1	21.189	"$1,754.39"	.	$350.88		
5431	0440T		Abltj perc uxtr/perph nrv							
5431	0441T		Abltj perc lxtr/perph nrv							
5431	27325		Neurectomy hamstring							
5431	27326		Neurectomy popliteal							
5431	28035		Decompression of tibia nerv							
5431	28055		Neurectomy foot							
5431	61790		Treat trigeminal nerve							
5431	61791		Treat trigeminal tract							
5431	62194		Replace/irrigate catheter							
5431	62287		Percutaneous diskectomy							
5431	62292		Njx chemonucleolysis lmbr							
5431	62355		Remove spinal canal cathete							
5431	63600		Remove spinal cord lesion							
5431	63610		Stimulation of spinal cord							
5431	63661		Remove spine eltrd perq ara							
5431	63746		Removal of spinal shunt							
5431	64605		Injection treatment of nerv							
5431	64610		Injection treatment of nerv							
5431	64624		Dstrj nulyt agt gnclr nrv							
5431	64625		Rf abltj nrv nrvtg si jt							
5431	64633		Destroy cerv/thor facet jnt							
5431	64635		Destroy lumb/sac facet jnt							
5431	64702		Revise finger/toe nerve							
5431	64704		Revise hand/foot nerve							
5431	64708		Revise arm/leg nerve							
5431	64712		Revision of sciatic nerve							
5431	64713		Revision of arm nerve(s)							
5431	64714		Revise low back nerve(s)							
5431	64716		Revision of cranial nerve							
5431	64718		Revise ulnar nerve at elbow							
5431	64719		Revise ulnar nerve at wrist							
5431	64721		Carpal tunnel surgery							
5431	64722		Relieve pressure on nerve(s							
5431	64726		Release foot/toe nerve							
5431	64732		Incision of brow nerve							
5431	64734		Incision of cheek nerve							
5431	64736		Incision of chin nerve							
5431	64738		Incision of jaw nerve							
5431	64740		Incision of tongue nerve							
5431	64742		Incision of facial nerve							
5431	64744		Incise nerve back of head							
5431	64746		Incise diaphragm nerve							
5431	64763		Incise hip/thigh nerve							
5431	64766		Incise hip/thigh nerve							
5431	64771		Sever cranial nerve							
5431	64772		Incision of spinal nerve							
5431	64774		Remove skin nerve lesion							
5431	64776		Remove digit nerve lesion							
5431	64782		Remove limb nerve lesion							
5431	64784		Remove nerve lesion							
5431	64788		Remove skin nerve lesion							
5431	64790		Removal of nerve lesion							
5431	64795		Biopsy of nerve							
5431	64802		Sympathectomy cervical							
5431	64804		Remove sympathetic nerves							
5431	64820		Sympathectomy digital arter							
5431	64831		Repair of digit nerve							
5431	64858		Repair sciatic nerve							
5431	64861		Repair of arm nerves							
5431	72285		Discography cerv/thor spine							
5431	72295		X-ray of lower spine disk							
5432		Level 2 Nerve Procedures		J1	68.8466	"$5,700.29"	.	"$1,140.06"		
5432	0269T		Rev/remvl crtd sns dev tota							
5432	0442T		Abltj perc plex/trncl nrv							
5432	61215		Insert brain-fluid device							
5432	61720		Incise skull/brain surgery							
5432	61770		Incise skull for treatment							
5432	62225		Replace/irrigate catheter							
5432	62230		Replace/revise brain shunt							
5432	62350		Implant spinal canal cath							
5432	62365		Remove spine infusion devic							
5432	63741		Install spinal shunt							
5432	63744		Revision of spinal shunt							
5432	64570		Remove vagus n eltrd							
5432	64786		Remove sciatic nerve lesion							
5432	64792		Removal of nerve lesion							
5432	64834		Repair of hand or foot nerv							
5432	64835		Repair of hand or foot nerv							
5432	64836		Repair of hand or foot nerv							
5432	64840		Repair of leg nerve							
5432	64856		Repair/transpose nerve							
5432	64857		Repair arm/leg nerve							
5432	64862		Repair of low back nerves							
5432	64864		Repair of facial nerve							
5432	64865		Repair of facial nerve							
5432	64885		Nerve graft head/neck </4 c							
5432	64886		Nerve graft head/neck >4 cm							
5432	64890		Nerve graft hand/foot </4 c							
5432	64891		Nerve graft hand/foot >4 cm							
5432	64892		Nerve graft arm/leg <4 cm							
5432	64893		Nerve graft arm/leg >4 cm							
5432	64895		Nerve graft hand/foot </4 c							
5432	64896		Nerve graft hand/foot >4 cm							
5432	64897		Nerve graft arm/leg </4 cm							
5432	64898		Nerve graft arm/leg >4 cm							
5432	64905		Nerve pedicle transfer							
5432	64907		Nerve pedicle transfer							
5432	64910		Nerve repair w/allograft							
5432	64911		Neurorraphy w/vein autograf							
5432	64912		Nrv rpr w/nrv algrft 1st							
5441		Level 1 Nerve Injections		T	3.1543	$261.17	.	$52.24		
5441	0566T		Autol cell implt adps njx							
5441	20526		Ther injection carp tunnel							
5441	20527		Inj dupuytren cord w/enzyme							
5441	20550		Inj tendon sheath/ligament							
5441	20551		Inj tendon origin/insertion							
5441	20552		Inj trigger point 1/2 muscl							
5441	20553		Inject trigger points 3/>							
5441	20600		Drain/inj joint/bursa w/o u							
5441	20604		Drain/inj joint/bursa w/us							
5441	20605		Drain/inj joint/bursa w/o u							
5441	20610		Drain/inj joint/bursa w/o u							
5441	20611		Drain/inj joint/bursa w/us							
5441	20612		Aspirate/inj ganglion cyst							
5441	61050		Remove brain canal fluid							
5441	61055		Injection into brain canal							
5441	64400		Njx aa&/strd trigeminal nrv							
5441	64405		Njx aa&/strd gr ocpl nrv							
5441	64408		Njx aa&/strd vagus nrv							
5441	64455		N block inj plantar digit							
5441	64505		N block spenopalatine gangl							
5441	64566		Neuroeltrd stim post tibial							
5441	64611		Chemodenerv saliv glands							
5441	64612		Destroy nerve face muscle							
5441	64615		Chemodenerv musc migraine							
5441	64616		Chemodenerv musc neck dysto							
5441	64617		Chemodener muscle larynx em							
5441	64632		N block inj common digit							
5441	64650		Chemodenerv eccrine glands							
5441	64653		Chemodenerv eccrine glands							
5441	64999		Nervous system surgery							
5441	95991		Spin/brain pump refil & mai							
5442		Level 2 Nerve Injections		T	7.6644	$634.59	.	$126.92		
5442	20606		Drain/inj joint/bursa w/us							
5442	61000		Remove cranial cavity fluid							
5442	61001		Remove cranial cavity fluid							
5442	61026		Injection into brain canal							
5442	61070		Brain canal shunt procedure							
5442	62270		Dx lmbr spi pnxr							
5442	62272		Ther spi pnxr drg csf							
5442	62273		Inject epidural patch							
5442	62320		Njx interlaminar crv/thrc							
5442	62321		Njx interlaminar crv/thrc							
5442	62322		Njx interlaminar lmbr/sac							
5442	62323		Njx interlaminar lmbr/sac							
5442	62328		Dx lmbr spi pnxr w/fluor/ct							
5442	62329		Ther spi pnxr csf fluor/ct							
5442	64418		Njx aa&/strd sprscap nrv							
5442	64420		Njx aa&/strd ntrcost nrv 1							
5442	64425		Njx aa&/strd ii ih nerves							
5442	64435		Njx aa&/strd paracrv nrv							
5442	64445		Njx aa&/strd sciatic nerve							
5442	64447		Njx aa&/strd femoral nerve							
5442	64450		Njx aa&/strd other pn/branc							
5442	64451		Njx aa&/strd nrv nrvtg si j							
5442	64454		Njx aa&/strd gnclr nrv brnc							
5442	64461		Pvb thoracic single inj sit							
5442	64463		Pvb thoracic cont infusion							
5442	64642		Chemodenerv 1 extremity 1-4							
5442	64644		Chemodenerv 1 extrem 5/> mu							
5442	64646		Chemodenerv trunk musc 1-5							
5442	64647		Chemodenerv trunk musc 6/>							
5442	G0260		Inj for sacroiliac jt anest							
5443		Level 3 Nerve Injections		T	9.9334	$822.46	.	$164.50		
5443	0213T		Njx paravert w/us cer/thor							
5443	0216T		Njx paravert w/us lumb/sac							
5443	61020		Remove brain cavity fluid							
5443	62263		Epidural lysis mult session							
5443	62264		Epidural lysis on single da							
5443	62268		Drain spinal cord cyst							
5443	62280		Treat spinal cord lesion							
5443	62281		Treat spinal cord lesion							
5443	62282		Treat spinal canal lesion							
5443	62294		Injection into spinal arter							
5443	62324		Njx interlaminar crv/thrc							
5443	62325		Njx interlaminar crv/thrc							
5443	62326		Njx interlaminar lmbr/sac							
5443	62327		Njx interlaminar lmbr/sac							
5443	64415		Njx aa&/strd brach plexus							
5443	64416		Njx aa&/strd brach plex nfs							
5443	64417		Njx aa&/strd axillary nrv							
5443	64421		Njx aa&/strd ntrcost nrv ea							
5443	64430		Njx aa&/strd pudendal nerve							
5443	64446		Njx aa&/strd sciatic nrv nf							
5443	64448		Njx aa&/strd fem nerve nfs							
5443	64449		Njx aa&/strd lmbr plex nfs							
5443	64479		Inj foramen epidural c/t							
5443	64483		Inj foramen epidural l/s							
5443	64490		Inj paravert f jnt c/t 1 le							
5443	64493		Inj paravert f jnt l/s 1 le							
5443	64510		N block stellate ganglion							
5443	64517		N block inj hypogas plxs							
5443	64520		N block lumbar/thoracic							
5443	64530		N block inj celiac pelus							
5443	64600		Injection treatment of nerv							
5443	64620		Injection treatment of nerv							
5443	64630		Injection treatment of nerv							
5443	64640		Injection treatment of nerv							
5443	64680		Injection treatment of nerv							
5443	64681		Injection treatment of nerv							
5461		Level 1 Neurostimulator and Related Procedures		J1	39.5582	"$3,275.30"	.	$655.06		
5461	0267T		Implt/rpl crtd sns dev lead							
5461	0270T		Rev/remvl crtd sns dev lead							
5461	0271T		Rev/remvl crtd sns dev gen							
5461	0313T		Laps rmvl nstim array vagus							
5461	0314T		Laps rmvl vgl arry&pls gen							
5461	0315T		Rmvl vagus nerve pls gen							
5461	0428T		Rmvl nstim apnea pls gen							
5461	0429T		Rmvl nstim apnea sen ld							
5461	0430T		Rmvl nstim apnea stimj ld							
5461	0432T		Repos nstim apnea stimj ld							
5461	0433T		Repos nstim apnea sensing l							
5461	0467T		Revj/rplmnt ch respir eltrd							
5461	0468T		Rmvl ch wal respir eltrd/ra							
5461	0588T		Revision/removal isdns ptn							
5461	61880		Revise/remove neuroelectrod							
5461	63662		Remove spine eltrd plate							
5461	63688		Revise/remove neuroreceiver							
5461	64585		Revise/remove neuroelectrod							
5461	64595		Revise/rmv pn/gastr stimul							
5462		Level 2 Neurostimulator and Related Procedures		J1	74.4071	"$6,160.69"	.	"$1,232.14"		
5462	0587T		Perq impltj/rplcmt isdns pt							
5462	63650		Implant neuroelectrodes							
5462	63663		Revise spine eltrd perq ara							
5462	64555		Implant neuroelectrodes							
5462	64561		Implant neuroelectrodes							
5462	64581		Implant neuroelectrodes							
5463		Level 3 Neurostimulator and Related Procedures		J1	135.7079	"$11,236.21"	.	"$2,247.25"	*	
5463	0398T		Mrgfus strtctc les abltj							
5463	0425T		Insj/rplc nstim apnea sen l							
5463	0426T		Insj/rplc nstim apnea stm l							
5463	43647		Lap impl electrode antrum							
5463	61888		Revise/remove neuroreceiver							
5463	63664		Revise spine eltrd plate							
5463	64553		Implant neuroelectrodes							
5463	64569		Revise/repl vagus n eltrd							
5463	64575		Implant neuroelectrodes							
5464		Level 4 Neurostimulator and Related Procedures		J1	247.3493	"$20,479.78"	.	"$4,095.96"	*	
5464	61885		Insrt/redo neurostim 1 arra							
5464	63655		Implant neuroelectrodes							
5464	64580		Implant neuroelectrodes							
5464	64590		Insrt/redo pn/gastr stimul							
5465		Level 5 Neurostimulator and Related Procedures		J1	355.623	"$29,444.52"	.	"$5,888.91"	*	
5465	0266T		Implt/rpl crtd sns dev tota							
5465	0268T		Implt/rpl crtd sns dev gen							
5465	0312T		Laps impltj nstim vagus							
5465	0316T		Replc vagus nerve pls gen							
5465	0424T		Insj/rplc nstim apnea compl							
5465	0427T		Insj/rplc nstim apnea pls g							
5465	0431T		Rmvl/rplc nstim apnea pls g							
5465	61886		Implant neurostim arrays							
5465	63685		Insrt/redo spine n generato							
5465	64568		Inc for vagus n elect impl							
5471		Implantation of Drug Infusion Device		J1	205.7067	"$17,031.90"	.	"$3,406.38"	*	
5471	62360		Insert spine infusion devic							
5471	62361		Implant spine infusion pump							
5471	62362		Implant spine infusion pump							
5481		Laser Eye Procedures		T	6.0855	$503.86	$100.90	$100.78		
5481	65855		Trabeculoplasty laser surg							
5481	65860		Incise inner eye adhesions							
5481	66761		Revision of iris							
5481	66762		Revision of iris							
5481	66770		Removal of inner eye lesion							
5481	66821		After cataract laser surger							
5481	67031		Laser surgery eye strands							
5481	67105		Repair detached retina pc							
5481	67145		Treatment of retina							
5481	67210		Treatment of retinal lesion							
5481	67220		Treatment of choroid lesion							
5481	67221		Ocular photodynamic ther							
5481	67228		Treatment x10sv retinopathy							
5481	67229		Tr retinal les preterm inf							
5481	G0186		"Dstry eye lesn,fdr vssl tec"							
5491		Level 1 Intraocular Procedures		J1	25.1115	"$2,079.16"	.	$415.84		
5491	0616T		Insertion of iris prosthesi							
5491	65235		Remove foreign body from ey							
5491	65260		Remove foreign body from ey							
5491	65265		Remove foreign body from ey							
5491	65286		Repair of eye wound							
5491	65800		Drainage of eye							
5491	65810		Drainage of eye							
5491	65815		Drainage of eye							
5491	65850		Incision of eye							
5491	65865		Incise inner eye adhesions							
5491	65870		Incise inner eye adhesions							
5491	65875		Incise inner eye adhesions							
5491	65900		Remove eye lesion							
5491	65920		Remove implant of eye							
5491	65930		Remove blood clot from eye							
5491	66020		Injection treatment of eye							
5491	66030		Injection treatment of eye							
5491	66160		Glaucoma surgery							
5491	66170		Glaucoma surgery							
5491	66172		Incision of eye							
5491	66184		Revision of aqueous shunt							
5491	66185		Revise aqueous shunt eye							
5491	66500		Incision of iris							
5491	66505		Incision of iris							
5491	66605		Removal of iris							
5491	66625		Removal of iris							
5491	66630		Removal of iris							
5491	66635		Removal of iris							
5491	66680		Repair iris & ciliary body							
5491	66682		Repair iris & ciliary body							
5491	66700		Destruction ciliary body							
5491	66711		Ecp ciliary body destructio							
5491	66820		Incision secondary cataract							
5491	66825		Reposition intraocular lens							
5491	66830		Removal of lens lesion							
5491	66840		Removal of lens material							
5491	66850		Removal of lens material							
5491	66920		Extraction of lens							
5491	66940		Extraction of lens							
5491	66982		Xcapsl ctrc rmvl cplx wo ec							
5491	66983		Cataract surg w/iol 1 stage							
5491	66984		Xcapsl ctrc rmvl w/o ecp							
5491	66985		Insert lens prosthesis							
5491	66986		Exchange lens prosthesis							
5491	66999		Eye surgery procedure							
5491	67005		Partial removal of eye flui							
5491	67010		Partial removal of eye flui							
5491	67015		Release of eye fluid							
5491	67025		Replace eye fluid							
5491	67030		Incise inner eye strands							
5491	67101		Repair detached retina crtx							
5491	67110		Repair detached retina							
5491	67120		Remove eye implant material							
5491	67121		Remove eye implant material							
5491	67255		Reinforce/graft eye wall							
5491	67299		Eye surgery procedure							
5491	68330		Revise eyelid lining							
5492		Level 2 Intraocular Procedures		J1	47.3174	"$3,917.74"	.	$783.55		
5492	0191T		Insert ant segment drain in							
5492	0253T		Insert aqueous drain device							
5492	0449T		Insj aqueous drain dev 1st							
5492	0617T		Insj iris prosth w/rmvl&ins							
5492	0618T		Insj iris prosth sec io len							
5492	65280		Repair of eye wound							
5492	65285		Repair of eye wound							
5492	65710		Corneal transplant							
5492	65730		Corneal transplant							
5492	65750		Corneal transplant							
5492	65755		Corneal transplant							
5492	65756		Corneal trnspl endothelial							
5492	65781		Ocular reconst transplant							
5492	65785		Impltj ntrstrml crnl rng se							
5492	65820		Relieve inner eye pressure							
5492	65880		Incise inner eye adhesions							
5492	66150		Glaucoma surgery							
5492	66155		Glaucoma surgery							
5492	66174		Translum dil eye canal							
5492	66175		Trnslum dil eye canal w/stn							
5492	66179		Aqueous shunt eye w/o graft							
5492	66180		Aqueous shunt eye w/graft							
5492	66183		Insert ant drainage device							
5492	66225		Repair/graft eye lesion							
5492	66600		Remove iris and lesion							
5492	66852		Removal of lens material							
5492	66930		Extraction of lens							
5492	66987		Xcapsl ctrc rmvl cplx w/ecp							
5492	66988		Xcapsl ctrc rmvl w/ecp							
5492	67036		Removal of inner eye fluid							
5492	67039		Laser treatment of retina							
5492	67040		Laser treatment of retina							
5492	67041		Vit for macular pucker							
5492	67042		Vit for macular hole							
5492	67043		Vit for membrane dissect							
5492	67107		Repair detached retina							
5492	67108		Repair detached retina							
5492	67113		Repair retinal detach cplx							
5492	67115		Release encircling material							
5493		Level 3 Intraocular Procedures		J1	88.6006	"$7,335.86"	.	"$1,467.18"		
5493	65770		Revise cornea with implant							
5494		Level 4 Intraocular Procedures		J1	181.2793	"$15,009.38"	.	"$3,001.88"	*	
5494	67027		Implant eye drug system							
5495		Level 5 Intraocular Procedures		J1	250.8129	"$20,766.56"	.	"$4,153.32"	*	
5495	0308T		Insj ocular telescope prost							
5501		"Level 1 Extraocular, Repair, and Plastic Eye Procedures"		T	3.1557	$261.28	.	$52.26		
5501	65450		Treatment of corneal lesion							
5501	67141		Treatment of retina							
5501	67208		Treatment of retinal lesion							
5501	67345		Destroy nerve of eye muscle							
5501	67399		Unlisted px extraocular mus							
5501	67500		Inject/treat eye socket							
5501	67505		Inject/treat eye socket							
5501	67515		Inject/treat eye socket							
5501	67599		Orbit surgery procedure							
5501	67700		Drainage of eyelid abscess							
5501	67800		Remove eyelid lesion							
5501	67805		Remove eyelid lesions							
5501	67810		Biopsy eyelid & lid margin							
5501	67825		Revise eyelashes							
5501	67938		Remove eyelid foreign body							
5501	67999		Revision of eyelid							
5501	68040		Treatment of eyelid lesions							
5501	68399		Eyelid lining surgery							
5501	68440		Incise tear duct opening							
5501	68530		Clearance of tear duct							
5501	68705		Revise tear duct opening							
5501	68760		Close tear duct opening							
5501	68761		Close tear duct opening							
5501	68810		Probe nasolacrimal duct							
5501	68840		Explore/irrigate tear ducts							
5501	68899		Tear duct system surgery							
5502		"Level 2 Extraocular, Repair, and Plastic Eye Procedures"		T	9.7774	$809.54	.	$161.91		
5502	65400		Removal of eye lesion							
5502	65435		Curette/treat cornea							
5502	65772		Correction of astigmatism							
5502	65778		Cover eye w/membrane							
5502	67710		Incision of eyelid							
5502	67801		Remove eyelid lesions							
5502	67830		Revise eyelashes							
5502	67840		Remove eyelid lesion							
5502	67850		Treat eyelid lesion							
5502	67875		Closure of eyelid by suture							
5502	68020		Incise/drain eyelid lining							
5502	68400		Incise/drain tear gland							
5503		"Level 3 Extraocular, Repair, and Plastic Eye Procedures"		J1	24.1839	"$2,002.35"	.	$400.48		
5503	0402T		Colgn cross-link crn med se							
5503	65125		Revise ocular implant							
5503	65270		Repair of eye wound							
5503	65272		Repair of eye wound							
5503	65410		Biopsy of cornea							
5503	65420		Removal of eye lesion							
5503	65426		Removal of eye lesion							
5503	65436		Curette/treat cornea							
5503	65600		Revision of cornea							
5503	65775		Correction of astigmatism							
5503	66130		Remove eye lesion							
5503	66250		Follow-up surgery of eye							
5503	66710		Ciliary transsleral therapy							
5503	66720		Destruction ciliary body							
5503	66740		Destruction ciliary body							
5503	67250		Reinforce eye wall							
5503	67311		Revise eye muscle							
5503	67314		Revise eye muscle							
5503	67316		Revise two eye muscles							
5503	67318		Revise eye muscle(s)							
5503	67343		Release eye tissue							
5503	67405		Explore/drain eye socket							
5503	67412		Explore/treat eye socket							
5503	67413		Explore/treat eye socket							
5503	67415		Aspiration orbital contents							
5503	67715		Incision of eyelid fold							
5503	67808		Remove eyelid lesion(s)							
5503	67835		Revise eyelashes							
5503	67880		Revision of eyelid							
5503	67882		Revision of eyelid							
5503	67900		Repair brow defect							
5503	67901		Repair eyelid defect							
5503	67903		Repair eyelid defect							
5503	67904		Repair eyelid defect							
5503	67908		Repair eyelid defect							
5503	67909		Revise eyelid defect							
5503	67911		Revise eyelid defect							
5503	67912		Correction eyelid w/implant							
5503	67914		Repair eyelid defect							
5503	67915		Repair eyelid defect							
5503	67916		Repair eyelid defect							
5503	67917		Repair eyelid defect							
5503	67921		Repair eyelid defect							
5503	67922		Repair eyelid defect							
5503	67923		Repair eyelid defect							
5503	67924		Repair eyelid defect							
5503	67930		Repair eyelid wound							
5503	67935		Repair eyelid wound							
5503	67950		Revision of eyelid							
5503	67961		Revision of eyelid							
5503	67966		Revision of eyelid							
5503	67971		Reconstruction of eyelid							
5503	67973		Reconstruction of eyelid							
5503	67975		Reconstruction of eyelid							
5503	68100		Biopsy of eyelid lining							
5503	68110		Remove eyelid lining lesion							
5503	68115		Remove eyelid lining lesion							
5503	68130		Remove eyelid lining lesion							
5503	68135		Remove eyelid lining lesion							
5503	68320		Revise/graft eyelid lining							
5503	68328		Revise/graft eyelid lining							
5503	68340		Separate eyelid adhesions							
5503	68362		Revise eyelid lining							
5503	68371		Harvest eye tissue alograft							
5503	68420		Incise/drain tear sac							
5503	68510		Biopsy of tear gland							
5503	68525		Biopsy of tear sac							
5503	68540		Remove tear gland lesion							
5503	68700		Repair tear ducts							
5503	68770		Close tear system fistula							
5503	68811		Probe nasolacrimal duct							
5503	68815		Probe nasolacrimal duct							
5503	68816		Probe nl duct w/balloon							
5503	92018		New eye exam & treatment							
5503	92019		Eye exam & treatment							
5504		"Level 4 Extraocular, Repair, and Plastic Eye Procedures"		J1	39.9223	"$3,305.45"	.	$661.09		
5504	65091		Revise eye							
5504	65093		Revise eye with implant							
5504	65101		Removal of eye							
5504	65103		Remove eye/insert implant							
5504	65105		Remove eye/attach implant							
5504	65110		Removal of eye							
5504	65112		Remove eye/revise socket							
5504	65114		Remove eye/revise socket							
5504	65130		Insert ocular implant							
5504	65135		Insert ocular implant							
5504	65140		Attach ocular implant							
5504	65150		Revise ocular implant							
5504	65155		Reinsert ocular implant							
5504	65175		Removal of ocular implant							
5504	65275		Repair of eye wound							
5504	65290		Repair of eye socket wound							
5504	65779		Cover eye w/membrane suture							
5504	65780		Ocular reconst transplant							
5504	65782		Ocular reconst transplant							
5504	67218		Treatment of retinal lesion							
5504	67227		Dstrj extensive retinopathy							
5504	67312		Revise two eye muscles							
5504	67346		Biopsy eye muscle							
5504	67400		Explore/biopsy eye socket							
5504	67414		Explr/decompress eye socket							
5504	67420		Explore/treat eye socket							
5504	67430		Explore/treat eye socket							
5504	67440		Explore/drain eye socket							
5504	67445		Explr/decompress eye socket							
5504	67450		Explore/biopsy eye socket							
5504	67550		Insert eye socket implant							
5504	67560		Revise eye socket implant							
5504	67570		Decompress optic nerve							
5504	67902		Repair eyelid defect							
5504	67906		Repair eyelid defect							
5504	67974		Reconstruction of eyelid							
5504	68325		Revise/graft eyelid lining							
5504	68326		Revise/graft eyelid lining							
5504	68335		Revise/graft eyelid lining							
5504	68360		Revise eyelid lining							
5504	68500		Removal of tear gland							
5504	68505		Partial removal tear gland							
5504	68520		Removal of tear sac							
5504	68550		Remove tear gland lesion							
5504	68720		Create tear sac drain							
5504	68745		Create tear duct drain							
5504	68750		Create tear duct drain							
5521		Level 1 Imaging without Contrast		S	0.9771	$80.90	.	$16.19		
5521	0350T		Rsa lower extr exam							
5521	0422T		Tactile breast img uni/bi							
5521	0558T		Ct scan f/biomchn ct alys							
5521	70030		X-ray eye for foreign body							
5521	70100		X-ray exam of jaw <4views							
5521	70140		X-ray exam of facial bones							
5521	70160		X-ray exam of nasal bones							
5521	70190		X-ray exam of eye sockets							
5521	70210		X-ray exam of sinuses							
5521	70220		X-ray exam of sinuses							
5521	70240		X-ray exam pituitary saddle							
5521	70300		X-ray exam of teeth							
5521	70328		X-ray exam of jaw joint							
5521	70330		X-ray exam of jaw joints							
5521	70350		X-ray head for orthodontia							
5521	70355		Panoramic x-ray of jaws							
5521	70360		X-ray exam of neck							
5521	70370		Throat x-ray & fluoroscopy							
5521	70380		X-ray exam of salivary glan							
5521	71045		X-ray exam chest 1 view							
5521	71046		X-ray exam chest 2 views							
5521	71047		X-ray exam chest 3 views							
5521	71100		X-ray exam ribs uni 2 views							
5521	71120		X-ray exam breastbone 2/>vw							
5521	71130		X-ray strenoclavic jt 3/>vw							
5521	71271		Ct thorax lung cancer scr c				$0.00	$0.00		
5521	72020		X-ray exam of spine 1 view							
5521	72040		X-ray exam neck spine 2-3 v							
5521	72080		X-ray exam thoracolmb 2/> v							
5521	72081		X-ray exam entire spi 1 vw							
5521	72220		X-ray exam sacrum tailbone							
5521	73000		X-ray exam of collar bone							
5521	73020		X-ray exam of shoulder							
5521	73030		X-ray exam of shoulder							
5521	73050		X-ray exam of shoulders							
5521	73060		X-ray exam of humerus							
5521	73070		X-ray exam of elbow							
5521	73080		X-ray exam of elbow							
5521	73090		X-ray exam of forearm							
5521	73100		X-ray exam of wrist							
5521	73110		X-ray exam of wrist							
5521	73130		X-ray exam of hand							
5521	73140		X-ray exam of finger(s)							
5521	73501		X-ray exam hip uni 1 view							
5521	73502		X-ray exam hip uni 2-3 view							
5521	73551		X-ray exam of femur 1							
5521	73552		X-ray exam of femur 2/>							
5521	73560		X-ray exam of knee 1 or 2							
5521	73562		X-ray exam of knee 3							
5521	73565		X-ray exam of knees							
5521	73590		X-ray exam of lower leg							
5521	73592		X-ray exam of leg infant							
5521	73600		X-ray exam of ankle							
5521	73610		X-ray exam of ankle							
5521	73620		X-ray exam of foot							
5521	73630		X-ray exam of foot							
5521	73650		X-ray exam of heel							
5521	73660		X-ray exam of toe(s)							
5521	74018		X-ray exam abdomen 1 view							
5521	74710		X-ray measurement of pelvis							
5521	75571		Ct hrt w/o dye w/ca test							
5521	76010		X-ray nose to rectum							
5521	76380		Cat scan follow-up study							
5521	76390		Mr spectroscopy							
5521	76496		Fluoroscopic procedure							
5521	76497		Ct procedure							
5521	76498		Mri procedure							
5521	76499		Radiographic procedure							
5521	76529		Echo exam of eye							
5521	76642		Ultrasound breast limited							
5521	76885		Us exam infant hips dynamic							
5521	76886		Us exam infant hips static							
5521	76999		Echo examination procedure							
5521	77071		X-ray stress view							
5521	77081		Dxa bone density/peripheral				$0.00	$0.00		
5522	77085		Dxa bone density study				$0.00	$0.00		
5521	77086		Fracture assessment via dxa							
5521	D0251		Extraoral posterior image							
5522		Level 2 Imaging without Contrast		S	1.3161	$108.97	.	$21.80		
5522	0348T		Rsa spine exam							
5522	0349T		Rsa upper extr exam							
5522	0508T		Pls echo us b1 dns meas tib							
5522	0633T		Ct breast w/3d uni c-							
5522	70110		X-ray exam of jaw 4/> views							
5522	70120		X-ray exam of mastoids							
5522	70130		X-ray exam of mastoids							
5522	70150		X-ray exam of facial bones							
5522	70200		X-ray exam of eye sockets							
5522	70250		X-ray exam of skull							
5522	70260		X-ray exam of skull							
5522	70450		Ct head/brain w/o dye							
5522	70480		Ct orbit/ear/fossa w/o dye							
5522	70486		Ct maxillofacial w/o dye							
5522	70490		Ct soft tissue neck w/o dye							
5522	71048		X-ray exam chest 4+ views							
5522	71101		X-ray exam unilat ribs/ches							
5522	71110		X-ray exam ribs bil 3 views							
5522	71111		X-ray exam ribs/chest4/> vw							
5522	71250		Ct thorax w/o dye							
5522	72050		X-ray exam neck spine 4/5vw							
5522	72052		X-ray exam neck spine 6/>vw							
5522	72070		X-ray exam thorac spine 2vw							
5522	72072		X-ray exam thorac spine 3vw							
5522	72074		X-ray exam thorac spine4/>v							
5522	72082		X-ray exam entire spi 2/3 v							
5522	72083		X-ray exam entire spi 4/5 v							
5522	72084		X-ray exam entire spi 6/> v							
5522	72100		X-ray exam l-s spine 2/3 vw							
5522	72110		X-ray exam l-2 spine 4/>vws							
5522	72114		X-ray exam l-s spine bendin							
5522	72120		X-ray bend only l-s spine							
5522	72125		Ct neck spine w/o dye							
5522	72128		Ct chest spine w/o dye							
5522	72131		Ct lumbar spine w/o dye							
5522	72170		X-ray exam of pelvis							
5522	72190		X-ray exam of pelvis							
5522	72192		Ct pelvis w/o dye							
5522	72200		X-ray exam si joints							
5522	72202		X-ray exam si joints 3/> vw							
5522	73010		X-ray exam of shoulder blad							
5522	73092		X-ray exam of arm infant							
5522	73120		X-ray exam of hand							
5522	73200		Ct upper extremity w/o dye							
5522	73503		X-ray exam hip uni 4/> view							
5522	73521		X-ray exam hips bi 2 views							
5522	73522		X-ray exam hips bi 3-4 view							
5522	73523		X-ray exam hips bi 5/> view							
5522	73564		X-ray exam knee 4 or more							
5522	73700		Ct lower extremity w/o dye							
5522	74019		X-ray exam abdomen 2 views							
5522	74021		X-ray exam abdomen 3+ views							
5522	74022		X-ray exam complete abdomen							
5522	74150		Ct abdomen w/o dye							
5522	74261		Ct colonography dx							
5522	74445		X-ray exam of penis							
5522	75809		Nonvascular shunt x-ray							
5522	76100		X-ray exam of body section							
5522	76101		Complex body section x-ray							
5522	76102		Complex body section x-rays							
5522	76120		Cine/video x-rays							
5522	76506		Echo exam of head							
5522	76511		Oph us dx quan a-scan only							
5522	76512		Oph us dx b-scan							
5522	76513		Echo exam of eye water bath							
5522	76516		Echo exam of eye							
5522	76519		Echo exam of eye							
5522	76536		Us exam of head and neck							
5522	76604		Us exam chest							
5522	76641		Ultrasound breast complete							
5522	76700		Us exam abdom complete							
5522	76705		Echo exam of abdomen							
5821	99406		Behav chng smoking 3-10 min				$0.00	$0.00		
5522	76770		Us exam abdo back wall comp							
5522	76775		Us exam abdo back wall lim							
5522	76776		Us exam k transpl w/doppler							
5522	76800		Us exam spinal canal							
5522	76801		Ob us < 14 wks single fetus							
5522	76805		Ob us >= 14 wks sngl fetus							
5522	76813		Ob us nuchal meas 1 gest							
5522	76815		Ob us limited fetus(s)							
5522	76816		Ob us follow-up per fetus							
5522	76817		Transvaginal us obstetric							
5522	76818		Fetal biophys profile w/nst							
5522	76819		Fetal biophys profil w/o ns							
5522	76820		Umbilical artery echo							
5522	76821		Middle cerebral artery echo							
5522	76827		Echo exam of fetal heart							
5522	76828		Echo exam of fetal heart							
5522	76830		Transvaginal us non-ob							
5522	76856		Us exam pelvic complete							
5522	76857		Us exam pelvic limited							
5522	76870		Us exam scrotum							
5522	76872		Us transrectal							
5522	76873		Echograp trans r pros study							
5522	76881		Us compl joint r-t w/img							
5522	76882		Us lmtd jt/nonvasc xtr stru							
5821	99407		Behav chng smoking > 10 min				$0.00	$0.00		
5522	76981		Use parenchyma							
5522	76982		Use 1st target lesion							
5522	77072		X-rays for bone age							
5522	77073		X-rays bone length studies							
5522	77074		X-rays bone survey limited							
5522	77075		X-rays bone survey complete							
5522	77076		X-rays bone survey infant							
5522	77077		Joint survey single view							
9370	A9591		Fluoroestradiol f 18				$0.00	$0.00		
5691	G0008		Admin influenza virus vac				$0.00	$0.00		
5522	93882		Extracranial uni/ltd study							
5522	93888		Intracranial limited study							
5522	93892		Tcd emboli detect w/o inj							
5522	93893		Tcd emboli detect w/inj							
5522	93926		Lower extremity study							
5522	93931		Upper extremity study							
5522	93971		Extremity study							
5522	93976		Vascular study							
5522	93979		Vascular study							
5522	93980		Penile vascular study							
5522	93981		Penile vascular study							
5522	93986		Dup-scan hemo compl uni std							
5522	93990		Doppler flow testing							
5691	G0009		Admin pneumococcal vaccine				$0.00	$0.00		
5523		Level 3 Imaging without Contrast		S	2.7794	$230.13	.	$46.03		
5523	0556T		B1 str & fx rsk assessment							
5523	0609T		Mrs disc pain acquisj data							
5523	0611T		Mrs disc pain alg alys data							
5523	0636T		Ct breast w/3d bi c-							
5523	49465		Fluoro exam of g/colon tube							
5523	70170		X-ray exam of tear duct							
5523	70310		X-ray exam of teeth							
5523	70320		Full mouth x-ray of teeth							
5523	70332		X-ray exam of jaw joint							
5523	70336		Magnetic image jaw joint							
5523	70371		Speech evaluation complex							
5523	70390		X-ray exam of salivary duct							
5523	70540		Mri orbit/face/neck w/o dye							
5523	70544		Mr angiography head w/o dye							
5523	70547		Mr angiography neck w/o dye							
5523	70551		Mri brain stem w/o dye							
5523	70554		Fmri brain by tech							
5523	70555		Fmri brain by phys/psych							
5523	71550		Mri chest w/o dye							
5523	72141		Mri neck spine w/o dye							
5523	72146		Mri chest spine w/o dye							
5523	72148		Mri lumbar spine w/o dye							
5523	72195		Mri pelvis w/o dye							
5523	73218		Mri upper extremity w/o dye							
5523	73221		Mri joint upr extrem w/o dy							
5523	73718		Mri lower extremity w/o dye							
5523	73721		Mri jnt of lwr extre w/o dy							
5523	74176		Ct abd & pelvis w/o contras							
5523	74181		Mri abdomen w/o dye							
5523	74440		X-ray male genital tract							
5523	74450		X-ray urethra/bladder							
5523	74455		X-ray urethra/bladder							
5523	74712		Mri fetal sngl/1st gestatio							
5523	74740		X-ray female genital tract							
5523	74775		X-ray exam of perineum							
5523	75557		Cardiac mri for morph							
5523	76000		Fluoroscopy <1 hr phys/qhp							
5523	76391		Mr elastography							
5523	76811		Ob us detailed sngl fetus							
5523	76826		Echo exam of fetal heart							
5523	76831		Echo exam uterus							
5523	76975		Gi endoscopic ultrasound							
5523	77046		Mri breast c- unilateral							
5523	77047		Mri breast c- bilateral							
5523	77053		X-ray of mammary duct							
5523	77054		X-ray of mammary ducts							
5523	77084		Magnetic image bone marrow							
5523	93307		Tte w/o doppler complete							
5523	93308		Tte f-up or lmtd							
5523	93880		Extracranial bilat study							
5523	93886		Intracranial complete study							
5523	93890		Tcd vasoreactivity study							
5523	93925		Lower extremity study							
5523	93930		Upper extremity study							
5523	93970		Extremity study							
5523	93975		Vascular study							
5523	93978		Vascular study							
5523	93985		Dup-scan hemo compl bi std							
5523	C8901		"Mra w/o cont, abd"							
5523	C8910		"Mra w/o cont, chest"							
5523	C8913		"Mra w/o cont, lwr ext"							
5523	C8919		"Mra w/o cont, pelvis"							
5523	C8932		"Mra, w/o dye, spinal canal"							
5523	C8935		"Mra, w/o dye, upper extr"							
5524		Level 4 Imaging without Contrast		S	5.8322	$482.89	.	$96.58		
5524	70134		X-ray exam of middle ear							
5524	70557		Mri brain w/o dye							
5524	74190		X-ray exam of peritoneum							
5524	74470		X-ray exam of kidney lesion							
5524	75559		Cardiac mri w/stress img							
5524	76080		X-ray exam of fistula							
5524	76098		X-ray exam surgical specime							
5524	76825		Echo exam of fetal heart							
5524	93303		Echo transthoracic							
5524	93304		Echo transthoracic							
5524	93306		Tte w/doppler complete							
5524	93312		Echo transesophageal							
5524	93313		Echo transesophageal							
5524	93315		Echo transesophageal							
5524	93316		Echo transesophageal							
5524	93318		Echo transesophageal intrao							
5524	93350		Stress tte only							
5524	93351		Stress tte complete							
5524	C9762		Cardiac mri seg dys strain							
5524	C9763		Cardiac mri seg dys stress							
5571		Level 1 Imaging with Contrast		S	2.1565	$178.55	.	$35.72		
5571	0634T		Ct breast w/3d uni c+							
5571	0635T		Ct breast w/3d uni c-/c+							
5571	70460		Ct head/brain w/dye							
5571	70470		Ct head/brain w/o & w/dye							
5571	70481		Ct orbit/ear/fossa w/dye							
5571	70482		Ct orbit/ear/fossa w/o&w/dy							
5571	70487		Ct maxillofacial w/dye							
5571	70488		Ct maxillofacial w/o & w/dy							
5571	70491		Ct soft tissue neck w/dye							
5571	70492		Ct sft tsue nck w/o & w/dye							
5571	70496		Ct angiography head							
5571	70498		Ct angiography neck							
5571	70558		Mri brain w/dye							
5571	70559		Mri brain w/o & w/dye							
5571	71260		Ct thorax w/dye							
5571	71270		Ct thorax w/o & w/dye							
5571	71275		Ct angiography chest							
5571	72127		Ct neck spine w/o & w/dye							
5571	72129		Ct chest spine w/dye							
5571	72130		Ct chest spine w/o & w/dye							
5571	72133		Ct lumbar spine w/o & w/dye							
5571	72191		Ct angiograph pelv w/o&w/dy							
5571	72193		Ct pelvis w/dye							
5571	72194		Ct pelvis w/o & w/dye							
5571	73202		Ct uppr extremity w/o&w/dye							
5571	73206		Ct angio upr extrm w/o&w/dy							
5571	73701		Ct lower extremity w/dye							
5571	73702		Ct lwr extremity w/o&w/dye							
5571	73706		Ct angio lwr extr w/o&w/dye							
5571	74160		Ct abdomen w/dye							
5571	74170		Ct abdomen w/o & w/dye							
5571	74175		Ct angio abdom w/o & w/dye							
5571	74210		X-ray xm phrnx&/crv esoph c							
5571	74220		X-ray xm esophagus 1cntrst							
5571	74221		X-ray xm esophagus 2cntrst							
5571	74230		X-ray xm swlng funcj c+							
5571	74240		X-ray xm upr gi trc 1cntrst							
5571	74246		X-ray xm upr gi trc 2cntrst							
5571	74250		X-ray xm sm int 1cntrst std							
5571	74251		X-ray xm sm int 2cntrst std							
5571	74262		Ct colonography dx w/dye							
5571	74270		X-ray xm colon 1cntrst std							
5571	74280		X-ray xm colon 2cntrst std							
5571	74283		Ther nma rdctj intus/obstrc							
5571	74290		Contrast x-ray gallbladder							
5571	74400		Urography iv +-kub tomog							
5571	74410		Urography nfs drip&/bolus							
5571	74415		Urography nfs drip&/bls w/n							
5571	75572		Ct hrt w/3d image							
5571	75573		Ct hrt w/3d image congen							
5571	75574		Ct angio hrt w/3d image							
5571	75635		Ct angio abdominal arteries							
5571	76978		Us trgt dyn mbubb 1st les							
5571	C8903		"Mri w/cont, breast,  uni"							
5691	G0010		Admin hepatitis b vaccine				$0.00	$0.00		
5572		Level 2 Imaging with Contrast		S	4.446	$368.12	.	$73.63		
5572	0637T		Ct breast w/3d bi c+							
5572	0638T		Ct breast w/3d bi c-/c+							
5572	70010		Contrast x-ray of brain							
5572	70542		Mri orbit/face/neck w/dye							
5572	70543		Mri orbt/fac/nck w/o &w/dye							
5572	70545		Mr angiography head w/dye							
5572	70546		Mr angiograph head w/o&w/dy							
5572	70548		Mr angiography neck w/dye							
5572	70549		Mr angiograph neck w/o&w/dy							
5572	70552		Mri brain stem w/dye							
5572	70553		Mri brain stem w/o & w/dye							
5572	71552		Mri chest w/o & w/dye							
5572	72126		Ct neck spine w/dye							
5572	72132		Ct lumbar spine w/dye							
5572	72142		Mri neck spine w/dye							
5572	72147		Mri chest spine w/dye							
5572	72149		Mri lumbar spine w/dye							
5572	72156		Mri neck spine w/o & w/dye							
5572	72157		Mri chest spine w/o & w/dye							
5572	72158		Mri lumbar spine w/o & w/dy							
5572	72196		Mri pelvis w/dye							
5572	72197		Mri pelvis w/o & w/dye							
5572	73040		Contrast x-ray of shoulder							
5572	73085		Contrast x-ray of elbow							
5572	73115		Contrast x-ray of wrist							
5572	73201		Ct upper extremity w/dye							
5572	73219		Mri upper extremity w/dye							
5572	73220		Mri uppr extremity w/o&w/dy							
5572	73223		Mri joint upr extr w/o&w/dy							
5572	73525		Contrast x-ray of hip							
5572	73580		Contrast x-ray of knee join							
5572	73615		Contrast x-ray of ankle							
5572	73719		Mri lower extremity w/dye							
5572	73720		Mri lwr extremity w/o&w/dye							
5572	73723		Mri joint lwr extr w/o&w/dy							
5572	74174		Ct angio abd&pelv w/o&w/dye							
5572	74177		Ct abd & pelv w/contrast							
5572	74178		Ct abd & pelv 1/> regns							
5572	74182		Mri abdomen w/dye							
5572	74183		Mri abdomen w/o & w/dye							
5572	74420		Urography rtrgr +-kub							
5572	74425		Contrst x-ray urinary tract							
5572	74430		Contrast x-ray bladder							
5572	75561		Cardiac mri for morph w/dye							
5572	C8900		"Mra w/cont, abd"							
5572	C8902		"Mra w/o fol w/cont, abd"							
5572	C8905		"Mri w/o fol w/cont, brst, u"							
5572	C8906		"Mri w/cont, breast,  bi"							
5572	C8908		"Mri w/o fol w/cont, breast,"							
5572	C8909		"Mra w/cont, chest"							
5572	C8911		"Mra w/o fol w/cont, chest"							
5572	C8912		"Mra w/cont, lwr ext"							
5572	C8914		"Mra w/o fol w/cont, lwr ext"							
5572	C8918		"Mra w/cont, pelvis"							
5572	C8920		"Mra w/o fol w/cont, pelvis"							
5572	C8924		"2d tte w or w/o fol w/con,f"							
5572	C8931		"Mra, w/dye, spinal canal"							
5572	C8933		"Mra, w/o&w/dye, spinal cana"							
5572	C8934		"Mra, w/dye, upper extremity"							
5572	C8936		"Mra, w/o&w/dye, upper extr"							
5572	C9733		Non-ophthalmic fva							
5822	G0101		Ca screen;pelvic/breast exa				$0.00	$0.00		
5573		Level 3 Imaging with Contrast		S	8.6377	$715.18	.	$143.04		
5573	62302		Myelography lumbar injectio							
5573	62303		Myelography lumbar injectio							
5573	62304		Myelography lumbar injectio							
5573	62305		Myelography lumbar injectio							
5573	70015		Contrast x-ray of brain							
5573	71551		Mri chest w/dye							
5573	72240		Myelography neck spine							
5573	72255		Myelography thoracic spine							
5573	72265		Myelography l-s spine							
5573	72270		Myelogphy 2/> spine regions							
5573	73222		Mri joint upr extrem w/dye							
5573	73722		Mri joint of lwr extr w/dye							
5573	75563		Card mri w/stress img & dye							
5573	C8921		"Tte w or w/o fol w/cont, co"							
5573	C8922		"Tte w or w/o fol w/cont, f/"							
5573	C8923		"2d tte w or w/o fol w/con,c"							
5573	C8925		"2d tee w or w/o fol w/con,i"							
5573	C8926		"Tee w or w/o fol w/cont,con"							
5573	C8927		"Tee w or w/o fol w/cont, mo"							
5573	C8928		"Tte w or w/o fol w/con,stre"							
5573	C8929		"Tte w or wo fol wcon,dopple"							
5573	C8930		"Tte w or w/o contr, cont ec"							
5591		Level 1 Nuclear Medicine and Related Services		S	4.5547	$377.12	.	$75.43		
5591	38792		Ra tracer id of sentinl nod							
5591	78012		Thyroid uptake measurement							
5591	78013		Thyroid imaging w/blood flo							
5591	78014		Thyroid imaging w/blood flo							
5591	78015		Thyroid met imaging							
5591	78016		Thyroid met imaging/studies							
5591	78070		Parathyroid planar imaging							
5591	78071		Parathyrd planar w/wo subtr							
5591	78099		Endocrine nuclear procedure							
5591	78102		Bone marrow imaging ltd							
5591	78103		Bone marrow imaging mult							
5591	78104		Bone marrow imaging body							
5591	78120		Red cell mass single							
5591	78130		Red cell survival study							
5591	78140		Red cell sequestration							
5591	78185		Spleen imaging							
5591	78191		Platelet survival							
5591	78199		Blood/lymph nuclear exam							
5591	78215		Liver and spleen imaging							
5591	78216		Liver & spleen image/flow							
5591	78226		Hepatobiliary system imagin							
5591	78230		Salivary gland imaging							
5591	78231		Serial salivary imaging							
5591	78232		Salivary gland function exa							
5591	78258		Esophageal motility study							
5591	78261		Gastric mucosa imaging							
5591	78262		Gastroesophageal reflux exa							
5591	78264		Gastric emptying imag study							
5591	78265		Gastric emptying imag study							
5591	78278		Acute gi blood loss imaging							
5591	78282		Gi protein loss exam							
5591	78290		Meckels divert exam							
5591	78291		Leveen/shunt patency exam							
5591	78299		Gi nuclear procedure							
5591	78300		Bone imaging limited area							
5591	78305		Bone imaging multiple areas							
5591	78306		Bone imaging whole body							
5591	78315		Bone imaging 3 phase							
5591	78399		Musculoskeletal nuclear exa							
5591	78428		Cardiac shunt imaging							
5591	78445		Vascular flow imaging							
5591	78458		Ven thrombosis images bilat							
5591	78466		Heart infarct image							
5591	78472		Gated heart planar single							
5591	78473		Gated heart multiple							
5591	78494		Heart image spect							
5591	78499		Cardiovascular nuclear exam							
5591	78579		Lung ventilation imaging							
5591	78580		Lung perfusion imaging							
5591	78597		Lung perfusion differential							
5591	78599		Respiratory nuclear exam							
5591	78600		Brain image < 4 views							
5591	78601		Brain image w/flow < 4 view							
5591	78660		Nuclear exam of tear flow							
5591	78699		Nervous system nuclear exam							
5591	78700		Kidney imaging morphol							
5591	78701		Kidney imaging with flow							
5591	78725		Kidney function study							
5591	78740		Ureteral reflux study							
5591	78761		Testicular imaging w/flow							
5591	78799		Genitourinary nuclear exam							
5591	78800		Rp loclzj tum 1 area 1 d im							
5591	78801		Rp loclzj tum 2+area 1+d im							
5591	78808		Iv inj ra drug dx study							
5591	78999		Nuclear diagnostic exam							
5591	G0235		Pet not otherwise specified							
5592		Level 2 Nuclear Medicine and Related Services		S	5.9108	$489.40	.	$97.88		
5592	78018		Thyroid met imaging body							
5592	78072		Parathyrd planar w/spect&ct							
5592	78121		Red cell mass multiple							
5592	78122		Blood volume							
5592	78195		Lymph system imaging							
5592	78201		Liver imaging							
5592	78202		Liver imaging with flow							
5592	78227		Hepatobil syst image w/drug							
5592	78266		Gastric emptying imag study							
5592	78414		Non-imaging heart function							
5592	78457		Venous thrombosis imaging							
5592	78468		Heart infarct image (ef)							
5592	78469		Heart infarct image (3d)							
5592	78481		Heart first pass single							
5592	78483		Heart first pass multiple							
5592	78582		Lung ventilat&perfus imagin							
5592	78598		Lung perf&ventilat diferent							
5592	78605		Brain image 4+ views							
5592	78606		Brain image w/flow 4 + view							
5592	78610		Brain flow imaging only							
5592	78630		Cerebrospinal fluid scan							
5592	78635		Csf ventriculography							
5592	78645		Csf shunt evaluation							
5592	78707		K flow/funct image w/o drug							
5592	78708		K flow/funct image w/drug							
5592	78709		K flow/funct image multiple							
5593		Level 3 Nuclear Medicine and Related Services		S	15.7728	"$1,305.94"	.	$261.19		
5593	0331T		Heart symp image plnr							
5593	0332T		Heart symp image plnr spect							
5593	78075		Adrenal cortex & medulla im							
5593	78110		Plasma volume single							
5593	78111		Plasma volume multiple							
5593	78451		Ht muscle image spect sing							
5593	78452		Ht muscle image spect mult							
5593	78453		Ht muscle image planar sing							
5593	78454		Ht musc image planar mult							
5593	78456		Acute venous thrombus image							
5593	78459		Myocrd img pet single study							
5593	78650		Csf leakage imaging							
5593	78802		Rp loclzj tum whbdy 1 d img							
5593	78803		Rp loclzj tum spect 1 area							
5593	78804		Rp loclzj tum whbdy 2+d img							
5593	78811		Pet image ltd area							
5593	78830		Rp loclzj tum spect w/ct 1							
5593	78831		Rp loclzj tum spect 2 areas							
5594		Level 4 Nuclear Medicine and Related Services		S	17.8791	"$1,480.34"	.	$296.07		
5594	78429		Myocrd img pet 1 std w/ct							
5594	78430		Myocrd img pet rst/strs w/c							
5594	78491		Myocrd img pet 1std rst/str							
5594	78492		Myocrd img pet mlt rst&strs							
5594	78608		Brain imaging (pet)							
5594	78812		Pet image skull-thigh							
5594	78813		Pet image full body							
5594	78814		Pet image w/ct lmtd							
5594	78815		Pet image w/ct skull-thigh							
5594	78816		Pet image w/ct full body							
5594	78832		Rp loclzj tum spect w/ct 2							
5611		Level 1 Therapeutic Radiation Treatment Preparation		S	1.5323	$126.87	$32.03	$25.38		
5611	76145		Med physic dos eval rad exp							
5611	77280		Set radiation therapy field							
5611	77299		Radiation therapy planning							
5611	77300		Radiation therapy dose plan							
5611	77331		Special radiation dosimetry							
5611	77332		Radiation treatment aid(s)							
5611	77333		Radiation treatment aid(s)							
5611	77336		Radiation physics consult							
5611	77370		Radiation physics consult							
5611	77399		External radiation dosimetr							
5612		Level 2 Therapeutic Radiation Treatment Preparation		S	4.0905	$338.68	.	$67.74		
5612	77285		Set radiation therapy field							
5612	77290		Set radiation therapy field							
5612	77306		Telethx isodose plan simple							
5612	77307		Telethx isodose plan cplx							
5612	77316		Brachytx isodose plan simpl							
5612	77317		Brachytx isodose intermed							
5612	77318		Brachytx isodose complex							
5612	77321		Special teletx port plan							
5612	77334		Radiation treatment aid(s)							
5612	77338		Design mlc device for imrt							
5613		Level 3 Therapeutic Radiation Treatment Preparation		S	15.2443	"$1,262.18"	.	$252.44		
5613	32553		Ins mark thor for rt perq							
5613	49411		Ins mark abd/pel for rt per							
5613	55876		Place rt device/marker pros							
5613	77295		3-d radiotherapy plan							
5613	77301		Radiotherapy dose plan imrt							
5613	C9728		"Place device/marker, non pr"							
5621		Level 1 Radiation Therapy		S	1.4559	$120.54	.	$24.11		
5621	77401		Radiation treatment deliver							
5621	77402		Radiation treatment deliver							
5621	77789		Apply surf ldr radionuclide							
5621	77799		Radium/radioisotope therapy							
5622		Level 2 Radiation Therapy		S	2.919	$241.68	.	$48.34		
5622	0394T		Hdr elctrnc skn surf brchyt							
5622	77407		Radiation treatment deliver							
5622	77412		Radiation treatment deliver							
5622	77600		Hyperthermia treatment							
5622	77750		Infuse radioactive material							
5622	77767		Hdr rdncl skn surf brachytx							
5622	77768		Hdr rdncl skn surf brachytx							
5623		Level 3 Radiation Therapy		S	6.5528	$542.55	.	$108.52		
5623	77385		Ntsty modul rad tx dlvr smp							
5623	77386		Ntsty modul rad tx dlvr cpl							
5623	77423		Neutron beam tx complex							
5623	77470		Special radiation treatment							
5623	77520		Proton trmt simple w/o comp							
5623	77610		Hyperthermia treatment							
5623	77615		Hyperthermia treatment							
5623	77620		Hyperthermia treatment							
5623	77761		Apply intrcav radiat simple							
5623	77762		Apply intrcav radiat interm							
5624		Level 4 Radiation Therapy		S	8.5566	$708.46	.	$141.70		
5624	0395T		Hdr elctr ntrst/ntrcv brcht							
5624	77605		Hyperthermia treatment							
5624	77763		Apply intrcav radiat compl							
5624	77770		Hdr rdncl ntrstl/icav brcht							
5624	77771		Hdr rdncl ntrstl/icav brcht							
5624	77772		Hdr rdncl ntrstl/icav brcht							
5624	77778		Apply interstit radiat comp							
5625		Level 5 Radiation Therapy		S	15.6759	"$1,297.92"	.	$259.59		
5625	77522		Proton trmt simple w/comp							
5625	77523		Proton trmt intermediate							
5625	77525		Proton treatment complex							
5626		Level 6 Radiation Therapy		S	20.9396	"$1,733.74"	.	$346.75		
5626	77373		Sbrt delivery							
5627		Level 7 Radiation Therapy		J1	93.8773	"$7,772.76"	.	"$1,554.56"	*	
5627	77371		Srs multisource							
5627	77372		Srs linear based							
5627	77424		Io rad tx delivery by x-ray							
5627	77425		Io rad tx deliver by elctrn							
5661		Therapeutic Nuclear Medicine		S	3.0149	$249.63	.	$49.93		
5661	79005		Nuclear rx oral admin							
5661	79101		Nuclear rx iv admin							
5661	79200		Nuclear rx intracav admin							
5661	79300		Nuclr rx interstit colloid							
5661	79403		Hematopoietic nuclear tx							
5661	79440		Nuclear rx intra-articular							
5661	79445		Nuclear rx intra-arterial							
5661	79999		Nuclear medicine therapy							
5671		Level 1 Pathology		S	0.601	$49.76	.	$9.96		
5671	0564T		Onc chemo rx cytotox csc 14							
5671	80500		Lab pathology consultation							
5671	86079		Phys blood bank serv authrj							
5671	86850		Rbc antibody screen							
5671	88112		Cytopath cell enhance tech							
5671	88125		Forensic cytopathology							
5671	88162		Cytopath smear other source							
5671	88173		Cytopath eval fna report							
5671	88182		Cell marker study							
5671	88199		Cytopathology procedure							
5671	88299		Cytogenetic study							
5671	88304		Tissue exam by pathologist							
5671	88305		Tissue exam by pathologist							
5671	88312		Special stains group 1							
5671	88323		Microslide consultation							
5671	88356		Analysis nerve							
5671	88399		Surgical pathology procedur							
5671	89230		Collect sweat for test							
5671	89240		Pathology lab procedure							
5671	89255		Prepare embryo for transfer							
5671	89257		Sperm identification							
5671	89260		Sperm isolation simple							
5671	89261		Sperm isolation complex							
5671	89264		Identify sperm tissue							
5671	89335		Cryopreserve testicular tis							
5671	89353		Thawing cryopresrved sperm							
5671	89398		Unlisted reprod med lab pro							
5672		Level 2 Pathology		S	1.8015	$149.16	.	$29.84		
5672	80502		Lab pathology consultation							
5672	86078		Phys blood bank serv reactj							
5672	86860		Rbc antibody elution							
5672	86885		Coombs test indirect qual							
5672	86886		Coombs test indirect titer							
5672	86890		Autologous blood process							
5672	86920		Compatibility test spin							
5672	86921		Compatibility test incubate							
5672	86922		Compatibility test antiglob							
5672	86923		Compatibility test electric							
5672	86927		Plasma fresh frozen							
5672	86950		Leukacyte transfusion							
5672	86960		Vol reduction of blood/prod							
5672	86965		Pooling blood platelets							
5672	86972		Rbc pretx incubatj w/densit							
5672	86977		Rbc serum pretx incubj/inhi							
5672	86985		Split blood or products							
5672	88120		Cytp urne 3-5 probes ea spe							
5672	88172		Cytp dx eval fna 1st ea sit							
5672	88325		Comprehensive review of dat							
5672	88331		Path consult intraop 1 bloc							
5672	88342		Immunohisto antb 1st stain							
5672	88355		Analysis skeletal muscle							
5672	88358		Analysis tumor							
5672	88360		Tumor immunohistochem/manua							
5672	88365		Insitu hybridization (fish)							
5672	88374		M/phmtrc alys ishquant/semi							
5672	88377		M/phmtrc alys ishquant/semi							
5672	89049		Chct for mal hyperthermia							
5672	89220		Sputum specimen collection							
5672	89250		Cultr oocyte/embryo <4 days							
5672	89251		Cultr oocyte/embryo <4 days							
5672	89253		Embryo hatching							
5672	89254		Oocyte identification							
5672	89259		Cryopreservation sperm							
5672	89268		Insemination of oocytes							
5672	89281		Assist oocyte fertilization							
5672	89290		Biopsy oocyte polar body							
5672	89291		Biopsy oocyte polar body							
5672	89337		Cryopreservation oocyte(s)							
5672	89342		Storage/year embryo(s)							
5672	89343		Storage/year sperm/semen							
5672	89344		Storage/year reprod tissue							
5672	89352		Thawing cryopresrved embryo							
5672	89354		Thaw cryoprsvrd reprod tiss							
5672	89356		Thawing cryopresrved oocyte							
5673		Level 3 Pathology		S	3.5177	$291.26	.	$58.26		
5673	86870		Rbc antibody identification							
5673	86902		Blood type antigen donor ea							
5673	86905		Blood typing rbc antigens							
5673	86930		Frozen blood prep							
5673	86931		Frozen blood thaw							
5673	86971		Rbc pretx incubatj w/enzyme							
5673	88121		Cytp urine 3-5 probes cmptr							
5673	88184		Flowcytometry/ tc 1 marker							
5673	88307		Tissue exam by pathologist							
5673	88344		Immunohisto antibody slide							
5673	88346		Immunofluor antb 1st stain							
5673	88361		Tumor immunohistochem/compu							
5673	88366		Insitu hybridization (fish)							
5673	88367		Insitu hybridization auto							
5673	88368		Insitu hybridization manual							
5673	89346		Storage/year oocyte(s)							
5673	G0416		"Prostate biopsy, any mthd"							
5674		Level 4 Pathology		S	7.9248	$656.15	.	$131.23		
5674	85097		Bone marrow interpretation							
5674	86891		Autologous blood op salvage							
5674	88309		Tissue exam by pathologist							
5674	88319		Enzyme histochemistry							
5674	88333		Intraop cyto path consult 1							
5674	88348		Electron microscopy							
5674	88362		Nerve teasing preparations							
5674	89258		Cryopreservation embryo(s)							
5674	89272		Extended culture of oocytes							
5674	89280		Assist oocyte fertilization							
5691		Level 1 Drug Administration		S	0.4831	$40.00	.	$8.00		
5691	95115		Immunotherapy one injection							
5691	95117		Immunotherapy injections							
5691	95144		Antigen therapy services							
5691	95145		Antigen therapy services							
5691	95146		Antigen therapy services							
5691	95165		Antigen therapy services							
5691	95170		Antigen therapy services							
5691	96361		Hydrate iv infusion add-on							
5691	96366		Ther/proph/diag iv inf addo							
5691	96370		Sc ther infusion addl hr							
5691	96375		Tx/pro/dx inj new drug addo							
5691	96377		Applicaton on-body injector							
5691	96379		Ther/prop/diag inj/inf proc							
5691	96423		Chemo ia infuse each addl h							
5691	96549		Chemotherapy unspecified							
5311	G0104		Ca screen;flexi sigmoidscop				$0.00	$0.00		
5311	G0105		Colorectal scrn; hi risk in				$0.00	$0.00		
5571	G0106		Colon ca screen;barium enem				$0.00	$0.00		
5692		Level 2 Drug Administration		S	0.7485	$61.97	.	$12.40		
5692	0356T		Insrt drug device for iop							
5692	90471		Immunization admin							
5692	90473		Immune admin oral/nasal							
5692	95147		Antigen therapy services							
5692	95148		Antigen therapy services							
5692	95149		Antigen therapy services							
5692	96367		Tx/proph/dg addl seq iv inf							
5692	96371		Sc ther infusion reset pump							
5692	96372		Ther/proph/diag inj sc/im							
5692	96401		Chemo anti-neopl sq/im							
5692	96402		Chemo hormon antineopl sq/i							
5692	96405		Chemo intralesional up to 7							
5692	96411		Chemo iv push addl drug							
5692	96415		Chemo iv infusion addl hr							
5692	96417		Chemo iv infus each addl se							
5693		Level 3 Drug Administration		S	2.4578	$203.50	.	$40.70		
5693	36598		Inj w/fluor eval cv device							
5693	96360		Hydration iv infusion init							
5693	96365		Ther/proph/diag iv inf init							
5693	96369		Sc ther infusion up to 1 hr							
5693	96373		Ther/proph/diag inj ia							
5693	96374		Ther/proph/diag inj iv push							
5693	96406		Chemo intralesional over 7							
5693	96409		Chemo iv push sngl drug							
5693	96422		Chemo ia infusion up to 1 h							
5693	96521		Refill/maint portable pump							
5693	96522		Refill/maint pump/resvr sys							
5693	96542		Chemotherapy injection							
5694		Level 4 Drug Administration		S	3.7532	$310.75	.	$62.16		
5694	0465T		Supchrdl njx rx w/o supply							
5694	0540T		Car-t cll admn autologous							
5694	36593		Declot vascular device							
5694	37195		Thrombolytic therapy stroke							
5694	67028		Injection eye drug							
5694	92977		Dissolve clot heart vessel							
5694	95990		Spin/brain pump refil & mai							
5694	96413		Chemo iv infusion 1 hr							
5694	96416		Chemo prolong infuse w/pump							
5694	96420		Chemo ia push tecnique							
5694	96425		Chemotherapy infusion metho							
5694	96440		Chemotherapy intracavitary							
5694	96446		Chemotx admn prtl cavity							
5694	96450		Chemotherapy into cns							
5694	C8957		"Prolonged iv inf, req pump"							
5694	G0498		Chemo extend iv infus w/pum							
5694	M0239		Bamlanivimab-xxxx infusion				$0.00	$0.00		
5694	M0243		Casirivi and imdevi infusion				$0.00	$0.00		
5572	G0120		Colon ca scrn; barium enema				$0.00	$0.00		
5721		Level 1 Diagnostic Tests and Related Services		S	1.6854	$139.55	.	$27.91		
5721	0212T		Compre audiometry evaluatio							
5721	0272T		Interrogate crtd sns dev							
5721	0273T		Interrogate crtd sns w/pgrm							
5721	0278T		Tempr							
5721	0464T		Visual ep test for glaucoma							
5721	43755		Dx gastr intub w/asp specs							
5721	50686		Measure ureter pressure							
5721	51703		Insert bladder cath complex							
5721	51741		Electro-uroflowmetry first							
5721	51784		Anal/urinary muscle study							
5721	53660		Dilation of urethra							
5721	91065		Breath hydrogen/methane tes							
5721	91200		Liver elastography							
5721	91299		Gastroenterology procedure							
5721	92274		Multifocal erg w/i&r							
5721	92517		Vemp test i&r cervical							
5721	92518		Vemp test i&r ocular							
5721	92537		Caloric vstblr test w/rec							
5721	92538		Caloric vstblr test w/rec							
5721	92540		Basic vestibular evaluation							
5721	92544		Optokinetic nystagmus test							
5721	92546		Sinusoidal rotational test							
5721	92550		Tympanometry & reflex thres							
5721	92553		Audiometry air & bone							
5721	92557		Comprehensive hearing test							
5721	92562		Loudness balance test							
5721	92570		Acoustic immitance testing							
5721	92572		Staggered spondaic word tes							
5721	92579		Visual audiometry (vra)							
5721	92582		Conditioning play audiometr							
5721	92584		Electrocochleography							
5721	92601		Cochlear implt f/up exam <7							
5721	92602		Reprogram cochlear implt <7							
5721	92603		Cochlear implt f/up exam 7/							
5721	92604		Reprogram cochlear implt 7/							
5721	92620		Auditory function 60 min							
5721	92625		Tinnitus assessment							
5721	92626		Eval aud funcj 1st hour							
5721	92640		Aud brainstem implt program							
5721	92651		Aep hearing status deter i&							
5721	93025		Microvolt t-wave assess							
5721	93229		Remote 30 day ecg tech supp							
5721	93702		Bis xtracell fluid analysis							
5721	93740		Temperature gradient studie							
5721	93799		Cardiovascular procedure							
5721	93923		Upr/lxtr art stdy 3+ lvls							
5721	94010		Breathing capacity test							
5721	94011		Spirometry up to 2 yrs old							
5721	94150		Vital capacity test							
5721	94680		Exhaled air analysis o2							
5721	94727		Pulm function test by gas							
5721	94762		Measure blood oxygen level							
5721	94775		Ped home apnea rec hk-up							
5721	94776		Ped home apnea rec downld							
5721	94799		Pulmonary service/procedure							
5721	95800		Slp stdy unattended							
5721	95806		Sleep study unatt&resp efft							
5721	95863		Muscle test 3 limbs							
5721	95864		Muscle test 4 limbs							
5721	95866		Muscle test hemidiaphragm							
5721	95869		Muscle test thor paraspinal							
5721	95872		Muscle test one fiber							
5721	95875		Limb exercise test							
5721	95907		Nvr cndj tst 1-2 studies							
5721	95921		Autonomic nrv parasym inerv							
5721	95937		Neuromuscular junction test							
5721	95943		Parasymp&symp hrt rate test							
5721	95999		Neurological procedure							
5721	96002		Dynamic surface emg							
5721	G0398		Home sleep test/type 2 port							
5721	G0399		Home sleep test/type 3 port							
5722		Level 2 Diagnostic Tests and Related Services		S	3.1939	$264.45	.	$52.89		
5722	0509T		Pattern erg w/i&r							
5722	0598T		Ncntc r-t fluor wnd img 1st							
5722	43753		Tx gastro intub w/asp							
5722	43754		Dx gastr intub w/asp spec							
5722	54240		Penis study							
5722	76936		Echo guide for artery repai							
5722	90867		Tcranial magn stim tx plan							
5722	90868		Tcranial magn stim tx deli							
5722	90869		Tcran magn stim redetemine							
5722	91037		Esoph imped function test							
5722	91120		Rectal sensation test							
5722	91132		Electrogastrography							
5722	92235		Fluorescein angrph uni/bi							
5722	92240		Icg angiography uni/bi							
5722	92242		Fluorescein icg angiography							
5722	92273		Full field erg w/i&r							
5722	92512		Nasal function studies							
5722	92516		Facial nerve function test							
5722	92519		Vemp tst i&r cervical&ocula							
5722	92545		Oscillating tracking test							
5722	92587		Evoked auditory test limite							
5722	92588		Evoked auditory tst complet							
5722	92652		Aep thrshld est mlt freq i&							
5722	92653		Aep neurodiagnostic i&r							
5722	92950		Heart/lung resuscitation cp							
5722	93017		Cardiovascular stress test							
5722	93924		Lwr xtr vasc stdy bilat							
5722	94012		Spirmtry w/brnchdil inf-2 y							
5722	94015		Patient recorded spirometry							
5722	94060		Evaluation of wheezing							
5722	94070		Evaluation of wheezing							
5722	94375		Respiratory flow volume loo							
5722	94450		Hypoxia response curve							
5722	94621		Cardiopulm exercise testing							
5722	94681		Exhaled air analysis o2/co2							
5722	94726		Pulm funct tst plethysmogra							
5722	94728		Airwy resist by oscillometr							
5722	95700		Eeg cont rec w/vid eeg tech							
5722	95705		Eeg w/o vid 2-12 hr unmntr							
5722	95706		Eeg wo vid 2-12hr intmt mnt							
5722	95707		Eeg w/o vid 2-12hr cont mnt							
5722	95711		Veeg 2-12 hr unmonitored							
5722	95712		Veeg 2-12 hr intmt mntr							
5722	95812		Eeg 41-60 minutes							
5722	95813		Eeg extnd mntr 61-119 min							
5722	95816		Eeg awake and drowsy							
5722	95819		Eeg awake and asleep							
5722	95822		Eeg coma or sleep only							
5722	95857		Cholinesterase challenge							
5722	95867		Muscle test cran nerv unila							
5722	95868		Muscle test cran nerve bila							
5722	95908		Nrv cndj tst 3-4 studies							
5722	95909		Nrv cndj tst 5-6 studies							
5722	95910		Nrv cndj test 7-8 studies							
5722	95924		Ans parasymp & symp w/tilt							
5722	95925		Somatosensory testing							
5722	95926		Somatosensory testing							
5722	95927		Somatosensory testing							
5722	95930		Visual ep test cns w/i&r							
5722	96003		Dynamic fine wire emg							
5722	96112		Devel tst phys/qhp 1st hr							
5722	96116		Nubhvl xm phys/qhp 1st hr							
5722	96130		Psycl tst eval phys/qhp 1st							
5722	96132		Nrpsyc tst eval phys/qhp 1s							
5722	G0303		Pre-op service lvrs 10-15do							
5722	G0400		Home sleep test/type 4 port							
5723		Level 3 Diagnostic Tests and Related Services		S	5.8913	$487.78	.	$97.56		
5723	0541T		Myocardial imaging mcg							
5723	90870		Electroconvulsive therapy							
5723	91010		Esophagus motility study							
5723	91020		Gastric motility studies							
5723	91022		Duodenal motility study							
5723	91030		Acid perfusion of esophagus							
5723	91034		Gastroesophageal reflux tes							
5723	91035		G-esoph reflx tst w/electro							
5723	91038		Esoph imped funct test > 1h							
5723	91040		Esoph balloon distension ts							
5723	92230		Eye exam with photos							
5723	92577		Stenger test speech							
5723	93660		Tilt table evaluation							
5723	94013		Meas lung vol thru 2 yrs							
5723	94772		Breath recording infant							
5723	95070		Bronchial allergy tests							
5723	95076		Ingest challenge ini 120 mi							
5723	95708		Eeg wo vid ea 12-26hr unmnt							
5723	95709		Eeg w/o vid ea 12-26hr intm							
5723	95710		Eeg w/o vid ea 12-26hr cont							
5723	95713		Veeg 2-12 hr cont mntr							
5723	95714		Veeg ea 12-26 hr unmntr							
5723	95715		Veeg ea 12-26hr intmt mntr							
5723	95805		Multiple sleep latency test							
5723	95807		Sleep study attended							
5723	95824		Eeg cerebral death only							
5723	95911		Nrv cndj test 9-10 studies							
5723	95912		Nrv cndj test 11-12 studies							
5723	95913		Nrv cndj test 13/> studies							
5723	95929		C motor evoked lwr limbs							
5723	95938		Somatosensory testing							
5723	95954		Eeg monitoring/giving drugs							
5723	96000		Motion analysis video/3d							
5723	G0302		Pre-op service lvrs complet							
5723	G0304		Pre-op service lvrs 1-9 dos							
5723	G0305		Post op service lvrs min 6							
5723	G2000		Blinded conv. tx mdd clin tr							
5724		Level 4 Diagnostic Tests and Related Services		S	11.1093	$919.82	.	$183.97		
5724	0436T		Prgrmg eval npgs apnea stud							
5724	51101		Drain bladder by trocar/cat							
5724	95004		Percut allergy skin tests							
5724	95044		Allergy patch tests							
5724	95716		Veeg ea 12-26hr cont mntr							
5724	95782		Polysom <6 yrs 4/> paramtrs							
5724	95783		Polysom <6 yrs cpap/bilvl							
5724	95808		Polysom any age 1-3> param							
5724	95810		Polysom 6/> yrs 4/> param							
5724	95811		Polysom 6/>yrs cpap 4/> par							
5724	95928		C motor evoked uppr limbs							
5724	95939		C motor evoked upr&lwr limb							
5724	95958		Eeg monitoring/function tes							
5724	95961		Electrode stimulation brain							
5724	95965		Meg spontaneous							
5724	95966		Meg evoked single							
5724	96001		Motion test w/ft press meas							
5731		Level 1 Minor Procedures		S	0.298	$24.67	.	$4.94		
5731	0358T		Bia whole body							
5731	0521T		Interrog dev eval wcs ip							
5731	0555T		B1 str&fx rsk transmis data							
5731	0631T		Tc vis lit hyperspectral im							
5731	20560		Ndl insj w/o njx 1 or 2 mus							
5731	20561		Ndl insj w/o njx 3+ musc							
5731	20979		Us bone stimulation							
5731	76514		Echo exam of eye thickness							
5731	86077		Phys blood bank serv xmatch							
5731	86485		Skin test candida							
5731	86486		Skin test nos antigen							
5731	86580		Tb intradermal test							
5731	86976		Rbc serum pretx id dilution							
5731	86999		Transfusion procedure							
5731	88106		Cytopath fl nongyn filter							
5731	88160		Cytopath smear other source							
5731	88161		Cytopath smear other source							
5731	88300		Surgical path gross							
5731	88302		Tissue exam by pathologist							
5731	88363		Xm archive tissue molec ana							
5731	92499		Eye service or procedure							
5731	92564		Sisi hearing test							
5731	92700		Ent procedure/service							
5731	93050		Art pressure waveform analy							
5731	93291		Interrog dev eval scrms ip							
5731	93998		Noninvas vasc dx study proc							
5731	95017		Perq & icut allg test venom							
5731	95027		Icut allergy titrate-airbor							
5731	95199		Allergy immunology services							
5731	96146		Psycl/nrpsyc tst auto resul							
5731	97810		Acupunct w/o stimul 15 min							
5731	97813		Acupunct w/stimul 15 min							
5731	99473		Self-meas bp pt educaj/trai							
5731	C9803		Hopd covid-19 spec collect							
5731	G0117		Glaucoma scrn hgh risk dire							
5731	G0237		Therapeutic procd strg endu							
5731	G0238		"Oth resp proc, indiv"							
5731	G0404		Ekg tracing for initial pre							
5731	G2011		Alcohol/sub abuse assess							
5311	G0121		Colon ca scrn not hi rsk in				$0.00	$0.00		
5732		Level 2 Minor Procedures		S	0.4087	$33.84	.	$6.77		
5732	0106T		Touch quant sensory test							
5732	0107T		Vibrate quant sensory test							
5732	0109T		Heat quant sensory test							
5732	0208T		Audiometry air only							
5732	0209T		Audiometry air & bone							
5732	0210T		Speech audiometry threshold							
5732	0211T		Speech audiom thresh & reco							
5732	0330T		Tear film img uni/bi w/i&r							
5732	0379T		Vis field assmnt tech suppt							
5732	0485T		Oct mid ear i&r unilateral							
5732	0486T		Oct mid ear i&r bilateral							
5732	17340		Cryotherapy of skin							
5732	86901		Blood typing serologic rh(d							
5732	86904		Blood typing patient serum							
5732	86906		Bld typing serologic rh phn							
5732	86932		Frozen blood freeze/thaw							
5732	86945		Blood product/irradiation							
5732	86970		Rbc pretx incubatj w/chemic							
5732	86978		Rbc pretreatment serum							
5732	88104		Cytopath fl nongyn smears							
5732	88108		Cytopath concentrate tech							
5732	88313		Special stains group 2							
5732	88321		Microslide consultation							
5732	88329		Path consult introp							
5732	92145		Corneal hysteresis deter							
5732	92227		Img rta detcj/mntr ds staff							
5732	92228		Img rta detc/mntr ds phy/qh							
5732	92260		Ophthalmoscopy/dynamometry							
5732	92317		Rx corneoscleral cntact len							
5732	92354		Fit spectacles single syste							
5732	92355		Fit spectacles compound len							
5732	92555		Speech threshold audiometry							
5732	92563		Tone decay hearing test							
5732	92565		Stenger test pure tone							
5732	92567		Tympanometry							
5732	92568		Acoustic refl threshold tst							
5732	92571		Filtered speech hearing tes							
5732	92575		Sensorineural acuity test							
5732	92576		Synthetic sentence test							
5732	92596		Ear protector evaluation							
5732	93242		Ext ecg>48hr<7d recording							
5732	94780		Cars/bd tst inft-12mo 60 mi							
5732	95012		Exhaled nitric oxide meas							
5732	95018		Perq&ic allg test drugs/bio							
5732	95028		Icut allergy test-delayed							
5732	95065		Nose allergy test							
5732	96127		Brief emotional/behav assmt							
5732	96900		Ultraviolet light therapy							
5732	G0118		Glaucoma scrn hgh risk dire							
5732	G0239		"Oth resp proc, group"							
5732	G0293		"Non-cov surg proc,clin tria"							
5732	G0294		"Non-cov proc, clinical tria"							
5732	P9100		Pathogen test for platelets							
5732	Q0035		Cardiokymography							
5733		Level 3 Minor Procedures		S	0.6722	$55.66	.	$11.14		
5733	0108T		Cool quant sensory test							
5733	0347T		Ins bone device for rsa							
5733	0506T		Mac pgmt opt dns meas hfp							
5733	0507T		Near ifr 2img mibmn glnd i&							
5733	0559T		Antmc mdl 3d print 1st cmpn							
5733	0561T		Antmc guide 3d print 1st gd							
5733	0563T		Evac meibomian glnd heat bi							
5733	0565T		Autol cell implt adps hrvg							
5733	11719		Trim nail(s) any number							
5733	11720		Debride nail 1-5							
5733	11721		Debride nail 6 or more							
5733	29131		Application of finger splin							
5733	29260		Strapping of elbow or wrist							
5733	29280		Strapping of hand or finger							
5733	29550		Strapping of toes							
5733	51792		Urinary reflex study							
5733	51798		Us urine capacity measure							
5733	57150		Treat vagina infection							
5733	69209		Remove impacted ear wax uni							
5733	69210		Remove impacted ear wax uni							
5733	86490		Coccidioidomycosis skin tes							
5733	86510		Histoplasmosis skin test							
5733	86880		Coombs test direct							
5733	92025		Corneal topography							
5733	92060		Special eye evaluation							
5733	92065		Orthoptic/pleoptic training							
5733	92081		Visual field examination(s)							
5733	92082		Visual field examination(s)							
5733	92132		Cmptr ophth dx img ant segm							
5733	92133		Cmptr ophth img optic nerve							
5733	92134		Cptr ophth dx img post segm							
5733	92201		Opscpy extnd rta draw uni/b							
5733	92202		Opscpy extnd on/mac draw							
5733	92229		Img rta detc/mntr ds poc al							
5733	92265		Eye muscle evaluation							
5733	92283		Color vision examination							
5733	92285		Eye photography							
5733	92326		Replacement of contact lens							
5733	92352		Fit aphakia spectcl monofoc							
5733	92353		Fit aphakia spectcl multifo							
5733	92358		Aphakia prosth service temp							
5733	92371		Repair & adjust spectacles							
5733	92556		Speech audiometry complete							
5733	92583		Select picture audiometry							
5733	93005		Electrocardiogram tracing							
5733	93041		Rhythm ecg tracing							
5733	93243		Ext ecg>48hr<7d scan a/r							
5733	93246		Ext ecg>7d<15d recording							
5733	93278		Ecg/signal-averaged							
5733	93668		Peripheral vascular rehab							
5733	94200		Lung function test (mbc/mvv							
5733	94619		Exercise tst brncspsm wo ec							
5733	94690		Exhaled air analysis							
5733	95024		Icut allergy test drug/bug							
5733	95052		Photo patch test							
5733	95249		Cont gluc mntr pt prov eqp							
5733	95803		Actigraphy testing							
5733	95933		Blink reflex test							
5733	96523		Irrig drug delivery device							
5733	96910		Photochemotherapy with uv-b							
5733	96912		Photochemotherapy with uv-a							
5733	G0127		Trim nail(s)							
5733	G0424		Pulmonary rehab w exer							
5734		Level 4 Minor Procedures		S	1.3521	$111.95	.	$22.39		
5734	0110T		Nos quant sensory test							
5734	0198T		Ocular blood flow measure							
5734	0207T		Clear eyelid gland w/heat							
5734	0476T		Rec ftl car sgl elec tr dat							
5734	0477T		Rec ftl car sgl xrtj alys							
5734	0487T		Trvg biomchn mapg w/reprt							
5734	0615T		Eye mvmt alys w/o calbrj i&							
5734	11740		Drain blood from under nail							
5734	11981		Insert drug implant device							
5734	29125		Apply forearm splint							
5734	29126		Apply forearm splint							
5734	29130		Application of finger splin							
5734	29240		Strapping of shoulder							
5734	29520		Strapping of hip							
5734	29530		Strapping of knee							
5734	30300		Remove nasal foreign body							
5734	30901		Control of nosebleed							
5734	30903		Control of nosebleed							
5734	30905		Control of nosebleed							
5734	36420		Vein access cutdown < 1 yr							
5734	36591		Draw blood off venous devic							
5734	36592		Collect blood from picc							
5734	36600		Withdrawal of arterial bloo							
5734	41800		Drainage of gum lesion							
5734	46600		Diagnostic anoscopy spx							
5734	46601		Diagnostic anoscopy							
5734	51701		Insert bladder catheter							
5734	51702		Insert temp bladder cath							
5734	51736		Urine flow measurement							
5734	53601		Dilate urethra stricture							
5734	53661		Dilation of urethra							
5734	65205		Remove foreign body from ey							
5734	65222		Remove foreign body from ey							
5734	67820		Revise eyelashes							
5734	69200		Clear outer ear canal							
5734	76510		Oph us dx b-scan&quan a-sca							
5734	86900		Blood typing serologic abo							
5734	91133		Electrogastrography w/test							
5734	92020		Special eye evaluation							
5734	92083		Visual field examination(s)							
5734	92136		Ophthalmic biometry							
5734	92250		Eye exam with photos							
5734	92270		Electro-oculography							
5734	92286		Internal eye photography							
5734	92287		Internal eye photography							
5734	92312		Contact lens fitting							
5734	92313		Contact lens fitting							
5734	92315		Rx cntact lens aphakia 1 ey							
5734	92316		Rx cntact lens aphakia 2 ey							
5734	92325		Modification of contact len							
5734	92520		Laryngeal function studies							
5734	92541		Spontaneous nystagmus test							
5734	92542		Positional nystagmus test							
5734	92548		Cdp-sot 6 cond w/i&r							
5734	92549		Cdp-sot 6 cond w/i&r mct&ad							
5734	92552		Pure tone audiometry air							
5734	92561		Bekesy audiometry diagnosis							
5734	93225		Ecg monit/reprt up to 48 hr							
5734	93226		Ecg monit/reprt up to 48 hr							
5734	93247		Ext ecg>7d<15d scan a/r							
5734	93701		Bioimpedance cv analysis							
5734	93786		Ambl bp mntr w/sw rec only							
5734	93788		Ambl bp mntr w/sw a/r							
5734	93922		Upr/l xtremity art 2 levels							
5734	94452		Hast w/report							
5734	94453		Hast w/oxygen titrate							
5734	94617		Exercise tst brncspsm							
5734	94618		Pulmonary stress testing							
5734	94644		Cbt 1st hour							
5734	94667		Chest wall manipulation							
5734	94668		Chest wall manipulation							
5734	95056		Photosensitivity tests							
5734	95060		Eye allergy tests							
5734	95801		Slp stdy unatnd w/anal							
5734	95860		Muscle test one limb							
5734	95861		Muscle test 2 limbs							
5734	95865		Muscle test larynx							
5734	95870		Muscle test nonparaspinal							
5734	95922		Autonomic nrv adrenrg inerv							
5734	95923		Autonomic nrv syst funj tes							
5734	95970		Alys npgt w/o prgrmg							
5734	95981		Io anal gast n-stim subsq							
5734	96136		Psycl/nrpsyc tst phy/qhp 1s							
5734	99195		Phlebotomy							
5734	G0166		"Extrnl counterpulse, per tx"							
5735		Level 5 Minor Procedures		S	3.2637	$270.23	.	$54.05		
5735	0232T		Njx platelet plasma							
5735	0481T		Njx autol wbc concentrate							
5735	11980		Implant hormone pellet(s)							
5735	11982		Remove drug implant device							
5735	11983		Remove/insert drug implant							
5735	15860		Test for blood flow in graf							
5735	20665		Removal of fixation device							
5735	36425		Vein access cutdown > 1 yr							
5735	36680		Insert needle bone cavity							
5735	41250		Repair tongue laceration							
5735	42809		Remove pharynx foreign body							
5735	43752		Nasal/orogastric w/tube plm							
5735	65210		Remove foreign body from ey							
5735	65220		Remove foreign body from ey							
5735	65430		Corneal smear							
5735	68200		Treat eyelid by injection							
5735	68801		Dilate tear duct opening							
5735	86975		Rbc serum pretx incubj drug							
5735	92284		Dark adaptation eye exam							
5735	92311		Contact lens fitting							
5735	93024		Cardiac drug stress test							
5735	94014		Patient recorded spirometry							
5735	95180		Rapid desensitization							
5735	95905		Motor &/ sens nrve cndj tes							
5735	96138		Psycl/nrpsyc tech 1st							
5735	G0516		"Insert drug del implant, >="							
5735	G0517		Remove drug implant							
5735	G0518		Remove w insert drug implant							
5741		Level 1 Electronic Analysis of Devices		S	0.4487	$37.15	.	$7.44		
5741	0317T		Elec alys vagus nrv pls gen							
5741	0417T		Prgrmg eval cardiac modulj							
5741	0418T		Interro eval cardiac modulj							
5741	0497T		Xtrnl pt act ecg in-off con							
5741	0522T		Prgrmg dev eval wcs ip							
5741	0528T		Prgrmg dev eval iims ip							
5741	0529T		Interrog dev eval iims ip							
5741	0534T		Cont rec mvmt do setup&trai							
5741	0535T		Cont rec mvmt do reprt cnfi							
5741	0575T		Prgrmg dev eval icds ss ip							
5741	0576T		Interrog dev eval icds ss i							
5741	0579T		Rem interrog dev icds tech							
5741	0605T		Rem oct rta techl sprt min							
5741	0608T		Rem mntr pulm flu mntr alys							
5741	93260		Prgrmg dev eval impltbl sys							
5741	93261		Interrogate subq defib							
5741	93270		Remote 30 day ecg rev/repor							
5741	93279		Prgrmg dev eval pm/ldls pm							
5741	93280		Pm device progr eval dual							
5741	93281		Pm device progr eval multi							
5741	93282		Prgrmg eval implantable dfb							
5741	93283		Prgrmg eval implantable dfb							
5741	93284		Prgrmg eval implantable dfb							
5741	93285		Prgrmg dev eval scrms ip							
5741	93288		Interrog evl pm/ldls pm ip							
5741	93289		Interrog device eval heart							
5741	93290		Interrog dev eval icpms ip							
5741	93292		Wcd device interrogate							
5741	93293		Pm phone r-strip device eva							
5741	93296		Rem interrog evl pm/ids							
5741	95836		Ecog impltd brn npgt <30 d							
5741	95976		Alys smpl cn npgt prgrmg							
5741	95982		Io ga n-stim subsq w/reprog							
5741	99454		Rem mntr physiol param dev							
5741	G2066		Inter devc remote 30d							
5742		Level 2 Electronic Analysis of Devices		S	1.2115	$100.31	.	$20.07		
5742	0434T		Interro eval npgs apnea							
5742	0435T		Prgrmg eval npgs apnea 1 se							
5742	0473T		Reprgrmg io rta eltrd ra							
5742	0589T		Elec alys smpl prgrmg iins							
5742	0590T		Elec alys cplx prgrmg iins							
5742	93271		Ecg/monitoring and analysis							
5742	93750		Interrogation vad in person							
5742	95971		Alys smpl sp/pn npgt w/prgr							
5742	95972		Alys cplx sp/pn npgt w/prgr							
5742	95977		Alys cplx cn npgt prgrmg							
5742	95983		Alys brn npgt prgrmg 15 min							
5743		Level 3 Electronic Analysis of Devices		S	3.2908	$272.47	.	$54.50		
5743	0462T		Prgrmg eval aortic ventr sy							
5743	0463T		Interrog aortic ventr sys							
5743	0472T		Prgrmg io rta eltrd ra							
5743	62252		Csf shunt reprogram							
5743	62367		Analyze spine infus pump							
5743	62368		Analyze sp inf pump w/repro							
5743	62369		Anal sp inf pmp w/reprg&fil							
5743	62370		Anl sp inf pmp w/mdreprg&fi							
5743	93724		Analyze pacemaker system							
5743	93745		Set-up cardiovert-defibrill							
5771		Cardiac Rehabilitation		S	1.4018	$116.07	.	$23.22		
5771	93797		Cardiac rehab							
5771	93798		Cardiac rehab/monitor							
5771	G0422		Intens cardiac rehab w/exer							
5771	G0423		Intens cardiac rehab no exe							
5781		Resuscitation and Cardioversion		S	6.7866	$561.91	.	$112.39		
5781	92953		Temporary external pacing							
5781	92960		Cardioversion electric ext							
5781	92961		Cardioversion electric int							
5781	99465		Nb resuscitation							
5791		Pulmonary Treatment		S	2.2692	$187.88	.	$37.58		
5791	31720		Clearance of airways							
5791	94610		Surfactant admin thru tube							
5791	94640		Airway inhalation treatment							
5791	94642		Aerosol inhalation treatmen							
5791	94660		Pos airway pressure cpap							
5791	94664		Evaluate pt use of inhaler							
5791	94669		Mechanical chest wall oscil							
5801		Ventilation Initiation and Management		S	5.8609	$485.27	.	$97.06		
5801	94002		Vent mgmt inpat init day							
5801	94003		Vent mgmt inpat subq day							
5801	94662		Neg press ventilation cnp							
5811		Manipulation Therapy		S	0.3207	$26.55	.	$5.32		
5811	98925		Osteopath manj 1-2 regions							
5811	98926		Osteopath manj 3-4 regions							
5811	98927		Osteopath manj 5-6 regions							
5811	98928		Osteopath manj 7-8 regions							
5811	98929		Osteopath manj 9-10 regions							
5811	98940		Chiropract manj 1-2 regions							
5811	98941		Chiropract manj 3-4 regions							
5811	98942		Chiropractic manj 5 regions							
5821		Level 1 Health and Behavior Services		S	0.3168	$26.23	.	$5.25		
5821	0362T		Bhv id suprt assmt ea 15 mi							
5821	0373T		Adapt bhv tx ea 15 min							
5821	90899		Psychiatric service/therapy							
5821	96160		Pt-focused hlth risk assmt							
5821	96161		Caregiver health risk assmt							
5821	96164		Hlth bhv ivntj grp 1st 30							
5821	96167		Hlth bhv ivntj fam 1st 30							
5821	97154		Grp adapt bhv tx by tech							
5821	97156		Fam adapt bhv tx gdn phy/qh							
5821	97157		Mult fam adapt bhv tx gdn							
5821	97158		Grp adapt bhv tx by phy/qhp							
5522	G0130		Single energy x-ray study				$0.00	$0.00		
5822	G0296		Visit to determ ldct elig				$0.00	$0.00		
5821	99484		Care mgmt svc bhvl hlth con							
5821	G0396		Alcohol/subs interv 15-30mn							
5012	G0402		Initial preventive exam				$0.00	$0.00		
5821	G0442		Annual alcohol screen 15 mi				$0.00	$0.00		
5822	G0443		Brief alcohol misuse counse				$0.00	$0.00		
5821	G0444		Depression screen annual				$0.00	$0.00		
5822		Level 2 Health and Behavior Services		S	0.9043	$74.87	.	$14.98		
5822	90853		Group psychotherapy							
5822	90880		Hypnotherapy							
5822	96156		Hlth bhv assmt/reassessment							
5822	96158		Hlth bhv ivntj indiv 1st 30							
5822	97151		Bhv id assmt by phys/qhp							
5822	97152		Bhv id suprt assmt by 1 tec							
5822	97153		Adaptive behavior tx by tec							
5822	97155		Adapt behavior tx phys/qhp							
5822	99483		Assmt & care pln pt cog imp							
5822	99490		Chrnc care mgmt svc 1st 20							
5822	99492		1st psyc collab care mgmt							
5822	99493		Sbsq psyc collab care mgmt							
5822	99497		Advncd care plan 30 min							
5822	G0445		High inten beh couns std 30				$0.00	$0.00		
5821	G0446		Intens behave ther cardio d				$0.00	$0.00		
5822	G0447		Behavior counsel obesity 15				$0.00	$0.00		
5821	G0473		Group behave couns 2-10				$0.00	$0.00		
5694	M0239		Bamlanivimab-xxxx infusion				$0.00	$0.00		
5822	G0451		Devlopment test interpt&rep							
5822	G2065		Clin mang h risk dx 30							
5822	G2214		Init/sub psych care m 1st 3							
5823		Level 3 Health and Behavior Services		S	1.6139	$133.63	.	$26.73		
5823	90791		Psych diagnostic evaluation							
5823	90792		Psych diag eval w/med srvcs							
5823	90832		Psytx w pt 30 minutes							
5823	90834		Psytx w pt 45 minutes							
5823	90837		Psytx w pt 60 minutes							
5823	90839		Psytx crisis initial 60 min							
5823	90845		Psychoanalysis							
5823	90846		Family psytx w/o pt 50 min							
5823	90847		Family psytx w/pt 50 min							
5823	90849		Multiple family group psytx							
5823	90865		Narcosynthesis							
5823	99487		Cmplx chron care w/o pt vsit							
5823	G0397		Alcohol/subs interv >30 min							
5823	G2086		Off base opioid tx 70min							
5823	G2087		"Off base opioid tx, 60 m"							
5871		Dental Procedures		S	16.8307	"$1,393.53"	.	$278.71		
5871	D0150		Comprehensve oral evaluatio							
5871	D0240		Intraoral occlusal film							
5871	D0250		Extraoral 2d project image							
5871	D0270		Dental bitewing single imag							
5871	D0272		Dental bitewings two images							
5871	D0274		Bitewings four images							
5871	D0277		Vert bitewings 7 to 8 image							
5871	D0460		Pulp vitality test							
5871	D0600		Non-ionizing diag proc							
5871	D1510		Space maintainer fxd unilat							
5871	D1516		"Fixed bilat space maint, ma"							
5871	D1517		"Fixed bilat space maint, ma"							
5871	D1520		Remove unilat space maintai							
5871	D1526		"Remove bilat space main, ma"							
5871	D1527		"Remove bilat space main, ma"							
5871	D1551		Recement space maint - max							
5871	D1552		Recement space maint - man							
5871	D1553		Recement unilat space maint							
5871	D1575		"Dist space maint, fixed uni"							
5871	D2999		Dental unspec restorative p							
5871	D3460		Endodontic endosseous impla							
5871	D3999		Endodontic procedure							
5871	D4260		Osseous surgery 4 or more							
5871	D4263		Bone replce graft first sit							
5871	D4264		Bone replce graft each add							
5871	D4268		Surgical revision procedure							
5871	D4270		Pedicle soft tissue graft p							
5871	D4273		Auto tissue graft 1st tooth							
5871	D4355		Full mouth debridement							
5871	D4381		Localized delivery antimicr							
5871	D5911		Facial moulage sectional							
5871	D5912		Facial moulage complete							
5871	D5983		Radiation applicator							
5871	D5984		Radiation shield							
5871	D5985		Radiation cone locator							
5871	D5987		Commissure splint							
5871	D6920		Dental connector bar							
5871	D7111		Extraction coronal remnants							
5871	D7140		Extraction erupted tooth/ex							
5871	D7210		Rem imp tooth w mucoper flp							
5871	D7220		Impact tooth remov soft tis							
5871	D7230		Impact tooth remov part bon							
5871	D7240		Impact tooth remov comp bon							
5871	D7241		Impact tooth rem bony w/com							
5871	D7250		Tooth root removal							
5871	D7260		Oral antral fistula closure							
5871	D7261		Primary closure sinus perf							
5871	D7291		Transseptal fiberotomy							
5871	D7940		Reshaping bone orthognathic							
5871	D9930		Treatment of complications							
5871	D9944		"Occ guard, hard, full arch"							
5871	D9945		"Occ guard, soft, full arch"							
5871	D9946		"Occ guard, hard, part arch"							
5871	D9950		Occlusion analysis							
5871	D9951		Limited occlusal adjustment							
5871	D9952		Complete occlusal adjustmen							
7000		Amifostine		K		"$1,135.691"	.	$227.14		
7000	J0207		Amifostine							
7035		Teniposide		K		"$2,645.707"	.	$529.15		
7035	Q2017		"Teniposide, 50 mg"							
7041		Tirofiban HCl		K		$2.191	.	$0.44		
7041	J3246		Tirofiban hcl							
7043		Infliximab not biosimil 10mg		K		$47.620	.	$9.53		
7043	J1745		Infliximab not biosimil 10m							
7046		Doxorubicin inj 10mg		K		$315.731	.	$63.15		
7046	Q2050		Doxorubicin inj 10mg							
7048		Alteplase recombinant		K		$87.154	.	$17.44		
7048	J2997		Alteplase recombinant							
7308		Aminolevulinic acid hcl top		K		$394.752	.	$78.96		
7308	J7308		Aminolevulinic acid hcl top							
9002		Tenecteplase injection		K		$129.255	.	$25.86		
9002	J3101		Tenecteplase injection							
9003		Palivizumab		K		"$1,838.680"	.	$367.74		
9003	90378		Rsv mab im 50mg							
9005		Reteplase injection		K		"$2,386.298"	.	$477.26		
9005	J2993		Reteplase injection							
9006		Tacrolimus injection		K		$211.974	.	$42.40		
9006	J7525		Tacrolimus injection							
9012		Arsenic trioxide injection		K		$22.063	.	$4.42		
9012	J9017		Arsenic trioxide injection							
9015		"Inj., haegarda 10 units"		K		$9.918	.	$1.99		
9015	J0599		"Inj., haegarda 10 units"							
9016		"Inj., triptorelin xr 3.75 mg"		K		"$3,044.011"	.	$608.81		
9016	J3316		"Inj., triptorelin xr 3.75 m"							
9018		"Inj, rimabotulinumtoxinB"		K		$11.929	.	$2.39		
9018	J0587		"Inj, rimabotulinumtoxinb"							
9024		Amphotericin b lipid complex		K		$9.358	.	$1.88		
9024	J0287		Amphotericin b lipid comple							
9028		Inj inotuzumab ozogam 0.1 mg		K		"$2,341.499"	.	$468.30		
9028	J9229		Inj inotuzumab ozogam 0.1 m							
9029		"Inj., guselkumab, 1 mg"		K		$93.123	.	$18.63		
9029	J1628		"Inj., guselkumab, 1 mg"							
9030		"Inj., copanlisib, 1 mg"		G		$78.989	.	$15.80		
9030	J9057		"Inj., copanlisib, 1 mg"							*
9032		Baclofen 10 MG injection		K		$171.593	.	$34.32		
9032	J0475		Baclofen 10 mg injection							
9033		Cidofovir injection		K		$666.250	.	$133.25		
9033	J0740		Cidofovir injection							
9034		"Inj cuvitru, 100 mg"		K		$14.022	.	$2.81		
9034	J1555		"Inj cuvitru, 100 mg"							
9035		Axicabtagene ciloleucel car+		G		"$395,380.000"	.	"$79,076.00"	*	
9035	Q2041		Axicabtagene ciloleucel car+							*
9036		"Injection, renflexis"		G		$44.547	.	$8.91		
9036	Q5104		"Injection, renflexis"							*
9038		Inj estrogen conjugate		K		$325.621	.	$65.13		
9038	J1410		Inj estrogen conjugate 25 m							
9042		Glucagon hydrochloride		K		$211.789	.	$42.36		
9042	J1610		Glucagon hydrochloride/1 mg							
9043		"Inj, afstyla, 1 i.u."		K		$1.338	.	$0.27		
9043	J7210		"Inj, afstyla, 1 i.u."							
9044		Ibutilide fumarate injection		K		$316.198	.	$63.24		
9044	J1742		Ibutilide fumarate injectio							
9058		Buprenorphine implant 74.2mg		K		"$1,207.160"	.	$241.44		
9058	J0570		Buprenorphine implant 74.2m							
9059		Vonvendi inj 1 iu vwf:rco		K		$1.783	.	$0.36		
9059	J7179		Vonvendi inj 1 iu vwf:rco							
9063		Rh ig minidose im		K		$151.410	.	$30.29		
9063	90385		Rh ig minidose im							
9065		Argatroban esrd dialysis 1mg		K		$1.307	.	$0.27		
9065	J0884		Argatroban esrd dialysis 1m							
9067		Lutetium lu 177 dotatat ther		G		$266.590	.	$53.32		
9067	A9513		Lutetium lu 177 dotatat the							*
9069		Phenobarbital sodium inj		K		$47.334	.	$9.47		
9069	J2560		Phenobarbital sodium inj							
9070		Inj luxturna 1 billion vec g		G		"$2,883.200"	.	$576.64		
9070	J3398		Inj luxturna 1 billion vec							*
9071		Capsaicin 8% patch		K		$3.250	.	$0.65		
9071	J7336		Capsaicin 8% patch							
9073		Buprenorph xr 100 mg or less		G		"$1,743.482"	.	$348.70		
9073	Q9991		Buprenorph xr 100 mg or les							*
9074		"Makena, 10 mg"		K		$15.881	.	$3.18		
9074	J1726		"Makena, 10 mg"							
9075		"Inj, kovaltry, 1 i.u."		K		$1.219	.	$0.25		
9075	J7211		"Inj, kovaltry, 1 i.u."							
9077		Epoetin beta non esrd		K		$1.544	.	$0.31		
9077	J0888		Epoetin beta non esrd							
9078		Testosterone undecanoate 1mg		K		$1.543	.	$0.31		
9078	J3145		Testosterone undecanoate 1m							
9079		"Genvisc 850, inj, 1mg"		K		$16.918	.	$3.39		
9079	J7320		"Genvisc 850, inj, 1mg"							
9087		"Inj, clevidipine butyrate"		K		$2.870	.	$0.58		
9087	C9248		"Inj, clevidipine butyrate"							
9088		Peng benzathine/procaine inj		K		$11.998	.	$2.40		
9088	J0558		Peng benzathine/procaine in							
9093		Plicamycin (mithramycin) inj		K		$115.400	.	$23.08		
9093	J9270		Plicamycin (mithramycin) in							
9094		Radiesse injection		K		$222.090	.	$44.42		
9094	Q2026		Radiesse injection							
9095		"Inj, sculptra, 0.5mg"		K		$3.190	.	$0.64		
9095	Q2028		"Inj, sculptra, 0.5mg"							
9096		Inj retacrit esrd on dialysi		G		$0.861	.	$0.18		
9096	Q5105		Inj retacrit esrd on dialys							*
9097		Inj retacrit non-esrd use		G		$8.612	.	$1.73		
9097	Q5106		Inj retacrit non-esrd use							*
9099		"Inj fosnetupitant, palonoset"		G		$695.767	.	$139.16		
9099	J1454		"Inj fosnetupitant, palonose"							*
9104		Antithymocyte globuln rabbit		K		$817.122	.	$163.43		
9104	J7511		Antithymocyte globuln rabbi							
9108		Thyrotropin injection		K		"$1,740.225"	.	$348.05		
9108	J3240		Thyrotropin injection							
9119		"Injection, pegfilgrastim 6mg"		K		"$3,571.681"	.	$714.34		
9119	J2505		"Injection, pegfilgrastim 6m"							
9120		"Injection, Fulvestrant"		K		$52.737	.	$10.55		
9120	J9395		"Injection, fulvestrant"							
9122		Triptorelin pamoate		K		$385.610	.	$77.13		
9122	J3315		Triptorelin pamoate							
9125		"Inj risperdal consta, 0.5 mg"		K		$10.532	.	$2.11		
9125	J2794		"Inj risperdal consta, 0.5 mg"							
9126		Natalizumab injection		K		$21.630	.	$4.33		
9126	J2323		Natalizumab injection							
9130		"Inj, Imm Glob Bivigam, 500mg"		K		$70.490	.	$14.10		
9130	J1556		"Inj, imm glob bivigam, 500m"							
9131		"Inj, Ado-trastuzumab Emt 1mg"		K		$32.789	.	$6.56		
9131	J9354		"Inj, ado-trastuzumab emt 1m"							
9132		"Kcentra, per i.u."		K		$2.091	.	$0.42		
9132	C9132		"Kcentra, per i.u."							
9133		"Rabies ig, im/sc"		K		$273.035	.	$54.61		
9133	90375		Rabies ig im/sc							
9134		"Rabies ig, heat treated"		K		$331.803	.	$66.37		
9134	90376		Rabies ig heat treated							
9135		"Varicella-zoster ig, im"		K		"$1,703.971"	.	$340.80		
9135	90396		Varicella-zoster ig im							
9139		"Rabies vaccine, im"		K		$303.241	.	$60.65		
9139	90675		Rabies vaccine im							
9140		"Rabies vaccine, id"		K		$227.530	.	$45.51		
9140	90676		Rabies vaccine id							
9171		Factor ix idelvion inj		K		$4.438	.	$0.89		
9171	J7202		Factor ix idelvion inj							
9172		"Injection, dexamethasone 9%"		G		$1.106	.	$0.23		
9172	J1095		"Injection, dexamethasone 9%"							
9173		"Injection, fulphila"		G		$269.041	.	$53.81		
9173	Q5108		"Injection, fulphila"							
9174		"Inj, durolane 1 mg"		G		$17.225	.	$3.45		
9174	J7318		"Inj, durolane 1 mg"							*
9178		"Inj., meropenem, vaborbactam"		K		$1.780	.	$0.36		
9178	J2186		"Inj., meropenem, vaborbacta"							
9179		"Injection, Aristada Initio"		G		$2.858	.	$0.58		
9179	J1943		"Inj., aristada initio, 1 mg"							
9180		"Inj., patisiran, 0.1 mg"		G		$97.843	.	$19.57		
9180	J0222		"Inj., patisiran, 0.1 mg"							
9181		"Inj., perseris, 0.5 mg"		G		$10.181	.	$2.04		
9181	J2798		"Inj., perseris, 0.5 mg"							
9182		"Inj mogamulizumab-kpkc, 1 mg"		G		$203.883	.	$40.78		
9182	J9204		"Inj mogamulizumab-kpkc, 1 m"							
9183		"Inj., plazomicin, 5 mg"		G		$3.105	.	$0.63		
9183	J0291		"Inj., plazomicin, 5 mg"							
9186		"Inj., rituximab, 10 mg"		K		$92.556	.	$18.52		
9186	J9312		"Inj., rituximab, 10 mg"							
9187		"Injection, burosumab-twza 1m"		K		$361.895	.	$72.38		
9187	J0584		"Injection, burosumab-twza 1"							
9188		"Inj crotalidae im f(ab"")2 eq"		K		"$1,264.210"	.	$252.85		
9188	J0841		Inj crotalidae im f(ab')2 e							
9189		"Inj., ibalizumab-uiyk, 10 mg"		K		$63.624	.	$12.73		
9189	J1746		"Inj., ibalizumab-uiyk, 10 m"							
9192		"Inj, bortezomib, nos, 0.1 mg"		K		$22.036	.	$4.41		
9192	J9044		"Inj, bortezomib, nos, 0.1 m"							
9193		Nivestym		G		$0.621	.	$0.13		
9193	Q5110		Nivestym							
9194		Tisagenlecleucel car-pos t		G		"$429,813.310"	.	"$85,962.67"	*	
9194	Q2042		Tisagenlecleucel car-pos t							*
9195		"Injection, udenyca 0.5 mg"		G		$286.674	.	$57.34		
9195	Q5111		"Injection, udenyca 0.5 mg"							
9196		"Inj, trivisc 1 mg"		K		$7.195	.	$1.44		
9196	J7329		"Inj, trivisc 1 mg"							
9197		"Inj., fremanezumab-vfrm 1 mg"		G		$2.249	.	$0.45		
9197	J3031		"Inj., fremanezumab-vfrm 1 m"							
9198		"Inj andexxa, 10 mg"		G		$291.500	.	$58.30		
9198	J7169		"Inj andexxa, 10 mg"							
9199		"Injection, caplacizumab-yhdp"		G		$690.680	.	$138.14		
9199	C9047		"Injection, caplacizumab-yhd"							
9207		"Inj., velcade 0.1 mg"		K		$44.973	.	$9.00		
9207	J9041		"Inj., velcade 0.1 mg"							
9208		Agalsidase beta injection		K		$188.990	.	$37.80		
9208	J0180		Agalsidase beta injection							
9209		Laronidase injection		K		$33.102	.	$6.63		
9209	J1931		Laronidase injection							
9213		Pemetrexed injection		K		$71.811	.	$14.37		
9213	J9305		Pemetrexed injection							
9214		Bevacizumab injection		K		$76.361	.	$15.28		
9214	J9035		Bevacizumab injection							
9215		Cetuximab injection		K		$64.286	.	$12.86		
9215	J9055		Cetuximab injection							
9217		Leuprolide acetate suspnsion		K		$224.452	.	$44.90		
9217	J9217		Leuprolide acetate suspnsio							
9224		Galsulfase injection		K		$405.755	.	$81.16		
9224	J1458		Galsulfase injection							
9225		"Inj., retisert, 0.01 mg"		K		$340.622	.	$68.13		
9225	J7311		"Inj., retisert, 0.01 mg"							
9227		Micafungin sodium injection		K		$1.180	.	$0.24		
9227	J2248		Micafungin sodium injection							
9228		Tigecycline injection		K		$1.378	.	$0.28		
9228	J3243		Tigecycline injection							
9229		Ibandronate sodium injection		K		$50.999	.	$10.20		
9229	J1740		Ibandronate sodium injectio							
9230		Abatacept injection		K		$58.103	.	$11.63		
9230	J0129		Abatacept injection							
9231		Decitabine injection		K		$4.260	.	$0.86		
9231	J0894		Decitabine injection							
9233		Ranibizumab injection		K		$324.272	.	$64.86		
9233	J2778		Ranibizumab injection							
9234		Alglucosidase alfa injection		K		$73.810	.	$14.77		
9234	J0220		Alglucosidase alfa injectio							
9235		Panitumumab injection		K		$123.553	.	$24.72		
9235	J9303		Panitumumab injection							
9236		Eculizumab injection		K		$230.479	.	$46.10		
9236	J1300		Eculizumab injection							
9237		"Inj, lanreotide acetate"		K		$68.475	.	$13.70		
9237	J1930		Lanreotide injection							
9239		Buprenorphine xr over 100 mg		G		"$1,743.482"	.	$348.70		
9239	Q9992		Buprenorphine xr over 100 m							*
9240		"Injection, ixabepilone"		K		$101.189	.	$20.24		
9240	J9207		Ixabepilone injection							
9242		"Injection, fosaprepitant"		K		$0.785	.	$0.16		
9242	J1453		Fosaprepitant injection							
9243		"Inj., treanda 1 mg"		K		$24.693	.	$4.94		
9243	J9033		"Inj., treanda 1 mg"							
9245		Romiplostim injection		K		$78.428	.	$15.69		
9245	J2796		Romiplostim injection							
9251		C1 esterase inhibitor inj		K		$56.199	.	$11.24		
9251	J0598		"C-1 esterase, cinryze"							
9252		Plerixafor injection		K		$365.294	.	$73.06		
9252	J2562		Plerixafor injection							
9253		Temozolomide injection		K		$10.377	.	$2.08		
9253	J9328		Temozolomide injection							
9255		Paliperidone palmitate inj		K		$12.102	.	$2.43		
9255	J2426		Paliperidone palmitate inj							
9256		Dexamethasone intra implant		K		$199.756	.	$39.96		
9256	J7312		Dexamethasone intra implant							
9257		"Inj., emicizumab-kxwh 0.5 mg"		G		$47.467	.	$9.50		
9257	J7170		"Inj., emicizumab-kxwh 0.5 m"							*
9258		Telavancin injection		K		$5.138	.	$1.03		
9258	J3095		Telavancin injection							
9259		Pralatrexate injection		K		$311.224	.	$62.25		
9259	J9307		Pralatrexate injection							
9260		Ofatumumab injection		K		$61.942	.	$12.39		
9260	J9302		Ofatumumab injection							
9261		"Ustekinumab sub cu inj, 1 mg"		K		$184.359	.	$36.88		
9261	J3357		"Ustekinumab sub cu inj, 1 m"							
9263		Ecallantide injection		K		$494.686	.	$98.94		
9263	J1290		Ecallantide injection							
9264		Tocilizumab injection		K		$5.401	.	$1.09		
9264	J3262		Tocilizumab injection							
9265		Romidepsin injection		K		$336.542	.	$67.31		
9265	J9315		Romidepsin injection							
9269		"C-1 esterase, berinert"		K		$54.134	.	$10.83		
9269	J0597		"C-1 esterase, berinert"							
9270		Gammaplex IVIG		K		$53.662	.	$10.74		
9270	J1557		Gammaplex injection							
9271		Velaglucerase alfa		K		$346.147	.	$69.23		
9271	J3385		Velaglucerase alfa							
9272		"Inj, denosumab"		K		$20.123	.	$4.03		
9272	J0897		Denosumab injection							
9273		Sipuleucel-T auto CD54+		K		"$49,671.772"	.	"$9,934.36"	*	
9273	Q2043		Sipuleucel-t auto cd54+							
9274		Crotalidae Poly Immune Fab		K		"$3,043.750"	.	$608.75		
9274	J0840		Crotalidae poly immune fab							
9276		Cabazitaxel injection		K		$181.509	.	$36.31		
9276	J9043		Cabazitaxel injection							
9278		Incobotulinumtoxin A		K		$5.019	.	$1.01		
9278	J0588		Incobotulinumtoxin a							
9281		"Injection, pegloticase"		K		"$2,801.076"	.	$560.22		
9281	J2507		Pegloticase injection							
9284		Ipilimumab injection		K		$157.382	.	$31.48		
9284	J9228		Ipilimumab injection							
9286		Belatacept injection		K		$3.775	.	$0.76		
9286	J0485		Belatacept injection							
9287		Brentuximab vedotin inj		K		$175.282	.	$35.06		
9287	J9042		Brentuximab vedotin inj							
9289		Erwinaze injection		K		$427.269	.	$85.46		
9289	J9019		Erwinaze injection							
9294		"Inj, taliglucerase alfa 10 u"		K		$40.857	.	$8.18		
9294	J3060		"Inj, taliglucerase alfa 10"							
9295		"Injection, Carfilzomib, 1 mg"		K		$39.198	.	$7.84		
9295	J9047		"Injection, carfilzomib, 1 m"							
9296		"Inj, ziv-aflibercept, 1mg"		K		$8.073	.	$1.62		
9296	J9400		"Inj, ziv-aflibercept, 1mg"							
9297		"Inj, Omacetaxine Mep, 0.01mg"		K		$2.976	.	$0.60		
9297	J9262		"Inj, omacetaxine mep, 0.01m"							
9298		"Inj, Ocriplasmin, 0.125 mg"		K		"$1,046.927"	.	$209.39		
9298	J7316		"Inj, ocriplasmin, 0.125 mg"							
9299		Inj. jivi 1 iu		G		$2.020	.	$0.41		
9299	J7208		Inj. jivi 1 iu							
9300		Omalizumab injection		K		$37.699	.	$7.54		
9300	J2357		Omalizumab injection							
9301		"Aminolevulinic acid, 10% gel"		K		$1.525	.	$0.31		
9301	J7345		"Aminolevulinic acid, 10% ge"							
9302		"Inj daunorubicin, cytarabine"		K		$197.794	.	$39.56		
9302	J9153		"Inj daunorubicin, cytarabin"							
9304		"Inj., cemiplimab-rwlc, 1 mg"		G		$27.401	.	$5.49		
9304	J9119		"Inj., cemiplimab-rwlc, 1 mg"							
9305		"Inj., lumoxiti, 0.01 mg"		G		$22.460	.	$4.50		
9305	J9313		"Inj., lumoxiti, 0.01 mg"							
9306		"Inj., tildrakizumab, 1 mg"		G		$135.673	.	$27.14		
9306	J3245		"Inj., tildrakizumab, 1 mg"							
9307		Cocaine hcl nasal solution		G		$1.230	.	$0.25		
9307	C9046		Cocaine hcl nasal solution							
9308		Dexametha opth insert 0.1 mg		G		$139.547	.	$27.91		
9308	J1096		Dexametha opth insert 0.1 m							
9309		Inj. tagraxofusp-erzs 10 mcg		G		$270.585	.	$54.12		
9309	J9269		Inj. tagraxofusp-erzs 10 mc							
9310		"Inj., emapalumab-lzsg, 1 mg"		G		$441.593	.	$88.32		
9310	J9210		"Inj., emapalumab-lzsg, 1 mg"							
9311		"Inj., omadacycline, 1 mg"		G		$3.147	.	$0.63		
9311	J0121		"Inj., omadacycline, 1 mg"							
9312		"Inj., ravulizumab-cwvz 10 mg"		G		$226.275	.	$45.26		
9312	J1303		"Inj., ravulizumab-cwvz 10 m"							
9313		Inj. belrapzo/bendamustine		G		$21.612	.	$4.33		
9313	J9036		Inj. belrapzo/bendamustine							
9314		"Inj. herceptin hylecta, 10mg"		G		$75.084	.	$15.02		
9314	J9356		"Inj. herceptin hylecta, 10m"							
9318		Inj hydroxyprogst capoat nos		K		$10.810	.	$2.17		
9318	J1729		Inj hydroxyprogst capoat no							
9319		Somatropin injection		K		$84.130	.	$16.83		
9319	J2941		Somatropin injection							
9320		Carbidopa levodopa ent 100ml		K		$213.095	.	$42.62		
9320	J7340		Carbidopa levodopa ent 100m							
9323		Gallium ga-68 dotatoc		G		$8.640	$0.00	$0.00		
9323	C9067		Gallium ga-68 dotatoc				$0.00	$0.00		
9327		Inj. romosozumab-aqqg 1 mg		G		$9.014	.	$1.81		
9327	J3111		Inj. romosozumab-aqqg 1 mg							
9328		"Inj., yutiq, 0.01 mg"		K		$491.133	.	$98.23		
9328	J7314		"Inj., yutiq, 0.01 mg"							
9329		Inj mvasi 10 mg		G		$60.939	.	$12.19		
9329	Q5107		Inj mvasi 10 mg							
9330		"Inj., kanjinti, 10 mg"		G		$78.723	.	$15.75		
9330	Q5117		"Inj., kanjinti, 10 mg"							
9331		"Inj, polatuzumab vedotin 1mg"		G		$110.717	.	$22.15		
9331	J9309		"Inj, polatuzumab vedotin 1m"							
9332		Inj lefamulin 1 mg		G		$0.724	.	$0.15		
9332	J0691		Inj lefamulin 1 mg							
9333		"Inj., brexanolone, 1 mg"		G		$76.909	.	$15.39		
9333	J1632		"Inj., brexanolone, 1 mg"							
9334		"Injection, khapzory, 0.5 mg"		G		$1.999	.	$0.40		
9334	J0642		"Injection, khapzory, 0.5 mg"							
9336		Inj truxima 10 mg		G		$68.799	.	$13.76		
9336	Q5115		Inj truxima 10 mg							
9337		"Synojoynt, inj., 1 mg"		G		$4.394	.	$0.88		
9337	J7331		"Synojoynt, inj., 1 mg"							
9339		Iodine i-131 iobenguane 1mci		G		$320.120	.	$64.03		
9339	A9590		Iodine i-131 iobenguane 1mc							
9340		"Inj, brolucizumab-dbll, 1 mg"		G		$311.994	.	$62.40		
9340	J0179		"Inj, brolucizumab-dbll, 1 m"							
9341		Inj ogivri 10 mg		G		$76.407	.	$15.29		
9341	Q5114		Inj ogivri 10 mg							
9343		Inj givosiran 0.5 mg		G		$106.875	.	$21.38		
9343	J0223		Inj givosiran 0.5 mg							
9345		Inj pegfilgrastim-bmez 0.5mg		G		$305.552	.	$61.12		
9345	Q5120		Inj pegfilgrastim-bmez 0.5m							
9346		Mometasone furoate (sinuva)		G		$10.252	.	$2.06		
9346	C9122		Mometasone furoate (sinuva)							
9347		Inj luspatercept-aamt 0.25mg		G		$36.320	.	$7.27		
9347	J0896		Inj luspatercept-aamt 0.25m							
9348		"Inj., zirabev, 10 mg"		G		$62.235	.	$12.45		
9348	Q5118		"Inj., zirabev, 10 mg"							
9349		Inj herzuma 10 mg		G		$91.523	.	$18.31		
9349	Q5113		Inj herzuma 10 mg							
9350		"Inj., trazimera, 10 mg"		G		$83.104	.	$16.63		
9350	Q5116		"Inj., trazimera, 10 mg"							
9351		Inj bimatoprost itc imp1mcg		G		$200.850	.	$40.17		
9351	J7351		Inj bimatoprost itc imp1mcg							
9352		Chloroquine injection		K		$165.220	.	$33.05		
9352	J0390		Chloroquine injection							
9353		Inj fam-trastu deru-nxki 1mg		G		$24.142	.	$4.83		
9353	J9358		Inj fam-trastu deru-nxki 1m							
9354		Inj recombin esperoct per iu		G		$2.286	.	$0.46		
9354	J7204		Inj recombin esperoct per i							
9355		Inj. teprotumumab-trbw 10 mg		G		$315.880	.	$63.18		
9355	J3241		Inj. teprotumumab-trbw 10 m							
9356		Inj golodirsen 10 mg		G		$166.326	.	$33.27		
9356	J1429		Inj golodirsen 10 mg							
9357		Inj. eptinezumab-jjmr 1 mg		G		$15.399	.	$3.08		
9357	J3032		Inj. eptinezumab-jjmr 1 mg							
9359		Inj crizanlizumab-tmca 5mg		G		$122.413	.	$24.49		
9359	J0791		Inj crizanlizumab-tmca 5mg							
9361		Inj. cetirizine hcl 0.5mg		G		$15.448	.	$3.09		
9361	J1201		Inj. cetirizine hcl 0.5mg							
9362		Inj imip 4 cilas 4 releb 2mg		G		$2.255	.	$0.46		
9362	J0742		Inj imip 4 cilas 4 releb 2m							
9364		Inj enfort vedo-ejfv 0.25mg		G		$27.958	.	$5.60		
9364	J9177		Inj enfort vedo-ejfv 0.25mg							
9367		"Inj ruxience, 10 mg"		G		$70.900	.	$14.18		
9367	Q5119		"Inj ruxience, 10 mg"							
5731	Q0091		Obtaining screen pap smear				$0.00	$0.00		
9370		Fluoroestradiol f 18		G		$0.752	$0.00	$0.00		
9371		Inj. meloxicam 1 mg		G		$3.255	$0.00	$0.00		
9371	J1738		Inj. meloxicam 1 mg				$0.00	$0.00		
9372		"Inj. xembify, 100 mg"		K		$14.223	.	$2.85		
9372	J1558		"Inj. xembify, 100 mg"							
9373		Inj onase abepar-xioi treat		K		"$2,213,634.280"	.	"$442,726.86"	*	
9373	J3399		Inj onase abepar-xioi treat							
9374		Mitomycin instillation		G		$275.216	.	$55.05		
9374	J9281		Mitomycin instillation							
9375		"Inj., evomela, 1 mg"		K		$26.959	.	$5.40		
9375	J9246		"Inj., evomela, 1 mg"							
9376		Sacituzumab govitecan-hziy		G		$28.790	.	$5.76		
9376	J9317		Sacituzumab govitecan-hziy							
9377		Inj. isatuximab-irfc 10 mg		G		$66.670	.	$13.34		
9377	J9227		Inj. isatuximab-irfc 10 mg							
9378		"Daratumumab, hyaluronidase"		G		$43.340	.	$8.67		
9378	J9144		"Daratumumab, hyaluronidase"							
9379		Romidepsin non-lyophilized		G		$329.456	.	$65.90		
9379	C9065		Romidepsin non-lyophilized							
9380		"Inj., cefiderocol, 5 mg"		G		$0.972	.	$0.20		
9380	J0693		"Inj., cefiderocol, 5 mg"							
9381		"Inj. avsola, 10 mg"		G		$51.500	.	$10.30		
9381	Q5121		"Inj. avsola, 10 mg"							
9382		Inj ontruzant 10 mg		G		$92.296	.	$18.46		
9382	Q5112		Inj ontruzant 10 mg							
9383		"Copper cu-64, dotatate, dx"		G		$901.250	$0.00	$0.00		
9383	C9068		"Copper cu-64, dotatate, dx"				$0.00	$0.00		
9384		Belantamab mafodontin-blmf		G		$42.627	.	$8.53		
9384	C9069		Belantamab mafodontin-blmf							
9385		"Injection, tafasitamab-cxix"		G		$6.180	.	$1.24		
9385	C9070		"Injection, tafasitamab-cxix"							
9386		"Injection, viltolarsen"		G		$58.092	.	$11.62		
9386	C9071		"Injection, viltolarsen"							
9387		"Inj. infugem, 100 mg"		G		$39.140	.	$7.83		
9387	J9198		"Inj. infugem, 100 mg"							
9388		Inj. fe derisomaltose 10 mg		G		$25.382	.	$5.08		
9388	J1437		Inj. fe derisomaltose 10 mg							
9389		"Inj. lurbinectedin, 0.1 mg"		G		$170.800	.	$34.16		
9389	J9223		"Inj. lurbinectedin, 0.1 mg"							
9390		"Pertuzu, trastuzu, 10 mg"		G		$72.709	.	$14.55		
9390	J9316		"Pertuzu, trastuzu, 10 mg"							
9391		Brexucabtagene autoleucel ca		G		"$384,190.000"	.	"$76,838.00"	*	
9391	C9073		Brexucabtagene autoleucel c							
9392		"Inj, imm glob asceniv"		G		$481.770	.	$96.36		
9392	C9072		"Inj, imm glob asceniv"							
9393		Inj codeine phosphate /30 mg		K		$135.640	.	$27.13		
9393	J0745		Inj codeine phosphate /30 m							
9394		"Inj. inebilizumab-cdon, 1 mg"		K		$449.767	.	$89.96		
9394	J1823		"Inj. inebilizumab-cdon, 1 m"							
9395		Factor viia recomb sevenfact		K		$2.585	.	$0.52		
9395	J7212		Factor viia recomb sevenfac							
9396		"Afamelanotide implant, 1 mg"		K		"$3,218.897"	.	$643.78		
9396	J7352		"Afamelanotide implant, 1 mg"							
9399		"MFN drug add-on, per dose"		K		$148.730	$0.00	$0.00		
9399	M1145		"MFN drug add-on, per dose"				$0.00	$0.00		
9441		Inj ferric carboxymaltos 1mg		K		$1.106	.	$0.23		
9441	J1439		Inj ferric carboxymaltos 1m							
9445		"Injection, ruconest"		K		$29.108	.	$5.83		
9445	J0596		"Injection, ruconest"							
9448		"Oral netupitant, palonosetro"		K		$270.102	.	$54.03		
9448	J8655		"Oral netupitant, palonosetr"							
9449		"Injection, blinatumomab"		K		$118.586	.	$23.72		
9449	J9039		"Injection, blinatumomab"							
9450		"Inj., iluvien, 0.01 mg"		K		$490.873	.	$98.18		
9450	J7313		"Inj., iluvien, 0.01 mg"							
9451		"Injection, peramivir"		K		$1.596	.	$0.32		
9451	J2547		"Injection, peramivir"							
9452		Inj ceftolozane tazobactam		K		$6.490	.	$1.30		
9452	J0695		Inj ceftolozane tazobactam							
9453		"Injection, nivolumab"		K		$28.559	.	$5.72		
9453	J9299		"Injection, nivolumab"							
9454		"Inj, pasireotide long acting"		K		$332.591	.	$66.52		
9454	J2502		"Inj, pasireotide long actin"							
9455		"Injection, siltuximab"		K		$111.935	.	$22.39		
9455	J2860		"Injection, siltuximab"							
9456		"Injection, isavuconazonium"		K		$0.783	.	$0.16		
9456	J1833		"Injection, isavuconazonium"							
9460		"Injection, cangrelor"		K		$15.320	.	$3.07		
9460	C9460		"Injection, cangrelor"							
9462		"Injection, delafloxacin"		G		$0.278	.	$0.06		
9462	C9462		"Injection, delafloxacin"							*
9463		"Inj., aprepitant, 1 mg"		G		$1.732	.	$0.35		
9463	J0185		"Inj., aprepitant, 1 mg"							*
9466		"Inj., benralizumab, 1 mg"		G		$170.112	.	$34.03		
9466	J0517		"Inj., benralizumab, 1 mg"							*
9467		"Inj rituximab, hyaluronidase"		G		$41.140	.	$8.23		
9467	J9311		"Inj rituximab, hyaluronidas"							*
9468		Factor ix recomb gly rebinyn		G		$4.009	.	$0.81		
9468	J7203		Factor ix recomb gly rebiny							*
9469		Inj triamcinolone ace xr 1mg		G		$18.204	.	$3.65		
9469	J3304		Inj triamcinolone ace xr 1m							*
9470		Aripirazole lauroxil 1 mg		K		$2.847	.	$0.57		
9470	J1944		Aripirazole lauroxil 1 mg							
9471		Hymovis injection 1 mg		K		$31.668	.	$6.34		
9471	J7322		Hymovis injection 1 mg							
9472		Inj talimogene laherparepvec		K		$53.923	.	$10.79		
9472	J9325		Inj talimogene laherparepve							
9473		"Injection, mepolizumab, 1mg"		K		$28.704	.	$5.75		
9473	J2182		"Injection, mepolizumab, 1mg"							
9474		Inj irinotecan liposome 1 mg		K		$54.331	.	$10.87		
9474	J9205		Inj irinotecan liposome 1 m							
9475		"Injection, necitumumab, 1 mg"		K		$5.731	.	$1.15		
9475	J9295		"Injection, necitumumab, 1 m"							
9476		"Injection, daratumumab 10 mg"		K		$56.286	.	$11.26		
9476	J9145		"Injection, daratumumab 10 m"							
9477		"Injection, elotuzumab, 1mg"		K		$6.671	.	$1.34		
9477	J9176		"Injection, elotuzumab, 1mg"							
9478		Inj sebelipase alfa 1 mg		K		$541.130	.	$108.23		
9478	J2840		Inj sebelipase alfa 1 mg							
9479		"Instill, ciprofloxacin otic"		K		$29.968	.	$6.00		
9479	J7342		Ciprofloxacin otic susp 6 m							
9480		Injection trabectedin 0.1mg		K		$318.927	.	$63.79		
9480	J9352		Injection trabectedin 0.1mg							
9481		"Injection, reslizumab"		K		$9.758	.	$1.96		
9481	J2786		"Injection, reslizumab, 1mg"							
9482		Sotalol hydrochloride IV		K		$15.999	.	$3.20		
9482	C9482		Sotalol hydrochloride iv							
9483		"Inj, atezolizumab,10 mg"		K		$78.279	.	$15.66		
9483	J9022		"Inj, atezolizumab,10 mg"							
9485		"Inj, olaratumab, 10 mg"		K		$52.067	.	$10.42		
9485	J9285		"Inj, olaratumab, 10 mg"							
9487		"Ustekinumab, iv inject,1 mg"		K		$12.033	.	$2.41		
9487	J3358		"Ustekinumab, iv inject, 1 m"							
9488		Conivaptan hcl		K		$32.571	.	$6.52		
9488	C9488		Conivaptan hcl							
9489		"Inj, nusinersen, 0.1mg"		K		"$1,122.512"	.	$224.51		
9489	J2326		"Inj, nusinersen, 0.1mg"							
9490		"Inj, bezlotoxumab, 10 mg"		K		$39.645	.	$7.93		
9490	J0565		"Inj, bezlotoxumab, 10 mg"							
9491		"Injection, avelumab, 10 mg"		K		$84.700	.	$16.94		
9491	J9023		"Injection, avelumab, 10 mg"							
9492		"Inj., durvalumab, 10 mg"		K		$76.023	.	$15.21		
9492	J9173		"Inj., durvalumab, 10 mg"							
9493		"Injection, edaravone, 1 mg"		K		$19.892	.	$3.98		
9493	J1301		"Injection, edaravone, 1 mg"							
9494		"Injection, ocrelizumab"		K		$57.383	.	$11.48		
9494	J2350		"Injection, ocrelizumab, 1 m"							
9495		Gemtuzumab ozogamicin inj		K		$205.380	.	$41.08		
9495	J9203		Gemtuzumab ozogamicin 0.1 m							
9500		"Platelets, irradiated"		R	1.7113	$141.69	.	$28.34		
9500	P9032		"Platelets, irradiated"							
9501		Platelet pheres leukoreduced		R	5.8794	$486.80	.	$97.36		
9501	P9035		Platelet pheres leukoreduce							
9502		Platelet pheresis irradiated		R	7.3057	$604.89	.	$120.98		
9502	P9036		Platelet pheresis irradiate							
9503		Fr frz plasma donor retested		R	0.786	$65.08	.	$13.02		
9503	P9060		Fr frz plasma donor reteste							
9504		RBC deglycerolized		R	5.2738	$436.66	.	$87.34		
9504	P9039		Rbc deglycerolized							
9505		RBC irradiated		R	2.0449	$169.31	.	$33.87		
9505	P9038		Rbc irradiated							
9507		"Platelets, pheresis"		R	3.9131	$323.99	.	$64.80		
9507	P9034		"Platelets, pheresis"							
9508		Plasma 1 donor frz w/in 8 hr		R	0.9984	$82.67	.	$16.54		
9508	P9017		Plasma 1 donor frz w/in 8 h							
9509		"Frozen plasma, pooled, sd"		R	1.0767	$89.15	.	$17.83		
9509	P9023		"Frozen plasma, pooled, sd"							
9510		Whole blood for transfusion		R	1.8134	$150.14	.	$30.03		
9510	P9010		Whole blood for transfusion							
9511		Cryoprecipitate each unit		R	0.9644	$79.85	.	$15.97		
9511	P9012		Cryoprecipitate each unit							
9512		RBC leukocytes reduced		R	2.2768	$188.51	.	$37.71		
9512	P9016		Rbc leukocytes reduced							
9513		"Plasma, frz between 8-24hour"		R	0.8593	$71.15	.	$14.23		
9513	P9059		"Plasma, frz between 8-24hou"							
9514		"Plasma protein fract,5%,50ml"		R	0.0965	$7.99	.	$1.60		
9514	P9043		"Plasma protein fract,5%,50m"							
9515		"Platelets, each unit"		R	0.861	$71.29	.	$14.26		
9515	P9019		"Platelets, each unit"							
9516		Plaelet rich plasma unit		R	2.4156	$200.00	.	$40.01		
9516	P9020		Plaelet rich plasma unit							
9517		Red blood cells unit		R	1.6623	$137.63	.	$27.53		
9517	P9021		Red blood cells unit							
9518		Washed red blood cells unit		R	4.5878	$379.86	.	$75.98		
9518	P9022		Washed red blood cells unit							
9519		"Plasmaprotein fract,5%,250ml"		R	1.9366	$160.35	.	$32.07		
9519	P9048		"Plasmaprotein fract,5%,250m"							
9520		Blood split unit		R	1.7824	$147.58	.	$29.52		
9520	P9011		Blood split unit							
9521		Platelets leukoreduced irrad		R	2.5748	$213.19	.	$42.64		
9521	P9033		Platelets leukoreduced irra							
9522		RBC leukoreduced irradiated		R	3.1468	$260.55	.	$52.11		
9522	P9040		Rbc leukoreduced irradiated							
9523		Cryoprecipitatereducedplasma		R	0.7935	$65.70	.	$13.14		
9523	P9044		Cryoprecipitatereducedplasm							
9524		"Blood, l/r, cmv-neg"		R	2.5632	$212.23	.	$42.45		
9524	P9051		"Blood, l/r, cmv-neg"							
9525		"Platelets, hla-m, l/r, unit"		R	9.7248	$805.18	.	$161.04		
9525	P9052		"Platelets, hla-m, l/r, unit"							
9526		Platelets leukocytes reduced		R	1.8107	$149.92	.	$29.99		
9526	P9031		Platelets leukocytes reduce							
9527		"Blood, l/r, froz/degly/wash"		R	3.7525	$310.70	.	$62.14		
9527	P9054		"Blood, l/r, froz/degly/wash"							
9528		"Plt, aph/pher, l/r, cmv-neg"		R	5.7978	$480.04	.	$96.01		
9528	P9055		"Plt, aph/pher, l/r, cmv-neg"							
9529		"Blood, l/r, irradiated"		R	1.8619	$154.16	.	$30.84		
9529	P9056		"Blood, l/r, irradiated"							
9530		Plate pheres leukoredu irrad		R	7.456	$617.33	.	$123.47		
9530	P9037		Plate pheres leukoredu irra							
9531		"Plt, pher, l/r cmv-neg, irr"		R	5.4025	$447.31	.	$89.47		
9531	P9053		"Plt, pher, l/r cmv-neg, irr"							
9532		"RBC, frz/deg/wsh, l/r, irrad"		R	3.1473	$260.59	.	$52.12		
9532	P9057		"Rbc, frz/deg/wsh, l/r, irra"							
9533		"RBC, l/r, cmv-neg, irrad"		R	2.9454	$243.87	.	$48.78		
9533	P9058		"Rbc, l/r, cmv-neg, irrad"							
9534		Pathogen reduced plasma pool		R	0.6413	$53.10	.	$10.62		
9534	P9070		Pathogen reduced plasma poo							
9535		Pathogen reduced plasma sing		R	1.4834	$122.82	.	$24.57		
9535	P9071		Pathogen reduced plasma sin							
9536		Platelets pheresis path redu		R	7.0518	$583.87	.	$116.78		
9536	P9073		Platelets pheresis path red							
9537		Blood component/product noc		R	0.0965	$7.99		$1.60		
9537	P9099		Blood component/product noc							
