	Addendum B.-Final OPPS Payment by HCPCS Code for CY 2020									
	CPT codes and descriptions only are copyright 2019 American Medical Association.  All Rights Reserved.  Applicable FARS/DFARS Apply. Dental codes (D codes) are copyright 2018 American Dental Association.  All Rights Reserved.									
HCPCS Code	Short Descriptor	SI	APC 	Relative Weight	Payment Rate 	National Unadjusted Copayment 	Minimum Unadjusted Copayment 	"Note: Actual copayments would be lower due to the cap on copayments at the Inpatient Deductible of $1,408.00"	* Indicates a Change 	
0001F	Heart failure composite	E1								
0001U	Rbc dna hea 35 ag 11 bld grp	A								
0002M	Liver dis 10 assays w/ash	Q4								
0002U	Onc clrct 3 ur metab alg plp	Q4								
0003M	Liver dis 10 assays w/nash	Q4								
0003U	Onc ovar 5 prtn ser alg scor	Q4								
0004M	Scoliosis dna alys	A								
0005F	Osteoarthritis composite	E1								
0005U	Onco prst8 3 gene ur alg	Q4								
0006M	Onc hep gene risk classifier	A								
0007M	Onc gastro 51 gene nomogram	A								
0007U	Rx test prsmv ur w/def conf	Q4								
0008U	Hpylori detcj abx rstnc dna	A								
0009U	Onc brst ca erbb2 amp/nonamp	Q4								
00100	Anesth salivary gland	N								
00102	Anesth repair of cleft lip	N								
00103	Anesth blepharoplasty	N								
00104	Anesth electroshock	N								
0010U	Nfct ds strn typ whl gen seq	A								
0011M	Onc prst8 ca mrna 12 gen alg	A								
0011U	Rx mntr lc-ms/ms oral fluid	Q4								
00120	Anesth ear surgery	N								
00124	Anesth ear exam	N								
00126	Anesth tympanotomy	N								
0012F	Cap bacterial assess	E1								
0012M	Onc mrna 5 gen rsk urthl ca	A								
0012U	Germln do gene reargmt detcj	A								
0013M	Onc mrna 5 gen recr urthl ca	A								
0013U	Onc sld org neo gene reargmt	A								
00140	Anesth procedures on eye	N								
00142	Anesth lens surgery	N								
00144	Anesth corneal transplant	N								
00145	Anesth vitreoretinal surg	N								
00147	Anesth iridectomy	N								
00148	Anesth eye exam	N								
0014F	Comp preop assess cat surg	E1								
0014M	Liver ds alys 3 bmrk srm alg	Q4								
0014U	Hem hmtlmf neo gene reargmt	A								
0015F	Melan follow-up complete	E1								
0015M	Adrnl cortcl tum bchm asy 25	Q4							*	
00160	Anesth nose/sinus surgery	N								
00162	Anesth nose/sinus surgery	N								
00164	Anesth biopsy of nose	N								
0016M	Onc bladder mrna 209 gen alg	Q4							*	
0016U	Onc hmtlmf neo rna bcr/abl1	A								
00170	Anesth procedure on mouth	N								
00172	Anesth cleft palate repair	N								
00174	Anesth pharyngeal surgery	N								
00176	Anesth pharyngeal surgery	C								
0017U	Onc hmtlmf neo jak2 mut dna	A								
0018U	Onc thyr 10 microrna seq alg	A								
00190	Anesth face/skull bone surg	N								
00192	Anesth facial bone surgery	C								
0019U	Onc rna tiss predict alg	A								
00210	Anesth cranial surg nos	N								
00211	Anesth cran surg hemotoma	C								
00212	Anesth skull drainage	N								
00214	Anesth skull drainage	C								
00215	Anesth skull repair/fract	C								
00216	Anesth head vessel surgery	N								
00218	Anesth special head surgery	N								
0021U	Onc prst8 detcj 8 autoantb	Q4								
00220	Anesth intrcrn nerve	N								
00222	Anesth head nerve surgery	N								
0022U	Trgt gen seq dna&rna 23 gene	A								
0023U	Onc aml dna detcj/nondetcj	A								
0024U	Glyca nuc mr spectrsc quan	Q4								
0025U	Tenofovir liq chrom ur quan	Q4								
0026U	Onc thyr dna&mrna 112 genes	A								
0027U	Jak2 gene trgt seq alys	A								
0029U	Rx metab advrs trgt seq alys	A								
00300	Anesth head/neck/ptrunk	N								
0030U	Rx metab warf trgt seq alys	A								
0031U	Cyp1a2 gene	A								
00320	Anesth neck organ 1yr/>	N								
00322	Anesth biopsy of thyroid	N								
00326	Anesth larynx/trach < 1 yr	N								
0032U	Comt gene	A								
0033U	Htr2a htr2c genes	A								
0034U	Tpmt nudt15 genes	A								
00350	Anesth neck vessel surgery	N								
00352	Anesth neck vessel surgery	N								
0035U	Neuro csf prion prtn qual	Q4								
0036U	Xome tum & nml spec seq alys	A								
0037U	Trgt gen seq dna 324 genes	A								
0038U	Vitamin d srm microsamp quan	Q4								
0039U	Dna antb 2strand hi avidity	Q4								
00400	Anesth skin ext/per/atrunk	N								
00402	Anesth surgery of breast	N								
00404	Anesth surgery of breast	N								
00406	Anesth surgery of breast	N								
0040U	Bcr/abl1 gene major bp quan	A								
00410	Anesth correct heart rhythm	N								
0041U	B brgdrferi antb 5 prtn igm	Q4								
0042T	Ct perfusion w/contrast cbf	N								
0042U	B brgdrferi antb 12 prtn igg	Q4								
0043U	Tbrf b grp antb 4 prtn igm	Q4								
0044U	Tbrf b grp antb 4 prtn igg	Q4								
00450	Anesth surgery of shoulder	N								
00454	Anesth collar bone biopsy	N								
0045U	Onc brst dux carc is 12 gene	A								
0046U	Flt3 gene itd variants quan	A								
00470	Anesth removal of rib	N								
00472	Anesth chest wall repair	N								
00474	Anesth surgery of rib	C								
0047U	Onc prst8 mrna 17 gene alg	A								
0048U	Onc sld org neo dna 468 gene	A								
0049U	Npm1 gene analysis quan	A								
00500	Anesth esophageal surgery	N								
0050U	Trgt gen seq dna 194 genes	A								
0051U	Rx mntr lc-ms/ms ur 31 pnl	Q4								
00520	Anesth chest procedure	N								
00522	Anesth chest lining biopsy	N								
00524	Anesth chest drainage	C								
00528	Anes mediascpy & dx thorscpy	N								
00529	Anes medscpy&thorscpy 1 lung	N								
0052U	Lpoprtn bld w/5 maj classes	Q4								
00530	Anesth pacemaker insertion	N								
00532	Anesth vascular access	N								
00534	Anesth cardioverter/defib	N								
00537	Anesth cardiac electrophys	N								
00539	Anesth trach-bronch reconst	N								
0053U	Onc prst8 ca fish alys 4 gen	A								
00540	Anesth chest surgery	C								
00541	Anesth one lung ventilation	N								
00542	Anesthesia removal pleura	C								
00546	Anesth lung chest wall surg	C								
00548	Anesth trachea bronchi surg	N								
0054T	Bone srgry cmptr fluor image	N								
0054U	Rx mntr 14+ drugs & sbsts	Q4								
00550	Anesth sternal debridement	N								
0055T	Bone srgry cmptr ct/mri imag	N								
0055U	Card hrt trnspl 96 dna seq	A								
00560	Anesth heart surg w/o pump	C								
00561	Anesth heart surg <1 yr	C								
00562	Anesth hrt surg w/pmp age 1+	C								
00563	Anesth heart surg w/arrest	N								
00566	Anesth cabg w/o pump	N								
00567	Anesth cabg w/pump	C								
0056U	Hem aml dna gene reargmt	A								
00580	Anesth heart/lung transplnt	C								
0058T	Cryopreservation ovary tiss	Q1	5672	1.7761	$143.50	.	$28.70			
0058U	Onc merkel cll carc srm quan	Q4								
0059U	Onc merkel cll carc srm +/-	Q4								
00600	Anesth spine cord surgery	N								
00604	Anesth sitting procedure	C								
0060U	Twn zyg gen seq alys chrms2	A								
0061U	Tc meas 5 bmrk sfdi m-s alys	Q4								
00620	Anesth spine cord surgery	N								
00625	Anes spine tranthor w/o vent	N								
00626	Anes spine transthor w/vent	N								
0062U	Ai sle igg&igm alys 80 bmrk	Q4								
00630	Anesth spine cord surgery	N								
00632	Anesth removal of nerves	C								
00635	Anesth lumbar puncture	N								
0063U	Neuro autism 32 amines alg	Q4								
00640	Anesth spine manipulation	N								
0064U	Antb tp total&rpr ia qual	Q4								
0065U	Syfls tst nontreponemal antb	Q4								
0066U	Pamg-1 ia cervico-vag fluid	Q4								
00670	Anesth spine cord surgery	N								
0067U	Onc brst imhchem prfl 4 bmrk	A								
0068U	Candida species pnl amp prb	Q4								
0069U	Onc clrct microrna mir-31-3p	A								
00700	Anesth abdominal wall surg	N								
00702	Anesth for liver biopsy	N								
0070U	Cyp2d6 gen com&slct rar vrnt	A								
0071T	Us leiomyomata ablate <200	J1	5414	30.9198	"$2,498.10"	.	$499.62			
0071U	Cyp2d6 full gene sequence	A								
0072T	Us leiomyomata ablate >200	J1	5414	30.9198	"$2,498.10"	.	$499.62			
0072U	Cyp2d6 gen cyp2d6-2d7 hybrid	A								
00730	Anesth abdominal wall surg	N								
00731	Anes upr gi ndsc px nos	N								
00732	Anes upr gi ndsc px ercp	N								
0073U	Cyp2d6 gen cyp2d7-2d6 hybrid	A								
0074U	Cyp2d6 nonduplicated gene	A								
00750	Anesth repair of hernia	N								
00752	Anesth repair of hernia	N								
00754	Anesth repair of hernia	N								
00756	Anesth repair of hernia	N								
0075T	Perq stent/chest vert art	C								
0075U	Cyp2d6 5' gene dup/mlt	A								
0076T	S&i stent/chest vert art	C								
0076U	Cyp2d6 3' gene dup/mlt	A								
00770	Anesth blood vessel repair	N								
0077U	Ig paraprotein qual bld/ur	Q4								
0078U	Pain mgt opi use gnotyp pnl	A								
00790	Anesth surg upper abdomen	N								
00792	Anesth hemorr/excise liver	C								
00794	Anesth pancreas removal	C								
00796	Anesth for liver transplant	C								
00797	Anesth surgery for obesity	N								
0079U	Cmprtv dna alys mlt snps	E1								
00800	Anesth abdominal wall surg	N								
00802	Anesth fat layer removal	N								
0080U	Onc lng 5 clin rsk factr alg	A								
00811	Anes lwr intst ndsc nos	N								
00812	Anes lwr intst scr colsc	N								
00813	Anes upr lwr gi ndsc px	N								
00820	Anesth abdominal wall surg	N								
0082U	Rx test def 90+ rx/sbsts ur	Q4								
00830	Anesth repair of hernia	N								
00832	Anesth repair of hernia	N								
00834	Anesth hernia repair < 1 yr	N								
00836	Anesth hernia repair preemie	N								
0083U	Onc rspse chemo cntrst tomog	Q4								
00840	Anesth surg lower abdomen	N								
00842	Anesth amniocentesis	N								
00844	Anesth pelvis surgery	C								
00846	Anesth hysterectomy	C								
00848	Anesth pelvic organ surg	C								
0084U	Rbc dna gnotyp 10 bld groups	A								
00851	Anesth tubal ligation	N								
0085T	Breath test heart reject	E1								
00860	Anesth surgery of abdomen	N								
00862	Anesth kidney/ureter surg	N								
00864	Anesth removal of bladder	C								
00865	Anesth removal of prostate	N								
00866	Anesth removal of adrenal	C								
00868	Anesth kidney transplant	C								
0086U	Nfct ds bact&fng org id 6+	A								
00870	Anesth bladder stone surg	N								
00872	Anesth kidney stone destruct	N								
00873	Anesth kidney stone destruct	N								
0087U	Crd hrt trnspl mrna 1283 gen	A								
00880	Anesth abdomen vessel surg	N								
00882	Anesth major vein ligation	C								
0088U	Trnsplj kdn algrft rej 1494	A								
0089U	Onc mlnma prame & linc00518	Q4								
00902	Anesth anorectal surgery	N								
00904	Anesth perineal surgery	C								
00906	Anesth removal of vulva	N								
00908	Anesth removal of prostate	C								
0090U	Onc cutan mlnma mrna 23 gene	A								
00910	Anesth bladder surgery	N								
00912	Anesth bladder tumor surg	N								
00914	Anesth removal of prostate	N								
00916	Anesth bleeding control	N								
00918	Anesth stone removal	N								
0091U	Onc clrct scr whl bld alg	E1								
00920	Anesth genitalia surgery	N								
00921	Anesth vasectomy	N								
00922	Anesth sperm duct surgery	N								
00924	Anesth testis exploration	N								
00926	Anesth removal of testis	N								
00928	Anesth removal of testis	N								
0092U	Onc lng 3 prtn bmrk plsm alg	Q4								
00930	Anesth testis suspension	N								
00932	Anesth amputation of penis	C								
00934	Anesth penis nodes removal	C								
00936	Anesth penis nodes removal	C								
00938	Anesth insert penis device	N								
0093U	Rx mntr 65 com drugs urine	Q4								
00940	Anesth vaginal procedures	N								
00942	Anesth surg on vag/urethral	N								
00944	Anesth vaginal hysterectomy	N								
00948	Anesth repair of cervix	N								
0094U	Genome rapid sequence alys	A								
00950	Anesth vaginal endoscopy	N								
00952	Anesth hysteroscope/graph	N								
0095T	Rmvl artific disc addl crvcl	C								
0095U	Inflm ee elisa alys alg	Q4								
0096U	Hpv hi risk types male urine	Q4								
0097U	Gi pathogen 22 targets	Q4								
0098T	Rev artific disc addl	C								
0098U	Respir pathogen 14 targets	Q4								
0099U	Respir pathogen 20 targets	Q4								
0100T	Prosth retina receive&gen	T	1908		"$152,500.50"	.	"$30,500.10"	*		
0100U	Respir pathogen 21 targets	Q4								
0101T	Extracorp shockwv tx hi enrg	J1	5113	33.8823	"$2,737.45"	.	$547.49			
0101U	Hered colon ca do 15 genes	A								
0102T	Extracorp shockwv tx anesth	J1	5113	33.8823	"$2,737.45"	.	$547.49			
0102U	Hered brst ca rltd do 17 gen	A								
0103U	Hered ova ca pnl 24 genes	A								
0105U	Neph ckd mult eclia tum nec	Q4								
0106T	Touch quant sensory test	Q1	5732	0.4138	$33.43	.	$6.69			
0106U	Gstr emptg 7 timed brth spec	Q4								
0107T	Vibrate quant sensory test	Q1	5732	0.4138	$33.43	.	$6.69			
0107U	C diff tox ag detcj ia stool	Q4								
0108T	Cool quant sensory test	Q1	5733	0.6809	$55.01	.	$11.01			
0108U	Gi barrett esoph 9 prtn bmrk	Q4								
0109T	Heat quant sensory test	Q1	5732	0.4138	$33.43	.	$6.69			
0109U	Id aspergillus dna 4 species	A								
0110T	Nos quant sensory test	Q1	5734	1.3495	$109.03	.	$21.81			
0110U	Rx mntr 1+oral onc rx&sbsts	Q4								
01112	Anesth bone aspirate/bx	N								
0111T	Rbc membranes fatty acids	A								
0111U	Onc colon ca kras&nras alys	A								
01120	Anesth pelvis surgery	N								
0112U	Iadi 16s&18s rrna genes	A								
01130	Anesth body cast procedure	N								
0113U	Onc prst8 pca3&tmprss2-erg	A								
01140	Anesth amputation at pelvis	C								
0114U	Gi barretts esoph vim&ccna1	A								
01150	Anesth pelvic tumor surgery	C								
0115U	Respir iadna 18 viral&2 bact	A								
01160	Anesth pelvis procedure	N								
0116U	Rx mntr nzm ia 35+oral flu	Q4								
01170	Anesth pelvis surgery	N								
01173	Anesth fx repair pelvis	N								
0117U	Pain mgmt 11 endogenous anal	Q4								
0118U	Trnsplj don-drv cll-fr dna	A								
0119U	Crd ceramides liq chrom plsm	Q4								
01200	Anesth hip joint procedure	N								
01202	Anesth arthroscopy of hip	N								
0120U	Onc b cll lymphm mrna 58 gen	A								
01210	Anesth hip joint surgery	N								
01212	Anesth hip disarticulation	C								
01214	Anesth hip arthroplasty	N								
01215	Anesth revise hip repair	N								
0121U	Sc dis vcam-1 whole blood	Q4								
01220	Anesth procedure on femur	N								
0122U	Sc dis p-selectin whl blood	Q4								
01230	Anesth surgery of femur	N								
01232	Anesth amputation of femur	C								
01234	Anesth radical femur surg	C								
0123U	Mchnl fragility rbc prflg	Q4								
01250	Anesth upper leg surgery	N								
01260	Anesth upper leg veins surg	N								
0126T	Chd risk imt study	Q1	5731	0.2845	$22.99		$4.60		*	
01270	Anesth thigh arteries surg	N								
01272	Anesth femoral artery surg	C								
01274	Anesth femoral embolectomy	C								
0129U	Hered brst ca rltd do panel	A								
0130U	Hered colon ca do mrna pnl	A								
0131U	Hered brst ca rltd do pnl 13	A								
01320	Anesth knee area surgery	N								
0132U	Hered ova ca rltd do pnl 17	A								
0133U	Hered prst8 ca rltd do 11	A								
01340	Anesth knee area procedure	N								
0134U	Hered pan ca mrna pnl 18 gen	A								
0135U	Hered gyn ca mrna pnl 12 gen	A								
01360	Anesth knee area surgery	N								
0136U	Atm mrna seq alys	A								
0137U	Palb2 mrna seq alys	A								
01380	Anesth knee joint procedure	N								
01382	Anesth dx knee arthroscopy	N								
0138U	Brca1 brca2 mrna seq alys	A								
01390	Anesth knee area procedure	N								
01392	Anesth knee area surgery	N								
0139U	Neuro austm meas 6 c metablt	Q4								
01400	Anesth knee joint surgery	N								
01402	Anesth knee arthroplasty	N								
01404	Anesth amputation at knee	C								
0140U	Nfct ds fungi dna 15 trgt	A								
0141U	Nfct ds bact&fng gram pos	A								
01420	Anesth knee joint casting	N								
0142U	Nfct ds bact&fng gram neg	A								
01430	Anesth knee veins surgery	N								
01432	Anesth knee vessel surg	N								
0143U	Drug assay 120+ rx/metablt	Q4								
01440	Anesth knee arteries surg	N								
01442	Anesth knee artery surg	C								
01444	Anesth knee artery repair	C								
0144U	Drug assay 160+ rx/metablt	Q4								
0145U	Drug assay 65+ rx/metablt	Q4								
01462	Anesth lower leg procedure	N								
01464	Anesth ankle/ft arthroscopy	N								
0146U	Drug assay 80+ rx/metablt	Q4								
01470	Anesth lower leg surgery	N								
01472	Anesth achilles tendon surg	N								
01474	Anesth lower leg surgery	N								
0147U	Drug assay 85+ rx/metablt	Q4								
01480	Anesth lower leg bone surg	N								
01482	Anesth radical leg surgery	N								
01484	Anesth lower leg revision	N								
01486	Anesth ankle replacement	C								
0148U	Drug assay 100+ rx/metablt	Q4								
01490	Anesth lower leg casting	N								
0149U	Drug assay 60+ rx/metablt	Q4								
01500	Anesth leg arteries surg	N								
01502	Anesth lwr leg embolectomy	C								
0150U	Drug assay 120+ rx/metablt	Q4								
0151U	Nfct bct/vir resp nfctj 33	A								
01520	Anesth lower leg vein surg	N								
01522	Anesth lower leg vein surg	N								
0152U	Nfct bct fng prst dna >1000	A								
0153U	Onc breast mrna 101 genes	A								
0154U	Onc urthl ca rna fgfr3 gene	A								
0155U	Onc brst ca dna pik3ca gene	A								
0156U	Copy number sequence alys	A								
0157U	Apc mrna seq alys	A  								
0158U	Mlh1 mrna seq alys	A 								
0159U	Msh2 mrna seq alys	A  								
0160U	Msh6 mrna seq alys	A 								
01610	Anesth surgery of shoulder	N								
0161U	Pms2 mrna seq alys	A 								
01620	Anesth shoulder procedure	N								
01622	Anes dx shoulder arthroscopy	N								
0162U	Hered colon ca trgt mrna pnl	A  								
01630	Anesth surgery of shoulder	N								
01634	Anesth shoulder joint amput	C								
01636	Anesth forequarter amput	C								
01638	Anesth shoulder replacement	C								
0163T	Lumb artif diskectomy addl	C								
0163U	Onc clrct scr 3 prtn alg	E1								
0164T	Remove lumb artif disc addl	C								
0164U	Gi ibs ia anti-cdtb&vinculin	Q4								
01650	Anesth shoulder artery surg	N								
01652	Anesth shoulder vessel surg	C								
01654	Anesth shoulder vessel surg	C								
01656	Anesth arm-leg vessel surg	C								
0165T	Revise lumb artif disc addl	C								
0165U	Peanut allg asmt epi  	Q4								
0166U	Liver ds 10 biochem asy srm	Q4								
01670	Anesth shoulder vein surg	N								
0167U	Chornc gonadotropin hcg ia	Q4								
01680	Anesth shoulder casting	N								
0168U	Ftl aneuploidy dna seq alys	Q4								
0169U	Nudt15&tpmt gene com vrnt	A								
0170U	Neuro asd rna next gen seq	A								
01710	Anesth elbow area surgery	N								
01712	Anesth uppr arm tendon surg	N								
01714	Anesth uppr arm tendon surg	N								
01716	Anesth biceps tendon repair	N								
0171U	Trgt gen seq alys pnl dna 23	A								
0172U	Onc sld tum alys brca1 brca2	A								
01730	Anesth uppr arm procedure	N								
01732	Anesth dx elbow arthroscopy	N								
0173U	Psyc gen alys panel 14 genes	A								
01740	Anesth upper arm surgery	N								
01742	Anesth humerus surgery	N								
01744	Anesth humerus repair	N								
0174T	Cad cxr with interp	N								
0174U	Onc solid tumor 30 prtn trgt	Q4								
01756	Anesth radical humerus surg	C								
01758	Anesth humeral lesion surg	N								
0175T	Cad cxr remote	N								
0175U	Psyc gen alys panel 15 genes	A								
01760	Anesth elbow replacement	N								
0176U	Cdtb&vinculin igg antb ia	Q4								
01770	Anesth uppr arm artery surg	N								
01772	Anesth uppr arm embolectomy	N								
0177U	Onc brst ca dna pik3ca 11	A								
01780	Anesth upper arm vein surg	N								
01782	Anesth uppr arm vein repair	N								
0178U	Peanut allg asmt epi clin rx	Q4								
0179U	Onc nonsm cll lng ca alys 23	A								
0180U	Abo gnotyp abo 7 exons	A								
01810	Anesth lower arm surgery	N								
0181U	Co gnotyp aqp1 exon 1	A								
01820	Anesth lower arm procedure	N								
01829	Anesth dx wrist arthroscopy	N								
0182U	Crom gnotyp cd55 exons 1-10	A								
01830	Anesth lower arm surgery	N								
01832	Anesth wrist replacement	N								
0183U	Di gnotyp slc4a1 exon 19	A								
01840	Anesth lwr arm artery surg	N								
01842	Anesth lwr arm embolectomy	N								
01844	Anesth vascular shunt surg	N								
0184T	Exc rectal tumor endoscopic	J1	5331	59.1738	"$4,780.83"	.	$956.17			
0184U	Do gnotyp art4 exon 2	A								
01850	Anesth lower arm vein surg	N								
01852	Anesth lwr arm vein repair	N								
0185U	Fut1 gnotyp fut1 exon 4	A								
01860	Anesth lower arm casting	N								
0186U	Fut2 gnotyp fut2 exon 2	A								
0187U	Fy gnotyp ackr1 exons 1-2	A								
0188U	Ge gnotyp gypc exons 1-4	A								
0189U	Gypa gnotyp ntrns 1 5 exon 2	A								
0190U	Gypb gnotyp ntrns 1 5 seux 3	A								
01916	Anesth dx arteriography	N								
0191T	Insert ant segment drain int	J1	5492	47.2606	"$3,818.33"	.	$763.67			
0191U	In gnotyp cd44 exons 2 3 6	A								
01920	Anesth catheterize heart	N								
01922	Anesth cat or mri scan	N								
01924	Anes ther interven rad artrl	N								
01925	Anes ther interven rad card	N								
01926	Anes tx interv rad hrt/cran	N								
0192U	Jk gnotyp slc14a1 exon 9	A								
01930	Anes ther interven rad vein	N								
01931	Anes ther interven rad tips	N								
01932	Anes tx interv rad th vein	N								
01933	Anes tx interv rad cran vein	N								
01935	Anesth perc img dx sp proc	N								
01936	Anesth perc img tx sp proc	N								
0193U	Jr gnotyp abcg2 exons 2-26	A								
0194U	Kel gnotyp kel exon 8	A								
01951	Anesth burn less 4 percent	N								
01952	Anesth burn 4-9 percent	N								
01953	Anesth burn each 9 percent	N								
01958	Anesth antepartum manipul	N								
0195U	Klf1 targeted sequencing	A								
01960	Anesth vaginal delivery	N								
01961	Anesth cs delivery	N								
01962	Anesth emer hysterectomy	N								
01963	Anesth cs hysterectomy	N								
01965	Anesth inc/missed ab proc	N								
01966	Anesth induced ab procedure	N								
01967	Anesth/analg vag delivery	N								
01968	Anes/analg cs deliver add-on	N								
01969	Anesth/analg cs hyst add-on	N								
0196U	Lu gnotyp bcam exon 3	A								
0197U	Lw gnotyp icam4 exon 1	A								
0198T	Ocular blood flow measure	Q1	5734	1.3495	$109.03	.	$21.81			
0198U	Rhd&rhce gntyp rhd1-10&rhce5	A								
01990	Support for organ donor	C								
01991	Anesth nerve block/inj	N								
01992	Anesth n block/inj prone	N								
01996	Hosp manage cont drug admin	N								
01999	Unlisted anesth procedure	N								
0199U	Sc gnotyp ermap exons 4 12	A								
0200T	Perq sacral augmt unilat inj	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
0200U	Xk gnotyp xk exons 1-3	A								
0201T	Perq sacral augmt bilat inj	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
0201U	Yt gnotyp ache exon 2	A								
0202T	Post vert arthrplst 1 lumbar	C								
0202U	Nfct ds 22 trgt sars-cov-2	A							*	
0203U	Ai ibd mrna xprsn prfl 17	Q4							*	
0204U	Onc thyr mrna xprsn alys 593	A							*	
0205U	Oph amd alys 3 gene variants	A							*	
0206U	Neuro alzheimer cell aggregj	Q4							*	
0207T	Clear eyelid gland w/heat	Q1	5733	0.6809	$55.01	.	$11.01			
0207U	Neuro alzheimer quan imaging	N							*	
0208T	Audiometry air only	Q1	5732	0.4138	$33.43	.	$6.69			
0208U	Onc mtc mrna xprsn alys 108	A							*	
0209T	Audiometry air & bone	Q1	5732	0.4138	$33.43	.	$6.69			
0209U	Cytog const alys interrog	A							*	
0210T	Speech audiometry threshold	Q1	5732	0.4138	$33.43	.	$6.69			
0210U	Syphilis tst antb ia quan	Q4							*	
0211T	Speech audiom thresh & recog	Q1	5732	0.4138	$33.43	.	$6.69			
0211U	Onc pan-tum dna&rna gnrj seq	E1							*	
0212T	Compre audiometry evaluation	Q1	5721	1.7124	$138.35	.	$27.67			
0212U	Rare ds gen dna alys proband	A							*	
0213T	Njx paravert w/us cer/thor	T	5443	10.0510	$812.05	.	$162.41			
0213U	Rare ds gen dna alys ea comp	A							*	
0214T	Njx paravert w/us cer/thor	N								
0214U	Rare ds xom dna alys proband	A							*	
0215T	Njx paravert w/us cer/thor	N								
0215U	Rare ds xom dna alys ea comp	A							*	
0216T	Njx paravert w/us lumb/sac	T	5443	10.0510	$812.05	.	$162.41			
0216U	Neuro inh ataxia dna 12 com	A							*	
0217T	Njx paravert w/us lumb/sac	N								
0217U	Neuro inh ataxia dna 51 gene	A							*	
0218T	Njx paravert w/us lumb/sac	N								
0218U	Neuro musc dys dmd seq alys	A							*	
0219T	Plmt post facet implt cerv	C								
0219U	Nfct agt hiv gnrj seq alys	A							*	
0220T	Plmt post facet implt thor	C								
0220U	Onc brst ca ai assmt 12 feat	Q4							*	
0221T	Plmt post facet implt lumb	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
0221U	Abo gnotyp next gnrj seq abo	A							*	
0222T	Plmt post facet implt addl	N								
0222U	Rhd&rhce gntyp next gnrj seq	A							*	
0223U	Nfct ds 22 trgt sars-cov-2	A							*	
0224U	Antibody sars-cov-2 titer(s)	A							*	
0225U	Nfct ds dna&rna 21 sarscov2	A							*	
0226U	Svnt sarscov2 elisa plsm srm	A							*	
0228T	Njx tfrml eprl w/us cer/thor	T	5443	10.0510	$812.05	.	$162.41			
0229T	Njx tfrml eprl w/us cer/thor	N								
0230T	Njx tfrml eprl w/us lumb/sac	T	5443	10.0510	$812.05	.	$162.41			
0231T	Njx tfrml eprl w/us lumb/sac	N								
0232T	Njx platelet plasma	Q1	5735	4.5003	$363.59	.	$72.72			
0234T	Trluml perip athrc renal art	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
0235T	Trluml perip athrc visceral	C								
0236T	Trluml perip athrc abd aorta	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
0237T	Trluml perip athrc brchiocph	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
0238T	Trluml perip athrc iliac art	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
0253T	Insert aqueous drain device	J1	5492	47.2606	"$3,818.33"	.	$763.67			
0263T	Im b1 mrw cel ther cmpl	S	5243	47.2610	"$3,818.36"	.	$763.68			
0264T	Im b1 mrw cel ther xcl hrvst	S	5243	47.2610	"$3,818.36"	.	$763.68			
0265T	Im b1 mrw cel ther hrvst onl	S	5243	47.2610	"$3,818.36"	.	$763.68			
0266T	Implt/rpl crtd sns dev total	J1	5464	360.4117	"$29,118.74"	.	"$5,823.75"	*		
0267T	Implt/rpl crtd sns dev lead	J1	5461	38.9699	"$3,148.50"	.	$629.70			
0268T	Implt/rpl crtd sns dev gen	J1	5464	360.4117	"$29,118.74"	.	"$5,823.75"	*		
0269T	Rev/remvl crtd sns dev total	Q2	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
0270T	Rev/remvl crtd sns dev lead	J1	5461	38.9699	"$3,148.50"	.	$629.70			
0271T	Rev/remvl crtd sns dev gen	J1	5461	38.9699	"$3,148.50"	.	$629.70			
0272T	Interrogate crtd sns dev	S	5721	1.7124	$138.35	.	$27.67			
0273T	Interrogate crtd sns w/pgrmg	S	5721	1.7124	$138.35	.	$27.67			
0274T	Perq lamot/lam crv/thrc	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
0275T	Perq lamot/lam lumbar	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
0278T	Tempr	Q1	5721	1.7124	$138.35	.	$27.67			
0290T	Laser inc for pkp/lkp recip	N								
0295T	Ext ecg complete	M								
0296T	Ext ecg recording	Q1	5733	0.6809	$55.01	.	$11.01			
0297T	Ext ecg scan w/report	Q1	5734	1.3495	$109.03	.	$21.81			
0298T	Ext ecg review and interp	M								
0308T	Insj ocular telescope prosth	J1	5495	255.9085	"$20,675.62"	.	"$4,135.13"	*		
0312T	Laps impltj nstim vagus	J1	5464	360.4117	"$29,118.74"	.	"$5,823.75"	*		
0313T	Laps rmvl nstim array vagus	J1	5461	38.9699	"$3,148.50"	.	$629.70			
0314T	Laps rmvl vgl arry&pls gen	J1	5461	38.9699	"$3,148.50"	.	$629.70			
0315T	Rmvl vagus nerve pls gen	J1	5461	38.9699	"$3,148.50"	.	$629.70			
0316T	Replc vagus nerve pls gen	J1	5464	360.4117	"$29,118.74"	.	"$5,823.75"	*		
0317T	Elec alys vagus nrv pls gen	Q1	5741	0.4487	$36.25	.	$7.25			
0329T	Mntr io press 24hrs/> uni/bi	E1								
0330T	Tear film img uni/bi w/i&r	Q1	5732	0.4138	$33.43	.	$6.69			
0331T	Heart symp image plnr	S	5593	15.7463	"$1,272.19"	.	$254.44			
0332T	Heart symp image plnr spect	S	5593	15.7463	"$1,272.19"	.	$254.44			
0333T	Visual ep scr acuity auto	E1								
0335T	Insj sinus tarsi implant	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
0338T	Trnscth renal symp denrv unl	J1	5192	61.3161	"$4,953.91"	.	$990.79			
0339T	Trnscth renal symp denrv bil	J1	5192	61.3161	"$4,953.91"	.	$990.79			
0342T	Thxp apheresis w/hdl delip	S	5243	47.2610	"$3,818.36"	.	$763.68			
0345T	Transcath mtral vlve repair	C								
0347T	Ins bone device for rsa	Q1	5733	0.6809	$55.01	.	$11.01			
0348T	Rsa spine exam	Q1	5522	1.3873	$112.08	.	$22.42			
0349T	Rsa upper extr exam	Q1	5522	1.3873	$112.08	.	$22.42			
0350T	Rsa lower extr exam	Q1	5521	0.9878	$79.81	.	$15.97			
0351T	Intraop oct brst/node spec	N								
0352T	Oct brst/node i&r per spec	B								
0353T	Intraop oct breast cavity	N								
0354T	Oct breast surg cavity i&r	B								
0355T	Gi tract capsule endoscopy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
0356T	Insrt drug device for iop	Q1	5692	0.7484	$60.47	.	$12.10			
0358T	Bia whole body	Q1	5731	0.2845	$22.99	.	$4.60			
0362T	Bhv id suprt assmt ea 15 min	Q3	5821	0.3382	$27.32	.	$5.47			
0373T	Adapt bhv tx ea 15 min	Q3	5821	0.3382	$27.32	.	$5.47			
0376T	Insert ant segment drain int	N								
0378T	Visual field assmnt rev/rprt	B								
0379T	Vis field assmnt tech suppt	Q1	5732	0.4138	$33.43	.	$6.69			
0381T	Ext h rate epi sz 14 days	M								
0382T	Ext h rate sz 14 day ri only	M								
0383T	Ext h rate sz up to 30 days	M								
0384T	Ex h rate sz 30 day ri only	M								
0385T	Ex h rate for sz ovr 30 day	M								
0386T	Ex h rate sz 30+ day ri only	M								
0394T	Hdr elctrnc skn surf brchytx	S	5622	2.9255	$236.36	.	$47.28			
0395T	Hdr elctr ntrst/ntrcv brchtx	S	5624	9.1657	$740.52	.	$148.11			
0396T	Intraop kinetic balnce sensr	N								
0397T	Ercp w/optical endomicroscpy	N								
0398T	Mrgfus strtctc les abltj	S	1575		"$12,500.50"	.	"$2,500.10"	*		
0400T	Mltispectrl digital les alys	N								
0401T	Mltispectrl digital les alys	N								
0402T	Colgn cross-link crn med sep	J1	5503	23.9526	"$1,935.20"	.	$387.04			
0403T	Diabetes prev standard curr	E1								
0404T	Trnscrv uterin fibroid abltj	J1	5416	82.9725	"$6,703.60"	"$1,405.70"	"$1,340.72"			
0405T	Ovrsght xtrcorp liv asst pat	B								
0408T	Insj/rplc cardiac modulj sys	J1	5231	281.1245	"$22,712.89"	.	"$4,542.58"	*		
0409T	Insj/rplc car modulj pls gn	J1	5231	281.1245	"$22,712.89"	.	"$4,542.58"	*		
0410T	Insj/rplc car modulj atr elt	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
0411T	Insj/rplc car modulj vnt elt	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
0412T	Rmvl cardiac modulj pls gen	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
0413T	Rmvl car modulj tranvns elt	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
0414T	Rmvl & rpl car modulj pls gn	J1	5231	281.1245	"$22,712.89"	.	"$4,542.58"	*		
0415T	Repos car modulj tranvns elt	T	5181	7.8040	$630.51	.	$126.11			
0416T	Reloc skin pocket pls gen	T	5054	20.0852	"$1,622.74"	.	$324.55			
0417T	Prgrmg eval cardiac modulj	Q1	5741	0.4487	$36.25	.	$7.25			
0418T	Interro eval cardiac modulj	Q1	5741	0.4487	$36.25	.	$7.25			
0419T	Dstrj neurofibroma xtnsv	T	5053	6.1518	$497.02	.	$99.41			
0420T	Dstrj neurofibroma xtnsv	T	5053	6.1518	$497.02	.	$99.41			
0421T	Waterjet prostate abltj cmpl	J1	5376	99.8593	"$8,067.93"	.	"$1,613.59"	*		
0422T	Tactile breast img uni/bi	Q1	5521	0.9878	$79.81	.	$15.97			
0423T	Assay secretory type ii pla2	A								
0424T	Insj/rplc nstim apnea compl	J1	5464	360.4117	"$29,118.74"	.	"$5,823.75"	*		
0425T	Insj/rplc nstim apnea sen ld	J1	5462	76.5800	"$6,187.13"	.	"$1,237.43"			
0426T	Insj/rplc nstim apnea stm ld	J1	5463	238.6273	"$19,279.42"	.	"$3,855.89"	*		
0427T	Insj/rplc nstim apnea pls gn	J1	5464	360.4117	"$29,118.74"	.	"$5,823.75"	*		
0428T	Rmvl nstim apnea pls gen	J1	5461	38.9699	"$3,148.50"	.	$629.70			
0429T	Rmvl nstim apnea sen ld	J1	5461	38.9699	"$3,148.50"	.	$629.70			
0430T	Rmvl nstim apnea stimj ld	J1	5461	38.9699	"$3,148.50"	.	$629.70			
0431T	Rmvl/rplc nstim apnea pls gn	J1	5464	360.4117	"$29,118.74"	.	"$5,823.75"	*		
0432T	Repos nstim apnea stimj ld	J1	5461	38.9699	"$3,148.50"	.	$629.70			
0433T	Repos nstim apnea sensing ld	J1	5461	38.9699	"$3,148.50"	.	$629.70			
0434T	Interro eval npgs apnea	S	5742	1.4039	$113.43	.	$22.69			
0435T	Prgrmg eval npgs apnea 1 ses	S	5742	1.4039	$113.43	.	$22.69			
0436T	Prgrmg eval npgs apnea study	S	5724	11.2503	$908.95	.	$181.79			
0437T	Impltj synth rnfcmt abdl wal	N								
0439T	Myocrd contrast prfuj echo	N								
0440T	Abltj perc uxtr/perph nrv	J1	5431	21.2809	"$1,719.35"	.	$343.87			
0441T	Abltj perc lxtr/perph nrv	J1	5431	21.2809	"$1,719.35"	.	$343.87			
0442T	Abltj perc plex/trncl nrv	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
0443T	R-t spctrl alys prst8 tiss	N								
0444T	1st plmt drug elut oc ins	N								
0445T	Sbsqt plmt drug elut oc ins	N								
0446T	Insj impltbl glucose sensor	T	5053	6.1518	$497.02	.	$99.41			
0447T	Rmvl impltbl glucose sensor	Q2	5051	2.1627	$174.73	.	$34.95			
0448T	Remvl insj impltbl gluc sens	T	5053	6.1518	$497.02	.	$99.41			
0449T	Insj aqueous drain dev 1st	J1	5492	47.2606	"$3,818.33"	.	$763.67			
0450T	Insj aqueous drain dev each	N								
0451T	Insj/rplcmt aortic ventr sys	C								
0452T	Insj/rplcmt dev vasc seal	C								
0453T	Insj/rplcmt mech-elec ntrfce	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
0454T	Insj/rplcmt subq electrode	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
0455T	Remvl aortic ventr cmpl sys	C								
0456T	Remvl aortic dev vasc seal	C								
0457T	Remvl mech-elec skin ntrfce	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
0458T	Remvl subq electrode	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
0459T	Relocaj rplcmt aortic ventr	C								
0460T	Repos aortic ventr dev eltrd	T	5221	36.9340	"$2,984.01"	.	$596.81			
0461T	Repos aortic contrpulsj dev	C								
0462T	Prgrmg eval aortic ventr sys	S	5743	3.3531	$270.91	.	$54.19			
0463T	Interrog aortic ventr sys	S	5743	3.3531	$270.91	.	$54.19			
0464T	Visual ep test for glaucoma	S	5721	1.7124	$138.35	.	$27.67			
0465T	Supchrdl njx rx w/o supply	T	5694	3.8320	$309.60	.	$61.92			
0466T	Insj ch wal respir eltrd/ra	N								
0467T	Revj/rplmnt ch respir eltrd	J1	5461	38.9699	"$3,148.50"	.	$629.70			
0468T	Rmvl ch wal respir eltrd/ra	J1	5461	38.9699	"$3,148.50"	.	$629.70			
0469T	Rta polarize scan oc scr bi	E1								
0470T	Oct skn img acquisj i&r 1st	M								
0471T	Oct skn img acquisj i&r addl	N								
0472T	Prgrmg io rta eltrd ra	Q1	5743	3.3531	$270.91	.	$54.19			
0473T	Reprgrmg io rta eltrd ra	Q1	5742	1.4039	$113.43	.	$22.69			
0474T	Insj aqueous drg dev io rsvr	E1								
0475T	Rec ftl car sgl 3 ch i&r	M								
0476T	Rec ftl car sgl elec tr data	Q1	5734	1.3495	$109.03	.	$21.81			
0477T	Rec ftl car sgl xrtj alys	Q1	5734	1.3495	$109.03	.	$21.81			
0478T	Rec ftl car 3 ch rev i&r	M								
0479T	Fxjl abl lsr 1st 100 sq cm	T	5052	3.9547	$319.51	.	$63.91			
0480T	Fxjl abl lsr ea addl 100sqcm	N								
0481T	Njx autol wbc concentrate	Q1	5735	4.5003	$363.59	.	$72.72			
0483T	Tmvi percutaneous approach	C								
0484T	Tmvi transthoracic exposure	C								
0485T	Oct mid ear i&r unilateral	Q1	5732	0.4138	$33.43	.	$6.69			
0486T	Oct mid ear i&r bilateral	Q1	5732	0.4138	$33.43	.	$6.69			
0487T	Trvg biomchn mapg w/reprt	Q1	5734	1.3495	$109.03	.	$21.81			
0488T	Diabetes prev online/elec	E1								
0489T	Regn cell tx scldr hands	E1								
0490T	Regn cell tx scldr h mlt inj	E1								
0491T	Abl lsr opn wnd 1st 20 sqcm	T	5052	3.9547	$319.51	.	$63.91			
0492T	Abl lsr opn wnd addl 20 sqcm	N								
0493T	Near ifr spectrsc of wounds	N								
0494T	Prep & cannulj cdvr don lung	C								
0495T	Mntr cdvr don lng 1st 2 hrs	C								
0496T	Mntr cdvr don lng ea addl hr	C								
0497T	Xtrnl pt act ecg in-off conn	Q1	5741	0.4487	$36.25	.	$7.25			
0498T	Xtrnl pt act ecg r&i pr 30 d	M								
0499T	Cysto f/urtl strix/stenosis	J1	5374	37.3614	"$3,018.54"	.	$603.71			
0500F	Initial prenatal care visit	E1								
0500T	Hpv 5+ hi risk hpv types	A								
0501F	Prenatal flow sheet	E1								
0501T	Cor ffr derived cor cta data	M								
0502F	Subsequent prenatal care	E1								
0502T	Cor ffr data prep & transmis	N								
0503F	Postpartum care visit	E1								
0503T	Cor ffr alys gnrj ffr mdl	S	1511		$950.50	.	$190.10			
0504T	Cor ffr data review i&r	M								
0505F	Hemodialysis plan docd	E1								
0505T	Ev fempop artl revsc	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
0506T	Mac pgmt opt dns meas hfp	Q1	5733	0.6809	$55.01	.	$11.01			
0507F	Periton dialysis plan docd	E1								
0507T	Near ifr 2img mibmn glnd i&r	Q1	5733	0.6809	$55.01	.	$11.01			
0508T	Pls echo us b1 dns meas tib	S	5522	1.3873	$112.08	.	$22.42			
0509F	Urine incon plan docd	M								
0509T	Pattern erg w/i&r	S	5721	1.7124	$138.35	.	$27.67			
0510T	Rmvl sinus tarsi implant	Q2	5113	33.8823	"$2,737.45"	.	$547.49			
0511T	Rmvl&rinsj sinus tarsi implt	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
0512T	Esw integ wnd hlg 1st wnd	S	5052	3.9547	$319.51	.	$63.91			
0513F	Elev bp plan of care docd	M								
0513T	Esw integ wnd hlg ea addl	N								
0514F	Care plan hgb docd esa pt	E1								
0514T	Intraop vis axis id pt fixj	N 								
0515T	Insj wcs lv compl sys	J1	5231	281.1245	"$22,712.89"	.	"$4,542.58"	*		
0516F	Anemia plan of care docd	E1								
0516T	Insj wcs lv eltrd only	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
0517F	Glaucoma plan of care docd	M								
0517T	Insj wcs lv pg compnt	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
0518F	Fall plan of care docd	M								
0518T	Rmvl pg compnt wcs	T	5221	36.9340	"$2,984.01"	.	$596.81			
0519F	Pland chemo docd b/4 txmnt	E1								
0519T	Rmvl & rplcmt pg compnt wcs	T	5221	36.9340	"$2,984.01"	.	$596.81			
0520F	Rad dos limts b/4 3d rad	M								
0520T	Rmvl&rplcmt pg wcs new eltrd	J1	5231	281.1245	"$22,712.89"	.	"$4,542.58"	*		
0521F	Plan of care 4 pain docd	E1								
0521T	Interrog dev eval wcs ip	Q1	5731	0.2845	$22.99	.	$4.60			
0522T	Prgrmg dev eval wcs ip	Q1	5741	0.4487	$36.25	.	$7.25			
0523T	Ntrapx c ffr w/3d funcjl map	N								
0524T	Ev cath dir chem abltj w/img	T	5183	34.3010	"$2,771.28"	.	$554.26			
0525F	Initial visit for episode	E1								
0525T	Insj/rplcmt compl iims	J1	5223	126.8914	"$10,251.94"	.	"$2,050.39"	*		
0526F	Subs visit for episode	M								
0526T	Insj/rplcmt iims eltrd only	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
0527T	Insj/rplcmt iims implt mntr	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
0528F	Rcmnd flw-up 10 yrs docd	M								
0528T	Prgrmg dev eval iims ip	Q1	5741	0.4487	$36.25	.	$7.25			
0529F	Intrvl 3/>yr pts clnscp docd	M								
0529T	Interrog dev eval iims ip	Q1	5741	0.4487	$36.25	.	$7.25			
0530T	Removal complete iims	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
0531T	Removal iims electrode only	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
0532T	Removal iims implt mntr only	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
0533T	Cont rec mvmt do 6-10 days	M								
0534T	Cont rec mvmt do setup&train	Q1	5741	0.4487	$36.25	.	$7.25			
0535F	Dyspnea mngmnt plan docd	E1								
0535T	Cont rec mvmt do reprt cnfig	Q1	5741	0.4487	$36.25	.	$7.25			
0536T	Cont rec mvmt do dl w/i&r	M								
0537T	Bld drv t lymphcyt car-t cll	B								
0538T	Bld drv t lymphcyt prep trns	B								
0539T	Receipt&prep car-t cll admn	B								
0540F	Gluco mngmnt plan docd	M								
0540T	Car-t cll admn autologous	S	5694	3.8320	$309.60	.	$61.92			
0541T	Myocardial imaging mcg	S	5723	6.0105	$485.61	.	$97.13			
0542T	Myocardial imaging mcg i&r	M								
0543T	Ta mv rpr w/artif chord tend	C								
0544T	Tcat mv annulus rcnstj	C								
0545F	Follow up care plan mdd docd	E1								
0545T	Tcat tv annulus rcnstj	C								
0546T	Rf spectrsc ntraop mrgn asmt	N								
0547T	B1 matrl qual tst mcrind tib	E1								
0548T	Tprnl balo cntnc dev bi	J1	5376	99.8593	"$8,067.93"	.	"$1,613.59"	*		
0549T	Tprnl balo cntnc dev uni	J1	5375	52.3761	"$4,231.62"	.	$846.33			
0550F	Cytopath report nongyn spcmn	E1								
0550T	Tprnl balo cntnc dev rmvl ea	J1	5374	37.3614	"$3,018.54"	.	$603.71			
0551F	Cytopath report non routine	E1								
0551T	Tprnl balo cntnc dev adjmt	T	5371	2.9074	$234.90	.	$46.98			
0552T	Low-level laser therapy	M								
0553T	Perq tcat iliac anast implt	E1								
0554T	B1 str & fx rsk analysis	M								
0555F	Symptom mgmnt plan care docd	E1								
0555T	B1 str&fx rsk transmis data	S	5731	0.2845	$22.99	.	$4.60			
0556F	Plan care lipid control docd	E1								
0556T	B1 str & fx rsk assessment	S	5523	2.8844	$233.04	.	$46.61			
0557F	Plan caremng angnl symptdocd	E1								
0557T	B1 str & fx rsk i&r	M								
0558T	Ct scan f/biomchn ct alys	S	5521	0.9878	$79.81	.	$15.97			
0559T	Antmc mdl 3d print 1st cmpnt	Q1	5733	0.6809	$55.01	.	$11.01			
0560T	Antmc mdl 3d print ea addl	N								
0561T	Antmc guide 3d print 1st gd	Q1	5733	0.6809	$55.01	.	$11.01			
0562T	Antmc guide 3d print ea addl	N								
0563T	Evac meibomian glnd heat bi	Q1	5733	0.6809	$55.01	.	$11.01			
0564T	Onc chemo rx cytotox csc 14	Q1	5671	0.6123	$49.47	.	$9.90			
0565T	Autol cell implt adps hrvg	Q1	5733	0.6809	$55.01	.	$11.01			
0566T	Autol cell implt adps njx	T	5441	3.2400	$261.77	.	$52.36			
0567T	Perm flp tube occls w/implt	E1								
0568T	Intro mix saline&air f/ssg	E1								
0569T	Ttvr perq appr 1st prosth	C								
0570T	Ttvr perq ea addl prosth	C								
0571T	Insj/rplcmt icds ss eltrd	J1	5232	399.5722	"$32,282.64"	.	"$6,456.53"	*		
0572T	Insertion ss dfb electrode	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
0573T	Removal ss dfb electrode	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
0574T	Repos prev ss impl dfb eltrd	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
0575F	Hiv rna plan care docd	E1								
0575T	Prgrmg dev eval icds ss ip	Q1	5741	0.4487	$36.25	.	$7.25			
0576T	Interrog dev eval icds ss ip	Q1	5741	0.4487	$36.25	.	$7.25			
0577T	Ephys eval icds ss	J1	5211	12.2233	$987.56	.	$197.52			
0578T	Rem interrog dev icds phys	M								
0579T	Rem interrog dev icds tech	Q1	5741	0.4487	$36.25	.	$7.25			
0580F	Multidisciplinary care plan	E1								
0580T	Rmvl ss impl dfb pg only	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
0581F	Pt trnsfrd from anesth to cc	M								
0581T	Abltj mal brst tum perq crtx	E1								
0582F	No trnsfr from anesth to cc	E1								
0582T	Trurl abltj mal prst8 tiss	E1								
0583F	Transfer care checklist used	M								
0583T	Tmpst auto tube dlvr sys	E1								
0584F	No transfercare chklist used	E1								
0584T	Perq islet cell transplant	C								
0585T	Laps islet cell transplant	C								
0586T	Open islet cell transplant	C								
0587T	Perq impltj/rplcmt isdns ptn	T	5442	7.7364	$625.05	.	$125.01			
0588T	Revision/removal isdns ptn	T	5441	3.2400	$261.77	.	$52.36			
0589T	Elec alys smpl prgrmg iins	S	5742	1.4039	$113.43	.	$22.69			
0590T	Elec alys cplx prgrmg iins	S	5742	1.4039	$113.43	.	$22.69			
0591T	Hlth&wb coaching indiv 1st	E1								
0592T	Hlth&wb coaching indiv f-up	E1								
0593T	Hlth&wb coaching group	E1								
0594T	Osteot hum xtrnl lngth dev	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
0596T	Temp fml iu vlv-pmp 1st insj	T	5372	6.8884	$556.53	.	$111.31			
0597T	Temp fml iu valve-pmp rplcmt	T	5372	6.8884	$556.53	.	$111.31			
0598T	Ncntc r-t fluor wnd img 1st	T	5722	3.1327	$253.10	.	$50.62			
0599T	Ncntc r-t fluor wnd img ea	N								
0600T	Ire abltj 1+tum organ perq	J1	5361	59.8283	"$4,833.71"	.	$966.75			
0601T	Ire abltj 1+tumors open	J1	5361	59.8283	"$4,833.71"	.	$966.75			
0602T	Transdermal gfr measurements	Q4								
0603T	Transdermal gfr monitoring	Q4								
0604T	Rem oct rta dev setup&educaj	V	5012	1.4349	$115.93	.	$23.19			
0605T	Rem oct rta techl sprt min 8	Q1	5741	0.4487	$36.25	.	$7.25			
0606T	Rem oct rta phys/qhp ea 30d	M								
0607T	Rem mntr pulm flu mntr setup	V	5012	1.4349	$115.93	.	$23.19			
0608T	Rem mntr pulm flu mntr alys	S	5741	0.4487	$36.25	.	$7.25			
0609T	Mrs disc pain acquisj data	E1								
0610T	Mrs disc pain transmis data	E1								
0611T	Mrs disc pain alg alys data	E1								
0612T	Mrs discogenic pain i&r	E1								
0613T	Perq tcat intratrl septl sht	E1								
0614T	Rmvl&rplcmt ss impl dfb pg	J1	5231	281.1245	"$22,712.89"	.	"$4,542.58"	*		
0615T	Eye mvmt alys w/o calbrj i&r	Q1	5734	1.3495	$109.03	.	$21.81			
0616T	Insertion of iris prosthesis	J1	5491	25.0252	"$2,021.86"	.	$404.38			
0617T	Insj iris prosth w/rmvl&insj	J1	5492	47.2606	"$3,818.33"	.	$763.67			
0618T	Insj iris prosth sec io lens	J1	5492	47.2606	"$3,818.33"	.	$763.67			
0619T	Cysto w/prst8 commissurotomy	J1	5375	52.3761	"$4,231.62"	.	$846.33			
10004	Fna bx w/o img gdn ea addl	N								
10005	Fna bx w/us gdn 1st les	T	5071	7.5503	$610.01	.	$122.01			
10006	Fna bx w/us gdn ea addl	N								
10007	Fna bx w/fluor gdn 1st les	T	5071	7.5503	$610.01	.	$122.01			
10008	Fna bx w/fluor gdn ea addl	N								
10009	Fna bx w/ct gdn 1st les	T	5071	7.5503	$610.01	.	$122.01			
1000F	Tobacco use assessed	E1								
10010	Fna bx w/ct gdn ea addl	N								
10011	Fna bx w/mr gdn 1st les	T	5071	7.5503	$610.01	.	$122.01			
10012	Fna bx w/mr gdn ea addl	N								
10021	Fna bx w/o img gdn 1st les	T	5052	3.9547	$319.51	.	$63.91			
1002F	Assess anginal symptom/level	E1								
10030	Guide cathet fluid drainage	T	5071	7.5503	$610.01	.	$122.01			
10035	Perq dev soft tiss 1st imag	T	5071	7.5503	$610.01	.	$122.01			
10036	Perq dev soft tiss add imag	N								
1003F	Level of activity assess	E1								
10040	Acne surgery	Q1	5051	2.1627	$174.73	.	$34.95			
1004F	Clin symp vol ovrld assess	E1								
1005F	Asthma symptoms evaluate	E1								
10060	Drainage of skin abscess	T	5051	2.1627	$174.73	.	$34.95			
10061	Drainage of skin abscess	T	5052	3.9547	$319.51	.	$63.91			
1006F	Osteoarthritis assess	M								
1007F	Anti-inflm/anlgsc otc assess	E1								
10080	Drainage of pilonidal cyst	T	5071	7.5503	$610.01	.	$122.01			
10081	Drainage of pilonidal cyst	T	5071	7.5503	$610.01	.	$122.01			
1008F	Gi/renal risk assess	E1								
1010F	Severity angina by actvty	E1								
1011F	Angina present	E1								
10120	Remove foreign body	T	5052	3.9547	$319.51	.	$63.91			
10121	Remove foreign body	J1	5072	16.9891	"$1,372.60"	.	$274.52			
1012F	Angina absent	E1								
10140	Drainage of hematoma/fluid	J1	5072	16.9891	"$1,372.60"	.	$274.52			
1015F	Copd symptoms assess	E1								
10160	Puncture drainage of lesion	T	5052	3.9547	$319.51	.	$63.91			
10180	Complex drainage wound	J1	5073	28.7016	"$2,318.89"	.	$463.78			
1018F	Assess dyspnea not present	E1								
1019F	Assess dyspnea present	E1								
1022F	Pneumo imm status assess	E1								
1026F	Co-morbid condition assess	E1								
1030F	Influenza imm status assess	E1								
1031F	Smoking & 2nd hand assessed	E1								
1032F	Smoker/exposed 2nd hnd smoke	E1								
1033F	Tobacco nonsmoker nor 2ndhnd	E1								
1034F	Current tobacco smoker	E1								
1035F	Smokeless tobacco user	E1								
1036F	Tobacco non-user	M								
1038F	Persistent asthma	M								
1039F	Intermittent asthma	M								
1040F	Dsm-5 info mdd docd	E1								
1050F	History of mole changes	E1								
1052F	Type location activityassess	E1								
1055F	Visual funct status assess	E1								
1060F	Doc perm/cont/parox atr fib	E1								
1061F	Doc lack perm+cont+parox fib	E1								
1065F	Ischm stroke symp lt3 hrsb/4	E1								
1066F	Ischm stroke symp ge3 hrsb/4	E1								
1070F	Alarm symp assessed-absent	E1								
1071F	Alarm symp assessed-1+ prsnt	E1								
1090F	Pres/absn urine incon assess	M								
1091F	Urine incon characterized	E1								
11000	Debride infected skin	T	5053	6.1518	$497.02	.	$99.41			
11001	Debride infected skin add-on	N								
11004	Debride genitalia & perineum	C								
11005	Debride abdom wall	C								
11006	Debride genit/per/abdom wall	C								
11008	Remove mesh from abd wall	C								
1100F	Ptfalls assess-docd ge2>/yr	M								
11010	Debride skin at fx site	T	5071	7.5503	$610.01	.	$122.01			
11011	Debride skin musc at fx site	T	5071	7.5503	$610.01	.	$122.01			
11012	Deb skin bone at fx site	J1	5073	28.7016	"$2,318.89"	.	$463.78			
1101F	Pt falls assess-docd le1/yr	M								
11042	Deb subq tissue 20 sq cm/<	T	5052	3.9547	$319.51	.	$63.91			
11043	Deb musc/fascia 20 sq cm/<	T	5053	6.1518	$497.02	.	$99.41			
11044	Deb bone 20 sq cm/<	J1	5072	16.9891	"$1,372.60"	.	$274.52			
11045	Deb subq tissue add-on	N								
11046	Deb musc/fascia add-on	N								
11047	Deb bone add-on	N								
11055	Trim skin lesion	Q1	5051	2.1627	$174.73	.	$34.95			
11056	Trim skin lesions 2 to 4	Q1	5051	2.1627	$174.73	.	$34.95			
11057	Trim skin lesions over 4	T	5051	2.1627	$174.73	.	$34.95			
11102	Tangntl bx skin single les	T	5051	2.1627	$174.73	.	$34.95			
11103	Tangntl bx skin ea sep/addl	N								
11104	Punch bx skin single lesion	T	5051	2.1627	$174.73	.	$34.95			
11105	Punch bx skin ea sep/addl	N								
11106	Incal bx skn single les	T	5052	3.9547	$319.51	.	$63.91			
11107	Incal bx skn ea sep/addl	N								
1110F	Pt lft inpt fac w/in 60 days	E1								
1111F	Dschrg med/current med merge	M								
1116F	Auric/peri pain assessed	E1								
1118F	Gerd symps assessed 12 month	E1								
1119F	Init eval for condition	E1								
11200	Removal of skin tags <w/15	Q1	5051	2.1627	$174.73	.	$34.95			
11201	Remove skin tags add-on	N								
1121F	Subs eval for condition	E1								
1123F	Acp discuss/dscn mkr docd	M								
1124F	Acp discuss-no dscnmkr docd	M								
1125F	Amnt pain noted pain prsnt	M								
1126F	Amnt pain noted none prsnt	M								
1127F	New episode for condition	E1								
1128F	Subs episode for condition	E1								
11300	Shave skin lesion 0.5 cm/<	Q1	5051	2.1627	$174.73	.	$34.95			
11301	Shave skin lesion 0.6-1.0 cm	Q1	5051	2.1627	$174.73	.	$34.95			
11302	Shave skin lesion 1.1-2.0 cm	Q1	5051	2.1627	$174.73	.	$34.95			
11303	Shave skin lesion >2.0 cm	Q1	5052	3.9547	$319.51	.	$63.91			
11305	Shave skin lesion 0.5 cm/<	Q1	5051	2.1627	$174.73	.	$34.95			
11306	Shave skin lesion 0.6-1.0 cm	Q1	5051	2.1627	$174.73	.	$34.95			
11307	Shave skin lesion 1.1-2.0 cm	T	5051	2.1627	$174.73	.	$34.95			
11308	Shave skin lesion >2.0 cm	Q1	5052	3.9547	$319.51	.	$63.91			
1130F	Bk pain & fxn assessed	E1								
11310	Shave skin lesion 0.5 cm/<	T	5051	2.1627	$174.73	.	$34.95			
11311	Shave skin lesion 0.6-1.0 cm	T	5051	2.1627	$174.73	.	$34.95			
11312	Shave skin lesion 1.1-2.0 cm	T	5052	3.9547	$319.51	.	$63.91			
11313	Shave skin lesion >2.0 cm	T	5052	3.9547	$319.51	.	$63.91			
1134F	Epsd bk pain for 6 wks/<	E1								
1135F	Epsd bk pain for >6 wks	E1								
1136F	Epsd bk pain for 12 wks/<	E1								
1137F	Epsd bk pain for >12 wks	E1								
11400	Exc tr-ext b9+marg 0.5 cm<	T	5071	7.5503	$610.01	.	$122.01			
11401	Exc tr-ext b9+marg 0.6-1 cm	T	5052	3.9547	$319.51	.	$63.91			
11402	Exc tr-ext b9+marg 1.1-2 cm	T	5071	7.5503	$610.01	.	$122.01			
11403	Exc tr-ext b9+marg 2.1-3cm	T	5071	7.5503	$610.01	.	$122.01			
11404	Exc tr-ext b9+marg 3.1-4 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
11406	Exc tr-ext b9+marg >4.0 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
11420	Exc h-f-nk-sp b9+marg 0.5/<	J1	5072	16.9891	"$1,372.60"	.	$274.52			
11421	Exc h-f-nk-sp b9+marg 0.6-1	T	5071	7.5503	$610.01	.	$122.01			
11422	Exc h-f-nk-sp b9+marg 1.1-2	J1	5072	16.9891	"$1,372.60"	.	$274.52			
11423	Exc h-f-nk-sp b9+marg 2.1-3	J1	5072	16.9891	"$1,372.60"	.	$274.52			
11424	Exc h-f-nk-sp b9+marg 3.1-4	J1	5072	16.9891	"$1,372.60"	.	$274.52			
11426	Exc h-f-nk-sp b9+marg >4 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
11440	Exc face-mm b9+marg 0.5 cm/<	T	5071	7.5503	$610.01	.	$122.01			
11441	Exc face-mm b9+marg 0.6-1 cm	T	5071	7.5503	$610.01	.	$122.01			
11442	Exc face-mm b9+marg 1.1-2 cm	T	5071	7.5503	$610.01	.	$122.01			
11443	Exc face-mm b9+marg 2.1-3 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
11444	Exc face-mm b9+marg 3.1-4 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
11446	Exc face-mm b9+marg >4 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
11450	Removal sweat gland lesion	J1	5073	28.7016	"$2,318.89"	.	$463.78			
11451	Removal sweat gland lesion	J1	5073	28.7016	"$2,318.89"	.	$463.78			
11462	Removal sweat gland lesion	J1	5073	28.7016	"$2,318.89"	.	$463.78			
11463	Removal sweat gland lesion	J1	5073	28.7016	"$2,318.89"	.	$463.78			
11470	Removal sweat gland lesion	J1	5073	28.7016	"$2,318.89"	.	$463.78			
11471	Removal sweat gland lesion	J1	5073	28.7016	"$2,318.89"	.	$463.78			
1150F	Doc pt rsk death w/in 1yr	E1								
1151F	Doc no pt rsk death w/in 1yr	E1								
1152F	Doc advncd dis comfort 1st	E1								
1153F	Doc advncd dis cmfrt not 1st	E1								
1157F	Advnc care plan in rcrd	E1								
1158F	Advnc care plan tlk docd	M								
1159F	Med list docd in rcrd	E1								
11600	Exc tr-ext mal+marg 0.5 cm/<	T	5071	7.5503	$610.01	.	$122.01			
11601	Exc tr-ext mal+marg 0.6-1 cm	T	5071	7.5503	$610.01	.	$122.01			
11602	Exc tr-ext mal+marg 1.1-2 cm	T	5052	3.9547	$319.51	.	$63.91			
11603	Exc tr-ext mal+marg 2.1-3 cm	T	5071	7.5503	$610.01	.	$122.01			
11604	Exc tr-ext mal+marg 3.1-4 cm	T	5071	7.5503	$610.01	.	$122.01			
11606	Exc tr-ext mal+marg >4 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
1160F	Rvw meds by rx/dr in rcrd	E1								
11620	Exc h-f-nk-sp mal+marg 0.5/<	J1	5072	16.9891	"$1,372.60"	.	$274.52			
11621	Exc s/n/h/f/g mal+mrg 0.6-1	T	5071	7.5503	$610.01	.	$122.01			
11622	Exc s/n/h/f/g mal+mrg 1.1-2	T	5071	7.5503	$610.01	.	$122.01			
11623	Exc s/n/h/f/g mal+mrg 2.1-3	J1	5072	16.9891	"$1,372.60"	.	$274.52			
11624	Exc s/n/h/f/g mal+mrg 3.1-4	J1	5072	16.9891	"$1,372.60"	.	$274.52			
11626	Exc s/n/h/f/g mal+mrg >4 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
11640	Exc f/e/e/n/l mal+mrg 0.5cm<	T	5071	7.5503	$610.01	.	$122.01			
11641	Exc f/e/e/n/l mal+mrg 0.6-1	T	5071	7.5503	$610.01	.	$122.01			
11642	Exc f/e/e/n/l mal+mrg 1.1-2	T	5071	7.5503	$610.01	.	$122.01			
11643	Exc f/e/e/n/l mal+mrg 2.1-3	J1	5072	16.9891	"$1,372.60"	.	$274.52			
11644	Exc f/e/e/n/l mal+mrg 3.1-4	J1	5072	16.9891	"$1,372.60"	.	$274.52			
11646	Exc f/e/e/n/l mal+mrg >4 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
1170F	Fxnl status assessed	M								
11719	Trim nail(s) any number	Q1	5733	0.6809	$55.01	.	$11.01			
11720	Debride nail 1-5	Q1	5733	0.6809	$55.01	.	$11.01			
11721	Debride nail 6 or more	Q1	5733	0.6809	$55.01	.	$11.01			
11730	Removal of nail plate	Q1	5051	2.1627	$174.73	.	$34.95			
11732	Remove nail plate add-on	N								
11740	Drain blood from under nail	Q1	5734	1.3495	$109.03	.	$21.81			
11750	Removal of nail bed	T	5052	3.9547	$319.51	.	$63.91			
11755	Biopsy nail unit	T	5071	7.5503	$610.01	.	$122.01			
1175F	Function stat assessed rvwd	E1								
11760	Repair of nail bed	T	5053	6.1518	$497.02	.	$99.41			
11762	Reconstruction of nail bed	T	5054	20.0852	"$1,622.74"	.	$324.55			
11765	Excision of nail fold toe	Q1	5052	3.9547	$319.51	.	$63.91			
11770	Remove pilonidal cyst simple	J1	5073	28.7016	"$2,318.89"	.	$463.78			
11771	Remove pilonidal cyst exten	J1	5073	28.7016	"$2,318.89"	.	$463.78			
11772	Remove pilonidal cyst compl	J1	5073	28.7016	"$2,318.89"	.	$463.78			
1180F	Thromboemb risk assessed	E1								
1181F	Neuropsychia sympts assessed	E1								
1182F	Neuropsychi sympt 1+present	E1								
1183F	Neuropsychiatric symp absent	E1								
11900	Inject skin lesions </w 7	Q1	5051	2.1627	$174.73	.	$34.95			
11901	Inject skin lesions >7	Q1	5051	2.1627	$174.73	.	$34.95			
11920	Correct skin color 6.0 cm/<	T	5053	6.1518	$497.02	.	$99.41			
11921	Correct skn color 6.1-20.0cm	T	5053	6.1518	$497.02	.	$99.41			
11922	Correct skin color ea 20.0cm	N								
11950	Tx contour defects 1 cc/<	T	5051	2.1627	$174.73	.	$34.95			
11951	Tx contour defects 1.1-5.0cc	T	5053	6.1518	$497.02	.	$99.41			
11952	Tx contour defects 5.1-10cc	T	5053	6.1518	$497.02	.	$99.41			
11954	Tx contour defects >10.0 cc	T	5052	3.9547	$319.51	.	$63.91			
11960	Insert tissue expander(s)	T	5055	36.8508	"$2,977.29"	.	$595.46			
11970	Replace tissue expander	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
11971	Remove tissue expander(s)	Q2	5073	28.7016	"$2,318.89"	.	$463.78			
11976	Remove contraceptive capsule	Q2	5071	7.5503	$610.01	.	$122.01			
11980	Implant hormone pellet(s)	Q1	5735	4.5003	$363.59	.	$72.72			
11981	Insert drug implant device	Q1	5734	1.3495	$109.03	.	$21.81			
11982	Remove drug implant device	Q1	5735	4.5003	$363.59	.	$72.72			
11983	Remove/insert drug implant	Q1	5735	4.5003	$363.59	.	$72.72			
12001	Rpr s/n/ax/gen/trnk 2.5cm/<	Q1	5051	2.1627	$174.73	.	$34.95			
12002	Rpr s/n/ax/gen/trnk2.6-7.5cm	Q1	5051	2.1627	$174.73	.	$34.95			
12004	Rpr s/n/ax/gen/trk7.6-12.5cm	Q1	5051	2.1627	$174.73	.	$34.95			
12005	Rpr s/n/a/gen/trk12.6-20.0cm	Q1	5052	3.9547	$319.51	.	$63.91			
12006	Rpr s/n/a/gen/trk20.1-30.0cm	Q2	5052	3.9547	$319.51	.	$63.91			
12007	Rpr s/n/ax/gen/trnk >30.0 cm	T	5051	2.1627	$174.73	.	$34.95			
1200F	Seizure type& frequ docd	E1								
12011	Rpr f/e/e/n/l/m 2.5 cm/<	Q1	5051	2.1627	$174.73	.	$34.95			
12013	Rpr f/e/e/n/l/m 2.6-5.0 cm	Q1	5051	2.1627	$174.73	.	$34.95			
12014	Rpr f/e/e/n/l/m 5.1-7.5 cm	Q1	5051	2.1627	$174.73	.	$34.95			
12015	Rpr f/e/e/n/l/m 7.6-12.5 cm	Q1	5051	2.1627	$174.73	.	$34.95			
12016	Rpr fe/e/en/l/m 12.6-20.0 cm	Q1	5052	3.9547	$319.51	.	$63.91			
12017	Rpr fe/e/en/l/m 20.1-30.0 cm	Q1	5052	3.9547	$319.51	.	$63.91			
12018	Rpr f/e/e/n/l/m >30.0 cm	Q1	5051	2.1627	$174.73	.	$34.95			
12020	Closure of split wound	T	5053	6.1518	$497.02	.	$99.41			
12021	Closure of split wound	T	5052	3.9547	$319.51	.	$63.91			
12031	Intmd rpr s/a/t/ext 2.5 cm/<	T	5052	3.9547	$319.51	.	$63.91			
12032	Intmd rpr s/a/t/ext 2.6-7.5	T	5052	3.9547	$319.51	.	$63.91			
12034	Intmd rpr s/tr/ext 7.6-12.5	T	5052	3.9547	$319.51	.	$63.91			
12035	Intmd rpr s/a/t/ext 12.6-20	T	5052	3.9547	$319.51	.	$63.91			
12036	Intmd rpr s/a/t/ext 20.1-30	T	5053	6.1518	$497.02	.	$99.41			
12037	Intmd rpr s/tr/ext >30.0 cm	T	5054	20.0852	"$1,622.74"	.	$324.55			
12041	Intmd rpr n-hf/genit 2.5cm/<	Q2	5052	3.9547	$319.51	.	$63.91			
12042	Intmd rpr n-hf/genit2.6-7.5	T	5052	3.9547	$319.51	.	$63.91			
12044	Intmd rpr n-hf/genit7.6-12.5	T	5053	6.1518	$497.02	.	$99.41			
12045	Intmd rpr n-hf/genit12.6-20	T	5053	6.1518	$497.02	.	$99.41			
12046	Intmd rpr n-hf/genit20.1-30	T	5052	3.9547	$319.51	.	$63.91			
12047	Intmd rpr n-hf/genit >30.0cm	T	5054	20.0852	"$1,622.74"	.	$324.55			
12051	Intmd rpr face/mm 2.5 cm/<	T	5052	3.9547	$319.51	.	$63.91			
12052	Intmd rpr face/mm 2.6-5.0 cm	T	5052	3.9547	$319.51	.	$63.91			
12053	Intmd rpr face/mm 5.1-7.5 cm	T	5052	3.9547	$319.51	.	$63.91			
12054	Intmd rpr face/mm 7.6-12.5cm	Q2	5052	3.9547	$319.51	.	$63.91			
12055	Intmd rpr face/mm 12.6-20 cm	T	5052	3.9547	$319.51	.	$63.91			
12056	Intmd rpr face/mm 20.1-30.0	Q2	5052	3.9547	$319.51	.	$63.91			
12057	Intmd rpr face/mm >30.0 cm	T	5052	3.9547	$319.51	.	$63.91			
1205F	Epi etiol synd rvwd and docd	E1								
1220F	Pt screened for depression	E1								
13100	Cmplx rpr trunk 1.1-2.5 cm	T	5053	6.1518	$497.02	.	$99.41			
13101	Cmplx rpr trunk 2.6-7.5 cm	T	5053	6.1518	$497.02	.	$99.41			
13102	Cmplx rpr trunk addl 5cm/<	N								
13120	Cmplx rpr s/a/l 1.1-2.5 cm	T	5053	6.1518	$497.02	.	$99.41			
13121	Cmplx rpr s/a/l 2.6-7.5 cm	T	5053	6.1518	$497.02	.	$99.41			
13122	Cmplx rpr s/a/l addl 5 cm/>	N								
13131	Cmplx rpr f/c/c/m/n/ax/g/h/f	T	5052	3.9547	$319.51	.	$63.91			
13132	Cmplx rpr f/c/c/m/n/ax/g/h/f	T	5053	6.1518	$497.02	.	$99.41			
13133	Cmplx rpr f/c/c/m/n/ax/g/h/f	N								
13151	Cmplx rpr e/n/e/l 1.1-2.5 cm	T	5053	6.1518	$497.02	.	$99.41			
13152	Cmplx rpr e/n/e/l 2.6-7.5 cm	T	5053	6.1518	$497.02	.	$99.41			
13153	Cmplx rpr e/n/e/l addl 5cm/<	N								
13160	Late closure of wound	T	5054	20.0852	"$1,622.74"	.	$324.55			
14000	Tis trnfr trunk 10 sq cm/<	T	5054	20.0852	"$1,622.74"	.	$324.55			
14001	Tis trnfr trunk 10.1-30sqcm	T	5054	20.0852	"$1,622.74"	.	$324.55			
1400F	Prkns diag rviewed	E1								
14020	Tis trnfr s/a/l 10 sq cm/<	T	5054	20.0852	"$1,622.74"	.	$324.55			
14021	Tis trnfr s/a/l 10.1-30 sqcm	T	5054	20.0852	"$1,622.74"	.	$324.55			
14040	Tis trnfr f/c/c/m/n/a/g/h/f	T	5054	20.0852	"$1,622.74"	.	$324.55			
14041	Tis trnfr f/c/c/m/n/a/g/h/f	T	5054	20.0852	"$1,622.74"	.	$324.55			
14060	Tis trnfr e/n/e/l 10 sq cm/<	T	5054	20.0852	"$1,622.74"	.	$324.55			
14061	Tis trnfr e/n/e/l10.1-30sqcm	T	5054	20.0852	"$1,622.74"	.	$324.55			
14301	Tis trnfr any 30.1-60 sq cm	T	5055	36.8508	"$2,977.29"	.	$595.46			
14302	Tis trnfr addl 30 sq cm	N								
14350	Filleted finger/toe flap	T	5054	20.0852	"$1,622.74"	.	$324.55			
1450F	Symptoms improved/consist	E1								
1451F	Sympt show clin import drop	E1								
1460F	Qual card diag prior 12 mons	M								
1461F	No qual card diag prior12mon	M								
1490F	Dem severity classified mild	E1								
1491F	Dem severity classified mod	E1								
1493F	Dem severity class severe	E1								
1494F	Cognit assessed and reviewed	E1								
15002	Wound prep trk/arm/leg	T	5054	20.0852	"$1,622.74"	.	$324.55			
15003	Wound prep addl 100 cm	N								
15004	Wound prep f/n/hf/g	T	5053	6.1518	$497.02	.	$99.41			
15005	Wnd prep f/n/hf/g addl cm	N								
1500F	Symptom+sign symm polyneuro	E1								
1501F	Not initial eval for cond	E1								
1502F	Pt queried pain fxn w/ instr	E1								
1503F	Pt queried symp resp insuff	E1								
15040	Harvest cultured skin graft	T	5054	20.0852	"$1,622.74"	.	$324.55			
1504F	Pt has resp insufficiency	E1								
15050	Skin pinch graft	T	5053	6.1518	$497.02	.	$99.41			
1505F	Pt has no resp insufficiency	E1								
15100	Skin splt grft trnk/arm/leg	T	5054	20.0852	"$1,622.74"	.	$324.55			
15101	Skin splt grft t/a/l add-on	N								
15110	Epidrm autogrft trnk/arm/leg	T	5054	20.0852	"$1,622.74"	.	$324.55			
15111	Epidrm autogrft t/a/l add-on	N								
15115	Epidrm a-grft face/nck/hf/g	T	5054	20.0852	"$1,622.74"	.	$324.55			
15116	Epidrm a-grft f/n/hf/g addl	N								
15120	Skn splt a-grft fac/nck/hf/g	T	5055	36.8508	"$2,977.29"	.	$595.46			
15121	Skn splt a-grft f/n/hf/g add	N								
15130	Derm autograft trnk/arm/leg	T	5054	20.0852	"$1,622.74"	.	$324.55			
15131	Derm autograft t/a/l add-on	N								
15135	Derm autograft face/nck/hf/g	T	5055	36.8508	"$2,977.29"	.	$595.46			
15136	Derm autograft f/n/hf/g add	N								
15150	Cult skin grft t/arm/leg	T	5054	20.0852	"$1,622.74"	.	$324.55			
15151	Cult skin grft t/a/l addl	N								
15152	Cult skin graft t/a/l +%	N								
15155	Cult skin graft f/n/hf/g	T	5055	36.8508	"$2,977.29"	.	$595.46			
15156	Cult skin grft f/n/hfg add	N								
15157	Cult epiderm grft f/n/hfg +%	N								
15200	Skin full graft trunk	T	5054	20.0852	"$1,622.74"	.	$324.55			
15201	Skin full graft trunk add-on	N								
15220	Skin full graft sclp/arm/leg	T	5054	20.0852	"$1,622.74"	.	$324.55			
15221	Skin full graft add-on	N								
15240	Skin full grft face/genit/hf	T	5054	20.0852	"$1,622.74"	.	$324.55			
15241	Skin full graft add-on	N								
15260	Skin full graft een & lips	T	5054	20.0852	"$1,622.74"	.	$324.55			
15261	Skin full graft add-on	N								
15271	Skin sub graft trnk/arm/leg	T	5054	20.0852	"$1,622.74"	.	$324.55			
15272	Skin sub graft t/a/l add-on	N								
15273	Skin sub grft t/arm/lg child	T	5055	36.8508	"$2,977.29"	.	$595.46			
15274	Skn sub grft t/a/l child add	N								
15275	Skin sub graft face/nk/hf/g	T	5054	20.0852	"$1,622.74"	.	$324.55			
15276	Skin sub graft f/n/hf/g addl	N								
15277	Skn sub grft f/n/hf/g child	T	5054	20.0852	"$1,622.74"	.	$324.55			
15278	Skn sub grft f/n/hf/g ch add	N								
15570	Skin pedicle flap trunk	T	5054	20.0852	"$1,622.74"	.	$324.55			
15572	Skin pedicle flap arms/legs	T	5055	36.8508	"$2,977.29"	.	$595.46			
15574	Pedcle fh/ch/ch/m/n/ax/g/h/f	T	5054	20.0852	"$1,622.74"	.	$324.55			
15576	Pedicle e/n/e/l/ntroral	T	5054	20.0852	"$1,622.74"	.	$324.55			
15600	Delay flap trunk	T	5055	36.8508	"$2,977.29"	.	$595.46			
15610	Delay flap arms/legs	T	5054	20.0852	"$1,622.74"	.	$324.55			
15620	Delay flap f/c/c/n/ax/g/h/f	T	5054	20.0852	"$1,622.74"	.	$324.55			
15630	Delay flap eye/nos/ear/lip	T	5054	20.0852	"$1,622.74"	.	$324.55			
15650	Transfer skin pedicle flap	T	5054	20.0852	"$1,622.74"	.	$324.55			
15730	Mdfc flap w/prsrv vasc pedcl	T	5055	36.8508	"$2,977.29"	.	$595.46			
15731	Forehead flap w/vasc pedicle	T	5055	36.8508	"$2,977.29"	.	$595.46			
15733	Musc myoq/fscq flp h&n pedcl	T	5055	36.8508	"$2,977.29"	.	$595.46			
15734	Muscle-skin graft trunk	T	5055	36.8508	"$2,977.29"	.	$595.46			
15736	Muscle-skin graft arm	T	5054	20.0852	"$1,622.74"	.	$324.55			
15738	Muscle-skin graft leg	T	5055	36.8508	"$2,977.29"	.	$595.46			
15740	Island pedicle flap graft	T	5054	20.0852	"$1,622.74"	.	$324.55			
15750	Neurovascular pedicle flap	T	5055	36.8508	"$2,977.29"	.	$595.46			
15756	Free myo/skin flap microvasc	C								
15757	Free skin flap microvasc	C								
15758	Free fascial flap microvasc	C								
15760	Composite skin graft	T	5054	20.0852	"$1,622.74"	.	$324.55			
15769	Grfg autol soft tiss dir exc	T	5055	36.8508	"$2,977.29"	.	$595.46			
15770	Derma-fat-fascia graft	T	5055	36.8508	"$2,977.29"	.	$595.46			
15771	Grfg autol fat lipo 50 cc/<	T	5055	36.8508	"$2,977.29"	.	$595.46			
15772	Grfg autol fat lipo ea addl	N								
15773	Grfg autol fat lipo 25 cc/<	T	5054	20.0852	"$1,622.74"	.	$324.55			
15774	Gfrg autol fat lipo ea addl	N								
15775	Hair trnspl 1-15 punch grfts	T	5052	3.9547	$319.51	.	$63.91			
15776	Hair trnspl >15 punch grafts	T	5052	3.9547	$319.51	.	$63.91			
15777	Acellular derm matrix implt	N								
15780	Dermabrasion total face	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15781	Dermabrasion segmental face	T	5071	7.5503	$610.01	.	$122.01			
15782	Dermabrasion other than face	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15783	Dermabrasion suprfl any site	T	5052	3.9547	$319.51	.	$63.91			
15786	Abrasion lesion single	Q1	5051	2.1627	$174.73	.	$34.95			
15787	Abrasion lesions add-on	N								
15788	Chemical peel face epiderm	Q1	5051	2.1627	$174.73	.	$34.95			
15789	Chemical peel face dermal	T	5053	6.1518	$497.02	.	$99.41			
15792	Chemical peel nonfacial	Q1	5052	3.9547	$319.51	.	$63.91			
15793	Chemical peel nonfacial	Q1	5052	3.9547	$319.51	.	$63.91			
15819	Plastic surgery neck	T	5054	20.0852	"$1,622.74"	.	$324.55			
15820	Revision of lower eyelid	T	5054	20.0852	"$1,622.74"	.	$324.55			
15821	Revision of lower eyelid	T	5054	20.0852	"$1,622.74"	.	$324.55			
15822	Revision of upper eyelid	T	5054	20.0852	"$1,622.74"	.	$324.55			
15823	Revision of upper eyelid	T	5054	20.0852	"$1,622.74"	.	$324.55			
15824	Removal of forehead wrinkles	T	5054	20.0852	"$1,622.74"	.	$324.55			
15825	Removal of neck wrinkles	T	5055	36.8508	"$2,977.29"	.	$595.46			
15826	Removal of brow wrinkles	T	5055	36.8508	"$2,977.29"	.	$595.46			
15828	Removal of face wrinkles	T	5055	36.8508	"$2,977.29"	.	$595.46			
15829	Removal of skin wrinkles	T	5055	36.8508	"$2,977.29"	.	$595.46			
15830	Exc skin abd	J1	5092	64.8236	"$5,237.29"	.	"$1,047.46"			
15832	Excise excessive skin thigh	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15833	Excise excessive skin leg	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15834	Excise excessive skin hip	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15835	Excise excessive skin buttck	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15836	Excise excessive skin arm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15837	Excise excess skin arm/hand	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15838	Excise excess skin fat pad	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15839	Excise excess skin & tissue	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15840	Nerve palsy fascial graft	T	5055	36.8508	"$2,977.29"	.	$595.46			
15841	Nerve palsy muscle graft	T	5055	36.8508	"$2,977.29"	.	$595.46			
15842	Nerve palsy microsurg graft	T	5054	20.0852	"$1,622.74"	.	$324.55			
15845	Skin and muscle repair face	T	5055	36.8508	"$2,977.29"	.	$595.46			
15847	Exc skin abd add-on	N								
15850	Remove sutures same surgeon	T	5053	6.1518	$497.02	.	$99.41			
15851	Remove sutures diff surgeon	T	5054	20.0852	"$1,622.74"	.	$324.55			
15852	Dressing change not for burn	Q1	5053	6.1518	$497.02	.	$99.41			
15860	Test for blood flow in graft	Q1	5735	4.5003	$363.59	.	$72.72			
15876	Suction lipectomy head&neck	T	5055	36.8508	"$2,977.29"	.	$595.46			
15877	Suction lipectomy trunk	T	5055	36.8508	"$2,977.29"	.	$595.46			
15878	Suction lipectomy upr extrem	T	5054	20.0852	"$1,622.74"	.	$324.55			
15879	Suction lipectomy lwr extrem	T	5055	36.8508	"$2,977.29"	.	$595.46			
15920	Removal of tail bone ulcer	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15922	Removal of tail bone ulcer	T	5055	36.8508	"$2,977.29"	.	$595.46			
15931	Remove sacrum pressure sore	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15933	Remove sacrum pressure sore	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15934	Remove sacrum pressure sore	T	5055	36.8508	"$2,977.29"	.	$595.46			
15935	Remove sacrum pressure sore	T	5055	36.8508	"$2,977.29"	.	$595.46			
15936	Remove sacrum pressure sore	T	5054	20.0852	"$1,622.74"	.	$324.55			
15937	Remove sacrum pressure sore	T	5054	20.0852	"$1,622.74"	.	$324.55			
15940	Remove hip pressure sore	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15941	Remove hip pressure sore	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15944	Remove hip pressure sore	T	5055	36.8508	"$2,977.29"	.	$595.46			
15945	Remove hip pressure sore	T	5054	20.0852	"$1,622.74"	.	$324.55			
15946	Remove hip pressure sore	T	5054	20.0852	"$1,622.74"	.	$324.55			
15950	Remove thigh pressure sore	J1	5072	16.9891	"$1,372.60"	.	$274.52			
15951	Remove thigh pressure sore	J1	5073	28.7016	"$2,318.89"	.	$463.78			
15952	Remove thigh pressure sore	T	5054	20.0852	"$1,622.74"	.	$324.55			
15953	Remove thigh pressure sore	T	5055	36.8508	"$2,977.29"	.	$595.46			
15956	Remove thigh pressure sore	T	5054	20.0852	"$1,622.74"	.	$324.55			
15958	Remove thigh pressure sore	T	5055	36.8508	"$2,977.29"	.	$595.46			
15999	Removal of pressure sore	T	5071	7.5503	$610.01	.	$122.01			
16000	Initial treatment of burn(s)	Q1	5051	2.1627	$174.73	.	$34.95			
16020	Dress/debrid p-thick burn s	Q1	5051	2.1627	$174.73	.	$34.95			
16025	Dress/debrid p-thick burn m	T	5051	2.1627	$174.73	.	$34.95			
16030	Dress/debrid p-thick burn l	T	5052	3.9547	$319.51	.	$63.91			
16035	Incision of burn scab initi	T	5052	3.9547	$319.51	.	$63.91			
16036	Escharotomy addl incision	C								
17000	Destruct premalg lesion	Q1	5051	2.1627	$174.73	.	$34.95			
17003	Destruct premalg les 2-14	N								
17004	Destroy premal lesions 15/>	T	5052	3.9547	$319.51	.	$63.91			
17106	Destruction of skin lesions	T	5052	3.9547	$319.51	.	$63.91			
17107	Destruction of skin lesions	T	5053	6.1518	$497.02	.	$99.41			
17108	Destruction of skin lesions	T	5054	20.0852	"$1,622.74"	.	$324.55			
17110	Destruct b9 lesion 1-14	Q1	5051	2.1627	$174.73	.	$34.95			
17111	Destruct lesion 15 or more	Q1	5051	2.1627	$174.73	.	$34.95			
17250	Chem caut of granltj tissue	Q1	5051	2.1627	$174.73	.	$34.95			
17260	Destruction of skin lesions	Q1	5051	2.1627	$174.73	.	$34.95			
17261	Destruction of skin lesions	Q1	5051	2.1627	$174.73	.	$34.95			
17262	Destruction of skin lesions	Q1	5051	2.1627	$174.73	.	$34.95			
17263	Destruction of skin lesions	Q1	5051	2.1627	$174.73	.	$34.95			
17264	Destruction of skin lesions	T	5052	3.9547	$319.51	.	$63.91			
17266	Destruction of skin lesions	T	5052	3.9547	$319.51	.	$63.91			
17270	Destruction of skin lesions	T	5051	2.1627	$174.73	.	$34.95			
17271	Destruction of skin lesions	T	5051	2.1627	$174.73	.	$34.95			
17272	Destruction of skin lesions	Q1	5051	2.1627	$174.73	.	$34.95			
17273	Destruction of skin lesions	T	5052	3.9547	$319.51	.	$63.91			
17274	Destruction of skin lesions	T	5052	3.9547	$319.51	.	$63.91			
17276	Destruction of skin lesions	T	5052	3.9547	$319.51	.	$63.91			
17280	Destruction of skin lesions	Q1	5051	2.1627	$174.73	.	$34.95			
17281	Destruction of skin lesions	T	5052	3.9547	$319.51	.	$63.91			
17282	Destruction of skin lesions	T	5052	3.9547	$319.51	.	$63.91			
17283	Destruction of skin lesions	T	5052	3.9547	$319.51	.	$63.91			
17284	Destruction of skin lesions	T	5053	6.1518	$497.02	.	$99.41			
17286	Destruction of skin lesions	T	5053	6.1518	$497.02	.	$99.41			
17311	Mohs 1 stage h/n/hf/g	T	5053	6.1518	$497.02	.	$99.41			
17312	Mohs addl stage	N								
17313	Mohs 1 stage t/a/l	T	5053	6.1518	$497.02	.	$99.41			
17314	Mohs addl stage t/a/l	N								
17315	Mohs surg addl block	N								
17340	Cryotherapy of skin	Q1	5732	0.4138	$33.43	.	$6.69			
17360	Skin peel therapy	Q1	5051	2.1627	$174.73	.	$34.95			
17380	Hair removal by electrolysis	T	5053	6.1518	$497.02	.	$99.41			
17999	Skin tissue procedure	Q1	5051	2.1627	$174.73	.	$34.95			
19000	Drainage of breast lesion	T	5071	7.5503	$610.01	.	$122.01			
19001	Drain breast lesion add-on	N								
19020	Incision of breast lesion	J1	5072	16.9891	"$1,372.60"	.	$274.52			
19030	Injection for breast x-ray	N								
19081	Bx breast 1st lesion strtctc	J1	5072	16.9891	"$1,372.60"	.	$274.52			
19082	Bx breast add lesion strtctc	N								
19083	Bx breast 1st lesion us imag	J1	5072	16.9891	"$1,372.60"	.	$274.52			
19084	Bx breast add lesion us imag	N								
19085	Bx breast 1st lesion mr imag	J1	5072	16.9891	"$1,372.60"	.	$274.52			
19086	Bx breast add lesion mr imag	N								
19100	Bx breast percut w/o image	J1	5072	16.9891	"$1,372.60"	.	$274.52			
19101	Biopsy of breast open	J1	5091	37.4977	"$3,029.55"	.	$605.91			
19105	Cryosurg ablate fa each	J1	5091	37.4977	"$3,029.55"	.	$605.91			
19110	Nipple exploration	J1	5091	37.4977	"$3,029.55"	.	$605.91			
19112	Excise breast duct fistula	J1	5091	37.4977	"$3,029.55"	.	$605.91			
19120	Removal of breast lesion	J1	5091	37.4977	"$3,029.55"	.	$605.91			
19125	Excision breast lesion	J1	5091	37.4977	"$3,029.55"	.	$605.91			
19126	Excision addl breast lesion	N								
19281	Perq device breast 1st imag	Q1	5071	7.5503	$610.01	.	$122.01			
19282	Perq device breast ea imag	N								
19283	Perq dev breast 1st strtctc	Q1	5071	7.5503	$610.01	.	$122.01			
19284	Perq dev breast add strtctc	N								
19285	Perq dev breast 1st us imag	Q1	5071	7.5503	$610.01	.	$122.01			
19286	Perq dev breast add us imag	N								
19287	Perq dev breast 1st mr guide	Q1	5071	7.5503	$610.01	.	$122.01			
19288	Perq dev breast add mr guide	N								
19294	Prep tum cav iort prtl mast	N								
19296	Place po breast cath for rad	J1	5093	100.6964	"$8,135.56"	.	"$1,627.12"	*		
19297	Place breast cath for rad	N								
19298	Place breast rad tube/caths	J1	5092	64.8236	"$5,237.29"	.	"$1,047.46"			
19300	Removal of breast tissue	J1	5091	37.4977	"$3,029.55"	.	$605.91			
19301	Partial mastectomy	J1	5091	37.4977	"$3,029.55"	.	$605.91			
19302	P-mastectomy w/ln removal	J1	5092	64.8236	"$5,237.29"	.	"$1,047.46"			
19303	Mast simple complete	J1	5092	64.8236	"$5,237.29"	.	"$1,047.46"			
19305	Mast radical	C								
19306	Mast rad urban type	C								
19307	Mast mod rad	J1	5092	64.8236	"$5,237.29"	.	"$1,047.46"			
19316	Suspension of breast	J1	5092	64.8236	"$5,237.29"	.	"$1,047.46"			
19318	Reduction of large breast	J1	5092	64.8236	"$5,237.29"	.	"$1,047.46"			
19324	Enlarge breast	J1	5093	100.6964	"$8,135.56"	.	"$1,627.12"	*		
19325	Enlarge breast with implant	J1	5093	100.6964	"$8,135.56"	.	"$1,627.12"	*		
19328	Removal of breast implant	Q2	5091	37.4977	"$3,029.55"	.	$605.91			
19330	Removal of implant material	Q2	5091	37.4977	"$3,029.55"	.	$605.91			
19340	Immediate breast prosthesis	J1	5092	64.8236	"$5,237.29"	.	"$1,047.46"			
19342	Delayed breast prosthesis	J1	5093	100.6964	"$8,135.56"	.	"$1,627.12"	*		
19350	Breast reconstruction	J1	5091	37.4977	"$3,029.55"	.	$605.91			
19355	Correct inverted nipple(s)	J1	5091	37.4977	"$3,029.55"	.	$605.91			
19357	Breast reconstruction	J1	5094	171.4670	"$13,853.33"	.	"$2,770.67"	*		
19361	Breast reconstr w/lat flap	C								
19364	Breast reconstruction	C								
19366	Breast reconstruction	J1	5092	64.8236	"$5,237.29"	.	"$1,047.46"			
19367	Breast reconstruction	C								
19368	Breast reconstruction	C								
19369	Breast reconstruction	C								
19370	Surgery of breast capsule	J1	5091	37.4977	"$3,029.55"	.	$605.91			
19371	Removal of breast capsule	J1	5091	37.4977	"$3,029.55"	.	$605.91			
19380	Revise breast reconstruction	J1	5092	64.8236	"$5,237.29"	.	"$1,047.46"			
19396	Design custom breast implant	J1	5091	37.4977	"$3,029.55"	.	$605.91			
19499	Breast surgery procedure	J1	5091	37.4977	"$3,029.55"	.	$605.91			
2000F	Blood pressure measure	M								
2001F	Weight record	E1								
2002F	Clin sign vol ovrld assess	E1								
2004F	Initial exam involved joints	E1								
20100	Explore wound neck	T	5162	5.4673	$441.72	.	$88.35			
20101	Explore wound chest	T	5054	20.0852	"$1,622.74"	.	$324.55			
20102	Explore wound abdomen	T	5054	20.0852	"$1,622.74"	.	$324.55			
20103	Explore wound extremity	T	5071	7.5503	$610.01	.	$122.01			
2010F	Vital signs recorded	E1								
2014F	Mental status assess	E1								
20150	Excise epiphyseal bar	J1	5113	33.8823	"$2,737.45"	.	$547.49			
2015F	Asthma impairment assessed	E1								
2016F	Asthma risk assessed	E1								
2018F	Hydration status assess	E1								
2019F	Dilated macul exam done	E1								
20200	Muscle biopsy	J1	5072	16.9891	"$1,372.60"	.	$274.52			
20205	Deep muscle biopsy	J1	5073	28.7016	"$2,318.89"	.	$463.78			
20206	Needle biopsy muscle	J1	5072	16.9891	"$1,372.60"	.	$274.52			
2020F	Dilated fundus eval done	E1								
2021F	Dilat macular exam done	E1								
20220	Bone biopsy trocar/needle	J1	5072	16.9891	"$1,372.60"	.	$274.52			
20225	Bone biopsy trocar/needle	J1	5072	16.9891	"$1,372.60"	.	$274.52			
2022F	Dilat rta xm evc rtnopthy	M								
2023F	Dilat rta xm w/o rtnopthy	E1								
20240	Bone biopsy open superficial	J1	5073	28.7016	"$2,318.89"	.	$463.78			
20245	Bone biopsy open deep	J1	5073	28.7016	"$2,318.89"	.	$463.78			
2024F	7 fld rta photo evc rtnopthy	M								
20250	Open bone biopsy	J1	5113	33.8823	"$2,737.45"	.	$547.49			
20251	Open bone biopsy	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
2025F	7 fld rta photo w/o rtnopthy	E1								
2026F	Eye img valid evc rtnopthy	M								
2027F	Optic nerve head eval done	M								
2028F	Foot exam performed	E1								
2029F	Complete phys skin exam done	E1								
2030F	H2o stat docd normal	E1								
2031F	H2o stat docd dehydrated	E1								
2033F	Eye img valid w/o rtnopthy	E1								
2035F	Tymp memb motion examd	E1								
2040F	Bk pn xm on init visit date	E1								
2044F	Doc mntl tst b/4 bk trxmnt	E1								
20500	Injection of sinus tract	J1	5163	16.7012	"$1,349.34"	.	$269.87			
20501	Inject sinus tract for x-ray	N								
2050F	Wound char size etc docd	E1								
20520	Removal of foreign body	J1	5072	16.9891	"$1,372.60"	.	$274.52			
20525	Removal of foreign body	J1	5073	28.7016	"$2,318.89"	.	$463.78			
20526	Ther injection carp tunnel	T	5441	3.2400	$261.77	.	$52.36			
20527	Inj dupuytren cord w/enzyme	T	5441	3.2400	$261.77	.	$52.36			
20550	Inj tendon sheath/ligament	T	5441	3.2400	$261.77	.	$52.36			
20551	Inj tendon origin/insertion	T	5441	3.2400	$261.77	.	$52.36			
20552	Inj trigger point 1/2 muscl	T	5441	3.2400	$261.77	.	$52.36			
20553	Inject trigger points 3/>	T	5441	3.2400	$261.77	.	$52.36			
20555	Place ndl musc/tis for rt	J1	5113	33.8823	"$2,737.45"	.	$547.49			
20560	Ndl insj w/o njx 1 or 2 musc	S	5731	0.2845	$22.99	.	$4.60			
20561	Ndl insj w/o njx 3+ musc	S	5731	0.2845	$22.99	.	$4.60			
20600	Drain/inj joint/bursa w/o us	T	5441	3.2400	$261.77	.	$52.36			
20604	Drain/inj joint/bursa w/us	T	5441	3.2400	$261.77	.	$52.36			
20605	Drain/inj joint/bursa w/o us	T	5441	3.2400	$261.77	.	$52.36			
20606	Drain/inj joint/bursa w/us	T	5442	7.7364	$625.05	.	$125.01			
2060F	Pt talk eval hlthwkr re mdd	E1								
20610	Drain/inj joint/bursa w/o us	T	5441	3.2400	$261.77	.	$52.36			
20611	Drain/inj joint/bursa w/us	T	5441	3.2400	$261.77	.	$52.36			
20612	Aspirate/inj ganglion cyst	T	5441	3.2400	$261.77	.	$52.36			
20615	Treatment of bone cyst	T	5071	7.5503	$610.01	.	$122.01			
20650	Insert and remove bone pin	J1	5113	33.8823	"$2,737.45"	.	$547.49			
20660	Apply rem fixation device	Q2	5112	16.7761	"$1,355.39"	.	$271.08			
20661	Application of head brace	C								
20662	Application of pelvis brace	J1	5112	16.7761	"$1,355.39"	.	$271.08			
20663	Application of thigh brace	J1	5113	33.8823	"$2,737.45"	.	$547.49			
20664	Application of halo	C								
20665	Removal of fixation device	Q1	5735	4.5003	$363.59	.	$72.72			
20670	Removal of support implant	Q2	5072	16.9891	"$1,372.60"	.	$274.52			
20680	Removal of support implant	Q2	5073	28.7016	"$2,318.89"	.	$463.78			
20690	Apply bone fixation device	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
20692	Apply bone fixation device	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
20693	Adjust bone fixation device	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
20694	Remove bone fixation device	Q2	5112	16.7761	"$1,355.39"	.	$271.08			
20696	Comp multiplane ext fixation	J1	5116	197.3696	"$15,946.08"	.	"$3,189.22"	*		
20697	Comp ext fixate strut change	J1	5112	16.7761	"$1,355.39"	.	$271.08			
20700	Mnl prep&insj dp rx dlvr dev	N								
20701	Rmvl deep rx delivery device	N								
20702	Mnl prep&insj imed rx dev	N								
20703	Rmvl imed rx delivery device	N								
20704	Mnl prep&insj i-artic rx dev	N								
20705	Rmvl i-artic rx delivery dev	N								
20802	Replantation arm complete	C								
20805	Replant forearm complete	C								
20808	Replantation hand complete	C								
20816	Replantation digit complete	C								
20822	Replantation digit complete	J1	5112	16.7761	"$1,355.39"	.	$271.08			
20824	Replantation thumb complete	C								
20827	Replantation thumb complete	C								
20838	Replantation foot complete	C								
20900	Removal of bone for graft	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
20902	Removal of bone for graft	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
20910	Remove cartilage for graft	T	5053	6.1518	$497.02	.	$99.41			
20912	Remove cartilage for graft	T	5055	36.8508	"$2,977.29"	.	$595.46			
20920	Removal of fascia for graft	T	5054	20.0852	"$1,622.74"	.	$324.55			
20922	Removal of fascia for graft	T	5054	20.0852	"$1,622.74"	.	$324.55			
20924	Removal of tendon for graft	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
20930	Sp bone algrft morsel add-on	N								
20931	Sp bone algrft struct add-on	N								
20932	Osteoart algrft w/surf & b1	N								
20933	Hemicrt intrclry algrft prtl	N								
20934	Intercalary algrft compl	N								
20936	Sp bone agrft local add-on	N								
20937	Sp bone agrft morsel add-on	N								
20938	Sp bone agrft struct add-on	N								
20939	Bone marrow aspir bone grfg	N								
20950	Fluid pressure muscle	T	5071	7.5503	$610.01	.	$122.01			
20955	Fibula bone graft microvasc	C								
20956	Iliac bone graft microvasc	C								
20957	Mt bone graft microvasc	C								
20962	Other bone graft microvasc	C								
20969	Bone/skin graft microvasc	C								
20970	Bone/skin graft iliac crest	C								
20972	Bone/skin graft metatarsal	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
20973	Bone/skin graft great toe	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
20974	Electrical bone stimulation	A								
20975	Electrical bone stimulation	N								
20979	Us bone stimulation	Q1	5731	0.2845	$22.99	.	$4.60			
20982	Ablate bone tumor(s) perq	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
20983	Ablate bone tumor(s) perq	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
20985	Cptr-asst dir ms px	N								
20999	Musculoskeletal surgery	T	5111	2.6691	$215.64	.	$43.13			
21010	Incision of jaw joint	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21011	Exc face les sc <2 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
21012	Exc face les sbq 2 cm/>	J1	5072	16.9891	"$1,372.60"	.	$274.52			
21013	Exc face tum deep < 2 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
21014	Exc face tum deep 2 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
21015	Resect face/scalp tum < 2 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
21016	Resect face/scalp tum 2 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
21025	Excision of bone lower jaw	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21026	Excision of facial bone(s)	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21029	Contour of face bone lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21030	Excise max/zygoma b9 tumor	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21031	Remove exostosis mandible	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21032	Remove exostosis maxilla	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21034	Excise max/zygoma mal tumor	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21040	Excise mandible lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21044	Removal of jaw bone lesion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21045	Extensive jaw surgery	C								
21046	Remove mandible cyst complex	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21047	Excise lwr jaw cyst w/repair	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21048	Remove maxilla cyst complex	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21049	Excis uppr jaw cyst w/repair	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21050	Removal of jaw joint	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21060	Remove jaw joint cartilage	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21070	Remove coronoid process	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21073	Mnpj of tmj w/anesth	J1	5163	16.7012	"$1,349.34"	.	$269.87			
21076	Prepare face/oral prosthesis	J1	5163	16.7012	"$1,349.34"	.	$269.87			
21077	Prepare face/oral prosthesis	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21079	Prepare face/oral prosthesis	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21080	Prepare face/oral prosthesis	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21081	Prepare face/oral prosthesis	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21082	Prepare face/oral prosthesis	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21083	Prepare face/oral prosthesis	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21084	Prepare face/oral prosthesis	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21085	Prepare face/oral prosthesis	T	5161	2.5205	$203.64	.	$40.73			
21086	Prepare face/oral prosthesis	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21087	Prepare face/oral prosthesis	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21088	Prepare face/oral prosthesis	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21089	Prepare face/oral prosthesis	T	5161	2.5205	$203.64	.	$40.73			
21100	Maxillofacial fixation	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21110	Interdental fixation	Q2	5163	16.7012	"$1,349.34"	.	$269.87			
21116	Injection jaw joint x-ray	N								
21120	Reconstruction of chin	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21121	Reconstruction of chin	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21122	Reconstruction of chin	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21123	Reconstruction of chin	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21125	Augmentation lower jaw bone	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21127	Augmentation lower jaw bone	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21137	Reduction of forehead	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21138	Reduction of forehead	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21139	Reduction of forehead	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21141	Lefort i-1 piece w/o graft	C								
21142	Lefort i-2 piece w/o graft	C								
21143	Lefort i-3/> piece w/o graft	C								
21145	Lefort i-1 piece w/ graft	C								
21146	Lefort i-2 piece w/ graft	C								
21147	Lefort i-3/> piece w/ graft	C								
21150	Lefort ii anterior intrusion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21151	Lefort ii w/bone grafts	C								
21154	Lefort iii w/o lefort i	C								
21155	Lefort iii w/ lefort i	C								
21159	Lefort iii w/fhdw/o lefort i	C								
21160	Lefort iii w/fhd w/ lefort i	C								
21172	Reconstruct orbit/forehead	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21175	Reconstruct orbit/forehead	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21179	Reconstruct entire forehead	C								
21180	Reconstruct entire forehead	C								
21181	Contour cranial bone lesion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21182	Reconstruct cranial bone	C								
21183	Reconstruct cranial bone	C								
21184	Reconstruct cranial bone	C								
21188	Reconstruction of midface	C								
21193	Reconst lwr jaw w/o graft	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21194	Reconst lwr jaw w/graft	C								
21195	Reconst lwr jaw w/o fixation	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21196	Reconst lwr jaw w/fixation	C								
21198	Reconstr lwr jaw segment	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21199	Reconstr lwr jaw w/advance	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21206	Reconstruct upper jaw bone	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21208	Augmentation of facial bones	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21209	Reduction of facial bones	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21210	Face bone graft	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21215	Lower jaw bone graft	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21230	Rib cartilage graft	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21235	Ear cartilage graft	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21240	Reconstruction of jaw joint	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21242	Reconstruction of jaw joint	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21243	Reconstruction of jaw joint	J1	5116	197.3696	"$15,946.08"	.	"$3,189.22"	*		
21244	Reconstruction of lower jaw	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21245	Reconstruction of jaw	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21246	Reconstruction of jaw	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21247	Reconstruct lower jaw bone	C								
21248	Reconstruction of jaw	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21249	Reconstruction of jaw	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21255	Reconstruct lower jaw bone	C								
21256	Reconstruction of orbit	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21260	Revise eye sockets	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21261	Revise eye sockets	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21263	Revise eye sockets	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21267	Revise eye sockets	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21268	Revise eye sockets	C								
21270	Augmentation cheek bone	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21275	Revision orbitofacial bones	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21280	Revision of eyelid	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21282	Revision of eyelid	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21295	Revision of jaw muscle/bone	J1	5163	16.7012	"$1,349.34"	.	$269.87			
21296	Revision of jaw muscle/bone	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21299	Cranio/maxillofacial surgery	T	5161	2.5205	$203.64	.	$40.73			
21310	Closed tx nose fx w/o manj	T	5111	2.6691	$215.64	.	$43.13			
21315	Closed tx nose fx w/o stablj	J1	5163	16.7012	"$1,349.34"	.	$269.87			
21320	Closed tx nose fx w/ stablj	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21325	Open tx nose fx uncomplicatd	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21330	Open tx nose fx w/skele fixj	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21335	Open tx nose & septal fx	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21336	Open tx septal fx w/wo stabj	J1	5113	33.8823	"$2,737.45"	.	$547.49			
21337	Closed tx septal&nose fx	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21338	Open nasoethmoid fx w/o fixj	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21339	Open nasoethmoid fx w/ fixj	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21340	Perq tx nasoethmoid fx	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21343	Open tx dprsd front sinus fx	C								
21344	Open tx compl front sinus fx	C								
21345	Closed tx nose/jaw fx	J1	5163	16.7012	"$1,349.34"	.	$269.87			
21346	Opn tx nasomax fx w/fixj	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21347	Opn tx nasomax fx multple	C								
21348	Opn tx nasomax fx w/graft	C								
21355	Perq tx malar fracture	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21356	Opn tx dprsd zygomatic arch	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21360	Opn tx dprsd malar fracture	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21365	Opn tx complx malar fx	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21366	Opn tx complx malar w/grft	C								
21385	Opn tx orbit fx transantral	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21386	Opn tx orbit fx periorbital	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21387	Opn tx orbit fx combined	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21390	Opn tx orbit periorbtl implt	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21395	Opn tx orbit periorbt w/grft	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21400	Closed tx orbit w/o manipulj	T	5162	5.4673	$441.72	.	$88.35			
21401	Closed tx orbit w/manipulj	J1	5163	16.7012	"$1,349.34"	.	$269.87			
21406	Opn tx orbit fx w/o implant	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21407	Opn tx orbit fx w/implant	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21408	Opn tx orbit fx w/bone grft	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21421	Treat mouth roof fracture	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21422	Treat mouth roof fracture	C								
21423	Treat mouth roof fracture	C								
21431	Treat craniofacial fracture	C								
21432	Treat craniofacial fracture	C								
21433	Treat craniofacial fracture	C								
21435	Treat craniofacial fracture	C								
21436	Treat craniofacial fracture	C								
21440	Treat dental ridge fracture	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21445	Treat dental ridge fracture	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21450	Treat lower jaw fracture	T	5162	5.4673	$441.72	.	$88.35			
21451	Treat lower jaw fracture	J1	5163	16.7012	"$1,349.34"	.	$269.87			
21452	Treat lower jaw fracture	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21453	Treat lower jaw fracture	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21454	Treat lower jaw fracture	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21461	Treat lower jaw fracture	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21462	Treat lower jaw fracture	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21465	Treat lower jaw fracture	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21470	Treat lower jaw fracture	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21480	Reset dislocated jaw	T	5111	2.6691	$215.64	.	$43.13			
21485	Reset dislocated jaw	J1	5163	16.7012	"$1,349.34"	.	$269.87			
21490	Repair dislocated jaw	J1	5164	32.4198	"$2,619.29"	.	$523.86			
21497	Interdental wiring	J1	5163	16.7012	"$1,349.34"	.	$269.87			
21499	Head surgery procedure	T	5161	2.5205	$203.64	.	$40.73			
21501	Drain neck/chest lesion	J1	5073	28.7016	"$2,318.89"	.	$463.78			
21502	Drain chest lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
21510	Drainage of bone lesion	C								
21550	Biopsy of neck/chest	J1	5072	16.9891	"$1,372.60"	.	$274.52			
21552	Exc neck les sc 3 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
21554	Exc neck tum deep 5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
21555	Exc neck les sc < 3 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
21556	Exc neck tum deep < 5 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
21557	Resect neck thorax tumor<5cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
21558	Resect neck tumor 5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
21600	Partial removal of rib	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
21601	Exc chest wall tumor w/ribs	J1	5073	28.7016	"$2,318.89"	.	$463.78			
21602	Exc ch wal tum w/o lymphadec	C								
21603	Exc ch wal tum w/lymphadec	C								
21610	Partial removal of rib	J1	5113	33.8823	"$2,737.45"	.	$547.49			
21615	Removal of rib	C								
21616	Removal of rib and nerves	C								
21620	Partial removal of sternum	C								
21627	Sternal debridement	C								
21630	Extensive sternum surgery	C								
21632	Extensive sternum surgery	C								
21685	Hyoid myotomy & suspension	J1	5165	60.0365	"$4,850.53"	.	$970.11			
21700	Revision of neck muscle	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
21705	Revision of neck muscle/rib	C								
21720	Revision of neck muscle	J1	5113	33.8823	"$2,737.45"	.	$547.49			
21725	Revision of neck muscle	T	5071	7.5503	$610.01	.	$122.01			
21740	Reconstruction of sternum	C								
21742	Repair stern/nuss w/o scope	J1	5113	33.8823	"$2,737.45"	.	$547.49			
21743	Repair sternum/nuss w/scope	J1	5113	33.8823	"$2,737.45"	.	$547.49			
21750	Repair of sternum separation	C								
21811	Optx of rib fx w/fixj scope	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
21812	Treatment of rib fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
21813	Treatment of rib fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
21820	Treat sternum fracture	T	5111	2.6691	$215.64	.	$43.13			
21825	Treat sternum fracture	C								
21899	Neck/chest surgery procedure	T	5161	2.5205	$203.64	.	$40.73			
21920	Biopsy soft tissue of back	J1	5072	16.9891	"$1,372.60"	.	$274.52			
21925	Biopsy soft tissue of back	J1	5072	16.9891	"$1,372.60"	.	$274.52			
21930	Exc back les sc < 3 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
21931	Exc back les sc 3 cm/>	J1	5072	16.9891	"$1,372.60"	.	$274.52			
21932	Exc back tum deep < 5 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
21933	Exc back tum deep 5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
21935	Resect back tum < 5 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
21936	Resect back tum 5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
22010	I&d p-spine c/t/cerv-thor	C								
22015	I&d abscess p-spine l/s/ls	C								
22100	Remove part of neck vertebra	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
22101	Remove part thorax vertebra	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
22102	Remove part lumbar vertebra	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
22103	Remove extra spine segment	N								
22110	Remove part of neck vertebra	C								
22112	Remove part thorax vertebra	C								
22114	Remove part lumbar vertebra	C								
22116	Remove extra spine segment	C								
22206	Incis spine 3 column thorac	C								
22207	Incis spine 3 column lumbar	C								
22208	Incis spine 3 column adl seg	C								
22210	Incis 1 vertebral seg cerv	C								
22212	Incis 1 vertebral seg thorac	C								
22214	Incis 1 vertebral seg lumbar	C								
22216	Incis addl spine segment	C								
22220	Incis w/discectomy cervical	C								
22222	Incis w/discectomy thoracic	C								
22224	Incis w/discectomy lumbar	C								
22226	Revise extra spine segment	C								
22310	Closed tx vert fx w/o manj	T	5111	2.6691	$215.64	.	$43.13			
22315	Closed tx vert fx w/manj	J1	5113	33.8823	"$2,737.45"	.	$547.49			
22318	Treat odontoid fx w/o graft	C								
22319	Treat odontoid fx w/graft	C								
22325	Treat spine fracture	C								
22326	Treat neck spine fracture	C								
22327	Treat thorax spine fracture	C								
22328	Treat each add spine fx	C								
22505	Manipulation of spine	J1	5112	16.7761	"$1,355.39"	.	$271.08			
22510	Perq cervicothoracic inject	J1	5113	33.8823	"$2,737.45"	.	$547.49			
22511	Perq lumbosacral injection	J1	5113	33.8823	"$2,737.45"	.	$547.49			
22512	Vertebroplasty addl inject	N								
22513	Perq vertebral augmentation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
22514	Perq vertebral augmentation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
22515	Perq vertebral augmentation	N								
22526	Idet single level	E1								
22527	Idet 1 or more levels	E1								
22532	Lat thorax spine fusion	C								
22533	Lat lumbar spine fusion	C								
22534	Lat thor/lumb addl seg	C								
22548	Neck spine fusion	C								
22551	Neck spine fuse&remov bel c2	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
22552	Addl neck spine fusion	N								
22554	Neck spine fusion	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
22556	Thorax spine fusion	C								
22558	Lumbar spine fusion	C								
22585	Additional spinal fusion	N								
22586	Prescrl fuse w/ instr l5-s1	C								
22590	Spine & skull spinal fusion	C								
22595	Neck spinal fusion	C								
22600	Neck spine fusion	C								
22610	Thorax spine fusion	C								
22612	Lumbar spine fusion	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
22614	Spine fusion extra segment	N								
22630	Lumbar spine fusion	C								
22632	Spine fusion extra segment	C								
22633	Lumbar spine fusion combined	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
22634	Spine fusion extra segment	N								
22800	Post fusion </6 vert seg	C								
22802	Post fusion 7-12 vert seg	C								
22804	Post fusion 13/> vert seg	C								
22808	Ant fusion 2-3 vert seg	C								
22810	Ant fusion 4-7 vert seg	C								
22812	Ant fusion 8/> vert seg	C								
22818	Kyphectomy 1-2 segments	C								
22819	Kyphectomy 3 or more	C								
22830	Exploration of spinal fusion	C								
22840	Insert spine fixation device	N								
22841	Insert spine fixation device	C								
22842	Insert spine fixation device	N								
22843	Insert spine fixation device	C								
22844	Insert spine fixation device	C								
22845	Insert spine fixation device	N								
22846	Insert spine fixation device	C								
22847	Insert spine fixation device	C								
22848	Insert pelv fixation device	C								
22849	Reinsert spinal fixation	C								
22850	Remove spine fixation device	C								
22852	Remove spine fixation device	C								
22853	Insj biomechanical device	N								
22854	Insj biomechanical device	N								
22855	Remove spine fixation device	C								
22856	Cerv artific diskectomy	J1	5116	197.3696	"$15,946.08"	.	"$3,189.22"	*		
22857	Lumbar artif diskectomy	C								
22858	Second level cer diskectomy	N								
22859	Insj biomechanical device	N								
22861	Revise cerv artific disc	C								
22862	Revise lumbar artif disc	C								
22864	Remove cerv artif disc	C								
22865	Remove lumb artif disc	C								
22867	Insj stablj dev w/dcmprn	J1	5116	197.3696	"$15,946.08"	.	"$3,189.22"	*		
22868	Insj stablj dev w/dcmprn	N								
22869	Insj stablj dev w/o dcmprn	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
22870	Insj stablj dev w/o dcmprn	N								
22899	Spine surgery procedure	T	5111	2.6691	$215.64	.	$43.13			
22900	Exc abdl tum deep < 5 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
22901	Exc abdl tum deep 5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
22902	Exc abd les sc < 3 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
22903	Exc abd les sc 3 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
22904	Radical resect abd tumor<5cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
22905	Rad resect abd tumor 5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
22999	Abdomen surgery procedure	T	5111	2.6691	$215.64	.	$43.13			
23000	Removal of calcium deposits	J1	5073	28.7016	"$2,318.89"	.	$463.78			
23020	Release shoulder joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
23030	Drain shoulder lesion	J1	5073	28.7016	"$2,318.89"	.	$463.78			
23031	Drain shoulder bursa	J1	5073	28.7016	"$2,318.89"	.	$463.78			
23035	Drain shoulder bone lesion	J1	5112	16.7761	"$1,355.39"	.	$271.08			
23040	Exploratory shoulder surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
23044	Exploratory shoulder surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
23065	Biopsy shoulder tissues	J1	5072	16.9891	"$1,372.60"	.	$274.52			
23066	Biopsy shoulder tissues	J1	5073	28.7016	"$2,318.89"	.	$463.78			
23071	Exc shoulder les sc 3 cm/>	J1	5072	16.9891	"$1,372.60"	.	$274.52			
23073	Exc shoulder tum deep 5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
23075	Exc shoulder les sc < 3 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
23076	Exc shoulder tum deep < 5 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
23077	Resect shoulder tumor < 5 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
23078	Resect shoulder tumor 5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
23100	Biopsy of shoulder joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
23101	Shoulder joint surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
23105	Remove shoulder joint lining	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23106	Incision of collarbone joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
23107	Explore treat shoulder joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23120	Partial removal collar bone	J1	5113	33.8823	"$2,737.45"	.	$547.49			
23125	Removal of collar bone	J1	5113	33.8823	"$2,737.45"	.	$547.49			
23130	Remove shoulder bone part	J1	5113	33.8823	"$2,737.45"	.	$547.49			
23140	Removal of bone lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
23145	Removal of bone lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
23146	Removal of bone lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23150	Removal of humerus lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
23155	Removal of humerus lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23156	Removal of humerus lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23170	Remove collar bone lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
23172	Remove shoulder blade lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
23174	Remove humerus lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23180	Remove collar bone lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23182	Remove shoulder blade lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23184	Remove humerus lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23190	Partial removal of scapula	J1	5113	33.8823	"$2,737.45"	.	$547.49			
23195	Removal of head of humerus	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23200	Resect clavicle tumor	C								
23210	Resect scapula tumor	C								
23220	Resect prox humerus tumor	C								
23330	Remove shoulder foreign body	T	5071	7.5503	$610.01	.	$122.01			
23333	Remove shoulder fb deep	J1	5073	28.7016	"$2,318.89"	.	$463.78			
23334	Shoulder prosthesis removal	J1	5073	28.7016	"$2,318.89"	.	$463.78			
23335	Shoulder prosthesis removal	C								
23350	Injection for shoulder x-ray	N								
23395	Muscle transfer shoulder/arm	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23397	Muscle transfers	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23400	Fixation of shoulder blade	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23405	Incision of tendon & muscle	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23406	Incise tendon(s) & muscle(s)	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23410	Repair rotator cuff acute	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23412	Repair rotator cuff chronic	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23415	Release of shoulder ligament	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23420	Repair of shoulder	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23430	Repair biceps tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23440	Remove/transplant tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23450	Repair shoulder capsule	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23455	Repair shoulder capsule	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23460	Repair shoulder capsule	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23462	Repair shoulder capsule	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23465	Repair shoulder capsule	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23466	Repair shoulder capsule	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23470	Reconstruct shoulder joint	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
23472	Reconstruct shoulder joint	C								
23473	Revis reconst shoulder joint	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
23474	Revis reconst shoulder joint	C								
23480	Revision of collar bone	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23485	Revision of collar bone	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
23490	Reinforce clavicle	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23491	Reinforce shoulder bones	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
23500	Treat clavicle fracture	T	5111	2.6691	$215.64	.	$43.13			
23505	Treat clavicle fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
23515	Treat clavicle fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23520	Treat clavicle dislocation	J1	5112	16.7761	"$1,355.39"	.	$271.08			
23525	Treat clavicle dislocation	T	5111	2.6691	$215.64	.	$43.13			
23530	Treat clavicle dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23532	Treat clavicle dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23540	Treat clavicle dislocation	T	5111	2.6691	$215.64	.	$43.13			
23545	Treat clavicle dislocation	T	5111	2.6691	$215.64	.	$43.13			
23550	Treat clavicle dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23552	Treat clavicle dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23570	Treat shoulder blade fx	T	5111	2.6691	$215.64	.	$43.13			
23575	Treat shoulder blade fx	J1	5112	16.7761	"$1,355.39"	.	$271.08			
23585	Treat scapula fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23600	Treat humerus fracture	T	5111	2.6691	$215.64	.	$43.13			
23605	Treat humerus fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
23615	Treat humerus fracture	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
23616	Treat humerus fracture	J1	5116	197.3696	"$15,946.08"	.	"$3,189.22"	*		
23620	Treat humerus fracture	T	5111	2.6691	$215.64	.	$43.13			
23625	Treat humerus fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
23630	Treat humerus fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23650	Treat shoulder dislocation	T	5111	2.6691	$215.64	.	$43.13			
23655	Treat shoulder dislocation	J1	5112	16.7761	"$1,355.39"	.	$271.08			
23660	Treat shoulder dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23665	Treat dislocation/fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
23670	Treat dislocation/fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23675	Treat dislocation/fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
23680	Treat dislocation/fracture	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
23700	Fixation of shoulder	J1	5112	16.7761	"$1,355.39"	.	$271.08			
23800	Fusion of shoulder joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
23802	Fusion of shoulder joint	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
23900	Amputation of arm & girdle	C								
23920	Amputation at shoulder joint	C								
23921	Amputation follow-up surgery	T	5054	20.0852	"$1,622.74"	.	$324.55			
23929	Shoulder surgery procedure	T	5111	2.6691	$215.64	.	$43.13			
23930	Drainage of arm lesion	J1	5073	28.7016	"$2,318.89"	.	$463.78			
23931	Drainage of arm bursa	J1	5072	16.9891	"$1,372.60"	.	$274.52			
23935	Drain arm/elbow bone lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24000	Exploratory elbow surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24006	Release elbow joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24065	Biopsy arm/elbow soft tissue	J1	5072	16.9891	"$1,372.60"	.	$274.52			
24066	Biopsy arm/elbow soft tissue	J1	5073	28.7016	"$2,318.89"	.	$463.78			
24071	Exc arm/elbow les sc 3 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
24073	Ex arm/elbow tum deep 5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
24075	Exc arm/elbow les sc < 3 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
24076	Ex arm/elbow tum deep < 5 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
24077	Resect arm/elbow tum < 5 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
24079	Resect arm/elbow tum 5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
24100	Biopsy elbow joint lining	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24101	Explore/treat elbow joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24102	Remove elbow joint lining	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24105	Removal of elbow bursa	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24110	Remove humerus lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24115	Remove/graft bone lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24116	Remove/graft bone lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24120	Remove elbow lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24125	Remove/graft bone lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24126	Remove/graft bone lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24130	Removal of head of radius	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24134	Removal of arm bone lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24136	Remove radius bone lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24138	Remove elbow bone lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24140	Partial removal of arm bone	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24145	Partial removal of radius	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24147	Partial removal of elbow	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24149	Radical resection of elbow	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24150	Resect distal humerus tumor	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24152	Resect radius tumor	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24155	Removal of elbow joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24160	Remove elbow joint implant	Q2	5113	33.8823	"$2,737.45"	.	$547.49			
24164	Remove radius head implant	Q2	5113	33.8823	"$2,737.45"	.	$547.49			
24200	Removal of arm foreign body	J1	5072	16.9891	"$1,372.60"	.	$274.52			
24201	Removal of arm foreign body	J1	5073	28.7016	"$2,318.89"	.	$463.78			
24220	Injection for elbow x-ray	N								
24300	Manipulate elbow w/anesth	J1	5112	16.7761	"$1,355.39"	.	$271.08			
24301	Muscle/tendon transfer	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24305	Arm tendon lengthening	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24310	Revision of arm tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24320	Repair of arm tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24330	Revision of arm muscles	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24331	Revision of arm muscles	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24332	Tenolysis triceps	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24340	Repair of biceps tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24341	Repair arm tendon/muscle	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24342	Repair of ruptured tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24343	Repr elbow lat ligmnt w/tiss	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24344	Reconstruct elbow lat ligmnt	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24345	Repr elbw med ligmnt w/tissu	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24346	Reconstruct elbow med ligmnt	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24357	Repair elbow perc	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24358	Repair elbow w/deb open	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24359	Repair elbow deb/attch open	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24360	Reconstruct elbow joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24361	Reconstruct elbow joint	J1	5116	197.3696	"$15,946.08"	.	"$3,189.22"	*		
24362	Reconstruct elbow joint	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24363	Replace elbow joint	J1	5116	197.3696	"$15,946.08"	.	"$3,189.22"	*		
24365	Reconstruct head of radius	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24366	Reconstruct head of radius	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24370	Revise reconst elbow joint	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24371	Revise reconst elbow joint	J1	5116	197.3696	"$15,946.08"	.	"$3,189.22"	*		
24400	Revision of humerus	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24410	Revision of humerus	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24420	Revision of humerus	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24430	Repair of humerus	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24435	Repair humerus with graft	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24470	Revision of elbow joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24495	Decompression of forearm	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24498	Reinforce humerus	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24500	Treat humerus fracture	T	5111	2.6691	$215.64	.	$43.13			
24505	Treat humerus fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
24515	Treat humerus fracture	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24516	Treat humerus fracture	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24530	Treat humerus fracture	T	5111	2.6691	$215.64	.	$43.13			
24535	Treat humerus fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
24538	Treat humerus fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24545	Treat humerus fracture	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24546	Treat humerus fracture	J1	5116	197.3696	"$15,946.08"	.	"$3,189.22"	*		
24560	Treat humerus fracture	T	5111	2.6691	$215.64	.	$43.13			
24565	Treat humerus fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
24566	Treat humerus fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
24575	Treat humerus fracture	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24576	Treat humerus fracture	T	5111	2.6691	$215.64	.	$43.13			
24577	Treat humerus fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
24579	Treat humerus fracture	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24582	Treat humerus fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24586	Treat elbow fracture	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24587	Treat elbow fracture	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24600	Treat elbow dislocation	T	5111	2.6691	$215.64	.	$43.13			
24605	Treat elbow dislocation	J1	5112	16.7761	"$1,355.39"	.	$271.08			
24615	Treat elbow dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24620	Treat elbow fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
24635	Treat elbow fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24640	Treat elbow dislocation	T	5111	2.6691	$215.64	.	$43.13			
24650	Treat radius fracture	T	5111	2.6691	$215.64	.	$43.13			
24655	Treat radius fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
24665	Treat radius fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24666	Treat radius fracture	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24670	Treat ulnar fracture	T	5111	2.6691	$215.64	.	$43.13			
24675	Treat ulnar fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
24685	Treat ulnar fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24800	Fusion of elbow joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24802	Fusion/graft of elbow joint	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
24900	Amputation of upper arm	C								
24920	Amputation of upper arm	C								
24925	Amputation follow-up surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
24930	Amputation follow-up surgery	C								
24931	Amputate upper arm & implant	C								
24935	Revision of amputation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
24940	Revision of upper arm	C								
24999	Upper arm/elbow surgery	T	5111	2.6691	$215.64	.	$43.13			
25000	Incision of tendon sheath	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25001	Incise flexor carpi radialis	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25020	Decompress forearm 1 space	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25023	Decompress forearm 1 space	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25024	Decompress forearm 2 spaces	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25025	Decompress forearm 2 spaces	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25028	Drainage of forearm lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25031	Drainage of forearm bursa	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25035	Treat forearm bone lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25040	Explore/treat wrist joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25065	Biopsy forearm soft tissues	J1	5072	16.9891	"$1,372.60"	.	$274.52			
25066	Biopsy forearm soft tissues	J1	5073	28.7016	"$2,318.89"	.	$463.78			
25071	Exc forearm les sc 3 cm/>	J1	5072	16.9891	"$1,372.60"	.	$274.52			
25073	Exc forearm tum deep 3 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
25075	Exc forearm les sc < 3 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
25076	Exc forearm tum deep < 3 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
25077	Resect forearm/wrist tum<3cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
25078	Resect forarm/wrist tum 3cm>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
25085	Incision of wrist capsule	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25100	Biopsy of wrist joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25101	Explore/treat wrist joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25105	Remove wrist joint lining	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25107	Remove wrist joint cartilage	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25109	Excise tendon forearm/wrist	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25110	Remove wrist tendon lesion	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25111	Remove wrist tendon lesion	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25112	Reremove wrist tendon lesion	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25115	Remove wrist/forearm lesion	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25116	Remove wrist/forearm lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25118	Excise wrist tendon sheath	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25119	Partial removal of ulna	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25120	Removal of forearm lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25125	Remove/graft forearm lesion	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25126	Remove/graft forearm lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25130	Removal of wrist lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25135	Remove & graft wrist lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25136	Remove & graft wrist lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25145	Remove forearm bone lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25150	Partial removal of ulna	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25151	Partial removal of radius	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25170	Resect radius/ulnar tumor	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25210	Removal of wrist bone	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25215	Removal of wrist bones	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25230	Partial removal of radius	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25240	Partial removal of ulna	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25246	Injection for wrist x-ray	N								
25248	Remove forearm foreign body	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25250	Removal of wrist prosthesis	Q2	5112	16.7761	"$1,355.39"	.	$271.08			
25251	Removal of wrist prosthesis	Q2	5113	33.8823	"$2,737.45"	.	$547.49			
25259	Manipulate wrist w/anesthes	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25260	Repair forearm tendon/muscle	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25263	Repair forearm tendon/muscle	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25265	Repair forearm tendon/muscle	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25270	Repair forearm tendon/muscle	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25272	Repair forearm tendon/muscle	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25274	Repair forearm tendon/muscle	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25275	Repair forearm tendon sheath	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25280	Revise wrist/forearm tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25290	Incise wrist/forearm tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25295	Release wrist/forearm tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25300	Fusion of tendons at wrist	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25301	Fusion of tendons at wrist	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25310	Transplant forearm tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25312	Transplant forearm tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25315	Revise palsy hand tendon(s)	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25316	Revise palsy hand tendon(s)	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25320	Repair/revise wrist joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25332	Revise wrist joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25335	Realignment of hand	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25337	Reconstruct ulna/radioulnar	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25350	Revision of radius	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25355	Revision of radius	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25360	Revision of ulna	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25365	Revise radius & ulna	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
25370	Revise radius or ulna	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25375	Revise radius & ulna	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25390	Shorten radius or ulna	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25391	Lengthen radius or ulna	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
25392	Shorten radius & ulna	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25393	Lengthen radius & ulna	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25394	Repair carpal bone shorten	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25400	Repair radius or ulna	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25405	Repair/graft radius or ulna	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25415	Repair radius & ulna	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25420	Repair/graft radius & ulna	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25425	Repair/graft radius or ulna	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25426	Repair/graft radius & ulna	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25430	Vasc graft into carpal bone	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25431	Repair nonunion carpal bone	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25440	Repair/graft wrist bone	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25441	Reconstruct wrist joint	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
25442	Reconstruct wrist joint	J1	5116	197.3696	"$15,946.08"	.	"$3,189.22"	*		
25443	Reconstruct wrist joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25444	Reconstruct wrist joint	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
25445	Reconstruct wrist joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25446	Wrist replacement	J1	5116	197.3696	"$15,946.08"	.	"$3,189.22"	*		
25447	Repair wrist joints	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25449	Remove wrist joint implant	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25450	Revision of wrist joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25455	Revision of wrist joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25490	Reinforce radius	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25491	Reinforce ulna	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
25492	Reinforce radius and ulna	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25500	Treat fracture of radius	T	5111	2.6691	$215.64	.	$43.13			
25505	Treat fracture of radius	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25515	Treat fracture of radius	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25520	Treat fracture of radius	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25525	Treat fracture of radius	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25526	Treat fracture of radius	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25530	Treat fracture of ulna	T	5111	2.6691	$215.64	.	$43.13			
25535	Treat fracture of ulna	T	5111	2.6691	$215.64	.	$43.13			
25545	Treat fracture of ulna	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25560	Treat fracture radius & ulna	T	5111	2.6691	$215.64	.	$43.13			
25565	Treat fracture radius & ulna	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25574	Treat fracture radius & ulna	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25575	Treat fracture radius/ulna	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25600	Treat fracture radius/ulna	T	5111	2.6691	$215.64	.	$43.13			
25605	Treat fracture radius/ulna	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25606	Treat fx distal radial	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25607	Treat fx rad extra-articul	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25608	Treat fx rad intra-articul	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25609	Treat fx radial 3+ frag	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25622	Treat wrist bone fracture	T	5111	2.6691	$215.64	.	$43.13			
25624	Treat wrist bone fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25628	Treat wrist bone fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25630	Treat wrist bone fracture	T	5111	2.6691	$215.64	.	$43.13			
25635	Treat wrist bone fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25645	Treat wrist bone fracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25650	Treat wrist bone fracture	T	5111	2.6691	$215.64	.	$43.13			
25651	Pin ulnar styloid fracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25652	Treat fracture ulnar styloid	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25660	Treat wrist dislocation	T	5111	2.6691	$215.64	.	$43.13			
25670	Treat wrist dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25671	Pin radioulnar dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25675	Treat wrist dislocation	T	5111	2.6691	$215.64	.	$43.13			
25676	Treat wrist dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25680	Treat wrist fracture	T	5111	2.6691	$215.64	.	$43.13			
25685	Treat wrist fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25690	Treat wrist dislocation	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25695	Treat wrist dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25800	Fusion of wrist joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25805	Fusion/graft of wrist joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25810	Fusion/graft of wrist joint	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
25820	Fusion of hand bones	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25825	Fuse hand bones with graft	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25830	Fusion radioulnar jnt/ulna	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25900	Amputation of forearm	C								
25905	Amputation of forearm	C								
25907	Amputation follow-up surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25909	Amputation follow-up surgery	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
25915	Amputation of forearm	C								
25920	Amputate hand at wrist	C								
25922	Amputate hand at wrist	J1	5112	16.7761	"$1,355.39"	.	$271.08			
25924	Amputation follow-up surgery	C								
25927	Amputation of hand	C								
25929	Amputation follow-up surgery	T	5054	20.0852	"$1,622.74"	.	$324.55			
25931	Amputation follow-up surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
25999	Forearm or wrist surgery	T	5111	2.6691	$215.64	.	$43.13			
26010	Drainage of finger abscess	T	5051	2.1627	$174.73	.	$34.95			
26011	Drainage of finger abscess	J1	5072	16.9891	"$1,372.60"	.	$274.52			
26020	Drain hand tendon sheath	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26025	Drainage of palm bursa	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26030	Drainage of palm bursas	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26034	Treat hand bone lesion	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26035	Decompress fingers/hand	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26037	Decompress fingers/hand	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26040	Release palm contracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26045	Release palm contracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26055	Incise finger tendon sheath	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26060	Incision of finger tendon	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26070	Explore/treat hand joint	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26075	Explore/treat finger joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26080	Explore/treat finger joint	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26100	Biopsy hand joint lining	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26105	Biopsy finger joint lining	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26110	Biopsy finger joint lining	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26111	Exc hand les sc 1.5 cm/>	J1	5072	16.9891	"$1,372.60"	.	$274.52			
26113	Exc hand tum deep 1.5 cm/>	J1	5072	16.9891	"$1,372.60"	.	$274.52			
26115	Exc hand les sc < 1.5 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
26116	Exc hand tum deep < 1.5 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
26117	Rad resect hand tumor < 3 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
26118	Rad resect hand tumor 3 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
26121	Release palm contracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26123	Release palm contracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26125	Release palm contracture	N								
26130	Remove wrist joint lining	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26135	Revise finger joint each	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26140	Revise finger joint each	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26145	Tendon excision palm/finger	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26160	Remove tendon sheath lesion	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26170	Removal of palm tendon each	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26180	Removal of finger tendon	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26185	Remove finger bone	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26200	Remove hand bone lesion	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26205	Remove/graft bone lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26210	Removal of finger lesion	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26215	Remove/graft finger lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26230	Partial removal of hand bone	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26235	Partial removal finger bone	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26236	Partial removal finger bone	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26250	Extensive hand surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26260	Resect prox finger tumor	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26262	Resect distal finger tumor	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26320	Removal of implant from hand	Q2	5072	16.9891	"$1,372.60"	.	$274.52			
26340	Manipulate finger w/anesth	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26341	Manipulat palm cord post inj	T	5111	2.6691	$215.64	.	$43.13			
26350	Repair finger/hand tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26352	Repair/graft hand tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26356	Repair finger/hand tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26357	Repair finger/hand tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26358	Repair/graft hand tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26370	Repair finger/hand tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26372	Repair/graft hand tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26373	Repair finger/hand tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26390	Revise hand/finger tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26392	Repair/graft hand tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26410	Repair hand tendon	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26412	Repair/graft hand tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26415	Excision hand/finger tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26416	Graft hand or finger tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26418	Repair finger tendon	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26420	Repair/graft finger tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26426	Repair finger/hand tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26428	Repair/graft finger tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26432	Repair finger tendon	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26433	Repair finger tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26434	Repair/graft finger tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26437	Realignment of tendons	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26440	Release palm/finger tendon	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26442	Release palm & finger tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26445	Release hand/finger tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26449	Release forearm/hand tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26450	Incision of palm tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26455	Incision of finger tendon	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26460	Incise hand/finger tendon	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26471	Fusion of finger tendons	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26474	Fusion of finger tendons	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26476	Tendon lengthening	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26477	Tendon shortening	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26478	Lengthening of hand tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26479	Shortening of hand tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26480	Transplant hand tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26483	Transplant/graft hand tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26485	Transplant palm tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26489	Transplant/graft palm tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26490	Revise thumb tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26492	Tendon transfer with graft	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26494	Hand tendon/muscle transfer	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26496	Revise thumb tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26497	Finger tendon transfer	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26498	Finger tendon transfer	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26499	Revision of finger	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26500	Hand tendon reconstruction	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26502	Hand tendon reconstruction	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26508	Release thumb contracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26510	Thumb tendon transfer	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26516	Fusion of knuckle joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26517	Fusion of knuckle joints	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26518	Fusion of knuckle joints	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26520	Release knuckle contracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26525	Release finger contracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26530	Revise knuckle joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26531	Revise knuckle with implant	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26535	Revise finger joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26536	Revise/implant finger joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26540	Repair hand joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26541	Repair hand joint with graft	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26542	Repair hand joint with graft	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26545	Reconstruct finger joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26546	Repair nonunion hand	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26548	Reconstruct finger joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26550	Construct thumb replacement	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26551	Great toe-hand transfer	C								
26553	Single transfer toe-hand	C								
26554	Double transfer toe-hand	C								
26555	Positional change of finger	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26556	Toe joint transfer	C								
26560	Repair of web finger	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26561	Repair of web finger	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26562	Repair of web finger	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26565	Correct metacarpal flaw	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26567	Correct finger deformity	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26568	Lengthen metacarpal/finger	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26580	Repair hand deformity	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26587	Reconstruct extra finger	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26590	Repair finger deformity	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26591	Repair muscles of hand	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26593	Release muscles of hand	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26596	Excision constricting tissue	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26600	Treat metacarpal fracture	T	5111	2.6691	$215.64	.	$43.13			
26605	Treat metacarpal fracture	T	5111	2.6691	$215.64	.	$43.13			
26607	Treat metacarpal fracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26608	Treat metacarpal fracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26615	Treat metacarpal fracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26641	Treat thumb dislocation	T	5111	2.6691	$215.64	.	$43.13			
26645	Treat thumb fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26650	Treat thumb fracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26665	Treat thumb fracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26670	Treat hand dislocation	T	5111	2.6691	$215.64	.	$43.13			
26675	Treat hand dislocation	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26676	Pin hand dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26685	Treat hand dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26686	Treat hand dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26700	Treat knuckle dislocation	T	5111	2.6691	$215.64	.	$43.13			
26705	Treat knuckle dislocation	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26706	Pin knuckle dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26715	Treat knuckle dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26720	Treat finger fracture each	T	5111	2.6691	$215.64	.	$43.13			
26725	Treat finger fracture each	T	5111	2.6691	$215.64	.	$43.13			
26727	Treat finger fracture each	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26735	Treat finger fracture each	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26740	Treat finger fracture each	T	5111	2.6691	$215.64	.	$43.13			
26742	Treat finger fracture each	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26746	Treat finger fracture each	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26750	Treat finger fracture each	T	5111	2.6691	$215.64	.	$43.13			
26755	Treat finger fracture each	T	5111	2.6691	$215.64	.	$43.13			
26756	Pin finger fracture each	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26765	Treat finger fracture each	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26770	Treat finger dislocation	T	5111	2.6691	$215.64	.	$43.13			
26775	Treat finger dislocation	T	5102	2.8445	$229.82	.	$45.97			
26776	Pin finger dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26785	Treat finger dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26820	Thumb fusion with graft	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26841	Fusion of thumb	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26842	Thumb fusion with graft	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26843	Fusion of hand joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26844	Fusion/graft of hand joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26850	Fusion of knuckle	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26852	Fusion of knuckle with graft	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
26860	Fusion of finger joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26861	Fusion of finger jnt add-on	N								
26862	Fusion/graft of finger joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26863	Fuse/graft added joint	N								
26910	Amputate metacarpal bone	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26951	Amputation of finger/thumb	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26952	Amputation of finger/thumb	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26989	Hand/finger surgery	T	5111	2.6691	$215.64	.	$43.13			
26990	Drainage of pelvis lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
26991	Drainage of pelvis bursa	J1	5112	16.7761	"$1,355.39"	.	$271.08			
26992	Drainage of bone lesion	C								
27000	Incision of hip tendon	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27001	Incision of hip tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27003	Incision of hip tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27005	Incision of hip tendon	C								
27006	Incision of hip tendons	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27025	Incision of hip/thigh fascia	C								
27027	Buttock fasciotomy	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27030	Drainage of hip joint	C								
27033	Exploration of hip joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27035	Denervation of hip joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27036	Excision of hip joint/muscle	C								
27040	Biopsy of soft tissues	J1	5072	16.9891	"$1,372.60"	.	$274.52			
27041	Biopsy of soft tissues	J1	5072	16.9891	"$1,372.60"	.	$274.52			
27043	Exc hip pelvis les sc 3 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27045	Exc hip/pelv tum deep 5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27047	Exc hip/pelvis les sc < 3 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27048	Exc hip/pelv tum deep < 5 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27049	Resect hip/pelv tum < 5 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27050	Biopsy of sacroiliac joint	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27052	Biopsy of hip joint	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27054	Removal of hip joint lining	C								
27057	Buttock fasciotomy w/dbrdmt	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27059	Resect hip/pelv tum 5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27060	Removal of ischial bursa	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27062	Remove femur lesion/bursa	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27065	Remove hip bone les super	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27066	Remove hip bone les deep	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27067	Remove/graft hip bone lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27070	Part remove hip bone super	C								
27071	Part removal hip bone deep	C								
27075	Resect hip tumor	C								
27076	Resect hip tum incl acetabul	C								
27077	Resect hip tum w/innom bone	C								
27078	Rsect hip tum incl femur	C								
27080	Removal of tail bone	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27086	Remove hip foreign body	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27087	Remove hip foreign body	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27090	Removal of hip prosthesis	C								
27091	Removal of hip prosthesis	C								
27093	Injection for hip x-ray	N								
27095	Injection for hip x-ray	N								
27096	Inject sacroiliac joint	B								
27097	Revision of hip tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27098	Transfer tendon to pelvis	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27100	Transfer of abdominal muscle	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27105	Transfer of spinal muscle	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27110	Transfer of iliopsoas muscle	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27111	Transfer of iliopsoas muscle	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27120	Reconstruction of hip socket	C								
27122	Reconstruction of hip socket	C								
27125	Partial hip replacement	C								
27130	Total hip arthroplasty	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27132	Total hip arthroplasty	C								
27134	Revise hip joint replacement	C								
27137	Revise hip joint replacement	C								
27138	Revise hip joint replacement	C								
27140	Transplant femur ridge	C								
27146	Incision of hip bone	C								
27147	Revision of hip bone	C								
27151	Incision of hip bones	C								
27156	Revision of hip bones	C								
27158	Revision of pelvis	C								
27161	Incision of neck of femur	C								
27165	Incision/fixation of femur	C								
27170	Repair/graft femur head/neck	C								
27175	Treat slipped epiphysis	C								
27176	Treat slipped epiphysis	C								
27177	Treat slipped epiphysis	C								
27178	Treat slipped epiphysis	C								
27179	Revise head/neck of femur	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27181	Treat slipped epiphysis	C								
27185	Revision of femur epiphysis	C								
27187	Reinforce hip bones	C								
27197	Clsd tx pelvic ring fx	T	5111	2.6691	$215.64	.	$43.13			
27198	Clsd tx pelvic ring fx	T	5111	2.6691	$215.64	.	$43.13			
27200	Treat tail bone fracture	T	5111	2.6691	$215.64	.	$43.13			
27202	Treat tail bone fracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27215	Treat pelvic fracture(s)	E1								
27216	Treat pelvic ring fracture	E1								
27217	Treat pelvic ring fracture	E1								
27218	Treat pelvic ring fracture	E1								
27220	Treat hip socket fracture	T	5111	2.6691	$215.64	.	$43.13			
27222	Treat hip socket fracture	C								
27226	Treat hip wall fracture	C								
27227	Treat hip fracture(s)	C								
27228	Treat hip fracture(s)	C								
27230	Treat thigh fracture	T	5111	2.6691	$215.64	.	$43.13			
27232	Treat thigh fracture	C								
27235	Treat thigh fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27236	Treat thigh fracture	C								
27238	Treat thigh fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27240	Treat thigh fracture	C								
27244	Treat thigh fracture	C								
27245	Treat thigh fracture	C								
27246	Treat thigh fracture	T	5111	2.6691	$215.64	.	$43.13			
27248	Treat thigh fracture	C								
27250	Treat hip dislocation	T	5111	2.6691	$215.64	.	$43.13			
27252	Treat hip dislocation	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27253	Treat hip dislocation	C								
27254	Treat hip dislocation	C								
27256	Treat hip dislocation	T	5111	2.6691	$215.64	.	$43.13			
27257	Treat hip dislocation	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27258	Treat hip dislocation	C								
27259	Treat hip dislocation	C								
27265	Treat hip dislocation	T	5111	2.6691	$215.64	.	$43.13			
27266	Treat hip dislocation	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27267	Cltx thigh fx	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27268	Cltx thigh fx w/mnpj	C								
27269	Optx thigh fx	C								
27275	Manipulation of hip joint	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27279	Arthrodesis sacroiliac joint	J1	5116	197.3696	"$15,946.08"	.	"$3,189.22"	*		
27280	Fusion of sacroiliac joint	C								
27282	Fusion of pubic bones	C								
27284	Fusion of hip joint	C								
27286	Fusion of hip joint	C								
27290	Amputation of leg at hip	C								
27295	Amputation of leg at hip	C								
27299	Pelvis/hip joint surgery	T	5111	2.6691	$215.64	.	$43.13			
27301	Drain thigh/knee lesion	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27303	Drainage of bone lesion	C								
27305	Incise thigh tendon & fascia	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27306	Incision of thigh tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27307	Incision of thigh tendons	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27310	Exploration of knee joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27323	Biopsy thigh soft tissues	J1	5072	16.9891	"$1,372.60"	.	$274.52			
27324	Biopsy thigh soft tissues	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27325	Neurectomy hamstring	J1	5431	21.2809	"$1,719.35"	.	$343.87			
27326	Neurectomy popliteal	J1	5431	21.2809	"$1,719.35"	.	$343.87			
27327	Exc thigh/knee les sc < 3 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
27328	Exc thigh/knee tum deep <5cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27329	Resect thigh/knee tum < 5 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27330	Biopsy knee joint lining	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27331	Explore/treat knee joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27332	Removal of knee cartilage	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27333	Removal of knee cartilage	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27334	Remove knee joint lining	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27335	Remove knee joint lining	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27337	Exc thigh/knee les sc 3 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27339	Exc thigh/knee tum dep 5cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27340	Removal of kneecap bursa	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27345	Removal of knee cyst	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27347	Remove knee cyst	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27350	Removal of kneecap	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27355	Remove femur lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27356	Remove femur lesion/graft	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27357	Remove femur lesion/graft	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27358	Remove femur lesion/fixation	N								
27360	Partial removal leg bone(s)	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27364	Resect thigh/knee tum 5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27365	Resect femur/knee tumor	C								
27369	Njx cntrst kne arthg/ct/mri	N								
27372	Removal of foreign body	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27380	Repair of kneecap tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27381	Repair/graft kneecap tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27385	Repair of thigh muscle	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27386	Repair/graft of thigh muscle	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27390	Incision of thigh tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27391	Incision of thigh tendons	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27392	Incision of thigh tendons	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27393	Lengthening of thigh tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27394	Lengthening of thigh tendons	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27395	Lengthening of thigh tendons	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27396	Transplant of thigh tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27397	Transplants of thigh tendons	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27400	Revise thigh muscles/tendons	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27403	Repair of knee cartilage	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27405	Repair of knee ligament	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27407	Repair of knee ligament	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27409	Repair of knee ligaments	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27412	Autochondrocyte implant knee	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27415	Osteochondral knee allograft	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27416	Osteochondral knee autograft	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27418	Repair degenerated kneecap	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27420	Revision of unstable kneecap	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27422	Revision of unstable kneecap	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27424	Revision/removal of kneecap	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27425	Lat retinacular release open	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27427	Reconstruction knee	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27428	Reconstruction knee	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27429	Reconstruction knee	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27430	Revision of thigh muscles	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27435	Incision of knee joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27437	Revise kneecap	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27438	Revise kneecap with implant	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27440	Revision of knee joint	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27441	Revision of knee joint	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27442	Revision of knee joint	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27443	Revision of knee joint	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27445	Revision of knee joint	C								
27446	Revision of knee joint	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27447	Total knee arthroplasty	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27448	Incision of thigh	C								
27450	Incision of thigh	C								
27454	Realignment of thigh bone	C								
27455	Realignment of knee	C								
27457	Realignment of knee	C								
27465	Shortening of thigh bone	C								
27466	Lengthening of thigh bone	C								
27468	Shorten/lengthen thighs	C								
27470	Repair of thigh	C								
27472	Repair/graft of thigh	C								
27475	Surgery to stop leg growth	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27477	Surgery to stop leg growth	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27479	Surgery to stop leg growth	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27485	Surgery to stop leg growth	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27486	Revise/replace knee joint	C								
27487	Revise/replace knee joint	C								
27488	Removal of knee prosthesis	C								
27495	Reinforce thigh	C								
27496	Decompression of thigh/knee	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27497	Decompression of thigh/knee	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27498	Decompression of thigh/knee	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27499	Decompression of thigh/knee	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27500	Treatment of thigh fracture	T	5111	2.6691	$215.64	.	$43.13			
27501	Treatment of thigh fracture	T	5111	2.6691	$215.64	.	$43.13			
27502	Treatment of thigh fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27503	Treatment of thigh fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27506	Treatment of thigh fracture	C								
27507	Treatment of thigh fracture	C								
27508	Treatment of thigh fracture	T	5111	2.6691	$215.64	.	$43.13			
27509	Treatment of thigh fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27510	Treatment of thigh fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27511	Treatment of thigh fracture	C								
27513	Treatment of thigh fracture	C								
27514	Treatment of thigh fracture	C								
27516	Treat thigh fx growth plate	T	5111	2.6691	$215.64	.	$43.13			
27517	Treat thigh fx growth plate	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27519	Treat thigh fx growth plate	C								
27520	Treat kneecap fracture	T	5111	2.6691	$215.64	.	$43.13			
27524	Treat kneecap fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27530	Treat knee fracture	T	5111	2.6691	$215.64	.	$43.13			
27532	Treat knee fracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27535	Treat knee fracture	C								
27536	Treat knee fracture	C								
27538	Treat knee fracture(s)	T	5111	2.6691	$215.64	.	$43.13			
27540	Treat knee fracture	C								
27550	Treat knee dislocation	T	5111	2.6691	$215.64	.	$43.13			
27552	Treat knee dislocation	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27556	Treat knee dislocation	C								
27557	Treat knee dislocation	C								
27558	Treat knee dislocation	C								
27560	Treat kneecap dislocation	T	5111	2.6691	$215.64	.	$43.13			
27562	Treat kneecap dislocation	T	5111	2.6691	$215.64	.	$43.13			
27566	Treat kneecap dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27570	Fixation of knee joint	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27580	Fusion of knee	C								
27590	Amputate leg at thigh	C								
27591	Amputate leg at thigh	C								
27592	Amputate leg at thigh	C								
27594	Amputation follow-up surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27596	Amputation follow-up surgery	C								
27598	Amputate lower leg at knee	C								
27599	Leg surgery procedure	T	5111	2.6691	$215.64	.	$43.13			
27600	Decompression of lower leg	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27601	Decompression of lower leg	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27602	Decompression of lower leg	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27603	Drain lower leg lesion	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27604	Drain lower leg bursa	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27605	Incision of achilles tendon	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27606	Incision of achilles tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27607	Treat lower leg bone lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27610	Explore/treat ankle joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27612	Exploration of ankle joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27613	Biopsy lower leg soft tissue	J1	5072	16.9891	"$1,372.60"	.	$274.52			
27614	Biopsy lower leg soft tissue	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27615	Resect leg/ankle tum < 5 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27616	Resect leg/ankle tum 5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27618	Exc leg/ankle tum < 3 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
27619	Exc leg/ankle tum deep <5 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27620	Explore/treat ankle joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27625	Remove ankle joint lining	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27626	Remove ankle joint lining	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27630	Removal of tendon lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27632	Exc leg/ankle les sc 3 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27634	Exc leg/ankle tum dep 5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
27635	Remove lower leg bone lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27637	Remove/graft leg bone lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27638	Remove/graft leg bone lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27640	Partial removal of tibia	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27641	Partial removal of fibula	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27645	Resect tibia tumor	C								
27646	Resect fibula tumor	C								
27647	Resect talus/calcaneus tum	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27648	Injection for ankle x-ray	N								
27650	Repair achilles tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27652	Repair/graft achilles tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27654	Repair of achilles tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27656	Repair leg fascia defect	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27658	Repair of leg tendon each	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27659	Repair of leg tendon each	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27664	Repair of leg tendon each	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27665	Repair of leg tendon each	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27675	Repair lower leg tendons	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27676	Repair lower leg tendons	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27680	Release of lower leg tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27681	Release of lower leg tendons	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27685	Revision of lower leg tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27686	Revise lower leg tendons	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27687	Revision of calf tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27690	Revise lower leg tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27691	Revise lower leg tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27692	Revise additional leg tendon	N								
27695	Repair of ankle ligament	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27696	Repair of ankle ligaments	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27698	Repair of ankle ligament	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27700	Revision of ankle joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27702	Reconstruct ankle joint	C								
27703	Reconstruction ankle joint	C								
27704	Removal of ankle implant	Q2	5113	33.8823	"$2,737.45"	.	$547.49			
27705	Incision of tibia	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27707	Incision of fibula	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27709	Incision of tibia & fibula	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27712	Realignment of lower leg	C								
27715	Revision of lower leg	C								
27720	Repair of tibia	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27722	Repair/graft of tibia	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27724	Repair/graft of tibia	C								
27725	Repair of lower leg	C								
27726	Repair fibula nonunion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27727	Repair of lower leg	C								
27730	Repair of tibia epiphysis	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27732	Repair of fibula epiphysis	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27734	Repair lower leg epiphyses	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27740	Repair of leg epiphyses	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27742	Repair of leg epiphyses	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27745	Reinforce tibia	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27750	Treatment of tibia fracture	T	5111	2.6691	$215.64	.	$43.13			
27752	Treatment of tibia fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27756	Treatment of tibia fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27758	Treatment of tibia fracture	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27759	Treatment of tibia fracture	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27760	Cltx medial ankle fx	T	5111	2.6691	$215.64	.	$43.13			
27762	Cltx med ankle fx w/mnpj	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27766	Optx medial ankle fx	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27767	Cltx post ankle fx	T	5111	2.6691	$215.64	.	$43.13			
27768	Cltx post ankle fx w/mnpj	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27769	Optx post ankle fx	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27780	Treatment of fibula fracture	T	5111	2.6691	$215.64	.	$43.13			
27781	Treatment of fibula fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27784	Treatment of fibula fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27786	Treatment of ankle fracture	T	5111	2.6691	$215.64	.	$43.13			
27788	Treatment of ankle fracture	T	5111	2.6691	$215.64	.	$43.13			
27792	Treatment of ankle fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27808	Treatment of ankle fracture	T	5111	2.6691	$215.64	.	$43.13			
27810	Treatment of ankle fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27814	Treatment of ankle fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27816	Treatment of ankle fracture	T	5111	2.6691	$215.64	.	$43.13			
27818	Treatment of ankle fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27822	Treatment of ankle fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27823	Treatment of ankle fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27824	Treat lower leg fracture	T	5111	2.6691	$215.64	.	$43.13			
27825	Treat lower leg fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27826	Treat lower leg fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27827	Treat lower leg fracture	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27828	Treat lower leg fracture	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27829	Treat lower leg joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27830	Treat lower leg dislocation	T	5111	2.6691	$215.64	.	$43.13			
27831	Treat lower leg dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27832	Treat lower leg dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27840	Treat ankle dislocation	T	5111	2.6691	$215.64	.	$43.13			
27842	Treat ankle dislocation	J1	5112	16.7761	"$1,355.39"	.	$271.08			
27846	Treat ankle dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27848	Treat ankle dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27860	Fixation of ankle joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27870	Fusion of ankle joint open	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27871	Fusion of tibiofibular joint	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
27880	Amputation of lower leg	C								
27881	Amputation of lower leg	C								
27882	Amputation of lower leg	C								
27884	Amputation follow-up surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27886	Amputation follow-up surgery	C								
27888	Amputation of foot at ankle	C								
27889	Amputation of foot at ankle	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27892	Decompression of leg	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27893	Decompression of leg	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
27894	Decompression of leg	J1	5113	33.8823	"$2,737.45"	.	$547.49			
27899	Leg/ankle surgery procedure	T	5111	2.6691	$215.64	.	$43.13			
28001	Drainage of bursa of foot	J1	5072	16.9891	"$1,372.60"	.	$274.52			
28002	Treatment of foot infection	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28003	Treatment of foot infection	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28005	Treat foot bone lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28008	Incision of foot fascia	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28010	Incision of toe tendon	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28011	Incision of toe tendons	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28020	Exploration of foot joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28022	Exploration of foot joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28024	Exploration of toe joint	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28035	Decompression of tibia nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
28039	Exc foot/toe tum sc 1.5 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
28041	Exc foot/toe tum dep 1.5cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
28043	Exc foot/toe tum sc < 1.5 cm	J1	5072	16.9891	"$1,372.60"	.	$274.52			
28045	Exc foot/toe tum deep <1.5cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
28046	Resect foot/toe tumor < 3 cm	J1	5073	28.7016	"$2,318.89"	.	$463.78			
28047	Resect foot/toe tumor 3 cm/>	J1	5073	28.7016	"$2,318.89"	.	$463.78			
28050	Biopsy of foot joint lining	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28052	Biopsy of foot joint lining	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28054	Biopsy of toe joint lining	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28055	Neurectomy foot	J1	5431	21.2809	"$1,719.35"	.	$343.87			
28060	Partial removal foot fascia	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28062	Removal of foot fascia	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28070	Removal of foot joint lining	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28072	Removal of foot joint lining	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28080	Removal of foot lesion	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28086	Excise foot tendon sheath	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28088	Excise foot tendon sheath	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28090	Removal of foot lesion	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28092	Removal of toe lesions	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28100	Removal of ankle/heel lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28102	Remove/graft foot lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28103	Remove/graft foot lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28104	Removal of foot lesion	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28106	Remove/graft foot lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28107	Remove/graft foot lesion	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28108	Removal of toe lesions	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28110	Part removal of metatarsal	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28111	Part removal of metatarsal	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28112	Part removal of metatarsal	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28113	Part removal of metatarsal	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28114	Removal of metatarsal heads	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28116	Revision of foot	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28118	Removal of heel bone	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28119	Removal of heel spur	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28120	Part removal of ankle/heel	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28122	Partial removal of foot bone	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28124	Partial removal of toe	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28126	Partial removal of toe	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28130	Removal of ankle bone	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28140	Removal of metatarsal	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28150	Removal of toe	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28153	Partial removal of toe	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28160	Partial removal of toe	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28171	Resect tarsal tumor	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28173	Resect metatarsal tumor	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28175	Resect phalanx of toe tumor	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28190	Removal of foot foreign body	T	5071	7.5503	$610.01	.	$122.01			
28192	Removal of foot foreign body	J1	5072	16.9891	"$1,372.60"	.	$274.52			
28193	Removal of foot foreign body	J1	5072	16.9891	"$1,372.60"	.	$274.52			
28200	Repair of foot tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28202	Repair/graft of foot tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28208	Repair of foot tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28210	Repair/graft of foot tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28220	Release of foot tendon	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28222	Release of foot tendons	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28225	Release of foot tendon	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28226	Release of foot tendons	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28230	Incision of foot tendon(s)	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28232	Incision of toe tendon	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28234	Incision of foot tendon	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28238	Revision of foot tendon	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28240	Release of big toe	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28250	Revision of foot fascia	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28260	Release of midfoot joint	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28261	Revision of foot tendon	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28262	Revision of foot and ankle	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28264	Release of midfoot joint	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28270	Release of foot contracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28272	Release of toe joint each	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28280	Fusion of toes	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28285	Repair of hammertoe	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28286	Repair of hammertoe	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28288	Partial removal of foot bone	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28289	Corrj halux rigdus w/o implt	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28291	Corrj halux rigdus w/implt	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28292	Correction hallux valgus	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28295	Correction hallux valgus	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28296	Correction hallux valgus	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28297	Correction hallux valgus	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28298	Correction hallux valgus	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28299	Correction hallux valgus	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28300	Incision of heel bone	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28302	Incision of ankle bone	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28304	Incision of midfoot bones	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28305	Incise/graft midfoot bones	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28306	Incision of metatarsal	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28307	Incision of metatarsal	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28308	Incision of metatarsal	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28309	Incision of metatarsals	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28310	Revision of big toe	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28312	Revision of toe	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28313	Repair deformity of toe	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28315	Removal of sesamoid bone	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28320	Repair of foot bones	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
28322	Repair of metatarsals	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28340	Resect enlarged toe tissue	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28341	Resect enlarged toe	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28344	Repair extra toe(s)	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28345	Repair webbed toe(s)	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28360	Reconstruct cleft foot	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28400	Treatment of heel fracture	T	5111	2.6691	$215.64	.	$43.13			
28405	Treatment of heel fracture	T	5111	2.6691	$215.64	.	$43.13			
28406	Treatment of heel fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28415	Treat heel fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28420	Treat/graft heel fracture	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
28430	Treatment of ankle fracture	T	5111	2.6691	$215.64	.	$43.13			
28435	Treatment of ankle fracture	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28436	Treatment of ankle fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28445	Treat ankle fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28446	Osteochondral talus autogrft	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28450	Treat midfoot fracture each	T	5111	2.6691	$215.64	.	$43.13			
28455	Treat midfoot fracture each	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28456	Treat midfoot fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28465	Treat midfoot fracture each	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28470	Treat metatarsal fracture	T	5111	2.6691	$215.64	.	$43.13			
28475	Treat metatarsal fracture	T	5111	2.6691	$215.64	.	$43.13			
28476	Treat metatarsal fracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28485	Treat metatarsal fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28490	Treat big toe fracture	T	5111	2.6691	$215.64	.	$43.13			
28495	Treat big toe fracture	T	5111	2.6691	$215.64	.	$43.13			
28496	Treat big toe fracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28505	Treat big toe fracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28510	Treatment of toe fracture	T	5111	2.6691	$215.64	.	$43.13			
28515	Treatment of toe fracture	T	5111	2.6691	$215.64	.	$43.13			
28525	Treat toe fracture	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28530	Treat sesamoid bone fracture	T	5111	2.6691	$215.64	.	$43.13			
28531	Treat sesamoid bone fracture	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28540	Treat foot dislocation	T	5111	2.6691	$215.64	.	$43.13			
28545	Treat foot dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28546	Treat foot dislocation	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28555	Repair foot dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28570	Treat foot dislocation	T	5111	2.6691	$215.64	.	$43.13			
28575	Treat foot dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28576	Treat foot dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28585	Repair foot dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28600	Treat foot dislocation	T	5111	2.6691	$215.64	.	$43.13			
28605	Treat foot dislocation	T	5111	2.6691	$215.64	.	$43.13			
28606	Treat foot dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28615	Repair foot dislocation	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28630	Treat toe dislocation	T	5111	2.6691	$215.64	.	$43.13			
28635	Treat toe dislocation	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28636	Treat toe dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28645	Repair toe dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28660	Treat toe dislocation	T	5111	2.6691	$215.64	.	$43.13			
28665	Treat toe dislocation	T	5102	2.8445	$229.82	.	$45.97			
28666	Treat toe dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28675	Repair of toe dislocation	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28705	Fusion of foot bones	J1	5116	197.3696	"$15,946.08"	.	"$3,189.22"	*		
28715	Fusion of foot bones	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
28725	Fusion of foot bones	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
28730	Fusion of foot bones	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
28735	Fusion of foot bones	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
28737	Revision of foot bones	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
28740	Fusion of foot bones	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28750	Fusion of big toe joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28755	Fusion of big toe joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28760	Fusion of big toe joint	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
28800	Amputation of midfoot	C								
28805	Amputation thru metatarsal	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28810	Amputation toe & metatarsal	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28820	Amputation of toe	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28825	Partial amputation of toe	J1	5113	33.8823	"$2,737.45"	.	$547.49			
28890	Hi enrgy eswt plantar fascia	J1	5112	16.7761	"$1,355.39"	.	$271.08			
28899	Foot/toes surgery procedure	T	5111	2.6691	$215.64	.	$43.13			
29000	Application of body cast	T	5102	2.8445	$229.82	.	$45.97			
29010	Application of body cast	T	5102	2.8445	$229.82	.	$45.97			
29015	Application of body cast	T	5102	2.8445	$229.82	.	$45.97			
29035	Application of body cast	T	5102	2.8445	$229.82	.	$45.97			
29040	Application of body cast	T	5102	2.8445	$229.82	.	$45.97			
29044	Application of body cast	T	5101	1.6553	$133.74	.	$26.75			
29046	Application of body cast	T	5102	2.8445	$229.82	.	$45.97			
29049	Application of figure eight	T	5102	2.8445	$229.82	.	$45.97			
29055	Application of shoulder cast	T	5102	2.8445	$229.82	.	$45.97			
29058	Application of shoulder cast	T	5102	2.8445	$229.82	.	$45.97			
29065	Application of long arm cast	T	5102	2.8445	$229.82	.	$45.97			
29075	Application of forearm cast	T	5102	2.8445	$229.82	.	$45.97			
29085	Apply hand/wrist cast	T	5101	1.6553	$133.74	.	$26.75			
29086	Apply finger cast	T	5101	1.6553	$133.74	.	$26.75			
29105	Apply long arm splint	T	5101	1.6553	$133.74	.	$26.75			
29125	Apply forearm splint	Q1	5734	1.3495	$109.03	.	$21.81			
29126	Apply forearm splint	Q1	5734	1.3495	$109.03	.	$21.81			
29130	Application of finger splint	Q1	5733	0.6809	$55.01	.	$11.01			
29131	Application of finger splint	Q1	5733	0.6809	$55.01	.	$11.01			
29200	Strapping of chest	T	5101	1.6553	$133.74	.	$26.75			
29240	Strapping of shoulder	Q1	5734	1.3495	$109.03	.	$21.81			
29260	Strapping of elbow or wrist	Q1	5732	0.4138	$33.43	.	$6.69			
29280	Strapping of hand or finger	Q1	5732	0.4138	$33.43	.	$6.69			
29305	Application of hip cast	T	5102	2.8445	$229.82	.	$45.97			
29325	Application of hip casts	T	5102	2.8445	$229.82	.	$45.97			
29345	Application of long leg cast	T	5102	2.8445	$229.82	.	$45.97			
29355	Application of long leg cast	T	5102	2.8445	$229.82	.	$45.97			
29358	Apply long leg cast brace	T	5102	2.8445	$229.82	.	$45.97			
29365	Application of long leg cast	T	5102	2.8445	$229.82	.	$45.97			
29405	Apply short leg cast	T	5102	2.8445	$229.82	.	$45.97			
29425	Apply short leg cast	T	5102	2.8445	$229.82	.	$45.97			
29435	Apply short leg cast	T	5102	2.8445	$229.82	.	$45.97			
29440	Addition of walker to cast	T	5101	1.6553	$133.74	.	$26.75			
29445	Apply rigid leg cast	T	5102	2.8445	$229.82	.	$45.97			
29450	Application of leg cast	T	5101	1.6553	$133.74	.	$26.75			
29505	Application long leg splint	T	5101	1.6553	$133.74	.	$26.75			
29515	Application lower leg splint	T	5101	1.6553	$133.74	.	$26.75			
29520	Strapping of hip	Q1	5733	0.6809	$55.01	.	$11.01			
29530	Strapping of knee	Q1	5734	1.3495	$109.03	.	$21.81			
29540	Strapping of ankle and/or ft	T	5101	1.6553	$133.74	.	$26.75			
29550	Strapping of toes	Q1	5733	0.6809	$55.01	.	$11.01			
29580	Application of paste boot	T	5101	1.6553	$133.74	.	$26.75			
29581	Apply multlay comprs lwr leg	T	5101	1.6553	$133.74	.	$26.75			
29584	Appl multlay comprs arm/hand	T	5101	1.6553	$133.74	.	$26.75			
29700	Removal/revision of cast	T	5102	2.8445	$229.82	.	$45.97			
29705	Removal/revision of cast	T	5102	2.8445	$229.82	.	$45.97			
29710	Removal/revision of cast	T	5102	2.8445	$229.82	.	$45.97			
29720	Repair of body cast	T	5101	1.6553	$133.74	.	$26.75			
29730	Windowing of cast	T	5101	1.6553	$133.74	.	$26.75			
29740	Wedging of cast	T	5102	2.8445	$229.82	.	$45.97			
29750	Wedging of clubfoot cast	T	5102	2.8445	$229.82	.	$45.97			
29799	Casting/strapping procedure	T	5101	1.6553	$133.74	.	$26.75			
29800	Jaw arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29804	Jaw arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29805	Shoulder arthroscopy dx	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29806	Shoulder arthroscopy/surgery	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29807	Shoulder arthroscopy/surgery	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29819	Shoulder arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29820	Shoulder arthroscopy/surgery	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29821	Shoulder arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29822	Shoulder arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29823	Shoulder arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29824	Shoulder arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29825	Shoulder arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29826	Shoulder arthroscopy/surgery	N								
29827	Arthroscop rotator cuff repr	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29828	Arthroscopy biceps tenodesis	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29830	Elbow arthroscopy	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29834	Elbow arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29835	Elbow arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29836	Elbow arthroscopy/surgery	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29837	Elbow arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29838	Elbow arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29840	Wrist arthroscopy	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29843	Wrist arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29844	Wrist arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29845	Wrist arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29846	Wrist arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29847	Wrist arthroscopy/surgery	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29848	Wrist endoscopy/surgery	J1	5112	16.7761	"$1,355.39"	.	$271.08			
29850	Knee arthroscopy/surgery	J1	5112	16.7761	"$1,355.39"	.	$271.08			
29851	Knee arthroscopy/surgery	J1	5112	16.7761	"$1,355.39"	.	$271.08			
29855	Tibial arthroscopy/surgery	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29856	Tibial arthroscopy/surgery	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
29860	Hip arthroscopy dx	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29861	Hip arthro w/fb removal	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29862	Hip arthr0 w/debridement	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29863	Hip arthr0 w/synovectomy	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29866	Autgrft implnt knee w/scope	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29867	Allgrft implnt knee w/scope	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
29868	Meniscal trnspl knee w/scpe	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29870	Knee arthroscopy dx	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29871	Knee arthroscopy/drainage	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29873	Knee arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29874	Knee arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29875	Knee arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29876	Knee arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29877	Knee arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29879	Knee arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29880	Knee arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29881	Knee arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29882	Knee arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29883	Knee arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29884	Knee arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29885	Knee arthroscopy/surgery	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29886	Knee arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29887	Knee arthroscopy/surgery	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29888	Knee arthroscopy/surgery	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29889	Knee arthroscopy/surgery	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
29891	Ankle arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29892	Ankle arthroscopy/surgery	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29893	Scope plantar fasciotomy	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29894	Ankle arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29895	Ankle arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29897	Ankle arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29898	Ankle arthroscopy/surgery	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29899	Ankle arthroscopy/surgery	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29900	Mcp joint arthroscopy dx	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29901	Mcp joint arthroscopy surg	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29902	Mcp joint arthroscopy surg	J1	5112	16.7761	"$1,355.39"	.	$271.08			
29904	Subtalar arthro w/fb rmvl	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29905	Subtalar arthro w/exc	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29906	Subtalar arthro w/deb	J1	5113	33.8823	"$2,737.45"	.	$547.49			
29907	Subtalar arthro w/fusion	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
29914	Hip arthro w/femoroplasty	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29915	Hip arthro acetabuloplasty	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29916	Hip arthro w/labral repair	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
29999	Arthroscopy of joint	T	5111	2.6691	$215.64	.	$43.13			
30000	Drainage of nose lesion	T	5161	2.5205	$203.64	.	$40.73			
30020	Drainage of nose lesion	T	5162	5.4673	$441.72	.	$88.35			
3006F	Cxr doc rev	E1								
3008F	Body mass index docd	E1								
30100	Intranasal biopsy	J1	5163	16.7012	"$1,349.34"	.	$269.87			
30110	Removal of nose polyp(s)	J1	5163	16.7012	"$1,349.34"	.	$269.87			
30115	Removal of nose polyp(s)	J1	5164	32.4198	"$2,619.29"	.	$523.86			
30117	Removal of intranasal lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
30118	Removal of intranasal lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
3011F	Lipid panel doc rev	E1								
30120	Revision of nose	J1	5164	32.4198	"$2,619.29"	.	$523.86			
30124	Removal of nose lesion	J1	5163	16.7012	"$1,349.34"	.	$269.87			
30125	Removal of nose lesion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
30130	Excise inferior turbinate	J1	5164	32.4198	"$2,619.29"	.	$523.86			
30140	Resect inferior turbinate	J1	5164	32.4198	"$2,619.29"	.	$523.86			
3014F	Screen mammo doc rev	E1								
30150	Partial removal of nose	J1	5165	60.0365	"$4,850.53"	.	$970.11			
3015F	Cerv cancer screen docd	E1								
30160	Removal of nose	J1	5165	60.0365	"$4,850.53"	.	$970.11			
3016F	Pt scrnd unhlthy oh use	E1								
3017F	Colorectal ca screen doc rev	M								
3018F	Pre-prxd rsk et al docd	E1								
3019F	Lvef assess planpost dschrge	E1								
30200	Injection treatment of nose	T	5162	5.4673	$441.72	.	$88.35			
3020F	Lvf assess	E1								
30210	Nasal sinus therapy	J1	5163	16.7012	"$1,349.34"	.	$269.87			
3021F	Lvef mod/sever deprs syst	M								
30220	Insert nasal septal button	J1	5163	16.7012	"$1,349.34"	.	$269.87			
3022F	Lvef >/=40% systolic	M								
3023F	Spirom doc rev	M								
3025F	Spirom fev/fvc <70% w/copd	E1								
3027F	Spirom fev/fvc>/=70%/w/ocopd	E1								
3028F	O2 saturation doc rev	E1								
30300	Remove nasal foreign body	Q1	5734	1.3495	$109.03	.	$21.81			
30310	Remove nasal foreign body	J1	5164	32.4198	"$2,619.29"	.	$523.86			
30320	Remove nasal foreign body	J1	5163	16.7012	"$1,349.34"	.	$269.87			
3035F	O2 saturation</=88%/pao</=55	E1								
3037F	O2 saturation >88%/pao>55 hg	E1								
3038F	Pulm fx w/in 12 mon b/4 surg	E1								
30400	Reconstruction of nose	J1	5165	60.0365	"$4,850.53"	.	$970.11			
3040F	Fev <40% predicted value	E1								
30410	Reconstruction of nose	J1	5165	60.0365	"$4,850.53"	.	$970.11			
30420	Reconstruction of nose	J1	5165	60.0365	"$4,850.53"	.	$970.11			
3042F	Fev >/=40% predicted value	E1								
30430	Revision of nose	J1	5165	60.0365	"$4,850.53"	.	$970.11			
30435	Revision of nose	J1	5165	60.0365	"$4,850.53"	.	$970.11			
3044F	Hg a1c level lt 7.0%	M								
30450	Revision of nose	J1	5165	60.0365	"$4,850.53"	.	$970.11			
30460	Revision of nose	J1	5165	60.0365	"$4,850.53"	.	$970.11			
30462	Revision of nose	J1	5165	60.0365	"$4,850.53"	.	$970.11			
30465	Repair nasal stenosis	J1	5165	60.0365	"$4,850.53"	.	$970.11			
3046F	Hemoglobin a1c level >9.0%	M								
3048F	Ldl-c <100 mg/dl	E1								
3049F	Ldl-c 100-129 mg/dl	E1								
3050F	Ldl-c >/= 130 mg/dl	E1								
3051F	Hg a1c>equal 7.0%<8.0%	E1								
30520	Repair of nasal septum	J1	5164	32.4198	"$2,619.29"	.	$523.86			
3052F	Hg a1c>equal 8.0%<equal 9.0%	E1								
30540	Repair nasal defect	J1	5165	60.0365	"$4,850.53"	.	$970.11			
30545	Repair nasal defect	J1	5165	60.0365	"$4,850.53"	.	$970.11			
3055F	Lvef less than/equal to 35%	E1								
30560	Release of nasal adhesions	T	5162	5.4673	$441.72	.	$88.35			
3056F	Lvef greater than 35%	E1								
30580	Repair upper jaw fistula	J1	5165	60.0365	"$4,850.53"	.	$970.11			
30600	Repair mouth/nose fistula	J1	5165	60.0365	"$4,850.53"	.	$970.11			
3060F	Pos microalbuminuria rev	M								
3061F	Neg microalbuminuria rev	M								
30620	Intranasal reconstruction	J1	5165	60.0365	"$4,850.53"	.	$970.11			
3062F	Pos macroalbuminuria rev	M								
30630	Repair nasal septum defect	J1	5164	32.4198	"$2,619.29"	.	$523.86			
3066F	Nephropathy doc tx	M								
3072F	Low risk for retinopathy	M								
3073F	Pre-surg eye measures docd	E1								
3074F	Syst bp lt 130 mm hg	E1								
3075F	Syst bp ge 130 - 139mm hg	E1								
3077F	Syst bp >/= 140 mm hg	E1								
3078F	Diast bp <80 mm hg	E1								
3079F	Diast bp 80-89 mm hg	E1								
30801	Ablate inf turbinate superf	J1	5163	16.7012	"$1,349.34"	.	$269.87			
30802	Ablate inf turbinate submuc	J1	5163	16.7012	"$1,349.34"	.	$269.87			
3080F	Diast bp >/= 90 mm hg	E1								
3082F	Kt/v <1.2	E1								
3083F	Kt/v =/> 1.2 & <1.7	E1								
3084F	Kt/v >= 1.7	E1								
3085F	Suicide risk assessed	E1								
3088F	Mdd mild	E1								
3089F	Mdd moderate	E1								
30901	Control of nosebleed	Q1	5734	1.3495	$109.03	.	$21.81			
30903	Control of nosebleed	T	5734	1.3495	$109.03	.	$21.81			
30905	Control of nosebleed	T	5734	1.3495	$109.03	.	$21.81			
30906	Repeat control of nosebleed	T	5161	2.5205	$203.64	.	$40.73			
3090F	Mdd severe w/o psych	E1								
30915	Ligation nasal sinus artery	J1	5183	34.3010	"$2,771.28"	.	$554.26			
3091F	Mdd severe w/psych	E1								
30920	Ligation upper jaw artery	J1	5183	34.3010	"$2,771.28"	.	$554.26			
3092F	Mdd in remission	E1								
30930	Ther fx nasal inf turbinate	J1	5164	32.4198	"$2,619.29"	.	$523.86			
3093F	Doc new diag 1st/addl mdd	E1								
3095F	Central dexa results docd	M								
3096F	Central dexa ordered	E1								
30999	Nasal surgery procedure	T	5161	2.5205	$203.64	.	$40.73			
31000	Irrigation maxillary sinus	T	5161	2.5205	$203.64	.	$40.73			
31002	Irrigation sphenoid sinus	J1	5163	16.7012	"$1,349.34"	.	$269.87			
3100F	Image test ref carot diam	M								
31020	Exploration maxillary sinus	J1	5164	32.4198	"$2,619.29"	.	$523.86			
31030	Exploration maxillary sinus	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31032	Explore sinus remove polyps	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31040	Exploration behind upper jaw	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31050	Exploration sphenoid sinus	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31051	Sphenoid sinus surgery	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31070	Exploration of frontal sinus	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31075	Exploration of frontal sinus	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31080	Removal of frontal sinus	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31081	Removal of frontal sinus	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31084	Removal of frontal sinus	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31085	Removal of frontal sinus	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31086	Removal of frontal sinus	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31087	Removal of frontal sinus	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31090	Exploration of sinuses	J1	5165	60.0365	"$4,850.53"	.	$970.11			
3110F	Pres/absn hmrhg/lesion docd	E1								
3111F	Ct/mri brain done w/in 24hrs	E1								
3112F	Ct/mri brain done 24 hrs	E1								
3115F	Quant results activity &symp	E1								
3117F	Hf assessment tool completed	E1								
3118F	Ny heart assoc class docd	E1								
3119F	No eval activity clin symp	E1								
31200	Removal of ethmoid sinus	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31201	Removal of ethmoid sinus	J1	5163	16.7012	"$1,349.34"	.	$269.87			
31205	Removal of ethmoid sinus	J1	5164	32.4198	"$2,619.29"	.	$523.86			
3120F	12-lead ecg performed	E1								
31225	Removal of upper jaw	C								
31230	Removal of upper jaw	C								
31231	Nasal endoscopy dx	T	5151	1.9377	$156.55	.	$31.31			
31233	Nsl/sins ndsc dx max sinusc	T	5152	4.6773	$377.89	.	$75.58			
31235	Nsl/sins ndsc dx sphn sinusc	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31237	Nasal/sinus endoscopy surg	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31238	Nasal/sinus endoscopy surg	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31239	Nasal/sinus endoscopy surg	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31240	Nasal/sinus endoscopy surg	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31241	Nsl/sins ndsc w/artery lig	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31253	Nsl/sins ndsc total	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31254	Nsl/sins ndsc w/prtl ethmdct	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31255	Nsl/sins ndsc w/tot ethmdct	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31256	Exploration maxillary sinus	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31257	Nsl/sins ndsc tot w/sphendt	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31259	Nsl/sins ndsc sphn tiss rmvl	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31267	Endoscopy maxillary sinus	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
3126F	Esoph bx rprt w/dyspl info	M								
31276	Nsl/sins ndsc frnt tiss rmvl	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31287	Nasal/sinus endoscopy surg	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31288	Nasal/sinus endoscopy surg	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31290	Nasal/sinus endoscopy surg	C								
31291	Nasal/sinus endoscopy surg	C								
31292	Nsl/sins ndsc med/inf dcmprn	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31293	Nsl/sins ndsc med&inf dcmprn	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31294	Nsl/sins ndsc surg on dcmprn	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31295	Nsl/sins ndsc surg max sins	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31296	Nsl/sins ndsc surg frnt sins	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31297	Nsl/sins ndsc surg sphn sins	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31298	Nsl/sins ndsc surg frnt&sphn	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31299	Sinus surgery procedure	T	5161	2.5205	$203.64	.	$40.73			
31300	Removal of larynx lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
3130F	Upper gi endoscopy performed	E1								
3132F	Doc ref upper gi endoscopy	E1								
31360	Removal of larynx	C								
31365	Removal of larynx	C								
31367	Partial removal of larynx	C								
31368	Partial removal of larynx	C								
31370	Partial removal of larynx	C								
31375	Partial removal of larynx	C								
31380	Partial removal of larynx	C								
31382	Partial removal of larynx	C								
31390	Removal of larynx & pharynx	C								
31395	Reconstruct larynx & pharynx	C								
31400	Revision of larynx	J1	5165	60.0365	"$4,850.53"	.	$970.11			
3140F	Upper gi endo shows barrtts	E1								
3141F	Upper gi endo not barrtts	E1								
31420	Removal of epiglottis	J1	5165	60.0365	"$4,850.53"	.	$970.11			
3142F	Barium swallow test ordered	E1								
31500	Insert emergency airway	T	5161	2.5205	$203.64	.	$40.73			
31502	Change of windpipe airway	T	5161	2.5205	$203.64	.	$40.73			
31505	Diagnostic laryngoscopy	T	5151	1.9377	$156.55	.	$31.31			
3150F	Forceps esoph biopsy done	E1								
31510	Laryngoscopy with biopsy	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31511	Remove foreign body larynx	T	5151	1.9377	$156.55	.	$31.31			
31512	Removal of larynx lesion	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31513	Injection into vocal cord	T	5152	4.6773	$377.89	.	$75.58			
31515	Laryngoscopy for aspiration	T	5152	4.6773	$377.89	.	$75.58			
31520	Dx laryngoscopy newborn	T	5152	4.6773	$377.89	.	$75.58			
31525	Dx laryngoscopy excl nb	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31526	Dx laryngoscopy w/oper scope	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31527	Laryngoscopy for treatment	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31528	Laryngoscopy and dilation	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31529	Laryngoscopy and dilation	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31530	Laryngoscopy w/fb removal	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31531	Laryngoscopy w/fb & op scope	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31535	Laryngoscopy w/biopsy	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31536	Laryngoscopy w/bx & op scope	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31540	Laryngoscopy w/exc of tumor	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31541	Larynscop w/tumr exc + scope	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31545	Remove vc lesion w/scope	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31546	Remove vc lesion scope/graft	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31551	Laryngoplasty laryngeal sten	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31552	Laryngoplasty laryngeal sten	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31553	Laryngoplasty laryngeal sten	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31554	Laryngoplasty laryngeal sten	J1	5165	60.0365	"$4,850.53"	.	$970.11			
3155F	Cytogen test marrow b/4 tx	M								
31560	Laryngoscop w/arytenoidectom	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31561	Larynscop remve cart + scop	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31570	Laryngoscope w/vc inj	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31571	Laryngoscop w/vc inj + scope	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31572	Largsc w/laser dstrj les	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31573	Largsc w/ther injection	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31574	Largsc w/njx augmentation	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31575	Diagnostic laryngoscopy	T	5151	1.9377	$156.55	.	$31.31			
31576	Laryngoscopy with biopsy	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31577	Largsc w/rmvl foreign bdy(s)	T	5152	4.6773	$377.89	.	$75.58			
31578	Largsc w/removal lesion	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31579	Laryngoscopy telescopic	T	5152	4.6773	$377.89	.	$75.58			
31580	Laryngoplasty laryngeal web	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31584	Laryngoplasty fx rdctj fixj	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31587	Laryngoplasty cricoid split	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31590	Reinnervate larynx	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31591	Laryngoplasty medialization	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31592	Cricotracheal resection	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31599	Larynx surgery procedure	T	5161	2.5205	$203.64	.	$40.73			
31600	Incision of windpipe	J1	5164	32.4198	"$2,619.29"	.	$523.86			
31601	Incision of windpipe	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31603	Incision of windpipe	J1	5163	16.7012	"$1,349.34"	.	$269.87			
31605	Incision of windpipe	T	5161	2.5205	$203.64	.	$40.73			
3160F	Doc fe+ stores b/4 epo thx	M								
31610	Incision of windpipe	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31611	Surgery/speech prosthesis	J1	5164	32.4198	"$2,619.29"	.	$523.86			
31612	Puncture/clear windpipe	J1	5164	32.4198	"$2,619.29"	.	$523.86			
31613	Repair windpipe opening	J1	5164	32.4198	"$2,619.29"	.	$523.86			
31614	Repair windpipe opening	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31615	Visualization of windpipe	T	5162	5.4673	$441.72	.	$88.35			
31622	Dx bronchoscope/wash	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31623	Dx bronchoscope/brush	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31624	Dx bronchoscope/lavage	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31625	Bronchoscopy w/biopsy(s)	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31626	Bronchoscopy w/markers	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31627	Navigational bronchoscopy	N								
31628	Bronchoscopy/lung bx each	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31629	Bronchoscopy/needle bx each	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31630	Bronchoscopy dilate/fx repr	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31631	Bronchoscopy dilate w/stent	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31632	Bronchoscopy/lung bx addl	N								
31633	Bronchoscopy/needle bx addl	N								
31634	Bronch w/balloon occlusion	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31635	Bronchoscopy w/fb removal	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31636	Bronchoscopy bronch stents	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31637	Bronchoscopy stent add-on	N								
31638	Bronchoscopy revise stent	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31640	Bronchoscopy w/tumor excise	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31641	Bronchoscopy treat blockage	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31643	Diag bronchoscope/catheter	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31645	Brnchsc w/ther aspir 1st	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31646	Brnchsc w/ther aspir sbsq	T	5152	4.6773	$377.89	.	$75.58			
31647	Bronchial valve init insert	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31648	Bronchial valve remov init	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31649	Bronchial valve remov addl	Q2	5153	17.7071	"$1,430.61"	.	$286.13			
31651	Bronchial valve addl insert	N								
31652	Bronch ebus samplng 1/2 node	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31653	Bronch ebus samplng 3/> node	J1	5154	36.3510	"$2,936.91"	.	$587.39			
31654	Bronch ebus ivntj perph les	N								
31660	Bronch thermoplsty 1 lobe	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
31661	Bronch thermoplsty 2/> lobes	J1	5155	67.3370	"$5,440.36"	.	"$1,088.08"			
3170F	Baselin flo cytometry b/4 tx	M								
31717	Bronchial brush biopsy	T	5152	4.6773	$377.89	.	$75.58			
31720	Clearance of airways	Q1	5791	2.2769	$183.96	.	$36.80			
31725	Clearance of airways	C								
31730	Intro windpipe wire/tube	J1	5153	17.7071	"$1,430.61"	.	$286.13			
31750	Repair of windpipe	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31755	Repair of windpipe	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31760	Repair of windpipe	C								
31766	Reconstruction of windpipe	C								
31770	Repair/graft of bronchus	C								
31775	Reconstruct bronchus	C								
31780	Reconstruct windpipe	C								
31781	Reconstruct windpipe	C								
31785	Remove windpipe lesion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
31786	Remove windpipe lesion	C								
31800	Repair of windpipe injury	C								
31805	Repair of windpipe injury	C								
31820	Closure of windpipe lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
31825	Repair of windpipe defect	J1	5164	32.4198	"$2,619.29"	.	$523.86			
31830	Revise windpipe scar	J1	5164	32.4198	"$2,619.29"	.	$523.86			
31899	Airways surgical procedure	T	5151	1.9377	$156.55	.	$31.31			
3200F	Barium swallow test not req	E1								
32035	Thoracostomy w/rib resection	C								
32036	Thoracostomy w/flap drainage	C								
32096	Open wedge/bx lung infiltr	C								
32097	Open wedge/bx lung nodule	C								
32098	Open biopsy of lung pleura	C								
32100	Exploration of chest	C								
3210F	Grp a strep test performed	M								
32110	Explore/repair chest	C								
32120	Re-exploration of chest	C								
32124	Explore chest free adhesions	C								
32140	Removal of lung lesion(s)	C								
32141	Remove/treat lung lesions	C								
32150	Removal of lung lesion(s)	C								
32151	Remove lung foreign body	C								
3215F	Pt immunity to hep a docd	E1								
32160	Open chest heart massage	C								
3216F	Pt immunity to hep b docd	E1								
3218F	Rna tstng hep c docd done	E1								
32200	Drain open lung lesion	C								
3220F	Hep c quant rna tstng docd	E1								
32215	Treat chest lining	C								
32220	Release of lung	C								
32225	Partial release of lung	C								
3230F	Note hring tst w/in 6 mon	E1								
32310	Removal of chest lining	C								
32320	Free/remove chest lining	C								
32400	Needle biopsy chest lining	J1	5072	16.9891	"$1,372.60"	.	$274.52			
32405	Percut bx lung/mediastinum	J1	5072	16.9891	"$1,372.60"	.	$274.52			
32440	Remove lung pneumonectomy	C								
32442	Sleeve pneumonectomy	C								
32445	Removal of lung extrapleural	C								
32480	Partial removal of lung	C								
32482	Bilobectomy	C								
32484	Segmentectomy	C								
32486	Sleeve lobectomy	C								
32488	Completion pneumonectomy	C								
32491	Lung volume reduction	C								
32501	Repair bronchus add-on	C								
32503	Resect apical lung tumor	C								
32504	Resect apical lung tum/chest	C								
32505	Wedge resect of lung initial	C								
32506	Wedge resect of lung add-on	C								
32507	Wedge resect of lung diag	C								
3250F	Nonprim loc anat bx site tum	M								
32540	Removal of lung lesion	C								
32550	Insert pleural cath	J1	5341	38.4853	"$3,109.34"	.	$621.87			
32551	Insertion of chest tube	J1	5182	20.1890	"$1,631.13"	.	$326.23			
32552	Remove lung catheter	Q2	5181	7.8040	$630.51	.	$126.11			
32553	Ins mark thor for rt perq	S	5613	15.4140	"$1,245.34"	.	$249.07			
32554	Aspirate pleura w/o imaging	T	5181	7.8040	$630.51	.	$126.11			
32555	Aspirate pleura w/ imaging	T	5181	7.8040	$630.51	.	$126.11			
32556	Insert cath pleura w/o image	J1	5302	19.2764	"$1,557.40"	.	$311.48			
32557	Insert cath pleura w/ image	J1	5182	20.1890	"$1,631.13"	.	$326.23			
32560	Treat pleurodesis w/agent	T	5181	7.8040	$630.51	.	$126.11			
32561	Lyse chest fibrin init day	T	5181	7.8040	$630.51	.	$126.11			
32562	Lyse chest fibrin subq day	T	5181	7.8040	$630.51	.	$126.11			
32601	Thoracoscopy diagnostic	J1	5361	59.8283	"$4,833.71"	.	$966.75			
32604	Thoracoscopy wbx sac	J1	5361	59.8283	"$4,833.71"	.	$966.75			
32606	Thoracoscopy w/bx med space	J1	5361	59.8283	"$4,833.71"	.	$966.75			
32607	Thoracoscopy w/bx infiltrate	J1	5361	59.8283	"$4,833.71"	.	$966.75			
32608	Thoracoscopy w/bx nodule	J1	5361	59.8283	"$4,833.71"	.	$966.75			
32609	Thoracoscopy w/bx pleura	J1	5361	59.8283	"$4,833.71"	.	$966.75			
3260F	Pt cat/pn cat/hist grd docd	M								
32650	Thoracoscopy w/pleurodesis	C								
32651	Thoracoscopy remove cortex	C								
32652	Thoracoscopy rem totl cortex	C								
32653	Thoracoscopy remov fb/fibrin	C								
32654	Thoracoscopy contrl bleeding	C								
32655	Thoracoscopy resect bullae	C								
32656	Thoracoscopy w/pleurectomy	C								
32658	Thoracoscopy w/sac fb remove	C								
32659	Thoracoscopy w/sac drainage	C								
3265F	Rna tstng hepc vir ord/docd	E1								
32661	Thoracoscopy w/pericard exc	C								
32662	Thoracoscopy w/mediast exc	C								
32663	Thoracoscopy w/lobectomy	C								
32664	Thoracoscopy w/ th nrv exc	C								
32665	Thoracoscop w/esoph musc exc	C								
32666	Thoracoscopy w/wedge resect	C								
32667	Thoracoscopy w/w resect addl	C								
32668	Thoracoscopy w/w resect diag	C								
32669	Thoracoscopy remove segment	C								
3266F	Hepc gn tstng docd b/4txmnt	E1								
32670	Thoracoscopy bilobectomy	C								
32671	Thoracoscopy pneumonectomy	C								
32672	Thoracoscopy for lvrs	C								
32673	Thoracoscopy w/thymus resect	C								
32674	Thoracoscopy lymph node exc	C								
3267F	Path rprt w/ pt pn cat et al	M								
3268F	Psa/t/glsc docd b/4 txmnt	E1								
3269F	Bone scn b/4 txmnt/aftr dx	M								
32701	Thorax stereo rad targetw/tx	B								
3270F	No bone scn b/4 txmnt/aftrdx	M								
3271F	Low risk prostate cancer	E1								
3272F	Med risk prostate cancer	E1								
3273F	High risk prostate cancer	E1								
3274F	Prost cncr rsk not lw/md/hgh	E1								
3278F	Serum lvls ca/ipth/lpd ord	E1								
3279F	Hgb lvl >/= 13 g/dl	E1								
32800	Repair lung hernia	C								
3280F	Hgb lvl 11-12.9 g/dl	E1								
32810	Close chest after drainage	C								
32815	Close bronchial fistula	C								
3281F	Hgb lvl <11 g/dl	E1								
32820	Reconstruct injured chest	C								
3284F	Iop down >15% of pre-svc lvl	M								
32850	Donor pneumonectomy	C								
32851	Lung transplant single	C								
32852	Lung transplant with bypass	C								
32853	Lung transplant double	C								
32854	Lung transplant with bypass	C								
32855	Prepare donor lung single	C								
32856	Prepare donor lung double	C								
3285F	Iop down <15% of pre-svc lvl	M								
3288F	Fall risk assessment docd	M								
32900	Removal of rib(s)	C								
32905	Revise & repair chest wall	C								
32906	Revise & repair chest wall	C								
3290F	Pt=d(rh)- and unsensitized	E1								
3291F	Pt=d(rh)+ or sensitized	E1								
3292F	Hiv tstng asked/docd/revwd	E1								
3293F	Abo rh blood typing docd	E1								
32940	Revision of lung	C								
3294F	Grp b strep screening docd	E1								
32960	Therapeutic pneumothorax	T	5181	7.8040	$630.51	.	$126.11			
32994	Ablate pulm tumor perq crybl	J1	5361	59.8283	"$4,833.71"	.	$966.75			
32997	Total lung lavage	C								
32998	Ablate pulm tumor perq rf	J1	5361	59.8283	"$4,833.71"	.	$966.75			
32999	Chest surgery procedure	T	5181	7.8040	$630.51	.	$126.11			
3300F	Ajcc stage docd b/4 thxpy	M								
33016	Pericardiocentesis w/imaging	J1	5182	20.1890	"$1,631.13"	.	$326.23			
33017	Prcrd drg 6yr+ w/o cgen car	C								
33018	Prcrd drg 0-5yr or w/anomly	C								
33019	Perq prcrd drg insj cath ct	C								
3301F	Cancer stage docd metast	M								
33020	Incision of heart sac	C								
33025	Incision of heart sac	C								
33030	Partial removal of heart sac	C								
33031	Partial removal of heart sac	C								
33050	Resect heart sac lesion	C								
33120	Removal of heart lesion	C								
33130	Removal of heart lesion	C								
33140	Heart revascularize (tmr)	C								
33141	Heart tmr w/other procedure	C								
3315F	Er+ or pr+ breast cancer	E1								
3316F	Er- or pr- breast cancer	E1								
3317F	Path rpt malig cancer docd	E1								
3318F	Path rpt malig cancer docd	E1								
3319F	X-ray/ct/ultrsnd et al ord	M								
33202	Insert epicard eltrd open	C								
33203	Insert epicard eltrd endo	C								
33206	Insert heart pm atrial	J1	5223	126.8914	"$10,251.94"	.	"$2,050.39"	*		
33207	Insert heart pm ventricular	J1	5223	126.8914	"$10,251.94"	.	"$2,050.39"	*		
33208	Insrt heart pm atrial & vent	J1	5223	126.8914	"$10,251.94"	.	"$2,050.39"	*		
3320F	No xray/ct/ et al ordd	M								
33210	Insert electrd/pm cath sngl	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
33211	Insert card electrodes dual	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
33212	Insert pulse gen sngl lead	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
33213	Insert pulse gen dual leads	J1	5223	126.8914	"$10,251.94"	.	"$2,050.39"	*		
33214	Upgrade of pacemaker system	J1	5223	126.8914	"$10,251.94"	.	"$2,050.39"	*		
33215	Reposition pacing-defib lead	J1	5183	34.3010	"$2,771.28"	.	$554.26			
33216	Insert 1 electrode pm-defib	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
33217	Insert 2 electrode pm-defib	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
33218	Repair lead pace-defib one	T	5221	36.9340	"$2,984.01"	.	$596.81			
3321F	Ajcc cncr 0/ia melan docd	M								
33220	Repair lead pace-defib dual	T	5221	36.9340	"$2,984.01"	.	$596.81			
33221	Insert pulse gen mult leads	J1	5224	226.6684	"$18,313.22"	.	"$3,662.65"	*		
33222	Relocation pocket pacemaker	T	5054	20.0852	"$1,622.74"	.	$324.55			
33223	Relocate pocket for defib	T	5054	20.0852	"$1,622.74"	.	$324.55			
33224	Insert pacing lead & connect	J1	5223	126.8914	"$10,251.94"	.	"$2,050.39"	*		
33225	L ventric pacing lead add-on	N								
33226	Reposition l ventric lead	J1	5183	34.3010	"$2,771.28"	.	$554.26			
33227	Remove&replace pm gen singl	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
33228	Remv&replc pm gen dual lead	J1	5223	126.8914	"$10,251.94"	.	"$2,050.39"	*		
33229	Remv&replc pm gen mult leads	J1	5224	226.6684	"$18,313.22"	.	"$3,662.65"	*		
3322F	Melanomaajcc stage 0 or ia	M								
33230	Insrt pulse gen w/dual leads	J1	5231	281.1245	"$22,712.89"	.	"$4,542.58"	*		
33231	Insrt pulse gen w/mult leads	J1	5232	399.5722	"$32,282.64"	.	"$6,456.53"	*		
33233	Removal of pm generator	Q2	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
33234	Removal of pacemaker system	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
33235	Removal pacemaker electrode	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
33236	Remove electrode/thoracotomy	C								
33237	Remove electrode/thoracotomy	C								
33238	Remove electrode/thoracotomy	C								
3323F	Clin node stgng docdb/4 surg	E1								
33240	Insrt pulse gen w/singl lead	J1	5231	281.1245	"$22,712.89"	.	"$4,542.58"	*		
33241	Remove pulse generator	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
33243	Remove eltrd/thoracotomy	C								
33244	Remove elctrd transvenously	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
33249	Insj/rplcmt defib w/lead(s)	J1	5232	399.5722	"$32,282.64"	.	"$6,456.53"	*		
3324F	Mri ct scan ord rvwd rqstd	E1								
33250	Ablate heart dysrhythm focus	C								
33251	Ablate heart dysrhythm focus	C								
33254	Ablate atria lmtd	C								
33255	Ablate atria w/o bypass ext	C								
33256	Ablate atria w/bypass exten	C								
33257	Ablate atria lmtd add-on	C								
33258	Ablate atria x10sv add-on	C								
33259	Ablate atria w/bypass add-on	C								
3325F	Preop asses 4 cataract surg	E1								
33261	Ablate heart dysrhythm focus	C								
33262	Rmvl& replc pulse gen 1 lead	J1	5231	281.1245	"$22,712.89"	.	"$4,542.58"	*		
33263	Rmvl & rplcmt dfb gen 2 lead	J1	5231	281.1245	"$22,712.89"	.	"$4,542.58"	*		
33264	Rmvl & rplcmt dfb gen mlt ld	J1	5232	399.5722	"$32,282.64"	.	"$6,456.53"	*		
33265	Ablate atria lmtd endo	C								
33266	Ablate atria x10sv endo	C								
33270	Ins/rep subq defibrillator	J1	5232	399.5722	"$32,282.64"	.	"$6,456.53"	*		
33271	Insj subq impltbl dfb elctrd	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
33272	Rmvl of subq defibrillator	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
33273	Repos prev impltbl subq dfb	T	5221	36.9340	"$2,984.01"	.	$596.81			
33274	Tcat insj/rpl perm ldls pm	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
33275	Tcat rmvl perm ldls pm w/img	T	5183	34.3010	"$2,771.28"	.	$554.26			
33285	Insj subq car rhythm mntr	J1	5222	94.5856	"$7,641.85"	.	"$1,528.37"	*		
33286	Rmvl subq car rhythm mntr	Q2	5071	7.5503	$610.01	.	$122.01			
33289	Tcat impl wrls p-art prs snr	J1	5200	353.0198	"$28,521.53"	.	"$5,704.31"	*		
3328F	Prfrmnc docd 2 wks b/4 surg	E1								
33300	Repair of heart wound	C								
33305	Repair of heart wound	C								
3330F	Imaging study ordered (bkp)	E1								
33310	Exploratory heart surgery	C								
33315	Exploratory heart surgery	C								
3331F	Bk imaging tst not ordered	E1								
33320	Repair major blood vessel(s)	C								
33321	Repair major vessel	C								
33322	Repair major blood vessel(s)	C								
33330	Insert major vessel graft	C								
33335	Insert major vessel graft	C								
33340	Perq clsr tcat l atr apndge	C								
33361	Replace aortic valve perq	C								
33362	Replace aortic valve open	C								
33363	Replace aortic valve open	C								
33364	Replace aortic valve open	C								
33365	Replace aortic valve open	C								
33366	Trcath replace aortic valve	C								
33367	Replace aortic valve w/byp	C								
33368	Replace aortic valve w/byp	C								
33369	Replace aortic valve w/byp	C								
33390	Valvuloplasty aortic valve	C								
33391	Valvuloplasty aortic valve	C								
33404	Prepare heart-aorta conduit	C								
33405	Replacement aortic valve opn	C								
33406	Replacement aortic valve opn	C								
3340F	Mammo assess inc xray docd	M								
33410	Replacement aortic valve opn	C								
33411	Replacement of aortic valve	C								
33412	Replacement of aortic valve	C								
33413	Replacement of aortic valve	C								
33414	Repair of aortic valve	C								
33415	Revision subvalvular tissue	C								
33416	Revise ventricle muscle	C								
33417	Repair of aortic valve	C								
33418	Repair tcat mitral valve	C								
33419	Repair tcat mitral valve	N								
3341F	Mammo assess negative docd	M								
33420	Revision of mitral valve	C								
33422	Revision of mitral valve	C								
33425	Repair of mitral valve	C								
33426	Repair of mitral valve	C								
33427	Repair of mitral valve	C								
3342F	Mammo assess bengn docd	M								
33430	Replacement of mitral valve	C								
3343F	Mammo probably bengn docd	M								
33440	Rplcmt a-valve tlcj autol pv	C								
3344F	Mammo assess susp docd	M								
3345F	Mammo assess hghlymalig doc	M								
33460	Revision of tricuspid valve	C								
33463	Valvuloplasty tricuspid	C								
33464	Valvuloplasty tricuspid	C								
33465	Replace tricuspid valve	C								
33468	Revision of tricuspid valve	C								
33470	Revision of pulmonary valve	C								
33471	Valvotomy pulmonary valve	C								
33474	Revision of pulmonary valve	C								
33475	Replacement pulmonary valve	C								
33476	Revision of heart chamber	C								
33477	Implant tcat pulm vlv perq	C								
33478	Revision of heart chamber	C								
33496	Repair prosth valve clot	C								
33500	Repair heart vessel fistula	C								
33501	Repair heart vessel fistula	C								
33502	Coronary artery correction	C								
33503	Coronary artery graft	C								
33504	Coronary artery graft	C								
33505	Repair artery w/tunnel	C								
33506	Repair artery translocation	C								
33507	Repair art intramural	C								
33508	Endoscopic vein harvest	N								
3350F	Mammo bx proven malig docd	M								
33510	Cabg vein single	C								
33511	Cabg vein two	C								
33512	Cabg vein three	C								
33513	Cabg vein four	C								
33514	Cabg vein five	C								
33516	Cabg vein six or more	C								
33517	Cabg artery-vein single	C								
33518	Cabg artery-vein two	C								
33519	Cabg artery-vein three	C								
3351F	Neg scrn dep symp by deptool	E1								
33521	Cabg artery-vein four	C								
33522	Cabg artery-vein five	C								
33523	Cabg art-vein six or more	C								
3352F	No sig dep symp by dep tool	E1								
33530	Coronary artery bypass/reop	C								
33533	Cabg arterial single	C								
33534	Cabg arterial two	C								
33535	Cabg arterial three	C								
33536	Cabg arterial four or more	C								
3353F	Mild-mod dep symp by deptool	E1								
33542	Removal of heart lesion	C								
33545	Repair of heart damage	C								
33548	Restore/remodel ventricle	C								
3354F	Clin sig dep sym by dep tool	E1								
33572	Open coronary endarterectomy	C								
33600	Closure of valve	C								
33602	Closure of valve	C								
33606	Anastomosis/artery-aorta	C								
33608	Repair anomaly w/conduit	C								
33610	Repair by enlargement	C								
33611	Repair double ventricle	C								
33612	Repair double ventricle	C								
33615	Repair modified fontan	C								
33617	Repair single ventricle	C								
33619	Repair single ventricle	C								
33620	Apply r&l pulm art bands	C								
33621	Transthor cath for stent	C								
33622	Redo compl cardiac anomaly	C								
33641	Repair heart septum defect	C								
33645	Revision of heart veins	C								
33647	Repair heart septum defects	C								
33660	Repair of heart defects	C								
33665	Repair of heart defects	C								
33670	Repair of heart chambers	C								
33675	Close mult vsd	C								
33676	Close mult vsd w/resection	C								
33677	Cl mult vsd w/rem pul band	C								
33681	Repair heart septum defect	C								
33684	Repair heart septum defect	C								
33688	Repair heart septum defect	C								
33690	Reinforce pulmonary artery	C								
33692	Repair of heart defects	C								
33694	Repair of heart defects	C								
33697	Repair of heart defects	C								
33702	Repair of heart defects	C								
3370F	Ajcc brst cncr stage 0 docd	E1								
33710	Repair of heart defects	C								
33720	Repair of heart defect	C								
33722	Repair of heart defect	C								
33724	Repair venous anomaly	C								
33726	Repair pul venous stenosis	C								
3372F	Ajcc brst cncr stage 1 docd	E1								
33730	Repair heart-vein defect(s)	C								
33732	Repair heart-vein defect	C								
33735	Revision of heart chamber	C								
33736	Revision of heart chamber	C								
33737	Revision of heart chamber	C								
3374F	Ajcc brst cncr stage 1 docd	E1								
33750	Major vessel shunt	C								
33755	Major vessel shunt	C								
33762	Major vessel shunt	C								
33764	Major vessel shunt & graft	C								
33766	Major vessel shunt	C								
33767	Major vessel shunt	C								
33768	Cavopulmonary shunting	C								
3376F	Ajcc brstcncr stage 2 docd	E1								
33770	Repair great vessels defect	C								
33771	Repair great vessels defect	C								
33774	Repair great vessels defect	C								
33775	Repair great vessels defect	C								
33776	Repair great vessels defect	C								
33777	Repair great vessels defect	C								
33778	Repair great vessels defect	C								
33779	Repair great vessels defect	C								
33780	Repair great vessels defect	C								
33781	Repair great vessels defect	C								
33782	Nikaidoh proc	C								
33783	Nikaidoh proc w/ostia implt	C								
33786	Repair arterial trunk	C								
33788	Revision of pulmonary artery	C								
3378F	Ajcc brstcncr stage 3 docd	E1								
33800	Aortic suspension	C								
33802	Repair vessel defect	C								
33803	Repair vessel defect	C								
3380F	Ajcc brstcncr stage 4 docd	E1								
33813	Repair septal defect	C								
33814	Repair septal defect	C								
33820	Revise major vessel	C								
33822	Revise major vessel	C								
33824	Revise major vessel	C								
3382F	Ajcc cln cncr stage 0 docd	E1								
33840	Remove aorta constriction	C								
33845	Remove aorta constriction	C								
3384F	Ajcc cln cncr stage 1 docd	E1								
33851	Remove aorta constriction	C								
33852	Repair septal defect	C								
33853	Repair septal defect	C								
33858	As-aort grf f/aortic dsj	C								
33859	As-aort grf f/ds oth/thn dsj	C								
33863	Ascending aortic graft	C								
33864	Ascending aortic graft	C								
33866	Aortic hemiarch graft	N								
3386F	Ajcc cln cncr stage 2 docd	E1								
33871	Transvrs a-arch grf hypthrm	C								
33875	Thoracic aortic graft	C								
33877	Thoracoabdominal graft	C								
33880	Endovasc taa repr incl subcl	C								
33881	Endovasc taa repr w/o subcl	C								
33883	Insert endovasc prosth taa	C								
33884	Endovasc prosth taa add-on	C								
33886	Endovasc prosth delayed	C								
33889	Artery transpose/endovas taa	C								
3388F	Ajcc cln cncr stage 3 docd	E1								
33891	Car-car bp grft/endovas taa	C								
3390F	Ajcc cln cncr stage 4 docd	E1								
33910	Remove lung artery emboli	C								
33915	Remove lung artery emboli	C								
33916	Surgery of great vessel	C								
33917	Repair pulmonary artery	C								
33920	Repair pulmonary atresia	C								
33922	Transect pulmonary artery	C								
33924	Remove pulmonary shunt	C								
33925	Rpr pul art unifocal w/o cpb	C								
33926	Repr pul art unifocal w/cpb	C								
33927	Impltj tot rplcmt hrt sys	C								
33928	Rmvl & rplcmt tot hrt sys	C								
33929	Rmvl rplcmt hrt sys f/trnspl	C								
33930	Removal of donor heart/lung	C								
33933	Prepare donor heart/lung	C								
33935	Transplantation heart/lung	C								
33940	Removal of donor heart	C								
33944	Prepare donor heart	C								
33945	Transplantation of heart	C								
33946	Ecmo/ecls initiation venous	C								
33947	Ecmo/ecls initiation artery	C								
33948	Ecmo/ecls daily mgmt-venous	C								
33949	Ecmo/ecls daily mgmt artery	C								
3394F	Quant her2 ihc eval brst cx	M								
33951	Ecmo/ecls insj prph cannula	C								
33952	Ecmo/ecls insj prph cannula	C								
33953	Ecmo/ecls insj prph cannula	C								
33954	Ecmo/ecls insj prph cannula	C								
33955	Ecmo/ecls insj ctr cannula	C								
33956	Ecmo/ecls insj ctr cannula	C								
33957	Ecmo/ecls repos perph cnula	C								
33958	Ecmo/ecls repos perph cnula	C								
33959	Ecmo/ecls repos perph cnula	C								
3395F	Quant nonher2 ihc brst cx	M								
33962	Ecmo/ecls repos perph cnula	C								
33963	Ecmo/ecls repos perph cnula	C								
33964	Ecmo/ecls repos perph cnula	C								
33965	Ecmo/ecls rmvl perph cannula	C								
33966	Ecmo/ecls rmvl prph cannula	C								
33967	Insert i-aort percut device	C								
33968	Remove aortic assist device	C								
33969	Ecmo/ecls rmvl perph cannula	C								
33970	Aortic circulation assist	C								
33971	Aortic circulation assist	C								
33973	Insert balloon device	C								
33974	Remove intra-aortic balloon	C								
33975	Implant ventricular device	C								
33976	Implant ventricular device	C								
33977	Remove ventricular device	C								
33978	Remove ventricular device	C								
33979	Insert intracorporeal device	C								
33980	Remove intracorporeal device	C								
33981	Replace vad pump ext	C								
33982	Replace vad intra w/o bp	C								
33983	Replace vad intra w/bp	C								
33984	Ecmo/ecls rmvl prph cannula	C								
33985	Ecmo/ecls rmvl ctr cannula	C								
33986	Ecmo/ecls rmvl ctr cannula	C								
33987	Artery expos/graft artery	C								
33988	Insertion of left heart vent	C								
33989	Removal of left heart vent	C								
33990	Insert vad artery access	C								
33991	Insert vad art&vein access	C								
33992	Remove vad different session	C								
33993	Reposition vad diff session	C								
33999	Cardiac surgery procedure	T	5181	7.8040	$630.51	.	$126.11			
34001	Removal of artery clot	C								
34051	Removal of artery clot	C								
34101	Removal of artery clot	J1	5184	56.8885	"$4,596.19"	.	$919.24			
34111	Removal of arm artery clot	J1	5184	56.8885	"$4,596.19"	.	$919.24			
34151	Removal of artery clot	C								
34201	Removal of artery clot	J1	5184	56.8885	"$4,596.19"	.	$919.24			
34203	Removal of leg artery clot	J1	5184	56.8885	"$4,596.19"	.	$919.24			
34401	Removal of vein clot	C								
34421	Removal of vein clot	J1	5183	34.3010	"$2,771.28"	.	$554.26			
34451	Removal of vein clot	C								
34471	Removal of vein clot	T	5181	7.8040	$630.51	.	$126.11			
34490	Removal of vein clot	J1	5183	34.3010	"$2,771.28"	.	$554.26			
34501	Repair valve femoral vein	J1	5184	56.8885	"$4,596.19"	.	$919.24			
34502	Reconstruct vena cava	C								
3450F	Dyspnea scrnd no-mild dysp	E1								
34510	Transposition of vein valve	J1	5184	56.8885	"$4,596.19"	.	$919.24			
3451F	Dyspnea scrnd mod-high dysp	E1								
34520	Cross-over vein graft	J1	5184	56.8885	"$4,596.19"	.	$919.24			
3452F	Dyspnea not screened	E1								
34530	Leg vein fusion	J1	5183	34.3010	"$2,771.28"	.	$554.26			
3455F	Tb scrng done-interpd 6mon	E1								
34701	Evasc rpr a-ao ndgft	C								
34702	Evasc rpr a-ao ndgft rpt	C								
34703	Evasc rpr a-unilac ndgft	C								
34704	Evasc rpr a-unilac ndgft rpt	C								
34705	Evac rpr a-biiliac ndgft	C								
34706	Evasc rpr a-biiliac rpt	C								
34707	Evasc rpr ilio-iliac ndgft	C								
34708	Evasc rpr ilio-iliac rpt	C								
34709	Plmt xtn prosth evasc rpr	C								
3470F	Ra disease activity low	E1								
34710	Dlyd plmt xtn prosth 1st vsl	C								
34711	Dlyd plmt xtn prosth ea addl	C								
34712	Tcat dlvr enhncd fixj dev	C								
34713	Perq access & clsr fem art	N								
34714	Opn fem art expos cndt crtj	N								
34715	Opn ax/subcla art expos	N								
34716	Opn ax/subcla art expos cndt	N								
34717	Evasc rpr a-iliac ndgft	C								
34718	Evasc rpr n/a a-iliac ndgft	C								
3471F	Ra disease activity mod	E1								
3472F	Ra disease activity high	E1								
3475F	Disease progn ra poor docd	M								
3476F	Disease progn ra good docd	M								
34808	Endovas iliac a device addon	C								
34812	Opn fem art expos	C								
34813	Femoral endovas graft add-on	C								
34820	Opn iliac art expos	C								
34830	Open aortic tube prosth repr	C								
34831	Open aortoiliac prosth repr	C								
34832	Open aortofemor prosth repr	C								
34833	Opn ilac art expos cndt crtj	C								
34834	Opn brach art expos	C								
34839	Plnning pt spec fenest graft	B								
34841	Endovasc visc aorta 1 graft	C								
34842	Endovasc visc aorta 2 graft	C								
34843	Endovasc visc aorta 3 graft	C								
34844	Endovasc visc aorta 4 graft	C								
34845	Visc & infraren abd 1 prosth	C								
34846	Visc & infraren abd 2 prosth	C								
34847	Visc & infraren abd 3 prosth	C								
34848	Visc & infraren abd 4+ prost	C								
3490F	History aids-defining cond	E1								
3491F	Hiv unsure baby of hiv+moms	E1								
3492F	History cd4+ cell count <350	E1								
3493F	No hist cd4+ cell count <350	E1								
3494F	Cd4+cell count <200cells/mm3	E1								
3495F	Cd4+cell cnt 200-499 cells	E1								
3496F	Cd4+ cell count >= 500 cells	E1								
3497F	Cd4+ cell percentage <15%	E1								
3498F	Cd4+ cell =15% (hiv)	E1								
35001	Repair defect of artery	C								
35002	Repair artery rupture neck	C								
35005	Repair defect of artery	C								
3500F	Cd4+cell cnt/% docd as done	E1								
35011	Repair defect of artery	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35013	Repair artery rupture arm	C								
35021	Repair defect of artery	C								
35022	Repair artery rupture chest	C								
3502F	Hiv rna vrl ld <lmts quantif	E1								
3503F	Hiv rna vrl ldnot<lmts quntf	E1								
35045	Repair defect of arm artery	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35081	Repair defect of artery	C								
35082	Repair artery rupture aorta	C								
35091	Repair defect of artery	C								
35092	Repair artery rupture aorta	C								
35102	Repair defect of artery	C								
35103	Repair artery rupture aorta	C								
3510F	Doc tb scrng-rslts interpd	E1								
35111	Repair defect of artery	C								
35112	Repair artery rupture spleen	C								
3511F	Chlmyd/gonrh tsts docd done	E1								
35121	Repair defect of artery	C								
35122	Repair artery rupture belly	C								
3512F	Syph scrng docd as done	E1								
35131	Repair defect of artery	C								
35132	Repair artery rupture groin	C								
3513F	Hep b scrng docd as done	E1								
35141	Repair defect of artery	C								
35142	Repair artery rupture thigh	C								
3514F	Hep c scrng docd as done	E1								
35151	Repair defect of artery	C								
35152	Repair ruptd popliteal art	C								
3515F	Pt has docd immun to hep c	E1								
3517F	Hbv assess&results intrp 1yr	E1								
35180	Repair blood vessel lesion	T	5181	7.8040	$630.51	.	$126.11			
35182	Repair blood vessel lesion	C								
35184	Repair blood vessel lesion	J1	5183	34.3010	"$2,771.28"	.	$554.26			
35188	Repair blood vessel lesion	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35189	Repair blood vessel lesion	C								
35190	Repair blood vessel lesion	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35201	Repair blood vessel lesion	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35206	Repair blood vessel lesion	J1	5183	34.3010	"$2,771.28"	.	$554.26			
35207	Repair blood vessel lesion	J1	5183	34.3010	"$2,771.28"	.	$554.26			
3520F	Cdifficile testing performed	E1								
35211	Repair blood vessel lesion	C								
35216	Repair blood vessel lesion	C								
35221	Repair blood vessel lesion	C								
35226	Repair blood vessel lesion	T	5071	7.5503	$610.01	.	$122.01			
35231	Repair blood vessel lesion	J1	5183	34.3010	"$2,771.28"	.	$554.26			
35236	Repair blood vessel lesion	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35241	Repair blood vessel lesion	C								
35246	Repair blood vessel lesion	C								
35251	Repair blood vessel lesion	C								
35256	Repair blood vessel lesion	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35261	Repair blood vessel lesion	J1	5183	34.3010	"$2,771.28"	.	$554.26			
35266	Repair blood vessel lesion	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35271	Repair blood vessel lesion	C								
35276	Repair blood vessel lesion	C								
35281	Repair blood vessel lesion	C								
35286	Repair blood vessel lesion	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35301	Rechanneling of artery	C								
35302	Rechanneling of artery	C								
35303	Rechanneling of artery	C								
35304	Rechanneling of artery	C								
35305	Rechanneling of artery	C								
35306	Rechanneling of artery	C								
35311	Rechanneling of artery	C								
35321	Rechanneling of artery	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35331	Rechanneling of artery	C								
35341	Rechanneling of artery	C								
35351	Rechanneling of artery	C								
35355	Rechanneling of artery	C								
35361	Rechanneling of artery	C								
35363	Rechanneling of artery	C								
35371	Rechanneling of artery	C								
35372	Rechanneling of artery	C								
35390	Reoperation carotid add-on	C								
35400	Angioscopy	C								
35500	Harvest vein for bypass	N								
35501	Art byp grft ipsilat carotid	C								
35506	Art byp grft subclav-carotid	C								
35508	Art byp grft carotid-vertbrl	C								
35509	Art byp grft contral carotid	C								
3550F	Low rsk thromboembolism	E1								
35510	Art byp grft carotid-brchial	C								
35511	Art byp grft subclav-subclav	C								
35512	Art byp grft subclav-brchial	C								
35515	Art byp grft subclav-vertbrl	C								
35516	Art byp grft subclav-axilary	C								
35518	Art byp grft axillary-axilry	C								
3551F	Intrmed rsk thromboembolism	E1								
35521	Art byp grft axill-femoral	C								
35522	Art byp grft axill-brachial	C								
35523	Art byp grft brchl-ulnr-rdl	C								
35525	Art byp grft brachial-brchl	C								
35526	Art byp grft aor/carot/innom	C								
3552F	Hgh risk for thromboembolism	E1								
35531	Art byp grft aorcel/aormesen	C								
35533	Art byp grft axill/fem/fem	C								
35535	Art byp grft hepatorenal	C								
35536	Art byp grft splenorenal	C								
35537	Art byp grft aortoiliac	C								
35538	Art byp grft aortobi-iliac	C								
35539	Art byp grft aortofemoral	C								
35540	Art byp grft aortbifemoral	C								
35556	Art byp grft fem-popliteal	C								
35558	Art byp grft fem-femoral	C								
3555F	Pt inr measurement performed	E1								
35560	Art byp grft aortorenal	C								
35563	Art byp grft ilioiliac	C								
35565	Art byp grft iliofemoral	C								
35566	Art byp fem-ant-post tib/prl	C								
35570	Art byp tibial-tib/peroneal	C								
35571	Art byp pop-tibl-prl-other	C								
35572	Harvest femoropopliteal vein	N								
35583	Vein byp grft fem-popliteal	C								
35585	Vein byp fem-tibial peroneal	C								
35587	Vein byp pop-tibl peroneal	C								
35600	Harvest art for cabg add-on	C								
35601	Art byp common ipsi carotid	C								
35606	Art byp carotid-subclavian	C								
35612	Art byp subclav-subclavian	C								
35616	Art byp subclav-axillary	C								
35621	Art byp axillary-femoral	C								
35623	Art byp axillary-pop-tibial	C								
35626	Art byp aorsubcl/carot/innom	C								
35631	Art byp aor-celiac-msn-renal	C								
35632	Art byp ilio-celiac	C								
35633	Art byp ilio-mesenteric	C								
35634	Art byp iliorenal	C								
35636	Art byp spenorenal	C								
35637	Art byp aortoiliac	C								
35638	Art byp aortobi-iliac	C								
35642	Art byp carotid-vertebral	C								
35645	Art byp subclav-vertebrl	C								
35646	Art byp aortobifemoral	C								
35647	Art byp aortofemoral	C								
35650	Art byp axillary-axillary	C								
35654	Art byp axill-fem-femoral	C								
35656	Art byp femoral-popliteal	C								
35661	Art byp femoral-femoral	C								
35663	Art byp ilioiliac	C								
35665	Art byp iliofemoral	C								
35666	Art byp fem-ant-post tib/prl	C								
35671	Art byp pop-tibl-prl-other	C								
35681	Composite byp grft pros&vein	C								
35682	Composite byp grft 2 veins	C								
35683	Composite byp grft 3/> segmt	C								
35685	Bypass graft patency/patch	N								
35686	Bypass graft/av fist patency	N								
35691	Art trnsposj vertbrl carotid	C								
35693	Art trnsposj subclavian	C								
35694	Art trnsposj subclav carotid	C								
35695	Art trnsposj carotid subclav	C								
35697	Reimplant artery each	C								
35700	Reoperation bypass graft	C								
35701	Expl n/flwd surg neck art	C								
35702	Expl n/flwd surg uxtr art	C								
35703	Expl n/flwd surg lxtr art	C								
3570F	Rprt bone scint xref w xray	M								
3572F	Pt consid poss risk fx	E1								
3573F	Pt not consid poss risk fx	E1								
35800	Explore neck vessels	C								
35820	Explore chest vessels	C								
35840	Explore abdominal vessels	C								
35860	Explore limb vessels	J1	5183	34.3010	"$2,771.28"	.	$554.26			
35870	Repair vessel graft defect	C								
35875	Removal of clot in graft	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35876	Removal of clot in graft	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35879	Revise graft w/vein	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35881	Revise graft w/vein	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35883	Revise graft w/nonauto graft	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35884	Revise graft w/vein	J1	5184	56.8885	"$4,596.19"	.	$919.24			
35901	Excision graft neck	C								
35903	Excision graft extremity	J1	5183	34.3010	"$2,771.28"	.	$554.26			
35905	Excision graft thorax	C								
35907	Excision graft abdomen	C								
36000	Place needle in vein	N								
36002	Pseudoaneurysm injection trt	T	5181	7.8040	$630.51	.	$126.11			
36005	Injection ext venography	N								
36010	Place catheter in vein	N								
36011	Place catheter in vein	N								
36012	Place catheter in vein	N								
36013	Place catheter in artery	N								
36014	Place catheter in artery	N								
36015	Place catheter in artery	N								
36100	Establish access to artery	N								
36140	Intro ndl icath upr/lxtr art	N								
36160	Establish access to aorta	N								
36200	Place catheter in aorta	N								
36215	Place catheter in artery	N								
36216	Place catheter in artery	N								
36217	Place catheter in artery	N								
36218	Place catheter in artery	N								
36221	Place cath thoracic aorta	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
36222	Place cath carotid/inom art	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
36223	Place cath carotid/inom art	Q2	5184	56.8885	"$4,596.19"	.	$919.24			
36224	Place cath carotd art	Q2	5184	56.8885	"$4,596.19"	.	$919.24			
36225	Place cath subclavian art	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
36226	Place cath vertebral art	Q2	5184	56.8885	"$4,596.19"	.	$919.24			
36227	Place cath xtrnl carotid	N								
36228	Place cath intracranial art	N								
36245	Ins cath abd/l-ext art 1st	N								
36246	Ins cath abd/l-ext art 2nd	N								
36247	Ins cath abd/l-ext art 3rd	N								
36248	Ins cath abd/l-ext art addl	N								
36251	Ins cath ren art 1st unilat	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
36252	Ins cath ren art 1st bilat	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
36253	Ins cath ren art 2nd+ unilat	Q2	5184	56.8885	"$4,596.19"	.	$919.24			
36254	Ins cath ren art 2nd+ bilat	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
36260	Insertion of infusion pump	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36261	Revision of infusion pump	T	5221	36.9340	"$2,984.01"	.	$596.81			
36262	Removal of infusion pump	Q2	5221	36.9340	"$2,984.01"	.	$596.81			
36299	Vessel injection procedure	N								
36400	Bl draw < 3 yrs fem/jugular	N								
36405	Bl draw <3 yrs scalp vein	N								
36406	Bl draw <3 yrs other vein	N								
36410	Non-routine bl draw 3/> yrs	N								
36415	Routine venipuncture	Q4								
36416	Capillary blood draw	N								
36420	Vein access cutdown < 1 yr	Q1	5733	0.6809	$55.01	.	$11.01			
36425	Vein access cutdown > 1 yr	Q1	5735	4.5003	$363.59	.	$72.72			
36430	Blood transfusion service	S	5241	4.8029	$388.04	.	$77.61			
36440	Bl push transfuse 2 yr/<	S	5241	4.8029	$388.04	.	$77.61			
36450	Bl exchange/transfuse nb	S	5241	4.8029	$388.04	.	$77.61			
36455	Bl exchange/transfuse non-nb	S	5241	4.8029	$388.04	.	$77.61			
36456	Prtl exchange transfuse nb	S	5241	4.8029	$388.04	.	$77.61			
36460	Transfusion service fetal	S	5241	4.8029	$388.04	.	$77.61			
36465	Njx noncmpnd sclrsnt 1 vein	T	5054	20.0852	"$1,622.74"	.	$324.55			
36466	Njx noncmpnd sclrsnt mlt vn	T	5054	20.0852	"$1,622.74"	.	$324.55			
36468	Njx sclrsnt spider veins	Q1	5051	2.1627	$174.73	.	$34.95			
36470	Njx sclrsnt 1 incmptnt vein	T	5052	3.9547	$319.51	.	$63.91			
36471	Njx sclrsnt mlt incmptnt vn	T	5052	3.9547	$319.51	.	$63.91			
36473	Endovenous mchnchem 1st vein	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36474	Endovenous mchnchem add-on	N								
36475	Endovenous rf 1st vein	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36476	Endovenous rf vein add-on	N								
36478	Endovenous laser 1st vein	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36479	Endovenous laser vein addon	N								
36481	Insertion of catheter vein	N								
36482	Endoven ther chem adhes 1st	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36483	Endoven ther chem adhes sbsq	N								
36500	Insertion of catheter vein	N								
3650F	Eeg ordered rvwd reqstd	E1								
36510	Insertion of catheter vein	N								
36511	Apheresis wbc	S	5242	16.3828	"$1,323.62"	.	$264.73			
36512	Apheresis rbc	S	5242	16.3828	"$1,323.62"	.	$264.73			
36513	Apheresis platelets	S	5241	4.8029	$388.04	.	$77.61			
36514	Apheresis plasma	S	5242	16.3828	"$1,323.62"	.	$264.73			
36516	Apheresis immunoads slctv	S	5243	47.2610	"$3,818.36"	.	$763.68			
36522	Photopheresis	S	5243	47.2610	"$3,818.36"	.	$763.68			
36555	Insert non-tunnel cv cath	J1	5182	20.1890	"$1,631.13"	.	$326.23			
36556	Insert non-tunnel cv cath	J1	5182	20.1890	"$1,631.13"	.	$326.23			
36557	Insert tunneled cv cath	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36558	Insert tunneled cv cath	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36560	Insert tunneled cv cath	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36561	Insert tunneled cv cath	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36563	Insert tunneled cv cath	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36565	Insert tunneled cv cath	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36566	Insert tunneled cv cath	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36568	Insj picc <5 yr w/o imaging	T	5181	7.8040	$630.51	.	$126.11			
36569	Insj picc 5 yr+ w/o imaging	J1	5182	20.1890	"$1,631.13"	.	$326.23			
36570	Insert picvad cath	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36571	Insert picvad cath	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36572	Insj picc rs&i <5 yr	T	5181	7.8040	$630.51	.	$126.11			
36573	Insj picc rs&i 5 yr+	J1	5182	20.1890	"$1,631.13"	.	$326.23			
36575	Repair tunneled cv cath	T	5181	7.8040	$630.51	.	$126.11			
36576	Repair tunneled cv cath	J1	5182	20.1890	"$1,631.13"	.	$326.23			
36578	Replace tunneled cv cath	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36580	Replace cvad cath	J1	5182	20.1890	"$1,631.13"	.	$326.23			
36581	Replace tunneled cv cath	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36582	Replace tunneled cv cath	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36583	Replace tunneled cv cath	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36584	Compl rplcmt picc rs&i	J1	5182	20.1890	"$1,631.13"	.	$326.23			
36585	Replace picvad cath	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36589	Removal tunneled cv cath	Q2	5181	7.8040	$630.51	.	$126.11			
36590	Removal tunneled cv cath	Q2	5181	7.8040	$630.51	.	$126.11			
36591	Draw blood off venous device	Q1	5734	1.3495	$109.03	.	$21.81			
36592	Collect blood from picc	Q1	5734	1.3495	$109.03	.	$21.81			
36593	Declot vascular device	T	5694	3.8320	$309.60	.	$61.92			
36595	Mech remov tunneled cv cath	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36596	Mech remov tunneled cv cath	J1	5182	20.1890	"$1,631.13"	.	$326.23			
36597	Reposition venous catheter	J1	5182	20.1890	"$1,631.13"	.	$326.23			
36598	Inj w/fluor eval cv device	T	5693	2.2742	$183.74	.	$36.75			
36600	Withdrawal of arterial blood	Q1	5734	1.3495	$109.03	.	$21.81			
36620	Insertion catheter artery	N								
36625	Insertion catheter artery	N								
36640	Insertion catheter artery	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36660	Insertion catheter artery	C								
36680	Insert needle bone cavity	Q1	5735	4.5003	$363.59	.	$72.72			
36800	Insertion of cannula	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36810	Insertion of cannula	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36815	Insertion of cannula	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36818	Av fuse uppr arm cephalic	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36819	Av fuse uppr arm basilic	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36820	Av fusion/forearm vein	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36821	Av fusion direct any site	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36823	Insertion of cannula(s)	C								
36825	Artery-vein autograft	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36830	Artery-vein nonautograft	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36831	Open thrombect av fistula	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36832	Av fistula revision open	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36833	Av fistula revision	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36835	Artery to vein shunt	J1	5183	34.3010	"$2,771.28"	.	$554.26			
36838	Dist revas ligation hemo	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36860	External cannula declotting	T	5181	7.8040	$630.51	.	$126.11			
36861	Cannula declotting	J1	5184	56.8885	"$4,596.19"	.	$919.24			
36901	Intro cath dialysis circuit	J1	5182	20.1890	"$1,631.13"	.	$326.23			
36902	Intro cath dialysis circuit	J1	5192	61.3161	"$4,953.91"	.	$990.79			
36903	Intro cath dialysis circuit	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
36904	Thrmbc/nfs dialysis circuit	J1	5192	61.3161	"$4,953.91"	.	$990.79			
36905	Thrmbc/nfs dialysis circuit	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
36906	Thrmbc/nfs dialysis circuit	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
36907	Balo angiop ctr dialysis seg	N								
36908	Stent plmt ctr dialysis seg	N								
36909	Dialysis circuit embolj	N								
3700F	Psych disorders assessed	E1								
37140	Revision of circulation	C								
37145	Revision of circulation	C								
37160	Revision of circulation	C								
37180	Revision of circulation	C								
37181	Splice spleen/kidney veins	C								
37182	Insert hepatic shunt (tips)	C								
37183	Remove hepatic shunt (tips)	J1	5192	61.3161	"$4,953.91"	.	$990.79			
37184	Prim art m-thrmbc 1st vsl	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
37185	Prim art m-thrmbc sbsq vsl	N								
37186	Sec art thrombectomy add-on	N								
37187	Venous mech thrombectomy	J1	5192	61.3161	"$4,953.91"	.	$990.79			
37188	Ven mechnl thrmbc repeat tx	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37191	Ins endovas vena cava filtr	J1	5184	56.8885	"$4,596.19"	.	$919.24			
37192	Redo endovas vena cava filtr	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37193	Rem endovas vena cava filter	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37195	Thrombolytic therapy stroke	T	5694	3.8320	$309.60	.	$61.92			
37197	Remove intrvas foreign body	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37200	Transcatheter biopsy	J1	5184	56.8885	"$4,596.19"	.	$919.24			
3720F	Cognit impairment assessed	M								
37211	Thrombolytic art therapy	J1	5184	56.8885	"$4,596.19"	.	$919.24			
37212	Thrombolytic venous therapy	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37213	Thromblytic art/ven therapy	J1	5182	20.1890	"$1,631.13"	.	$326.23			
37214	Cessj therapy cath removal	J1	5182	20.1890	"$1,631.13"	.	$326.23			
37215	Transcath stent cca w/eps	C								
37216	Transcath stent cca w/o eps	E1								
37217	Stent placemt retro carotid	C								
37218	Stent placemt ante carotid	C								
37220	Iliac revasc	J1	5192	61.3161	"$4,953.91"	.	$990.79			
37221	Iliac revasc w/stent	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
37222	Iliac revasc add-on	N								
37223	Iliac revasc w/stent add-on	N								
37224	Fem/popl revas w/tla	J1	5192	61.3161	"$4,953.91"	.	$990.79			
37225	Fem/popl revas w/ather	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
37226	Fem/popl revasc w/stent	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
37227	Fem/popl revasc stnt & ather	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
37228	Tib/per revasc w/tla	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
37229	Tib/per revasc w/ather	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
37230	Tib/per revasc w/stent	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
37231	Tib/per revasc stent & ather	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
37232	Tib/per revasc add-on	N								
37233	Tibper revasc w/ather add-on	N								
37234	Revsc opn/prq tib/pero stent	N								
37235	Tib/per revasc stnt & ather	N								
37236	Open/perq place stent 1st	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
37237	Open/perq place stent ea add	N								
37238	Open/perq place stent same	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
37239	Open/perq place stent ea add	N								
37241	Vasc embolize/occlude venous	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
37242	Vasc embolize/occlude artery	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
37243	Vasc embolize/occlude organ	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
37244	Vasc embolize/occlude bleed	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
37246	Trluml balo angiop 1st art	J1	5192	61.3161	"$4,953.91"	.	$990.79			
37247	Trluml balo angiop addl art	N								
37248	Trluml balo angiop 1st vein	J1	5192	61.3161	"$4,953.91"	.	$990.79			
37249	Trluml balo angiop addl vein	N								
37252	Intrvasc us noncoronary 1st	N								
37253	Intrvasc us noncoronary addl	N								
3725F	Screen depression performed	M								
37500	Endoscopy ligate perf veins	J1	5184	56.8885	"$4,596.19"	.	$919.24			
37501	Vascular endoscopy procedure	T	5181	7.8040	$630.51	.	$126.11			
3750F	Ptnotrcvngsteroid>/=10mg/day	E1								
3751F	Electrodiag polyneuro 6 mn	E1								
3752F	No electrodiag polyneuro 6mn	E1								
3753F	Pt has symp&signs neuropathy	E1								
3754F	Screening tests dm done	E1								
3755F	Cog&behav imprmnt scrng done	E1								
37565	Ligation of neck vein	J1	5182	20.1890	"$1,631.13"	.	$326.23			
3756F	Pt w/pseudobulb affect/als	E1								
3757F	Pt w/o pseudobulbaffect/als	E1								
3758F	Pt ref pulm fx test/peakflow	E1								
3759F	Pt scrn dysphag/wt loss/nutr	E1								
37600	Ligation of neck artery	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37605	Ligation of neck artery	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37606	Ligation of neck artery	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37607	Ligation of a-v fistula	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37609	Temporal artery procedure	J1	5072	16.9891	"$1,372.60"	.	$274.52			
3760F	Pt w/ dysphag/wt loss/nutr	E1								
37615	Ligation of neck artery	J1	5182	20.1890	"$1,631.13"	.	$326.23			
37616	Ligation of chest artery	C								
37617	Ligation of abdomen artery	C								
37618	Ligation of extremity artery	C								
37619	Ligation of inf vena cava	J1	5184	56.8885	"$4,596.19"	.	$919.24			
3761F	Pt w/o dysphag/wt loss/nutr	E1								
3762F	Patient is dysarthric	E1								
3763F	Patient is not dysarthric	E1								
37650	Revision of major vein	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37660	Revision of major vein	C								
37700	Revise leg vein	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37718	Ligate/strip short leg vein	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37722	Ligate/strip long leg vein	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37735	Removal of leg veins/lesion	J1	5183	34.3010	"$2,771.28"	.	$554.26			
3775F	Adenoma detected screening	E1								
37760	Ligate leg veins radical	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37761	Ligate leg veins open	J1	5182	20.1890	"$1,631.13"	.	$326.23			
37765	Stab phleb veins xtr 10-20	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37766	Phleb veins - extrem 20+	J1	5183	34.3010	"$2,771.28"	.	$554.26			
3776F	Adenoma not detect screening	E1								
37780	Revision of leg vein	J1	5182	20.1890	"$1,631.13"	.	$326.23			
37785	Ligate/divide/excise vein	J1	5183	34.3010	"$2,771.28"	.	$554.26			
37788	Revascularization penis	C								
37790	Penile venous occlusion	J1	5374	37.3614	"$3,018.54"	.	$603.71			
37799	Vascular surgery procedure	T	5181	7.8040	$630.51	.	$126.11			
38100	Removal of spleen total	C								
38101	Removal of spleen partial	C								
38102	Removal of spleen total	C								
38115	Repair of ruptured spleen	C								
38120	Laparoscopy splenectomy	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
38129	Laparoscope proc spleen	J1	5361	59.8283	"$4,833.71"	.	$966.75			
38200	Injection for spleen x-ray	N								
38204	Bl donor search management	N								
38205	Harvest allogeneic stem cell	B								
38206	Harvest auto stem cells	S	5242	16.3828	"$1,323.62"	.	$264.73			
38207	Cryopreserve stem cells	S	5241	4.8029	$388.04	.	$77.61			
38208	Thaw preserved stem cells	S	5241	4.8029	$388.04	.	$77.61			
38209	Wash harvest stem cells	S	5241	4.8029	$388.04	.	$77.61			
38210	T-cell depletion of harvest	S	5241	4.8029	$388.04	.	$77.61			
38211	Tumor cell deplete of harvst	S	5241	4.8029	$388.04	.	$77.61			
38212	Rbc depletion of harvest	S	5241	4.8029	$388.04	.	$77.61			
38213	Platelet deplete of harvest	S	5241	4.8029	$388.04	.	$77.61			
38214	Volume deplete of harvest	S	5241	4.8029	$388.04	.	$77.61			
38215	Harvest stem cell concentrte	S	5241	4.8029	$388.04	.	$77.61			
38220	Dx bone marrow aspirations	J1	5072	16.9891	"$1,372.60"	.	$274.52			
38221	Dx bone marrow biopsies	J1	5072	16.9891	"$1,372.60"	.	$274.52			
38222	Dx bone marrow bx & aspir	J1	5073	28.7016	"$2,318.89"	.	$463.78			
38230	Bone marrow harvest allogen	S	5242	16.3828	"$1,323.62"	.	$264.73			
38232	Bone marrow harvest autolog	S	5243	47.2610	"$3,818.36"	.	$763.68			
38240	Transplt allo hct/donor	J1	5244	463.3555	"$37,435.88"	.	"$7,487.18"	*		
38241	Transplt autol hct/donor	S	5242	16.3828	"$1,323.62"	.	$264.73			
38242	Transplt allo lymphocytes	S	5242	16.3828	"$1,323.62"	.	$264.73			
38243	Transplj hematopoietic boost	S	5242	16.3828	"$1,323.62"	.	$264.73			
38300	Drainage lymph node lesion	J1	5073	28.7016	"$2,318.89"	.	$463.78			
38305	Drainage lymph node lesion	J1	5073	28.7016	"$2,318.89"	.	$463.78			
38308	Incision of lymph channels	J1	5091	37.4977	"$3,029.55"	.	$605.91			
38380	Thoracic duct procedure	C								
38381	Thoracic duct procedure	C								
38382	Thoracic duct procedure	C								
38500	Biopsy/removal lymph nodes	J1	5091	37.4977	"$3,029.55"	.	$605.91			
38505	Needle biopsy lymph nodes	J1	5072	16.9891	"$1,372.60"	.	$274.52			
38510	Biopsy/removal lymph nodes	J1	5091	37.4977	"$3,029.55"	.	$605.91			
38520	Biopsy/removal lymph nodes	J1	5091	37.4977	"$3,029.55"	.	$605.91			
38525	Biopsy/removal lymph nodes	J1	5091	37.4977	"$3,029.55"	.	$605.91			
38530	Biopsy/removal lymph nodes	J1	5091	37.4977	"$3,029.55"	.	$605.91			
38531	Open bx/exc inguinofem nodes	J1	5091	37.4977	"$3,029.55"	.	$605.91			
38542	Explore deep node(s) neck	J1	5361	59.8283	"$4,833.71"	.	$966.75			
38550	Removal neck/armpit lesion	J1	5091	37.4977	"$3,029.55"	.	$605.91			
38555	Removal neck/armpit lesion	J1	5092	64.8236	"$5,237.29"	.	"$1,047.46"			
38562	Removal pelvic lymph nodes	C								
38564	Removal abdomen lymph nodes	C								
38570	Laparoscopy lymph node biop	J1	5361	59.8283	"$4,833.71"	.	$966.75			
38571	Laparoscopy lymphadenectomy	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
38572	Laparoscopy lymphadenectomy	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
38573	Laps pelvic lymphadec	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
38589	Laparoscope proc lymphatic	J1	5361	59.8283	"$4,833.71"	.	$966.75			
38700	Removal of lymph nodes neck	J1	5092	64.8236	"$5,237.29"	.	"$1,047.46"			
38720	Removal of lymph nodes neck	J1	5093	100.6964	"$8,135.56"	.	"$1,627.12"	*		
38724	Removal of lymph nodes neck	C								
38740	Remove armpit lymph nodes	J1	5361	59.8283	"$4,833.71"	.	$966.75			
38745	Remove armpit lymph nodes	J1	5361	59.8283	"$4,833.71"	.	$966.75			
38746	Remove thoracic lymph nodes	C								
38747	Remove abdominal lymph nodes	C								
38760	Remove groin lymph nodes	J1	5092	64.8236	"$5,237.29"	.	"$1,047.46"			
38765	Remove groin lymph nodes	C								
38770	Remove pelvis lymph nodes	C								
38780	Remove abdomen lymph nodes	C								
38790	Inject for lymphatic x-ray	N								
38792	Ra tracer id of sentinl node	Q1	5591	4.5564	$368.13	.	$73.63			
38794	Access thoracic lymph duct	N								
38900	Io map of sent lymph node	N								
38999	Blood/lymph system procedure	S	5241	4.8029	$388.04	.	$77.61			
39000	Exploration of chest	C								
39010	Exploration of chest	C								
39200	Resect mediastinal cyst	C								
39220	Resect mediastinal tumor	C								
39401	Mediastinoscpy w/medstnl bx	J1	5361	59.8283	"$4,833.71"	.	$966.75			
39402	Mediastinoscpy w/lmph nod bx	J1	5361	59.8283	"$4,833.71"	.	$966.75			
39499	Chest procedure	C								
39501	Repair diaphragm laceration	C								
39503	Repair of diaphragm hernia	C								
39540	Repair of diaphragm hernia	C								
39541	Repair of diaphragm hernia	C								
39545	Revision of diaphragm	C								
39560	Resect diaphragm simple	C								
39561	Resect diaphragm complex	C								
39599	Diaphragm surgery procedure	C								
4000F	Tobacco use txmnt counseling	E1								
4001F	Tobacco use txmnt pharmacol	E1								
4003F	Pt ed write/oral pts w/ hf	E1								
4004F	Pt tobacco screen rcvd tlk	M								
4005F	Pharm thx for op rxd	E1								
4008F	Beta-blocker therapy rxd/tkn	M								
4010F	Ace/arb therapy rxd/taken	M								
4011F	Oral antiplatelet therapy rx	E1								
4012F	Warfarin therapy rx	E1								
4013F	Statin therapy/currently tkn	E1								
4014F	Written discharge instr prvd	E1								
4015F	Persist asthma medicine ctrl	E1								
4016F	Anti-inflm/anlgsc agent rx	E1								
4017F	Gi prophylaxis for nsaid rx	E1								
4018F	Therapy exercise joint rx	E1								
4019F	Doc recpt counsl vit d/calc+	E1								
4025F	Inhaled bronchodilator rx	E1								
4030F	Oxygen therapy rx	E1								
4033F	Pulmonary rehab rec	E1								
4035F	Influenza imm rec	E1								
4037F	Influenza imm order/admin	E1								
4040F	Pneumoc vac/admin/rcvd	M								
4041F	Doc order cefazolin/cefurox	E1								
4042F	Doc antibio not given	E1								
4043F	Doc order given stop antibio	E1								
4044F	Doc order given vte prophylx	M								
4045F	Empiric antibiotic rx	E1								
4046F	Doc antibio given b/4 surg	E1								
4047F	Doc antibio given b/4 surg	E1								
4048F	Doc antibio given b/4 surg	E1								
40490	Biopsy of lip	T	5161	2.5205	$203.64	.	$40.73			
4049F	Doc order given stop antibio	E1								
40500	Partial excision of lip	J1	5164	32.4198	"$2,619.29"	.	$523.86			
4050F	Ht care plan doc	E1								
40510	Partial excision of lip	J1	5164	32.4198	"$2,619.29"	.	$523.86			
4051F	Referred for an av fistula	E1								
40520	Partial excision of lip	J1	5164	32.4198	"$2,619.29"	.	$523.86			
40525	Reconstruct lip with flap	J1	5164	32.4198	"$2,619.29"	.	$523.86			
40527	Reconstruct lip with flap	J1	5165	60.0365	"$4,850.53"	.	$970.11			
4052F	Hemodialysis via av fistula	E1								
40530	Partial removal of lip	J1	5164	32.4198	"$2,619.29"	.	$523.86			
4053F	Hemodialysis via av graft	E1								
4054F	Hemodialysis via catheter	E1								
4055F	Pt rcvng periton dialysis	E1								
4056F	Approp oral rehyd recommd	E1								
4058F	Ped gastro ed given caregvr	E1								
4060F	Psych svcs provided	E1								
4062F	Pt referral psych docd	E1								
4063F	Antidepres rxthxpy not rxd	E1								
4064F	Antidepressant rx	E1								
40650	Repair lip	T	5162	5.4673	$441.72	.	$88.35			
40652	Repair lip	T	5162	5.4673	$441.72	.	$88.35			
40654	Repair lip	J1	5163	16.7012	"$1,349.34"	.	$269.87			
4065F	Antipsychotic rx	E1								
4066F	Ect provided	E1								
4067F	Pt referral for ect docd	E1								
4069F	Vte prophylaxis rcvd	E1								
40700	Repair cleft lip/nasal	J1	5165	60.0365	"$4,850.53"	.	$970.11			
40701	Repair cleft lip/nasal	J1	5165	60.0365	"$4,850.53"	.	$970.11			
40702	Repair cleft lip/nasal	J1	5165	60.0365	"$4,850.53"	.	$970.11			
4070F	Dvt prophylx recvd day 2	E1								
40720	Repair cleft lip/nasal	J1	5164	32.4198	"$2,619.29"	.	$523.86			
4073F	Oral antiplat thx rx dischrg	E1								
4075F	Anticoag thx rx at dischrg	E1								
40761	Repair cleft lip/nasal	J1	5165	60.0365	"$4,850.53"	.	$970.11			
4077F	Doc t-pa admin considered	E1								
40799	Lip surgery procedure	T	5161	2.5205	$203.64	.	$40.73			
4079F	Doc rehab svcs considered	E1								
40800	Drainage of mouth lesion	T	5071	7.5503	$610.01	.	$122.01			
40801	Drainage of mouth lesion	T	5162	5.4673	$441.72	.	$88.35			
40804	Removal foreign body mouth	Q1	5301	9.7276	$785.92	.	$157.19			
40805	Removal foreign body mouth	T	5162	5.4673	$441.72	.	$88.35			
40806	Incision of lip fold	T	5162	5.4673	$441.72	.	$88.35			
40808	Biopsy of mouth lesion	T	5162	5.4673	$441.72	.	$88.35			
40810	Excision of mouth lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
40812	Excise/repair mouth lesion	J1	5163	16.7012	"$1,349.34"	.	$269.87			
40814	Excise/repair mouth lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
40816	Excision of mouth lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
40818	Excise oral mucosa for graft	T	5162	5.4673	$441.72	.	$88.35			
40819	Excise lip or cheek fold	J1	5163	16.7012	"$1,349.34"	.	$269.87			
40820	Treatment of mouth lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
40830	Repair mouth laceration	T	5161	2.5205	$203.64	.	$40.73			
40831	Repair mouth laceration	T	5162	5.4673	$441.72	.	$88.35			
40840	Reconstruction of mouth	J1	5165	60.0365	"$4,850.53"	.	$970.11			
40842	Reconstruction of mouth	J1	5165	60.0365	"$4,850.53"	.	$970.11			
40843	Reconstruction of mouth	J1	5165	60.0365	"$4,850.53"	.	$970.11			
40844	Reconstruction of mouth	J1	5165	60.0365	"$4,850.53"	.	$970.11			
40845	Reconstruction of mouth	J1	5165	60.0365	"$4,850.53"	.	$970.11			
4084F	Aspirin recvd w/in 24 hrs	E1								
4086F	Aspirin/clopidogrel rxd	M								
40899	Mouth surgery procedure	T	5161	2.5205	$203.64	.	$40.73			
4090F	Pt rcvng epo thxpy	M								
4095F	Pt not rcvng epo thxpy	E1								
41000	Drainage of mouth lesion	T	5162	5.4673	$441.72	.	$88.35			
41005	Drainage of mouth lesion	T	5161	2.5205	$203.64	.	$40.73			
41006	Drainage of mouth lesion	J1	5163	16.7012	"$1,349.34"	.	$269.87			
41007	Drainage of mouth lesion	J1	5163	16.7012	"$1,349.34"	.	$269.87			
41008	Drainage of mouth lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
41009	Drainage of mouth lesion	T	5162	5.4673	$441.72	.	$88.35			
4100F	Biphos thxpy vein ord/recvd	M								
41010	Incision of tongue fold	J1	5163	16.7012	"$1,349.34"	.	$269.87			
41015	Drainage of mouth lesion	T	5162	5.4673	$441.72	.	$88.35			
41016	Drainage of mouth lesion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
41017	Drainage of mouth lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
41018	Drainage of mouth lesion	J1	5163	16.7012	"$1,349.34"	.	$269.87			
41019	Place needles h&n for rt	J1	5165	60.0365	"$4,850.53"	.	$970.11			
41100	Biopsy of tongue	T	5162	5.4673	$441.72	.	$88.35			
41105	Biopsy of tongue	J1	5164	32.4198	"$2,619.29"	.	$523.86			
41108	Biopsy of floor of mouth	J1	5072	16.9891	"$1,372.60"	.	$274.52			
4110F	Int mam art used for cabg	M								
41110	Excision of tongue lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
41112	Excision of tongue lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
41113	Excision of tongue lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
41114	Excision of tongue lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
41115	Excision of tongue fold	J1	5163	16.7012	"$1,349.34"	.	$269.87			
41116	Excision of mouth lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
41120	Partial removal of tongue	J1	5165	60.0365	"$4,850.53"	.	$970.11			
41130	Partial removal of tongue	C								
41135	Tongue and neck surgery	C								
41140	Removal of tongue	C								
41145	Tongue removal neck surgery	C								
41150	Tongue mouth jaw surgery	C								
41153	Tongue mouth neck surgery	C								
41155	Tongue jaw & neck surgery	C								
4115F	Beta blckr admin w/in 24 hrs	M								
4120F	Antibiot rxd/given	M								
4124F	Antibiot not rxd/given	M								
41250	Repair tongue laceration	Q1	5734	1.3495	$109.03	.	$21.81			
41251	Repair tongue laceration	T	5161	2.5205	$203.64	.	$40.73			
41252	Repair tongue laceration	T	5161	2.5205	$203.64	.	$40.73			
4130F	Topical prep rx aoe	M								
4131F	Syst antimicrobial thx rx	M								
4132F	No syst antimicrobial thx rx	M								
4133F	Antihist/decong rx/recom	E1								
4134F	No antihist/decong rx/recom	E1								
4135F	Systemic corticosteroids rx	E1								
4136F	Syst corticosteroids not rx	E1								
4140F	Inhaled corticosteroids rxd	E1								
4142F	Corticoster sparng thrpy rxd	E1								
4144F	Alt long-term cntrl med rxd	E1								
4145F	2+ anti-hyprtnsv agents tkn	E1								
4148F	Hep a vac injxn admin/recvd	E1								
4149F	Hep b vac injxn admin/recvd	E1								
4150F	Pt recvng antivir txmnt hepc	E1								
41510	Tongue to lip surgery	J1	5164	32.4198	"$2,619.29"	.	$523.86			
41512	Tongue suspension	J1	5165	60.0365	"$4,850.53"	.	$970.11			
4151F	Pt not recvng antiv hep c	E1								
41520	Reconstruction tongue fold	J1	5164	32.4198	"$2,619.29"	.	$523.86			
41530	Tongue base vol reduction	J1	5164	32.4198	"$2,619.29"	.	$523.86			
4153F	Combo pegintf/rib rx	E1								
4155F	Hep a vac series prev recvd	E1								
4157F	Hep b vac series prev recvd	E1								
4158F	Pt edu re alcoh drnkng done	E1								
41599	Tongue and mouth surgery	T	5161	2.5205	$203.64	.	$40.73			
4159F	Contrcp talk b/4 antiv txmnt	E1								
4163F	Pt couns 4 txmnt opt prost	E1								
4164F	Adjv hrmnl thxpy rxd	E1								
4165F	3d-crt/imrt received	E1								
4167F	Hd bed tilted 1st day vent	E1								
4168F	Pt care icu&vent w/in 24hrs	E1								
4169F	No pt care icu/vent in 24hrs	E1								
4171F	Pt rcvng esa thxpy	E1								
4172F	Pt not rcvng esa thxpy	E1								
4174F	Couns potent glauc impct	E1								
4175F	Vis 20/40/> w/in 90 days	M								
4176F	Talk re uv light pt/crgvr	E1								
4177F	Talk pt/crgvr re areds prev	M								
4178F	Antid glbln rcvd w/in 26wks	E1								
4179F	Tamoxifen/ai prescribed	E1								
41800	Drainage of gum lesion	Q1	5734	1.3495	$109.03	.	$21.81			
41805	Removal foreign body gum	J1	5163	16.7012	"$1,349.34"	.	$269.87			
41806	Removal foreign body jawbone	J1	5163	16.7012	"$1,349.34"	.	$269.87			
4180F	Adjv thxpyrxd/rcvd colon ca	E1								
4181F	Conformal radn thxpy rcvd	E1								
41820	Excision gum each quadrant	J1	5164	32.4198	"$2,619.29"	.	$523.86			
41821	Excision of gum flap	J1	5163	16.7012	"$1,349.34"	.	$269.87			
41822	Excision of gum lesion	J1	5163	16.7012	"$1,349.34"	.	$269.87			
41823	Excision of gum lesion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
41825	Excision of gum lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
41826	Excision of gum lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
41827	Excision of gum lesion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
41828	Excision of gum lesion	J1	5163	16.7012	"$1,349.34"	.	$269.87			
4182F	No conformal radn thxpy	E1								
41830	Removal of gum tissue	J1	5164	32.4198	"$2,619.29"	.	$523.86			
41850	Treatment of gum lesion	J1	5163	16.7012	"$1,349.34"	.	$269.87			
4185F	Continuous ppi or h2ra rcvd	E1								
4186F	No cont ppi or h2ra rcvd	E1								
41870	Gum graft	J1	5163	16.7012	"$1,349.34"	.	$269.87			
41872	Repair gum	J1	5164	32.4198	"$2,619.29"	.	$523.86			
41874	Repair tooth socket	J1	5164	32.4198	"$2,619.29"	.	$523.86			
4187F	Anti rheum drugthxpyrxd/gvn	E1								
4188F	Approp ace/arb tstng done	E1								
41899	Dental surgery procedure	T	5161	2.5205	$203.64	.	$40.73			
4189F	Approp digoxin tstng done	E1								
4190F	Approp diuretic tstng done	E1								
4191F	Approp anticonvuls tstng	E1								
4192F	Pt not rcvng glucoco thxpy	M								
4193F	Pt rcvng<10mg daily predniso	M								
4194F	Pt rcvng10mg daily predniso	M								
4195F	Pt rcvng anti-rheum thxpy ra	M								
4196F	Ptnot rcvng anti-rhm thxpyra	M								
42000	Drainage mouth roof lesion	T	5161	2.5205	$203.64	.	$40.73			
4200F	External beam to prost only	E1								
4201F	Extrnl beam other than prost	E1								
42100	Biopsy roof of mouth	J1	5163	16.7012	"$1,349.34"	.	$269.87			
42104	Excision lesion mouth roof	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42106	Excision lesion mouth roof	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42107	Excision lesion mouth roof	J1	5165	60.0365	"$4,850.53"	.	$970.11			
4210F	Ace/arb thxpy for mos/>	E1								
42120	Remove palate/lesion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42140	Excision of uvula	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42145	Repair palate pharynx/uvula	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42160	Treatment mouth roof lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42180	Repair palate	T	5162	5.4673	$441.72	.	$88.35			
42182	Repair palate	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42200	Reconstruct cleft palate	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42205	Reconstruct cleft palate	J1	5164	32.4198	"$2,619.29"	.	$523.86			
4220F	Digoxin thxpy for 6 mos/>	E1								
42210	Reconstruct cleft palate	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42215	Reconstruct cleft palate	J1	5165	60.0365	"$4,850.53"	.	$970.11			
4221F	Diuretic thxpy for 6 mos/>	E1								
42220	Reconstruct cleft palate	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42225	Reconstruct cleft palate	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42226	Lengthening of palate	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42227	Lengthening of palate	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42235	Repair palate	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42260	Repair nose to lip fistula	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42280	Preparation palate mold	T	5162	5.4673	$441.72	.	$88.35			
42281	Insertion palate prosthesis	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42299	Palate/uvula surgery	T	5161	2.5205	$203.64	.	$40.73			
42300	Drainage of salivary gland	J1	5163	16.7012	"$1,349.34"	.	$269.87			
42305	Drainage of salivary gland	J1	5164	32.4198	"$2,619.29"	.	$523.86			
4230F	Anticonv thxpy for 6 mos/>	E1								
42310	Drainage of salivary gland	T	5162	5.4673	$441.72	.	$88.35			
42320	Drainage of salivary gland	T	5162	5.4673	$441.72	.	$88.35			
42330	Removal of salivary stone	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42335	Removal of salivary stone	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42340	Removal of salivary stone	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42400	Biopsy of salivary gland	T	5071	7.5503	$610.01	.	$122.01			
42405	Biopsy of salivary gland	J1	5163	16.7012	"$1,349.34"	.	$269.87			
42408	Excision of salivary cyst	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42409	Drainage of salivary cyst	J1	5164	32.4198	"$2,619.29"	.	$523.86			
4240F	Instr xrcz back pain 12 wks	E1								
42410	Excise parotid gland/lesion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42415	Excise parotid gland/lesion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42420	Excise parotid gland/lesion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42425	Excise parotid gland/lesion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42426	Excise parotid gland/lesion	C								
4242F	Sprvsd xrcz back pn >12 wks	E1								
42440	Excise submaxillary gland	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42450	Excise sublingual gland	J1	5165	60.0365	"$4,850.53"	.	$970.11			
4245F	Pt instr nrml lifest	E1								
4248F	Pt instr no bd rest 4 days/>	E1								
42500	Repair salivary duct	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42505	Repair salivary duct	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42507	Parotid duct diversion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42509	Parotid duct diversion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
4250F	Wrmng 4 surg normothermia	E1								
42510	Parotid duct diversion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42550	Injection for salivary x-ray	N								
4255F	Anesth 60 min/> as docd	M								
4256F	Anesthe <60 min as docd	E1								
42600	Closure of salivary fistula	J1	5164	32.4198	"$2,619.29"	.	$523.86			
4260F	Wound srfc culturetech used	E1								
4261F	Tech other than surfc cultr	E1								
42650	Dilation of salivary duct	J1	5163	16.7012	"$1,349.34"	.	$269.87			
4265F	Wet-dry dressings rx recmd	E1								
42660	Dilation of salivary duct	T	5162	5.4673	$441.72	.	$88.35			
42665	Ligation of salivary duct	J1	5164	32.4198	"$2,619.29"	.	$523.86			
4266F	No wet-dry drssings rx recmd	E1								
4267F	Comprssion thxpy prescribed	E1								
4268F	Pt ed re comp thxpy rcvd	E1								
42699	Salivary surgery procedure	T	5161	2.5205	$203.64	.	$40.73			
4269F	Appropos mthd offloading rxd	E1								
42700	Drainage of tonsil abscess	T	5161	2.5205	$203.64	.	$40.73			
4270F	Pt rcvng anti r-viral thxpy	E1								
4271F	Pt rcvng anti r-viral thxpy	E1								
42720	Drainage of throat abscess	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42725	Drainage of throat abscess	J1	5165	60.0365	"$4,850.53"	.	$970.11			
4274F	Flu immuno admind rcvd	E1								
4276F	Potent antivir thxpy rxd	E1								
4279F	Pcp prophylaxis rxd	E1								
42800	Biopsy of throat	J1	5163	16.7012	"$1,349.34"	.	$269.87			
42804	Biopsy of upper nose/throat	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42806	Biopsy of upper nose/throat	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42808	Excise pharynx lesion	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42809	Remove pharynx foreign body	Q1	5735	4.5003	$363.59	.	$72.72			
4280F	Pcp prophylax rxd 3mon low %	E1								
42810	Excision of neck cyst	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42815	Excision of neck cyst	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42820	Remove tonsils and adenoids	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42821	Remove tonsils and adenoids	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42825	Removal of tonsils	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42826	Removal of tonsils	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42830	Removal of adenoids	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42831	Removal of adenoids	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42835	Removal of adenoids	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42836	Removal of adenoids	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42842	Extensive surgery of throat	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42844	Extensive surgery of throat	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42845	Extensive surgery of throat	C								
42860	Excision of tonsil tags	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42870	Excision of lingual tonsil	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42890	Partial removal of pharynx	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42892	Revision of pharyngeal walls	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42894	Revision of pharyngeal walls	C								
42900	Repair throat wound	J1	5163	16.7012	"$1,349.34"	.	$269.87			
4290F	Pt scrned for inj drug use	E1								
4293F	Pt scrnd hgh-risk sex behav	E1								
42950	Reconstruction of throat	J1	5165	60.0365	"$4,850.53"	.	$970.11			
42953	Repair throat esophagus	C								
42955	Surgical opening of throat	J1	5163	16.7012	"$1,349.34"	.	$269.87			
42960	Control throat bleeding	T	5162	5.4673	$441.72	.	$88.35			
42961	Control throat bleeding	C								
42962	Control throat bleeding	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42970	Control nose/throat bleeding	T	5161	2.5205	$203.64	.	$40.73			
42971	Control nose/throat bleeding	C								
42972	Control nose/throat bleeding	J1	5164	32.4198	"$2,619.29"	.	$523.86			
42999	Throat surgery procedure	T	5161	2.5205	$203.64	.	$40.73			
4300F	Pt rcvng warf thxpy	E1								
4301F	Pt not rcvng warf thxpy	E1								
43020	Incision of esophagus	J1	5163	16.7012	"$1,349.34"	.	$269.87			
43030	Throat muscle surgery	J1	5165	60.0365	"$4,850.53"	.	$970.11			
43045	Incision of esophagus	C								
4305F	Pt ed re ft care inspct rcvd	E1								
4306F	Pt tlk psych & rx opd addic	E1								
43100	Excision of esophagus lesion	C								
43101	Excision of esophagus lesion	C								
43107	Removal of esophagus	C								
43108	Removal of esophagus	C								
43112	Esphg tot w/thrcm	C								
43113	Removal of esophagus	C								
43116	Partial removal of esophagus	C								
43117	Partial removal of esophagus	C								
43118	Partial removal of esophagus	C								
43121	Partial removal of esophagus	C								
43122	Partial removal of esophagus	C								
43123	Partial removal of esophagus	C								
43124	Removal of esophagus	C								
43130	Removal of esophagus pouch	J1	5165	60.0365	"$4,850.53"	.	$970.11			
43135	Removal of esophagus pouch	C								
43180	Esophagoscopy rigid trnso	J1	5165	60.0365	"$4,850.53"	.	$970.11			
43191	Esophagoscopy rigid trnso dx	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43192	Esophagoscp rig trnso inject	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43193	Esophagoscp rig trnso biopsy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43194	Esophagoscp rig trnso rem fb	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43195	Esophagoscopy rigid balloon	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43196	Esophagoscp guide wire dilat	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43197	Esophagoscopy flex dx brush	T	5301	9.7276	$785.92	.	$157.19			
43198	Esophagosc flex trnsn biopsy	T	5301	9.7276	$785.92	.	$157.19			
43200	Esophagoscopy flexible brush	T	5301	9.7276	$785.92	.	$157.19			
43201	Esoph scope w/submucous inj	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43202	Esophagoscopy flex biopsy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43204	Esoph scope w/sclerosis inj	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43205	Esophagus endoscopy/ligation	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43206	Esoph optical endomicroscopy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
4320F	Pt talk psychsoc&rx oh dpnd	E1								
43210	Egd esophagogastrc fndoplsty	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
43211	Esophagoscop mucosal resect	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43212	Esophagoscop stent placement	J1	5331	59.1738	"$4,780.83"	.	$956.17			
43213	Esophagoscopy retro balloon	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43214	Esophagosc dilate balloon 30	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43215	Esophagoscopy flex remove fb	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43216	Esophagoscopy lesion removal	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43217	Esophagoscopy snare les remv	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43220	Esophagoscopy balloon <30mm	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43226	Esoph endoscopy dilation	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43227	Esophagoscopy control bleed	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43229	Esophagoscopy lesion ablate	J1	5303	37.1206	"$2,999.08"	.	$599.82			
4322F	Crgvr prov w/ ed addl rsrcs	M								
43231	Esophagoscop ultrasound exam	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43232	Esophagoscopy w/us needle bx	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43233	Egd balloon dil esoph30 mm/>	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43235	Egd diagnostic brush wash	T	5301	9.7276	$785.92	.	$157.19			
43236	Uppr gi scope w/submuc inj	T	5301	9.7276	$785.92	.	$157.19			
43237	Endoscopic us exam esoph	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43238	Egd us fine needle bx/aspir	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43239	Egd biopsy single/multiple	T	5301	9.7276	$785.92	.	$157.19			
43240	Egd w/transmural drain cyst	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43241	Egd tube/cath insertion	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43242	Egd us fine needle bx/aspir	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43243	Egd injection varices	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43244	Egd varices ligation	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43245	Egd dilate stricture	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43246	Egd place gastrostomy tube	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43247	Egd remove foreign body	T	5301	9.7276	$785.92	.	$157.19			
43248	Egd guide wire insertion	T	5301	9.7276	$785.92	.	$157.19			
43249	Esoph egd dilation <30 mm	J1	5302	19.2764	"$1,557.40"	.	$311.48			
4324F	Pt queried prkns complic	E1								
43250	Egd cautery tumor polyp	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43251	Egd remove lesion snare	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43252	Egd optical endomicroscopy	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43253	Egd us transmural injxn/mark	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43254	Egd endo mucosal resection	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43255	Egd control bleeding any	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43257	Egd w/thrml txmnt gerd	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43259	Egd us exam duodenum/jejunum	J1	5302	19.2764	"$1,557.40"	.	$311.48			
4325F	Med txmnt options rvwd w/pt	M								
43260	Ercp w/specimen collection	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43261	Endo cholangiopancreatograph	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43262	Endo cholangiopancreatograph	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43263	Ercp sphincter pressure meas	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43264	Ercp remove duct calculi	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43265	Ercp lithotripsy calculi	J1	5331	59.1738	"$4,780.83"	.	$956.17			
43266	Egd endoscopic stent place	J1	5331	59.1738	"$4,780.83"	.	$956.17			
4326F	Pt asked re symp auto dysfxn	E1								
43270	Egd lesion ablation	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43273	Endoscopic pancreatoscopy	N								
43274	Ercp duct stent placement	J1	5331	59.1738	"$4,780.83"	.	$956.17			
43275	Ercp remove forgn body duct	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43276	Ercp stent exchange w/dilate	J1	5331	59.1738	"$4,780.83"	.	$956.17			
43277	Ercp ea duct/ampulla dilate	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43278	Ercp lesion ablate w/dilate	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43279	Lap myotomy heller	C								
43280	Laparoscopy fundoplasty	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
43281	Lap paraesophag hern repair	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
43282	Lap paraesoph her rpr w/mesh	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
43283	Lap esoph lengthening	C								
43284	Laps esophgl sphnctr agmntj	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
43285	Rmvl esophgl sphnctr dev	Q2	5361	59.8283	"$4,833.71"	.	$966.75			
43286	Esphg tot w/laps moblj	C								
43287	Esphg dstl 2/3 w/laps moblj	C								
43288	Esphg thrsc moblj	C								
43289	Laparoscope proc esoph	J1	5361	59.8283	"$4,833.71"	.	$966.75			
4328F	Pt asked re sleep disturb	E1								
43300	Repair of esophagus	C								
43305	Repair esophagus and fistula	C								
4330F	Cnslng epi spec sfty issues	E1								
43310	Repair of esophagus	C								
43312	Repair esophagus and fistula	C								
43313	Esophagoplasty congenital	C								
43314	Tracheo-esophagoplasty cong	C								
43320	Fuse esophagus & stomach	C								
43325	Revise esophagus & stomach	C								
43327	Esoph fundoplasty lap	C								
43328	Esoph fundoplasty thor	C								
43330	Esophagomyotomy abdominal	C								
43331	Esophagomyotomy thoracic	C								
43332	Transab esoph hiat hern rpr	C								
43333	Transab esoph hiat hern rpr	C								
43334	Transthor diaphrag hern rpr	C								
43335	Transthor diaphrag hern rpr	C								
43336	Thorabd diaphr hern repair	C								
43337	Thorabd diaphr hern repair	C								
43338	Esoph lengthening	C								
43340	Fuse esophagus & intestine	C								
43341	Fuse esophagus & intestine	C								
43351	Surgical opening esophagus	C								
43352	Surgical opening esophagus	C								
43360	Gastrointestinal repair	C								
43361	Gastrointestinal repair	C								
43400	Ligate esophagus veins	C								
43405	Ligate/staple esophagus	C								
4340F	Cnslng chldbrng women epi	M								
43410	Repair esophagus wound	C								
43415	Repair esophagus wound	C								
43420	Repair esophagus opening	J1	5164	32.4198	"$2,619.29"	.	$523.86			
43425	Repair esophagus opening	C								
43450	Dilate esophagus 1/mult pass	T	5301	9.7276	$785.92	.	$157.19			
43453	Dilate esophagus	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43460	Pressure treatment esophagus	C								
43496	Free jejunum flap microvasc	C								
43499	Esophagus surgery procedure	T	5301	9.7276	$785.92	.	$157.19			
43500	Surgical opening of stomach	C								
43501	Surgical repair of stomach	C								
43502	Surgical repair of stomach	C								
4350F	Cnslng provided symp mngmnt	E1								
43510	Surgical opening of stomach	T	5301	9.7276	$785.92	.	$157.19			
43520	Incision of pyloric muscle	C								
43605	Biopsy of stomach	C								
43610	Excision of stomach lesion	C								
43611	Excision of stomach lesion	C								
43620	Removal of stomach	C								
43621	Removal of stomach	C								
43622	Removal of stomach	C								
43631	Removal of stomach partial	C								
43632	Removal of stomach partial	C								
43633	Removal of stomach partial	C								
43634	Removal of stomach partial	C								
43635	Removal of stomach partial	C								
43640	Vagotomy & pylorus repair	C								
43641	Vagotomy & pylorus repair	C								
43644	Lap gastric bypass/roux-en-y	C								
43645	Lap gastr bypass incl smll i	C								
43647	Lap impl electrode antrum	J1	5462	76.5800	"$6,187.13"	.	"$1,237.43"			
43648	Lap revise/remv eltrd antrum	J1	5361	59.8283	"$4,833.71"	.	$966.75			
43651	Laparoscopy vagus nerve	J1	5361	59.8283	"$4,833.71"	.	$966.75			
43652	Laparoscopy vagus nerve	J1	5361	59.8283	"$4,833.71"	.	$966.75			
43653	Laparoscopy gastrostomy	J1	5361	59.8283	"$4,833.71"	.	$966.75			
43659	Laparoscope proc stom	J1	5361	59.8283	"$4,833.71"	.	$966.75			
43752	Nasal/orogastric w/tube plmt	Q1	5735	4.5003	$363.59	.	$72.72			
43753	Tx gastro intub w/asp	Q1	5722	3.1327	$253.10	.	$50.62			
43754	Dx gastr intub w/asp spec	Q1	5722	3.1327	$253.10	.	$50.62			
43755	Dx gastr intub w/asp specs	S	5721	1.7124	$138.35	.	$27.67			
43756	Dx duod intub w/asp spec	Q1	5301	9.7276	$785.92	.	$157.19			
43757	Dx duod intub w/asp specs	T	5301	9.7276	$785.92	.	$157.19			
43761	Reposition gastrostomy tube	T	5371	2.9074	$234.90	.	$46.98			
43762	Rplc gtube no revj trc	T	5371	2.9074	$234.90	.	$46.98			
43763	Rplc gtube revj gstrst trc	T	5371	2.9074	$234.90	.	$46.98			
43770	Lap place gastr adj device	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
43771	Lap revise gastr adj device	C								
43772	Lap rmvl gastr adj device	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43773	Lap replace gastr adj device	J1	5361	59.8283	"$4,833.71"	.	$966.75			
43774	Lap rmvl gastr adj all parts	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43775	Lap sleeve gastrectomy	C								
43800	Reconstruction of pylorus	C								
43810	Fusion of stomach and bowel	C								
43820	Fusion of stomach and bowel	C								
43825	Fusion of stomach and bowel	C								
43830	Place gastrostomy tube	J1	5302	19.2764	"$1,557.40"	.	$311.48			
43831	Place gastrostomy tube	T	5301	9.7276	$785.92	.	$157.19			
43832	Place gastrostomy tube	C								
43840	Repair of stomach lesion	C								
43842	V-band gastroplasty	E1								
43843	Gastroplasty w/o v-band	C								
43845	Gastroplasty duodenal switch	C								
43846	Gastric bypass for obesity	C								
43847	Gastric bypass incl small i	C								
43848	Revision gastroplasty	C								
43850	Revise stomach-bowel fusion	C								
43855	Revise stomach-bowel fusion	C								
43860	Revise stomach-bowel fusion	C								
43865	Revise stomach-bowel fusion	C								
43870	Repair stomach opening	J1	5303	37.1206	"$2,999.08"	.	$599.82			
43880	Repair stomach-bowel fistula	C								
43881	Impl/redo electrd antrum	C								
43882	Revise/remove electrd antrum	C								
43886	Revise gastric port open	T	5055	36.8508	"$2,977.29"	.	$595.46			
43887	Remove gastric port open	Q2	5054	20.0852	"$1,622.74"	.	$324.55			
43888	Change gastric port open	T	5055	36.8508	"$2,977.29"	.	$595.46			
43999	Stomach surgery procedure	T	5301	9.7276	$785.92	.	$157.19			
44005	Freeing of bowel adhesion	C								
4400F	Rehab thxpy options w/pt	M								
44010	Incision of small bowel	C								
44015	Insert needle cath bowel	C								
44020	Explore small intestine	C								
44021	Decompress small bowel	C								
44025	Incision of large bowel	C								
44050	Reduce bowel obstruction	C								
44055	Correct malrotation of bowel	C								
44100	Biopsy of bowel	T	5301	9.7276	$785.92	.	$157.19			
44110	Excise intestine lesion(s)	C								
44111	Excision of bowel lesion(s)	C								
44120	Removal of small intestine	C								
44121	Removal of small intestine	C								
44125	Removal of small intestine	C								
44126	Enterectomy w/o taper cong	C								
44127	Enterectomy w/taper cong	C								
44128	Enterectomy cong add-on	C								
44130	Bowel to bowel fusion	C								
44132	Enterectomy cadaver donor	C								
44133	Enterectomy live donor	C								
44135	Intestine transplnt cadaver	C								
44136	Intestine transplant live	C								
44137	Remove intestinal allograft	C								
44139	Mobilization of colon	C								
44140	Partial removal of colon	C								
44141	Partial removal of colon	C								
44143	Partial removal of colon	C								
44144	Partial removal of colon	C								
44145	Partial removal of colon	C								
44146	Partial removal of colon	C								
44147	Partial removal of colon	C								
44150	Removal of colon	C								
44151	Removal of colon/ileostomy	C								
44155	Removal of colon/ileostomy	C								
44156	Removal of colon/ileostomy	C								
44157	Colectomy w/ileoanal anast	C								
44158	Colectomy w/neo-rectum pouch	C								
44160	Removal of colon	C								
44180	Lap enterolysis	J1	5361	59.8283	"$4,833.71"	.	$966.75			
44186	Lap jejunostomy	J1	5361	59.8283	"$4,833.71"	.	$966.75			
44187	Lap ileo/jejuno-stomy	C								
44188	Lap colostomy	C								
44202	Lap enterectomy	C								
44203	Lap resect s/intestine addl	C								
44204	Laparo partial colectomy	C								
44205	Lap colectomy part w/ileum	C								
44206	Lap part colectomy w/stoma	C								
44207	L colectomy/coloproctostomy	C								
44208	L colectomy/coloproctostomy	C								
44210	Laparo total proctocolectomy	C								
44211	Lap colectomy w/proctectomy	C								
44212	Laparo total proctocolectomy	C								
44213	Lap mobil splenic fl add-on	C								
44227	Lap close enterostomy	C								
44238	Laparoscope proc intestine	J1	5361	59.8283	"$4,833.71"	.	$966.75			
44300	Open bowel to skin	C								
44310	Ileostomy/jejunostomy	C								
44312	Revision of ileostomy	T	5055	36.8508	"$2,977.29"	.	$595.46			
44314	Revision of ileostomy	C								
44316	Devise bowel pouch	C								
44320	Colostomy	C								
44322	Colostomy with biopsies	C								
44340	Revision of colostomy	T	5055	36.8508	"$2,977.29"	.	$595.46			
44345	Revision of colostomy	C								
44346	Revision of colostomy	C								
44360	Small bowel endoscopy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
44361	Small bowel endoscopy/biopsy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
44363	Small bowel endoscopy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
44364	Small bowel endoscopy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
44365	Small bowel endoscopy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
44366	Small bowel endoscopy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
44369	Small bowel endoscopy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
44370	Small bowel endoscopy/stent	J1	5331	59.1738	"$4,780.83"	.	$956.17			
44372	Small bowel endoscopy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
44373	Small bowel endoscopy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
44376	Small bowel endoscopy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
44377	Small bowel endoscopy/biopsy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
44378	Small bowel endoscopy	J1	5302	19.2764	"$1,557.40"	.	$311.48			
44379	S bowel endoscope w/stent	J1	5331	59.1738	"$4,780.83"	.	$956.17			
44380	Small bowel endoscopy br/wa	T	5301	9.7276	$785.92	.	$157.19			
44381	Small bowel endoscopy br/wa	J1	5302	19.2764	"$1,557.40"	.	$311.48			
44382	Small bowel endoscopy	T	5301	9.7276	$785.92	.	$157.19			
44384	Small bowel endoscopy	J1	5303	37.1206	"$2,999.08"	.	$599.82			
44385	Endoscopy of bowel pouch	T	5311	9.4548	$763.88	.	$152.78			
44386	Endoscopy bowel pouch/biop	T	5311	9.4548	$763.88	.	$152.78			
44388	Colonoscopy thru stoma spx	T	5311	9.4548	$763.88	.	$152.78			
44389	Colonoscopy with biopsy	T	5312	12.4295	"$1,004.22"	.	$200.85			
44390	Colonoscopy for foreign body	T	5311	9.4548	$763.88	.	$152.78			
44391	Colonoscopy for bleeding	T	5312	12.4295	"$1,004.22"	.	$200.85			
44392	Colonoscopy & polypectomy	T	5312	12.4295	"$1,004.22"	.	$200.85			
44394	Colonoscopy w/snare	T	5312	12.4295	"$1,004.22"	.	$200.85			
44401	Colonoscopy with ablation	T	5312	12.4295	"$1,004.22"	.	$200.85			
44402	Colonoscopy w/stent plcmt	J1	5331	59.1738	"$4,780.83"	.	$956.17			
44403	Colonoscopy w/resection	T	5312	12.4295	"$1,004.22"	.	$200.85			
44404	Colonoscopy w/injection	T	5312	12.4295	"$1,004.22"	.	$200.85			
44405	Colonoscopy w/dilation	T	5312	12.4295	"$1,004.22"	.	$200.85			
44406	Colonoscopy w/ultrasound	T	5312	12.4295	"$1,004.22"	.	$200.85			
44407	Colonoscopy w/ndl aspir/bx	T	5312	12.4295	"$1,004.22"	.	$200.85			
44408	Colonoscopy w/decompression	T	5311	9.4548	$763.88	.	$152.78			
44500	Intro gastrointestinal tube	T	5301	9.7276	$785.92	.	$157.19			
4450F	Self-care ed provided to pt	E1								
44602	Suture small intestine	C								
44603	Suture small intestine	C								
44604	Suture large intestine	C								
44605	Repair of bowel lesion	C								
44615	Intestinal stricturoplasty	C								
44620	Repair bowel opening	C								
44625	Repair bowel opening	C								
44626	Repair bowel opening	C								
44640	Repair bowel-skin fistula	C								
44650	Repair bowel fistula	C								
44660	Repair bowel-bladder fistula	C								
44661	Repair bowel-bladder fistula	C								
44680	Surgical revision intestine	C								
44700	Suspend bowel w/prosthesis	C								
44701	Intraop colon lavage add-on	N								
44705	Prepare fecal microbiota	B								
4470F	Icd counseling provided	E1								
44715	Prepare donor intestine	C								
44720	Prep donor intestine/venous	C								
44721	Prep donor intestine/artery	C								
44799	Unlisted px small intestine	T	5301	9.7276	$785.92	.	$157.19			
44800	Excision of bowel pouch	C								
4480F	Pt rcvng ace/arb b-blockertx	E1								
4481F	Pt rcvng ace/arb blker >3mos	E1								
44820	Excision of mesentery lesion	C								
44850	Repair of mesentery	C								
44899	Bowel surgery procedure	C								
44900	Drain appendix abscess open	C								
44950	Appendectomy	J1	5341	38.4853	"$3,109.34"	.	$621.87			
44955	Appendectomy add-on	N								
44960	Appendectomy	C								
44970	Laparoscopy appendectomy	J1	5361	59.8283	"$4,833.71"	.	$966.75			
44979	Laparoscope proc app	J1	5361	59.8283	"$4,833.71"	.	$966.75			
45000	Drainage of pelvic abscess	T	5312	12.4295	"$1,004.22"	.	$200.85			
45005	Drainage of rectal abscess	T	5312	12.4295	"$1,004.22"	.	$200.85			
4500F	Ref to outpt card rehab prog	M								
45020	Drainage of rectal abscess	J1	5313	29.0147	"$2,344.18"	.	$468.84			
45100	Biopsy of rectum	J1	5313	29.0147	"$2,344.18"	.	$468.84			
45108	Removal of anorectal lesion	J1	5313	29.0147	"$2,344.18"	.	$468.84			
4510F	Prev cardrehab qualcardevent	M								
45110	Removal of rectum	C								
45111	Partial removal of rectum	C								
45112	Removal of rectum	C								
45113	Partial proctectomy	C								
45114	Partial removal of rectum	C								
45116	Partial removal of rectum	C								
45119	Remove rectum w/reservoir	C								
45120	Removal of rectum	C								
45121	Removal of rectum and colon	C								
45123	Partial proctectomy	C								
45126	Pelvic exenteration	C								
45130	Excision of rectal prolapse	C								
45135	Excision of rectal prolapse	C								
45136	Excise ileoanal reservior	C								
45150	Excision of rectal stricture	T	5312	12.4295	"$1,004.22"	.	$200.85			
45160	Excision of rectal lesion	J1	5313	29.0147	"$2,344.18"	.	$468.84			
45171	Exc rect tum transanal part	J1	5313	29.0147	"$2,344.18"	.	$468.84			
45172	Exc rect tum transanal full	J1	5313	29.0147	"$2,344.18"	.	$468.84			
45190	Destruction rectal tumor	J1	5313	29.0147	"$2,344.18"	.	$468.84			
4525F	Neuropsychia interven order	E1								
4526F	Neuropsychia interven rcvd	E1								
45300	Proctosigmoidoscopy dx	T	5311	9.4548	$763.88	.	$152.78			
45303	Proctosigmoidoscopy dilate	T	5312	12.4295	"$1,004.22"	.	$200.85			
45305	Proctosigmoidoscopy w/bx	T	5312	12.4295	"$1,004.22"	.	$200.85			
45307	Proctosigmoidoscopy fb	J1	5313	29.0147	"$2,344.18"	.	$468.84			
45308	Proctosigmoidoscopy removal	J1	5313	29.0147	"$2,344.18"	.	$468.84			
45309	Proctosigmoidoscopy removal	T	5312	12.4295	"$1,004.22"	.	$200.85			
45315	Proctosigmoidoscopy removal	T	5312	12.4295	"$1,004.22"	.	$200.85			
45317	Proctosigmoidoscopy bleed	T	5312	12.4295	"$1,004.22"	.	$200.85			
45320	Proctosigmoidoscopy ablate	J1	5313	29.0147	"$2,344.18"	.	$468.84			
45321	Proctosigmoidoscopy volvul	J1	5313	29.0147	"$2,344.18"	.	$468.84			
45327	Proctosigmoidoscopy w/stent	J1	5331	59.1738	"$4,780.83"	.	$956.17			
45330	Diagnostic sigmoidoscopy	T	5311	9.4548	$763.88	.	$152.78			
45331	Sigmoidoscopy and biopsy	T	5311	9.4548	$763.88	.	$152.78			
45332	Sigmoidoscopy w/fb removal	T	5312	12.4295	"$1,004.22"	.	$200.85			
45333	Sigmoidoscopy & polypectomy	T	5311	9.4548	$763.88	.	$152.78			
45334	Sigmoidoscopy for bleeding	T	5312	12.4295	"$1,004.22"	.	$200.85			
45335	Sigmoidoscopy w/submuc inj	T	5311	9.4548	$763.88	.	$152.78			
45337	Sigmoidoscopy & decompress	T	5311	9.4548	$763.88	.	$152.78			
45338	Sigmoidoscopy w/tumr remove	T	5312	12.4295	"$1,004.22"	.	$200.85			
45340	Sig w/tndsc balloon dilation	T	5312	12.4295	"$1,004.22"	.	$200.85			
45341	Sigmoidoscopy w/ultrasound	T	5311	9.4548	$763.88	.	$152.78			
45342	Sigmoidoscopy w/us guide bx	T	5312	12.4295	"$1,004.22"	.	$200.85			
45346	Sigmoidoscopy w/ablation	T	5312	12.4295	"$1,004.22"	.	$200.85			
45347	Sigmoidoscopy w/plcmt stent	J1	5331	59.1738	"$4,780.83"	.	$956.17			
45349	Sigmoidoscopy w/resection	J1	5313	29.0147	"$2,344.18"	.	$468.84			
45350	Sgmdsc w/band ligation	T	5312	12.4295	"$1,004.22"	.	$200.85			
45378	Diagnostic colonoscopy	T	5311	9.4548	$763.88	.	$152.78			
45379	Colonoscopy w/fb removal	T	5312	12.4295	"$1,004.22"	.	$200.85			
45380	Colonoscopy and biopsy	T	5312	12.4295	"$1,004.22"	.	$200.85			
45381	Colonoscopy submucous njx	T	5312	12.4295	"$1,004.22"	.	$200.85			
45382	Colonoscopy w/control bleed	T	5312	12.4295	"$1,004.22"	.	$200.85			
45384	Colonoscopy w/lesion removal	T	5312	12.4295	"$1,004.22"	.	$200.85			
45385	Colonoscopy w/lesion removal	T	5312	12.4295	"$1,004.22"	.	$200.85			
45386	Colonoscopy w/balloon dilat	T	5312	12.4295	"$1,004.22"	.	$200.85			
45388	Colonoscopy w/ablation	T	5312	12.4295	"$1,004.22"	.	$200.85			
45389	Colonoscopy w/stent plcmt	J1	5331	59.1738	"$4,780.83"	.	$956.17			
45390	Colonoscopy w/resection	J1	5313	29.0147	"$2,344.18"	.	$468.84			
45391	Colonoscopy w/endoscope us	T	5312	12.4295	"$1,004.22"	.	$200.85			
45392	Colonoscopy w/endoscopic fnb	T	5312	12.4295	"$1,004.22"	.	$200.85			
45393	Colonoscopy w/decompression	T	5312	12.4295	"$1,004.22"	.	$200.85			
45395	Lap removal of rectum	C								
45397	Lap remove rectum w/pouch	C								
45398	Colonoscopy w/band ligation	T	5312	12.4295	"$1,004.22"	.	$200.85			
45399	Unlisted procedure colon	T	5311	9.4548	$763.88	.	$152.78			
45400	Laparoscopic proc	C								
45402	Lap proctopexy w/sig resect	C								
4540F	Disease modif pharmacothxpy	E1								
4541F	Pt offered tx for pseudobulb	E1								
45499	Laparoscope proc rectum	J1	5361	59.8283	"$4,833.71"	.	$966.75			
45500	Repair of rectum	J1	5313	29.0147	"$2,344.18"	.	$468.84			
45505	Repair of rectum	J1	5313	29.0147	"$2,344.18"	.	$468.84			
4550F	Noninvas resp support talk	E1								
4551F	Nutritional support offered	E1								
45520	Treatment of rectal prolapse	Q1	5311	9.4548	$763.88	.	$152.78			
4552F	Pt ref for speech lang path	E1								
4553F	Pt asst re end life issues	E1								
45540	Correct rectal prolapse	C								
45541	Correct rectal prolapse	J1	5313	29.0147	"$2,344.18"	.	$468.84			
4554F	Pt recvd inhal anesthetic	M								
45550	Repair rectum/remove sigmoid	C								
4555F	Pt recvd no inhal anesthic	E1								
45560	Repair of rectocele	J1	5313	29.0147	"$2,344.18"	.	$468.84			
45562	Exploration/repair of rectum	C								
45563	Exploration/repair of rectum	C								
4556F	Pt w/3+ post-op nausea&vom	M								
4557F	Pt w/o 3+ post-opnausea&vom	E1								
4558F	Pt recvd 2 rx anti-emet agt	E1								
4559F	1 bodytemp >=35.5cw/in 30min	E1								
4560F	Anesth w/o gen/neurax anesth	E1								
4561F	Pt w/ coronary artery stent	E1								
4562F	Pt w/o coronary artery stent	E1								
4563F	Pt recvd aspirin w/in 24 hrs	E1								
45800	Repair rect/bladder fistula	C								
45805	Repair fistula w/colostomy	C								
45820	Repair rectourethral fistula	C								
45825	Repair fistula w/colostomy	C								
45900	Reduction of rectal prolapse	T	5311	9.4548	$763.88	.	$152.78			
45905	Dilation of anal sphincter	T	5312	12.4295	"$1,004.22"	.	$200.85			
45910	Dilation of rectal narrowing	T	5312	12.4295	"$1,004.22"	.	$200.85			
45915	Remove rectal obstruction	T	5312	12.4295	"$1,004.22"	.	$200.85			
45990	Surg dx exam anorectal	J1	5313	29.0147	"$2,344.18"	.	$468.84			
45999	Rectum surgery procedure	T	5311	9.4548	$763.88	.	$152.78			
46020	Placement of seton	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46030	Removal of rectal marker	T	5312	12.4295	"$1,004.22"	.	$200.85			
46040	Incision of rectal abscess	T	5312	12.4295	"$1,004.22"	.	$200.85			
46045	Incision of rectal abscess	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46050	Incision of anal abscess	T	5311	9.4548	$763.88	.	$152.78			
46060	Incision of rectal abscess	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46070	Incision of anal septum	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46080	Incision of anal sphincter	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46083	Incise external hemorrhoid	T	5371	2.9074	$234.90	.	$46.98			
46200	Removal of anal fissure	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46220	Excise anal ext tag/papilla	T	5312	12.4295	"$1,004.22"	.	$200.85			
46221	Ligation of hemorrhoid(s)	T	5311	9.4548	$763.88	.	$152.78			
46230	Removal of anal tags	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46250	Remove ext hem groups 2+	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46255	Remove int/ext hem 1 group	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46257	Remove in/ex hem grp & fiss	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46258	Remove in/ex hem grp w/fistu	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46260	Remove in/ex hem groups 2+	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46261	Remove in/ex hem grps & fiss	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46262	Remove in/ex hem grps w/fist	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46270	Remove anal fist subq	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46275	Remove anal fist inter	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46280	Remove anal fist complex	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46285	Remove anal fist 2 stage	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46288	Repair anal fistula	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46320	Removal of hemorrhoid clot	T	5312	12.4295	"$1,004.22"	.	$200.85			
46500	Injection into hemorrhoid(s)	T	5311	9.4548	$763.88	.	$152.78			
46505	Chemodenervation anal musc	T	5312	12.4295	"$1,004.22"	.	$200.85			
46600	Diagnostic anoscopy spx	Q1	5734	1.3495	$109.03	.	$21.81			
46601	Diagnostic anoscopy	Q1	5734	1.3495	$109.03	.	$21.81			
46604	Anoscopy and dilation	T	5312	12.4295	"$1,004.22"	.	$200.85			
46606	Anoscopy and biopsy	T	5312	12.4295	"$1,004.22"	.	$200.85			
46607	Diagnostic anoscopy & biopsy	T	5312	12.4295	"$1,004.22"	.	$200.85			
46608	Anoscopy remove for body	T	5311	9.4548	$763.88	.	$152.78			
46610	Anoscopy remove lesion	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46611	Anoscopy	T	5311	9.4548	$763.88	.	$152.78			
46612	Anoscopy remove lesions	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46614	Anoscopy control bleeding	T	5312	12.4295	"$1,004.22"	.	$200.85			
46615	Anoscopy	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46700	Repair of anal stricture	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46705	Repair of anal stricture	C								
46706	Repr of anal fistula w/glue	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46707	Repair anorectal fist w/plug	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46710	Repr per/vag pouch sngl proc	C								
46712	Repr per/vag pouch dbl proc	C								
46715	Rep perf anoper fistu	C								
46716	Rep perf anoper/vestib fistu	C								
46730	Construction of absent anus	C								
46735	Construction of absent anus	C								
46740	Construction of absent anus	C								
46742	Repair of imperforated anus	C								
46744	Repair of cloacal anomaly	C								
46746	Repair of cloacal anomaly	C								
46748	Repair of cloacal anomaly	C								
46750	Repair of anal sphincter	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46751	Repair of anal sphincter	C								
46753	Reconstruction of anus	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46754	Removal of suture from anus	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46760	Repair of anal sphincter	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46761	Repair of anal sphincter	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46900	Destruction anal lesion(s)	T	5052	3.9547	$319.51	.	$63.91			
46910	Destruction anal lesion(s)	T	5054	20.0852	"$1,622.74"	.	$324.55			
46916	Cryosurgery anal lesion(s)	T	5051	2.1627	$174.73	.	$34.95			
46917	Laser surgery anal lesions	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46922	Excision of anal lesion(s)	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46924	Destruction anal lesion(s)	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46930	Destroy internal hemorrhoids	T	5312	12.4295	"$1,004.22"	.	$200.85			
46940	Treatment of anal fissure	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46942	Treatment of anal fissure	T	5311	9.4548	$763.88	.	$152.78			
46945	Int hrhc lig 1 hroid w/o img	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46946	Int hrhc lig 2+hroid w/o img	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46947	Hemorrhoidopexy by stapling	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46948	Int hrhc tranal dartlzj 2+	J1	5313	29.0147	"$2,344.18"	.	$468.84			
46999	Anus surgery procedure	T	5311	9.4548	$763.88	.	$152.78			
47000	Needle biopsy of liver	J1	5072	16.9891	"$1,372.60"	.	$274.52			
47001	Needle biopsy liver add-on	N								
47010	Open drainage liver lesion	C								
47015	Inject/aspirate liver cyst	C								
47100	Wedge biopsy of liver	C								
47120	Partial removal of liver	C								
47122	Extensive removal of liver	C								
47125	Partial removal of liver	C								
47130	Partial removal of liver	C								
47133	Removal of donor liver	C								
47135	Transplantation of liver	C								
47140	Partial removal donor liver	C								
47141	Partial removal donor liver	C								
47142	Partial removal donor liver	C								
47143	Prep donor liver whole	C								
47144	Prep donor liver 3-segment	C								
47145	Prep donor liver lobe split	C								
47146	Prep donor liver/venous	C								
47147	Prep donor liver/arterial	C								
47300	Surgery for liver lesion	C								
47350	Repair liver wound	C								
47360	Repair liver wound	C								
47361	Repair liver wound	C								
47362	Repair liver wound	C								
47370	Laparo ablate liver tumor rf	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
47371	Laparo ablate liver cryosurg	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
47379	Laparoscope procedure liver	J1	5361	59.8283	"$4,833.71"	.	$966.75			
47380	Open ablate liver tumor rf	C								
47381	Open ablate liver tumor cryo	C								
47382	Percut ablate liver rf	J1	5361	59.8283	"$4,833.71"	.	$966.75			
47383	Perq abltj lvr cryoablation	J1	5361	59.8283	"$4,833.71"	.	$966.75			
47399	Liver surgery procedure	T	5071	7.5503	$610.01	.	$122.01			
47400	Incision of liver duct	C								
47420	Incision of bile duct	C								
47425	Incision of bile duct	C								
47460	Incise bile duct sphincter	C								
47480	Incision of gallbladder	C								
47490	Incision of gallbladder	J1	5341	38.4853	"$3,109.34"	.	$621.87			
47531	Injection for cholangiogram	Q2	5341	38.4853	"$3,109.34"	.	$621.87			
47532	Injection for cholangiogram	Q2	5341	38.4853	"$3,109.34"	.	$621.87			
47533	Plmt biliary drainage cath	J1	5341	38.4853	"$3,109.34"	.	$621.87			
47534	Plmt biliary drainage cath	J1	5341	38.4853	"$3,109.34"	.	$621.87			
47535	Conversion ext bil drg cath	J1	5341	38.4853	"$3,109.34"	.	$621.87			
47536	Exchange biliary drg cath	J1	5341	38.4853	"$3,109.34"	.	$621.87			
47537	Removal biliary drg cath	Q2	5301	9.7276	$785.92	.	$157.19			
47538	Perq plmt bile duct stent	J1	5361	59.8283	"$4,833.71"	.	$966.75			
47539	Perq plmt bile duct stent	J1	5361	59.8283	"$4,833.71"	.	$966.75			
47540	Perq plmt bile duct stent	J1	5361	59.8283	"$4,833.71"	.	$966.75			
47541	Plmt access bil tree sm bwl	J1	5341	38.4853	"$3,109.34"	.	$621.87			
47542	Dilate biliary duct/ampulla	N								
47543	Endoluminal bx biliary tree	N								
47544	Removal duct glbldr calculi	N								
47550	Bile duct endoscopy add-on	C								
47552	Biliary endo perq dx w/speci	J1	5341	38.4853	"$3,109.34"	.	$621.87			
47553	Biliary endoscopy thru skin	J1	5341	38.4853	"$3,109.34"	.	$621.87			
47554	Biliary endoscopy thru skin	J1	5361	59.8283	"$4,833.71"	.	$966.75			
47555	Biliary endoscopy thru skin	J1	5341	38.4853	"$3,109.34"	.	$621.87			
47556	Biliary endoscopy thru skin	J1	5361	59.8283	"$4,833.71"	.	$966.75			
47562	Laparoscopic cholecystectomy	J1	5361	59.8283	"$4,833.71"	.	$966.75			
47563	Laparo cholecystectomy/graph	J1	5361	59.8283	"$4,833.71"	.	$966.75			
47564	Laparo cholecystectomy/explr	J1	5361	59.8283	"$4,833.71"	.	$966.75			
47570	Laparo cholecystoenterostomy	C								
47579	Laparoscope proc biliary	J1	5361	59.8283	"$4,833.71"	.	$966.75			
47600	Removal of gallbladder	C								
47605	Removal of gallbladder	C								
47610	Removal of gallbladder	C								
47612	Removal of gallbladder	C								
47620	Removal of gallbladder	C								
47700	Exploration of bile ducts	C								
47701	Bile duct revision	C								
47711	Excision of bile duct tumor	C								
47712	Excision of bile duct tumor	C								
47715	Excision of bile duct cyst	C								
47720	Fuse gallbladder & bowel	C								
47721	Fuse upper gi structures	C								
47740	Fuse gallbladder & bowel	C								
47741	Fuse gallbladder & bowel	C								
47760	Fuse bile ducts and bowel	C								
47765	Fuse liver ducts & bowel	C								
47780	Fuse bile ducts and bowel	C								
47785	Fuse bile ducts and bowel	C								
47800	Reconstruction of bile ducts	C								
47801	Placement bile duct support	C								
47802	Fuse liver duct & intestine	C								
47900	Suture bile duct injury	C								
47999	Bile tract surgery procedure	T	5301	9.7276	$785.92	.	$157.19			
48000	Drainage of abdomen	C								
48001	Placement of drain pancreas	C								
48020	Removal of pancreatic stone	C								
48100	Biopsy of pancreas open	C								
48102	Needle biopsy pancreas	J1	5072	16.9891	"$1,372.60"	.	$274.52			
48105	Resect/debride pancreas	C								
48120	Removal of pancreas lesion	C								
48140	Partial removal of pancreas	C								
48145	Partial removal of pancreas	C								
48146	Pancreatectomy	C								
48148	Removal of pancreatic duct	C								
48150	Partial removal of pancreas	C								
48152	Pancreatectomy	C								
48153	Pancreatectomy	C								
48154	Pancreatectomy	C								
48155	Removal of pancreas	C								
48160	Pancreas removal/transplant	E1								
48400	Injection intraop add-on	C								
48500	Surgery of pancreatic cyst	C								
48510	Drain pancreatic pseudocyst	C								
48520	Fuse pancreas cyst and bowel	C								
48540	Fuse pancreas cyst and bowel	C								
48545	Pancreatorrhaphy	C								
48547	Duodenal exclusion	C								
48548	Fuse pancreas and bowel	C								
48550	Donor pancreatectomy	E1								
48551	Prep donor pancreas	C								
48552	Prep donor pancreas/venous	C								
48554	Transpl allograft pancreas	C								
48556	Removal allograft pancreas	C								
48999	Pancreas surgery procedure	T	5071	7.5503	$610.01	.	$122.01			
49000	Exploration of abdomen	C								
49002	Reopening of abdomen	C								
49010	Exploration behind abdomen	C								
49013	Prpertl pel pack hemrrg trma	C								
49014	Reexploration pelvic wound	C								
49020	Drainage abdom abscess open	C								
49040	Drain open abdom abscess	C								
49060	Drain open retroperi abscess	C								
49062	Drain to peritoneal cavity	C								
49082	Abd paracentesis	T	5301	9.7276	$785.92	.	$157.19			
49083	Abd paracentesis w/imaging	T	5301	9.7276	$785.92	.	$157.19			
49084	Peritoneal lavage	T	5301	9.7276	$785.92	.	$157.19			
49180	Biopsy abdominal mass	J1	5072	16.9891	"$1,372.60"	.	$274.52			
49185	Sclerotx fluid collection	T	5071	7.5503	$610.01	.	$122.01			
49203	Exc abd tum 5 cm or less	C								
49204	Exc abd tum over 5 cm	C								
49205	Exc abd tum over 10 cm	C								
49215	Excise sacral spine tumor	C								
49220	Multiple surgery abdomen	C								
49250	Excision of umbilicus	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49255	Removal of omentum	C								
49320	Diag laparo separate proc	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49321	Laparoscopy biopsy	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49322	Laparoscopy aspiration	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49323	Laparo drain lymphocele	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49324	Lap insert tunnel ip cath	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49325	Lap revision perm ip cath	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49326	Lap w/omentopexy add-on	N								
49327	Lap ins device for rt	N								
49329	Laparo proc abdm/per/oment	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49400	Air injection into abdomen	N								
49402	Remove foreign body adbomen	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49405	Image cath fluid colxn visc	J1	5072	16.9891	"$1,372.60"	.	$274.52			
49406	Image cath fluid peri/retro	J1	5072	16.9891	"$1,372.60"	.	$274.52			
49407	Image cath fluid trns/vgnl	J1	5072	16.9891	"$1,372.60"	.	$274.52			
49411	Ins mark abd/pel for rt perq	S	5613	15.4140	"$1,245.34"	.	$249.07			
49412	Ins device for rt guide open	C								
49418	Insert tun ip cath perc	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49419	Insert tun ip cath w/port	J1	5184	56.8885	"$4,596.19"	.	$919.24			
49421	Ins tun ip cath for dial opn	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49422	Remove tunneled ip cath	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
49423	Exchange drainage catheter	J1	5302	19.2764	"$1,557.40"	.	$311.48			
49424	Assess cyst contrast inject	N								
49425	Insert abdomen-venous drain	C								
49426	Revise abdomen-venous shunt	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49427	Injection abdominal shunt	N								
49428	Ligation of shunt	C								
49429	Removal of shunt	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
49435	Insert subq exten to ip cath	N								
49436	Embedded ip cath exit-site	J1	5302	19.2764	"$1,557.40"	.	$311.48			
49440	Place gastrostomy tube perc	J1	5302	19.2764	"$1,557.40"	.	$311.48			
49441	Place duod/jej tube perc	J1	5302	19.2764	"$1,557.40"	.	$311.48			
49442	Place cecostomy tube perc	T	5312	12.4295	"$1,004.22"	.	$200.85			
49446	Change g-tube to g-j perc	J1	5302	19.2764	"$1,557.40"	.	$311.48			
49450	Replace g/c tube perc	T	5301	9.7276	$785.92	.	$157.19			
49451	Replace duod/jej tube perc	T	5301	9.7276	$785.92	.	$157.19			
49452	Replace g-j tube perc	T	5301	9.7276	$785.92	.	$157.19			
49460	Fix g/colon tube w/device	T	5301	9.7276	$785.92	.	$157.19			
49465	Fluoro exam of g/colon tube	Q1	5523	2.8844	$233.04	.	$46.61			
49491	Rpr hern preemie reduc	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49492	Rpr ing hern premie blocked	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49495	Rpr ing hernia baby reduc	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49496	Rpr ing hernia baby blocked	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49500	Rpr ing hernia init reduce	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49501	Rpr ing hernia init blocked	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49505	Prp i/hern init reduc >5 yr	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49507	Prp i/hern init block >5 yr	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49520	Rerepair ing hernia reduce	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49521	Rerepair ing hernia blocked	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49525	Repair ing hernia sliding	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49540	Repair lumbar hernia	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49550	Rpr rem hernia init reduce	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49553	Rpr fem hernia init blocked	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49555	Rerepair fem hernia reduce	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49557	Rerepair fem hernia blocked	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49560	Rpr ventral hern init reduc	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49561	Rpr ventral hern init block	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49565	Rerepair ventrl hern reduce	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49566	Rerepair ventrl hern block	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49568	Hernia repair w/mesh	N								
49570	Rpr epigastric hern reduce	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49572	Rpr epigastric hern blocked	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49580	Rpr umbil hern reduc < 5 yr	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49582	Rpr umbil hern block < 5 yr	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49585	Rpr umbil hern reduc > 5 yr	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49587	Rpr umbil hern block > 5 yr	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49590	Repair spigelian hernia	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49600	Repair umbilical lesion	J1	5341	38.4853	"$3,109.34"	.	$621.87			
49605	Repair umbilical lesion	C								
49606	Repair umbilical lesion	C								
49610	Repair umbilical lesion	C								
49611	Repair umbilical lesion	C								
49650	Lap ing hernia repair init	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49651	Lap ing hernia repair recur	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49652	Lap vent/abd hernia repair	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49653	Lap vent/abd hern proc comp	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49654	Lap inc hernia repair	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
49655	Lap inc hern repair comp	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
49656	Lap inc hernia repair recur	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
49657	Lap inc hern recur comp	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
49659	Laparo proc hernia repair	J1	5361	59.8283	"$4,833.71"	.	$966.75			
49900	Repair of abdominal wall	C								
49904	Omental flap extra-abdom	C								
49905	Omental flap intra-abdom	C								
49906	Free omental flap microvasc	C								
49999	Abdomen surgery procedure	T	5301	9.7276	$785.92	.	$157.19			
50010	Exploration of kidney	C								
50020	Renal abscess open drain	J1	5373	21.9270	"$1,771.55"	.	$354.31			
50040	Drainage of kidney	C								
50045	Exploration of kidney	C								
5005F	Pt counsld on exam for moles	E1								
50060	Removal of kidney stone	C								
50065	Incision of kidney	C								
50070	Incision of kidney	C								
50075	Removal of kidney stone	C								
50080	Removal of kidney stone	J1	5376	99.8593	"$8,067.93"	.	"$1,613.59"	*		
50081	Removal of kidney stone	J1	5376	99.8593	"$8,067.93"	.	"$1,613.59"	*		
50100	Revise kidney blood vessels	C								
5010F	Macul result phy/qhp mng dm	M								
50120	Exploration of kidney	C								
50125	Explore and drain kidney	C								
50130	Removal of kidney stone	C								
50135	Exploration of kidney	C								
5015F	Doc fx & test/txmnt for op	M								
50200	Renal biopsy perq	J1	5072	16.9891	"$1,372.60"	.	$274.52			
50205	Renal biopsy open	C								
5020F	Txmnts 2 phys/qhp by 1 mon	E1								
50220	Remove kidney open	C								
50225	Removal kidney open complex	C								
50230	Removal kidney open radical	C								
50234	Removal of kidney & ureter	C								
50236	Removal of kidney & ureter	C								
50240	Partial removal of kidney	C								
50250	Cryoablate renal mass open	C								
50280	Removal of kidney lesion	C								
50290	Removal of kidney lesion	C								
50300	Remove cadaver donor kidney	C								
50320	Remove kidney living donor	C								
50323	Prep cadaver renal allograft	C								
50325	Prep donor renal graft	C								
50327	Prep renal graft/venous	C								
50328	Prep renal graft/arterial	C								
50329	Prep renal graft/ureteral	C								
50340	Removal of kidney	C								
50360	Transplantation of kidney	C								
50365	Transplantation of kidney	C								
50370	Remove transplanted kidney	C								
50380	Reimplantation of kidney	C								
50382	Change ureter stent percut	J1	5373	21.9270	"$1,771.55"	.	$354.31			
50384	Remove ureter stent percut	Q2	5373	21.9270	"$1,771.55"	.	$354.31			
50385	Change stent via transureth	J1	5373	21.9270	"$1,771.55"	.	$354.31			
50386	Remove stent via transureth	Q2	5373	21.9270	"$1,771.55"	.	$354.31			
50387	Change nephroureteral cath	J1	5373	21.9270	"$1,771.55"	.	$354.31			
50389	Remove renal tube w/fluoro	Q2	5372	6.8884	$556.53	.	$111.31			
50390	Drainage of kidney lesion	T	5071	7.5503	$610.01	.	$122.01			
50391	Instll rx agnt into rnal tub	T	5371	2.9074	$234.90	.	$46.98			
50396	Measure kidney pressure	T	5372	6.8884	$556.53	.	$111.31			
50400	Revision of kidney/ureter	C								
50405	Revision of kidney/ureter	C								
50430	Njx px nfrosgrm &/urtrgrm	Q2	5372	6.8884	$556.53	.	$111.31			
50431	Njx px nfrosgrm &/urtrgrm	Q2	5372	6.8884	$556.53	.	$111.31			
50432	Plmt nephrostomy catheter	J1	5373	21.9270	"$1,771.55"	.	$354.31			
50433	Plmt nephroureteral catheter	J1	5374	37.3614	"$3,018.54"	.	$603.71			
50434	Convert nephrostomy catheter	J1	5373	21.9270	"$1,771.55"	.	$354.31			
50435	Exchange nephrostomy cath	J1	5373	21.9270	"$1,771.55"	.	$354.31			
50436	Dilat xst trc ndurlgc px	J1	5373	21.9270	"$1,771.55"	.	$354.31			
50437	Dilat xst trc new access rcs	J1	5374	37.3614	"$3,018.54"	.	$603.71			
50500	Repair of kidney wound	C								
5050F	Plan 2 main dr by 1 month	M								
50520	Close kidney-skin fistula	C								
50525	Close nephrovisceral fistula	C								
50526	Close nephrovisceral fistula	C								
50540	Revision of horseshoe kidney	C								
50541	Laparo ablate renal cyst	J1	5361	59.8283	"$4,833.71"	.	$966.75			
50542	Laparo ablate renal mass	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
50543	Laparo partial nephrectomy	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
50544	Laparoscopy pyeloplasty	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
50545	Laparo radical nephrectomy	C								
50546	Laparoscopic nephrectomy	C								
50547	Laparo removal donor kidney	C								
50548	Laparo remove w/ureter	C								
50549	Laparoscope proc renal	J1	5361	59.8283	"$4,833.71"	.	$966.75			
50551	Kidney endoscopy	J1	5375	52.3761	"$4,231.62"	.	$846.33			
50553	Kidney endoscopy	J1	5375	52.3761	"$4,231.62"	.	$846.33			
50555	Kidney endoscopy & biopsy	J1	5376	99.8593	"$8,067.93"	.	"$1,613.59"	*		
50557	Kidney endoscopy & treatment	J1	5376	99.8593	"$8,067.93"	.	"$1,613.59"	*		
50561	Kidney endoscopy & treatment	J1	5375	52.3761	"$4,231.62"	.	$846.33			
50562	Renal scope w/tumor resect	J1	5376	99.8593	"$8,067.93"	.	"$1,613.59"	*		
50570	Kidney endoscopy	J1	5374	37.3614	"$3,018.54"	.	$603.71			
50572	Kidney endoscopy	T	5372	6.8884	$556.53	.	$111.31			
50574	Kidney endoscopy & biopsy	J1	5373	21.9270	"$1,771.55"	.	$354.31			
50575	Kidney endoscopy	J1	5375	52.3761	"$4,231.62"	.	$846.33			
50576	Kidney endoscopy & treatment	J1	5375	52.3761	"$4,231.62"	.	$846.33			
50580	Kidney endoscopy & treatment	J1	5375	52.3761	"$4,231.62"	.	$846.33			
50590	Fragmenting of kidney stone	J1	5374	37.3614	"$3,018.54"	.	$603.71			
50592	Perc rf ablate renal tumor	J1	5361	59.8283	"$4,833.71"	.	$966.75			
50593	Perc cryo ablate renal tum	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
50600	Exploration of ureter	C								
50605	Insert ureteral support	C								
50606	Endoluminal bx urtr rnl plvs	N								
5060F	Fndngs mammo 2pt w/in 3 days	E1								
50610	Removal of ureter stone	C								
50620	Removal of ureter stone	C								
5062F	Mammo result com to pt 5 day	E1								
50630	Removal of ureter stone	C								
50650	Removal of ureter	C								
50660	Removal of ureter	C								
50684	Injection for ureter x-ray	N								
50686	Measure ureter pressure	S	5721	1.7124	$138.35	.	$27.67			
50688	Change of ureter tube/stent	J1	5373	21.9270	"$1,771.55"	.	$354.31			
50690	Injection for ureter x-ray	N								
50693	Plmt ureteral stent prq	J1	5374	37.3614	"$3,018.54"	.	$603.71			
50694	Plmt ureteral stent prq	J1	5374	37.3614	"$3,018.54"	.	$603.71			
50695	Plmt ureteral stent prq	J1	5374	37.3614	"$3,018.54"	.	$603.71			
50700	Revision of ureter	C								
50705	Ureteral embolization/occl	N								
50706	Balloon dilate urtrl strix	N								
50715	Release of ureter	C								
50722	Release of ureter	C								
50725	Release/revise ureter	C								
50727	Revise ureter	J1	5374	37.3614	"$3,018.54"	.	$603.71			
50728	Revise ureter	C								
50740	Fusion of ureter & kidney	C								
50750	Fusion of ureter & kidney	C								
50760	Fusion of ureters	C								
50770	Splicing of ureters	C								
50780	Reimplant ureter in bladder	C								
50782	Reimplant ureter in bladder	C								
50783	Reimplant ureter in bladder	C								
50785	Reimplant ureter in bladder	C								
50800	Implant ureter in bowel	C								
50810	Fusion of ureter & bowel	C								
50815	Urine shunt to intestine	C								
50820	Construct bowel bladder	C								
50825	Construct bowel bladder	C								
50830	Revise urine flow	C								
50840	Replace ureter by bowel	C								
50845	Appendico-vesicostomy	C								
50860	Transplant ureter to skin	C								
50900	Repair of ureter	C								
50920	Closure ureter/skin fistula	C								
50930	Closure ureter/bowel fistula	C								
50940	Release of ureter	C								
50945	Laparoscopy ureterolithotomy	J1	5361	59.8283	"$4,833.71"	.	$966.75			
50947	Laparo new ureter/bladder	J1	5361	59.8283	"$4,833.71"	.	$966.75			
50948	Laparo new ureter/bladder	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
50949	Laparoscope proc ureter	J1	5361	59.8283	"$4,833.71"	.	$966.75			
50951	Endoscopy of ureter	J1	5374	37.3614	"$3,018.54"	.	$603.71			
50953	Endoscopy of ureter	J1	5374	37.3614	"$3,018.54"	.	$603.71			
50955	Ureter endoscopy & biopsy	J1	5375	52.3761	"$4,231.62"	.	$846.33			
50957	Ureter endoscopy & treatment	J1	5375	52.3761	"$4,231.62"	.	$846.33			
50961	Ureter endoscopy & treatment	J1	5375	52.3761	"$4,231.62"	.	$846.33			
50970	Ureter endoscopy	J1	5374	37.3614	"$3,018.54"	.	$603.71			
50972	Ureter endoscopy & catheter	J1	5374	37.3614	"$3,018.54"	.	$603.71			
50974	Ureter endoscopy & biopsy	J1	5375	52.3761	"$4,231.62"	.	$846.33			
50976	Ureter endoscopy & treatment	J1	5375	52.3761	"$4,231.62"	.	$846.33			
50980	Ureter endoscopy & treatment	J1	5375	52.3761	"$4,231.62"	.	$846.33			
5100F	Rsk fx ref w/n 24 hrs xray	E1								
51020	Incise & treat bladder	J1	5374	37.3614	"$3,018.54"	.	$603.71			
51030	Incise & treat bladder	J1	5374	37.3614	"$3,018.54"	.	$603.71			
51040	Incise & drain bladder	J1	5373	21.9270	"$1,771.55"	.	$354.31			
51045	Incise bladder/drain ureter	J1	5373	21.9270	"$1,771.55"	.	$354.31			
51050	Removal of bladder stone	J1	5375	52.3761	"$4,231.62"	.	$846.33			
51060	Removal of ureter stone	J1	5373	21.9270	"$1,771.55"	.	$354.31			
51065	Remove ureter calculus	J1	5374	37.3614	"$3,018.54"	.	$603.71			
51080	Drainage of bladder abscess	J1	5073	28.7016	"$2,318.89"	.	$463.78			
51100	Drain bladder by needle	T	5371	2.9074	$234.90	.	$46.98			
51101	Drain bladder by trocar/cath	S	5724	11.2503	$908.95	.	$181.79			
51102	Drain bl w/cath insertion	J1	5373	21.9270	"$1,771.55"	.	$354.31			
51500	Removal of bladder cyst	J1	5361	59.8283	"$4,833.71"	.	$966.75			
51520	Removal of bladder lesion	J1	5374	37.3614	"$3,018.54"	.	$603.71			
51525	Removal of bladder lesion	C								
51530	Removal of bladder lesion	C								
51535	Repair of ureter lesion	J1	5374	37.3614	"$3,018.54"	.	$603.71			
51550	Partial removal of bladder	C								
51555	Partial removal of bladder	C								
51565	Revise bladder & ureter(s)	C								
51570	Removal of bladder	C								
51575	Removal of bladder & nodes	C								
51580	Remove bladder/revise tract	C								
51585	Removal of bladder & nodes	C								
51590	Remove bladder/revise tract	C								
51595	Remove bladder/revise tract	C								
51596	Remove bladder/create pouch	C								
51597	Removal of pelvic structures	C								
51600	Injection for bladder x-ray	N								
51605	Preparation for bladder xray	N								
51610	Injection for bladder x-ray	N								
51700	Irrigation of bladder	T	5371	2.9074	$234.90	.	$46.98			
51701	Insert bladder catheter	Q1	5734	1.3495	$109.03	.	$21.81			
51702	Insert temp bladder cath	Q1	5734	1.3495	$109.03	.	$21.81			
51703	Insert bladder cath complex	S	5721	1.7124	$138.35	.	$27.67			
51705	Change of bladder tube	T	5371	2.9074	$234.90	.	$46.98			
51710	Change of bladder tube	T	5372	6.8884	$556.53	.	$111.31			
51715	Endoscopic injection/implant	J1	5374	37.3614	"$3,018.54"	.	$603.71			
51720	Treatment of bladder lesion	T	5371	2.9074	$234.90	.	$46.98			
51725	Simple cystometrogram	T	5371	2.9074	$234.90	.	$46.98			
51726	Complex cystometrogram	T	5371	2.9074	$234.90	.	$46.98			
51727	Cystometrogram w/up	T	5372	6.8884	$556.53	.	$111.31			
51728	Cystometrogram w/vp	T	5372	6.8884	$556.53	.	$111.31			
51729	Cystometrogram w/vp&up	T	5372	6.8884	$556.53	.	$111.31			
51736	Urine flow measurement	Q1	5734	1.3495	$109.03	.	$21.81			
51741	Electro-uroflowmetry first	Q1	5721	1.7124	$138.35	.	$27.67			
51784	Anal/urinary muscle study	S	5721	1.7124	$138.35	.	$27.67			
51785	Anal/urinary muscle study	T	5371	2.9074	$234.90	.	$46.98			
51792	Urinary reflex study	Q1	5733	0.6809	$55.01	.	$11.01			
51797	Intraabdominal pressure test	N								
51798	Us urine capacity measure	Q1	5733	0.6809	$55.01	.	$11.01			
51800	Revision of bladder/urethra	C								
51820	Revision of urinary tract	C								
51840	Attach bladder/urethra	C								
51841	Attach bladder/urethra	C								
51845	Repair bladder neck	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
51860	Repair of bladder wound	J1	5375	52.3761	"$4,231.62"	.	$846.33			
51865	Repair of bladder wound	C								
51880	Repair of bladder opening	J1	5374	37.3614	"$3,018.54"	.	$603.71			
51900	Repair bladder/vagina lesion	C								
51920	Close bladder-uterus fistula	C								
51925	Hysterectomy/bladder repair	C								
51940	Correction of bladder defect	C								
51960	Revision of bladder & bowel	C								
51980	Construct bladder opening	C								
51990	Laparo urethral suspension	J1	5361	59.8283	"$4,833.71"	.	$966.75			
51992	Laparo sling operation	J1	5361	59.8283	"$4,833.71"	.	$966.75			
51999	Laparoscope proc bla	J1	5361	59.8283	"$4,833.71"	.	$966.75			
52000	Cystoscopy	T	5372	6.8884	$556.53	.	$111.31			
52001	Cystoscopy removal of clots	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52005	Cystoscopy & ureter catheter	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52007	Cystoscopy and biopsy	J1	5374	37.3614	"$3,018.54"	.	$603.71			
5200F	Eval appros surg thxpy epi	E1								
52010	Cystoscopy & duct catheter	T	5372	6.8884	$556.53	.	$111.31			
52204	Cystoscopy w/biopsy(s)	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52214	Cystoscopy and treatment	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52224	Cystoscopy and treatment	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52234	Cystoscopy and treatment	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52235	Cystoscopy and treatment	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52240	Cystoscopy and treatment	J1	5375	52.3761	"$4,231.62"	.	$846.33			
52250	Cystoscopy and radiotracer	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52260	Cystoscopy and treatment	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52265	Cystoscopy and treatment	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52270	Cystoscopy & revise urethra	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52275	Cystoscopy & revise urethra	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52276	Cystoscopy and treatment	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52277	Cystoscopy and treatment	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52281	Cystoscopy and treatment	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52282	Cystoscopy implant stent	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52283	Cystoscopy and treatment	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52285	Cystoscopy and treatment	T	5372	6.8884	$556.53	.	$111.31			
52287	Cystoscopy chemodenervation	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52290	Cystoscopy and treatment	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52300	Cystoscopy and treatment	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52301	Cystoscopy and treatment	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52305	Cystoscopy and treatment	J1	5375	52.3761	"$4,231.62"	.	$846.33			
52310	Cystoscopy and treatment	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52315	Cystoscopy and treatment	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52317	Remove bladder stone	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52318	Remove bladder stone	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52320	Cystoscopy and treatment	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52325	Cystoscopy stone removal	J1	5375	52.3761	"$4,231.62"	.	$846.33			
52327	Cystoscopy inject material	J1	5375	52.3761	"$4,231.62"	.	$846.33			
52330	Cystoscopy and treatment	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52332	Cystoscopy and treatment	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52334	Create passage to kidney	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52341	Cysto w/ureter stricture tx	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52342	Cysto w/up stricture tx	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52343	Cysto w/renal stricture tx	J1	5373	21.9270	"$1,771.55"	.	$354.31			
52344	Cysto/uretero stricture tx	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52345	Cysto/uretero w/up stricture	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52346	Cystouretero w/renal strict	J1	5375	52.3761	"$4,231.62"	.	$846.33			
52351	Cystouretero & or pyeloscope	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52352	Cystouretero w/stone remove	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52353	Cystouretero w/lithotripsy	J1	5375	52.3761	"$4,231.62"	.	$846.33			
52354	Cystouretero w/biopsy	J1	5375	52.3761	"$4,231.62"	.	$846.33			
52355	Cystouretero w/excise tumor	J1	5375	52.3761	"$4,231.62"	.	$846.33			
52356	Cysto/uretero w/lithotripsy	J1	5375	52.3761	"$4,231.62"	.	$846.33			
52400	Cystouretero w/congen repr	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52402	Cystourethro cut ejacul duct	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52441	Cystourethro w/implant	B								
52442	Cystourethro w/addl implant	B								
52450	Incision of prostate	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52500	Revision of bladder neck	J1	5374	37.3614	"$3,018.54"	.	$603.71			
5250F	Asthma discharge plan presnt	E1								
52601	Prostatectomy (turp)	J1	5375	52.3761	"$4,231.62"	.	$846.33			
52630	Remove prostate regrowth	J1	5375	52.3761	"$4,231.62"	.	$846.33			
52640	Relieve bladder contracture	J1	5374	37.3614	"$3,018.54"	.	$603.71			
52647	Laser surgery of prostate	J1	5375	52.3761	"$4,231.62"	.	$846.33			
52648	Laser surgery of prostate	J1	5375	52.3761	"$4,231.62"	.	$846.33			
52649	Prostate laser enucleation	J1	5375	52.3761	"$4,231.62"	.	$846.33			
52700	Drainage of prostate abscess	J1	5374	37.3614	"$3,018.54"	.	$603.71			
53000	Incision of urethra	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53010	Incision of urethra	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53020	Incision of urethra	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53025	Incision of urethra	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53040	Drainage of urethra abscess	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53060	Drainage of urethra abscess	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53080	Drainage of urinary leakage	T	5372	6.8884	$556.53	.	$111.31			
53085	Drainage of urinary leakage	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53200	Biopsy of urethra	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53210	Removal of urethra	J1	5374	37.3614	"$3,018.54"	.	$603.71			
53215	Removal of urethra	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53220	Treatment of urethra lesion	J1	5374	37.3614	"$3,018.54"	.	$603.71			
53230	Removal of urethra lesion	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53235	Removal of urethra lesion	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53240	Surgery for urethra pouch	J1	5374	37.3614	"$3,018.54"	.	$603.71			
53250	Removal of urethra gland	J1	5374	37.3614	"$3,018.54"	.	$603.71			
53260	Treatment of urethra lesion	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53265	Treatment of urethra lesion	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53270	Removal of urethra gland	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53275	Repair of urethra defect	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53400	Revise urethra stage 1	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53405	Revise urethra stage 2	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53410	Reconstruction of urethra	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53415	Reconstruction of urethra	C								
53420	Reconstruct urethra stage 1	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53425	Reconstruct urethra stage 2	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53430	Reconstruction of urethra	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53431	Reconstruct urethra/bladder	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53440	Male sling procedure	J1	5376	99.8593	"$8,067.93"	.	"$1,613.59"	*		
53442	Remove/revise male sling	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53444	Insert tandem cuff	J1	5377	217.5184	"$17,573.96"	.	"$3,514.80"	*		
53445	Insert uro/ves nck sphincter	J1	5377	217.5184	"$17,573.96"	.	"$3,514.80"	*		
53446	Remove uro sphincter	Q2	5375	52.3761	"$4,231.62"	.	$846.33			
53447	Remove/replace ur sphincter	J1	5377	217.5184	"$17,573.96"	.	"$3,514.80"	*		
53448	Remov/replc ur sphinctr comp	C								
53449	Repair uro sphincter	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53450	Revision of urethra	J1	5374	37.3614	"$3,018.54"	.	$603.71			
53460	Revision of urethra	J1	5374	37.3614	"$3,018.54"	.	$603.71			
53500	Urethrlys transvag w/ scope	J1	5374	37.3614	"$3,018.54"	.	$603.71			
53502	Repair of urethra injury	J1	5374	37.3614	"$3,018.54"	.	$603.71			
53505	Repair of urethra injury	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53510	Repair of urethra injury	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53515	Repair of urethra injury	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53520	Repair of urethra defect	J1	5375	52.3761	"$4,231.62"	.	$846.33			
53600	Dilate urethra stricture	T	5371	2.9074	$234.90	.	$46.98			
53601	Dilate urethra stricture	Q1	5734	1.3495	$109.03	.	$21.81			
53605	Dilate urethra stricture	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53620	Dilate urethra stricture	T	5372	6.8884	$556.53	.	$111.31			
53621	Dilate urethra stricture	T	5371	2.9074	$234.90	.	$46.98			
53660	Dilation of urethra	S	5721	1.7124	$138.35	.	$27.67			
53661	Dilation of urethra	Q1	5734	1.3495	$109.03	.	$21.81			
53665	Dilation of urethra	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53850	Prostatic microwave thermotx	J1	5374	37.3614	"$3,018.54"	.	$603.71			
53852	Prostatic rf thermotx	J1	5374	37.3614	"$3,018.54"	.	$603.71			
53854	Trurl dstrj prst8 tiss rf wv	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53855	Insert prost urethral stent	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53860	Transurethral rf treatment	J1	5373	21.9270	"$1,771.55"	.	$354.31			
53899	Urology surgery procedure	T	5371	2.9074	$234.90	.	$46.98			
54000	Slitting of prepuce	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54001	Slitting of prepuce	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54015	Drain penis lesion	J1	5072	16.9891	"$1,372.60"	.	$274.52			
54050	Destruction penis lesion(s)	Q1	5052	3.9547	$319.51	.	$63.91			
54055	Destruction penis lesion(s)	T	5054	20.0852	"$1,622.74"	.	$324.55			
54056	Cryosurgery penis lesion(s)	Q1	5051	2.1627	$174.73	.	$34.95			
54057	Laser surg penis lesion(s)	T	5054	20.0852	"$1,622.74"	.	$324.55			
54060	Excision of penis lesion(s)	T	5054	20.0852	"$1,622.74"	.	$324.55			
54065	Destruction penis lesion(s)	T	5054	20.0852	"$1,622.74"	.	$324.55			
54100	Biopsy of penis	J1	5072	16.9891	"$1,372.60"	.	$274.52			
54105	Biopsy of penis	J1	5073	28.7016	"$2,318.89"	.	$463.78			
54110	Treatment of penis lesion	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54111	Treat penis lesion graft	J1	5375	52.3761	"$4,231.62"	.	$846.33			
54112	Treat penis lesion graft	J1	5376	99.8593	"$8,067.93"	.	"$1,613.59"	*		
54115	Treatment of penis lesion	J1	5073	28.7016	"$2,318.89"	.	$463.78			
54120	Partial removal of penis	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54125	Removal of penis	C								
54130	Remove penis & nodes	C								
54135	Remove penis & nodes	C								
54150	Circumcision w/regionl block	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54160	Circumcision neonate	T	5372	6.8884	$556.53	.	$111.31			
54161	Circum 28 days or older	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54162	Lysis penil circumic lesion	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54163	Repair of circumcision	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54164	Frenulotomy of penis	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54200	Treatment of penis lesion	T	5371	2.9074	$234.90	.	$46.98			
54205	Treatment of penis lesion	J1	5375	52.3761	"$4,231.62"	.	$846.33			
54220	Treatment of penis lesion	T	5371	2.9074	$234.90	.	$46.98			
54230	Prepare penis study	N								
54231	Dynamic cavernosometry	T	5371	2.9074	$234.90	.	$46.98			
54235	Penile injection	T	5371	2.9074	$234.90	.	$46.98			
54240	Penis study	S	5721	1.7124	$138.35	.	$27.67			
54250	Penis study	T	5371	2.9074	$234.90	.	$46.98			
54300	Revision of penis	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54304	Revision of penis	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54308	Reconstruction of urethra	J1	5375	52.3761	"$4,231.62"	.	$846.33			
54312	Reconstruction of urethra	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54316	Reconstruction of urethra	J1	5375	52.3761	"$4,231.62"	.	$846.33			
54318	Reconstruction of urethra	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54322	Reconstruction of urethra	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54324	Reconstruction of urethra	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54326	Reconstruction of urethra	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54328	Revise penis/urethra	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54332	Revise penis/urethra	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54336	Revise penis/urethra	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54340	Secondary urethral surgery	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54344	Secondary urethral surgery	J1	5375	52.3761	"$4,231.62"	.	$846.33			
54348	Secondary urethral surgery	J1	5375	52.3761	"$4,231.62"	.	$846.33			
54352	Reconstruct urethra/penis	J1	5375	52.3761	"$4,231.62"	.	$846.33			
54360	Penis plastic surgery	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54380	Repair penis	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54385	Repair penis	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54390	Repair penis and bladder	C								
54400	Insert semi-rigid prosthesis	J1	5377	217.5184	"$17,573.96"	.	"$3,514.80"	*		
54401	Insert self-contd prosthesis	J1	5377	217.5184	"$17,573.96"	.	"$3,514.80"	*		
54405	Insert multi-comp penis pros	J1	5377	217.5184	"$17,573.96"	.	"$3,514.80"	*		
54406	Remove muti-comp penis pros	Q2	5374	37.3614	"$3,018.54"	.	$603.71			
54408	Repair multi-comp penis pros	J1	5375	52.3761	"$4,231.62"	.	$846.33			
54410	Remove/replace penis prosth	J1	5377	217.5184	"$17,573.96"	.	"$3,514.80"	*		
54411	Remov/replc penis pros comp	J1	5377	217.5184	"$17,573.96"	.	"$3,514.80"	*		
54415	Remove self-contd penis pros	Q2	5374	37.3614	"$3,018.54"	.	$603.71			
54416	Remv/repl penis contain pros	J1	5377	217.5184	"$17,573.96"	.	"$3,514.80"	*		
54417	Remv/replc penis pros compl	J1	5377	217.5184	"$17,573.96"	.	"$3,514.80"	*		
54420	Revision of penis	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54430	Revision of penis	C								
54435	Revision of penis	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54437	Repair corporeal tear	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54438	Replantation of penis	C								
54440	Repair of penis	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54450	Preputial stretching	T	5371	2.9074	$234.90	.	$46.98			
54500	Biopsy of testis	J1	5073	28.7016	"$2,318.89"	.	$463.78			
54505	Biopsy of testis	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54512	Excise lesion testis	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54520	Removal of testis	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54522	Orchiectomy partial	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54530	Removal of testis	J1	5341	38.4853	"$3,109.34"	.	$621.87			
54535	Extensive testis surgery	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54550	Exploration for testis	J1	5341	38.4853	"$3,109.34"	.	$621.87			
54560	Exploration for testis	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54600	Reduce testis torsion	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54620	Suspension of testis	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54640	Orchiopexy ingun/scrot appr	J1	5341	38.4853	"$3,109.34"	.	$621.87			
54650	Orchiopexy (fowler-stephens)	J1	5341	38.4853	"$3,109.34"	.	$621.87			
54660	Revision of testis	J1	5375	52.3761	"$4,231.62"	.	$846.33			
54670	Repair testis injury	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54680	Relocation of testis(es)	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54690	Laparoscopy orchiectomy	J1	5361	59.8283	"$4,833.71"	.	$966.75			
54692	Laparoscopy orchiopexy	J1	5361	59.8283	"$4,833.71"	.	$966.75			
54699	Laparoscope proc testis	J1	5361	59.8283	"$4,833.71"	.	$966.75			
54700	Drainage of scrotum	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54800	Biopsy of epididymis	J1	5072	16.9891	"$1,372.60"	.	$274.52			
54830	Remove epididymis lesion	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54840	Remove epididymis lesion	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54860	Removal of epididymis	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54861	Removal of epididymis	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54865	Explore epididymis	J1	5374	37.3614	"$3,018.54"	.	$603.71			
54900	Fusion of spermatic ducts	J1	5373	21.9270	"$1,771.55"	.	$354.31			
54901	Fusion of spermatic ducts	J1	5374	37.3614	"$3,018.54"	.	$603.71			
55000	Drainage of hydrocele	T	5071	7.5503	$610.01	.	$122.01			
55040	Removal of hydrocele	J1	5341	38.4853	"$3,109.34"	.	$621.87			
55041	Removal of hydroceles	J1	5341	38.4853	"$3,109.34"	.	$621.87			
55060	Repair of hydrocele	J1	5374	37.3614	"$3,018.54"	.	$603.71			
55100	Drainage of scrotum abscess	J1	5072	16.9891	"$1,372.60"	.	$274.52			
55110	Explore scrotum	J1	5374	37.3614	"$3,018.54"	.	$603.71			
55120	Removal of scrotum lesion	J1	5373	21.9270	"$1,771.55"	.	$354.31			
55150	Removal of scrotum	J1	5374	37.3614	"$3,018.54"	.	$603.71			
55175	Revision of scrotum	J1	5374	37.3614	"$3,018.54"	.	$603.71			
55180	Revision of scrotum	J1	5375	52.3761	"$4,231.62"	.	$846.33			
55200	Incision of sperm duct	J1	5374	37.3614	"$3,018.54"	.	$603.71			
55250	Removal of sperm duct(s)	J1	5373	21.9270	"$1,771.55"	.	$354.31			
55300	Prepare sperm duct x-ray	N								
55400	Repair of sperm duct	J1	5374	37.3614	"$3,018.54"	.	$603.71			
55500	Removal of hydrocele	J1	5374	37.3614	"$3,018.54"	.	$603.71			
55520	Removal of sperm cord lesion	J1	5374	37.3614	"$3,018.54"	.	$603.71			
55530	Revise spermatic cord veins	J1	5374	37.3614	"$3,018.54"	.	$603.71			
55535	Revise spermatic cord veins	J1	5341	38.4853	"$3,109.34"	.	$621.87			
55540	Revise hernia & sperm veins	J1	5341	38.4853	"$3,109.34"	.	$621.87			
55550	Laparo ligate spermatic vein	J1	5361	59.8283	"$4,833.71"	.	$966.75			
55559	Laparo proc spermatic cord	J1	5361	59.8283	"$4,833.71"	.	$966.75			
55600	Incise sperm duct pouch	J1	5373	21.9270	"$1,771.55"	.	$354.31			
55605	Incise sperm duct pouch	C								
55650	Remove sperm duct pouch	C								
55680	Remove sperm pouch lesion	J1	5374	37.3614	"$3,018.54"	.	$603.71			
55700	Biopsy of prostate	J1	5373	21.9270	"$1,771.55"	.	$354.31			
55705	Biopsy of prostate	J1	5373	21.9270	"$1,771.55"	.	$354.31			
55706	Prostate saturation sampling	J1	5374	37.3614	"$3,018.54"	.	$603.71			
55720	Drainage of prostate abscess	J1	5373	21.9270	"$1,771.55"	.	$354.31			
55725	Drainage of prostate abscess	J1	5374	37.3614	"$3,018.54"	.	$603.71			
55801	Removal of prostate	C								
55810	Extensive prostate surgery	C								
55812	Extensive prostate surgery	C								
55815	Extensive prostate surgery	C								
55821	Removal of prostate	C								
55831	Removal of prostate	C								
55840	Extensive prostate surgery	C								
55842	Extensive prostate surgery	C								
55845	Extensive prostate surgery	C								
55860	Surgical exposure prostate	J1	5375	52.3761	"$4,231.62"	.	$846.33			
55862	Extensive prostate surgery	C								
55865	Extensive prostate surgery	C								
55866	Laparo radical prostatectomy	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
55870	Electroejaculation	T	5413	7.9024	$638.46	.	$127.70			
55873	Cryoablate prostate	J1	5376	99.8593	"$8,067.93"	.	"$1,613.59"	*		
55874	Tprnl plmt biodegrdabl matrl	T	5375	52.3761	"$4,231.62"	.	$846.33			
55875	Transperi needle place pros	J1	5375	52.3761	"$4,231.62"	.	$846.33			
55876	Place rt device/marker pros	S	5613	15.4140	"$1,245.34"	.	$249.07			
55899	Genital surgery procedure	T	5371	2.9074	$234.90	.	$46.98			
55920	Place needles pelvic for rt	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
55970	Sex transformation m to f	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
55980	Sex transformation f to m	J1	5374	37.3614	"$3,018.54"	.	$603.71			
56405	I & d of vulva/perineum	T	5412	3.3508	$270.72	.	$54.15			
56420	Drainage of gland abscess	T	5411	2.0552	$166.05	.	$33.21			
56440	Surgery for vulva lesion	J1	5414	30.9198	"$2,498.10"	.	$499.62			
56441	Lysis of labial lesion(s)	J1	5414	30.9198	"$2,498.10"	.	$499.62			
56442	Hymenotomy	J1	5414	30.9198	"$2,498.10"	.	$499.62			
56501	Destroy vulva lesions sim	T	5054	20.0852	"$1,622.74"	.	$324.55			
56515	Destroy vulva lesion/s compl	T	5054	20.0852	"$1,622.74"	.	$324.55			
56605	Biopsy of vulva/perineum	T	5413	7.9024	$638.46	.	$127.70			
56606	Biopsy of vulva/perineum	N								
56620	Partial removal of vulva	J1	5414	30.9198	"$2,498.10"	.	$499.62			
56625	Complete removal of vulva	J1	5414	30.9198	"$2,498.10"	.	$499.62			
56630	Extensive vulva surgery	C								
56631	Extensive vulva surgery	C								
56632	Extensive vulva surgery	C								
56633	Extensive vulva surgery	C								
56634	Extensive vulva surgery	C								
56637	Extensive vulva surgery	C								
56640	Extensive vulva surgery	C								
56700	Partial removal of hymen	J1	5414	30.9198	"$2,498.10"	.	$499.62			
56740	Remove vagina gland lesion	J1	5414	30.9198	"$2,498.10"	.	$499.62			
56800	Repair of vagina	J1	5414	30.9198	"$2,498.10"	.	$499.62			
56805	Repair clitoris	J1	5414	30.9198	"$2,498.10"	.	$499.62			
56810	Repair of perineum	J1	5414	30.9198	"$2,498.10"	.	$499.62			
56820	Exam of vulva w/scope	T	5411	2.0552	$166.05	.	$33.21			
56821	Exam/biopsy of vulva w/scope	T	5412	3.3508	$270.72	.	$54.15			
57000	Exploration of vagina	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57010	Drainage of pelvic abscess	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57020	Drainage of pelvic fluid	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57022	I & d vaginal hematoma pp	J1	5073	28.7016	"$2,318.89"	.	$463.78			
57023	I & d vag hematoma non-ob	J1	5073	28.7016	"$2,318.89"	.	$463.78			
57061	Destroy vag lesions simple	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57065	Destroy vag lesions complex	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57100	Biopsy of vagina	T	5413	7.9024	$638.46	.	$127.70			
57105	Biopsy of vagina	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57106	Remove vagina wall partial	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57107	Remove vagina tissue part	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57109	Vaginectomy partial w/nodes	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57110	Remove vagina wall complete	C								
57111	Remove vagina tissue compl	C								
57112	Vaginectomy w/nodes compl	C								
57120	Closure of vagina	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57130	Remove vagina lesion	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57135	Remove vagina lesion	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57150	Treat vagina infection	Q1	5733	0.6809	$55.01	.	$11.01			
57155	Insert uteri tandem/ovoids	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57156	Ins vag brachytx device	T	5412	3.3508	$270.72	.	$54.15			
57160	Insert pessary/other device	T	5411	2.0552	$166.05	.	$33.21			
57170	Fitting of diaphragm/cap	T	5411	2.0552	$166.05	.	$33.21			
57180	Treat vaginal bleeding	T	5411	2.0552	$166.05	.	$33.21			
57200	Repair of vagina	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57210	Repair vagina/perineum	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57220	Revision of urethra	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57230	Repair of urethral lesion	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57240	Anterior colporrhaphy	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57250	Repair rectum & vagina	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57260	Cmbn ant pst colprhy	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57265	Cmbn ap colprhy w/ntrcl rpr	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57267	Insert mesh/pelvic flr addon	N								
57268	Repair of bowel bulge	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57270	Repair of bowel pouch	C								
57280	Suspension of vagina	C								
57282	Colpopexy extraperitoneal	J1	5416	82.9725	"$6,703.60"	"$1,405.70"	"$1,340.72"			
57283	Colpopexy intraperitoneal	J1	5416	82.9725	"$6,703.60"	"$1,405.70"	"$1,340.72"			
57284	Repair paravag defect open	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57285	Repair paravag defect vag	J1	5416	82.9725	"$6,703.60"	"$1,405.70"	"$1,340.72"			
57287	Revise/remove sling repair	Q2	5414	30.9198	"$2,498.10"	.	$499.62			
57288	Repair bladder defect	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57289	Repair bladder & vagina	J1	5416	82.9725	"$6,703.60"	"$1,405.70"	"$1,340.72"			
57291	Construction of vagina	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57292	Construct vagina with graft	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57295	Revise vag graft via vagina	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57296	Revise vag graft open abd	C								
57300	Repair rectum-vagina fistula	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57305	Repair rectum-vagina fistula	C								
57307	Fistula repair & colostomy	C								
57308	Fistula repair transperine	C								
57310	Repair urethrovaginal lesion	J1	5416	82.9725	"$6,703.60"	"$1,405.70"	"$1,340.72"			
57311	Repair urethrovaginal lesion	C								
57320	Repair bladder-vagina lesion	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57330	Repair bladder-vagina lesion	J1	5416	82.9725	"$6,703.60"	"$1,405.70"	"$1,340.72"			
57335	Repair vagina	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57400	Dilation of vagina	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57410	Pelvic examination	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57415	Remove vaginal foreign body	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57420	Exam of vagina w/scope	T	5412	3.3508	$270.72	.	$54.15			
57421	Exam/biopsy of vag w/scope	T	5413	7.9024	$638.46	.	$127.70			
57423	Repair paravag defect lap	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
57425	Laparoscopy surg colpopexy	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
57426	Revise prosth vag graft lap	J1	5416	82.9725	"$6,703.60"	"$1,405.70"	"$1,340.72"			
57452	Exam of cervix w/scope	T	5411	2.0552	$166.05	.	$33.21			
57454	Bx/curett of cervix w/scope	T	5412	3.3508	$270.72	.	$54.15			
57455	Biopsy of cervix w/scope	T	5412	3.3508	$270.72	.	$54.15			
57456	Endocerv curettage w/scope	T	5412	3.3508	$270.72	.	$54.15			
57460	Bx of cervix w/scope leep	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57461	Conz of cervix w/scope leep	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57500	Biopsy of cervix	T	5413	7.9024	$638.46	.	$127.70			
57505	Endocervical curettage	T	5413	7.9024	$638.46	.	$127.70			
57510	Cauterization of cervix	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57511	Cryocautery of cervix	T	5412	3.3508	$270.72	.	$54.15			
57513	Laser surgery of cervix	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57520	Conization of cervix	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57522	Conization of cervix	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57530	Removal of cervix	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57531	Removal of cervix radical	C								
57540	Removal of residual cervix	C								
57545	Remove cervix/repair pelvis	C								
57550	Removal of residual cervix	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57555	Remove cervix/repair vagina	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57556	Remove cervix repair bowel	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
57558	D&c of cervical stump	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57700	Revision of cervix	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57720	Revision of cervix	J1	5414	30.9198	"$2,498.10"	.	$499.62			
57800	Dilation of cervical canal	J1	5414	30.9198	"$2,498.10"	.	$499.62			
58100	Biopsy of uterus lining	T	5411	2.0552	$166.05	.	$33.21			
58110	Bx done w/colposcopy add-on	N								
58120	Dilation and curettage	J1	5414	30.9198	"$2,498.10"	.	$499.62			
58140	Myomectomy abdom method	C								
58145	Myomectomy vag method	J1	5414	30.9198	"$2,498.10"	.	$499.62			
58146	Myomectomy abdom complex	C								
58150	Total hysterectomy	C								
58152	Total hysterectomy	C								
58180	Partial hysterectomy	C								
58200	Extensive hysterectomy	C								
58210	Extensive hysterectomy	C								
58240	Removal of pelvis contents	C								
58260	Vaginal hysterectomy	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58262	Vag hyst including t/o	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58263	Vag hyst w/t/o & vag repair	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58267	Vag hyst w/urinary repair	C								
58270	Vag hyst w/enterocele repair	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58275	Hysterectomy/revise vagina	C								
58280	Hysterectomy/revise vagina	C								
58285	Extensive hysterectomy	C								
58290	Vag hyst complex	J1	5416	82.9725	"$6,703.60"	"$1,405.70"	"$1,340.72"			
58291	Vag hyst incl t/o complex	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58292	Vag hyst t/o & repair compl	J1	5416	82.9725	"$6,703.60"	"$1,405.70"	"$1,340.72"			
58293	Vag hyst w/uro repair compl	C								
58294	Vag hyst w/enterocele compl	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58300	Insert intrauterine device	E1								
58301	Remove intrauterine device	Q2	5412	3.3508	$270.72	.	$54.15			
58321	Artificial insemination	T	5412	3.3508	$270.72	.	$54.15			
58322	Artificial insemination	T	5411	2.0552	$166.05	.	$33.21			
58323	Sperm washing	T	5411	2.0552	$166.05	.	$33.21			
58340	Catheter for hysterography	N								
58345	Reopen fallopian tube	J1	5414	30.9198	"$2,498.10"	.	$499.62			
58346	Insert heyman uteri capsule	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58350	Reopen fallopian tube	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58353	Endometr ablate thermal	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58356	Endometrial cryoablation	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58400	Suspension of uterus	C								
58410	Suspension of uterus	C								
58520	Repair of ruptured uterus	C								
58540	Revision of uterus	C								
58541	Lsh uterus 250 g or less	J1	5361	59.8283	"$4,833.71"	.	$966.75			
58542	Lsh w/t/o ut 250 g or less	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
58543	Lsh uterus above 250 g	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
58544	Lsh w/t/o uterus above 250 g	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
58545	Laparoscopic myomectomy	J1	5361	59.8283	"$4,833.71"	.	$966.75			
58546	Laparo-myomectomy complex	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
58548	Lap radical hyst	C								
58550	Laparo-asst vag hysterectomy	J1	5361	59.8283	"$4,833.71"	.	$966.75			
58552	Laparo-vag hyst incl t/o	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
58553	Laparo-vag hyst complex	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
58554	Laparo-vag hyst w/t/o compl	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
58555	Hysteroscopy dx sep proc	J1	5414	30.9198	"$2,498.10"	.	$499.62			
58558	Hysteroscopy biopsy	J1	5414	30.9198	"$2,498.10"	.	$499.62			
58559	Hysteroscopy lysis	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58560	Hysteroscopy resect septum	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58561	Hysteroscopy remove myoma	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58562	Hysteroscopy remove fb	J1	5414	30.9198	"$2,498.10"	.	$499.62			
58563	Hysteroscopy ablation	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58565	Hysteroscopy sterilization	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58570	Tlh uterus 250 g or less	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
58571	Tlh w/t/o 250 g or less	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
58572	Tlh uterus over 250 g	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
58573	Tlh w/t/o uterus over 250 g	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
58575	Laps tot hyst resj mal	C								
58578	Laparo proc uterus	J1	5361	59.8283	"$4,833.71"	.	$966.75			
58579	Hysteroscope procedure	T	5411	2.0552	$166.05	.	$33.21			
58600	Division of fallopian tube	J1	5414	30.9198	"$2,498.10"	.	$499.62			
58605	Division of fallopian tube	C								
58611	Ligate oviduct(s) add-on	C								
58615	Occlude fallopian tube(s)	J1	5414	30.9198	"$2,498.10"	.	$499.62			
58660	Laparoscopy lysis	J1	5361	59.8283	"$4,833.71"	.	$966.75			
58661	Laparoscopy remove adnexa	J1	5361	59.8283	"$4,833.71"	.	$966.75			
58662	Laparoscopy excise lesions	J1	5361	59.8283	"$4,833.71"	.	$966.75			
58670	Laparoscopy tubal cautery	J1	5361	59.8283	"$4,833.71"	.	$966.75			
58671	Laparoscopy tubal block	J1	5361	59.8283	"$4,833.71"	.	$966.75			
58672	Laparoscopy fimbrioplasty	J1	5361	59.8283	"$4,833.71"	.	$966.75			
58673	Laparoscopy salpingostomy	J1	5361	59.8283	"$4,833.71"	.	$966.75			
58674	Laps abltj uterine fibroids	J1	5362	104.1317	"$8,413.11"	.	"$1,682.63"	*		
58679	Laparo proc oviduct-ovary	J1	5361	59.8283	"$4,833.71"	.	$966.75			
58700	Removal of fallopian tube	C								
58720	Removal of ovary/tube(s)	C								
58740	Adhesiolysis tube ovary	C								
58750	Repair oviduct	C								
58752	Revise ovarian tube(s)	C								
58760	Fimbrioplasty	C								
58770	Create new tubal opening	J1	5414	30.9198	"$2,498.10"	.	$499.62			
58800	Drainage of ovarian cyst(s)	J1	5414	30.9198	"$2,498.10"	.	$499.62			
58805	Drainage of ovarian cyst(s)	J1	5414	30.9198	"$2,498.10"	.	$499.62			
58820	Drain ovary abscess open	J1	5414	30.9198	"$2,498.10"	.	$499.62			
58822	Drain ovary abscess percut	C								
58825	Transposition ovary(s)	C								
58900	Biopsy of ovary(s)	J1	5414	30.9198	"$2,498.10"	.	$499.62			
58920	Partial removal of ovary(s)	J1	5416	82.9725	"$6,703.60"	"$1,405.70"	"$1,340.72"			
58925	Removal of ovarian cyst(s)	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
58940	Removal of ovary(s)	C								
58943	Removal of ovary(s)	C								
58950	Resect ovarian malignancy	C								
58951	Resect ovarian malignancy	C								
58952	Resect ovarian malignancy	C								
58953	Tah rad dissect for debulk	C								
58954	Tah rad debulk/lymph remove	C								
58956	Bso omentectomy w/tah	C								
58957	Resect recurrent gyn mal	C								
58958	Resect recur gyn mal w/lym	C								
58960	Exploration of abdomen	C								
58970	Retrieval of oocyte	T	5413	7.9024	$638.46	.	$127.70			
58974	Transfer of embryo	T	5413	7.9024	$638.46	.	$127.70			
58976	Transfer of embryo	T	5412	3.3508	$270.72	.	$54.15			
58999	Genital surgery procedure	T	5411	2.0552	$166.05	.	$33.21			
59000	Amniocentesis diagnostic	T	5413	7.9024	$638.46	.	$127.70			
59001	Amniocentesis therapeutic	T	5412	3.3508	$270.72	.	$54.15			
59012	Fetal cord puncture prenatal	T	5412	3.3508	$270.72	.	$54.15			
59015	Chorion biopsy	T	5413	7.9024	$638.46	.	$127.70			
59020	Fetal contract stress test	T	5411	2.0552	$166.05	.	$33.21			
59025	Fetal non-stress test	T	5411	2.0552	$166.05	.	$33.21			
59030	Fetal scalp blood sample	T	5412	3.3508	$270.72	.	$54.15			
59050	Fetal monitor w/report	M								
59051	Fetal monitor/interpret only	B								
59070	Transabdom amnioinfus w/us	T	5412	3.3508	$270.72	.	$54.15			
59072	Umbilical cord occlud w/us	T	5412	3.3508	$270.72	.	$54.15			
59074	Fetal fluid drainage w/us	T	5412	3.3508	$270.72	.	$54.15			
59076	Fetal shunt placement w/us	T	5412	3.3508	$270.72	.	$54.15			
59100	Remove uterus lesion	J1	5415	52.8702	"$4,271.54"	$902.82	$854.31			
59120	Treat ectopic pregnancy	C								
59121	Treat ectopic pregnancy	C								
59130	Treat ectopic pregnancy	C								
59135	Treat ectopic pregnancy	C								
59136	Treat ectopic pregnancy	C								
59140	Treat ectopic pregnancy	C								
59150	Treat ectopic pregnancy	J1	5361	59.8283	"$4,833.71"	.	$966.75			
59151	Treat ectopic pregnancy	J1	5361	59.8283	"$4,833.71"	.	$966.75			
59160	D & c after delivery	J1	5414	30.9198	"$2,498.10"	.	$499.62			
59200	Insert cervical dilator	T	5412	3.3508	$270.72	.	$54.15			
59300	Episiotomy or vaginal repair	J1	5414	30.9198	"$2,498.10"	.	$499.62			
59320	Revision of cervix	J1	5414	30.9198	"$2,498.10"	.	$499.62			
59325	Revision of cervix	C								
59350	Repair of uterus	C								
59400	Obstetrical care	B								
59409	Obstetrical care	J1	5414	30.9198	"$2,498.10"	.	$499.62			
59410	Obstetrical care	B								
59412	Antepartum manipulation	J1	5414	30.9198	"$2,498.10"	.	$499.62			
59414	Deliver placenta	J1	5414	30.9198	"$2,498.10"	.	$499.62			
59425	Antepartum care only	B								
59426	Antepartum care only	B								
59430	Care after delivery	B								
59510	Cesarean delivery	B								
59514	Cesarean delivery only	C								
59515	Cesarean delivery	B								
59525	Remove uterus after cesarean	C								
59610	Vbac delivery	B								
59612	Vbac delivery only	J1	5414	30.9198	"$2,498.10"	.	$499.62			
59614	Vbac care after delivery	B								
59618	Attempted vbac delivery	B								
59620	Attempted vbac delivery only	C								
59622	Attempted vbac after care	B								
59812	Treatment of miscarriage	J1	5414	30.9198	"$2,498.10"	.	$499.62			
59820	Care of miscarriage	J1	5414	30.9198	"$2,498.10"	.	$499.62			
59821	Treatment of miscarriage	J1	5414	30.9198	"$2,498.10"	.	$499.62			
59830	Treat uterus infection	C								
59840	Abortion	J1	5414	30.9198	"$2,498.10"	.	$499.62			
59841	Abortion	J1	5414	30.9198	"$2,498.10"	.	$499.62			
59850	Abortion	C								
59851	Abortion	C								
59852	Abortion	C								
59855	Abortion	C								
59856	Abortion	C								
59857	Abortion	C								
59866	Abortion (mpr)	T	5412	3.3508	$270.72	.	$54.15			
59870	Evacuate mole of uterus	J1	5414	30.9198	"$2,498.10"	.	$499.62			
59871	Remove cerclage suture	Q2	5414	30.9198	"$2,498.10"	.	$499.62			
59897	Fetal invas px w/us	T	5411	2.0552	$166.05	.	$33.21			
59898	Laparo proc ob care/deliver	J1	5361	59.8283	"$4,833.71"	.	$966.75			
59899	Maternity care procedure	T	5411	2.0552	$166.05	.	$33.21			
60000	Drain thyroid/tongue cyst	J1	5163	16.7012	"$1,349.34"	.	$269.87			
6005F	Care level rationale doc	E1								
60100	Biopsy of thyroid	T	5071	7.5503	$610.01	.	$122.01			
6010F	Dysphag test done b/4 eating	E1								
6015F	Dysphag test done b/4 eating	E1								
60200	Remove thyroid lesion	J1	5361	59.8283	"$4,833.71"	.	$966.75			
6020F	Npo (nothing-mouth) ordered	E1								
60210	Partial thyroid excision	J1	5361	59.8283	"$4,833.71"	.	$966.75			
60212	Partial thyroid excision	J1	5361	59.8283	"$4,833.71"	.	$966.75			
60220	Partial removal of thyroid	J1	5361	59.8283	"$4,833.71"	.	$966.75			
60225	Partial removal of thyroid	J1	5361	59.8283	"$4,833.71"	.	$966.75			
60240	Removal of thyroid	J1	5361	59.8283	"$4,833.71"	.	$966.75			
60252	Removal of thyroid	J1	5165	60.0365	"$4,850.53"	.	$970.11			
60254	Extensive thyroid surgery	C								
60260	Repeat thyroid surgery	J1	5165	60.0365	"$4,850.53"	.	$970.11			
60270	Removal of thyroid	C								
60271	Removal of thyroid	J1	5165	60.0365	"$4,850.53"	.	$970.11			
60280	Remove thyroid duct lesion	J1	5361	59.8283	"$4,833.71"	.	$966.75			
60281	Remove thyroid duct lesion	J1	5361	59.8283	"$4,833.71"	.	$966.75			
60300	Aspir/inj thyroid cyst	T	5071	7.5503	$610.01	.	$122.01			
6030F	Max sterile barriers follwd	M								
6040F	Appro rad ds dvcs techs docd	E1								
6045F	Radxps in end rprt4fluro pxd	E1								
60500	Explore parathyroid glands	J1	5165	60.0365	"$4,850.53"	.	$970.11			
60502	Re-explore parathyroids	J1	5165	60.0365	"$4,850.53"	.	$970.11			
60505	Explore parathyroid glands	C								
60512	Autotransplant parathyroid	N								
60520	Removal of thymus gland	J1	5165	60.0365	"$4,850.53"	.	$970.11			
60521	Removal of thymus gland	C								
60522	Removal of thymus gland	C								
60540	Explore adrenal gland	C								
60545	Explore adrenal gland	C								
60600	Remove carotid body lesion	C								
60605	Remove carotid body lesion	C								
60650	Laparoscopy adrenalectomy	C								
60659	Laparo proc endocrine	J1	5361	59.8283	"$4,833.71"	.	$966.75			
60699	Endocrine surgery procedure	J1	5361	59.8283	"$4,833.71"	.	$966.75			
6070F	Pt asked/cnsld aed effects	E1								
6080F	Pt/caregiver queried falls	E1								
6090F	Pt/caregiver counsel safety	E1								
61000	Remove cranial cavity fluid	T	5442	7.7364	$625.05	.	$125.01			
61001	Remove cranial cavity fluid	T	5442	7.7364	$625.05	.	$125.01			
6100F	Verify pt site pxd docd	E1								
6101F	Safety counseling dementia	E1								
61020	Remove brain cavity fluid	T	5443	10.0510	$812.05	.	$162.41			
61026	Injection into brain canal	T	5442	7.7364	$625.05	.	$125.01			
6102F	Safety counseling dem order	E1								
61050	Remove brain canal fluid	T	5441	3.2400	$261.77	.	$52.36			
61055	Injection into brain canal	T	5441	3.2400	$261.77	.	$52.36			
61070	Brain canal shunt procedure	T	5442	7.7364	$625.05	.	$125.01			
61105	Twist drill hole	C								
61107	Drill skull for implantation	C								
61108	Drill skull for drainage	C								
6110F	Counsel prov driving risks	E1								
61120	Burr hole for puncture	C								
61140	Pierce skull for biopsy	C								
61150	Pierce skull for drainage	C								
61151	Pierce skull for drainage	C								
61154	Pierce skull & remove clot	C								
61156	Pierce skull for drainage	C								
61210	Pierce skull implant device	C								
61215	Insert brain-fluid device	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
61250	Pierce skull & explore	C								
61253	Pierce skull & explore	C								
61304	Open skull for exploration	C								
61305	Open skull for exploration	C								
61312	Open skull for drainage	C								
61313	Open skull for drainage	C								
61314	Open skull for drainage	C								
61315	Open skull for drainage	C								
61316	Implt cran bone flap to abdo	C								
61320	Open skull for drainage	C								
61321	Open skull for drainage	C								
61322	Decompressive craniotomy	C								
61323	Decompressive lobectomy	C								
61330	Decompress eye socket	J1	5164	32.4198	"$2,619.29"	.	$523.86			
61333	Explore orbit/remove lesion	C								
61340	Subtemporal decompression	C								
61343	Incise skull (press relief)	C								
61345	Relieve cranial pressure	C								
61450	Incise skull for surgery	C								
61458	Incise skull for brain wound	C								
61460	Incise skull for surgery	C								
61500	Removal of skull lesion	C								
61501	Remove infected skull bone	C								
6150F	Pt notrcvng1st antitnf txmnt	E1								
61510	Removal of brain lesion	C								
61512	Remove brain lining lesion	C								
61514	Removal of brain abscess	C								
61516	Removal of brain lesion	C								
61517	Implt brain chemotx add-on	C								
61518	Removal of brain lesion	C								
61519	Remove brain lining lesion	C								
61520	Removal of brain lesion	C								
61521	Removal of brain lesion	C								
61522	Removal of brain abscess	C								
61524	Removal of brain lesion	C								
61526	Removal of brain lesion	C								
61530	Removal of brain lesion	C								
61531	Implant brain electrodes	C								
61533	Implant brain electrodes	C								
61534	Removal of brain lesion	C								
61535	Remove brain electrodes	C								
61536	Removal of brain lesion	C								
61537	Removal of brain tissue	C								
61538	Removal of brain tissue	C								
61539	Removal of brain tissue	C								
61540	Removal of brain tissue	C								
61541	Incision of brain tissue	C								
61543	Removal of brain tissue	C								
61544	Remove & treat brain lesion	C								
61545	Excision of brain tumor	C								
61546	Removal of pituitary gland	C								
61548	Removal of pituitary gland	C								
61550	Release of skull seams	C								
61552	Release of skull seams	C								
61556	Incise skull/sutures	C								
61557	Incise skull/sutures	C								
61558	Excision of skull/sutures	C								
61559	Excision of skull/sutures	C								
61563	Excision of skull tumor	C								
61564	Excision of skull tumor	C								
61566	Removal of brain tissue	C								
61567	Incision of brain tissue	C								
61570	Remove foreign body brain	C								
61571	Incise skull for brain wound	C								
61575	Skull base/brainstem surgery	C								
61576	Skull base/brainstem surgery	C								
61580	Craniofacial approach skull	C								
61581	Craniofacial approach skull	C								
61582	Craniofacial approach skull	C								
61583	Craniofacial approach skull	C								
61584	Orbitocranial approach/skull	C								
61585	Orbitocranial approach/skull	C								
61586	Resect nasopharynx skull	C								
61590	Infratemporal approach/skull	C								
61591	Infratemporal approach/skull	C								
61592	Orbitocranial approach/skull	C								
61595	Transtemporal approach/skull	C								
61596	Transcochlear approach/skull	C								
61597	Transcondylar approach/skull	C								
61598	Transpetrosal approach/skull	C								
61600	Resect/excise cranial lesion	C								
61601	Resect/excise cranial lesion	C								
61605	Resect/excise cranial lesion	C								
61606	Resect/excise cranial lesion	C								
61607	Resect/excise cranial lesion	C								
61608	Resect/excise cranial lesion	C								
61611	Transect artery sinus	C								
61613	Remove aneurysm sinus	C								
61615	Resect/excise lesion skull	C								
61616	Resect/excise lesion skull	C								
61618	Repair dura	C								
61619	Repair dura	C								
61623	Endovasc tempory vessel occl	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
61624	Transcath occlusion cns	C								
61626	Transcath occlusion non-cns	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
61630	Intracranial angioplasty	C								
61635	Intracran angioplsty w/stent	C								
61640	Dilate ic vasospasm init	E1								
61641	Dilat ic vspsm ea vsl sm ter	E1								
61642	Dilat ic vspsm ea diff ter	E1								
61645	Perq art m-thrombect &/nfs	C								
61650	Evasc prlng admn rx agnt 1st	C								
61651	Evasc prlng admn rx agnt add	C								
61680	Intracranial vessel surgery	C								
61682	Intracranial vessel surgery	C								
61684	Intracranial vessel surgery	C								
61686	Intracranial vessel surgery	C								
61690	Intracranial vessel surgery	C								
61692	Intracranial vessel surgery	C								
61697	Brain aneurysm repr complx	C								
61698	Brain aneurysm repr complx	C								
61700	Brain aneurysm repr simple	C								
61702	Inner skull vessel surgery	C								
61703	Clamp neck artery	C								
61705	Revise circulation to head	C								
61708	Revise circulation to head	C								
61710	Revise circulation to head	C								
61711	Fusion of skull arteries	C								
61720	Incise skull/brain surgery	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
61735	Incise skull/brain surgery	C								
61750	Incise skull/brain biopsy	C								
61751	Brain biopsy w/ct/mr guide	C								
61760	Implant brain electrodes	C								
61770	Incise skull for treatment	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
61781	Scan proc cranial intra	N								
61782	Scan proc cranial extra	N								
61783	Scan proc spinal	N								
61790	Treat trigeminal nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
61791	Treat trigeminal tract	J1	5431	21.2809	"$1,719.35"	.	$343.87			
61796	Srs cranial lesion simple	B								
61797	Srs cran les simple addl	B								
61798	Srs cranial lesion complex	B								
61799	Srs cran les complex addl	B								
61800	Apply srs headframe add-on	B								
61850	Implant neuroelectrodes	C								
61860	Implant neuroelectrodes	C								
61863	Implant neuroelectrode	C								
61864	Implant neuroelectrde addl	C								
61867	Implant neuroelectrode	C								
61868	Implant neuroelectrde addl	C								
61870	Implant neuroelectrodes	C								
61880	Revise/remove neuroelectrode	J1	5461	38.9699	"$3,148.50"	.	$629.70			
61885	Insrt/redo neurostim 1 array	J1	5463	238.6273	"$19,279.42"	.	"$3,855.89"	*		
61886	Implant neurostim arrays	J1	5464	360.4117	"$29,118.74"	.	"$5,823.75"	*		
61888	Revise/remove neuroreceiver	J1	5462	76.5800	"$6,187.13"	.	"$1,237.43"			
62000	Treat skull fracture	J1	5164	32.4198	"$2,619.29"	.	$523.86			
62005	Treat skull fracture	C								
62010	Treatment of head injury	C								
62100	Repair brain fluid leakage	C								
62115	Reduction of skull defect	C								
62117	Reduction of skull defect	C								
62120	Repair skull cavity lesion	C								
62121	Incise skull repair	C								
62140	Repair of skull defect	C								
62141	Repair of skull defect	C								
62142	Remove skull plate/flap	C								
62143	Replace skull plate/flap	C								
62145	Repair of skull & brain	C								
62146	Repair of skull with graft	C								
62147	Repair of skull with graft	C								
62148	Retr bone flap to fix skull	C								
62160	Neuroendoscopy add-on	N								
62161	Dissect brain w/scope	C								
62162	Remove colloid cyst w/scope	C								
62163	Zneuroendoscopy w/fb removal	C								
62164	Remove brain tumor w/scope	C								
62165	Remove pituit tumor w/scope	C								
62180	Establish brain cavity shunt	C								
62190	Establish brain cavity shunt	C								
62192	Establish brain cavity shunt	C								
62194	Replace/irrigate catheter	J1	5431	21.2809	"$1,719.35"	.	$343.87			
62200	Establish brain cavity shunt	C								
62201	Brain cavity shunt w/scope	C								
62220	Establish brain cavity shunt	C								
62223	Establish brain cavity shunt	C								
62225	Replace/irrigate catheter	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
62230	Replace/revise brain shunt	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
62252	Csf shunt reprogram	S	5743	3.3531	$270.91	.	$54.19			
62256	Remove brain cavity shunt	C								
62258	Replace brain cavity shunt	C								
62263	Epidural lysis mult sessions	T	5443	10.0510	$812.05	.	$162.41			
62264	Epidural lysis on single day	T	5443	10.0510	$812.05	.	$162.41			
62267	Interdiscal perq aspir dx	T	5071	7.5503	$610.01	.	$122.01			
62268	Drain spinal cord cyst	T	5443	10.0510	$812.05	.	$162.41			
62269	Needle biopsy spinal cord	J1	5072	16.9891	"$1,372.60"	.	$274.52			
62270	Dx lmbr spi pnxr	T	5442	7.7364	$625.05	.	$125.01			
62272	Ther spi pnxr drg csf	T	5442	7.7364	$625.05	.	$125.01			
62273	Inject epidural patch	T	5442	7.7364	$625.05	.	$125.01			
62280	Treat spinal cord lesion	T	5443	10.0510	$812.05	.	$162.41			
62281	Treat spinal cord lesion	T	5443	10.0510	$812.05	.	$162.41			
62282	Treat spinal canal lesion	T	5443	10.0510	$812.05	.	$162.41			
62284	Injection for myelogram	N								
62287	Percutaneous diskectomy	J1	5431	21.2809	"$1,719.35"	.	$343.87			
62290	Njx px discography lumbar	N								
62291	Njx px discography crv/thrc	N								
62292	Njx chemonucleolysis lmbr	J1	5431	21.2809	"$1,719.35"	.	$343.87			
62294	Injection into spinal artery	T	5443	10.0510	$812.05	.	$162.41			
62302	Myelography lumbar injection	Q2	5573	8.4267	$680.82	.	$136.17			
62303	Myelography lumbar injection	Q2	5573	8.4267	$680.82	.	$136.17			
62304	Myelography lumbar injection	Q2	5573	8.4267	$680.82	.	$136.17			
62305	Myelography lumbar injection	Q2	5573	8.4267	$680.82	.	$136.17			
62320	Njx interlaminar crv/thrc	T	5442	7.7364	$625.05	.	$125.01			
62321	Njx interlaminar crv/thrc	T	5442	7.7364	$625.05	.	$125.01			
62322	Njx interlaminar lmbr/sac	T	5442	7.7364	$625.05	.	$125.01			
62323	Njx interlaminar lmbr/sac	T	5442	7.7364	$625.05	.	$125.01			
62324	Njx interlaminar crv/thrc	T	5443	10.0510	$812.05	.	$162.41			
62325	Njx interlaminar crv/thrc	T	5443	10.0510	$812.05	.	$162.41			
62326	Njx interlaminar lmbr/sac	T	5443	10.0510	$812.05	.	$162.41			
62327	Njx interlaminar lmbr/sac	T	5443	10.0510	$812.05	.	$162.41			
62328	Dx lmbr spi pnxr w/fluor/ct	T	5442	7.7364	$625.05	.	$125.01			
62329	Ther spi pnxr csf fluor/ct	T	5442	7.7364	$625.05	.	$125.01			
62350	Implant spinal canal cath	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
62351	Implant spinal canal cath	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
62355	Remove spinal canal catheter	Q2	5431	21.2809	"$1,719.35"	.	$343.87			
62360	Insert spine infusion device	J1	5471	204.4291	"$16,516.44"	.	"$3,303.29"	*		
62361	Implant spine infusion pump	J1	5471	204.4291	"$16,516.44"	.	"$3,303.29"	*		
62362	Implant spine infusion pump	J1	5471	204.4291	"$16,516.44"	.	"$3,303.29"	*		
62365	Remove spine infusion device	Q2	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
62367	Analyze spine infus pump	S	5743	3.3531	$270.91	.	$54.19			
62368	Analyze sp inf pump w/reprog	S	5743	3.3531	$270.91	.	$54.19			
62369	Anal sp inf pmp w/reprg&fill	S	5743	3.3531	$270.91	.	$54.19			
62370	Anl sp inf pmp w/mdreprg&fil	S	5743	3.3531	$270.91	.	$54.19			
62380	Ndsc dcmprn 1 ntrspc lumbar	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63001	Remove spine lamina 1/2 crvl	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63003	Remove spine lamina 1/2 thrc	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63005	Remove spine lamina 1/2 lmbr	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63011	Remove spine lamina 1/2 scrl	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63012	Remove lamina/facets lumbar	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63015	Remove spine lamina >2 crvcl	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63016	Remove spine lamina >2 thrc	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63017	Remove spine lamina >2 lmbr	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63020	Neck spine disk surgery	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63030	Low back disk surgery	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63035	Spinal disk surgery add-on	N								
63040	Laminotomy single cervical	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63042	Laminotomy single lumbar	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63043	Laminotomy addl cervical	N								
63044	Laminotomy addl lumbar	N								
63045	Remove spine lamina 1 crvl	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63046	Remove spine lamina 1 thrc	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63047	Remove spine lamina 1 lmbr	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63048	Remove spinal lamina add-on	N								
63050	Cervical laminoplsty 2/> seg	C								
63051	C-laminoplasty w/graft/plate	C								
63055	Decompress spinal cord thrc	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63056	Decompress spinal cord lmbr	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63057	Decompress spine cord add-on	N								
63064	Decompress spinal cord thrc	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63066	Decompress spine cord add-on	N								
63075	Neck spine disk surgery	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63076	Neck spine disk surgery	N								
63077	Spine disk surgery thorax	C								
63078	Spine disk surgery thorax	C								
63081	Remove vert body dcmprn crvl	C								
63082	Remove vertebral body add-on	C								
63085	Remove vert body dcmprn thrc	C								
63086	Remove vertebral body add-on	C								
63087	Remov vertbr dcmprn thrclmbr	C								
63088	Remove vertebral body add-on	C								
63090	Remove vert body dcmprn lmbr	C								
63091	Remove vertebral body add-on	C								
63101	Remove vert body dcmprn thrc	C								
63102	Remove vert body dcmprn lmbr	C								
63103	Remove vertebral body add-on	C								
63170	Incise spinal cord tract(s)	C								
63172	Drainage of spinal cyst	C								
63173	Drainage of spinal cyst	C								
63180	Revise spinal cord ligaments	C								
63182	Revise spinal cord ligaments	C								
63185	Incise spine nrv half segmnt	C								
63190	Incise spine nrv >2 segmnts	C								
63191	Incise spine accessory nerve	C								
63194	Incise spine & cord cervical	C								
63195	Incise spine & cord thoracic	C								
63196	Incise spine&cord 2 trx crvl	C								
63197	Incise spine&cord 2 trx thrc	C								
63198	Incise spin&cord 2 stgs crvl	C								
63199	Incise spin&cord 2 stgs thrc	C								
63200	Release spinal cord lumbar	C								
63250	Revise spinal cord vsls crvl	C								
63251	Revise spinal cord vsls thrc	C								
63252	Revise spine cord vsl thrlmb	C								
63265	Excise intraspinl lesion crv	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63266	Excise intrspinl lesion thrc	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63267	Excise intrspinl lesion lmbr	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63268	Excise intrspinl lesion scrl	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
63270	Excise intrspinl lesion crvl	C								
63271	Excise intrspinl lesion thrc	C								
63272	Excise intrspinl lesion lmbr	C								
63273	Excise intrspinl lesion scrl	C								
63275	Bx/exc xdrl spine lesn crvl	C								
63276	Bx/exc xdrl spine lesn thrc	C								
63277	Bx/exc xdrl spine lesn lmbr	C								
63278	Bx/exc xdrl spine lesn scrl	C								
63280	Bx/exc idrl spine lesn crvl	C								
63281	Bx/exc idrl spine lesn thrc	C								
63282	Bx/exc idrl spine lesn lmbr	C								
63283	Bx/exc idrl spine lesn scrl	C								
63285	Bx/exc idrl imed lesn cervl	C								
63286	Bx/exc idrl imed lesn thrc	C								
63287	Bx/exc idrl imed lesn thrlmb	C								
63290	Bx/exc xdrl/idrl lsn any lvl	C								
63295	Repair laminectomy defect	C								
63300	Remove vert xdrl body crvcl	C								
63301	Remove vert xdrl body thrc	C								
63302	Remove vert xdrl body thrlmb	C								
63303	Remov vert xdrl bdy lmbr/sac	C								
63304	Remove vert idrl body crvcl	C								
63305	Remove vert idrl body thrc	C								
63306	Remov vert idrl bdy thrclmbr	C								
63307	Remov vert idrl bdy lmbr/sac	C								
63308	Remove vertebral body add-on	C								
63600	Remove spinal cord lesion	J1	5431	21.2809	"$1,719.35"	.	$343.87			
63610	Stimulation of spinal cord	J1	5431	21.2809	"$1,719.35"	.	$343.87			
63620	Srs spinal lesion	B								
63621	Srs spinal lesion addl	B								
63650	Implant neuroelectrodes	J1	5462	76.5800	"$6,187.13"	.	"$1,237.43"			
63655	Implant neuroelectrodes	J1	5463	238.6273	"$19,279.42"	.	"$3,855.89"	*		
63661	Remove spine eltrd perq aray	Q2	5431	21.2809	"$1,719.35"	.	$343.87			
63662	Remove spine eltrd plate	J1	5461	38.9699	"$3,148.50"	.	$629.70			
63663	Revise spine eltrd perq aray	J1	5462	76.5800	"$6,187.13"	.	"$1,237.43"			
63664	Revise spine eltrd plate	J1	5463	238.6273	"$19,279.42"	.	"$3,855.89"	*		
63685	Insrt/redo spine n generator	J1	5464	360.4117	"$29,118.74"	.	"$5,823.75"	*		
63688	Revise/remove neuroreceiver	J1	5461	38.9699	"$3,148.50"	.	$629.70			
63700	Repair of spinal herniation	C								
63702	Repair of spinal herniation	C								
63704	Repair of spinal herniation	C								
63706	Repair of spinal herniation	C								
63707	Repair spinal fluid leakage	C								
63709	Repair spinal fluid leakage	C								
63710	Graft repair of spine defect	C								
63740	Install spinal shunt	C								
63741	Install spinal shunt	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
63744	Revision of spinal shunt	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
63746	Removal of spinal shunt	Q2	5431	21.2809	"$1,719.35"	.	$343.87			
64400	Njx aa&/strd trigeminal nrv	T	5441	3.2400	$261.77	.	$52.36			
64405	Njx aa&/strd gr ocpl nrv	T	5441	3.2400	$261.77	.	$52.36			
64408	Njx aa&/strd vagus nrv	T	5441	3.2400	$261.77	.	$52.36			
64415	Njx aa&/strd brach plexus	T	5443	10.0510	$812.05	.	$162.41			
64416	Njx aa&/strd brach plex nfs	T	5443	10.0510	$812.05	.	$162.41			
64417	Njx aa&/strd axillary nrv	T	5443	10.0510	$812.05	.	$162.41			
64418	Njx aa&/strd sprscap nrv	T	5442	7.7364	$625.05	.	$125.01			
64420	Njx aa&/strd ntrcost nrv 1	T	5442	7.7364	$625.05	.	$125.01			
64421	Njx aa&/strd ntrcost nrv ea	T	5443	10.0510	$812.05	.	$162.41			
64425	Njx aa&/strd ii ih nerves	T	5442	7.7364	$625.05	.	$125.01			
64430	Njx aa&/strd pudendal nerve	T	5443	10.0510	$812.05	.	$162.41			
64435	Njx aa&/strd paracrv nrv	T	5442	7.7364	$625.05	.	$125.01			
64445	Njx aa&/strd sciatic nerve	T	5442	7.7364	$625.05	.	$125.01			
64446	Njx aa&/strd sciatic nrv nfs	T	5443	10.0510	$812.05	.	$162.41			
64447	Njx aa&/strd femoral nerve	T	5442	7.7364	$625.05	.	$125.01			
64448	Njx aa&/strd fem nerve nfs	T	5443	10.0510	$812.05	.	$162.41			
64449	Njx aa&/strd lmbr plex nfs	T	5443	10.0510	$812.05	.	$162.41			
64450	Njx aa&/strd other pn/branch	T	5442	7.7364	$625.05	.	$125.01			
64451	Njx aa&/strd nrv nrvtg si jt	T	5442	7.7364	$625.05	.	$125.01			
64454	Njx aa&/strd gnclr nrv brnch	T	5442	7.7364	$625.05	.	$125.01			
64455	N block inj plantar digit	T	5441	3.2400	$261.77	.	$52.36			
64461	Pvb thoracic single inj site	T	5442	7.7364	$625.05	.	$125.01			
64462	Pvb thoracic 2nd+ inj site	N								
64463	Pvb thoracic cont infusion	T	5442	7.7364	$625.05	.	$125.01			
64479	Inj foramen epidural c/t	T	5443	10.0510	$812.05	.	$162.41			
64480	Inj foramen epidural add-on	N								
64483	Inj foramen epidural l/s	T	5443	10.0510	$812.05	.	$162.41			
64484	Inj foramen epidural add-on	N								
64486	Tap block unil by injection	N								
64487	Tap block uni by infusion	N								
64488	Tap block bi injection	N								
64489	Tap block bi by infusion	N								
64490	Inj paravert f jnt c/t 1 lev	T	5443	10.0510	$812.05	.	$162.41			
64491	Inj paravert f jnt c/t 2 lev	N								
64492	Inj paravert f jnt c/t 3 lev	N								
64493	Inj paravert f jnt l/s 1 lev	T	5443	10.0510	$812.05	.	$162.41			
64494	Inj paravert f jnt l/s 2 lev	N								
64495	Inj paravert f jnt l/s 3 lev	N								
64505	N block spenopalatine gangl	T	5441	3.2400	$261.77	.	$52.36			
64510	N block stellate ganglion	T	5443	10.0510	$812.05	.	$162.41			
64517	N block inj hypogas plxs	T	5443	10.0510	$812.05	.	$162.41			
64520	N block lumbar/thoracic	T	5443	10.0510	$812.05	.	$162.41			
64530	N block inj celiac pelus	T	5443	10.0510	$812.05	.	$162.41			
64553	Implant neuroelectrodes	J1	5462	76.5800	"$6,187.13"	.	"$1,237.43"			
64555	Implant neuroelectrodes	J1	5462	76.5800	"$6,187.13"	.	"$1,237.43"			
64561	Implant neuroelectrodes	J1	5462	76.5800	"$6,187.13"	.	"$1,237.43"			
64566	Neuroeltrd stim post tibial	T	5441	3.2400	$261.77	.	$52.36			
64568	Inc for vagus n elect impl	J1	5464	360.4117	"$29,118.74"	.	"$5,823.75"	*		
64569	Revise/repl vagus n eltrd	J1	5462	76.5800	"$6,187.13"	.	"$1,237.43"			
64570	Remove vagus n eltrd	Q2	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64575	Implant neuroelectrodes	J1	5463	238.6273	"$19,279.42"	.	"$3,855.89"	*		
64580	Implant neuroelectrodes	J1	5463	238.6273	"$19,279.42"	.	"$3,855.89"	*		
64581	Implant neuroelectrodes	J1	5462	76.5800	"$6,187.13"	.	"$1,237.43"			
64585	Revise/remove neuroelectrode	J1	5461	38.9699	"$3,148.50"	.	$629.70			
64590	Insrt/redo pn/gastr stimul	J1	5463	238.6273	"$19,279.42"	.	"$3,855.89"	*		
64595	Revise/rmv pn/gastr stimul	J1	5461	38.9699	"$3,148.50"	.	$629.70			
64600	Injection treatment of nerve	T	5443	10.0510	$812.05	.	$162.41			
64605	Injection treatment of nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64610	Injection treatment of nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64611	Chemodenerv saliv glands	T	5441	3.2400	$261.77	.	$52.36			
64612	Destroy nerve face muscle	T	5441	3.2400	$261.77	.	$52.36			
64615	Chemodenerv musc migraine	T	5441	3.2400	$261.77	.	$52.36			
64616	Chemodenerv musc neck dyston	T	5441	3.2400	$261.77	.	$52.36			
64617	Chemodener muscle larynx emg	T	5441	3.2400	$261.77	.	$52.36			
64620	Injection treatment of nerve	T	5443	10.0510	$812.05	.	$162.41			
64624	Dstrj nulyt agt gnclr nrv	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64625	Rf abltj nrv nrvtg si jt	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64630	Injection treatment of nerve	T	5443	10.0510	$812.05	.	$162.41			
64632	N block inj common digit	T	5441	3.2400	$261.77	.	$52.36			
64633	Destroy cerv/thor facet jnt	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64634	Destroy c/th facet jnt addl	N								
64635	Destroy lumb/sac facet jnt	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64636	Destroy l/s facet jnt addl	N								
64640	Injection treatment of nerve	T	5443	10.0510	$812.05	.	$162.41			
64642	Chemodenerv 1 extremity 1-4	T	5442	7.7364	$625.05	.	$125.01			
64643	Chemodenerv 1 extrem 1-4 ea	N								
64644	Chemodenerv 1 extrem 5/> mus	T	5442	7.7364	$625.05	.	$125.01			
64645	Chemodenerv 1 extrem 5/> ea	N								
64646	Chemodenerv trunk musc 1-5	T	5442	7.7364	$625.05	.	$125.01			
64647	Chemodenerv trunk musc 6/>	T	5442	7.7364	$625.05	.	$125.01			
64650	Chemodenerv eccrine glands	T	5441	3.2400	$261.77	.	$52.36			
64653	Chemodenerv eccrine glands	T	5441	3.2400	$261.77	.	$52.36			
64680	Injection treatment of nerve	T	5443	10.0510	$812.05	.	$162.41			
64681	Injection treatment of nerve	T	5443	10.0510	$812.05	.	$162.41			
64702	Revise finger/toe nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64704	Revise hand/foot nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64708	Revise arm/leg nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64712	Revision of sciatic nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64713	Revision of arm nerve(s)	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64714	Revise low back nerve(s)	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64716	Revision of cranial nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64718	Revise ulnar nerve at elbow	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64719	Revise ulnar nerve at wrist	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64721	Carpal tunnel surgery	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64722	Relieve pressure on nerve(s)	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64726	Release foot/toe nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64727	Internal nerve revision	N								
64732	Incision of brow nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64734	Incision of cheek nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64736	Incision of chin nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64738	Incision of jaw nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64740	Incision of tongue nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64742	Incision of facial nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64744	Incise nerve back of head	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64746	Incise diaphragm nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64755	Incision of stomach nerves	C								
64760	Incision of vagus nerve	C								
64763	Incise hip/thigh nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64766	Incise hip/thigh nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64771	Sever cranial nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64772	Incision of spinal nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64774	Remove skin nerve lesion	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64776	Remove digit nerve lesion	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64778	Digit nerve surgery add-on	N								
64782	Remove limb nerve lesion	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64783	Limb nerve surgery add-on	N								
64784	Remove nerve lesion	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64786	Remove sciatic nerve lesion	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64787	Implant nerve end	N								
64788	Remove skin nerve lesion	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64790	Removal of nerve lesion	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64792	Removal of nerve lesion	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64795	Biopsy of nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64802	Sympathectomy cervical	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64804	Remove sympathetic nerves	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64809	Remove sympathetic nerves	C								
64818	Remove sympathetic nerves	C								
64820	Sympathectomy digital artery	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64821	Remove sympathetic nerves	J1	5113	33.8823	"$2,737.45"	.	$547.49			
64822	Remove sympathetic nerves	J1	5113	33.8823	"$2,737.45"	.	$547.49			
64823	Sympathectomy supfc palmar	J1	5113	33.8823	"$2,737.45"	.	$547.49			
64831	Repair of digit nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64832	Repair nerve add-on	N								
64834	Repair of hand or foot nerve	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64835	Repair of hand or foot nerve	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64836	Repair of hand or foot nerve	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64837	Repair nerve add-on	N								
64840	Repair of leg nerve	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64856	Repair/transpose nerve	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64857	Repair arm/leg nerve	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64858	Repair sciatic nerve	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64859	Nerve surgery	N								
64861	Repair of arm nerves	J1	5431	21.2809	"$1,719.35"	.	$343.87			
64862	Repair of low back nerves	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64864	Repair of facial nerve	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64865	Repair of facial nerve	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64866	Fusion of facial/other nerve	C								
64868	Fusion of facial/other nerve	C								
64872	Subsequent repair of nerve	N								
64874	Repair & revise nerve add-on	N								
64876	Repair nerve/shorten bone	N								
64885	Nerve graft head/neck </4 cm	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64886	Nerve graft head/neck >4 cm	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64890	Nerve graft hand/foot </4 cm	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64891	Nerve graft hand/foot >4 cm	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64892	Nerve graft arm/leg <4 cm	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64893	Nerve graft arm/leg >4 cm	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64895	Nerve graft hand/foot </4 cm	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64896	Nerve graft hand/foot >4 cm	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64897	Nerve graft arm/leg </4 cm	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64898	Nerve graft arm/leg >4 cm	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64901	Nerve graft add-on	N								
64902	Nerve graft add-on	N								
64905	Nerve pedicle transfer	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64907	Nerve pedicle transfer	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64910	Nerve repair w/allograft	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64911	Neurorraphy w/vein autograft	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64912	Nrv rpr w/nrv algrft 1st	J1	5432	68.1867	"$5,509.01"	.	"$1,101.81"			
64913	Nrv rpr w/nrv algrft ea addl	N								
64999	Nervous system surgery	T	5441	3.2400	$261.77	.	$52.36			
65091	Revise eye	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65093	Revise eye with implant	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65101	Removal of eye	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65103	Remove eye/insert implant	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65105	Remove eye/attach implant	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65110	Removal of eye	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65112	Remove eye/revise socket	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65114	Remove eye/revise socket	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65125	Revise ocular implant	J1	5503	23.9526	"$1,935.20"	.	$387.04			
65130	Insert ocular implant	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65135	Insert ocular implant	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65140	Attach ocular implant	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65150	Revise ocular implant	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65155	Reinsert ocular implant	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65175	Removal of ocular implant	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65205	Remove foreign body from eye	Q1	5734	1.3495	$109.03	.	$21.81			
65210	Remove foreign body from eye	Q1	5735	4.5003	$363.59	.	$72.72			
65220	Remove foreign body from eye	Q1	5735	4.5003	$363.59	.	$72.72			
65222	Remove foreign body from eye	Q1	5734	1.3495	$109.03	.	$21.81			
65235	Remove foreign body from eye	J1	5491	25.0252	"$2,021.86"	.	$404.38			
65260	Remove foreign body from eye	J1	5491	25.0252	"$2,021.86"	.	$404.38			
65265	Remove foreign body from eye	J1	5491	25.0252	"$2,021.86"	.	$404.38			
65270	Repair of eye wound	J1	5503	23.9526	"$1,935.20"	.	$387.04			
65272	Repair of eye wound	J1	5503	23.9526	"$1,935.20"	.	$387.04			
65273	Repair of eye wound	C								
65275	Repair of eye wound	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65280	Repair of eye wound	J1	5492	47.2606	"$3,818.33"	.	$763.67			
65285	Repair of eye wound	J1	5492	47.2606	"$3,818.33"	.	$763.67			
65286	Repair of eye wound	J1	5491	25.0252	"$2,021.86"	.	$404.38			
65290	Repair of eye socket wound	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65400	Removal of eye lesion	T	5502	9.9881	$806.97	.	$161.40			
65410	Biopsy of cornea	J1	5503	23.9526	"$1,935.20"	.	$387.04			
65420	Removal of eye lesion	J1	5503	23.9526	"$1,935.20"	.	$387.04			
65426	Removal of eye lesion	J1	5503	23.9526	"$1,935.20"	.	$387.04			
65430	Corneal smear	Q1	5735	4.5003	$363.59	.	$72.72			
65435	Curette/treat cornea	T	5502	9.9881	$806.97	.	$161.40			
65436	Curette/treat cornea	J1	5503	23.9526	"$1,935.20"	.	$387.04			
65450	Treatment of corneal lesion	T	5501	3.3479	$270.49	.	$54.10			
65600	Revision of cornea	J1	5503	23.9526	"$1,935.20"	.	$387.04			
65710	Corneal transplant	J1	5492	47.2606	"$3,818.33"	.	$763.67			
65730	Corneal transplant	J1	5492	47.2606	"$3,818.33"	.	$763.67			
65750	Corneal transplant	J1	5492	47.2606	"$3,818.33"	.	$763.67			
65755	Corneal transplant	J1	5492	47.2606	"$3,818.33"	.	$763.67			
65756	Corneal trnspl endothelial	J1	5492	47.2606	"$3,818.33"	.	$763.67			
65757	Prep corneal endo allograft	N								
65760	Revision of cornea	E1								
65765	Revision of cornea	E1								
65767	Corneal tissue transplant	E1								
65770	Revise cornea with implant	J1	5493	76.7308	"$6,199.31"	.	"$1,239.87"			
65771	Radial keratotomy	E1								
65772	Correction of astigmatism	T	5502	9.9881	$806.97	.	$161.40			
65775	Correction of astigmatism	J1	5503	23.9526	"$1,935.20"	.	$387.04			
65778	Cover eye w/membrane	Q2	5502	9.9881	$806.97	.	$161.40			
65779	Cover eye w/membrane suture	Q2	5504	38.7046	"$3,127.06"	.	$625.42			
65780	Ocular reconst transplant	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65781	Ocular reconst transplant	J1	5492	47.2606	"$3,818.33"	.	$763.67			
65782	Ocular reconst transplant	J1	5504	38.7046	"$3,127.06"	.	$625.42			
65785	Impltj ntrstrml crnl rng seg	J1	5492	47.2606	"$3,818.33"	.	$763.67			
65800	Drainage of eye	J1	5491	25.0252	"$2,021.86"	.	$404.38			
65810	Drainage of eye	J1	5491	25.0252	"$2,021.86"	.	$404.38			
65815	Drainage of eye	J1	5491	25.0252	"$2,021.86"	.	$404.38			
65820	Relieve inner eye pressure	J1	5492	47.2606	"$3,818.33"	.	$763.67			
65850	Incision of eye	J1	5491	25.0252	"$2,021.86"	.	$404.38			
65855	Trabeculoplasty laser surg	T	5481	6.2744	$506.93	$101.51	$101.39			
65860	Incise inner eye adhesions	T	5481	6.2744	$506.93	$101.51	$101.39			
65865	Incise inner eye adhesions	J1	5491	25.0252	"$2,021.86"	.	$404.38			
65870	Incise inner eye adhesions	J1	5491	25.0252	"$2,021.86"	.	$404.38			
65875	Incise inner eye adhesions	J1	5491	25.0252	"$2,021.86"	.	$404.38			
65880	Incise inner eye adhesions	J1	5492	47.2606	"$3,818.33"	.	$763.67			
65900	Remove eye lesion	J1	5491	25.0252	"$2,021.86"	.	$404.38			
65920	Remove implant of eye	J1	5491	25.0252	"$2,021.86"	.	$404.38			
65930	Remove blood clot from eye	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66020	Injection treatment of eye	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66030	Injection treatment of eye	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66130	Remove eye lesion	J1	5503	23.9526	"$1,935.20"	.	$387.04			
66150	Glaucoma surgery	J1	5492	47.2606	"$3,818.33"	.	$763.67			
66155	Glaucoma surgery	J1	5492	47.2606	"$3,818.33"	.	$763.67			
66160	Glaucoma surgery	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66170	Glaucoma surgery	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66172	Incision of eye	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66174	Translum dil eye canal	J1	5492	47.2606	"$3,818.33"	.	$763.67			
66175	Trnslum dil eye canal w/stnt	J1	5492	47.2606	"$3,818.33"	.	$763.67			
66179	Aqueous shunt eye w/o graft	J1	5492	47.2606	"$3,818.33"	.	$763.67			
66180	Aqueous shunt eye w/graft	J1	5492	47.2606	"$3,818.33"	.	$763.67			
66183	Insert ant drainage device	J1	5492	47.2606	"$3,818.33"	.	$763.67			
66184	Revision of aqueous shunt	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66185	Revise aqueous shunt eye	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66225	Repair/graft eye lesion	J1	5492	47.2606	"$3,818.33"	.	$763.67			
66250	Follow-up surgery of eye	J1	5503	23.9526	"$1,935.20"	.	$387.04			
66500	Incision of iris	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66505	Incision of iris	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66600	Remove iris and lesion	J1	5492	47.2606	"$3,818.33"	.	$763.67			
66605	Removal of iris	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66625	Removal of iris	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66630	Removal of iris	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66635	Removal of iris	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66680	Repair iris & ciliary body	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66682	Repair iris & ciliary body	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66700	Destruction ciliary body	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66710	Ciliary transsleral therapy	J1	5503	23.9526	"$1,935.20"	.	$387.04			
66711	Ecp ciliary body destruction	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66720	Destruction ciliary body	J1	5503	23.9526	"$1,935.20"	.	$387.04			
66740	Destruction ciliary body	J1	5503	23.9526	"$1,935.20"	.	$387.04			
66761	Revision of iris	T	5481	6.2744	$506.93	$101.51	$101.39			
66762	Revision of iris	T	5481	6.2744	$506.93	$101.51	$101.39			
66770	Removal of inner eye lesion	T	5481	6.2744	$506.93	$101.51	$101.39			
66820	Incision secondary cataract	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66821	After cataract laser surgery	T	5481	6.2744	$506.93	$101.51	$101.39			
66825	Reposition intraocular lens	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66830	Removal of lens lesion	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66840	Removal of lens material	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66850	Removal of lens material	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66852	Removal of lens material	J1	5492	47.2606	"$3,818.33"	.	$763.67			
66920	Extraction of lens	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66930	Extraction of lens	J1	5492	47.2606	"$3,818.33"	.	$763.67			
66940	Extraction of lens	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66982	Xcapsl ctrc rmvl cplx wo ecp	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66983	Cataract surg w/iol 1 stage	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66984	Xcapsl ctrc rmvl w/o ecp	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66985	Insert lens prosthesis	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66986	Exchange lens prosthesis	J1	5491	25.0252	"$2,021.86"	.	$404.38			
66987	Xcapsl ctrc rmvl cplx w/ecp	J1	5492	47.2606	"$3,818.33"	.	$763.67			
66988	Xcapsl ctrc rmvl w/ecp	J1	5492	47.2606	"$3,818.33"	.	$763.67			
66990	Ophthalmic endoscope add-on	N								
66999	Eye surgery procedure	J1	5491	25.0252	"$2,021.86"	.	$404.38			
67005	Partial removal of eye fluid	J1	5491	25.0252	"$2,021.86"	.	$404.38			
67010	Partial removal of eye fluid	J1	5491	25.0252	"$2,021.86"	.	$404.38			
67015	Release of eye fluid	J1	5491	25.0252	"$2,021.86"	.	$404.38			
67025	Replace eye fluid	J1	5491	25.0252	"$2,021.86"	.	$404.38			
67027	Implant eye drug system	J1	5494	159.3718	"$12,876.13"	.	"$2,575.23"	*		
67028	Injection eye drug	S	5694	3.8320	$309.60	.	$61.92			
67030	Incise inner eye strands	J1	5491	25.0252	"$2,021.86"	.	$404.38			
67031	Laser surgery eye strands	T	5481	6.2744	$506.93	$101.51	$101.39			
67036	Removal of inner eye fluid	J1	5492	47.2606	"$3,818.33"	.	$763.67			
67039	Laser treatment of retina	J1	5492	47.2606	"$3,818.33"	.	$763.67			
67040	Laser treatment of retina	J1	5492	47.2606	"$3,818.33"	.	$763.67			
67041	Vit for macular pucker	J1	5492	47.2606	"$3,818.33"	.	$763.67			
67042	Vit for macular hole	J1	5492	47.2606	"$3,818.33"	.	$763.67			
67043	Vit for membrane dissect	J1	5492	47.2606	"$3,818.33"	.	$763.67			
67101	Repair detached retina crtx	J1	5491	25.0252	"$2,021.86"	.	$404.38			
67105	Repair detached retina pc	T	5481	6.2744	$506.93	$101.51	$101.39			
67107	Repair detached retina	J1	5492	47.2606	"$3,818.33"	.	$763.67			
67108	Repair detached retina	J1	5492	47.2606	"$3,818.33"	.	$763.67			
67110	Repair detached retina	J1	5491	25.0252	"$2,021.86"	.	$404.38			
67113	Repair retinal detach cplx	J1	5492	47.2606	"$3,818.33"	.	$763.67			
67115	Release encircling material	J1	5492	47.2606	"$3,818.33"	.	$763.67			
67120	Remove eye implant material	J1	5491	25.0252	"$2,021.86"	.	$404.38			
67121	Remove eye implant material	J1	5491	25.0252	"$2,021.86"	.	$404.38			
67141	Treatment of retina	T	5501	3.3479	$270.49	.	$54.10			
67145	Treatment of retina	T	5481	6.2744	$506.93	$101.51	$101.39			
67208	Treatment of retinal lesion	T	5501	3.3479	$270.49	.	$54.10			
67210	Treatment of retinal lesion	T	5481	6.2744	$506.93	$101.51	$101.39			
67218	Treatment of retinal lesion	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67220	Treatment of choroid lesion	T	5481	6.2744	$506.93	$101.51	$101.39			
67221	Ocular photodynamic ther	T	5481	6.2744	$506.93	$101.51	$101.39			
67225	Eye photodynamic ther add-on	N								
67227	Dstrj extensive retinopathy	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67228	Treatment x10sv retinopathy	T	5481	6.2744	$506.93	$101.51	$101.39			
67229	Tr retinal les preterm inf	T	5481	6.2744	$506.93	$101.51	$101.39			
67250	Reinforce eye wall	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67255	Reinforce/graft eye wall	J1	5491	25.0252	"$2,021.86"	.	$404.38			
67299	Eye surgery procedure	J1	5491	25.0252	"$2,021.86"	.	$404.38			
67311	Revise eye muscle	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67312	Revise two eye muscles	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67314	Revise eye muscle	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67316	Revise two eye muscles	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67318	Revise eye muscle(s)	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67320	Revise eye muscle(s) add-on	N								
67331	Eye surgery follow-up add-on	N								
67332	Rerevise eye muscles add-on	N								
67334	Revise eye muscle w/suture	N								
67335	Eye suture during surgery	N								
67340	Revise eye muscle add-on	N								
67343	Release eye tissue	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67345	Destroy nerve of eye muscle	T	5501	3.3479	$270.49	.	$54.10			
67346	Biopsy eye muscle	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67399	Unlisted px extraocular musc	T	5501	3.3479	$270.49	.	$54.10			
67400	Explore/biopsy eye socket	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67405	Explore/drain eye socket	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67412	Explore/treat eye socket	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67413	Explore/treat eye socket	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67414	Explr/decompress eye socket	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67415	Aspiration orbital contents	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67420	Explore/treat eye socket	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67430	Explore/treat eye socket	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67440	Explore/drain eye socket	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67445	Explr/decompress eye socket	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67450	Explore/biopsy eye socket	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67500	Inject/treat eye socket	T	5501	3.3479	$270.49	.	$54.10			
67505	Inject/treat eye socket	T	5501	3.3479	$270.49	.	$54.10			
67515	Inject/treat eye socket	T	5501	3.3479	$270.49	.	$54.10			
67550	Insert eye socket implant	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67560	Revise eye socket implant	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67570	Decompress optic nerve	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67599	Orbit surgery procedure	T	5501	3.3479	$270.49	.	$54.10			
67700	Drainage of eyelid abscess	T	5501	3.3479	$270.49	.	$54.10			
67710	Incision of eyelid	T	5502	9.9881	$806.97	.	$161.40			
67715	Incision of eyelid fold	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67800	Remove eyelid lesion	T	5501	3.3479	$270.49	.	$54.10			
67801	Remove eyelid lesions	T	5502	9.9881	$806.97	.	$161.40			
67805	Remove eyelid lesions	T	5501	3.3479	$270.49	.	$54.10			
67808	Remove eyelid lesion(s)	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67810	Biopsy eyelid & lid margin	T	5501	3.3479	$270.49	.	$54.10			
67820	Revise eyelashes	Q1	5734	1.3495	$109.03	.	$21.81			
67825	Revise eyelashes	T	5501	3.3479	$270.49	.	$54.10			
67830	Revise eyelashes	T	5502	9.9881	$806.97	.	$161.40			
67835	Revise eyelashes	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67840	Remove eyelid lesion	T	5502	9.9881	$806.97	.	$161.40			
67850	Treat eyelid lesion	T	5502	9.9881	$806.97	.	$161.40			
67875	Closure of eyelid by suture	T	5502	9.9881	$806.97	.	$161.40			
67880	Revision of eyelid	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67882	Revision of eyelid	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67900	Repair brow defect	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67901	Repair eyelid defect	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67902	Repair eyelid defect	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67903	Repair eyelid defect	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67904	Repair eyelid defect	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67906	Repair eyelid defect	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67908	Repair eyelid defect	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67909	Revise eyelid defect	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67911	Revise eyelid defect	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67912	Correction eyelid w/implant	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67914	Repair eyelid defect	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67915	Repair eyelid defect	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67916	Repair eyelid defect	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67917	Repair eyelid defect	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67921	Repair eyelid defect	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67922	Repair eyelid defect	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67923	Repair eyelid defect	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67924	Repair eyelid defect	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67930	Repair eyelid wound	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67935	Repair eyelid wound	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67938	Remove eyelid foreign body	T	5501	3.3479	$270.49	.	$54.10			
67950	Revision of eyelid	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67961	Revision of eyelid	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67966	Revision of eyelid	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67971	Reconstruction of eyelid	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67973	Reconstruction of eyelid	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67974	Reconstruction of eyelid	J1	5504	38.7046	"$3,127.06"	.	$625.42			
67975	Reconstruction of eyelid	J1	5503	23.9526	"$1,935.20"	.	$387.04			
67999	Revision of eyelid	T	5501	3.3479	$270.49	.	$54.10			
68020	Incise/drain eyelid lining	T	5502	9.9881	$806.97	.	$161.40			
68040	Treatment of eyelid lesions	T	5501	3.3479	$270.49	.	$54.10			
68100	Biopsy of eyelid lining	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68110	Remove eyelid lining lesion	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68115	Remove eyelid lining lesion	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68130	Remove eyelid lining lesion	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68135	Remove eyelid lining lesion	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68200	Treat eyelid by injection	Q1	5734	1.3495	$109.03	.	$21.81			
68320	Revise/graft eyelid lining	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68325	Revise/graft eyelid lining	J1	5504	38.7046	"$3,127.06"	.	$625.42			
68326	Revise/graft eyelid lining	J1	5504	38.7046	"$3,127.06"	.	$625.42			
68328	Revise/graft eyelid lining	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68330	Revise eyelid lining	J1	5491	25.0252	"$2,021.86"	.	$404.38			
68335	Revise/graft eyelid lining	J1	5504	38.7046	"$3,127.06"	.	$625.42			
68340	Separate eyelid adhesions	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68360	Revise eyelid lining	J1	5504	38.7046	"$3,127.06"	.	$625.42			
68362	Revise eyelid lining	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68371	Harvest eye tissue alograft	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68399	Eyelid lining surgery	T	5501	3.3479	$270.49	.	$54.10			
68400	Incise/drain tear gland	T	5502	9.9881	$806.97	.	$161.40			
68420	Incise/drain tear sac	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68440	Incise tear duct opening	T	5501	3.3479	$270.49	.	$54.10			
68500	Removal of tear gland	J1	5504	38.7046	"$3,127.06"	.	$625.42			
68505	Partial removal tear gland	J1	5504	38.7046	"$3,127.06"	.	$625.42			
68510	Biopsy of tear gland	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68520	Removal of tear sac	J1	5504	38.7046	"$3,127.06"	.	$625.42			
68525	Biopsy of tear sac	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68530	Clearance of tear duct	T	5501	3.3479	$270.49	.	$54.10			
68540	Remove tear gland lesion	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68550	Remove tear gland lesion	J1	5504	38.7046	"$3,127.06"	.	$625.42			
68700	Repair tear ducts	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68705	Revise tear duct opening	T	5501	3.3479	$270.49	.	$54.10			
68720	Create tear sac drain	J1	5504	38.7046	"$3,127.06"	.	$625.42			
68745	Create tear duct drain	J1	5504	38.7046	"$3,127.06"	.	$625.42			
68750	Create tear duct drain	J1	5504	38.7046	"$3,127.06"	.	$625.42			
68760	Close tear duct opening	T	5501	3.3479	$270.49	.	$54.10			
68761	Close tear duct opening	T	5501	3.3479	$270.49	.	$54.10			
68770	Close tear system fistula	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68801	Dilate tear duct opening	Q1	5735	4.5003	$363.59	.	$72.72			
68810	Probe nasolacrimal duct	T	5501	3.3479	$270.49	.	$54.10			
68811	Probe nasolacrimal duct	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68815	Probe nasolacrimal duct	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68816	Probe nl duct w/balloon	J1	5503	23.9526	"$1,935.20"	.	$387.04			
68840	Explore/irrigate tear ducts	T	5501	3.3479	$270.49	.	$54.10			
68850	Injection for tear sac x-ray	N								
68899	Tear duct system surgery	T	5501	3.3479	$270.49	.	$54.10			
69000	Drain external ear lesion	T	5071	7.5503	$610.01	.	$122.01			
69005	Drain external ear lesion	J1	5072	16.9891	"$1,372.60"	.	$274.52			
69020	Drain outer ear canal lesion	T	5071	7.5503	$610.01	.	$122.01			
69090	Pierce earlobes	E1								
69100	Biopsy of external ear	T	5161	2.5205	$203.64	.	$40.73			
69105	Biopsy of external ear canal	J1	5163	16.7012	"$1,349.34"	.	$269.87			
69110	Remove external ear partial	J1	5073	28.7016	"$2,318.89"	.	$463.78			
69120	Removal of external ear	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69140	Remove ear canal lesion(s)	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69145	Remove ear canal lesion(s)	J1	5073	28.7016	"$2,318.89"	.	$463.78			
69150	Extensive ear canal surgery	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69155	Extensive ear/neck surgery	C								
69200	Clear outer ear canal	Q1	5734	1.3495	$109.03	.	$21.81			
69205	Clear outer ear canal	J1	5072	16.9891	"$1,372.60"	.	$274.52			
69209	Remove impacted ear wax uni	Q1	5733	0.6809	$55.01	.	$11.01			
69210	Remove impacted ear wax uni	Q1	5733	0.6809	$55.01	.	$11.01			
69220	Clean out mastoid cavity	Q1	5051	2.1627	$174.73	.	$34.95			
69222	Clean out mastoid cavity	T	5162	5.4673	$441.72	.	$88.35			
69300	Revise external ear	J1	5164	32.4198	"$2,619.29"	.	$523.86			
69310	Rebuild outer ear canal	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69320	Rebuild outer ear canal	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69399	Outer ear surgery procedure	T	5161	2.5205	$203.64	.	$40.73			
69420	Incision of eardrum	T	5161	2.5205	$203.64	.	$40.73			
69421	Incision of eardrum	J1	5164	32.4198	"$2,619.29"	.	$523.86			
69424	Remove ventilating tube	Q2	5164	32.4198	"$2,619.29"	.	$523.86			
69433	Create eardrum opening	T	5162	5.4673	$441.72	.	$88.35			
69436	Create eardrum opening	J1	5163	16.7012	"$1,349.34"	.	$269.87			
69440	Exploration of middle ear	J1	5164	32.4198	"$2,619.29"	.	$523.86			
69450	Eardrum revision	J1	5164	32.4198	"$2,619.29"	.	$523.86			
69501	Mastoidectomy	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69502	Mastoidectomy	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69505	Remove mastoid structures	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69511	Extensive mastoid surgery	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69530	Extensive mastoid surgery	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69535	Remove part of temporal bone	C								
69540	Remove ear lesion	J1	5163	16.7012	"$1,349.34"	.	$269.87			
69550	Remove ear lesion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69552	Remove ear lesion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69554	Remove ear lesion	C								
69601	Mastoid surgery revision	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69602	Mastoid surgery revision	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69603	Mastoid surgery revision	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69604	Mastoid surgery revision	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69605	Mastoid surgery revision	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69610	Repair of eardrum	J1	5163	16.7012	"$1,349.34"	.	$269.87			
69620	Repair of eardrum	J1	5164	32.4198	"$2,619.29"	.	$523.86			
69631	Repair eardrum structures	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69632	Rebuild eardrum structures	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69633	Rebuild eardrum structures	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69635	Repair eardrum structures	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69636	Rebuild eardrum structures	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69637	Rebuild eardrum structures	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69641	Revise middle ear & mastoid	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69642	Revise middle ear & mastoid	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69643	Revise middle ear & mastoid	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69644	Revise middle ear & mastoid	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69645	Revise middle ear & mastoid	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69646	Revise middle ear & mastoid	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69650	Release middle ear bone	J1	5164	32.4198	"$2,619.29"	.	$523.86			
69660	Revise middle ear bone	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69661	Revise middle ear bone	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69662	Revise middle ear bone	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69666	Repair middle ear structures	J1	5164	32.4198	"$2,619.29"	.	$523.86			
69667	Repair middle ear structures	J1	5164	32.4198	"$2,619.29"	.	$523.86			
69670	Remove mastoid air cells	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69676	Remove middle ear nerve	J1	5164	32.4198	"$2,619.29"	.	$523.86			
69700	Close mastoid fistula	J1	5163	16.7012	"$1,349.34"	.	$269.87			
69710	Implant/replace hearing aid	E1								
69711	Remove/repair hearing aid	J1	5164	32.4198	"$2,619.29"	.	$523.86			
69714	Implant temple bone w/stimul	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
69715	Temple bne implnt w/stimulat	J1	5116	197.3696	"$15,946.08"	.	"$3,189.22"	*		
69717	Temple bone implant revision	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
69718	Revise temple bone implant	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
69720	Release facial nerve	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69725	Release facial nerve	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69740	Repair facial nerve	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69745	Repair facial nerve	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69799	Middle ear surgery procedure	T	5161	2.5205	$203.64	.	$40.73			
69801	Incise inner ear	J1	5163	16.7012	"$1,349.34"	.	$269.87			
69805	Explore inner ear	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69806	Explore inner ear	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69905	Remove inner ear	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69910	Remove inner ear & mastoid	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69915	Incise inner ear nerve	J1	5164	32.4198	"$2,619.29"	.	$523.86			
69930	Implant cochlear device	J1	5166	409.7919	"$33,108.32"	"$7,683.79"	"$6,621.67"	*		
69949	Inner ear surgery procedure	T	5161	2.5205	$203.64	.	$40.73			
69950	Incise inner ear nerve	C								
69955	Release facial nerve	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69960	Release inner ear canal	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69970	Remove inner ear lesion	J1	5165	60.0365	"$4,850.53"	.	$970.11			
69979	Temporal bone surgery	T	5161	2.5205	$203.64	.	$40.73			
69990	Microsurgery add-on	N								
70010	Contrast x-ray of brain	Q2	5572	4.7263	$381.85	.	$76.37			
70015	Contrast x-ray of brain	Q2	5573	8.4267	$680.82	.	$136.17			
70030	X-ray eye for foreign body	Q1	5521	0.9878	$79.81	.	$15.97			
70100	X-ray exam of jaw <4views	Q1	5521	0.9878	$79.81	.	$15.97			
7010F	Pt info into recall system	M								
70110	X-ray exam of jaw 4/> views	Q1	5522	1.3873	$112.08	.	$22.42			
70120	X-ray exam of mastoids	Q1	5522	1.3873	$112.08	.	$22.42			
70130	X-ray exam of mastoids	Q1	5522	1.3873	$112.08	.	$22.42			
70134	X-ray exam of middle ear	Q1	5524	5.9607	$481.58	.	$96.32			
70140	X-ray exam of facial bones	Q1	5521	0.9878	$79.81	.	$15.97			
70150	X-ray exam of facial bones	Q1	5522	1.3873	$112.08	.	$22.42			
70160	X-ray exam of nasal bones	Q1	5521	0.9878	$79.81	.	$15.97			
70170	X-ray exam of tear duct	Q2	5523	2.8844	$233.04	.	$46.61			
70190	X-ray exam of eye sockets	Q1	5521	0.9878	$79.81	.	$15.97			
70200	X-ray exam of eye sockets	Q1	5522	1.3873	$112.08	.	$22.42			
7020F	Mammo assess cat in dbase	E1								
70210	X-ray exam of sinuses	Q1	5521	0.9878	$79.81	.	$15.97			
70220	X-ray exam of sinuses	Q1	5521	0.9878	$79.81	.	$15.97			
70240	X-ray exam pituitary saddle	Q1	5521	0.9878	$79.81	.	$15.97			
70250	X-ray exam of skull	Q1	5522	1.3873	$112.08	.	$22.42			
7025F	Pt infosys alarm 4 nxt mammo	M								
70260	X-ray exam of skull	Q1	5522	1.3873	$112.08	.	$22.42			
70300	X-ray exam of teeth	Q1	5521	0.9878	$79.81	.	$15.97			
70310	X-ray exam of teeth	Q1	5523	2.8844	$233.04	.	$46.61			
70320	Full mouth x-ray of teeth	Q1	5523	2.8844	$233.04	.	$46.61			
70328	X-ray exam of jaw joint	Q1	5521	0.9878	$79.81	.	$15.97			
70330	X-ray exam of jaw joints	Q1	5521	0.9878	$79.81	.	$15.97			
70332	X-ray exam of jaw joint	Q2	5523	2.8844	$233.04	.	$46.61			
70336	Magnetic image jaw joint	Q3	5523	2.8844	$233.04	.	$46.61			
70350	X-ray head for orthodontia	Q1	5521	0.9878	$79.81	.	$15.97			
70355	Panoramic x-ray of jaws	Q1	5521	0.9878	$79.81	.	$15.97			
70360	X-ray exam of neck	Q1	5521	0.9878	$79.81	.	$15.97			
70370	Throat x-ray & fluoroscopy	Q1	5521	0.9878	$79.81	.	$15.97			
70371	Speech evaluation complex	Q1	5523	2.8844	$233.04	.	$46.61			
70380	X-ray exam of salivary gland	Q1	5521	0.9878	$79.81	.	$15.97			
70390	X-ray exam of salivary duct	Q2	5523	2.8844	$233.04	.	$46.61			
70450	Ct head/brain w/o dye	Q3	5522	1.3873	$112.08	.	$22.42			
70460	Ct head/brain w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
70470	Ct head/brain w/o & w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
70480	Ct orbit/ear/fossa w/o dye	Q3	5522	1.3873	$112.08	.	$22.42			
70481	Ct orbit/ear/fossa w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
70482	Ct orbit/ear/fossa w/o&w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
70486	Ct maxillofacial w/o dye	Q3	5522	1.3873	$112.08	.	$22.42			
70487	Ct maxillofacial w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
70488	Ct maxillofacial w/o & w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
70490	Ct soft tissue neck w/o dye	Q3	5522	1.3873	$112.08	.	$22.42			
70491	Ct soft tissue neck w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
70492	Ct sft tsue nck w/o & w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
70496	Ct angiography head	Q3	5571	2.2554	$182.22	.	$36.45			
70498	Ct angiography neck	Q3	5571	2.2554	$182.22	.	$36.45			
70540	Mri orbit/face/neck w/o dye	Q3	5523	2.8844	$233.04	.	$46.61			
70542	Mri orbit/face/neck w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
70543	Mri orbt/fac/nck w/o &w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
70544	Mr angiography head w/o dye	Q3	5523	2.8844	$233.04	.	$46.61			
70545	Mr angiography head w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
70546	Mr angiograph head w/o&w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
70547	Mr angiography neck w/o dye	Q3	5523	2.8844	$233.04	.	$46.61			
70548	Mr angiography neck w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
70549	Mr angiograph neck w/o&w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
70551	Mri brain stem w/o dye	Q3	5523	2.8844	$233.04	.	$46.61			
70552	Mri brain stem w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
70553	Mri brain stem w/o & w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
70554	Fmri brain by tech	Q3	5523	2.8844	$233.04	.	$46.61			
70555	Fmri brain by phys/psych	S	5523	2.8844	$233.04	.	$46.61			
70557	Mri brain w/o dye	S	5524	5.9607	$481.58	.	$96.32			
70558	Mri brain w/dye	S	5571	2.2554	$182.22	.	$36.45			
70559	Mri brain w/o & w/dye	S	5571	2.2554	$182.22	.	$36.45			
71045	X-ray exam chest 1 view	Q3	5521	0.9878	$79.81	.	$15.97			
71046	X-ray exam chest 2 views	Q3	5521	0.9878	$79.81	.	$15.97			
71047	X-ray exam chest 3 views	Q1	5521	0.9878	$79.81	.	$15.97			
71048	X-ray exam chest 4+ views	Q1	5522	1.3873	$112.08	.	$22.42			
71100	X-ray exam ribs uni 2 views	Q1	5521	0.9878	$79.81	.	$15.97			
71101	X-ray exam unilat ribs/chest	Q1	5522	1.3873	$112.08	.	$22.42			
71110	X-ray exam ribs bil 3 views	Q1	5522	1.3873	$112.08	.	$22.42			
71111	X-ray exam ribs/chest4/> vws	Q1	5522	1.3873	$112.08	.	$22.42			
71120	X-ray exam breastbone 2/>vws	Q1	5521	0.9878	$79.81	.	$15.97			
71130	X-ray strenoclavic jt 3/>vws	Q1	5521	0.9878	$79.81	.	$15.97			
71250	Ct thorax w/o dye	Q3	5522	1.3873	$112.08	.	$22.42			
71260	Ct thorax w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
71270	Ct thorax w/o & w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
71275	Ct angiography chest	Q3	5571	2.2554	$182.22	.	$36.45			
71550	Mri chest w/o dye	Q3	5523	2.8844	$233.04	.	$46.61			
71551	Mri chest w/dye	Q3	5573	8.4267	$680.82	.	$136.17			
71552	Mri chest w/o & w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
71555	Mri angio chest w or w/o dye	B								
72020	X-ray exam of spine 1 view	Q1	5521	0.9878	$79.81	.	$15.97			
72040	X-ray exam neck spine 2-3 vw	Q1	5521	0.9878	$79.81	.	$15.97			
72050	X-ray exam neck spine 4/5vws	Q1	5522	1.3873	$112.08	.	$22.42			
72052	X-ray exam neck spine 6/>vws	Q1	5522	1.3873	$112.08	.	$22.42			
72070	X-ray exam thorac spine 2vws	Q1	5522	1.3873	$112.08	.	$22.42			
72072	X-ray exam thorac spine 3vws	Q1	5522	1.3873	$112.08	.	$22.42			
72074	X-ray exam thorac spine4/>vw	Q1	5522	1.3873	$112.08	.	$22.42			
72080	X-ray exam thoracolmb 2/> vw	Q1	5521	0.9878	$79.81	.	$15.97			
72081	X-ray exam entire spi 1 vw	Q1	5521	0.9878	$79.81	.	$15.97			
72082	X-ray exam entire spi 2/3 vw	Q1	5522	1.3873	$112.08	.	$22.42			
72083	X-ray exam entire spi 4/5 vw	S	5522	1.3873	$112.08	.	$22.42			
72084	X-ray exam entire spi 6/> vw	S	5522	1.3873	$112.08	.	$22.42			
72100	X-ray exam l-s spine 2/3 vws	Q1	5522	1.3873	$112.08	.	$22.42			
72110	X-ray exam l-2 spine 4/>vws	Q1	5522	1.3873	$112.08	.	$22.42			
72114	X-ray exam l-s spine bending	Q1	5522	1.3873	$112.08	.	$22.42			
72120	X-ray bend only l-s spine	Q1	5522	1.3873	$112.08	.	$22.42			
72125	Ct neck spine w/o dye	Q3	5522	1.3873	$112.08	.	$22.42			
72126	Ct neck spine w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
72127	Ct neck spine w/o & w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
72128	Ct chest spine w/o dye	Q3	5522	1.3873	$112.08	.	$22.42			
72129	Ct chest spine w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
72130	Ct chest spine w/o & w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
72131	Ct lumbar spine w/o dye	Q3	5522	1.3873	$112.08	.	$22.42			
72132	Ct lumbar spine w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
72133	Ct lumbar spine w/o & w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
72141	Mri neck spine w/o dye	Q3	5523	2.8844	$233.04	.	$46.61			
72142	Mri neck spine w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
72146	Mri chest spine w/o dye	Q3	5523	2.8844	$233.04	.	$46.61			
72147	Mri chest spine w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
72148	Mri lumbar spine w/o dye	Q3	5523	2.8844	$233.04	.	$46.61			
72149	Mri lumbar spine w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
72156	Mri neck spine w/o & w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
72157	Mri chest spine w/o & w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
72158	Mri lumbar spine w/o & w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
72159	Mr angio spine w/o&w/dye	B								
72170	X-ray exam of pelvis	Q1	5522	1.3873	$112.08	.	$22.42			
72190	X-ray exam of pelvis	Q1	5522	1.3873	$112.08	.	$22.42			
72191	Ct angiograph pelv w/o&w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
72192	Ct pelvis w/o dye	Q3	5522	1.3873	$112.08	.	$22.42			
72193	Ct pelvis w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
72194	Ct pelvis w/o & w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
72195	Mri pelvis w/o dye	Q3	5523	2.8844	$233.04	.	$46.61			
72196	Mri pelvis w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
72197	Mri pelvis w/o & w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
72198	Mr angio pelvis w/o & w/dye	B								
72200	X-ray exam si joints	Q1	5522	1.3873	$112.08	.	$22.42			
72202	X-ray exam si joints 3/> vws	Q1	5522	1.3873	$112.08	.	$22.42			
72220	X-ray exam sacrum tailbone	Q1	5521	0.9878	$79.81	.	$15.97			
72240	Myelography neck spine	Q2	5573	8.4267	$680.82	.	$136.17			
72255	Myelography thoracic spine	Q2	5573	8.4267	$680.82	.	$136.17			
72265	Myelography l-s spine	Q2	5573	8.4267	$680.82	.	$136.17			
72270	Myelogphy 2/> spine regions	Q2	5573	8.4267	$680.82	.	$136.17			
72275	Epidurography	N								
72285	Discography cerv/thor spine	Q2	5431	21.2809	"$1,719.35"	.	$343.87			
72295	X-ray of lower spine disk	Q2	5431	21.2809	"$1,719.35"	.	$343.87			
73000	X-ray exam of collar bone	Q1	5521	0.9878	$79.81	.	$15.97			
73010	X-ray exam of shoulder blade	Q1	5522	1.3873	$112.08	.	$22.42			
73020	X-ray exam of shoulder	Q1	5521	0.9878	$79.81	.	$15.97			
73030	X-ray exam of shoulder	Q1	5521	0.9878	$79.81	.	$15.97			
73040	Contrast x-ray of shoulder	Q2	5572	4.7263	$381.85	.	$76.37			
73050	X-ray exam of shoulders	Q1	5521	0.9878	$79.81	.	$15.97			
73060	X-ray exam of humerus	Q1	5521	0.9878	$79.81	.	$15.97			
73070	X-ray exam of elbow	Q1	5521	0.9878	$79.81	.	$15.97			
73080	X-ray exam of elbow	Q1	5521	0.9878	$79.81	.	$15.97			
73085	Contrast x-ray of elbow	Q2	5572	4.7263	$381.85	.	$76.37			
73090	X-ray exam of forearm	Q1	5521	0.9878	$79.81	.	$15.97			
73092	X-ray exam of arm infant	Q1	5522	1.3873	$112.08	.	$22.42			
73100	X-ray exam of wrist	Q1	5521	0.9878	$79.81	.	$15.97			
73110	X-ray exam of wrist	Q1	5521	0.9878	$79.81	.	$15.97			
73115	Contrast x-ray of wrist	Q2	5572	4.7263	$381.85	.	$76.37			
73120	X-ray exam of hand	Q1	5522	1.3873	$112.08	.	$22.42			
73130	X-ray exam of hand	Q1	5521	0.9878	$79.81	.	$15.97			
73140	X-ray exam of finger(s)	Q1	5521	0.9878	$79.81	.	$15.97			
73200	Ct upper extremity w/o dye	Q3	5522	1.3873	$112.08	.	$22.42			
73201	Ct upper extremity w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
73202	Ct uppr extremity w/o&w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
73206	Ct angio upr extrm w/o&w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
73218	Mri upper extremity w/o dye	Q3	5523	2.8844	$233.04	.	$46.61			
73219	Mri upper extremity w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
73220	Mri uppr extremity w/o&w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
73221	Mri joint upr extrem w/o dye	Q3	5523	2.8844	$233.04	.	$46.61			
73222	Mri joint upr extrem w/dye	Q3	5573	8.4267	$680.82	.	$136.17			
73223	Mri joint upr extr w/o&w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
73225	Mr angio upr extr w/o&w/dye	B								
73501	X-ray exam hip uni 1 view	Q1	5521	0.9878	$79.81	.	$15.97			
73502	X-ray exam hip uni 2-3 views	Q1	5521	0.9878	$79.81	.	$15.97			
73503	X-ray exam hip uni 4/> views	Q1	5522	1.3873	$112.08	.	$22.42			
73521	X-ray exam hips bi 2 views	Q1	5522	1.3873	$112.08	.	$22.42			
73522	X-ray exam hips bi 3-4 views	Q1	5522	1.3873	$112.08	.	$22.42			
73523	X-ray exam hips bi 5/> views	S	5522	1.3873	$112.08	.	$22.42			
73525	Contrast x-ray of hip	Q2	5572	4.7263	$381.85	.	$76.37			
73551	X-ray exam of femur 1	Q1	5521	0.9878	$79.81	.	$15.97			
73552	X-ray exam of femur 2/>	Q1	5521	0.9878	$79.81	.	$15.97			
73560	X-ray exam of knee 1 or 2	Q1	5521	0.9878	$79.81	.	$15.97			
73562	X-ray exam of knee 3	Q1	5521	0.9878	$79.81	.	$15.97			
73564	X-ray exam knee 4 or more	Q1	5522	1.3873	$112.08	.	$22.42			
73565	X-ray exam of knees	Q1	5521	0.9878	$79.81	.	$15.97			
73580	Contrast x-ray of knee joint	Q2	5572	4.7263	$381.85	.	$76.37			
73590	X-ray exam of lower leg	Q1	5521	0.9878	$79.81	.	$15.97			
73592	X-ray exam of leg infant	Q1	5521	0.9878	$79.81	.	$15.97			
73600	X-ray exam of ankle	Q1	5521	0.9878	$79.81	.	$15.97			
73610	X-ray exam of ankle	Q1	5521	0.9878	$79.81	.	$15.97			
73615	Contrast x-ray of ankle	Q2	5572	4.7263	$381.85	.	$76.37			
73620	X-ray exam of foot	Q1	5521	0.9878	$79.81	.	$15.97			
73630	X-ray exam of foot	Q1	5521	0.9878	$79.81	.	$15.97			
73650	X-ray exam of heel	Q1	5521	0.9878	$79.81	.	$15.97			
73660	X-ray exam of toe(s)	Q1	5521	0.9878	$79.81	.	$15.97			
73700	Ct lower extremity w/o dye	Q3	5522	1.3873	$112.08	.	$22.42			
73701	Ct lower extremity w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
73702	Ct lwr extremity w/o&w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
73706	Ct angio lwr extr w/o&w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
73718	Mri lower extremity w/o dye	Q3	5523	2.8844	$233.04	.	$46.61			
73719	Mri lower extremity w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
73720	Mri lwr extremity w/o&w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
73721	Mri jnt of lwr extre w/o dye	Q3	5523	2.8844	$233.04	.	$46.61			
73722	Mri joint of lwr extr w/dye	Q3	5573	8.4267	$680.82	.	$136.17			
73723	Mri joint lwr extr w/o&w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
73725	Mr ang lwr ext w or w/o dye	B								
74018	X-ray exam abdomen 1 view	Q1	5521	0.9878	$79.81	.	$15.97			
74019	X-ray exam abdomen 2 views	Q1	5522	1.3873	$112.08	.	$22.42			
74021	X-ray exam abdomen 3+ views	Q1	5522	1.3873	$112.08	.	$22.42			
74022	X-ray exam complete abdomen	Q1	5522	1.3873	$112.08	.	$22.42			
74150	Ct abdomen w/o dye	Q3	5522	1.3873	$112.08	.	$22.42			
74160	Ct abdomen w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
74170	Ct abdomen w/o & w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
74174	Ct angio abd&pelv w/o&w/dye	S	5572	4.7263	$381.85	.	$76.37			
74175	Ct angio abdom w/o & w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
74176	Ct abd & pelvis w/o contrast	Q3	5523	2.8844	$233.04	.	$46.61			
74177	Ct abd & pelv w/contrast	Q3	5572	4.7263	$381.85	.	$76.37			
74178	Ct abd & pelv 1/> regns	Q3	5572	4.7263	$381.85	.	$76.37			
74181	Mri abdomen w/o dye	Q3	5523	2.8844	$233.04	.	$46.61			
74182	Mri abdomen w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
74183	Mri abdomen w/o & w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
74185	Mri angio abdom w orw/o dye	B								
74190	X-ray exam of peritoneum	Q2	5524	5.9607	$481.58	.	$96.32			
74210	X-ray xm phrnx&/crv esoph c+	Q1	5571	2.2554	$182.22	.	$36.45			
74220	X-ray xm esophagus 1cntrst	Q1	5571	2.2554	$182.22	.	$36.45			
74221	X-ray xm esophagus 2cntrst	Q1	5571	2.2554	$182.22	.	$36.45			
74230	X-ray xm swlng funcj c+	Q1	5571	2.2554	$182.22	.	$36.45			
74235	Remove esophagus obstruction	N								
74240	X-ray xm upr gi trc 1cntrst	Q1	5571	2.2554	$182.22	.	$36.45			
74246	X-ray xm upr gi trc 2cntrst	Q1	5571	2.2554	$182.22	.	$36.45			
74248	X-ray sm int f-thru std	N 								
74250	X-ray xm sm int 1cntrst std	Q1	5571	2.2554	$182.22	.	$36.45			
74251	X-ray xm sm int 2cntrst std	Q1	5571	2.2554	$182.22	.	$36.45			
74261	Ct colonography dx	Q3	5522	1.3873	$112.08	.	$22.42			
74262	Ct colonography dx w/dye	Q3	5571	2.2554	$182.22	.	$36.45			
74263	Ct colonography screening	E1								
74270	X-ray xm colon 1cntrst std	Q1	5571	2.2554	$182.22	.	$36.45			
74280	X-ray xm colon 2cntrst std	Q1	5571	2.2554	$182.22	.	$36.45			
74283	Ther nma rdctj intus/obstrcj	S	5571	2.2554	$182.22	.	$36.45			
74290	Contrast x-ray gallbladder	Q1	5571	2.2554	$182.22	.	$36.45			
74300	X-ray bile ducts/pancreas	N								
74301	X-rays at surgery add-on	N								
74328	X-ray bile duct endoscopy	N								
74329	X-ray for pancreas endoscopy	N								
74330	X-ray bile/panc endoscopy	N								
74340	X-ray guide for gi tube	N								
74355	X-ray guide intestinal tube	N								
74360	X-ray guide gi dilation	N								
74363	X-ray bile duct dilation	N								
74400	Contrst x-ray urinary tract	S	5571	2.2554	$182.22	.	$36.45			
74410	Contrst x-ray urinary tract	S	5571	2.2554	$182.22	.	$36.45			
74415	Contrst x-ray urinary tract	S	5571	2.2554	$182.22	.	$36.45			
74420	Contrst x-ray urinary tract	S	5572	4.7263	$381.85	.	$76.37			
74425	Contrst x-ray urinary tract	Q2	5572	4.7263	$381.85	.	$76.37			
74430	Contrast x-ray bladder	Q2	5572	4.7263	$381.85	.	$76.37			
74440	X-ray male genital tract	Q2	5523	2.8844	$233.04	.	$46.61			
74445	X-ray exam of penis	Q2	5522	1.3873	$112.08	.	$22.42			
74450	X-ray urethra/bladder	Q2	5523	2.8844	$233.04	.	$46.61			
74455	X-ray urethra/bladder	Q2	5523	2.8844	$233.04	.	$46.61			
74470	X-ray exam of kidney lesion	Q2	5524	5.9607	$481.58	.	$96.32			
74485	Dilation urtr/urt rs&i	Q2	5373	21.9270	"$1,771.55"	.	$354.31			
74710	X-ray measurement of pelvis	Q1	5521	0.9878	$79.81	.	$15.97			
74712	Mri fetal sngl/1st gestation	S	5523	2.8844	$233.04	.	$46.61			
74713	Mri fetal ea addl gestation	N								
74740	X-ray female genital tract	Q2	5523	2.8844	$233.04	.	$46.61			
74742	X-ray fallopian tube	N								
74775	X-ray exam of perineum	S	5523	2.8844	$233.04	.	$46.61			
75557	Cardiac mri for morph	Q3	5523	2.8844	$233.04	.	$46.61			
75559	Cardiac mri w/stress img	Q3	5524	5.9607	$481.58	.	$96.32			
75561	Cardiac mri for morph w/dye	Q3	5572	4.7263	$381.85	.	$76.37			
75563	Card mri w/stress img & dye	Q3	5573	8.4267	$680.82	.	$136.17			
75565	Card mri veloc flow mapping	N								
75571	Ct hrt w/o dye w/ca test	Q1	5521	0.9878	$79.81	.	$15.97			
75572	Ct hrt w/3d image	S	5571	2.2554	$182.22	.	$36.45			
75573	Ct hrt w/3d image congen	S	5571	2.2554	$182.22	.	$36.45			
75574	Ct angio hrt w/3d image	S	5571	2.2554	$182.22	.	$36.45			
75600	Contrast exam thoracic aorta	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75605	Contrast exam thoracic aorta	Q2	5184	56.8885	"$4,596.19"	.	$919.24			
75625	Contrast exam abdominl aorta	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75630	X-ray aorta leg arteries	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75635	Ct angio abdominal arteries	Q2	5571	2.2554	$182.22	.	$36.45			
75705	Artery x-rays spine	Q2	5184	56.8885	"$4,596.19"	.	$919.24			
75710	Artery x-rays arm/leg	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75716	Artery x-rays arms/legs	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75726	Artery x-rays abdomen	Q2	5184	56.8885	"$4,596.19"	.	$919.24			
75731	Artery x-rays adrenal gland	J1	5182	20.1890	"$1,631.13"	.	$326.23			
75733	Artery x-rays adrenals	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75736	Artery x-rays pelvis	Q2	5184	56.8885	"$4,596.19"	.	$919.24			
75741	Artery x-rays lung	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75743	Artery x-rays lungs	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75746	Artery x-rays lung	J1	5182	20.1890	"$1,631.13"	.	$326.23			
75756	Artery x-rays chest	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75774	Artery x-ray each vessel	N								
75801	Lymph vessel x-ray arm/leg	Q2	5181	7.8040	$630.51	.	$126.11			
75803	Lymph vessel x-ray arms/legs	J1	5182	20.1890	"$1,631.13"	.	$326.23			
75805	Lymph vessel x-ray trunk	J1	5182	20.1890	"$1,631.13"	.	$326.23			
75807	Lymph vessel x-ray trunk	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75809	Nonvascular shunt x-ray	Q2	5522	1.3873	$112.08	.	$22.42			
75810	Vein x-ray spleen/liver	J1	5182	20.1890	"$1,631.13"	.	$326.23			
75820	Vein x-ray arm/leg	Q2	5181	7.8040	$630.51	.	$126.11			
75822	Vein x-ray arms/legs	J1	5182	20.1890	"$1,631.13"	.	$326.23			
75825	Vein x-ray trunk	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75827	Vein x-ray chest	Q2	5181	7.8040	$630.51	.	$126.11			
75831	Vein x-ray kidney	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75833	Vein x-ray kidneys	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75840	Vein x-ray adrenal gland	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75842	Vein x-ray adrenal glands	Q2	5184	56.8885	"$4,596.19"	.	$919.24			
75860	Vein x-ray neck	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75870	Vein x-ray skull	J1	5182	20.1890	"$1,631.13"	.	$326.23			
75872	Vein x-ray skull epidural	Q2	5181	7.8040	$630.51	.	$126.11			
75880	Vein x-ray eye socket	Q2	5181	7.8040	$630.51	.	$126.11			
75885	Vein x-ray liver w/hemodynam	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75887	Vein x-ray liver w/o hemodyn	J1	5182	20.1890	"$1,631.13"	.	$326.23			
75889	Vein x-ray liver w/hemodynam	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75891	Vein x-ray liver	Q2	5183	34.3010	"$2,771.28"	.	$554.26			
75893	Venous sampling by catheter	Q2	5184	56.8885	"$4,596.19"	.	$919.24			
75894	X-rays transcath therapy	N								
75898	Follow-up angiography	J1	5182	20.1890	"$1,631.13"	.	$326.23			
75901	Remove cva device obstruct	N								
75902	Remove cva lumen obstruct	N								
75956	Xray endovasc thor ao repr	C								
75957	Xray endovasc thor ao repr	C								
75958	Xray place prox ext thor ao	C								
75959	Xray place dist ext thor ao	C								
75970	Vascular biopsy	N								
75984	Xray control catheter change	N								
75989	Abscess drainage under x-ray	N								
76000	Fluoroscopy <1 hr phys/qhp	S	5523	2.8844	$233.04	.	$46.61			
76010	X-ray nose to rectum	Q1	5521	0.9878	$79.81	.	$15.97			
76080	X-ray exam of fistula	Q2	5524	5.9607	$481.58	.	$96.32			
76098	X-ray exam surgical specimen	Q2	5524	5.9607	$481.58	.	$96.32			
76100	X-ray exam of body section	Q1	5522	1.3873	$112.08	.	$22.42			
76101	Complex body section x-ray	Q1	5522	1.3873	$112.08	.	$22.42			
76102	Complex body section x-rays	S	5522	1.3873	$112.08	.	$22.42			
76120	Cine/video x-rays	Q1	5522	1.3873	$112.08	.	$22.42			
76125	Cine/video x-rays add-on	N								
76140	X-ray consultation	E1								
76376	3d render w/intrp postproces	N								
76377	3d render w/intrp postproces	N								
76380	Cat scan follow-up study	Q1	5521	0.9878	$79.81	.	$15.97			
76390	Mr spectroscopy	E1								
76391	Mr elastography	Q3	5523	2.8844	$233.04	.	$46.61			
76496	Fluoroscopic procedure	Q1	5521	0.9878	$79.81	.	$15.97			
76497	Ct procedure	Q1	5521	0.9878	$79.81	.	$15.97			
76498	Mri procedure	S	5521	0.9878	$79.81	.	$15.97			
76499	Radiographic procedure	Q1	5521	0.9878	$79.81	.	$15.97			
76506	Echo exam of head	Q1	5522	1.3873	$112.08	.	$22.42			
76510	Ophth us b & quant a	Q1	5734	1.3495	$109.03	.	$21.81			
76511	Ophth us quant a only	Q1	5522	1.3873	$112.08	.	$22.42			
76512	Ophth us b w/non-quant a	Q1	5522	1.3873	$112.08	.	$22.42			
76513	Echo exam of eye water bath	Q1	5522	1.3873	$112.08	.	$22.42			
76514	Echo exam of eye thickness	Q1	5731	0.2845	$22.99	.	$4.60			
76516	Echo exam of eye	Q1	5522	1.3873	$112.08	.	$22.42			
76519	Echo exam of eye	Q1	5522	1.3873	$112.08	.	$22.42			
76529	Echo exam of eye	Q1	5521	0.9878	$79.81	.	$15.97			
76536	Us exam of head and neck	Q1	5522	1.3873	$112.08	.	$22.42			
76604	Us exam chest	Q1	5522	1.3873	$112.08	.	$22.42			
76641	Ultrasound breast complete	Q1	5522	1.3873	$112.08	.	$22.42			
76642	Ultrasound breast limited	Q1	5521	0.9878	$79.81	.	$15.97			
76700	Us exam abdom complete	Q3	5522	1.3873	$112.08	.	$22.42			
76705	Echo exam of abdomen	Q3	5522	1.3873	$112.08	.	$22.42			
76706	Us abdl aorta screen aaa	S	5522	1.3873	$112.08	$0.00	$0.00			
76770	Us exam abdo back wall comp	Q3	5522	1.3873	$112.08	.	$22.42			
76775	Us exam abdo back wall lim	Q1	5522	1.3873	$112.08	.	$22.42			
76776	Us exam k transpl w/doppler	Q3	5522	1.3873	$112.08	.	$22.42			
76800	Us exam spinal canal	Q1	5522	1.3873	$112.08	.	$22.42			
76801	Ob us < 14 wks single fetus	S	5522	1.3873	$112.08	.	$22.42			
76802	Ob us < 14 wks addl fetus	N								
76805	Ob us >= 14 wks sngl fetus	S	5522	1.3873	$112.08	.	$22.42			
76810	Ob us >= 14 wks addl fetus	N								
76811	Ob us detailed sngl fetus	S	5523	2.8844	$233.04	.	$46.61			
76812	Ob us detailed addl fetus	N								
76813	Ob us nuchal meas 1 gest	Q1	5522	1.3873	$112.08	.	$22.42			
76814	Ob us nuchal meas add-on	N								
76815	Ob us limited fetus(s)	Q1	5522	1.3873	$112.08	.	$22.42			
76816	Ob us follow-up per fetus	Q1	5522	1.3873	$112.08	.	$22.42			
76817	Transvaginal us obstetric	Q1	5522	1.3873	$112.08	.	$22.42			
76818	Fetal biophys profile w/nst	S	5522	1.3873	$112.08	.	$22.42			
76819	Fetal biophys profil w/o nst	S	5522	1.3873	$112.08	.	$22.42			
76820	Umbilical artery echo	Q1	5522	1.3873	$112.08	.	$22.42			
76821	Middle cerebral artery echo	Q1	5522	1.3873	$112.08	.	$22.42			
76825	Echo exam of fetal heart	S	5524	5.9607	$481.58	.	$96.32			
76826	Echo exam of fetal heart	S	5523	2.8844	$233.04	.	$46.61			
76827	Echo exam of fetal heart	Q1	5522	1.3873	$112.08	.	$22.42			
76828	Echo exam of fetal heart	Q1	5522	1.3873	$112.08	.	$22.42			
76830	Transvaginal us non-ob	S	5522	1.3873	$112.08	.	$22.42			
76831	Echo exam uterus	Q3	5523	2.8844	$233.04	.	$46.61			
76856	Us exam pelvic complete	Q3	5522	1.3873	$112.08	.	$22.42			
76857	Us exam pelvic limited	Q3	5522	1.3873	$112.08	.	$22.42			
76870	Us exam scrotum	Q1	5522	1.3873	$112.08	.	$22.42			
76872	Us transrectal	S	5522	1.3873	$112.08	.	$22.42			
76873	Echograp trans r pros study	S	5522	1.3873	$112.08	.	$22.42			
76881	Us compl joint r-t w/img	S	5522	1.3873	$112.08	.	$22.42			
76882	Us lmtd jt/nonvasc xtr strux	Q1	5522	1.3873	$112.08	.	$22.42			
76885	Us exam infant hips dynamic	Q1	5521	0.9878	$79.81	.	$15.97			
76886	Us exam infant hips static	Q1	5521	0.9878	$79.81	.	$15.97			
76932	Echo guide for heart biopsy	N								
76936	Echo guide for artery repair	S	5722	3.1327	$253.10	.	$50.62			
76937	Us guide vascular access	N								
76940	Us guide tissue ablation	N								
76941	Echo guide for transfusion	N								
76942	Echo guide for biopsy	N								
76945	Echo guide villus sampling	N								
76946	Echo guide for amniocentesis	N								
76948	Echo guide ova aspiration	N								
76965	Echo guidance radiotherapy	N								
76970	Ultrasound exam follow-up	Q1	5522	1.3873	$112.08	.	$22.42			
76975	Gi endoscopic ultrasound	Q2	5523	2.8844	$233.04	.	$46.61			
76977	Us bone density measure	S	5522	1.3873	$112.08	$0.00	$0.00			
76978	Us trgt dyn mbubb 1st les	S	5571	2.2554	$182.22	.	$36.45			
76979	Us trgt dyn mbubb ea addl	N 								
76981	Use parenchyma	Q3	5522	1.3873	$112.08	.	$22.42			
76982	Use 1st target lesion	Q3	5522	1.3873	$112.08	.	$22.42			
76983	Use ea addl target lesion	N 								
76998	Us guide intraop	N								
76999	Echo examination procedure	Q1	5521	0.9878	$79.81	.	$15.97			
77001	Fluoroguide for vein device	N								
77002	Needle localization by xray	N								
77003	Fluoroguide for spine inject	N								
77011	Ct scan for localization	N								
77012	Ct scan for needle biopsy	N								
77013	Ct guide for tissue ablation	N								
77014	Ct scan for therapy guide	N								
77021	Mri guidance ndl plmt rs&i	N								
77022	Mri gdn parnchyma tiss abltj	N								
77046	Mri breast c- unilateral	Q3	5523	2.8844	$233.04	.	$46.61			
77047	Mri breast c- bilateral	Q3	5523	2.8844	$233.04	.	$46.61			
77048	Mri breast c-+ w/cad uni	B								
77049	Mri breast c-+ w/cad bi	B								
77053	X-ray of mammary duct	Q2	5523	2.8844	$233.04	.	$46.61			
77054	X-ray of mammary ducts	Q2	5523	2.8844	$233.04	.	$46.61			
77061	Breast tomosynthesis uni	E1								
77062	Breast tomosynthesis bi	E1								
77063	Breast tomosynthesis bi	A								
77065	Dx mammo incl cad uni	A								
77066	Dx mammo incl cad bi	A								
77067	Scr mammo bi incl cad	A								
77071	X-ray stress view	Q1	5521	0.9878	$79.81	.	$15.97			
77072	X-rays for bone age	Q1	5522	1.3873	$112.08	.	$22.42			
77073	X-rays bone length studies	Q1	5522	1.3873	$112.08	.	$22.42			
77074	X-rays bone survey limited	Q1	5522	1.3873	$112.08	.	$22.42			
77075	X-rays bone survey complete	Q1	5522	1.3873	$112.08	.	$22.42			
77076	X-rays bone survey infant	Q1	5522	1.3873	$112.08	.	$22.42			
77077	Joint survey single view	Q1	5522	1.3873	$112.08	.	$22.42			
77078	Ct bone density axial	S	5521	0.9878	$79.81	$0.00	$0.00			
77080	Dxa bone density axial	S	5522	1.3873	$112.08	$0.00	$0.00			
77081	Dxa bone density/peripheral	S	5521	0.9878	$79.81	$0.00	$0.00			
77084	Magnetic image bone marrow	S	5523	2.8844	$233.04	.	$46.61			
77085	Dxa bone density study	Q1	5522	1.3873	$112.08	$0.00	$0.00			
77086	Fracture assessment via dxa	Q1	5521	0.9878	$79.81	.	$15.97			
77261	Radiation therapy planning	B								
77262	Radiation therapy planning	B								
77263	Radiation therapy planning	B								
77280	Set radiation therapy field	S	5611	1.5669	$126.59	$32.03	$25.32			
77285	Set radiation therapy field	S	5612	4.1484	$335.16	.	$67.04			
77290	Set radiation therapy field	S	5612	4.1484	$335.16	.	$67.04			
77293	Respirator motion mgmt simul	N								
77295	3-d radiotherapy plan	S	5613	15.4140	"$1,245.34"	.	$249.07			
77299	Radiation therapy planning	S	5611	1.5669	$126.59	$32.03	$25.32			
77300	Radiation therapy dose plan	S	5611	1.5669	$126.59	$32.03	$25.32			
77301	Radiotherapy dose plan imrt	S	5613	15.4140	"$1,245.34"	.	$249.07			
77306	Telethx isodose plan simple	S	5612	4.1484	$335.16	.	$67.04			
77307	Telethx isodose plan cplx	S	5612	4.1484	$335.16	.	$67.04			
77316	Brachytx isodose plan simple	S	5612	4.1484	$335.16	.	$67.04			
77317	Brachytx isodose intermed	S	5612	4.1484	$335.16	.	$67.04			
77318	Brachytx isodose complex	S	5612	4.1484	$335.16	.	$67.04			
77321	Special teletx port plan	S	5612	4.1484	$335.16	.	$67.04			
77331	Special radiation dosimetry	S	5611	1.5669	$126.59	$32.03	$25.32			
77332	Radiation treatment aid(s)	S	5611	1.5669	$126.59	$32.03	$25.32			
77333	Radiation treatment aid(s)	S	5611	1.5669	$126.59	$32.03	$25.32			
77334	Radiation treatment aid(s)	S	5612	4.1484	$335.16	.	$67.04			
77336	Radiation physics consult	S	5611	1.5669	$126.59	$32.03	$25.32			
77338	Design mlc device for imrt	S	5612	4.1484	$335.16	.	$67.04			
77370	Radiation physics consult	S	5611	1.5669	$126.59	$32.03	$25.32			
77371	Srs multisource	J1	5627	98.3057	"$7,942.41"	.	"$1,588.49"	*		
77372	Srs linear based	J1	5627	98.3057	"$7,942.41"	.	"$1,588.49"	*		
77373	Sbrt delivery	S	5626	21.8887	"$1,768.45"	.	$353.69			
77385	Ntsty modul rad tx dlvr smpl	S	5623	6.6693	$538.83	.	$107.77			
77386	Ntsty modul rad tx dlvr cplx	S	5623	6.6693	$538.83	.	$107.77			
77387	Guidance for radj tx dlvr	N								
77399	External radiation dosimetry	S	5611	1.5669	$126.59	$32.03	$25.32			
77401	Radiation treatment delivery	S	5621	1.5188	$122.71	.	$24.55			
77402	Radiation treatment delivery	S	5621	1.5188	$122.71	.	$24.55			
77407	Radiation treatment delivery	S	5622	2.9255	$236.36	.	$47.28			
77412	Radiation treatment delivery	S	5622	2.9255	$236.36	.	$47.28			
77417	Radiology port images(s)	N								
77423	Neutron beam tx complex	S	5623	6.6693	$538.83	.	$107.77			
77424	Io rad tx delivery by x-ray	J1	5627	98.3057	"$7,942.41"	.	"$1,588.49"	*		
77425	Io rad tx deliver by elctrns	J1	5627	98.3057	"$7,942.41"	.	"$1,588.49"	*		
77427	Radiation tx management x5	B								
77431	Radiation therapy management	B								
77432	Stereotactic radiation trmt	B								
77435	Sbrt management	N								
77469	Io radiation tx management	B								
77470	Special radiation treatment	S	5623	6.6693	$538.83	.	$107.77			
77499	Radiation therapy management	B								
77520	Proton trmt simple w/o comp	S	5623	6.6693	$538.83	.	$107.77			
77522	Proton trmt simple w/comp	S	5625	15.4315	"$1,246.76"	.	$249.36			
77523	Proton trmt intermediate	S	5625	15.4315	"$1,246.76"	.	$249.36			
77525	Proton treatment complex	S	5625	15.4315	"$1,246.76"	.	$249.36			
77600	Hyperthermia treatment	S	5622	2.9255	$236.36	.	$47.28			
77605	Hyperthermia treatment	S	5624	9.1657	$740.52	.	$148.11			
77610	Hyperthermia treatment	S	5623	6.6693	$538.83	.	$107.77			
77615	Hyperthermia treatment	S	5623	6.6693	$538.83	.	$107.77			
77620	Hyperthermia treatment	S	5623	6.6693	$538.83	.	$107.77			
77750	Infuse radioactive materials	S	5622	2.9255	$236.36	.	$47.28			
77761	Apply intrcav radiat simple	S	5623	6.6693	$538.83	.	$107.77			
77762	Apply intrcav radiat interm	S	5623	6.6693	$538.83	.	$107.77			
77763	Apply intrcav radiat compl	S	5624	9.1657	$740.52	.	$148.11			
77767	Hdr rdncl skn surf brachytx	S	5622	2.9255	$236.36	.	$47.28			
77768	Hdr rdncl skn surf brachytx	S	5622	2.9255	$236.36	.	$47.28			
77770	Hdr rdncl ntrstl/icav brchtx	S	5624	9.1657	$740.52	.	$148.11			
77771	Hdr rdncl ntrstl/icav brchtx	S	5624	9.1657	$740.52	.	$148.11			
77772	Hdr rdncl ntrstl/icav brchtx	S	5624	9.1657	$740.52	.	$148.11			
77778	Apply interstit radiat compl	S	5624	9.1657	$740.52	.	$148.11			
77789	Apply surf ldr radionuclide	S	5621	1.5188	$122.71	.	$24.55			
77790	Radiation handling	N								
77799	Radium/radioisotope therapy	S	5621	1.5188	$122.71	.	$24.55			
78012	Thyroid uptake measurement	S	5591	4.5564	$368.13	.	$73.63			
78013	Thyroid imaging w/blood flow	S	5591	4.5564	$368.13	.	$73.63			
78014	Thyroid imaging w/blood flow	S	5591	4.5564	$368.13	.	$73.63			
78015	Thyroid met imaging	S	5591	4.5564	$368.13	.	$73.63			
78016	Thyroid met imaging/studies	S	5591	4.5564	$368.13	.	$73.63			
78018	Thyroid met imaging body	S	5592	5.8419	$471.98	.	$94.40			
78020	Thyroid met uptake	N								
78070	Parathyroid planar imaging	S	5591	4.5564	$368.13	.	$73.63			
78071	Parathyrd planar w/wo subtrj	S	5591	4.5564	$368.13	.	$73.63			
78072	Parathyrd planar w/spect&ct	S	5592	5.8419	$471.98	.	$94.40			
78075	Adrenal cortex & medulla img	S	5593	15.7463	"$1,272.19"	.	$254.44			
78099	Endocrine nuclear procedure	S	5591	4.5564	$368.13	.	$73.63			
78102	Bone marrow imaging ltd	S	5591	4.5564	$368.13	.	$73.63			
78103	Bone marrow imaging mult	S	5591	4.5564	$368.13	.	$73.63			
78104	Bone marrow imaging body	S	5591	4.5564	$368.13	.	$73.63			
78110	Plasma volume single	S	5593	15.7463	"$1,272.19"	.	$254.44			
78111	Plasma volume multiple	S	5593	15.7463	"$1,272.19"	.	$254.44			
78120	Red cell mass single	S	5591	4.5564	$368.13	.	$73.63			
78121	Red cell mass multiple	S	5592	5.8419	$471.98	.	$94.40			
78122	Blood volume	S	5592	5.8419	$471.98	.	$94.40			
78130	Red cell survival study	S	5591	4.5564	$368.13	.	$73.63			
78135	Red cell survival kinetics	S	5591	4.5564	$368.13	.	$73.63			
78140	Red cell sequestration	S	5591	4.5564	$368.13	.	$73.63			
78185	Spleen imaging	S	5591	4.5564	$368.13	.	$73.63			
78191	Platelet survival	S	5591	4.5564	$368.13	.	$73.63			
78195	Lymph system imaging	S	5592	5.8419	$471.98	.	$94.40			
78199	Blood/lymph nuclear exam	S	5591	4.5564	$368.13	.	$73.63			
78201	Liver imaging	S	5593	15.7463	"$1,272.19"	.	$254.44			
78202	Liver imaging with flow	S	5593	15.7463	"$1,272.19"	.	$254.44			
78215	Liver and spleen imaging	S	5591	4.5564	$368.13	.	$73.63			
78216	Liver & spleen image/flow	S	5591	4.5564	$368.13	.	$73.63			
78226	Hepatobiliary system imaging	S	5591	4.5564	$368.13	.	$73.63			
78227	Hepatobil syst image w/drug	S	5592	5.8419	$471.98	.	$94.40			
78230	Salivary gland imaging	S	5591	4.5564	$368.13	.	$73.63			
78231	Serial salivary imaging	S	5591	4.5564	$368.13	.	$73.63			
78232	Salivary gland function exam	S	5591	4.5564	$368.13	.	$73.63			
78258	Esophageal motility study	S	5591	4.5564	$368.13	.	$73.63			
78261	Gastric mucosa imaging	S	5591	4.5564	$368.13	.	$73.63			
78262	Gastroesophageal reflux exam	S	5591	4.5564	$368.13	.	$73.63			
78264	Gastric emptying imag study	S	5591	4.5564	$368.13	.	$73.63			
78265	Gastric emptying imag study	S	5591	4.5564	$368.13	.	$73.63			
78266	Gastric emptying imag study	S	5592	5.8419	$471.98	.	$94.40			
78267	Breath tst attain/anal c-14	A								
78268	Breath test analysis c-14	A								
78278	Acute gi blood loss imaging	S	5591	4.5564	$368.13	.	$73.63			
78282	Gi protein loss exam	S	5591	4.5564	$368.13	.	$73.63			
78290	Meckels divert exam	S	5591	4.5564	$368.13	.	$73.63			
78291	Leveen/shunt patency exam	S	5591	4.5564	$368.13	.	$73.63			
78299	Gi nuclear procedure	S	5591	4.5564	$368.13	.	$73.63			
78300	Bone imaging limited area	S	5591	4.5564	$368.13	.	$73.63			
78305	Bone imaging multiple areas	S	5591	4.5564	$368.13	.	$73.63			
78306	Bone imaging whole body	S	5591	4.5564	$368.13	.	$73.63			
78315	Bone imaging 3 phase	S	5591	4.5564	$368.13	.	$73.63			
78350	Bone mineral single photon	E1								
78351	Bone mineral dual photon	E1								
78399	Musculoskeletal nuclear exam	S	5591	4.5564	$368.13	.	$73.63			
78414	Non-imaging heart function	S	5592	5.8419	$471.98	.	$94.40			
78428	Cardiac shunt imaging	S	5591	4.5564	$368.13	.	$73.63			
78429	Myocrd img pet 1 std w/ct	S	5594	17.8616	"$1,443.09"	.	$288.63			
78430	Myocrd img pet rst/strs w/ct	S	5594	17.8616	"$1,443.09"	.	$288.63			
78431	Myocrd img pet rst&strs ct	S	1522		"$2,250.50"	.	$450.10			
78432	Myocrd img pet 2rtracer	S	1523		"$2,750.50"	.	$550.10			
78433	Myocrd img pet 2rtracer ct	S	1523		"$2,750.50"	.	$550.10			
78434	Aqmbf pet rest & rx stress	N 								
78445	Vascular flow imaging	S	5591	4.5564	$368.13	.	$73.63			
78451	Ht muscle image spect sing	S	5593	15.7463	"$1,272.19"	.	$254.44			
78452	Ht muscle image spect mult	S	5593	15.7463	"$1,272.19"	.	$254.44			
78453	Ht muscle image planar sing	S	5593	15.7463	"$1,272.19"	.	$254.44			
78454	Ht musc image planar mult	S	5593	15.7463	"$1,272.19"	.	$254.44			
78456	Acute venous thrombus image	S	5593	15.7463	"$1,272.19"	.	$254.44			
78457	Venous thrombosis imaging	S	5593	15.7463	"$1,272.19"	.	$254.44			
78458	Ven thrombosis images bilat	S	5591	4.5564	$368.13	.	$73.63			
78459	Myocrd img pet single study	S	5593	15.7463	"$1,272.19"	.	$254.44			
78466	Heart infarct image	S	5591	4.5564	$368.13	.	$73.63			
78468	Heart infarct image (ef)	S	5592	5.8419	$471.98	.	$94.40			
78469	Heart infarct image (3d)	S	5593	15.7463	"$1,272.19"	.	$254.44			
78472	Gated heart planar single	S	5591	4.5564	$368.13	.	$73.63			
78473	Gated heart multiple	S	5591	4.5564	$368.13	.	$73.63			
78481	Heart first pass single	S	5592	5.8419	$471.98	.	$94.40			
78483	Heart first pass multiple	S	5592	5.8419	$471.98	.	$94.40			
78491	Myocrd img pet 1std rst/strs	S	5594	17.8616	"$1,443.09"	.	$288.63			
78492	Myocrd img pet mlt rst&strs	S	5594	17.8616	"$1,443.09"	.	$288.63			
78494	Heart image spect	S	5591	4.5564	$368.13	.	$73.63			
78496	Heart first pass add-on	N								
78499	Cardiovascular nuclear exam	S	5591	4.5564	$368.13	.	$73.63			
78579	Lung ventilation imaging	S	5591	4.5564	$368.13	.	$73.63			
78580	Lung perfusion imaging	S	5591	4.5564	$368.13	.	$73.63			
78582	Lung ventilat&perfus imaging	S	5592	5.8419	$471.98	.	$94.40			
78597	Lung perfusion differential	S	5591	4.5564	$368.13	.	$73.63			
78598	Lung perf&ventilat diferentl	S	5592	5.8419	$471.98	.	$94.40			
78599	Respiratory nuclear exam	S	5591	4.5564	$368.13	.	$73.63			
78600	Brain image < 4 views	S	5591	4.5564	$368.13	.	$73.63			
78601	Brain image w/flow < 4 views	S	5591	4.5564	$368.13	.	$73.63			
78605	Brain image 4+ views	S	5592	5.8419	$471.98	.	$94.40			
78606	Brain image w/flow 4 + views	S	5592	5.8419	$471.98	.	$94.40			
78608	Brain imaging (pet)	S	5594	17.8616	"$1,443.09"	.	$288.63			
78609	Brain imaging (pet)	E1								
78610	Brain flow imaging only	S	5592	5.8419	$471.98	.	$94.40			
78630	Cerebrospinal fluid scan	S	5592	5.8419	$471.98	.	$94.40			
78635	Csf ventriculography	S	5592	5.8419	$471.98	.	$94.40			
78645	Csf shunt evaluation	S	5592	5.8419	$471.98	.	$94.40			
78650	Csf leakage imaging	S	5593	15.7463	"$1,272.19"	.	$254.44			
78660	Nuclear exam of tear flow	S	5591	4.5564	$368.13	.	$73.63			
78699	Nervous system nuclear exam	S	5591	4.5564	$368.13	.	$73.63			
78700	Kidney imaging morphol	S	5591	4.5564	$368.13	.	$73.63			
78701	Kidney imaging with flow	S	5591	4.5564	$368.13	.	$73.63			
78707	K flow/funct image w/o drug	S	5592	5.8419	$471.98	.	$94.40			
78708	K flow/funct image w/drug	S	5592	5.8419	$471.98	.	$94.40			
78709	K flow/funct image multiple	S	5592	5.8419	$471.98	.	$94.40			
78725	Kidney function study	S	5591	4.5564	$368.13	.	$73.63			
78730	Urinary bladder retention	N								
78740	Ureteral reflux study	S	5591	4.5564	$368.13	.	$73.63			
78761	Testicular imaging w/flow	S	5591	4.5564	$368.13	.	$73.63			
78799	Genitourinary nuclear exam	S	5591	4.5564	$368.13	.	$73.63			
78800	Rp loclzj tum 1 area 1 d img	S	5591	4.5564	$368.13	.	$73.63			
78801	Rp loclzj tum 2+area 1+d img	S	5591	4.5564	$368.13	.	$73.63			
78802	Rp loclzj tum whbdy 1 d img	S	5593	15.7463	"$1,272.19"	.	$254.44			
78803	Rp loclzj tum spect 1 area	S	5593	15.7463	"$1,272.19"	.	$254.44			
78804	Rp loclzj tum whbdy 2+d img	S	5593	15.7463	"$1,272.19"	.	$254.44			
78808	Iv inj ra drug dx study	Q1	5591	4.5564	$368.13	.	$73.63			
78811	Pet image ltd area	S	5593	15.7463	"$1,272.19"	.	$254.44			
78812	Pet image skull-thigh	S	5594	17.8616	"$1,443.09"	.	$288.63			
78813	Pet image full body	S	5594	17.8616	"$1,443.09"	.	$288.63			
78814	Pet image w/ct lmtd	S	5594	17.8616	"$1,443.09"	.	$288.63			
78815	Pet image w/ct skull-thigh	S	5594	17.8616	"$1,443.09"	.	$288.63			
78816	Pet image w/ct full body	S	5594	17.8616	"$1,443.09"	.	$288.63			
78830	Rp loclzj tum spect w/ct 1	S	5593	15.7463	"$1,272.19"	.	$254.44			
78831	Rp loclzj tum spect 2 areas	S	5593	15.7463	"$1,272.19"	.	$254.44			
78832	Rp loclzj tum spect w/ct 2	S	5594	17.8616	"$1,443.09"	.	$288.63			
78835	Rp quan meas single area	N								
78999	Nuclear diagnostic exam	S	5591	4.5564	$368.13	.	$73.63			
79005	Nuclear rx oral admin	S	5661	2.9384	$237.40	.	$47.48			
79101	Nuclear rx iv admin	S	5661	2.9384	$237.40	.	$47.48			
79200	Nuclear rx intracav admin	S	5661	2.9384	$237.40	.	$47.48			
79300	Nuclr rx interstit colloid	S	5661	2.9384	$237.40	.	$47.48			
79403	Hematopoietic nuclear tx	S	5661	2.9384	$237.40	.	$47.48			
79440	Nuclear rx intra-articular	S	5661	2.9384	$237.40	.	$47.48			
79445	Nuclear rx intra-arterial	S	5661	2.9384	$237.40	.	$47.48			
79999	Nuclear medicine therapy	S	5661	2.9384	$237.40	.	$47.48			
80047	Metabolic panel ionized ca	Q4								
80048	Metabolic panel total ca	Q4								
80050	General health panel	E1								
80051	Electrolyte panel	Q4								
80053	Comprehen metabolic panel	Q4								
80055	Obstetric panel	Q4								
80061	Lipid panel	A								
80069	Renal function panel	Q4								
80074	Acute hepatitis panel	Q4								
80076	Hepatic function panel	Q4								
80081	Obstetric panel	Q4								
80145	Drug assay adalimumab	Q4								
80150	Assay of amikacin	Q4								
80155	Drug assay caffeine	Q4								
80156	Assay carbamazepine total	Q4								
80157	Assay carbamazepine free	Q4								
80158	Drug assay cyclosporine	Q4								
80159	Drug assay clozapine	Q4								
80162	Assay of digoxin total	Q4								
80163	Assay of digoxin free	Q4								
80164	Assay dipropylacetic acd tot	Q4								
80165	Dipropylacetic acid free	Q4								
80168	Assay of ethosuximide	Q4								
80169	Drug assay everolimus	Q4								
80170	Assay of gentamicin	Q4								
80171	Drug screen quant gabapentin	Q4								
80173	Assay of haloperidol	Q4								
80175	Drug screen quan lamotrigine	Q4								
80176	Assay of lidocaine	Q4								
80177	Drug scrn quan levetiracetam	Q4								
80178	Assay of lithium	Q4								
80180	Drug scrn quan mycophenolate	Q4								
80183	Drug scrn quant oxcarbazepin	Q4								
80184	Assay of phenobarbital	Q4								
80185	Assay of phenytoin total	Q4								
80186	Assay of phenytoin free	Q4								
80187	Drug assay posaconazole	Q4								
80188	Assay of primidone	Q4								
80190	Assay of procainamide	Q4								
80192	Assay of procainamide	Q4								
80194	Assay of quinidine	Q4								
80195	Assay of sirolimus	Q4								
80197	Assay of tacrolimus	Q4								
80198	Assay of theophylline	Q4								
80199	Drug screen quant tiagabine	Q4								
80200	Assay of tobramycin	Q4								
80201	Assay of topiramate	Q4								
80202	Assay of vancomycin	Q4								
80203	Drug screen quant zonisamide	Q4								
80230	Drug assay infliximab	Q4								
80235	Drug assay lacosamide	Q4								
80280	Drug assay vedolizumab	Q4								
80285	Drug assay voriconazole	Q4								
80299	Quantitative assay drug	Q4								
80305	Drug test prsmv dir opt obs	Q4								
80306	Drug test prsmv instrmnt	Q4								
80307	Drug test prsmv chem anlyzr	Q4								
80320	Drug screen quantalcohols	B								
80321	Alcohols biomarkers 1or 2	B								
80322	Alcohols biomarkers 3/more	B								
80323	Alkaloids nos	B								
80324	Drug screen amphetamines 1/2	B								
80325	Amphetamines 3or 4	B								
80326	Amphetamines 5 or more	B								
80327	Anabolic steroid 1 or 2	B								
80328	Anabolic steroid 3 or more	B								
80329	Analgesics non-opioid 1 or 2	B								
80330	Analgesics non-opioid 3-5	B								
80331	Analgesics non-opioid 6/more	B								
80332	Antidepressants class 1 or 2	B								
80333	Antidepressants class 3-5	B								
80334	Antidepressants class 6/more	B								
80335	Antidepressant tricyclic 1/2	B								
80336	Antidepressant tricyclic 3-5	B								
80337	Tricyclic & cyclicals 6/more	B								
80338	Antidepressant not specified	B								
80339	Antiepileptics nos 1-3	B								
80340	Antiepileptics nos 4-6	B								
80341	Antiepileptics nos 7/more	B								
80342	Antipsychotics nos 1-3	B								
80343	Antipsychotics nos 4-6	B								
80344	Antipsychotics nos 7/more	B								
80345	Drug screening barbiturates	B								
80346	Benzodiazepines1-12	B								
80347	Benzodiazepines 13 or more	B								
80348	Drug screening buprenorphine	B								
80349	Cannabinoids natural	B								
80350	Cannabinoids synthetic 1-3	B								
80351	Cannabinoids synthetic 4-6	B								
80352	Cannabinoid synthetic 7/more	B								
80353	Drug screening cocaine	B								
80354	Drug screening fentanyl	B								
80355	Gabapentin non-blood	B								
80356	Heroin metabolite	B								
80357	Ketamine and norketamine	B								
80358	Drug screening methadone	B								
80359	Methylenedioxyamphetamines	B								
80360	Methylphenidate	B								
80361	Opiates 1 or more	B								
80362	Opioids & opiate analogs 1/2	B								
80363	Opioids & opiate analogs 3/4	B								
80364	Opioid &opiate analog 5/more	B								
80365	Drug screening oxycodone	B								
80366	Drug screening pregabalin	B								
80367	Drug screening propoxyphene	B								
80368	Sedative hypnotics	B								
80369	Skeletal muscle relaxant 1/2	B								
80370	Skel musc relaxant 3 or more	B								
80371	Stimulants synthetic	B								
80372	Drug screening tapentadol	B								
80373	Drug screening tramadol	B								
80374	Stereoisomer analysis	B								
80375	Drug/substance nos 1-3	B								
80376	Drug/substance nos 4-6	B								
80377	Drug/substance nos 7/more	B								
80400	Acth stimulation panel	Q4								
80402	Acth stimulation panel	Q4								
80406	Acth stimulation panel	Q4								
80408	Aldosterone suppression eval	Q4								
80410	Calcitonin stimul panel	Q4								
80412	Crh stimulation panel	Q4								
80414	Testosterone response	Q4								
80415	Estradiol response panel	Q4								
80416	Renin stimulation panel	Q4								
80417	Renin stimulation panel	Q4								
80418	Pituitary evaluation panel	Q4								
80420	Dexamethasone panel	Q4								
80422	Glucagon tolerance panel	Q4								
80424	Glucagon tolerance panel	Q4								
80426	Gonadotropin hormone panel	Q4								
80428	Growth hormone panel	Q4								
80430	Growth hormone panel	Q4								
80432	Insulin suppression panel	Q4								
80434	Insulin tolerance panel	Q4								
80435	Insulin tolerance panel	Q4								
80436	Metyrapone panel	Q4								
80438	Trh stimulation panel	Q4								
80439	Trh stimulation panel	Q4								
80500	Lab pathology consultation	Q1	5671	0.6123	$49.47	.	$9.90			
80502	Lab pathology consultation	Q1	5671	0.6123	$49.47	.	$9.90			
81000	Urinalysis nonauto w/scope	Q4								
81001	Urinalysis auto w/scope	Q4								
81002	Urinalysis nonauto w/o scope	Q4								
81003	Urinalysis auto w/o scope	Q4								
81005	Urinalysis	Q4								
81007	Urine screen for bacteria	Q4								
81015	Microscopic exam of urine	Q4								
81020	Urinalysis glass test	Q4								
81025	Urine pregnancy test	Q4								
81050	Urinalysis volume measure	Q4								
81099	Urinalysis test procedure	Q4								
81105	Hpa-1 genotyping	A								
81106	Hpa-2 genotyping	A								
81107	Hpa-3 genotyping	A								
81108	Hpa-4 genotyping	A								
81109	Hpa-5 genotyping	A								
81110	Hpa-6 genotyping	A								
81111	Hpa-9 genotyping	A								
81112	Hpa-15 genotyping	A								
81120	Idh1 common variants	A								
81121	Idh2 common variants	A								
81161	Dmd dup/delet analysis	A								
81162	Brca1&2 gen full seq dup/del	A								
81163	Brca1&2 gene full seq alys	A								
81164	Brca1&2 gen ful dup/del alys	A								
81165	Brca1 gene full seq alys	A								
81166	Brca1 gene full dup/del alys	A								
81167	Brca2 gene full dup/del alys	A								
81170	Abl1 gene	A								
81171	Aff2 gene detc abnor alleles	A								
81172	Aff2 gene charac alleles	A								
81173	Ar gene full gene sequence	A								
81174	Ar gene known famil variant	A								
81175	Asxl1 full gene sequence	A								
81176	Asxl1 gene target seq alys	A								
81177	Atn1 gene detc abnor alleles	A								
81178	Atxn1 gene detc abnor allele	A								
81179	Atxn2 gene detc abnor allele	A								
81180	Atxn3 gene detc abnor allele	A								
81181	Atxn7 gene detc abnor allele	A								
81182	Atxn8os gen detc abnor allel	A								
81183	Atxn10 gene detc abnor allel	A								
81184	Cacna1a gen detc abnor allel	A								
81185	Cacna1a gene full gene seq	A								
81186	Cacna1a gen known famil vrnt	A								
81187	Cnbp gene detc abnor allele	A								
81188	Cstb gene detc abnor allele	A								
81189	Cstb gene full gene sequence	A								
81190	Cstb gene known famil vrnt	A								
81200	Aspa gene	A								
81201	Apc gene full sequence	A								
81202	Apc gene known fam variants	A								
81203	Apc gene dup/delet variants	A								
81204	Ar gene charac alleles	A								
81205	Bckdhb gene	A								
81206	Bcr/abl1 gene major bp	A								
81207	Bcr/abl1 gene minor bp	A								
81208	Bcr/abl1 gene other bp	A								
81209	Blm gene	A								
81210	Braf gene	A								
81212	Brca1&2 185&5385&6174 vrnt	A								
81215	Brca1 gene known famil vrnt	A								
81216	Brca2 gene full seq alys	A								
81217	Brca2 gene known famil vrnt	A								
81218	Cebpa gene full sequence	A								
81219	Calr gene com variants	A								
81220	Cftr gene com variants	A								
81221	Cftr gene known fam variants	A								
81222	Cftr gene dup/delet variants	A								
81223	Cftr gene full sequence	A								
81224	Cftr gene intron poly t	A								
81225	Cyp2c19 gene com variants	A								
81226	Cyp2d6 gene com variants	A								
81227	Cyp2c9 gene com variants	A								
81228	Cytogen micrarray copy nmbr	A								
81229	Cytogen m array copy no&snp	A								
81230	Cyp3a4 gene common variants	A								
81231	Cyp3a5 gene common variants	A								
81232	Dpyd gene common variants	A								
81233	Btk gene common variants	A								
81234	Dmpk gene detc abnor allele	A								
81235	Egfr gene com variants	A								
81236	Ezh2 gene full gene sequence	A								
81237	Ezh2 gene common variants	A								
81238	F9 full gene sequence	A								
81239	Dmpk gene charac alleles	A								
81240	F2 gene	A								
81241	F5 gene	A								
81242	Fancc gene	A								
81243	Fmr1 gene detection	A								
81244	Fmr1 gene charac alleles	A								
81245	Flt3 gene	A								
81246	Flt3 gene analysis	A								
81247	G6pd gene alys cmn variant	A								
81248	G6pd known familial variant	A								
81249	G6pd full gene sequence	A								
81250	G6pc gene	A								
81251	Gba gene	A								
81252	Gjb2 gene full sequence	A								
81253	Gjb2 gene known fam variants	A								
81254	Gjb6 gene com variants	A								
81255	Hexa gene	A								
81256	Hfe gene	A								
81257	Hba1/hba2 gene	A								
81258	Hba1/hba2 gene fam vrnt	A								
81259	Hba1/hba2 full gene sequence	A								
81260	Ikbkap gene	A								
81261	Igh gene rearrange amp meth	A								
81262	Igh gene rearrang dir probe	A								
81263	Igh vari regional mutation	A								
81264	Igk rearrangeabn clonal pop	A								
81265	Str markers specimen anal	A								
81266	Str markers spec anal addl	A								
81267	Chimerism anal no cell selec	A								
81268	Chimerism anal w/cell select	A								
81269	Hba1/hba2 gene dup/del vrnts	A								
81270	Jak2 gene	A								
81271	Htt gene detc abnor alleles	A								
81272	Kit gene targeted seq analys	A								
81273	Kit gene analys d816 variant	A								
81274	Htt gene charac alleles	A								
81275	Kras gene variants exon 2	A								
81276	Kras gene addl variants	A								
81277	Cytogenomic neo microra alys	A								
81283	Ifnl3 gene	A								
81284	Fxn gene detc abnor alleles	A								
81285	Fxn gene charac alleles	A								
81286	Fxn gene full gene sequence	A								
81287	Mgmt gene prmtr mthyltn alys	A								
81288	Mlh1 gene	A								
81289	Fxn gene known famil variant	A								
81290	Mcoln1 gene	A								
81291	Mthfr gene	A								
81292	Mlh1 gene full seq	A								
81293	Mlh1 gene known variants	A								
81294	Mlh1 gene dup/delete variant	A								
81295	Msh2 gene full seq	A								
81296	Msh2 gene known variants	A								
81297	Msh2 gene dup/delete variant	A								
81298	Msh6 gene full seq	A								
81299	Msh6 gene known variants	A								
81300	Msh6 gene dup/delete variant	A								
81301	Microsatellite instability	A								
81302	Mecp2 gene full seq	A								
81303	Mecp2 gene known variant	A								
81304	Mecp2 gene dup/delet variant	A								
81305	Myd88 gene p.leu265pro vrnt	A								
81306	Nudt15 gene common variants	A								
81307	Palb2 gene full gene seq	A								
81308	Palb2 gene known famil vrnt	A								
81309	Pik3ca gene trgt seq alys	A								
81310	Npm1 gene	A								
81311	Nras gene variants exon 2&3	A								
81312	Pabpn1 gene detc abnor allel	A								
81313	Pca3/klk3 antigen	A								
81314	Pdgfra gene	A								
81315	Pml/raralpha com breakpoints	A								
81316	Pml/raralpha 1 breakpoint	A								
81317	Pms2 gene full seq analysis	A								
81318	Pms2 known familial variants	A								
81319	Pms2 gene dup/delet variants	A								
81320	Plcg2 gene common variants	A								
81321	Pten gene full sequence	A								
81322	Pten gene known fam variant	A								
81323	Pten gene dup/delet variant	A								
81324	Pmp22 gene dup/delet	A								
81325	Pmp22 gene full sequence	A								
81326	Pmp22 gene known fam variant	A								
81327	Sept9 gen prmtr mthyltn alys	A								
81328	Slco1b1 gene com variants	A								
81329	Smn1 gene dos/deletion alys	A								
81330	Smpd1 gene common variants	A								
81331	Snrpn/ube3a gene	A								
81332	Serpina1 gene	A								
81333	Tgfbi gene common variants	A								
81334	Runx1 gene targeted seq alys	A								
81335	Tpmt gene com variants	A								
81336	Smn1 gene full gene sequence	A								
81337	Smn1 gen nown famil seq vrnt	A								
81340	Trb@ gene rearrange amplify	A								
81341	Trb@ gene rearrange dirprobe	A								
81342	Trg gene rearrangement anal	A								
81343	Ppp2r2b gen detc abnor allel	A								
81344	Tbp gene detc abnor alleles	A								
81345	Tert gene targeted seq alys	A								
81346	Tyms gene com variants	A								
81350	Ugt1a1 gene common variants	A								
81355	Vkorc1 gene	A								
81361	Hbb gene com variants	A								
81362	Hbb gene known fam variant	A								
81363	Hbb gene dup/del variants	A								
81364	Hbb full gene sequence	A								
81370	Hla i & ii typing lr	A								
81371	Hla i & ii type verify lr	A								
81372	Hla i typing complete lr	A								
81373	Hla i typing 1 locus lr	A								
81374	Hla i typing 1 antigen lr	A								
81375	Hla ii typing ag equiv lr	A								
81376	Hla ii typing 1 locus lr	A								
81377	Hla ii type 1 ag equiv lr	A								
81378	Hla i & ii typing hr	A								
81379	Hla i typing complete hr	A								
81380	Hla i typing 1 locus hr	A								
81381	Hla i typing 1 allele hr	A								
81382	Hla ii typing 1 loc hr	A								
81383	Hla ii typing 1 allele hr	A								
81400	Mopath procedure level 1	A								
81401	Mopath procedure level 2	A								
81402	Mopath procedure level 3	A								
81403	Mopath procedure level 4	A								
81404	Mopath procedure level 5	A								
81405	Mopath procedure level 6	A								
81406	Mopath procedure level 7	A								
81407	Mopath procedure level 8	A								
81408	Mopath procedure level 9	A								
81410	Aortic dysfunction/dilation	A								
81411	Aortic dysfunction/dilation	A								
81412	Ashkenazi jewish assoc dis	A								
81413	Car ion chnnlpath inc 10 gns	A								
81414	Car ion chnnlpath inc 2 gns	A								
81415	Exome sequence analysis	A								
81416	Exome sequence analysis	A								
81417	Exome re-evaluation	A								
81420	Fetal chrmoml aneuploidy	A								
81422	Fetal chrmoml microdeltj	A								
81425	Genome sequence analysis	A								
81426	Genome sequence analysis	A								
81427	Genome re-evaluation	A								
81430	Hearing loss sequence analys	A								
81431	Hearing loss dup/del analys	A								
81432	Hrdtry brst ca-rlatd dsordrs	A								
81433	Hrdtry brst ca-rlatd dsordrs	A								
81434	Hereditary retinal disorders	A								
81435	Hereditary colon ca dsordrs	A								
81436	Hereditary colon ca dsordrs	A								
81437	Heredtry nurondcrn tum dsrdr	A								
81438	Heredtry nurondcrn tum dsrdr	A								
81439	Hrdtry cardmypy gene panel	A								
81440	Mitochondrial gene	A								
81442	Noonan spectrum disorders	A								
81443	Genetic tstg severe inh cond	A								
81445	Targeted genomic seq analys	A								
81448	Hrdtry perph neurphy panel	A								
81450	Targeted genomic seq analys	A								
81455	Targeted genomic seq analys	A								
81460	Whole mitochondrial genome	A								
81465	Whole mitochondrial genome	A								
81470	X-linked intellectual dblt	A								
81471	X-linked intellectual dblt	A								
81479	Unlisted molecular pathology	A								
81490	Autoimmune rheumatoid arthr	Q4								
81493	Cor artery disease mrna	A								
81500	Onco (ovar) two proteins	E1								
81503	Onco (ovar) five proteins	Q4								
81504	Oncology tissue of origin	A								
81506	Endo assay seven anal	E1								
81507	Fetal aneuploidy trisom risk	A								
81508	Ftl cgen abnor two proteins	Q4								
81509	Ftl cgen abnor 3 proteins	Q4								
81510	Ftl cgen abnor three anal	Q4								
81511	Ftl cgen abnor four anal	Q4								
81512	Ftl cgen abnor five anal	Q4								
81518	Onc brst mrna 11 genes	A								
81519	Oncology breast mrna	A								
81520	Onc breast mrna 58 genes	A								
81521	Onc breast mrna 70 genes	A								
81522	Onc breast mrna 12 genes	A								
81525	Oncology colon mrna	A								
81528	Oncology colorectal scr	A								
81535	Oncology gynecologic	Q4								
81536	Oncology gynecologic	Q4								
81538	Oncology lung	A								
81539	Oncology prostate prob score	Q4								
81540	Oncology tum unknown origin	A								
81541	Onc prostate mrna 46 genes	A								
81542	Onc prostate mrna 22 cnt gen	A								
81545	Oncology thyroid	A								
81551	Onc prostate 3 genes	A								
81552	Onc uveal mlnma mrna 15 gene	A								
81595	Cardiology hrt trnspl mrna	A								
81596	Nfct ds chrnc hcv 6 assays	A								
81599	Unlisted maaa	A								
82009	Test for acetone/ketones	Q4								
82010	Acetone assay	Q4								
82013	Acetylcholinesterase assay	Q4								
82016	Acylcarnitines qual	Q4								
82017	Acylcarnitines quant	Q4								
82024	Assay of acth	Q4								
82030	Assay of adp & amp	Q4								
82040	Assay of serum albumin	Q4								
82042	Other source albumin quan ea	Q4								
82043	Ur albumin quantitative	Q4								
82044	Ur albumin semiquantitative	Q4								
82045	Albumin ischemia modified	Q4								
82075	Assay of breath ethanol	Q4								
82085	Assay of aldolase	Q4								
82088	Assay of aldosterone	Q4								
82103	Alpha-1-antitrypsin total	Q4								
82104	Alpha-1-antitrypsin pheno	Q4								
82105	Alpha-fetoprotein serum	Q4								
82106	Alpha-fetoprotein amniotic	Q4								
82107	Alpha-fetoprotein l3	Q4								
82108	Assay of aluminum	Q4								
82120	Amines vaginal fluid qual	Q4								
82127	Amino acid single qual	Q4								
82128	Amino acids mult qual	Q4								
82131	Amino acids single quant	Q4								
82135	Assay aminolevulinic acid	Q4								
82136	Amino acids quant 2-5	Q4								
82139	Amino acids quan 6 or more	Q4								
82140	Assay of ammonia	Q4								
82143	Amniotic fluid scan	Q4								
82150	Assay of amylase	Q4								
82154	Androstanediol glucuronide	Q4								
82157	Assay of androstenedione	Q4								
82160	Assay of androsterone	Q4								
82163	Assay of angiotensin ii	Q4								
82164	Angiotensin i enzyme test	Q4								
82172	Assay of apolipoprotein	Q4								
82175	Assay of arsenic	Q4								
82180	Assay of ascorbic acid	Q4								
82190	Atomic absorption	Q4								
82232	Assay of beta-2 protein	Q4								
82239	Bile acids total	Q4								
82240	Bile acids cholylglycine	Q4								
82247	Bilirubin total	Q4								
82248	Bilirubin direct	Q4								
82252	Fecal bilirubin test	Q4								
82261	Assay of biotinidase	Q4								
82270	Occult blood feces	A								
82271	Occult blood other sources	Q4								
82272	Occult bld feces 1-3 tests	Q4								
82274	Assay test for blood fecal	Q4								
82286	Assay of bradykinin	Q4								
82300	Assay of cadmium	Q4								
82306	Vitamin d 25 hydroxy	Q4								
82308	Assay of calcitonin	Q4								
82310	Assay of calcium	Q4								
82330	Assay of calcium	Q4								
82331	Calcium infusion test	Q4								
82340	Assay of calcium in urine	Q4								
82355	Calculus analysis qual	Q4								
82360	Calculus assay quant	Q4								
82365	Calculus spectroscopy	Q4								
82370	X-ray assay calculus	Q4								
82373	Assay c-d transfer measure	Q4								
82374	Assay blood carbon dioxide	Q4								
82375	Assay carboxyhb quant	Q4								
82376	Assay carboxyhb qual	Q4								
82378	Carcinoembryonic antigen	Q4								
82379	Assay of carnitine	Q4								
82380	Assay of carotene	Q4								
82382	Assay urine catecholamines	Q4								
82383	Assay blood catecholamines	Q4								
82384	Assay three catecholamines	Q4								
82387	Assay of cathepsin-d	Q4								
82390	Assay of ceruloplasmin	Q4								
82397	Chemiluminescent assay	Q4								
82415	Assay of chloramphenicol	Q4								
82435	Assay of blood chloride	Q4								
82436	Assay of urine chloride	Q4								
82438	Assay other fluid chlorides	Q4								
82441	Test for chlorohydrocarbons	Q4								
82465	Assay bld/serum cholesterol	A								
82480	Assay serum cholinesterase	Q4								
82482	Assay rbc cholinesterase	Q4								
82485	Assay chondroitin sulfate	Q4								
82495	Assay of chromium	Q4								
82507	Assay of citrate	Q4								
82523	Collagen crosslinks	Q4								
82525	Assay of copper	Q4								
82528	Assay of corticosterone	Q4								
82530	Cortisol free	Q4								
82533	Total cortisol	Q4								
82540	Assay of creatine	Q4								
82542	Col chromotography qual/quan	Q4								
82550	Assay of ck (cpk)	Q4								
82552	Assay of cpk in blood	Q4								
82553	Creatine mb fraction	Q4								
82554	Creatine isoforms	Q4								
82565	Assay of creatinine	Q4								
82570	Assay of urine creatinine	Q4								
82575	Creatinine clearance test	Q4								
82585	Assay of cryofibrinogen	Q4								
82595	Assay of cryoglobulin	Q4								
82600	Assay of cyanide	Q4								
82607	Vitamin b-12	Q4								
82608	B-12 binding capacity	Q4								
82610	Cystatin c	Q4								
82615	Test for urine cystines	Q4								
82626	Dehydroepiandrosterone	Q4								
82627	Dehydroepiandrosterone	Q4								
82633	Desoxycorticosterone	Q4								
82634	Deoxycortisol	Q4								
82638	Assay of dibucaine number	Q4								
82642	Dihydrotestosterone	Q4								
82652	Vit d 1 25-dihydroxy	Q4								
82656	Pancreatic elastase fecal	Q4								
82657	Enzyme cell activity	Q4								
82658	Enzyme cell activity ra	Q4								
82664	Electrophoretic test	Q4								
82668	Assay of erythropoietin	Q4								
82670	Assay of estradiol	Q4								
82671	Assay of estrogens	Q4								
82672	Assay of estrogen	Q4								
82677	Assay of estriol	Q4								
82679	Assay of estrone	Q4								
82693	Assay of ethylene glycol	Q4								
82696	Assay of etiocholanolone	Q4								
82705	Fats/lipids feces qual	Q4								
82710	Fats/lipids feces quant	Q4								
82715	Assay of fecal fat	Q4								
82725	Assay of blood fatty acids	Q4								
82726	Long chain fatty acids	Q4								
82728	Assay of ferritin	Q4								
82731	Assay of fetal fibronectin	Q4								
82735	Assay of fluoride	Q4								
82746	Assay of folic acid serum	Q4								
82747	Assay of folic acid rbc	Q4								
82757	Assay of semen fructose	Q4								
82759	Assay of rbc galactokinase	Q4								
82760	Assay of galactose	Q4								
82775	Assay galactose transferase	Q4								
82776	Galactose transferase test	Q4								
82777	Galectin-3	Q4								
82784	Assay iga/igd/igg/igm each	Q4								
82785	Assay of ige	Q4								
82787	Igg 1 2 3 or 4 each	Q4								
82800	Blood ph	Q4								
82803	Blood gases any combination	Q4								
82805	Blood gases w/o2 saturation	Q4								
82810	Blood gases o2 sat only	Q4								
82820	Hemoglobin-oxygen affinity	Q4								
82930	Gastric analy w/ph ea spec	Q4								
82938	Gastrin test	Q4								
82941	Assay of gastrin	Q4								
82943	Assay of glucagon	Q4								
82945	Glucose other fluid	Q4								
82946	Glucagon tolerance test	Q4								
82947	Assay glucose blood quant	A								
82948	Reagent strip/blood glucose	Q4								
82950	Glucose test	A								
82951	Glucose tolerance test (gtt)	A								
82952	Gtt-added samples	Q4								
82955	Assay of g6pd enzyme	Q4								
82960	Test for g6pd enzyme	Q4								
82962	Glucose blood test	Q4								
82963	Assay of glucosidase	Q4								
82965	Assay of gdh enzyme	Q4								
82977	Assay of ggt	Q4								
82978	Assay of glutathione	Q4								
82979	Assay rbc glutathione	Q4								
82985	Assay of glycated protein	Q4								
83001	Assay of gonadotropin (fsh)	Q4								
83002	Assay of gonadotropin (lh)	Q4								
83003	Assay growth hormone (hgh)	Q4								
83006	Growth stimulation gene 2	Q4								
83009	H pylori (c-13) blood	Q4								
83010	Assay of haptoglobin quant	Q4								
83012	Assay of haptoglobins	Q4								
83013	H pylori (c-13) breath	Q4								
83014	H pylori drug admin	Q4								
83015	Heavy metal qual any anal	Q4								
83018	Heavy metal quant each nes	Q4								
83020	Hemoglobin electrophoresis	Q4								
83021	Hemoglobin chromotography	Q4								
83026	Hemoglobin copper sulfate	Q4								
83030	Fetal hemoglobin chemical	Q4								
83033	Fetal hemoglobin assay qual	Q4								
83036	Glycosylated hemoglobin test	Q4								
83037	Glycosylated hb home device	Q4								
83045	Blood methemoglobin test	Q4								
83050	Blood methemoglobin assay	Q4								
83051	Assay of plasma hemoglobin	Q4								
83060	Blood sulfhemoglobin assay	Q4								
83065	Assay of hemoglobin heat	Q4								
83068	Hemoglobin stability screen	Q4								
83069	Assay of urine hemoglobin	Q4								
83070	Assay of hemosiderin qual	Q4								
83080	Assay of b hexosaminidase	Q4								
83088	Assay of histamine	Q4								
83090	Assay of homocystine	Q4								
83150	Assay of homovanillic acid	Q4								
83491	Assay of corticosteroids 17	Q4								
83497	Assay of 5-hiaa	Q4								
83498	Assay of progesterone 17-d	Q4								
83500	Assay free hydroxyproline	Q4								
83505	Assay total hydroxyproline	Q4								
83516	Immunoassay nonantibody	Q4								
83518	Immunoassay dipstick	Q4								
83519	Ria nonantibody	Q4								
83520	Immunoassay quant nos nonab	Q4								
83525	Assay of insulin	Q4								
83527	Assay of insulin	Q4								
83528	Assay of intrinsic factor	Q4								
83540	Assay of iron	Q4								
83550	Iron binding test	Q4								
83570	Assay of idh enzyme	Q4								
83582	Assay of ketogenic steroids	Q4								
83586	Assay 17- ketosteroids	Q4								
83593	Fractionation ketosteroids	Q4								
83605	Assay of lactic acid	Q4								
83615	Lactate (ld) (ldh) enzyme	Q4								
83625	Assay of ldh enzymes	Q4								
83630	Lactoferrin fecal (qual)	Q4								
83631	Lactoferrin fecal (quant)	Q4								
83632	Placental lactogen	Q4								
83633	Test urine for lactose	Q4								
83655	Assay of lead	Q4								
83661	L/s ratio fetal lung	Q4								
83662	Foam stability fetal lung	Q4								
83663	Fluoro polarize fetal lung	Q4								
83664	Lamellar bdy fetal lung	Q4								
83670	Assay of lap enzyme	Q4								
83690	Assay of lipase	Q4								
83695	Assay of lipoprotein(a)	Q4								
83698	Assay lipoprotein pla2	Q4								
83700	Lipopro bld electrophoretic	Q4								
83701	Lipoprotein bld hr fraction	Q4								
83704	Lipoprotein bld quan part	Q4								
83718	Assay of lipoprotein	Q4								
83719	Assay of blood lipoprotein	Q4								
83721	Assay of blood lipoprotein	Q4								
83722	Lipoprtn dir meas sd ldl chl	Q4								
83727	Assay of lrh hormone	Q4								
83735	Assay of magnesium	Q4								
83775	Assay malate dehydrogenase	Q4								
83785	Assay of manganese	Q4								
83789	Mass spectrometry qual/quan	Q4								
83825	Assay of mercury	Q4								
83835	Assay of metanephrines	Q4								
83857	Assay of methemalbumin	Q4								
83861	Microfluid analy tears	Q4								
83864	Mucopolysaccharides	Q4								
83872	Assay synovial fluid mucin	Q4								
83873	Assay of csf protein	Q4								
83874	Assay of myoglobin	Q4								
83876	Assay myeloperoxidase	Q4								
83880	Assay of natriuretic peptide	Q4								
83883	Assay nephelometry not spec	Q4								
83885	Assay of nickel	Q4								
83915	Assay of nucleotidase	Q4								
83916	Oligoclonal bands	Q4								
83918	Organic acids total quant	Q4								
83919	Organic acids qual each	Q4								
83921	Organic acid single quant	Q4								
83930	Assay of blood osmolality	Q4								
83935	Assay of urine osmolality	Q4								
83937	Assay of osteocalcin	Q4								
83945	Assay of oxalate	Q4								
83950	Oncoprotein her-2/neu	Q4								
83951	Oncoprotein dcp	Q4								
83970	Assay of parathormone	Q4								
83986	Assay ph body fluid nos	Q4								
83987	Exhaled breath condensate	Q4								
83992	Assay for phencyclidine	E1								
83993	Assay for calprotectin fecal	Q4								
84030	Assay of blood pku	Q4								
84035	Assay of phenylketones	Q4								
84060	Assay acid phosphatase	Q4								
84066	Assay prostate phosphatase	Q4								
84075	Assay alkaline phosphatase	Q4								
84078	Assay alkaline phosphatase	Q4								
84080	Assay alkaline phosphatases	Q4								
84081	Assay phosphatidylglycerol	Q4								
84085	Assay of rbc pg6d enzyme	Q4								
84087	Assay phosphohexose enzymes	Q4								
84100	Assay of phosphorus	Q4								
84105	Assay of urine phosphorus	Q4								
84106	Test for porphobilinogen	Q4								
84110	Assay of porphobilinogen	Q4								
84112	Eval amniotic fluid protein	Q4								
84119	Test urine for porphyrins	Q4								
84120	Assay of urine porphyrins	Q4								
84126	Assay of feces porphyrins	Q4								
84132	Assay of serum potassium	Q4								
84133	Assay of urine potassium	Q4								
84134	Assay of prealbumin	Q4								
84135	Assay of pregnanediol	Q4								
84138	Assay of pregnanetriol	Q4								
84140	Assay of pregnenolone	Q4								
84143	Assay of 17-hydroxypregneno	Q4								
84144	Assay of progesterone	Q4								
84145	Procalcitonin (pct)	Q4								
84146	Assay of prolactin	Q4								
84150	Assay of prostaglandin	Q4								
84152	Assay of psa complexed	Q4								
84153	Assay of psa total	Q4								
84154	Assay of psa free	Q4								
84155	Assay of protein serum	Q4								
84156	Assay of protein urine	Q4								
84157	Assay of protein other	Q4								
84160	Assay of protein any source	Q4								
84163	Pappa serum	Q4								
84165	Protein e-phoresis serum	Q4								
84166	Protein e-phoresis/urine/csf	Q4								
84181	Western blot test	Q4								
84182	Protein western blot test	Q4								
84202	Assay rbc protoporphyrin	Q4								
84203	Test rbc protoporphyrin	Q4								
84206	Assay of proinsulin	Q4								
84207	Assay of vitamin b-6	Q4								
84210	Assay of pyruvate	Q4								
84220	Assay of pyruvate kinase	Q4								
84228	Assay of quinine	Q4								
84233	Assay of estrogen	Q4								
84234	Assay of progesterone	Q4								
84235	Assay of endocrine hormone	Q4								
84238	Assay nonendocrine receptor	Q4								
84244	Assay of renin	Q4								
84252	Assay of vitamin b-2	Q4								
84255	Assay of selenium	Q4								
84260	Assay of serotonin	Q4								
84270	Assay of sex hormone globul	Q4								
84275	Assay of sialic acid	Q4								
84285	Assay of silica	Q4								
84295	Assay of serum sodium	Q4								
84300	Assay of urine sodium	Q4								
84302	Assay of sweat sodium	Q4								
84305	Assay of somatomedin	Q4								
84307	Assay of somatostatin	Q4								
84311	Spectrophotometry	Q4								
84315	Body fluid specific gravity	Q4								
84375	Chromatogram assay sugars	Q4								
84376	Sugars single qual	Q4								
84377	Sugars multiple qual	Q4								
84378	Sugars single quant	Q4								
84379	Sugars multiple quant	Q4								
84392	Assay of urine sulfate	Q4								
84402	Assay of free testosterone	Q4								
84403	Assay of total testosterone	Q4								
84410	Testosterone bioavailable	Q4								
84425	Assay of vitamin b-1	Q4								
84430	Assay of thiocyanate	Q4								
84431	Thromboxane urine	Q4								
84432	Assay of thyroglobulin	Q4								
84436	Assay of total thyroxine	Q4								
84437	Assay of neonatal thyroxine	Q4								
84439	Assay of free thyroxine	Q4								
84442	Assay of thyroid activity	Q4								
84443	Assay thyroid stim hormone	Q4								
84445	Assay of tsi globulin	Q4								
84446	Assay of vitamin e	Q4								
84449	Assay of transcortin	Q4								
84450	Transferase (ast) (sgot)	Q4								
84460	Alanine amino (alt) (sgpt)	Q4								
84466	Assay of transferrin	Q4								
84478	Assay of triglycerides	A								
84479	Assay of thyroid (t3 or t4)	Q4								
84480	Assay triiodothyronine (t3)	Q4								
84481	Free assay (ft-3)	Q4								
84482	T3 reverse	Q4								
84484	Assay of troponin quant	Q4								
84485	Assay duodenal fluid trypsin	Q4								
84488	Test feces for trypsin	Q4								
84490	Assay of feces for trypsin	Q4								
84510	Assay of tyrosine	Q4								
84512	Assay of troponin qual	Q4								
84520	Assay of urea nitrogen	Q4								
84525	Urea nitrogen semi-quant	Q4								
84540	Assay of urine/urea-n	Q4								
84545	Urea-n clearance test	Q4								
84550	Assay of blood/uric acid	Q4								
84560	Assay of urine/uric acid	Q4								
84577	Assay of feces/urobilinogen	Q4								
84578	Test urine urobilinogen	Q4								
84580	Assay of urine urobilinogen	Q4								
84583	Assay of urine urobilinogen	Q4								
84585	Assay of urine vma	Q4								
84586	Assay of vip	Q4								
84588	Assay of vasopressin	Q4								
84590	Assay of vitamin a	Q4								
84591	Assay of nos vitamin	Q4								
84597	Assay of vitamin k	Q4								
84600	Assay of volatiles	Q4								
84620	Xylose tolerance test	Q4								
84630	Assay of zinc	Q4								
84681	Assay of c-peptide	Q4								
84702	Chorionic gonadotropin test	Q4								
84703	Chorionic gonadotropin assay	Q4								
84704	Hcg free betachain test	Q4								
84830	Ovulation tests	Q4								
84999	Clinical chemistry test	Q4								
85002	Bleeding time test	Q4								
85004	Automated diff wbc count	Q4								
85007	Bl smear w/diff wbc count	Q4								
85008	Bl smear w/o diff wbc count	Q4								
85009	Manual diff wbc count b-coat	Q4								
85013	Spun microhematocrit	Q4								
85014	Hematocrit	Q4								
85018	Hemoglobin	Q4								
85025	Complete cbc w/auto diff wbc	Q4								
85027	Complete cbc automated	Q4								
85032	Manual cell count each	Q4								
85041	Automated rbc count	Q4								
85044	Manual reticulocyte count	Q4								
85045	Automated reticulocyte count	Q4								
85046	Reticyte/hgb concentrate	Q4								
85048	Automated leukocyte count	Q4								
85049	Automated platelet count	Q4								
85055	Reticulated platelet assay	Q4								
85060	Blood smear interpretation	B								
85097	Bone marrow interpretation	Q2	5674	7.7754	$628.20	.	$125.64			
85130	Chromogenic substrate assay	Q4								
85170	Blood clot retraction	Q4								
85175	Blood clot lysis time	Q4								
85210	Clot factor ii prothrom spec	Q4								
85220	Blooc clot factor v test	Q4								
85230	Clot factor vii proconvertin	Q4								
85240	Clot factor viii ahg 1 stage	Q4								
85244	Clot factor viii reltd antgn	Q4								
85245	Clot factor viii vw ristoctn	Q4								
85246	Clot factor viii vw antigen	Q4								
85247	Clot factor viii multimetric	Q4								
85250	Clot factor ix ptc/chrstmas	Q4								
85260	Clot factor x stuart-power	Q4								
85270	Clot factor xi pta	Q4								
85280	Clot factor xii hageman	Q4								
85290	Clot factor xiii fibrin stab	Q4								
85291	Clot factor xiii fibrin scrn	Q4								
85292	Clot factor fletcher fact	Q4								
85293	Clot factor wght kininogen	Q4								
85300	Antithrombin iii activity	Q4								
85301	Antithrombin iii antigen	Q4								
85302	Clot inhibit prot c antigen	Q4								
85303	Clot inhibit prot c activity	Q4								
85305	Clot inhibit prot s total	Q4								
85306	Clot inhibit prot s free	Q4								
85307	Assay activated protein c	Q4								
85335	Factor inhibitor test	Q4								
85337	Thrombomodulin	Q4								
85345	Coagulation time lee & white	Q4								
85347	Coagulation time activated	Q4								
85348	Coagulation time otr method	Q4								
85360	Euglobulin lysis	Q4								
85362	Fibrin degradation products	Q4								
85366	Fibrinogen test	Q4								
85370	Fibrinogen test	Q4								
85378	Fibrin degrade semiquant	Q4								
85379	Fibrin degradation quant	Q4								
85380	Fibrin degradj d-dimer	Q4								
85384	Fibrinogen activity	Q4								
85385	Fibrinogen antigen	Q4								
85390	Fibrinolysins screen i&r	Q4								
85396	Clotting assay whole blood	N								
85397	Clotting funct activity	Q4								
85400	Fibrinolytic plasmin	Q4								
85410	Fibrinolytic antiplasmin	Q4								
85415	Fibrinolytic plasminogen	Q4								
85420	Fibrinolytic plasminogen	Q4								
85421	Fibrinolytic plasminogen	Q4								
85441	Heinz bodies direct	Q4								
85445	Heinz bodies induced	Q4								
85460	Hemoglobin fetal	Q4								
85461	Hemoglobin fetal	Q4								
85475	Hemolysin acid	Q4								
85520	Heparin assay	Q4								
85525	Heparin neutralization	Q4								
85530	Heparin-protamine tolerance	Q4								
85536	Iron stain peripheral blood	Q4								
85540	Wbc alkaline phosphatase	Q4								
85547	Rbc mechanical fragility	Q4								
85549	Muramidase	Q4								
85555	Rbc osmotic fragility	Q4								
85557	Rbc osmotic fragility	Q4								
85576	Blood platelet aggregation	Q4								
85597	Phospholipid pltlt neutraliz	Q4								
85598	Hexagnal phosph pltlt neutrl	Q4								
85610	Prothrombin time	Q4								
85611	Prothrombin test	Q4								
85612	Viper venom prothrombin time	Q4								
85613	Russell viper venom diluted	Q4								
85635	Reptilase test	Q4								
85651	Rbc sed rate nonautomated	Q4								
85652	Rbc sed rate automated	Q4								
85660	Rbc sickle cell test	Q4								
85670	Thrombin time plasma	Q4								
85675	Thrombin time titer	Q4								
85705	Thromboplastin inhibition	Q4								
85730	Thromboplastin time partial	Q4								
85732	Thromboplastin time partial	Q4								
85810	Blood viscosity examination	Q4								
85999	Hematology procedure	Q4								
86000	Agglutinins febrile antigen	Q4								
86001	Allergen specific igg	Q4								
86003	Allg spec ige crude xtrc ea	Q4								
86005	Allg spec ige multiallg scr	Q4								
86008	Allg spec ige recomb ea	Q4								
86021	Wbc antibody identification	Q4								
86022	Platelet antibodies	Q4								
86023	Immunoglobulin assay	Q4								
86038	Antinuclear antibodies	Q4								
86039	Antinuclear antibodies (ana)	Q4								
86060	Antistreptolysin o titer	Q4								
86063	Antistreptolysin o screen	Q4								
86077	Phys blood bank serv xmatch	Q1	5731	0.2845	$22.99	.	$4.60			
86078	Phys blood bank serv reactj	Q1	5672	1.7761	$143.50	.	$28.70			
86079	Phys blood bank serv authrj	Q1	5671	0.6123	$49.47	.	$9.90			
86140	C-reactive protein	Q4								
86141	C-reactive protein hs	Q4								
86146	Beta-2 glycoprotein antibody	Q4								
86147	Cardiolipin antibody ea ig	Q4								
86148	Anti-phospholipid antibody	Q4								
86152	Cell enumeration & id	Q4								
86153	Cell enumeration phys interp	B								
86155	Chemotaxis assay	Q4								
86156	Cold agglutinin screen	Q4								
86157	Cold agglutinin titer	Q4								
86160	Complement antigen	Q4								
86161	Complement/function activity	Q4								
86162	Complement total (ch50)	Q4								
86171	Complement fixation each	Q4								
86200	Ccp antibody	Q4								
86215	Deoxyribonuclease antibody	Q4								
86225	Dna antibody native	Q4								
86226	Dna antibody single strand	Q4								
86235	Nuclear antigen antibody	Q4								
86255	Fluorescent antibody screen	Q4								
86256	Fluorescent antibody titer	Q4								
86277	Growth hormone antibody	Q4								
86280	Hemagglutination inhibition	Q4								
86294	Immunoassay tumor qual	Q4								
86300	Immunoassay tumor ca 15-3	Q4								
86301	Immunoassay tumor ca 19-9	Q4								
86304	Immunoassay tumor ca 125	Q4								
86305	Human epididymis protein 4	Q4								
86308	Heterophile antibody screen	Q4								
86309	Heterophile antibody titer	Q4								
86310	Heterophile antibody absrbj	Q4								
86316	Immunoassay tumor other	Q4								
86317	Immunoassay infectious agent	Q4								
86318	Ia infectious agent antibody	Q4								
86320	Serum immunoelectrophoresis	Q4								
86325	Other immunoelectrophoresis	Q4								
86327	Immunoelectrophoresis assay	Q4								
86328	Ia nfct ab sarscov2 covid19	A 								
86329	Immunodiffusion nes	Q4								
86331	Immunodiffusion ouchterlony	Q4								
86332	Immune complex assay	Q4								
86334	Immunofix e-phoresis serum	Q4								
86335	Immunfix e-phorsis/urine/csf	Q4								
86336	Inhibin a	Q4								
86337	Insulin antibodies	Q4								
86340	Intrinsic factor antibody	Q4								
86341	Islet cell antibody	Q4								
86343	Leukocyte histamine release	Q4								
86344	Leukocyte phagocytosis	Q4								
86352	Cell function assay w/stim	Q4								
86353	Lymphocyte transformation	Q4								
86355	B cells total count	Q4								
86356	Mononuclear cell antigen	Q4								
86357	Nk cells total count	Q4								
86359	T cells total count	Q4								
86360	T cell absolute count/ratio	Q4								
86361	T cell absolute count	Q4								
86367	Stem cells total count	Q4								
86376	Microsomal antibody each	Q4								
86382	Neutralization test viral	Q4								
86384	Nitroblue tetrazolium dye	Q4								
86386	Nuclear matrix protein 22	Q4								
86403	Particle agglut antbdy scrn	Q4								
86406	Particle agglut antbdy titr	Q4								
86408	Neutrlzg antb sarscov2 scr	A							*	
86409	Neutrlzg antb sarscov2 titer	A							*	
86413	Sars-cov-2 antb quantitative	A							*	
86430	Rheumatoid factor test qual	Q4								
86431	Rheumatoid factor quant	Q4								
86480	Tb test cell immun measure	Q4								
86481	Tb ag response t-cell susp	Q4								
86485	Skin test candida	Q1	5731	0.2845	$22.99	.	$4.60			
86486	Skin test nos antigen	Q1	5731	0.2845	$22.99	.	$4.60			
86490	Coccidioidomycosis skin test	Q1	5733	0.6809	$55.01	.	$11.01			
86510	Histoplasmosis skin test	Q1	5733	0.6809	$55.01	.	$11.01			
86580	Tb intradermal test	Q1	5731	0.2845	$22.99	.	$4.60			
86590	Streptokinase antibody	Q4								
86592	Syphilis test non-trep qual	A								
86593	Syphilis test non-trep quant	A								
86602	Antinomyces antibody	Q4								
86603	Adenovirus antibody	Q4								
86606	Aspergillus antibody	Q4								
86609	Bacterium antibody	Q4								
86611	Bartonella antibody	Q4								
86612	Blastomyces antibody	Q4								
86615	Bordetella antibody	Q4								
86617	Lyme disease antibody	Q4								
86618	Lyme disease antibody	Q4								
86619	Borrelia antibody	Q4								
86622	Brucella antibody	Q4								
86625	Campylobacter antibody	Q4								
86628	Candida antibody	Q4								
86631	Chlamydia antibody	A								
86632	Chlamydia igm antibody	A								
86635	Coccidioides antibody	Q4								
86638	Q fever antibody	Q4								
86641	Cryptococcus antibody	Q4								
86644	Cmv antibody	Q4								
86645	Cmv antibody igm	Q4								
86648	Diphtheria antibody	Q4								
86651	Encephalitis californ antbdy	Q4								
86652	Encephaltis east eqne anbdy	Q4								
86653	Encephaltis st louis antbody	Q4								
86654	Encephaltis west eqne antbdy	Q4								
86658	Enterovirus antibody	Q4								
86663	Epstein-barr antibody	Q4								
86664	Epstein-barr nuclear antigen	Q4								
86665	Epstein-barr capsid vca	Q4								
86666	Ehrlichia antibody	Q4								
86668	Francisella tularensis	Q4								
86671	Fungus nes antibody	Q4								
86674	Giardia lamblia antibody	Q4								
86677	Helicobacter pylori antibody	Q4								
86682	Helminth antibody	Q4								
86684	Hemophilus influenza antibdy	Q4								
86687	Htlv-i antibody	Q4								
86688	Htlv-ii antibody	Q4								
86689	Htlv/hiv confirmj antibody	Q4								
86692	Hepatitis delta agent antbdy	Q4								
86694	Herpes simplex nes antbdy	Q4								
86695	Herpes simplex type 1 test	Q4								
86696	Herpes simplex type 2 test	Q4								
86698	Histoplasma antibody	Q4								
86701	Hiv-1antibody	Q4								
86702	Hiv-2 antibody	Q4								
86703	Hiv-1/hiv-2 1 result antbdy	Q4								
86704	Hep b core antibody total	Q4								
86705	Hep b core antibody igm	Q4								
86706	Hep b surface antibody	Q4								
86707	Hepatitis be antibody	Q4								
86708	Hepatitis a antibody	Q4								
86709	Hepatitis a igm antibody	Q4								
86710	Influenza virus antibody	Q4								
86711	John cunningham antibody	Q4								
86713	Legionella antibody	Q4								
86717	Leishmania antibody	Q4								
86720	Leptospira antibody	Q4								
86723	Listeria monocytogenes	Q4								
86727	Lymph choriomeningitis ab	Q4								
86732	Mucormycosis antibody	Q4								
86735	Mumps antibody	Q4								
86738	Mycoplasma antibody	Q4								
86741	Neisseria meningitidis	Q4								
86744	Nocardia antibody	Q4								
86747	Parvovirus antibody	Q4								
86750	Malaria antibody	Q4								
86753	Protozoa antibody nos	Q4								
86756	Respiratory virus antibody	Q4								
86757	Rickettsia antibody	Q4								
86759	Rotavirus antibody	Q4								
86762	Rubella antibody	Q4								
86765	Rubeola antibody	Q4								
86768	Salmonella antibody	Q4								
86769	Sars-cov-2 covid-19 antibody	A								
86771	Shigella antibody	Q4								
86774	Tetanus antibody	Q4								
86777	Toxoplasma antibody	Q4								
86778	Toxoplasma antibody igm	Q4								
86780	Treponema pallidum	A								
86784	Trichinella antibody	Q4								
86787	Varicella-zoster antibody	Q4								
86788	West nile virus ab igm	Q4								
86789	West nile virus antibody	Q4								
86790	Virus antibody nos	Q4								
86793	Yersinia antibody	Q4								
86794	Zika virus igm antibody	Q4								
86800	Thyroglobulin antibody	Q4								
86803	Hepatitis c ab test	Q4								
86804	Hep c ab test confirm	Q4								
86805	Lymphocytotoxicity assay	Q4								
86806	Lymphocytotoxicity assay	Q4								
86807	Cytotoxic antibody screening	Q4								
86808	Cytotoxic antibody screening	Q4								
86812	Hla typing a b or c	Q4								
86813	Hla typing a b or c	Q4								
86816	Hla typing dr/dq	Q4								
86817	Hla typing dr/dq	Q4								
86821	Lymphocyte culture mixed	Q4								
86825	Hla x-math non-cytotoxic	Q4								
86826	Hla x-match noncytotoxc addl	Q4								
86828	Hla class i&ii antibody qual	Q4								
86829	Hla class i/ii antibody qual	Q4								
86830	Hla class i phenotype qual	Q4								
86831	Hla class ii phenotype qual	Q4								
86832	Hla class i high defin qual	Q4								
86833	Hla class ii high defin qual	Q4								
86834	Hla class i semiquant panel	Q4								
86835	Hla class ii semiquant panel	Q4								
86849	Immunology procedure	N								
86850	Rbc antibody screen	Q1	5671	0.6123	$49.47	.	$9.90			
86860	Rbc antibody elution	Q1	5672	1.7761	$143.50	.	$28.70			
86870	Rbc antibody identification	Q2	5673	3.5078	$283.41	.	$56.69			
86880	Coombs test direct	Q1	5732	0.4138	$33.43	.	$6.69			
86885	Coombs test indirect qual	Q1	5672	1.7761	$143.50	.	$28.70			
86886	Coombs test indirect titer	Q1	5672	1.7761	$143.50	.	$28.70			
86890	Autologous blood process	Q1	5672	1.7761	$143.50	.	$28.70			
86891	Autologous blood op salvage	Q1	5674	7.7754	$628.20	.	$125.64			
86900	Blood typing serologic abo	Q1	5734	1.3495	$109.03	.	$21.81			
86901	Blood typing serologic rh(d)	Q1	5732	0.4138	$33.43	.	$6.69			
86902	Blood type antigen donor ea	Q1	5673	3.5078	$283.41	.	$56.69			
86904	Blood typing patient serum	Q1	5732	0.4138	$33.43	.	$6.69			
86905	Blood typing rbc antigens	Q1	5673	3.5078	$283.41	.	$56.69			
86906	Bld typing serologic rh phnt	Q1	5732	0.4138	$33.43	.	$6.69			
86910	Blood typing paternity test	E1								
86911	Blood typing antigen system	E1								
86920	Compatibility test spin	Q1	5672	1.7761	$143.50	.	$28.70			
86921	Compatibility test incubate	Q1	5672	1.7761	$143.50	.	$28.70			
86922	Compatibility test antiglob	Q1	5672	1.7761	$143.50	.	$28.70			
86923	Compatibility test electric	Q1	5672	1.7761	$143.50	.	$28.70			
86927	Plasma fresh frozen	S	5672	1.7761	$143.50	.	$28.70			
86930	Frozen blood prep	Q1	5673	3.5078	$283.41	.	$56.69			
86931	Frozen blood thaw	Q1	5673	3.5078	$283.41	.	$56.69			
86932	Frozen blood freeze/thaw	Q1	5732	0.4138	$33.43	.	$6.69			
86940	Hemolysins/agglutinins auto	Q4								
86941	Hemolysins/agglutinins	Q4								
86945	Blood product/irradiation	Q1	5732	0.4138	$33.43	.	$6.69			
86950	Leukacyte transfusion	Q1	5672	1.7761	$143.50	.	$28.70			
86960	Vol reduction of blood/prod	Q1	5672	1.7761	$143.50	.	$28.70			
86965	Pooling blood platelets	Q1	5672	1.7761	$143.50	.	$28.70			
86970	Rbc pretx incubatj w/chemicl	Q1	5732	0.4138	$33.43	.	$6.69			
86971	Rbc pretx incubatj w/enzymes	Q1	5673	3.5078	$283.41	.	$56.69			
86972	Rbc pretx incubatj w/density	Q1	5672	1.7761	$143.50	.	$28.70			
86975	Rbc serum pretx incubj drugs	Q1	5734	1.3495	$109.03	.	$21.81			
86976	Rbc serum pretx id dilution	Q1	5731	0.2845	$22.99	.	$4.60			
86977	Rbc serum pretx incubj/inhib	Q1	5672	1.7761	$143.50	.	$28.70			
86978	Rbc pretreatment serum	Q1	5732	0.4138	$33.43	.	$6.69			
86985	Split blood or products	Q1	5672	1.7761	$143.50	.	$28.70			
86999	Transfusion procedure	Q1	5731	0.2845	$22.99	.	$4.60			
87003	Small animal inoculation	Q4								
87015	Specimen infect agnt concntj	Q4								
87040	Blood culture for bacteria	Q4								
87045	Feces culture aerobic bact	Q4								
87046	Stool cultr aerobic bact ea	Q4								
87070	Culture othr specimn aerobic	Q4								
87071	Culture aerobic quant other	Q4								
87073	Culture bacteria anaerobic	Q4								
87075	Cultr bacteria except blood	Q4								
87076	Culture anaerobe ident each	Q4								
87077	Culture aerobic identify	Q4								
87081	Culture screen only	Q4								
87084	Culture of specimen by kit	Q4								
87086	Urine culture/colony count	Q4								
87088	Urine bacteria culture	Q4								
87101	Skin fungi culture	Q4								
87102	Fungus isolation culture	Q4								
87103	Blood fungus culture	Q4								
87106	Fungi identification yeast	Q4								
87107	Fungi identification mold	Q4								
87109	Mycoplasma	Q4								
87110	Chlamydia culture	A								
87116	Mycobacteria culture	Q4								
87118	Mycobacteric identification	Q4								
87140	Culture type immunofluoresc	Q4								
87143	Culture typing glc/hplc	Q4								
87147	Culture type immunologic	Q4								
87149	Dna/rna direct probe	Q4								
87150	Dna/rna amplified probe	Q4								
87152	Culture type pulse field gel	Q4								
87153	Dna/rna sequencing	Q4								
87158	Culture typing added method	Q4								
87164	Dark field examination	Q4								
87166	Dark field examination	Q4								
87168	Macroscopic exam arthropod	Q4								
87169	Macroscopic exam parasite	Q4								
87172	Pinworm exam	Q4								
87176	Tissue homogenization cultr	Q4								
87177	Ova and parasites smears	Q4								
87181	Microbe susceptible diffuse	Q4								
87184	Microbe susceptible disk	Q4								
87185	Microbe susceptible enzyme	Q4								
87186	Microbe susceptible mic	Q4								
87187	Microbe susceptible mlc	Q4								
87188	Microbe suscept macrobroth	Q4								
87190	Microbe suscept mycobacteri	Q4								
87197	Bactericidal level serum	Q4								
87205	Smear gram stain	Q4								
87206	Smear fluorescent/acid stai	Q4								
87207	Smear special stain	Q4								
87209	Smear complex stain	Q4								
87210	Smear wet mount saline/ink	Q4								
87220	Tissue exam for fungi	Q4								
87230	Assay toxin or antitoxin	Q4								
87250	Virus inoculate eggs/animal	Q4								
87252	Virus inoculation tissue	Q4								
87253	Virus inoculate tissue addl	Q4								
87254	Virus inoculation shell via	Q4								
87255	Genet virus isolate hsv	Q4								
87260	Adenovirus ag if	Q4								
87265	Pertussis ag if	Q4								
87267	Enterovirus antibody dfa	Q4								
87269	Giardia ag if	Q4								
87270	Chlamydia trachomatis ag if	A								
87271	Cytomegalovirus dfa	Q4								
87272	Cryptosporidium ag if	Q4								
87273	Herpes simplex 2 ag if	Q4								
87274	Herpes simplex 1 ag if	Q4								
87275	Influenza b ag if	Q4								
87276	Influenza a ag if	Q4								
87278	Legion pneumophilia ag if	Q4								
87279	Parainfluenza ag if	Q4								
87280	Respiratory syncytial ag if	Q4								
87281	Pneumocystis carinii ag if	Q4								
87283	Rubeola ag if	Q4								
87285	Treponema pallidum ag if	Q4								
87290	Varicella zoster ag if	Q4								
87299	Antibody detection nos if	Q4								
87300	Ag detection polyval if	Q4								
87301	Adenovirus ag ia	Q4								
87305	Aspergillus ag ia	Q4								
87320	Chylmd trach ag ia	A								
87324	Clostridium ag ia	Q4								
87327	Cryptococcus neoform ag ia	Q4								
87328	Cryptosporidium ag ia	Q4								
87329	Giardia ag ia	Q4								
87332	Cytomegalovirus ag ia	Q4								
87335	E coli 0157 ag ia	Q4								
87336	Entamoeb hist dispr ag ia	Q4								
87337	Entamoeb hist group ag ia	Q4								
87338	Hpylori stool ia	Q4								
87339	H pylori ag ia	Q4								
87340	Hepatitis b surface ag ia	Q4								
87341	Hepatitis b surface ag ia	A								
87350	Hepatitis be ag ia	Q4								
87380	Hepatitis delta ag ia	Q4								
87385	Histoplasma capsul ag ia	Q4								
87389	Hiv-1 ag w/hiv-1 & hiv-2 ab	Q4								
87390	Hiv-1 ag ia	Q4								
87391	Hiv-2 ag ia	Q4								
87400	Influenza a/b ag ia	Q4								
87420	Resp syncytial ag ia	Q4								
87425	Rotavirus ag ia	Q4								
87426	Coronavirus ag ia	A							*	
87427	Shiga-like toxin ag ia	Q4								
87430	Strep a ag ia	Q4								
87449	Ag detect nos ia mult	Q4								
87450	Ag detect nos ia single	Q4								
87451	Ag detect polyval ia mult	Q4								
87471	Bartonella dna amp probe	Q4								
87472	Bartonella dna quant	Q4								
87475	Lyme dis dna dir probe	Q4								
87476	Lyme dis dna amp probe	Q4								
87480	Candida dna dir probe	Q4								
87481	Candida dna amp probe	Q4								
87482	Candida dna quant	Q4								
87483	Cns dna amp probe type 12-25	Q4								
87485	Chylmd pneum dna dir probe	Q4								
87486	Chylmd pneum dna amp probe	Q4								
87487	Chylmd pneum dna quant	Q4								
87490	Chylmd trach dna dir probe	Q4								
87491	Chylmd trach dna amp probe	Q4								
87492	Chylmd trach dna quant	Q4								
87493	C diff amplified probe	Q4								
87495	Cytomeg dna dir probe	Q4								
87496	Cytomeg dna amp probe	Q4								
87497	Cytomeg dna quant	Q4								
87498	Enterovirus probe&revrs trns	Q4								
87500	Vanomycin dna amp probe	Q4								
87501	Influenza dna amp prob 1+	Q4								
87502	Influenza dna amp probe	Q4								
87503	Influenza dna amp prob addl	Q4								
87505	Nfct agent detection gi	Q4								
87506	Iadna-dna/rna probe tq 6-11	Q4								
87507	Iadna-dna/rna probe tq 12-25	Q4								
87510	Gardner vag dna dir probe	Q4								
87511	Gardner vag dna amp probe	Q4								
87512	Gardner vag dna quant	Q4								
87516	Hepatitis b dna amp probe	Q4								
87517	Hepatitis b dna quant	Q4								
87520	Hepatitis c rna dir probe	Q4								
87521	Hepatitis c probe&rvrs trnsc	Q4								
87522	Hepatitis c revrs trnscrpj	Q4								
87525	Hepatitis g dna dir probe	Q4								
87526	Hepatitis g dna amp probe	Q4								
87527	Hepatitis g dna quant	Q4								
87528	Hsv dna dir probe	Q4								
87529	Hsv dna amp probe	Q4								
87530	Hsv dna quant	Q4								
87531	Hhv-6 dna dir probe	Q4								
87532	Hhv-6 dna amp probe	Q4								
87533	Hhv-6 dna quant	Q4								
87534	Hiv-1 dna dir probe	Q4								
87535	Hiv-1 probe&reverse trnscrpj	Q4								
87536	Hiv-1 quant&revrse trnscrpj	Q4								
87537	Hiv-2 dna dir probe	Q4								
87538	Hiv-2 probe&revrse trnscripj	Q4								
87539	Hiv-2 quant&revrse trnscripj	Q4								
87540	Legion pneumo dna dir prob	Q4								
87541	Legion pneumo dna amp prob	Q4								
87542	Legion pneumo dna quant	Q4								
87550	Mycobacteria dna dir probe	Q4								
87551	Mycobacteria dna amp probe	Q4								
87552	Mycobacteria dna quant	Q4								
87555	M.tuberculo dna dir probe	Q4								
87556	M.tuberculo dna amp probe	Q4								
87557	M.tuberculo dna quant	Q4								
87560	M.avium-intra dna dir prob	Q4								
87561	M.avium-intra dna amp prob	Q4								
87562	M.avium-intra dna quant	Q4								
87563	M. genitalium amp probe	Q4								
87580	M.pneumon dna dir probe	Q4								
87581	M.pneumon dna amp probe	Q4								
87582	M.pneumon dna quant	Q4								
87590	N.gonorrhoeae dna dir prob	Q4								
87591	N.gonorrhoeae dna amp prob	Q4								
87592	N.gonorrhoeae dna quant	Q4								
87623	Hpv low-risk types	Q4								
87624	Hpv high-risk types	Q4								
87625	Hpv types 16 & 18 only	Q4								
87631	Resp virus 3-5 targets	Q4								
87632	Resp virus 6-11 targets	Q4								
87633	Resp virus 12-25 targets	Q4								
87634	Rsv dna/rna amp probe	Q4								
87635	Sars-cov-2 covid-19 amp prb	A								
87640	Staph a dna amp probe	Q4								
87641	Mr-staph dna amp probe	Q4								
87650	Strep a dna dir probe	Q4								
87651	Strep a dna amp probe	Q4								
87652	Strep a dna quant	Q4								
87653	Strep b dna amp probe	Q4								
87660	Trichomonas vagin dir probe	Q4								
87661	Trichomonas vaginalis amplif	Q4								
87662	Zika virus dna/rna amp probe	Q4								
87797	Detect agent nos dna dir	Q4								
87798	Detect agent nos dna amp	Q4								
87799	Detect agent nos dna quant	Q4								
87800	Detect agnt mult dna direc	Q4								
87801	Detect agnt mult dna ampli	Q4								
87802	Strep b assay w/optic	Q4								
87803	Clostridium toxin a w/optic	Q4								
87804	Influenza assay w/optic	Q4								
87806	Hiv antigen w/hiv antibodies	Q4								
87807	Rsv assay w/optic	Q4								
87808	Trichomonas assay w/optic	Q4								
87809	Adenovirus assay w/optic	Q4								
87810	Chylmd trach assay w/optic	A								
87850	N. gonorrhoeae assay w/optic	A								
87880	Strep a assay w/optic	Q4								
87899	Agent nos assay w/optic	Q4								
87900	Phenotype infect agent drug	Q4								
87901	Genotype dna hiv reverse t	Q4								
87902	Genotype dna/rna hep c	Q4								
87903	Phenotype dna hiv w/culture	Q4								
87904	Phenotype dna hiv w/clt add	Q4								
87905	Sialidase enzyme assay	Q4								
87906	Genotype dna/rna hiv	Q4								
87910	Genotype cytomegalovirus	Q4								
87912	Genotype dna hepatitis b	Q4								
87999	Microbiology procedure	N								
88000	Autopsy (necropsy) gross	E1								
88005	Autopsy (necropsy) gross	E1								
88007	Autopsy (necropsy) gross	E1								
88012	Autopsy (necropsy) gross	E1								
88014	Autopsy (necropsy) gross	E1								
88016	Autopsy (necropsy) gross	E1								
88020	Autopsy (necropsy) complete	E1								
88025	Autopsy (necropsy) complete	E1								
88027	Autopsy (necropsy) complete	E1								
88028	Autopsy (necropsy) complete	E1								
88029	Autopsy (necropsy) complete	E1								
88036	Limited autopsy	E1								
88037	Limited autopsy	E1								
88040	Forensic autopsy (necropsy)	E1								
88045	Coroners autopsy (necropsy)	E1								
88099	Necropsy (autopsy) procedure	E1								
88104	Cytopath fl nongyn smears	Q1	5732	0.4138	$33.43	.	$6.69			
88106	Cytopath fl nongyn filter	Q1	5731	0.2845	$22.99	.	$4.60			
88108	Cytopath concentrate tech	Q1	5732	0.4138	$33.43	.	$6.69			
88112	Cytopath cell enhance tech	Q1	5671	0.6123	$49.47	.	$9.90			
88120	Cytp urne 3-5 probes ea spec	Q2	5672	1.7761	$143.50	.	$28.70			
88121	Cytp urine 3-5 probes cmptr	Q1	5673	3.5078	$283.41	.	$56.69			
88125	Forensic cytopathology	Q1	5671	0.6123	$49.47	.	$9.90			
88130	Sex chromatin identification	Q4								
88140	Sex chromatin identification	Q4								
88141	Cytopath c/v interpret	N								
88142	Cytopath c/v thin layer	Q4								
88143	Cytopath c/v thin layer redo	Q4								
88147	Cytopath c/v automated	Q4								
88148	Cytopath c/v auto rescreen	Q4								
88150	Cytopath c/v manual	Q4								
88152	Cytopath c/v auto redo	Q4								
88153	Cytopath c/v redo	Q4								
88155	Cytopath c/v index add-on	Q4								
88160	Cytopath smear other source	Q1	5731	0.2845	$22.99	.	$4.60			
88161	Cytopath smear other source	Q1	5731	0.2845	$22.99	.	$4.60			
88162	Cytopath smear other source	Q1	5671	0.6123	$49.47	.	$9.90			
88164	Cytopath tbs c/v manual	Q4								
88165	Cytopath tbs c/v redo	Q4								
88166	Cytopath tbs c/v auto redo	Q4								
88167	Cytopath tbs c/v select	Q4								
88172	Cytp dx eval fna 1st ea site	Q1	5672	1.7761	$143.50	.	$28.70			
88173	Cytopath eval fna report	Q1	5671	0.6123	$49.47	.	$9.90			
88174	Cytopath c/v auto in fluid	Q4								
88175	Cytopath c/v auto fluid redo	Q4								
88177	Cytp fna eval ea addl	N								
88182	Cell marker study	Q2	5671	0.6123	$49.47	.	$9.90			
88184	Flowcytometry/ tc 1 marker	Q2	5673	3.5078	$283.41	.	$56.69			
88185	Flowcytometry/tc add-on	N								
88187	Flowcytometry/read 2-8	B								
88188	Flowcytometry/read 9-15	B								
88189	Flowcytometry/read 16 & >	B								
88199	Cytopathology procedure	Q1	5671	0.6123	$49.47	.	$9.90			
88230	Tissue culture lymphocyte	Q4								
88233	Tissue culture skin/biopsy	Q4								
88235	Tissue culture placenta	Q4								
88237	Tissue culture bone marrow	Q4								
88239	Tissue culture tumor	Q4								
88240	Cell cryopreserve/storage	Q4								
88241	Frozen cell preparation	Q4								
88245	Chromosome analysis 20-25	Q4								
88248	Chromosome analysis 50-100	Q4								
88249	Chromosome analysis 100	Q4								
88261	Chromosome analysis 5	Q4								
88262	Chromosome analysis 15-20	Q4								
88263	Chromosome analysis 45	Q4								
88264	Chromosome analysis 20-25	Q4								
88267	Chromosome analys placenta	Q4								
88269	Chromosome analys amniotic	Q4								
88271	Cytogenetics dna probe	Q4								
88272	Cytogenetics 3-5	Q4								
88273	Cytogenetics 10-30	Q4								
88274	Cytogenetics 25-99	Q4								
88275	Cytogenetics 100-300	Q4								
88280	Chromosome karyotype study	Q4								
88283	Chromosome banding study	Q4								
88285	Chromosome count additional	Q4								
88289	Chromosome study additional	Q4								
88291	Cyto/molecular report	M								
88299	Cytogenetic study	Q1	5671	0.6123	$49.47	.	$9.90			
88300	Surgical path gross	Q1	5731	0.2845	$22.99	.	$4.60			
88302	Tissue exam by pathologist	Q1	5731	0.2845	$22.99	.	$4.60			
88304	Tissue exam by pathologist	Q1	5671	0.6123	$49.47	.	$9.90			
88305	Tissue exam by pathologist	Q1	5671	0.6123	$49.47	.	$9.90			
88307	Tissue exam by pathologist	Q2	5673	3.5078	$283.41	.	$56.69			
88309	Tissue exam by pathologist	Q2	5674	7.7754	$628.20	.	$125.64			
88311	Decalcify tissue	N								
88312	Special stains group 1	Q1	5671	0.6123	$49.47	.	$9.90			
88313	Special stains group 2	Q1	5732	0.4138	$33.43	.	$6.69			
88314	Histochemical stains add-on	N								
88319	Enzyme histochemistry	Q2	5674	7.7754	$628.20	.	$125.64			
88321	Microslide consultation	Q1	5732	0.4138	$33.43	.	$6.69			
88323	Microslide consultation	Q1	5671	0.6123	$49.47	.	$9.90			
88325	Comprehensive review of data	Q1	5671	0.6123	$49.47	.	$9.90			
88329	Path consult introp	Q1	5732	0.4138	$33.43	.	$6.69			
88331	Path consult intraop 1 bloc	Q1	5672	1.7761	$143.50	.	$28.70			
88332	Path consult intraop addl	N								
88333	Intraop cyto path consult 1	Q2	5674	7.7754	$628.20	.	$125.64			
88334	Intraop cyto path consult 2	N								
88341	Immunohisto antb addl slide	N								
88342	Immunohisto antb 1st stain	Q2	5672	1.7761	$143.50	.	$28.70			
88344	Immunohisto antibody slide	Q1	5673	3.5078	$283.41	.	$56.69			
88346	Immunofluor antb 1st stain	Q2	5673	3.5078	$283.41	.	$56.69			
88348	Electron microscopy	Q2	5674	7.7754	$628.20	.	$125.64			
88350	Immunofluor antb addl stain	N								
88355	Analysis skeletal muscle	Q1	5672	1.7761	$143.50	.	$28.70			
88356	Analysis nerve	Q1	5671	0.6123	$49.47	.	$9.90			
88358	Analysis tumor	Q2	5672	1.7761	$143.50	.	$28.70			
88360	Tumor immunohistochem/manual	Q2	5672	1.7761	$143.50	.	$28.70			
88361	Tumor immunohistochem/comput	Q2	5673	3.5078	$283.41	.	$56.69			
88362	Nerve teasing preparations	Q2	5674	7.7754	$628.20	.	$125.64			
88363	Xm archive tissue molec anal	Q1	5731	0.2845	$22.99	.	$4.60			
88364	Insitu hybridization (fish)	N								
88365	Insitu hybridization (fish)	Q1	5672	1.7761	$143.50	.	$28.70			
88366	Insitu hybridization (fish)	Q1	5673	3.5078	$283.41	.	$56.69			
88367	Insitu hybridization auto	Q2	5673	3.5078	$283.41	.	$56.69			
88368	Insitu hybridization manual	Q2	5673	3.5078	$283.41	.	$56.69			
88369	M/phmtrc alysishquant/semiq	N								
88371	Protein western blot tissue	N								
88372	Protein analysis w/probe	N								
88373	M/phmtrc alys ishquant/semiq	N								
88374	M/phmtrc alys ishquant/semiq	Q1	5672	1.7761	$143.50	.	$28.70			
88375	Optical endomicroscpy interp	B								
88377	M/phmtrc alys ishquant/semiq	Q1	5672	1.7761	$143.50	.	$28.70			
88380	Microdissection laser	N								
88381	Microdissection manual	N								
88387	Tiss exam molecular study	N								
88388	Tiss ex molecul study add-on	N								
88399	Surgical pathology procedure	Q1	5671	0.6123	$49.47	.	$9.90			
88720	Bilirubin total transcut	Q4								
88738	Hgb quant transcutaneous	Q4								
88740	Transcutaneous carboxyhb	Q4								
88741	Transcutaneous methb	Q4								
88749	In vivo lab service	Q4								
89049	Chct for mal hyperthermia	Q1	5672	1.7761	$143.50	.	$28.70			
89050	Body fluid cell count	Q4								
89051	Body fluid cell count	Q4								
89055	Leukocyte assessment fecal	Q4								
89060	Exam synovial fluid crystals	Q4								
89125	Specimen fat stain	Q4								
89160	Exam feces for meat fibers	Q4								
89190	Nasal smear for eosinophils	Q4								
89220	Sputum specimen collection	Q1	5672	1.7761	$143.50	.	$28.70			
89230	Collect sweat for test	Q1	5671	0.6123	$49.47	.	$9.90			
89240	Pathology lab procedure	Q1	5671	0.6123	$49.47	.	$9.90			
89250	Cultr oocyte/embryo <4 days	Q1	5672	1.7761	$143.50	.	$28.70			
89251	Cultr oocyte/embryo <4 days	Q2	5672	1.7761	$143.50	.	$28.70			
89253	Embryo hatching	Q1	5672	1.7761	$143.50	.	$28.70			
89254	Oocyte identification	Q1	5672	1.7761	$143.50	.	$28.70			
89255	Prepare embryo for transfer	Q1	5671	0.6123	$49.47	.	$9.90			
89257	Sperm identification	Q1	5671	0.6123	$49.47	.	$9.90			
89258	Cryopreservation embryo(s)	Q2	5674	7.7754	$628.20	.	$125.64			
89259	Cryopreservation sperm	Q1	5672	1.7761	$143.50	.	$28.70			
89260	Sperm isolation simple	Q1	5671	0.6123	$49.47	.	$9.90			
89261	Sperm isolation complex	Q1	5671	0.6123	$49.47	.	$9.90			
89264	Identify sperm tissue	Q1	5671	0.6123	$49.47	.	$9.90			
89268	Insemination of oocytes	Q1	5672	1.7761	$143.50	.	$28.70			
89272	Extended culture of oocytes	Q2	5674	7.7754	$628.20	.	$125.64			
89280	Assist oocyte fertilization	Q2	5674	7.7754	$628.20	.	$125.64			
89281	Assist oocyte fertilization	Q1	5672	1.7761	$143.50	.	$28.70			
89290	Biopsy oocyte polar body	Q1	5672	1.7761	$143.50	.	$28.70			
89291	Biopsy oocyte polar body	Q1	5672	1.7761	$143.50	.	$28.70			
89300	Semen analysis w/huhner	Q4								
89310	Semen analysis w/count	Q4								
89320	Semen anal vol/count/mot	Q4								
89321	Semen anal sperm detection	Q4								
89322	Semen anal strict criteria	Q4								
89325	Sperm antibody test	Q4								
89329	Sperm evaluation test	Q4								
89330	Evaluation cervical mucus	Q4								
89331	Retrograde ejaculation anal	Q4								
89335	Cryopreserve testicular tiss	Q1	5671	0.6123	$49.47	.	$9.90			
89337	Cryopreservation oocyte(s)	Q1	5672	1.7761	$143.50	.	$28.70			
89342	Storage/year embryo(s)	Q1	5672	1.7761	$143.50	.	$28.70			
89343	Storage/year sperm/semen	Q1	5672	1.7761	$143.50	.	$28.70			
89344	Storage/year reprod tissue	Q1	5672	1.7761	$143.50	.	$28.70			
89346	Storage/year oocyte(s)	Q2	5673	3.5078	$283.41	.	$56.69			
89352	Thawing cryopresrved embryo	Q1	5672	1.7761	$143.50	.	$28.70			
89353	Thawing cryopresrved sperm	Q1	5671	0.6123	$49.47	.	$9.90			
89354	Thaw cryoprsvrd reprod tiss	Q1	5672	1.7761	$143.50	.	$28.70			
89356	Thawing cryopresrved oocyte	Q1	5672	1.7761	$143.50	.	$28.70			
89398	Unlisted reprod med lab proc	Q1	5671	0.6123	$49.47	.	$9.90			
9001F	Aortic aneurysm<5cm diam ct	E1								
9002F	Aortic aneurysm 5-5.4cm diam	E1								
9003F	Aortic anrysm5.5-5.9cm diam	M								
9004F	Aortic anrysm 6/> cm diam	M								
9005F	Asympt carot/vrtbrbas sten	E1								
9006F	Sympt sten-tia/strk<120days	M								
9007F	Other carot sten 120 days/>	M								
90281	Human ig im	E1								
90283	Human ig iv	E1								
90284	Human ig sc	E1								
90287	Botulinum antitoxin	E1								
90288	Botulism ig iv	E1								
90291	Cmv ig iv	E1								
90296	Diphtheria antitoxin	K	9315		"$2,957.760"	.	$591.56		*	
90371	Hep b ig im	K	1630		$119.087	.	$23.82		*	
90375	Rabies ig im/sc	K	9133		$273.035	.	$54.61		*	
90376	Rabies ig heat treated	K	9134		$331.803	.	$66.37		*	
90378	Rsv mab im 50mg	K	9003		"$1,838.680"	.	$367.74		*	
90384	Rh ig full-dose im	E1								
90385	Rh ig minidose im	N								
90386	Rh ig iv	E1								
90389	Tetanus ig im	E1								
90393	Vaccina ig im	E2								
90396	Varicella-zoster ig im	K	9135		"$1,703.971"	.	$340.80		*	
90399	Immune globulin	E1								
90460	Im admin 1st/only component	B								
90461	Im admin each addl component	B								
90471	Immunization admin	Q1	5692	0.7484	$60.47	.	$12.10			
90472	Immunization admin each add	N								
90473	Immune admin oral/nasal	Q1	5692	0.7484	$60.47	.	$12.10			
90474	Immune admin oral/nasal addl	N								
90476	Adenovirus vaccine type 4	N								
90477	Adenovirus vaccine type 7	M								
90581	Anthrax vaccine sc or im	E2								
90585	Bcg vaccine percut	M								
90586	Bcg vaccine intravesical	B								
90587	Dengue vacc quad 3 dose subq	E1								
90619	Menacwy-tt vaccine im	E1								
90620	Menb-4c vacc 2 dose im	M								
90621	Menb-fhbp vacc 2/3 dose im	M								
90625	Cholera vaccine live oral	E1								
90630	Flu vacc iiv4 no preserv id	L								
90632	Hepa vaccine adult im	N								
90633	Hepa vacc ped/adol 2 dose im	N								
90634	Hepa vacc ped/adol 3 dose	N								
90636	Hep a/hep b vacc adult im	N								
90644	Hib-mency vacc 6wk-18m0 im	M								
90647	Hib prp-omp vacc 3 dose im	N								
90648	Hib prp-t vaccine 4 dose im	N								
90649	4vhpv vaccine 3 dose im	M								
90650	2vhpv vaccine 3 dose im	M								
90651	9vhpv vaccine 2/3 dose im	M								
90653	Iiv adjuvant vaccine im	L								
90654	Flu vacc iiv3 no preserv id	L								
90655	Iiv3 vacc no prsv 0.25 ml im	L								
90656	Iiv3 vacc no prsv 0.5 ml im	L								
90657	Iiv3 vaccine splt 0.25 ml im	L								
90658	Iiv3 vaccine splt 0.5 ml im	E1								
90660	Laiv3 vaccine intranasal	L								
90661	Cciiv3 vac no prsv 0.5 ml im	L								
90662	Iiv no prsv increased ag im	L								
90664	Laiv vacc pandemic intranasl	E1								
90666	Flu vac pandem prsrv free im	E1								
90667	Iiv vacc pandemic adjuvt im	E1								
90668	Iiv vaccine pandemic im	E1								
90670	Pcv13 vaccine im	L								
90672	Laiv4 vaccine intranasal	L								
90673	Riv3 vaccine no preserv im	L								
90674	Cciiv4 vac no prsv 0.5 ml im	L								
90675	Rabies vaccine im	K	9139		$303.241	.	$60.65		*	
90676	Rabies vaccine id	K	9140		$227.530	.	$45.51		*	
90680	Rv5 vacc 3 dose live oral	N								
90681	Rv1 vacc 2 dose live oral	M								
90682	Riv4 vacc recombinant dna im	L								
90685	Iiv4 vacc no prsv 0.25 ml im	L								
90686	Iiv4 vacc no prsv 0.5 ml im	L								
90687	Iiv4 vaccine splt 0.25 ml im	L								
90688	Iiv4 vaccine splt 0.5 ml im	L								
90689	Vacc iiv4 no prsrv 0.25ml im	L								
90690	Typhoid vaccine oral	N								
90691	Typhoid vaccine im	N								
90694	Vacc aiiv4 no prsrv 0.5ml im	L								
90696	Dtap-ipv vaccine 4-6 yrs im	N								
90697	Dtap-ipv-hib-hepb vaccine im	M								
90698	Dtap-ipv/hib vaccine im	N								
90700	Dtap vaccine < 7 yrs im	N								
90702	Dt vaccine under 7 yrs im	N								
90707	Mmr vaccine sc	N								
90710	Mmrv vaccine sc	N								
90713	Poliovirus ipv sc/im	N								
90714	Td vacc no presv 7 yrs+ im	N								
90715	Tdap vaccine 7 yrs/> im	N								
90716	Var vaccine live subq	M								
90717	Yellow fever vaccine subq	N								
90723	Dtap-hep b-ipv vaccine im	M								
90732	Ppsv23 vacc 2 yrs+ subq/im	L								
90733	Mpsv4 vaccine subq	M								
90734	Menacwyd/menacwycrm vacc im	M								
90736	Hzv vaccine live subq	M								
90738	Inactivated je vacc im	M								
90739	Hepb vacc 2 dose adult im	F								
90740	Hepb vacc 3 dose immunsup im	F								
90743	Hepb vacc 2 dose adolesc im	F								
90744	Hepb vacc 3 dose ped/adol im	F								
90746	Hepb vaccine 3 dose adult im	F								
90747	Hepb vacc 4 dose immunsup im	F								
90748	Hib-hepb vaccine im	E1								
90749	Vaccine toxoid	N								
90750	Hzv vacc recombinant im	M								
90756	Cciiv4 vacc abx free im	L								
90785	Psytx complex interactive	N								
90791	Psych diagnostic evaluation	Q3	5823	1.6259	$131.36	.	$26.28			
90792	Psych diag eval w/med srvcs	Q3	5823	1.6259	$131.36	.	$26.28			
90832	Psytx w pt 30 minutes	Q3	5823	1.6259	$131.36	.	$26.28			
90833	Psytx w pt w e/m 30 min	N								
90834	Psytx w pt 45 minutes	Q3	5823	1.6259	$131.36	.	$26.28			
90836	Psytx w pt w e/m 45 min	N								
90837	Psytx w pt 60 minutes	Q3	5823	1.6259	$131.36	.	$26.28			
90838	Psytx w pt w e/m 60 min	N								
90839	Psytx crisis initial 60 min	Q3	5823	1.6259	$131.36	.	$26.28			
90840	Psytx crisis ea addl 30 min	N								
90845	Psychoanalysis	Q3	5823	1.6259	$131.36	.	$26.28			
90846	Family psytx w/o pt 50 min	Q3	5823	1.6259	$131.36	.	$26.28			
90847	Family psytx w/pt 50 min	Q3	5823	1.6259	$131.36	.	$26.28			
90849	Multiple family group psytx	Q3	5823	1.6259	$131.36	.	$26.28			
90853	Group psychotherapy	Q3	5822	0.9721	$78.54	.	$15.71			
90863	Pharmacologic mgmt w/psytx	E1								
90865	Narcosynthesis	Q3	5823	1.6259	$131.36	.	$26.28			
90867	Tcranial magn stim tx plan	S	5722	3.1327	$253.10	.	$50.62			
90868	Tcranial magn stim tx deli	S	5721	1.7124	$138.35	.	$27.67			
90869	Tcran magn stim redetemine	S	5721	1.7124	$138.35	.	$27.67			
90870	Electroconvulsive therapy	S	5723	6.0105	$485.61	.	$97.13			
90875	Psychophysiological therapy	E1								
90876	Psychophysiological therapy	E1								
90880	Hypnotherapy	Q3	5822	0.9721	$78.54	.	$15.71			
90882	Environmental manipulation	E1								
90885	Psy evaluation of records	N								
90887	Consultation with family	N								
90889	Preparation of report	N								
90899	Psychiatric service/therapy	Q3	5821	0.3382	$27.32	.	$5.47			
90901	Biofeedback train any meth	A								
90912	Bfb training 1st 15 min	A								
90913	Bfb training ea addl 15 min	A								
90935	Hemodialysis one evaluation	S	5401	7.9219	$640.03	.	$128.01			
90937	Hemodialysis repeated eval	B								
90940	Hemodialysis access study	N								
90945	Dialysis one evaluation	V	5024	4.3542	$351.79	.	$70.36			
90947	Dialysis repeated eval	B								
90951	Esrd serv 4 visits p mo <2yr	M								
90952	Esrd serv 2-3 vsts p mo <2yr	M								
90953	Esrd serv 1 visit p mo <2yrs	M								
90954	Esrd serv 4 vsts p mo 2-11	M								
90955	Esrd srv 2-3 vsts p mo 2-11	M								
90956	Esrd srv 1 visit p mo 2-11	M								
90957	Esrd srv 4 vsts p mo 12-19	M								
90958	Esrd srv 2-3 vsts p mo 12-19	M								
90959	Esrd serv 1 vst p mo 12-19	M								
90960	Esrd srv 4 visits p mo 20+	M								
90961	Esrd srv 2-3 vsts p mo 20+	M								
90962	Esrd serv 1 visit p mo 20+	M								
90963	Esrd home pt serv p mo <2yrs	M								
90964	Esrd home pt serv p mo 2-11	M								
90965	Esrd home pt serv p mo 12-19	M								
90966	Esrd home pt serv p mo 20+	M								
90967	Esrd svc pr day pt <2	M								
90968	Esrd svc pr day pt 2-11	M								
90969	Esrd svc pr day pt 12-19	M								
90970	Esrd svc pr day pt 20+	M								
90989	Dialysis training complete	B								
90993	Dialysis training incompl	B								
90997	Hemoperfusion	B								
90999	Dialysis procedure	B								
91010	Esophagus motility study	S	5723	6.0105	$485.61	.	$97.13			
91013	Esophgl motil w/stim/perfus	N								
91020	Gastric motility studies	S	5723	6.0105	$485.61	.	$97.13			
91022	Duodenal motility study	S	5723	6.0105	$485.61	.	$97.13			
91030	Acid perfusion of esophagus	S	5723	6.0105	$485.61	.	$97.13			
91034	Gastroesophageal reflux test	S	5723	6.0105	$485.61	.	$97.13			
91035	G-esoph reflx tst w/electrod	S	5723	6.0105	$485.61	.	$97.13			
91037	Esoph imped function test	S	5722	3.1327	$253.10	.	$50.62			
91038	Esoph imped funct test > 1hr	S	5723	6.0105	$485.61	.	$97.13			
91040	Esoph balloon distension tst	S	5723	6.0105	$485.61	.	$97.13			
91065	Breath hydrogen/methane test	S	5721	1.7124	$138.35	.	$27.67			
91110	Gi tract capsule endoscopy	T	5301	9.7276	$785.92	.	$157.19			
91111	Esophageal capsule endoscopy	T	5301	9.7276	$785.92	.	$157.19			
91112	Gi wireless capsule measure	T	5301	9.7276	$785.92	.	$157.19			
91117	Colon motility 6 hr study	T	5371	2.9074	$234.90	.	$46.98			
91120	Rectal sensation test	S	5721	1.7124	$138.35	.	$27.67			
91122	Anal pressure record	T	5371	2.9074	$234.90	.	$46.98			
91132	Electrogastrography	S	5721	1.7124	$138.35	.	$27.67			
91133	Electrogastrography w/test	Q1	5734	1.3495	$109.03	.	$21.81			
91200	Liver elastography	Q1	5721	1.7124	$138.35	.	$27.67			
91299	Gastroenterology procedure	S	5721	1.7124	$138.35	.	$27.67			
92002	Eye exam new patient	V	5012	1.4349	$115.93	.	$23.19			
92004	Eye exam new patient	V	5012	1.4349	$115.93	.	$23.19			
92012	Eye exam establish patient	V	5012	1.4349	$115.93	.	$23.19			
92014	Eye exam&tx estab pt 1/>vst	V	5012	1.4349	$115.93	.	$23.19			
92015	Determine refractive state	E1								
92018	New eye exam & treatment	J1	5503	23.9526	"$1,935.20"	.	$387.04			
92019	Eye exam & treatment	J1	5503	23.9526	"$1,935.20"	.	$387.04			
92020	Special eye evaluation	Q1	5734	1.3495	$109.03	.	$21.81			
92025	Corneal topography	Q1	5733	0.6809	$55.01	.	$11.01			
92060	Special eye evaluation	Q1	5733	0.6809	$55.01	.	$11.01			
92065	Orthoptic/pleoptic training	Q1	5733	0.6809	$55.01	.	$11.01			
92071	Contact lens fitting for tx	N								
92072	Fit contac lens for managmnt	N								
92081	Visual field examination(s)	Q1	5733	0.6809	$55.01	.	$11.01			
92082	Visual field examination(s)	Q1	5733	0.6809	$55.01	.	$11.01			
92083	Visual field examination(s)	Q1	5734	1.3495	$109.03	.	$21.81			
92100	Serial tonometry exam(s)	N								
92132	Cmptr ophth dx img ant segmt	Q1	5733	0.6809	$55.01	.	$11.01			
92133	Cmptr ophth img optic nerve	Q1	5733	0.6809	$55.01	.	$11.01			
92134	Cptr ophth dx img post segmt	Q1	5733	0.6809	$55.01	.	$11.01			
92136	Ophthalmic biometry	Q1	5734	1.3495	$109.03	.	$21.81			
92145	Corneal hysteresis deter	Q1	5732	0.4138	$33.43	.	$6.69			
92201	Opscpy extnd rta draw uni/bi	Q1	5733	0.6809	$55.01	.	$11.01			
92202	Opscpy extnd on/mac draw	Q1	5733	0.6809	$55.01	.	$11.01			
92227	Remote dx retinal imaging	Q1	5732	0.4138	$33.43	.	$6.69			
92228	Remote retinal imaging mgmt	Q1	5732	0.4138	$33.43	.	$6.69			
92230	Eye exam with photos	Q1	5723	6.0105	$485.61	.	$97.13			
92235	Fluorescein angrph uni/bi	S	5722	3.1327	$253.10	.	$50.62			
92240	Icg angiography uni/bi	S	5722	3.1327	$253.10	.	$50.62			
92242	Fluorescein icg angiography	S	5722	3.1327	$253.10	.	$50.62			
92250	Eye exam with photos	Q1	5734	1.3495	$109.03	.	$21.81			
92260	Ophthalmoscopy/dynamometry	Q1	5732	0.4138	$33.43	.	$6.69			
92265	Eye muscle evaluation	Q1	5733	0.6809	$55.01	.	$11.01			
92270	Electro-oculography	Q1	5734	1.3495	$109.03	.	$21.81			
92273	Full field erg w/i&r	S	5722	3.1327	$253.10	.	$50.62			
92274	Multifocal erg w/i&r	S	5721	1.7124	$138.35	.	$27.67			
92283	Color vision examination	Q1	5733	0.6809	$55.01	.	$11.01			
92284	Dark adaptation eye exam	Q1	5735	4.5003	$363.59	.	$72.72			
92285	Eye photography	Q1	5733	0.6809	$55.01	.	$11.01			
92286	Internal eye photography	Q1	5734	1.3495	$109.03	.	$21.81			
92287	Internal eye photography	Q1	5734	1.3495	$109.03	.	$21.81			
92310	Contact lens fitting	E1								
92311	Contact lens fitting	Q1	5735	4.5003	$363.59	.	$72.72			
92312	Contact lens fitting	Q1	5734	1.3495	$109.03	.	$21.81			
92313	Contact lens fitting	Q1	5734	1.3495	$109.03	.	$21.81			
92314	Prescription of contact lens	E1								
92315	Rx cntact lens aphakia 1 eye	Q1	5734	1.3495	$109.03	.	$21.81			
92316	Rx cntact lens aphakia 2 eye	Q1	5733	0.6809	$55.01	.	$11.01			
92317	Rx corneoscleral cntact lens	Q1	5732	0.4138	$33.43	.	$6.69			
92325	Modification of contact lens	Q1	5734	1.3495	$109.03	.	$21.81			
92326	Replacement of contact lens	Q1	5733	0.6809	$55.01	.	$11.01			
92340	Fit spectacles monofocal	E1								
92341	Fit spectacles bifocal	E1								
92342	Fit spectacles multifocal	E1								
92352	Fit aphakia spectcl monofocl	Q1	5733	0.6809	$55.01	.	$11.01			
92353	Fit aphakia spectcl multifoc	Q1	5733	0.6809	$55.01	.	$11.01			
92354	Fit spectacles single system	Q1	5732	0.4138	$33.43	.	$6.69			
92355	Fit spectacles compound lens	Q1	5732	0.4138	$33.43	.	$6.69			
92358	Aphakia prosth service temp	Q1	5733	0.6809	$55.01	.	$11.01			
92370	Repair & adjust spectacles	E1								
92371	Repair & adjust spectacles	Q1	5733	0.6809	$55.01	.	$11.01			
92499	Eye service or procedure	Q1	5731	0.2845	$22.99	.	$4.60			
92502	Ear and throat examination	T	5162	5.4673	$441.72	.	$88.35			
92504	Ear microscopy examination	N								
92507	Speech/hearing therapy	A								
92508	Speech/hearing therapy	A								
92511	Nasopharyngoscopy	T	5151	1.9377	$156.55	.	$31.31			
92512	Nasal function studies	S	5722	3.1327	$253.10	.	$50.62			
92516	Facial nerve function test	S	5721	1.7124	$138.35	.	$27.67			
92520	Laryngeal function studies	Q1	5734	1.3495	$109.03	.	$21.81			
92521	Evaluation of speech fluency	A								
92522	Evaluate speech production	A								
92523	Speech sound lang comprehen	A								
92524	Behavral qualit analys voice	A								
92526	Oral function therapy	A								
92531	Spontaneous nystagmus study	N								
92532	Positional nystagmus test	N								
92533	Caloric vestibular test	N								
92534	Optokinetic nystagmus test	N								
92537	Caloric vstblr test w/rec	S	5721	1.7124	$138.35	.	$27.67			
92538	Caloric vstblr test w/rec	S	5721	1.7124	$138.35	.	$27.67			
92540	Basic vestibular evaluation	S	5721	1.7124	$138.35	.	$27.67			
92541	Spontaneous nystagmus test	Q1	5734	1.3495	$109.03	.	$21.81			
92542	Positional nystagmus test	Q1	5734	1.3495	$109.03	.	$21.81			
92544	Optokinetic nystagmus test	S	5721	1.7124	$138.35	.	$27.67			
92545	Oscillating tracking test	S	5721	1.7124	$138.35	.	$27.67			
92546	Sinusoidal rotational test	S	5721	1.7124	$138.35	.	$27.67			
92547	Supplemental electrical test	N								
92548	Cdp-sot 6 cond w/i&r	Q1	5734	1.3495	$109.03	.	$21.81			
92549	Cdp-sot 6 cond w/i&r mct&adt	Q1	5734	1.3495	$109.03	.	$21.81			
92550	Tympanometry & reflex thresh	Q1	5721	1.7124	$138.35	.	$27.67			
92551	Pure tone hearing test air	E1								
92552	Pure tone audiometry air	Q1	5734	1.3495	$109.03	.	$21.81			
92553	Audiometry air & bone	Q1	5721	1.7124	$138.35	.	$27.67			
92555	Speech threshold audiometry	Q1	5732	0.4138	$33.43	.	$6.69			
92556	Speech audiometry complete	Q1	5732	0.4138	$33.43	.	$6.69			
92557	Comprehensive hearing test	Q1	5721	1.7124	$138.35	.	$27.67			
92558	Evoked auditory test qual	E1								
92559	Group audiometric testing	E1								
92560	Bekesy audiometry screen	E1								
92561	Bekesy audiometry diagnosis	Q1	5734	1.3495	$109.03	.	$21.81			
92562	Loudness balance test	Q1	5721	1.7124	$138.35	.	$27.67			
92563	Tone decay hearing test	Q1	5732	0.4138	$33.43	.	$6.69			
92564	Sisi hearing test	Q1	5731	0.2845	$22.99	.	$4.60			
92565	Stenger test pure tone	Q1	5732	0.4138	$33.43	.	$6.69			
92567	Tympanometry	Q1	5732	0.4138	$33.43	.	$6.69			
92568	Acoustic refl threshold tst	Q1	5732	0.4138	$33.43	.	$6.69			
92570	Acoustic immitance testing	Q1	5721	1.7124	$138.35	.	$27.67			
92571	Filtered speech hearing test	Q1	5732	0.4138	$33.43	.	$6.69			
92572	Staggered spondaic word test	Q1	5721	1.7124	$138.35	.	$27.67			
92575	Sensorineural acuity test	Q1	5732	0.4138	$33.43	.	$6.69			
92576	Synthetic sentence test	Q1	5732	0.4138	$33.43	.	$6.69			
92577	Stenger test speech	Q1	5723	6.0105	$485.61	.	$97.13			
92579	Visual audiometry (vra)	Q1	5721	1.7124	$138.35	.	$27.67			
92582	Conditioning play audiometry	Q1	5721	1.7124	$138.35	.	$27.67			
92583	Select picture audiometry	Q1	5732	0.4138	$33.43	.	$6.69			
92584	Electrocochleography	S	5721	1.7124	$138.35	.	$27.67			
92585	Auditor evoke potent compre	S	5722	3.1327	$253.10	.	$50.62			
92586	Auditor evoke potent limit	S	5721	1.7124	$138.35	.	$27.67			
92587	Evoked auditory test limited	S	5722	3.1327	$253.10	.	$50.62			
92588	Evoked auditory tst complete	S	5722	3.1327	$253.10	.	$50.62			
92590	Hearing aid exam one ear	E1								
92591	Hearing aid exam both ears	E1								
92592	Hearing aid check one ear	E1								
92593	Hearing aid check both ears	E1								
92594	Electro hearng aid test one	E1								
92595	Electro hearng aid tst both	E1								
92596	Ear protector evaluation	Q1	5732	0.4138	$33.43	.	$6.69			
92597	Oral speech device eval	A								
92601	Cochlear implt f/up exam <7	S	5721	1.7124	$138.35	.	$27.67			
92602	Reprogram cochlear implt <7	S	5721	1.7124	$138.35	.	$27.67			
92603	Cochlear implt f/up exam 7/>	S	5721	1.7124	$138.35	.	$27.67			
92604	Reprogram cochlear implt 7/>	S	5721	1.7124	$138.35	.	$27.67			
92605	Ex for nonspeech device rx	A								
92606	Non-speech device service	A								
92607	Ex for speech device rx 1hr	A								
92608	Ex for speech device rx addl	A								
92609	Use of speech device service	A								
92610	Evaluate swallowing function	A								
92611	Motion fluoroscopy/swallow	A								
92612	Endoscopy swallow (fees) vid	A								
92613	Endoscopy swallow (fees) i&r	B								
92614	Laryngoscopic sensory vid	A								
92615	Laryngoscopic sensory i&r	E1								
92616	Fees w/laryngeal sense test	A								
92617	Fees w/laryngeal sense i&r	E1								
92618	Ex for nonspeech dev rx add	A								
92620	Auditory function 60 min	Q1	5721	1.7124	$138.35	.	$27.67			
92621	Auditory function + 15 min	N								
92625	Tinnitus assessment	Q1	5721	1.7124	$138.35	.	$27.67			
92626	Eval aud funcj 1st hour	Q1	5721	1.7124	$138.35	.	$27.67			
92627	Eval aud funcj ea addl 15	N								
92630	Aud rehab pre-ling hear loss	E1								
92633	Aud rehab postling hear loss	E1								
92640	Aud brainstem implt programg	S	5721	1.7124	$138.35	.	$27.67			
92700	Ent procedure/service	Q1	5731	0.2845	$22.99	.	$4.60			
92920	Prq cardiac angioplast 1 art	J1	5192	61.3161	"$4,953.91"	.	$990.79			
92921	Prq cardiac angio addl art	N								
92924	Prq card angio/athrect 1 art	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
92925	Prq card angio/athrect addl	N								
92928	Prq card stent w/angio 1 vsl	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
92929	Prq card stent w/angio addl	N								
92933	Prq card stent/ath/angio	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
92934	Prq card stent/ath/angio	N								
92937	Prq revasc byp graft 1 vsl	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
92938	Prq revasc byp graft addl	N								
92941	Prq card revasc mi 1 vsl	C								
92943	Prq card revasc chronic 1vsl	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
92944	Prq card revasc chronic addl	N								
92950	Heart/lung resuscitation cpr	S	5722	3.1327	$253.10	.	$50.62			
92953	Temporary external pacing	Q3	5781	6.6399	$536.46	.	$107.30			
92960	Cardioversion electric ext	S	5781	6.6399	$536.46	.	$107.30			
92961	Cardioversion electric int	S	5781	6.6399	$536.46	.	$107.30			
92970	Cardioassist internal	C								
92971	Cardioassist external	C								
92973	Prq coronary mech thrombect	N								
92974	Cath place cardio brachytx	N								
92975	Dissolve clot heart vessel	C								
92977	Dissolve clot heart vessel	T	5694	3.8320	$309.60	.	$61.92			
92978	Endoluminl ivus oct c 1st	N								
92979	Endoluminl ivus oct c ea	N								
92986	Revision of aortic valve	J1	5192	61.3161	"$4,953.91"	.	$990.79			
92987	Revision of mitral valve	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
92990	Revision of pulmonary valve	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
92992	Revision of heart chamber	C								
92993	Revision of heart chamber	C								
92997	Pul art balloon repr percut	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
92998	Pul art balloon repr percut	N								
93000	Electrocardiogram complete	M								
93005	Electrocardiogram tracing	Q1	5733	0.6809	$55.01	.	$11.01			
93010	Electrocardiogram report	B								
93015	Cardiovascular stress test	B								
93016	Cardiovascular stress test	B								
93017	Cardiovascular stress test	Q1	5722	3.1327	$253.10	.	$50.62			
93018	Cardiovascular stress test	B								
93024	Cardiac drug stress test	Q1	5735	4.5003	$363.59	.	$72.72			
93025	Microvolt t-wave assess	S	5721	1.7124	$138.35	.	$27.67			
93040	Rhythm ecg with report	B								
93041	Rhythm ecg tracing	Q1	5733	0.6809	$55.01	.	$11.01			
93042	Rhythm ecg report	B								
93050	Art pressure waveform analys	Q1	5731	0.2845	$22.99	.	$4.60			
93224	Ecg monit/reprt up to 48 hrs	M								
93225	Ecg monit/reprt up to 48 hrs	Q1	5734	1.3495	$109.03	.	$21.81			
93226	Ecg monit/reprt up to 48 hrs	Q1	5734	1.3495	$109.03	.	$21.81			
93227	Ecg monit/reprt up to 48 hrs	M								
93228	Remote 30 day ecg rev/report	M								
93229	Remote 30 day ecg tech supp	S	5721	1.7124	$138.35	.	$27.67			
93260	Prgrmg dev eval impltbl sys	Q1	5741	0.4487	$36.25	.	$7.25			
93261	Interrogate subq defib	Q1	5741	0.4487	$36.25	.	$7.25			
93264	Rem mntr wrls p-art prs snr	M								
93268	Ecg record/review	M								
93270	Remote 30 day ecg rev/report	Q1	5741	0.4487	$36.25	.	$7.25			
93271	Ecg/monitoring and analysis	S	5742	1.4039	$113.43	.	$22.69			
93272	Ecg/review interpret only	M								
93278	Ecg/signal-averaged	Q1	5733	0.6809	$55.01	.	$11.01			
93279	Prgrmg dev eval pm/ldls pm	Q1	5741	0.4487	$36.25	.	$7.25			
93280	Pm device progr eval dual	Q1	5741	0.4487	$36.25	.	$7.25			
93281	Pm device progr eval multi	Q1	5741	0.4487	$36.25	.	$7.25			
93282	Prgrmg eval implantable dfb	Q1	5741	0.4487	$36.25	.	$7.25			
93283	Prgrmg eval implantable dfb	Q1	5741	0.4487	$36.25	.	$7.25			
93284	Prgrmg eval implantable dfb	Q1	5741	0.4487	$36.25	.	$7.25			
93285	Prgrmg dev eval scrms ip	Q1	5741	0.4487	$36.25	.	$7.25			
93286	Peri-px eval pm/ldls pm ip	N								
93287	Peri-px device eval & prgr	N								
93288	Interrog evl pm/ldls pm ip	Q1	5741	0.4487	$36.25	.	$7.25			
93289	Interrog device eval heart	Q1	5741	0.4487	$36.25	.	$7.25			
93290	Interrog dev eval icpms ip	Q1	5741	0.4487	$36.25	.	$7.25			
93291	Interrog dev eval scrms ip	Q1	5731	0.2845	$22.99	.	$4.60			
93292	Wcd device interrogate	Q1	5741	0.4487	$36.25	.	$7.25			
93293	Pm phone r-strip device eval	Q1	5741	0.4487	$36.25	.	$7.25			
93294	Rem interrog evl pm/ldls pm	M								
93295	Dev interrog remote 1/2/mlt	M								
93296	Rem interrog evl pm/ids	Q1	5741	0.4487	$36.25	.	$7.25			
93297	Rem interrog dev eval icpms	M								
93298	Rem interrog dev eval scrms	M								
93303	Echo transthoracic	S	5524	5.9607	$481.58	.	$96.32			
93304	Echo transthoracic	S	5524	5.9607	$481.58	.	$96.32			
93306	Tte w/doppler complete	S	5524	5.9607	$481.58	.	$96.32			
93307	Tte w/o doppler complete	S	5523	2.8844	$233.04	.	$46.61			
93308	Tte f-up or lmtd	S	5523	2.8844	$233.04	.	$46.61			
93312	Echo transesophageal	S	5524	5.9607	$481.58	.	$96.32			
93313	Echo transesophageal	S	5524	5.9607	$481.58	.	$96.32			
93314	Echo transesophageal	N								
93315	Echo transesophageal	S	5524	5.9607	$481.58	.	$96.32			
93316	Echo transesophageal	S	5524	5.9607	$481.58	.	$96.32			
93317	Echo transesophageal	N								
93318	Echo transesophageal intraop	S	5524	5.9607	$481.58	.	$96.32			
93320	Doppler echo exam heart	N								
93321	Doppler echo exam heart	N								
93325	Doppler color flow add-on	N								
93350	Stress tte only	S	5524	5.9607	$481.58	.	$96.32			
93351	Stress tte complete	S	5524	5.9607	$481.58	.	$96.32			
93352	Admin ecg contrast agent	M								
93355	Echo transesophageal (tee)	N								
93356	Myocrd strain img spckl trck	N								
93451	Right heart cath	J1	5191	35.2747	"$2,849.95"	$864.64	$569.99			
93452	Left hrt cath w/ventrclgrphy	J1	5191	35.2747	"$2,849.95"	$864.64	$569.99			
93453	R&l hrt cath w/ventriclgrphy	J1	5191	35.2747	"$2,849.95"	$864.64	$569.99			
93454	Coronary artery angio s&i	J1	5191	35.2747	"$2,849.95"	$864.64	$569.99			
93455	Coronary art/grft angio s&i	J1	5191	35.2747	"$2,849.95"	$864.64	$569.99			
93456	R hrt coronary artery angio	J1	5191	35.2747	"$2,849.95"	$864.64	$569.99			
93457	R hrt art/grft angio	J1	5191	35.2747	"$2,849.95"	$864.64	$569.99			
93458	L hrt artery/ventricle angio	J1	5191	35.2747	"$2,849.95"	$864.64	$569.99			
93459	L hrt art/grft angio	J1	5191	35.2747	"$2,849.95"	$864.64	$569.99			
93460	R&l hrt art/ventricle angio	J1	5191	35.2747	"$2,849.95"	$864.64	$569.99			
93461	R&l hrt art/ventricle angio	J1	5191	35.2747	"$2,849.95"	$864.64	$569.99			
93462	L hrt cath trnsptl puncture	N								
93463	Drug admin & hemodynmic meas	N								
93464	Exercise w/hemodynamic meas	N								
93503	Insert/place heart catheter	J1	5182	20.1890	"$1,631.13"	.	$326.23			
93505	Biopsy of heart lining	J1	5183	34.3010	"$2,771.28"	.	$554.26			
93530	Rt heart cath congenital	J1	5191	35.2747	"$2,849.95"	$864.64	$569.99			
93531	R & l heart cath congenital	J1	5191	35.2747	"$2,849.95"	$864.64	$569.99			
93532	R & l heart cath congenital	J1	5191	35.2747	"$2,849.95"	$864.64	$569.99			
93533	R & l heart cath congenital	J1	5191	35.2747	"$2,849.95"	$864.64	$569.99			
93561	Cardiac output measurement	N								
93562	Card output measure subsq	N								
93563	Inject congenital card cath	N								
93564	Inject hrt congntl art/grft	N								
93565	Inject l ventr/atrial angio	N								
93566	Inject r ventr/atrial angio	N								
93567	Inject suprvlv aortography	N								
93568	Inject pulm art hrt cath	N								
93571	Heart flow reserve measure	N								
93572	Heart flow reserve measure	N								
93580	Transcath closure of asd	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
93581	Transcath closure of vsd	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
93582	Perq transcath closure pda	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
93583	Perq transcath septal reduxn	C								
93590	Perq transcath cls mitral	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
93591	Perq transcath cls aortic	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
93592	Perq transcath closure each	N								
93600	Bundle of his recording	J1	5212	72.8493	"$5,885.71"	.	"$1,177.15"			
93602	Intra-atrial recording	J1	5212	72.8493	"$5,885.71"	.	"$1,177.15"			
93603	Right ventricular recording	J1	5211	12.2233	$987.56	.	$197.52			
93609	Map tachycardia add-on	N								
93610	Intra-atrial pacing	J1	5212	72.8493	"$5,885.71"	.	"$1,177.15"			
93612	Intraventricular pacing	J1	5212	72.8493	"$5,885.71"	.	"$1,177.15"			
93613	Electrophys map 3d add-on	N								
93615	Esophageal recording	J1	5211	12.2233	$987.56	.	$197.52			
93616	Esophageal recording	J1	5211	12.2233	$987.56	.	$197.52			
93618	Heart rhythm pacing	J1	5211	12.2233	$987.56	.	$197.52			
93619	Electrophysiology evaluation	J1	5212	72.8493	"$5,885.71"	.	"$1,177.15"			
93620	Electrophysiology evaluation	J1	5212	72.8493	"$5,885.71"	.	"$1,177.15"			
93621	Electrophysiology evaluation	N								
93622	Electrophysiology evaluation	N								
93623	Stimulation pacing heart	N								
93624	Electrophysiologic study	J1	5212	72.8493	"$5,885.71"	.	"$1,177.15"			
93631	Heart pacing mapping	N								
93640	Evaluation heart device	N								
93641	Electrophysiology evaluation	N								
93642	Electrophysiology evaluation	J1	5211	12.2233	$987.56	.	$197.52			
93644	Electrophysiology evaluation	N								
93650	Ablate heart dysrhythm focus	J1	5212	72.8493	"$5,885.71"	.	"$1,177.15"			
93653	Ep & ablate supravent arrhyt	J1	5213	252.9337	"$20,435.27"	.	"$4,087.06"	*		
93654	Ep & ablate ventric tachy	J1	5213	252.9337	"$20,435.27"	.	"$4,087.06"	*		
93655	Ablate arrhythmia add on	N								
93656	Tx atrial fib pulm vein isol	J1	5213	252.9337	"$20,435.27"	.	"$4,087.06"	*		
93657	Tx l/r atrial fib addl	N								
93660	Tilt table evaluation	S	5723	6.0105	$485.61	.	$97.13			
93662	Intracardiac ecg (ice)	N								
93668	Peripheral vascular rehab	S	5733	0.6809	$55.01	.	$11.01			
93701	Bioimpedance cv analysis	Q1	5734	1.3495	$109.03	.	$21.81			
93702	Bis xtracell fluid analysis	S	5721	1.7124	$138.35	.	$27.67			
93724	Analyze pacemaker system	S	5743	3.3531	$270.91	.	$54.19			
93740	Temperature gradient studies	Q1	5721	1.7124	$138.35	.	$27.67			
93745	Set-up cardiovert-defibrill	S	5743	3.3531	$270.91	.	$54.19			
93750	Interrogation vad in person	S	5742	1.4039	$113.43	.	$22.69			
93770	Measure venous pressure	N								
93784	Ambl bp mntr w/software	B								
93786	Ambl bp mntr w/sw rec only	Q1	5734	1.3495	$109.03	.	$21.81			
93788	Ambl bp mntr w/sw a/r	Q1	5734	1.3495	$109.03	.	$21.81			
93790	Ambl bp mntr w/sw i&r	M								
93792	Pt/caregiver traing home inr	B								
93793	Anticoag mgmt pt warfarin	B								
93797	Cardiac rehab	S	5771	1.3619	$110.03	.	$22.01			
93798	Cardiac rehab/monitor	S	5771	1.3619	$110.03	.	$22.01			
93799	Cardiovascular procedure	S	5721	1.7124	$138.35	.	$27.67			
93880	Extracranial bilat study	S	5523	2.8844	$233.04	.	$46.61			
93882	Extracranial uni/ltd study	S	5522	1.3873	$112.08	.	$22.42			
93886	Intracranial complete study	S	5523	2.8844	$233.04	.	$46.61			
93888	Intracranial limited study	S	5522	1.3873	$112.08	.	$22.42			
93890	Tcd vasoreactivity study	Q1	5523	2.8844	$233.04	.	$46.61			
93892	Tcd emboli detect w/o inj	Q1	5522	1.3873	$112.08	.	$22.42			
93893	Tcd emboli detect w/inj	Q1	5522	1.3873	$112.08	.	$22.42			
93895	Carotid intima atheroma eval	E1								
93922	Upr/l xtremity art 2 levels	Q1	5734	1.3495	$109.03	.	$21.81			
93923	Upr/lxtr art stdy 3+ lvls	S	5721	1.7124	$138.35	.	$27.67			
93924	Lwr xtr vasc stdy bilat	S	5721	1.7124	$138.35	.	$27.67			
93925	Lower extremity study	S	5523	2.8844	$233.04	.	$46.61			
93926	Lower extremity study	S	5522	1.3873	$112.08	.	$22.42			
93930	Upper extremity study	S	5523	2.8844	$233.04	.	$46.61			
93931	Upper extremity study	S	5522	1.3873	$112.08	.	$22.42			
93970	Extremity study	S	5523	2.8844	$233.04	.	$46.61			
93971	Extremity study	S	5522	1.3873	$112.08	.	$22.42			
93975	Vascular study	S	5523	2.8844	$233.04	.	$46.61			
93976	Vascular study	S	5522	1.3873	$112.08	.	$22.42			
93978	Vascular study	S	5523	2.8844	$233.04	.	$46.61			
93979	Vascular study	Q1	5522	1.3873	$112.08	.	$22.42			
93980	Penile vascular study	S	5522	1.3873	$112.08	.	$22.42			
93981	Penile vascular study	S	5522	1.3873	$112.08	.	$22.42			
93985	Dup-scan hemo compl bi std	S	5523	2.8844	$233.04	.	$46.61			
93986	Dup-scan hemo compl uni std	S	5522	1.3873	$112.08	.	$22.42			
93990	Doppler flow testing	Q1	5522	1.3873	$112.08	.	$22.42			
93998	Noninvas vasc dx study proc	Q1	5731	0.2845	$22.99	.	$4.60			
94002	Vent mgmt inpat init day	Q3	5801	5.7496	$464.53	.	$92.91			
94003	Vent mgmt inpat subq day	Q3	5801	5.7496	$464.53	.	$92.91			
94004	Vent mgmt nf per day	B								
94005	Home vent mgmt supervision	M								
94010	Breathing capacity test	Q1	5721	1.7124	$138.35	.	$27.67			
94011	Spirometry up to 2 yrs old	Q1	5721	1.7124	$138.35	.	$27.67			
94012	Spirmtry w/brnchdil inf-2 yr	Q1	5722	3.1327	$253.10	.	$50.62			
94013	Meas lung vol thru 2 yrs	S	5723	6.0105	$485.61	.	$97.13			
94014	Patient recorded spirometry	Q1	5735	4.5003	$363.59	.	$72.72			
94015	Patient recorded spirometry	Q1	5722	3.1327	$253.10	.	$50.62			
94016	Review patient spirometry	A								
94060	Evaluation of wheezing	S	5722	3.1327	$253.10	.	$50.62			
94070	Evaluation of wheezing	S	5722	3.1327	$253.10	.	$50.62			
94150	Vital capacity test	Q1	5721	1.7124	$138.35	.	$27.67			
94200	Lung function test (mbc/mvv)	Q1	5733	0.6809	$55.01	.	$11.01			
94250	Expired gas collection	Q1	5733	0.6809	$55.01	.	$11.01			
94375	Respiratory flow volume loop	Q1	5722	3.1327	$253.10	.	$50.62			
94400	Co2 breathing response curve	Q1	5721	1.7124	$138.35	.	$27.67			
94450	Hypoxia response curve	Q1	5721	1.7124	$138.35	.	$27.67			
94452	Hast w/report	Q1	5734	1.3495	$109.03	.	$21.81			
94453	Hast w/oxygen titrate	Q1	5734	1.3495	$109.03	.	$21.81			
94610	Surfactant admin thru tube	Q1	5791	2.2769	$183.96	.	$36.80			
94617	Exercise tst brncspsm	Q1	5734	1.3495	$109.03	.	$21.81			
94618	Pulmonary stress testing	Q1	5734	1.3495	$109.03	.	$21.81			
94621	Cardiopulm exercise testing	S	5722	3.1327	$253.10	.	$50.62			
94640	Airway inhalation treatment	Q1	5791	2.2769	$183.96	.	$36.80			
94642	Aerosol inhalation treatment	Q1	5791	2.2769	$183.96	.	$36.80			
94644	Cbt 1st hour	Q1	5734	1.3495	$109.03	.	$21.81			
94645	Cbt each addl hour	N								
94660	Pos airway pressure cpap	Q1 	5791	2.2769	$183.96	.	$36.80			
94662	Neg press ventilation cnp	Q3	5801	5.7496	$464.53	.	$92.91			
94664	Evaluate pt use of inhaler	Q1	5791	2.2769	$183.96	.	$36.80			
94667	Chest wall manipulation	Q1	5734	1.3495	$109.03	.	$21.81			
94668	Chest wall manipulation	Q1	5734	1.3495	$109.03	.	$21.81			
94669	Mechanical chest wall oscill	Q1	5791	2.2769	$183.96	.	$36.80			
94680	Exhaled air analysis o2	Q1	5721	1.7124	$138.35	.	$27.67			
94681	Exhaled air analysis o2/co2	Q1	5722	3.1327	$253.10	.	$50.62			
94690	Exhaled air analysis	Q1	5732	0.4138	$33.43	.	$6.69			
94726	Pulm funct tst plethysmograp	Q1	5722	3.1327	$253.10	.	$50.62			
94727	Pulm function test by gas	Q1	5721	1.7124	$138.35	.	$27.67			
94728	Airwy resist by oscillometry	Q1	5722	3.1327	$253.10	.	$50.62			
94729	Co/membane diffuse capacity	N								
94750	Pulmonary compliance study	Q1	5721	1.7124	$138.35	.	$27.67			
94760	Measure blood oxygen level	N								
94761	Measure blood oxygen level	N								
94762	Measure blood oxygen level	Q3	5721	1.7124	$138.35	.	$27.67			
94770	Exhaled carbon dioxide test	S	5721	1.7124	$138.35	.	$27.67			
94772	Breath recording infant	S	5723	6.0105	$485.61	.	$97.13			
94774	Ped home apnea rec compl	B								
94775	Ped home apnea rec hk-up	S	5721	1.7124	$138.35	.	$27.67			
94776	Ped home apnea rec downld	S	5721	1.7124	$138.35	.	$27.67			
94777	Ped home apnea rec report	B								
94780	Cars/bd tst inft-12mo 60 min	Q1	5732	0.4138	$33.43	.	$6.69			
94781	Cars/bd tst inft-12mo +30min	N								
94799	Pulmonary service/procedure	Q1	5721	1.7124	$138.35	.	$27.67			
95004	Percut allergy skin tests	Q1	5724	11.2503	$908.95	.	$181.79			
95012	Exhaled nitric oxide meas	Q1	5732	0.4138	$33.43	.	$6.69			
95017	Perq & icut allg test venoms	Q1	5731	0.2845	$22.99	.	$4.60			
95018	Perq&ic allg test drugs/biol	Q1	5732	0.4138	$33.43	.	$6.69			
95024	Icut allergy test drug/bug	Q1	5733	0.6809	$55.01	.	$11.01			
95027	Icut allergy titrate-airborn	Q1	5731	0.2845	$22.99	.	$4.60			
95028	Icut allergy test-delayed	Q1	5732	0.4138	$33.43	.	$6.69			
95044	Allergy patch tests	Q1	5724	11.2503	$908.95	.	$181.79			
95052	Photo patch test	Q1	5732	0.4138	$33.43	.	$6.69			
95056	Photosensitivity tests	Q1	5734	1.3495	$109.03	.	$21.81			
95060	Eye allergy tests	Q1	5734	1.3495	$109.03	.	$21.81			
95065	Nose allergy test	Q1	5732	0.4138	$33.43	.	$6.69			
95070	Bronchial allergy tests	S	5723	6.0105	$485.61	.	$97.13			
95071	Bronchial allergy tests	Q1	5722	3.1327	$253.10	.	$50.62			
95076	Ingest challenge ini 120 min	S	5723	6.0105	$485.61	.	$97.13			
95079	Ingest challenge addl 60 min	N								
95115	Immunotherapy one injection	Q1	5691	0.4717	$38.11	.	$7.63			
95117	Immunotherapy injections	Q1	5691	0.4717	$38.11	.	$7.63			
95120	Immunotherapy one injection	E1								
95125	Immunotherapy 2/> injections	E1								
95130	Immntx 1 sting insect	E1								
95131	Immntx 2 sting insects	E1								
95132	Immntx 3 sting insects	E1								
95133	Immntx 4 sting insects	E1								
95134	Immntx 5 sting insects	E1								
95144	Antigen therapy services	Q1	5691	0.4717	$38.11	.	$7.63			
95145	Antigen therapy services	Q1	5691	0.4717	$38.11	.	$7.63			
95146	Antigen therapy services	Q1	5691	0.4717	$38.11	.	$7.63			
95147	Antigen therapy services	Q1	5692	0.7484	$60.47	.	$12.10			
95148	Antigen therapy services	Q1	5692	0.7484	$60.47	.	$12.10			
95149	Antigen therapy services	Q1	5692	0.7484	$60.47	.	$12.10			
95165	Antigen therapy services	Q1	5691	0.4717	$38.11	.	$7.63			
95170	Antigen therapy services	Q1	5691	0.4717	$38.11	.	$7.63			
95180	Rapid desensitization	Q1	5735	4.5003	$363.59	.	$72.72			
95199	Allergy immunology services	Q1	5731	0.2845	$22.99	.	$4.60			
95249	Cont gluc mntr pt prov eqp	S	5733	0.6809	$55.01	.	$11.01			
95250	Cont gluc mntr phys/qhp eqp	V	5012	1.4349	$115.93	.	$23.19			
95251	Cont gluc mntr analysis i&r	B								
95700	Eeg cont rec w/vid eeg tech	S	5722	3.1327	$253.10	.	$50.62			
95705	Eeg w/o vid 2-12 hr unmntr	S	5722	3.1327	$253.10	.	$50.62			
95706	Eeg wo vid 2-12hr intmt mntr	S	5722	3.1327	$253.10	.	$50.62			
95707	Eeg w/o vid 2-12hr cont mntr	S	5722	3.1327	$253.10	.	$50.62			
95708	Eeg wo vid ea 12-26hr unmntr	S	5723	6.0105	$485.61	.	$97.13			
95709	Eeg w/o vid ea 12-26hr intmt	S	5723	6.0105	$485.61	.	$97.13			
95710	Eeg w/o vid ea 12-26hr cont	S	5723	6.0105	$485.61	.	$97.13			
95711	Veeg 2-12 hr unmonitored	S	5722	3.1327	$253.10	.	$50.62			
95712	Veeg 2-12 hr intmt mntr	S	5722	3.1327	$253.10	.	$50.62			
95713	Veeg 2-12 hr cont mntr	S	5723	6.0105	$485.61	.	$97.13			
95714	Veeg ea 12-26 hr unmntr	S	5723	6.0105	$485.61	.	$97.13			
95715	Veeg ea 12-26hr intmt mntr	S	5723	6.0105	$485.61	.	$97.13			
95716	Veeg ea 12-26hr cont mntr	S	5724	11.2503	$908.95	.	$181.79			
95717	Eeg phys/qhp 2-12 hr w/o vid	M								
95718	Eeg phys/qhp 2-12 hr w/veeg	M								
95719	Eeg phys/qhp ea incr w/o vid	M								
95720	Eeg phy/qhp ea incr w/veeg	M								
95721	Eeg phy/qhp>36<60 hr w/o vid	M								
95722	Eeg phy/qhp>36<60 hr w/veeg	M								
95723	Eeg phy/qhp>60<84 hr w/o vid	M								
95724	Eeg phy/qhp>60<84 hr w/veeg	M								
95725	Eeg phy/qhp>84 hr w/o vid	M								
95726	Eeg phy/qhp>84 hr w/veeg	M								
95782	Polysom <6 yrs 4/> paramtrs	S	5724	11.2503	$908.95	.	$181.79			
95783	Polysom <6 yrs cpap/bilvl	S	5724	11.2503	$908.95	.	$181.79			
95800	Slp stdy unattended	S	5721	1.7124	$138.35	.	$27.67			
95801	Slp stdy unatnd w/anal	Q1	5734	1.3495	$109.03	.	$21.81			
95803	Actigraphy testing	Q1	5733	0.6809	$55.01	.	$11.01			
95805	Multiple sleep latency test	S	5723	6.0105	$485.61	.	$97.13			
95806	Sleep study unatt&resp efft	S	5721	1.7124	$138.35	.	$27.67			
95807	Sleep study attended	S	5723	6.0105	$485.61	.	$97.13			
95808	Polysom any age 1-3> param	S	5724	11.2503	$908.95	.	$181.79			
95810	Polysom 6/> yrs 4/> param	S	5724	11.2503	$908.95	.	$181.79			
95811	Polysom 6/>yrs cpap 4/> parm	S	5724	11.2503	$908.95	.	$181.79			
95812	Eeg 41-60 minutes	S	5722	3.1327	$253.10	.	$50.62			
95813	Eeg extnd mntr 61-119 min	S	5722	3.1327	$253.10	.	$50.62			
95816	Eeg awake and drowsy	S	5722	3.1327	$253.10	.	$50.62			
95819	Eeg awake and asleep	S	5722	3.1327	$253.10	.	$50.62			
95822	Eeg coma or sleep only	S	5722	3.1327	$253.10	.	$50.62			
95824	Eeg cerebral death only	S	5723	6.0105	$485.61	.	$97.13			
95829	Surgery electrocorticogram	N								
95830	Insert electrodes for eeg	B								
95836	Ecog impltd brn npgt <30 d	Q1	5741	0.4487	$36.25	.	$7.25			
95851	Range of motion measurements	A								
95852	Range of motion measurements	A								
95857	Cholinesterase challenge	S	5722	3.1327	$253.10	.	$50.62			
95860	Muscle test one limb	Q1	5734	1.3495	$109.03	.	$21.81			
95861	Muscle test 2 limbs	Q1	5734	1.3495	$109.03	.	$21.81			
95863	Muscle test 3 limbs	S	5721	1.7124	$138.35	.	$27.67			
95864	Muscle test 4 limbs	S	5721	1.7124	$138.35	.	$27.67			
95865	Muscle test larynx	Q1	5734	1.3495	$109.03	.	$21.81			
95866	Muscle test hemidiaphragm	Q1	5721	1.7124	$138.35	.	$27.67			
95867	Muscle test cran nerv unilat	S	5721	1.7124	$138.35	.	$27.67			
95868	Muscle test cran nerve bilat	S	5721	1.7124	$138.35	.	$27.67			
95869	Muscle test thor paraspinal	Q1	5721	1.7124	$138.35	.	$27.67			
95870	Muscle test nonparaspinal	Q1	5733	0.6809	$55.01	.	$11.01			
95872	Muscle test one fiber	S	5721	1.7124	$138.35	.	$27.67			
95873	Guide nerv destr elec stim	N								
95874	Guide nerv destr needle emg	N								
95875	Limb exercise test	S	5721	1.7124	$138.35	.	$27.67			
95885	Musc tst done w/nerv tst lim	N								
95886	Musc test done w/n test comp	N								
95887	Musc tst done w/n tst nonext	N								
95905	Motor &/ sens nrve cndj test	Q1	5734	1.3495	$109.03	.	$21.81			
95907	Nvr cndj tst 1-2 studies	S	5721	1.7124	$138.35	.	$27.67			
95908	Nrv cndj tst 3-4 studies	S	5722	3.1327	$253.10	.	$50.62			
95909	Nrv cndj tst 5-6 studies	S	5722	3.1327	$253.10	.	$50.62			
95910	Nrv cndj test 7-8 studies	S	5722	3.1327	$253.10	.	$50.62			
95911	Nrv cndj test 9-10 studies	S	5723	6.0105	$485.61	.	$97.13			
95912	Nrv cndj test 11-12 studies	S	5723	6.0105	$485.61	.	$97.13			
95913	Nrv cndj test 13/> studies	S	5723	6.0105	$485.61	.	$97.13			
95921	Autonomic nrv parasym inervj	S	5721	1.7124	$138.35	.	$27.67			
95922	Autonomic nrv adrenrg inervj	Q1	5734	1.3495	$109.03	.	$21.81			
95923	Autonomic nrv syst funj test	Q1	5734	1.3495	$109.03	.	$21.81			
95924	Ans parasymp & symp w/tilt	S	5721	1.7124	$138.35	.	$27.67			
95925	Somatosensory testing	S	5722	3.1327	$253.10	.	$50.62			
95926	Somatosensory testing	S	5722	3.1327	$253.10	.	$50.62			
95927	Somatosensory testing	S	5721	1.7124	$138.35	.	$27.67			
95928	C motor evoked uppr limbs	S	5724	11.2503	$908.95	.	$181.79			
95929	C motor evoked lwr limbs	S	5723	6.0105	$485.61	.	$97.13			
95930	Visual ep test cns w/i&r	S	5721	1.7124	$138.35	.	$27.67			
95933	Blink reflex test	Q1	5733	0.6809	$55.01	.	$11.01			
95937	Neuromuscular junction test	S	5721	1.7124	$138.35	.	$27.67			
95938	Somatosensory testing	S	5723	6.0105	$485.61	.	$97.13			
95939	C motor evoked upr&lwr limbs	S	5724	11.2503	$908.95	.	$181.79			
95940	Ionm in operatng room 15 min	N								
95941	Ionm remote/>1 pt or per hr	N								
95943	Parasymp&symp hrt rate test	S	5721	1.7124	$138.35	.	$27.67			
95954	Eeg monitoring/giving drugs	S	5723	6.0105	$485.61	.	$97.13			
95955	Eeg during surgery	N								
95957	Eeg digital analysis	N								
95958	Eeg monitoring/function test	S	5724	11.2503	$908.95	.	$181.79			
95961	Electrode stimulation brain	S	5724	11.2503	$908.95	.	$181.79			
95962	Electrode stim brain add-on	N								
95965	Meg spontaneous	S	5724	11.2503	$908.95	.	$181.79			
95966	Meg evoked single	S	5724	11.2503	$908.95	.	$181.79			
95967	Meg evoked each addl	N								
95970	Alys npgt w/o prgrmg	Q1	5734	1.3495	$109.03	.	$21.81			
95971	Alys smpl sp/pn npgt w/prgrm	S	5742	1.4039	$113.43	.	$22.69			
95972	Alys cplx sp/pn npgt w/prgrm	S	5742	1.4039	$113.43	.	$22.69			
95976	Alys smpl cn npgt prgrmg	S	5741	0.4487	$36.25	.	$7.25			
95977	Alys cplx cn npgt prgrmg	S	5742	1.4039	$113.43	.	$22.69			
95980	Io anal gast n-stim init	N								
95981	Io anal gast n-stim subsq	Q1	5734	1.3495	$109.03	.	$21.81			
95982	Io ga n-stim subsq w/reprog	Q1	5741	0.4487	$36.25	.	$7.25			
95983	Alys brn npgt prgrmg 15 min	S	5742	1.4039	$113.43	.	$22.69			
95984	Alys brn npgt prgrmg addl 15	N								
95990	Spin/brain pump refil & main	S	5694	3.8320	$309.60	.	$61.92			
95991	Spin/brain pump refil & main	T	5441	3.2400	$261.77	.	$52.36			
95992	Canalith repositioning proc	A								
95999	Neurological procedure	Q1	5721	1.7124	$138.35	.	$27.67			
96000	Motion analysis video/3d	S	5723	6.0105	$485.61	.	$97.13			
96001	Motion test w/ft press meas	S	5724	11.2503	$908.95	.	$181.79			
96002	Dynamic surface emg	S	5721	1.7124	$138.35	.	$27.67			
96003	Dynamic fine wire emg	Q1	5722	3.1327	$253.10	.	$50.62			
96004	Phys review of motion tests	B								
96020	Functional brain mapping	N								
96040	Genetic counseling 30 min	B								
96105	Assessment of aphasia	A								
96110	Developmental screen w/score	E1								
96112	Devel tst phys/qhp 1st hr	Q3	5721	1.7124	$138.35	.	$27.67			
96113	Devel tst phys/qhp ea addl	N 								
96116	Nubhvl xm phys/qhp 1st hr	Q3	5722	3.1327	$253.10	.	$50.62			
96121	Nubhvl xm phy/qhp ea addl hr	N 								
96125	Cognitive test by hc pro	A								
96127	Brief emotional/behav assmt	Q1	5732	0.4138	$33.43	.	$6.69			
96130	Psycl tst eval phys/qhp 1st	Q3	5721	1.7124	$138.35	.	$27.67			
96131	Psycl tst eval phys/qhp ea	N 								
96132	Nrpsyc tst eval phys/qhp 1st	Q3	5721	1.7124	$138.35	.	$27.67			
96133	Nrpsyc tst eval phys/qhp ea	N 								
96136	Psycl/nrpsyc tst phy/qhp 1st	Q3	5731	0.2845	$22.99	.	$4.60			
96137	Psycl/nrpsyc tst phy/qhp ea	N 								
96138	Psycl/nrpsyc tech 1st	Q3	5731	0.2845	$22.99	.	$4.60			
96139	Psycl/nrpsyc tst tech ea	N								
96146	Psycl/nrpsyc tst auto result	Q3	5731	0.2845	$22.99	.	$4.60			
96156	Hlth bhv assmt/reassessment	Q3	5822	0.9721	$78.54	.	$15.71			
96158	Hlth bhv ivntj indiv 1st 30	Q3	5822	0.9721	$78.54	.	$15.71			
96159	Hlth bhv ivntj indiv ea addl	N								
96160	Pt-focused hlth risk assmt	S	5821	0.3382	$27.32	.	$5.47			
96161	Caregiver health risk assmt	S	5821	0.3382	$27.32	.	$5.47			
96164	Hlth bhv ivntj grp 1st 30	Q3	5821	0.3382	$27.32	.	$5.47			
96165	Hlth bhv ivntj grp ea addl	N								
96167	Hlth bhv ivntj fam 1st 30	Q3	5821	0.3382	$27.32	.	$5.47			
96168	Hlth bhv ivntj fam ea addl	N								
96170	Hlth bhv ivntj fam wo pt 1st	E1								
96171	Hlth bhv ivntj fam w/o pt ea	E1								
96360	Hydration iv infusion init	S	5693	2.2742	$183.74	.	$36.75			
96361	Hydrate iv infusion add-on	S	5691	0.4717	$38.11	.	$7.63			
96365	Ther/proph/diag iv inf init	S	5693	2.2742	$183.74	.	$36.75			
96366	Ther/proph/diag iv inf addon	S	5691	0.4717	$38.11	.	$7.63			
96367	Tx/proph/dg addl seq iv inf	S	5692	0.7484	$60.47	.	$12.10			
96368	Ther/diag concurrent inf	N								
96369	Sc ther infusion up to 1 hr	S	5693	2.2742	$183.74	.	$36.75			
96370	Sc ther infusion addl hr	S	5691	0.4717	$38.11	.	$7.63			
96371	Sc ther infusion reset pump	Q1	5692	0.7484	$60.47	.	$12.10			
96372	Ther/proph/diag inj sc/im	Q1	5692	0.7484	$60.47	.	$12.10			
96373	Ther/proph/diag inj ia	S	5693	2.2742	$183.74	.	$36.75			
96374	Ther/proph/diag inj iv push	S	5693	2.2742	$183.74	.	$36.75			
96375	Tx/pro/dx inj new drug addon	S	5691	0.4717	$38.11	.	$7.63			
96376	Tx/pro/dx inj same drug adon	N								
96377	Applicaton on-body injector	Q1	5691	0.4717	$38.11	.	$7.63			
96379	Ther/prop/diag inj/inf proc	Q1	5691	0.4717	$38.11	.	$7.63			
96401	Chemo anti-neopl sq/im	Q1	5692	0.7484	$60.47	.	$12.10			
96402	Chemo hormon antineopl sq/im	Q1	5692	0.7484	$60.47	.	$12.10			
96405	Chemo intralesional up to 7	Q1	5692	0.7484	$60.47	.	$12.10			
96406	Chemo intralesional over 7	S	5693	2.2742	$183.74	.	$36.75			
96409	Chemo iv push sngl drug	S	5693	2.2742	$183.74	.	$36.75			
96411	Chemo iv push addl drug	S	5692	0.7484	$60.47	.	$12.10			
96413	Chemo iv infusion 1 hr	S	5694	3.8320	$309.60	.	$61.92			
96415	Chemo iv infusion addl hr	S	5692	0.7484	$60.47	.	$12.10			
96416	Chemo prolong infuse w/pump	S	5694	3.8320	$309.60	.	$61.92			
96417	Chemo iv infus each addl seq	S	5692	0.7484	$60.47	.	$12.10			
96420	Chemo ia push tecnique	S	5694	3.8320	$309.60	.	$61.92			
96422	Chemo ia infusion up to 1 hr	S	5693	2.2742	$183.74	.	$36.75			
96423	Chemo ia infuse each addl hr	S	5691	0.4717	$38.11	.	$7.63			
96425	Chemotherapy infusion method	S	5694	3.8320	$309.60	.	$61.92			
96440	Chemotherapy intracavitary	S	5694	3.8320	$309.60	.	$61.92			
96446	Chemotx admn prtl cavity	S	5694	3.8320	$309.60	.	$61.92			
96450	Chemotherapy into cns	S	5694	3.8320	$309.60	.	$61.92			
96521	Refill/maint portable pump	S	5693	2.2742	$183.74	.	$36.75			
96522	Refill/maint pump/resvr syst	S	5693	2.2742	$183.74	.	$36.75			
96523	Irrig drug delivery device	Q1	5733	0.6809	$55.01	.	$11.01			
96542	Chemotherapy injection	S	5693	2.2742	$183.74	.	$36.75			
96549	Chemotherapy unspecified	Q1	5691	0.4717	$38.11	.	$7.63			
96567	Pdt dstr prmlg les skn	Q1	5051	2.1627	$174.73	.	$34.95			
96570	Photodynmc tx 30 min add-on	N								
96571	Photodynamic tx addl 15 min	N								
96573	Pdt dstr prmlg les phys/qhp	Q1	5051	2.1627	$174.73	.	$34.95			
96574	Dbrdmt prmlg les w/pdt	Q1	5051	2.1627	$174.73	.	$34.95			
96900	Ultraviolet light therapy	Q1	5732	0.4138	$33.43	.	$6.69			
96902	Trichogram	N								
96904	Whole body photography	N								
96910	Photochemotherapy with uv-b	Q1	5733	0.6809	$55.01	.	$11.01			
96912	Photochemotherapy with uv-a	Q1	5733	0.6809	$55.01	.	$11.01			
96913	Photochemotherapy uv-a or b	T	5052	3.9547	$319.51	.	$63.91			
96920	Laser tx skin < 250 sq cm	Q1	5051	2.1627	$174.73	.	$34.95			
96921	Laser tx skin 250-500 sq cm	Q1	5051	2.1627	$174.73	.	$34.95			
96922	Laser tx skin >500 sq cm	Q1	5052	3.9547	$319.51	.	$63.91			
96931	Rcm celulr subcelulr img skn	M								
96932	Rcm celulr subcelulr img skn	N								
96933	Rcm celulr subcelulr img skn	B								
96934	Rcm celulr subcelulr img skn	N								
96935	Rcm celulr subcelulr img skn	N								
96936	Rcm celulr subcelulr img skn	N								
96999	Dermatological procedure	Q1	5051	2.1627	$174.73	.	$34.95			
97010	Hot or cold packs therapy	A								
97012	Mechanical traction therapy	A								
97014	Electric stimulation therapy	E1								
97016	Vasopneumatic device therapy	A								
97018	Paraffin bath therapy	A								
97022	Whirlpool therapy	A								
97024	Diathermy eg microwave	A								
97026	Infrared therapy	A								
97028	Ultraviolet therapy	A								
97032	Electrical stimulation	A								
97033	Electric current therapy	A								
97034	Contrast bath therapy	A								
97035	Ultrasound therapy	A								
97036	Hydrotherapy	A								
97039	Physical therapy treatment	A								
97110	Therapeutic exercises	A								
97112	Neuromuscular reeducation	A								
97113	Aquatic therapy/exercises	A								
97116	Gait training therapy	A								
97124	Massage therapy	A								
97129	Ther ivntj 1st 15 min	A								
97130	Ther ivntj ea addl 15 min	A								
97139	Physical medicine procedure	A								
97140	Manual therapy 1/> regions	A								
97150	Group therapeutic procedures	A								
97151	Bhv id assmt by phys/qhp	Q3	5821	0.3382	$27.32	.	$5.47			
97152	Bhv id suprt assmt by 1 tech	Q3	5821	0.3382	$27.32	.	$5.47			
97153	Adaptive behavior tx by tech	Q3	5821	0.3382	$27.32	.	$5.47			
97154	Grp adapt bhv tx by tech	Q3	5821	0.3382	$27.32	.	$5.47			
97155	Adapt behavior tx phys/qhp	Q3	5821	0.3382	$27.32	.	$5.47			
97156	Fam adapt bhv tx gdn phy/qhp	Q3	5821	0.3382	$27.32	.	$5.47			
97157	Mult fam adapt bhv tx gdn	Q3	5821	0.3382	$27.32	.	$5.47			
97158	Grp adapt bhv tx by phy/qhp	Q3	5821	0.3382	$27.32	.	$5.47			
97161	Pt eval low complex 20 min	A								
97162	Pt eval mod complex 30 min	A								
97163	Pt eval high complex 45 min	A								
97164	Pt re-eval est plan care	A								
97165	Ot eval low complex 30 min	A								
97166	Ot eval mod complex 45 min	A								
97167	Ot eval high complex 60 min	A								
97168	Ot re-eval est plan care	A								
97169	Athletic trn eval low cmplx	E1								
97170	Athletic trn eval mod cmplx	E1								
97171	Athletic trn eval high cmplx	E1								
97172	Athletic trn re-eval plan cr	E1								
97530	Therapeutic activities	A								
97533	Sensory integration	A								
97535	Self care mngment training	A								
97537	Community/work reintegration	A								
97542	Wheelchair mngment training	A								
97545	Work hardening	A								
97546	Work hardening add-on	A								
97597	Rmvl devital tis 20 cm/<	T	5051	2.1627	$174.73	.	$34.95			
97598	Rmvl devital tis addl 20cm/<	N								
97602	Wound(s) care non-selective	Q1	5051	2.1627	$174.73	.	$34.95			
97605	Neg press wound tx <=50 cm	Q1	5051	2.1627	$174.73	.	$34.95			
97606	Neg press wound tx >50 cm	Q1	5052	3.9547	$319.51	.	$63.91			
97607	Neg press wnd tx <=50 sq cm	T	5052	3.9547	$319.51	.	$63.91			
97608	Neg press wound tx >50 cm	T	5052	3.9547	$319.51	.	$63.91			
97610	Low frequency non-thermal us	Q1	5051	2.1627	$174.73	.	$34.95			
97750	Physical performance test	A								
97755	Assistive technology assess	A								
97760	Orthotic mgmt&traing 1st enc	A								
97761	Prosthetic traing 1st enc	A								
97763	Orthc/prostc mgmt sbsq enc	A								
97799	Physical medicine procedure	A								
97802	Medical nutrition indiv in	A								
97803	Med nutrition indiv subseq	A								
97804	Medical nutrition group	A								
97810	Acupunct w/o stimul 15 min	S	5731	0.2845	$22.99	.	$4.60			
97811	Acupunct w/o stimul addl 15m	N								
97813	Acupunct w/stimul 15 min	S	5731	0.2845	$22.99	.	$4.60			
97814	Acupunct w/stimul addl 15m	N								
98925	Osteopath manj 1-2 regions	Q1	5811	0.3035	$24.52	.	$4.91			
98926	Osteopath manj 3-4 regions	Q1	5811	0.3035	$24.52	.	$4.91			
98927	Osteopath manj 5-6 regions	Q1	5811	0.3035	$24.52	.	$4.91			
98928	Osteopath manj 7-8 regions	Q1	5811	0.3035	$24.52	.	$4.91			
98929	Osteopath manj 9-10 regions	Q1	5811	0.3035	$24.52	.	$4.91			
98940	Chiropract manj 1-2 regions	Q1	5811	0.3035	$24.52	.	$4.91			
98941	Chiropract manj 3-4 regions	Q1	5811	0.3035	$24.52	.	$4.91			
98942	Chiropractic manj 5 regions	Q1	5811	0.3035	$24.52	.	$4.91			
98943	Chiropract manj xtrspinl 1/>	E1								
98960	Self-mgmt educ & train 1 pt	E1								
98961	Self-mgmt educ/train 2-4 pt	E1								
98962	Self-mgmt educ/train 5-8 pt	E1								
98966	Hc pro phone call 5-10 min	A								
98967	Hc pro phone call 11-20 min	A								
98968	Hc pro phone call 21-30 min	A								
98970	Qnhp ol dig e/m svc 5-10min	B								
98971	Qnhp ol dig em svc 11-20min	B								
98972	Qnhp ol dig e/m svc 21+ min	B								
99000	Specimen handling office-lab	E1								
99001	Specimen handling pt-lab	E1								
99002	Device handling phys/qhp	B								
99024	Postop follow-up visit	B								
99026	In-hospital on call service	E1								
99027	Out-of-hosp on call service	E1								
99050	Medical services after hrs	B								
99051	Med serv eve/wkend/holiday	B								
99053	Med serv 10pm-8am 24 hr fac	B								
99056	Med service out of office	B								
99058	Office emergency care	B								
99060	Out of office emerg med serv	B								
99070	Special supplies phys/qhp	B								
99071	Patient education materials	B								
99072	Addl supl matrl&staf tm phe 	B							*	
99075	Medical testimony	E1								
99078	Group health education	N								
99080	Special reports or forms	B								
99082	Unusual physician travel	B								
99091	Collj & interpj data ea 30 d	N								
99100	Special anesthesia service	B								
99116	Anesthesia with hypothermia	B								
99135	Special anesthesia procedure	B								
99140	Emergency anesthesia	B								
99151	Mod sed same phys/qhp <5 yrs	N								
99152	Mod sed same phys/qhp 5/>yrs	N								
99153	Mod sed same phys/qhp ea	N								
99155	Mod sed oth phys/qhp <5 yrs	N								
99156	Mod sed oth phys/qhp 5/>yrs	N								
99157	Mod sed other phys/qhp ea	N								
99170	Anogenital exam child w imag	T	5411	2.0552	$166.05	.	$33.21			
99172	Ocular function screen	E1								
99173	Visual acuity screen	E1								
99174	Ocular instrumnt screen bil	E1								
99175	Induction of vomiting	N								
99177	Ocular instrumnt screen bil	E1								
99183	Hyperbaric oxygen therapy	B								
99184	Hypothermia ill neonate	C								
99188	App topical fluoride varnish	E1								
99190	Special pump services	C								
99191	Special pump services	C								
99192	Special pump services	C								
99195	Phlebotomy	Q1	5734	1.3495	$109.03	.	$21.81			
99199	Special service/proc/report	B								
99201	Office/outpatient visit new	B								
99202	Office/outpatient visit new	B								
99203	Office/outpatient visit new	B								
99204	Office/outpatient visit new	B								
99205	Office/outpatient visit new	B								
99211	Office/outpatient visit est	B								
99212	Office/outpatient visit est	B								
99213	Office/outpatient visit est	B								
99214	Office/outpatient visit est	B								
99215	Office/outpatient visit est	B								
99217	Observation care discharge	B								
99218	Initial observation care	B								
99219	Initial observation care	B								
99220	Initial observation care	B								
99221	Initial hospital care	B								
99222	Initial hospital care	B								
99223	Initial hospital care	B								
99224	Subsequent observation care	B								
99225	Subsequent observation care	B								
99226	Subsequent observation care	B								
99231	Subsequent hospital care	B								
99232	Subsequent hospital care	B								
99233	Subsequent hospital care	B								
99234	Observ/hosp same date	B								
99235	Observ/hosp same date	B								
99236	Observ/hosp same date	B								
99238	Hospital discharge day	B								
99239	Hospital discharge day	B								
99241	Office consultation	E1								
99242	Office consultation	E1								
99243	Office consultation	E1								
99244	Office consultation	E1								
99245	Office consultation	E1								
99251	Inpatient consultation	E1								
99252	Inpatient consultation	E1								
99253	Inpatient consultation	E1								
99254	Inpatient consultation	E1								
99255	Inpatient consultation	E1								
99281	Emergency dept visit	J2	5021	0.8617	$69.62	.	$13.93			
99282	Emergency dept visit	J2	5022	1.5838	$127.96	.	$25.60			
99283	Emergency dept visit	J2	5023	2.7643	$223.34	.	$44.67			
99284	Emergency dept visit	J2	5024	4.3542	$351.79	.	$70.36			
99285	Emergency dept visit	J2	5025	6.2445	$504.51	.	$100.91			
99288	Direct advanced life support	B								
99291	Critical care first hour	J2	5041	8.2514	$666.66	.	$133.34			
99292	Critical care addl 30 min	N								
99304	Nursing facility care init	B								
99305	Nursing facility care init	B								
99306	Nursing facility care init	B								
99307	Nursing fac care subseq	B								
99308	Nursing fac care subseq	B								
99309	Nursing fac care subseq	B								
99310	Nursing fac care subseq	B								
99315	Nursing fac discharge day	B								
99316	Nursing fac discharge day	B								
99318	Annual nursing fac assessmnt	B								
99324	Domicil/r-home visit new pat	B								
99325	Domicil/r-home visit new pat	B								
99326	Domicil/r-home visit new pat	B								
99327	Domicil/r-home visit new pat	B								
99328	Domicil/r-home visit new pat	B								
99334	Domicil/r-home visit est pat	B								
99335	Domicil/r-home visit est pat	B								
99336	Domicil/r-home visit est pat	B								
99337	Domicil/r-home visit est pat	B								
99339	Domicil/r-home care supervis	B								
99340	Domicil/r-home care supervis	B								
99341	Home visit new patient	B								
99342	Home visit new patient	B								
99343	Home visit new patient	B								
99344	Home visit new patient	B								
99345	Home visit new patient	B								
99347	Home visit est patient	B								
99348	Home visit est patient	B								
99349	Home visit est patient	B								
99350	Home visit est patient	B								
99354	Prolong e&m/psyctx serv o/p	N								
99355	Prolong e&m/psyctx serv o/p	N								
99356	Prolonged service inpatient	C								
99357	Prolonged service inpatient	C								
99358	Prolong service w/o contact	N								
99359	Prolong serv w/o contact add	N								
99360	Physician standby services	B								
99366	Team conf w/pat by hc prof	N								
99367	Team conf w/o pat by phys	N								
99368	Team conf w/o pat by hc pro	N								
99374	Home health care supervision	B								
99375	Home health care supervision	E1								
99377	Hospice care supervision	B								
99378	Hospice care supervision	E1								
99379	Nursing fac care supervision	B								
99380	Nursing fac care supervision	B								
99381	Init pm e/m new pat infant	E1								
99382	Init pm e/m new pat 1-4 yrs	E1								
99383	Prev visit new age 5-11	E1								
99384	Prev visit new age 12-17	E1								
99385	Prev visit new age 18-39	E1								
99386	Prev visit new age 40-64	E1								
99387	Init pm e/m new pat 65+ yrs	E1								
99391	Per pm reeval est pat infant	E1								
99392	Prev visit est age 1-4	E1								
99393	Prev visit est age 5-11	E1								
99394	Prev visit est age 12-17	E1								
99395	Prev visit est age 18-39	E1								
99396	Prev visit est age 40-64	E1								
99397	Per pm reeval est pat 65+ yr	E1								
99401	Preventive counseling indiv	E1								
99402	Preventive counseling indiv	E1								
99403	Preventive counseling indiv	E1								
99404	Preventive counseling indiv	E1								
99406	Behav chng smoking 3-10 min	S	5821	0.3382	$27.32	$0.00	$0.00			
99407	Behav chng smoking > 10 min	S	5821	0.3382	$27.32	$0.00	$0.00			
99408	Audit/dast 15-30 min	E1								
99409	Audit/dast over 30 min	E1								
99411	Preventive counseling group	E1								
99412	Preventive counseling group	E1								
99415	Prolong clincl staff svc	N								
99416	Prolong clincl staff svc add	N								
99421	Ol dig e/m svc 5-10 min	B								
99422	Ol dig e/m svc 11-20 min	B								
99423	Ol dig e/m svc 21+ min	B								
99429	Unlisted preventive service	E1								
99441	Phone e/m phys/qhp 5-10 min	B								
99442	Phone e/m phys/qhp 11-20 min	B								
99443	Phone e/m phys/qhp 21-30 min	B								
99446	Ntrprof ph1/ntrnet/ehr 5-10	M								
99447	Ntrprof ph1/ntrnet/ehr 11-20	M								
99448	Ntrprof ph1/ntrnet/ehr 21-30	M								
99449	Ntrprof ph1/ntrnet/ehr 31/>	M								
99450	Basic life disability exam	E1								
99451	Ntrprof ph1/ntrnet/ehr 5/>	M								
99452	Ntrprof ph1/ntrnet/ehr rfrl	M								
99453	Rem mntr physiol param setup	V	5012	1.4349	$115.93	.	$23.19			
99454	Rem mntr physiol param dev	Q1	5741	0.4487	$36.25	.	$7.25			
99455	Work related disability exam	B								
99456	Disability examination	B								
99457	Rem physiol mntr 1st 20 min	B								
99458	Rem physiol mntr ea addl 20	B							*	
99460	Init nb em per day hosp	V	5012	1.4349	$115.93	.	$23.19			
99461	Init nb em per day non-fac	M								
99462	Sbsq nb em per day hosp	C								
99463	Same day nb discharge	V	5012	1.4349	$115.93	.	$23.19			
99464	Attendance at delivery	N								
99465	Nb resuscitation	S	5781	6.6399	$536.46	.	$107.30			
99466	Ped crit care transport	N								
99467	Ped crit care transport addl	N								
99468	Neonate crit care initial	C								
99469	Neonate crit care subsq	C								
99471	Ped critical care initial	C								
99472	Ped critical care subsq	C								
99473	Self-meas bp pt educaj/train	Q1	5731	0.2845	$22.99	.	$4.60			
99474	Self-meas bp 2 readg bid 30d	B								
99475	Ped crit care age 2-5 init	C								
99476	Ped crit care age 2-5 subsq	C								
99477	Init day hosp neonate care	C								
99478	Ic lbw inf < 1500 gm subsq	C								
99479	Ic lbw inf 1500-2500 g subsq	C								
99480	Ic inf pbw 2501-5000 g subsq	C								
99483	Assmt & care pln pt cog imp	S	5822	0.9721	$78.54	.	$15.71			
99484	Care mgmt svc bhvl hlth cond	S	5821	0.3382	$27.32	.	$5.47			
99485	Suprv interfacilty transport	B								
99486	Suprv interfac trnsport addl	B								
99487	Cmplx chron care w/o pt vsit	S	5822	0.9721	$78.54		$15.71			
99489	Cmplx chron care addl 30 min	N								
99490	Chron care mgmt srvc 20 min	S	5822	0.9721	$78.54		$15.71			
99491	Chrnc care mgmt svc 30 min	M								
99492	1st psyc collab care mgmt	S	5822	0.9721	$78.54	.	$15.71			
99493	Sbsq psyc collab care mgmt	S	5822	0.9721	$78.54	.	$15.71			
99494	1st/sbsq psyc collab care	N								
99495	Trans care mgmt 14 day disch	V	5012	1.4349	$115.93	.	$23.19			
99496	Trans care mgmt 7 day disch	V	5012	1.4349	$115.93	.	$23.19			
99497	Advncd care plan 30 min	Q1	5822	0.9721	$78.54	.	$15.71			
99498	Advncd care plan addl 30 min	N								
99499	Unlisted e&m service	B								
99500	Home visit prenatal	E1								
99501	Home visit postnatal	E1								
99502	Home visit nb care	E1								
99503	Home visit resp therapy	E1								
99504	Home visit mech ventilator	E1								
99505	Home visit stoma care	E1								
99506	Home visit im injection	E1								
99507	Home visit cath maintain	E1								
99509	Home visit day life activity	E1								
99510	Home visit sing/m/fam couns	E1								
99511	Home visit fecal/enema mgmt	E1								
99512	Home visit for hemodialysis	E1								
99600	Home visit nos	E1								
99601	Home infusion/visit 2 hrs	E1								
99602	Home infusion each addtl hr	E1								
99605	Mtms by pharm np 15 min	E1								
99606	Mtms by pharm est 15 min	E1								
99607	Mtms by pharm addl 15 min	E1								
A0021	Outside state ambulance serv	E1								
A0080	Noninterest escort in non er	E1								
A0090	Interest escort in non er	E1								
A0100	Nonemergency transport taxi	E1								
A0110	Nonemergency transport bus	E1								
A0120	Noner transport mini-bus	E1								
A0130	Noner transport wheelch van	E1								
A0140	Nonemergency transport air	E1								
A0160	Noner transport case worker	E1								
A0170	Transport parking fees/tolls	E1								
A0180	Noner transport lodgng recip	E1								
A0190	Noner transport meals recip	E1								
A0200	Noner transport lodgng escrt	E1								
A0210	Noner transport meals escort	E1								
A0225	Neonatal emergency transport	E1								
A0380	Basic life support mileage	E1								
A0382	Basic support routine suppls	E1								
A0384	Bls defibrillation supplies	E1								
A0390	Advanced life support mileag	E1								
A0392	Als defibrillation supplies	E1								
A0394	Als iv drug therapy supplies	E1								
A0396	Als esophageal intub suppls	E1								
A0398	Als routine disposble suppls	E1								
A0420	Ambulance waiting 1/2 hr	E1								
A0422	Ambulance 02 life sustaining	E1								
A0424	Extra ambulance attendant	E1								
A0425	Ground mileage	A								
A0426	Als 1	A								
A0427	Als1-emergency	A								
A0428	Bls	A								
A0429	Bls-emergency	A								
A0430	Fixed wing air transport	A								
A0431	Rotary wing air transport	A								
A0432	Pi volunteer ambulance co	A								
A0433	Als 2	A								
A0434	Specialty care transport	A								
A0435	Fixed wing air mileage	A								
A0436	Rotary wing air mileage	A								
A0888	Noncovered ambulance mileage	E1								
A0998	Ambulance response/treatment	E1								
A0999	Unlisted ambulance service	A								
A4206	1 cc sterile syringe&needle	N								
A4207	2 cc sterile syringe&needle	N								
A4208	3 cc sterile syringe&needle	N								
A4209	5+ cc sterile syringe&needle	N								
A4210	Nonneedle injection device	E1								
A4211	Supp for self-adm injections	N								
A4212	Non coring needle or stylet	N								
A4213	20+ cc syringe only	N								
A4215	Sterile needle	N								
A4216	"Sterile water/saline, 10 ml"	N								
A4217	"Sterile water/saline, 500 ml"	N								
A4218	Sterile saline or water	N								
A4220	Infusion pump refill kit	N								
A4221	Supp non-insulin inf cath/wk	N								
A4222	Infusion supplies with pump	N								
A4223	Infusion supplies w/o pump	N								
A4224	Supply insulin inf cath/wk	N								
A4225	Sup/ext insulin inf pump syr	N								
A4226	Weekly supply maint cgs pump	E1							*	
A4230	Infus insulin pump non needl	N								
A4231	Infusion insulin pump needle	N								
A4232	Syringe w/needle insulin 3cc	E1								
A4233	Alkalin batt for glucose mon	E1								
A4234	J-cell batt for glucose mon	E1								
A4235	Lithium batt for glucose mon	E1								
A4236	Silvr oxide batt glucose mon	E1								
A4244	Alcohol or peroxide per pint	N								
A4245	Alcohol wipes per box	N								
A4246	Betadine/phisohex solution	N								
A4247	Betadine/iodine swabs/wipes	N								
A4248	Chlorhexidine antisept	N								
A4250	Urine reagent strips/tablets	E1								
A4252	Blood ketone test or strip	E1								
A4253	Blood glucose/reagent strips	N								
A4255	Glucose monitor platforms	N								
A4256	Calibrator solution/chips	N								
A4257	Replace lensshield cartridge	E1								
A4258	Lancet device each	N								
A4259	Lancets per box	N								
A4261	Cervical cap contraceptive	E1								
A4262	Temporary tear duct plug	N								
A4263	Permanent tear duct plug	N								
A4264	Intratubal occlusion device	E1								
A4265	Paraffin	N								
A4266	Diaphragm	E1								
A4267	Male condom	E1								
A4268	Female condom	E1								
A4269	Spermicide	E1								
A4270	Disposable endoscope sheath	N								
A4280	Brst prsths adhsv attchmnt	N								
A4281	Replacement breastpump tube	E1								
A4282	Replacement breastpump adpt	E1								
A4283	Replacement breastpump cap	E1								
A4284	Replcmnt breast pump shield	E1								
A4285	Replcmnt breast pump bottle	E1								
A4286	Replcmnt breastpump lok ring	E1								
A4290	Sacral nerve stim test lead	N								
A4300	Cath impl vasc access portal	N								
A4301	Implantable access syst perc	N								
A4305	Drug delivery system >=50 ml	N								
A4306	Drug delivery system <=50 ml	N								
A4310	Insert tray w/o bag/cath	N								
A4311	Catheter w/o bag 2-way latex	N								
A4312	Cath w/o bag 2-way silicone	N								
A4313	Catheter w/bag 3-way	N								
A4314	Cath w/drainage 2-way latex	N								
A4315	Cath w/drainage 2-way silcne	N								
A4316	Cath w/drainage 3-way	N								
A4320	Irrigation tray	N								
A4321	Cath therapeutic irrig agent	N								
A4322	Irrigation syringe	N								
A4326	Male external catheter	N								
A4327	Fem urinary collect dev cup	N								
A4328	Fem urinary collect pouch	N								
A4330	Stool collection pouch	N								
A4331	Extension drainage tubing	N								
A4332	Lube sterile packet	N								
A4333	Urinary cath anchor device	N								
A4334	Urinary cath leg strap	N								
A4335	Incontinence supply	N								
A4336	Urethral insert	N								
A4337	Incontinent rectal insert	N								
A4338	Indwelling catheter latex	N								
A4340	Indwelling catheter special	N								
A4344	Cath indw foley 2 way silicn	N								
A4346	Cath indw foley 3 way	N								
A4349	Disposable male external cat	N								
A4351	Straight tip urine catheter	N								
A4352	Coude tip urinary catheter	N								
A4353	Intermittent urinary cath	N								
A4354	Cath insertion tray w/bag	N								
A4355	Bladder irrigation tubing	N								
A4356	Ext ureth clmp or compr dvc	N								
A4357	Bedside drainage bag	N								
A4358	Urinary leg or abdomen bag	N								
A4360	Disposable ext urethral dev	N								
A4361	Ostomy face plate	N								
A4362	Solid skin barrier	N								
A4363	"Ostomy clamp, replacement"	E1								
A4364	"Adhesive, liquid or equal"	N								
A4366	Ostomy vent	N								
A4367	Ostomy belt	N								
A4368	Ostomy filter	N								
A4369	Skin barrier liquid per oz	N								
A4371	Skin barrier powder per oz	N								
A4372	Skin barrier solid 4x4 equiv	N								
A4373	Skin barrier with flange	N								
A4375	Drainable plastic pch w fcpl	N								
A4376	Drainable rubber pch w fcplt	N								
A4377	Drainable plstic pch w/o fp	N								
A4378	Drainable rubber pch w/o fp	N								
A4379	Urinary plastic pouch w fcpl	N								
A4380	Urinary rubber pouch w fcplt	N								
A4381	Urinary plastic pouch w/o fp	N								
A4382	Urinary hvy plstc pch w/o fp	N								
A4383	Urinary rubber pouch w/o fp	N								
A4384	Ostomy faceplt/silicone ring	N								
A4385	Ost skn barrier sld ext wear	N								
A4387	Ost clsd pouch w att st barr	N								
A4388	Drainable pch w ex wear barr	N								
A4389	Drainable pch w st wear barr	N								
A4390	Drainable pch ex wear convex	N								
A4391	Urinary pouch w ex wear barr	N								
A4392	Urinary pouch w st wear barr	N								
A4393	Urine pch w ex wear bar conv	N								
A4394	Ostomy pouch liq deodorant	N								
A4395	Ostomy pouch solid deodorant	N								
A4396	Peristomal hernia supprt blt	N								
A4397	Irrigation supply sleeve	N								
A4398	Ostomy irrigation bag	N								
A4399	Ostomy irrig cone/cath w brs	N								
A4400	Ostomy irrigation set	N								
A4402	Lubricant per ounce	N								
A4404	Ostomy ring each	N								
A4405	Nonpectin based ostomy paste	N								
A4406	Pectin based ostomy paste	N								
A4407	"Ext wear ost skn barr <=4sq"""	N								
A4408	"Ext wear ost skn barr >4sq"""	N								
A4409	Ost skn barr convex <=4 sq i	N								
A4410	Ost skn barr extnd >4 sq	N								
A4411	Ost skn barr extnd =4sq	N								
A4412	Ost pouch drain high output	N								
A4413	2 pc drainable ost pouch	N								
A4414	Ost sknbar w/o conv<=4 sq in	N								
A4415	Ost skn barr w/o conv >4 sqi	N								
A4416	Ost pch clsd w barrier/filtr	N								
A4417	Ost pch w bar/bltinconv/fltr	N								
A4418	Ost pch clsd w/o bar w filtr	N								
A4419	Ost pch for bar w flange/flt	N								
A4420	Ost pch clsd for bar w lk fl	N								
A4421	Ostomy supply misc	N								
A4422	Ost pouch absorbent material	N								
A4423	Ost pch for bar w lk fl/fltr	N								
A4424	Ost pch drain w bar & filter	N								
A4425	Ost pch drain for barrier fl	N								
A4426	Ost pch drain 2 piece system	N								
A4427	Ost pch drain/barr lk flng/f	N								
A4428	Urine ost pouch w faucet/tap	N								
A4429	Urine ost pouch w bltinconv	N								
A4430	Ost urine pch w b/bltin conv	N								
A4431	Ost pch urine w barrier/tapv	N								
A4432	Os pch urine w bar/fange/tap	N								
A4433	Urine ost pch bar w lock fln	N								
A4434	Ost pch urine w lock flng/ft	N								
A4435	1pc ost pch drain hgh output	N								
A4450	Non-waterproof tape	N								
A4452	Waterproof tape	N								
A4455	Adhesive remover per ounce	N								
A4456	"Adhesive remover, wipes"	N								
A4458	Reusable enema bag	N								
A4459	"Manual pump enema, reusable"	N								
A4461	Surgicl dress hold non-reuse	N								
A4463	Surgical dress holder reuse	N								
A4465	Non-elastic extremity binder	N								
A4467	Belt strap sleev grmnt cover	E1								
A4470	Gravlee jet washer	N								
A4480	Vabra aspirator	N								
A4481	Tracheostoma filter	N								
A4483	Moisture exchanger	N								
A4490	Above knee surgical stocking	E1								
A4495	Thigh length surg stocking	E1								
A4500	Below knee surgical stocking	E1								
A4510	Full length surg stocking	E1								
A4520	Incontinence garment anytype	E1								
A4550	Surgical trays	B								
A4553	"Nondisp underpads, all sizes"	E1								
A4554	Disposable underpads	E1								
A4555	Ca tx e-stim electr/transduc	E1								
A4556	"Electrodes, pair"	N								
A4557	"Lead wires, pair"	N								
A4558	Conductive gel or paste	N								
A4559	Coupling gel or paste	N								
A4561	"Pessary rubber, any type"	N								
A4562	"Pessary, non rubber,any type"	N								
A4563	Vag inser rectal control sys	A								
A4565	Slings	N								
A4566	Should sling/vest/abrestrain	E1								
A4570	Splint	E1								
A4575	Hyperbaric o2 chamber disps	A								
A4580	Cast supplies (plaster)	E1								
A4590	Special casting material	E1								
A4595	Tens suppl 2 lead per month	N								
A4600	"Sleeve, inter limb comp dev"	E1								
A4601	Lith ion non prosth recharge	E1								
A4602	Replace lithium battery 1.5v	N								
A4604	Tubing with heating element	N								
A4605	Trach suction cath close sys	N								
A4606	Oxygen probe used w oximeter	N								
A4608	Transtracheal oxygen cath	N								
A4611	Heavy duty battery	E1								
A4612	Battery cables	E1								
A4613	Battery charger	E1								
A4614	Hand-held pefr meter	N								
A4615	Cannula nasal	N								
A4616	Tubing (oxygen) per foot	N								
A4617	Mouth piece	N								
A4618	Breathing circuits	N								
A4619	Face tent	N								
A4620	Variable concentration mask	N								
A4623	Tracheostomy inner cannula	N								
A4624	Tracheal suction tube	N								
A4625	Trach care kit for new trach	N								
A4626	Tracheostomy cleaning brush	N								
A4627	Spacer bag/reservoir	E1								
A4628	Oropharyngeal suction cath	N								
A4629	Tracheostomy care kit	N								
A4630	Repl bat t.e.n.s. own by pt	E1								
A4633	Uvl replacement bulb	E1								
A4634	Replacement bulb th lightbox	N								
A4635	Underarm crutch pad	E1								
A4636	Handgrip for cane etc	E1								
A4637	Repl tip cane/crutch/walker	E1								
A4638	Repl batt pulse gen sys	E1								
A4639	Infrared ht sys replcmnt pad	E1								
A4640	Alternating pressure pad	E1								
A4641	Radiopharm dx agent noc	N								
A4642	In111 satumomab	N								
A4648	Implantable tissue marker	N								
A4649	Surgical supplies	N								
A4650	Implant radiation dosimeter	N								
A4651	Calibrated microcap tube	N								
A4652	Microcapillary tube sealant	N								
A4653	Pd catheter anchor belt	N								
A4657	Syringe w/wo needle	N								
A4660	Sphyg/bp app w cuff and stet	N								
A4663	Dialysis blood pressure cuff	N								
A4670	"Automatic bp monitor, dial"	E1								
A4671	Disposable cycler set	B								
A4672	"Drainage ext line, dialysis"	B								
A4673	Ext line w easy lock connect	B								
A4674	"Chem/antisept solution, 8oz"	B								
A4680	"Activated carbon filter, ea"	N								
A4690	"Dialyzer, each"	N								
A4706	Bicarbonate conc sol per gal	N								
A4707	Bicarbonate conc pow per pac	N								
A4708	Acetate conc sol per gallon	N								
A4709	Acid conc sol per gallon	N								
A4714	Treated water per gallon	N								
A4719	"""y set"" tubing"	N								
A4720	Dialysat sol fld vol > 249cc	N								
A4721	Dialysat sol fld vol > 999cc	N								
A4722	Dialys sol fld vol > 1999cc	N								
A4723	Dialys sol fld vol > 2999cc	N								
A4724	Dialys sol fld vol > 3999cc	N								
A4725	Dialys sol fld vol > 4999cc	N								
A4726	Dialys sol fld vol > 5999cc	N								
A4728	"Dialysate solution, non-dex"	B								
A4730	"Fistula cannulation set, ea"	N								
A4736	"Topical anesthetic, per gram"	N								
A4737	Inj anesthetic per 10 ml	N								
A4740	Shunt accessory	N								
A4750	Art or venous blood tubing	N								
A4755	Comb art/venous blood tubing	N								
A4760	"Dialysate sol test kit, each"	N								
A4765	Dialysate conc pow per pack	N								
A4766	Dialysate conc sol add 10 ml	N								
A4770	Blood collection tube/vacuum	N								
A4771	Serum clotting time tube	N								
A4772	Blood glucose test strips	N								
A4773	Occult blood test strips	N								
A4774	Ammonia test strips	N								
A4802	Protamine sulfate per 50 mg	N								
A4860	Disposable catheter tips	N								
A4870	Plumb/elec wk hm hemo equip	N								
A4890	Repair/maint cont hemo equip	N								
A4911	Drain bag/bottle	N								
A4913	Misc dialysis supplies noc	N								
A4918	Venous pressure clamp	N								
A4927	Non-sterile gloves	N								
A4928	Surgical mask	N								
A4929	"Tourniquet for dialysis, ea"	N								
A4930	"Sterile, gloves per pair"	N								
A4931	Reusable oral thermometer	N								
A4932	Reusable rectal thermometer	N								
A5051	Pouch clsd w barr attached	N								
A5052	Clsd ostomy pouch w/o barr	N								
A5053	Clsd ostomy pouch faceplate	N								
A5054	Clsd ostomy pouch w/flange	N								
A5055	Stoma cap	N								
A5056	1 pc ost pouch w filter	N								
A5057	1 pc ost pou w built-in conv	N								
A5061	Pouch drainable w barrier at	N								
A5062	Drnble ostomy pouch w/o barr	N								
A5063	Drain ostomy pouch w/flange	N								
A5071	Urinary pouch w/barrier	N								
A5072	Urinary pouch w/o barrier	N								
A5073	Urinary pouch on barr w/flng	N								
A5081	"Stoma plug or seal, any type"	N								
A5082	Continent stoma catheter	N								
A5083	Stoma absorptive cover	N								
A5093	Ostomy accessory convex inse	N								
A5102	Bedside drain btl w/wo tube	N								
A5105	Urinary suspensory	N								
A5112	Urinary leg bag	N								
A5113	Latex leg strap	E1								
A5114	Foam/fabric leg strap	E1								
A5120	"Skin barrier, wipe or swab"	N								
A5121	Solid skin barrier 6x6	N								
A5122	Solid skin barrier 8x8	N								
A5126	Disk/foam pad +or- adhesive	N								
A5131	Appliance cleaner	N								
A5200	Percutaneous catheter anchor	N								
A5500	Diab shoe for density insert	Y								
A5501	Diabetic custom molded shoe	Y								
A5503	Diabetic shoe w/roller/rockr	Y								
A5504	Diabetic shoe with wedge	Y								
A5505	Diab shoe w/metatarsal bar	Y								
A5506	Diabetic shoe w/off set heel	Y								
A5507	Modification diabetic shoe	Y								
A5508	Diabetic deluxe shoe	Y								
A5510	Compression form shoe insert	N								
A5512	Multi den insert direct form	Y								
A5513	Multi den insert custom mold	Y								
A5514	Mult den insert dir carv/cam	Y								
A6000	Wound warming wound cover	E1								
A6010	Collagen based wound filler	N								
A6011	Collagen gel/paste wound fil	N								
A6021	Collagen dressing <=16 sq in	N								
A6022	Collagen drsg>16<=48 sq in	N								
A6023	Collagen dressing >48 sq in	N								
A6024	Collagen dsg wound filler	N								
A6025	"Silicone gel sheet, each"	N								
A6154	Wound pouch each	N								
A6196	Alginate dressing <=16 sq in	N								
A6197	Alginate drsg >16 <=48 sq in	N								
A6198	Alginate dressing > 48 sq in	N								
A6199	Alginate drsg wound filler	N								
A6203	Composite drsg <= 16 sq in	N								
A6204	Composite drsg >16<=48 sq in	N								
A6205	Composite drsg > 48 sq in	N								
A6206	Contact layer <= 16 sq in	N								
A6207	Contact layer >16<= 48 sq in	N								
A6208	Contact layer > 48 sq in	N								
A6209	Foam drsg <=16 sq in w/o bdr	N								
A6210	Foam drg >16<=48 sq in w/o b	N								
A6211	Foam drg > 48 sq in w/o brdr	N								
A6212	Foam drg <=16 sq in w/border	N								
A6213	Foam drg >16<=48 sq in w/bdr	N								
A6214	Foam drg > 48 sq in w/border	N								
A6215	Foam dressing wound filler	N								
A6216	Non-sterile gauze<=16 sq in	N								
A6217	Non-sterile gauze>16<=48 sq	N								
A6218	Non-sterile gauze > 48 sq in	N								
A6219	Gauze <= 16 sq in w/border	N								
A6220	Gauze >16 <=48 sq in w/bordr	N								
A6221	Gauze > 48 sq in w/border	N								
A6222	Gauze <=16 in no w/sal w/o b	N								
A6223	Gauze >16<=48 no w/sal w/o b	N								
A6224	Gauze > 48 in no w/sal w/o b	N								
A6228	Gauze <= 16 sq in water/sal	N								
A6229	Gauze >16<=48 sq in watr/sal	N								
A6230	Gauze > 48 sq in water/salne	N								
A6231	Hydrogel dsg<=16 sq in	N								
A6232	Hydrogel dsg>16<=48 sq in	N								
A6233	Hydrogel dressing >48 sq in	N								
A6234	Hydrocolld drg <=16 w/o bdr	N								
A6235	Hydrocolld drg >16<=48 w/o b	N								
A6236	Hydrocolld drg > 48 in w/o b	N								
A6237	Hydrocolld drg <=16 in w/bdr	N								
A6238	Hydrocolld drg >16<=48 w/bdr	N								
A6239	Hydrocolld drg > 48 in w/bdr	N								
A6240	Hydrocolld drg filler paste	N								
A6241	Hydrocolloid drg filler dry	N								
A6242	Hydrogel drg <=16 in w/o bdr	N								
A6243	Hydrogel drg >16<=48 w/o bdr	N								
A6244	Hydrogel drg >48 in w/o bdr	N								
A6245	Hydrogel drg <= 16 in w/bdr	N								
A6246	Hydrogel drg >16<=48 in w/b	N								
A6247	Hydrogel drg > 48 sq in w/b	N								
A6248	Hydrogel drsg gel filler	N								
A6250	Skin seal protect moisturizr	N								
A6251	Absorpt drg <=16 sq in w/o b	N								
A6252	Absorpt drg >16 <=48 w/o bdr	N								
A6253	Absorpt drg > 48 sq in w/o b	N								
A6254	Absorpt drg <=16 sq in w/bdr	N								
A6255	Absorpt drg >16<=48 in w/bdr	N								
A6256	Absorpt drg > 48 sq in w/bdr	N								
A6257	Transparent film <= 16 sq in	N								
A6258	Transparent film >16<=48 in	N								
A6259	Transparent film > 48 sq in	N								
A6260	Wound cleanser any type/size	N								
A6261	Wound filler gel/paste /oz	N								
A6262	Wound filler dry form / gram	N								
A6266	Impreg gauze no h20/sal/yard	N								
A6402	Sterile gauze <= 16 sq in	N								
A6403	Sterile gauze>16 <= 48 sq in	N								
A6404	Sterile gauze > 48 sq in	N								
A6407	"Packing strips, non-impreg"	N								
A6410	Sterile eye pad	N								
A6411	Non-sterile eye pad	N								
A6412	Occlusive eye patch	N								
A6413	"Adhesive bandage, first-aid"	E1								
A6441	"Pad band w>=3"" <5""/yd"	N								
A6442	"Conform band n/s w<3""/yd"	N								
A6443	"Conform band n/s w>=3""<5""/yd"	N								
A6444	"Conform band n/s w>=5""/yd"	N								
A6445	"Conform band s w <3""/yd"	N								
A6446	"Conform band s w>=3"" <5""/yd"	N								
A6447	"Conform band s w >=5""/yd"	N								
A6448	"Lt compres band <3""/yd"	N								
A6449	"Lt compres band >=3"" <5""/yd"	N								
A6450	"Lt compres band >=5""/yd"	N								
A6451	"Mod compres band w>=3""<5""/yd"	N								
A6452	"High compres band w>=3""<5""yd"	N								
A6453	"Self-adher band w <3""/yd"	N								
A6454	"Self-adher band w>=3"" <5""/yd"	N								
A6455	"Self-adher band >=5""/yd"	N								
A6456	"Zinc paste band w >=3""<5""/yd"	N								
A6457	Tubular dressing	N								
A6460	Synthetic drsg <= 16 sq in	N								
A6461	Synthetic drsg >16<=48 sq in	N								
A6501	Compres burngarment bodysuit	N								
A6502	Compres burngarment chinstrp	N								
A6503	Compres burngarment facehood	N								
A6504	Cmprsburngarment glove-wrist	N								
A6505	Cmprsburngarment glove-elbow	N								
A6506	Cmprsburngrmnt glove-axilla	N								
A6507	Cmprs burngarment foot-knee	N								
A6508	Cmprs burngarment foot-thigh	N								
A6509	Compres burn garment jacket	N								
A6510	Compres burn garment leotard	N								
A6511	Compres burn garment panty	N								
A6512	"Compres burn garment, noc"	N								
A6513	Compress burn mask face/neck	B								
A6530	Compression stocking bk18-30	E1								
A6531	Compression stocking bk30-40	N								
A6532	Compression stocking bk40-50	N								
A6533	Gc stocking thighlngth 18-30	E1								
A6534	Gc stocking thighlngth 30-40	E1								
A6535	Gc stocking thighlngth 40-50	E1								
A6536	Gc stocking full lngth 18-30	E1								
A6537	Gc stocking full lngth 30-40	E1								
A6538	Gc stocking full lngth 40-50	E1								
A6539	Gc stocking waistlngth 18-30	E1								
A6540	Gc stocking waistlngth 30-40	E1								
A6541	Gc stocking waistlngth 40-50	E1								
A6544	Gc stocking garter belt	E1								
A6545	Grad comp non-elastic bk	N								
A6549	G compression stocking	E1								
A6550	Neg pres wound ther drsg set	N								
A7000	Disposable canister for pump	Y								
A7001	Nondisposable pump canister	Y								
A7002	Tubing used w suction pump	Y								
A7003	Nebulizer administration set	Y								
A7004	Disposable nebulizer sml vol	Y								
A7005	Nondisposable nebulizer set	Y								
A7006	Filtered nebulizer admin set	Y								
A7007	Lg vol nebulizer disposable	Y								
A7008	Disposable nebulizer prefill	Y								
A7009	Nebulizer reservoir bottle	Y								
A7010	Disposable corrugated tubing	Y								
A7012	Nebulizer water collec devic	Y								
A7013	Disposable compressor filter	Y								
A7014	Compressor nondispos filter	Y								
A7015	Aerosol mask used w nebulize	Y								
A7016	Nebulizer dome & mouthpiece	Y								
A7017	Nebulizer not used w oxygen	Y								
A7018	Water distilled w/nebulizer	Y								
A7020	"Interface, cough stim device"	Y								
A7025	Replace chest compress vest	N								
A7026	Replace chst cmprss sys hose	Y								
A7027	Combination oral/nasal mask	Y								
A7028	Repl oral cushion combo mask	Y								
A7029	Repl nasal pillow comb mask	Y								
A7030	Cpap full face mask	Y								
A7031	Replacement facemask interfa	Y								
A7032	Replacement nasal cushion	Y								
A7033	Replacement nasal pillows	Y								
A7034	Nasal application device	Y								
A7035	Pos airway press headgear	Y								
A7036	Pos airway press chinstrap	Y								
A7037	Pos airway pressure tubing	Y								
A7038	Pos airway pressure filter	Y								
A7039	"Filter, non disposable w pap"	Y								
A7040	One way chest drain valve	N								
A7041	Water seal drain container	N								
A7044	Pap oral interface	Y								
A7045	Repl exhalation port for pap	Y								
A7046	"Repl water chamber, pap dev"	Y								
A7047	Resp suction oral interface	N								
A7048	Vacuum drain bottle/tube kit	N								
A7501	Tracheostoma valve w diaphra	N								
A7502	Replacement diaphragm/fplate	N								
A7503	Hmes filter holder or cap	N								
A7504	Tracheostoma hmes filter	N								
A7505	Hmes or trach valve housing	N								
A7506	Hmes/trachvalve adhesivedisk	N								
A7507	Integrated filter & holder	N								
A7508	Housing & integrated adhesiv	N								
A7509	Heat & moisture exchange sys	N								
A7520	Trach/laryn tube non-cuffed	N								
A7521	Trach/laryn tube cuffed	N								
A7522	Trach/laryn tube stainless	N								
A7523	Tracheostomy shower protect	N								
A7524	Tracheostoma stent/stud/bttn	N								
A7525	Tracheostomy mask	N								
A7526	Tracheostomy tube collar	N								
A7527	Trach/laryn tube plug/stop	N								
A8000	Soft protect helmet prefab	Y								
A8001	Hard protect helmet prefab	Y								
A8002	Soft protect helmet custom	Y								
A8003	Hard protect helmet custom	Y								
A8004	"Repl soft interface, helmet"	Y								
A9150	Misc/exper non-prescript dru	B								
A9152	Single vitamin nos	E1								
A9153	Multi-vitamin nos	E1								
A9155	Artificial saliva	B								
A9180	"Lice treatment, topical"	E1								
A9270	Non-covered item or service	E1								
A9272	"Disp wound suct, drsg/access"	E1								
A9273	Hot/cold botle/cap/col/wrap	E1								
A9274	Ext amb insulin delivery sys	E1								
A9275	Disp home glucose monitor	E1								
A9276	"Disposable sensor, cgm sys"	E1								
A9277	"External transmitter, cgm"	E1								
A9278	"External receiver, cgm sys"	E1								
A9279	Monitoring feature/devicenoc	E1								
A9280	"Alert device, noc"	E1								
A9281	Reaching/grabbing device	E1								
A9282	Wig any type	E1								
A9283	Foot press off load supp dev	E1								
A9284	Non-electronic spirometer	N								
A9285	Inversion eversion cor devic	A								
A9286	"Any hygienic item, device"	E1								
A9300	Exercise equipment	E1								
A9500	Tc99m sestamibi	N								
A9501	Technetium tc-99m teboroxime	N								
A9502	Tc99m tetrofosmin	N								
A9503	Tc99m medronate	N								
A9504	Tc99m apcitide	N								
A9505	Tl201 thallium	N								
A9507	In111 capromab	N								
A9508	"I131 iodobenguate, dx"	N								
A9509	Iodine i-123 sod iodide mil	N								
A9510	Tc99m disofenin	N								
A9512	Tc99m pertechnetate	N								
A9513	Lutetium lu 177 dotatat ther	G	9067		$266.590	.	$53.32			
A9515	Choline c-11	N								
A9516	Iodine i-123 sod iodide mic	N								
A9517	"I131 iodide cap, rx"	K	1064		$20.690	.	$4.14		*	
A9520	Tc99 tilmanocept diag 0.5mci	N								
A9521	Tc99m exametazime	N								
A9524	"I131 serum albumin, dx"	N								
A9526	Nitrogen n-13 ammonia	N								
A9527	Iodine i-125 sodium iodide	U	2632	0.3870	$31.27	.	$6.26			
A9528	"Iodine i-131 iodide cap, dx"	N								
A9529	"I131 iodide sol, dx"	N								
A9530	"I131 iodide sol, rx"	K	1150		$13.360	.	$2.68		*	
A9531	I131 max 100uci	N								
A9532	"I125 serum albumin, dx"	N								
A9536	Tc99m depreotide	N								
A9537	Tc99m mebrofenin	N								
A9538	Tc99m pyrophosphate	N								
A9539	Tc99m pentetate	N								
A9540	Tc99m maa	N								
A9541	Tc99m sulfur colloid	N								
A9542	"In111 ibritumomab, dx"	N								
A9543	"Y90 ibritumomab, rx"	K	1643		"$56,746.934"	.	"$11,349.39"	*	*	
A9546	Co57/58	N								
A9547	In111 oxyquinoline	N								
A9548	In111 pentetate	N								
A9550	Tc99m gluceptate	N								
A9551	Tc99m succimer	N								
A9552	F18 fdg	N								
A9553	Cr51 chromate	N								
A9554	"I125 iothalamate, dx"	N								
A9555	Rb82 rubidium	N								
A9556	Ga67 gallium	N								
A9557	Tc99m bicisate	N								
A9558	Xe133 xenon 10mci	N								
A9559	Co57 cyano	N								
A9560	Tc99m labeled rbc	N								
A9561	Tc99m oxidronate	N								
A9562	Tc99m mertiatide	N								
A9563	P32 na phosphate	K	1675		$449.310	.	$89.87		*	
A9564	P32 chromic phosphate	E1								
A9566	Tc99m fanolesomab	N								
A9567	Technetium tc-99m aerosol	N								
A9568	Technetium tc99m arcitumomab	N								
A9569	Technetium tc-99m auto wbc	N								
A9570	Indium in-111 auto wbc	N								
A9571	Indium in-111 auto platelet	N								
A9572	Indium in-111 pentetreotide	N								
A9575	Inj gadoterate meglumi 0.1ml	N								
A9576	Inj prohance multipack	N								
A9577	Inj multihance	N								
A9578	Inj multihance multipack	N								
A9579	"Gad-base mr contrast nos,1ml"	N								
A9580	Sodium fluoride f-18	N								
A9581	Gadoxetate disodium inj	N								
A9582	Iodine i-123 iobenguane	N								
A9583	Gadofosveset trisodium inj	N								
A9584	Iodine i-123 ioflupane	N								
A9585	Gadobutrol injection	N								
A9586	Florbetapir f18	N							*	
A9587	Gallium ga-68	N								
A9588	Fluciclovine f-18	N								
A9589	Insti hexaminolevulinate hcl	N 								
A9590	Iodine i-131 iobenguane 1mci	G	9339		$320.120	.	$64.03		*	
A9597	"Pet, dx, for tumor id, noc"	N								
A9598	"Pet dx for non-tumor id, noc"	N								
A9600	Sr89 strontium	K	0701		"$2,045.702"	.	$409.15		*	
A9604	Sm 153 lexidronam	K	1295		"$17,259.853"	.	"$3,451.98"	*		
A9606	Radium ra223 dichloride ther	K	1745		$140.961	.	$28.20		*	
A9698	Non-rad contrast materialnoc	N								
A9699	Radiopharm rx agent noc	N								
A9700	Echocardiography contrast	N								
A9900	Supply/accessory/service	Y								
A9901	Delivery/set up/dispensing	A								
A9999	"Dme supply or accessory, nos"	Y								
B4034	Enter feed supkit syr by day	Y								
B4035	Enteral feed supp pump per d	Y								
B4036	Enteral feed sup kit grav by	Y								
B4081	Enteral ng tubing w/ stylet	Y								
B4082	Enteral ng tubing w/o stylet	Y								
B4083	Enteral stomach tube levine	Y								
B4087	"Gastro/jejuno tube, std"	Y								
B4088	"Gastro/jejuno tube, low-pro"	Y								
B4100	Food thickener oral	E1								
B4102	Ef adult fluids and electro	Y								
B4103	Ef ped fluid and electrolyte	Y								
B4104	Additive for enteral formula	E1								
B4105	Enzyme cartridge enteral nut	Y								
B4149	Ef blenderized foods	Y								
B4150	Ef complet w/intact nutrient	Y								
B4152	Ef calorie dense>/=1.5kcal	Y								
B4153	Ef hydrolyzed/amino acids	Y								
B4154	Ef spec metabolic noninherit	Y								
B4155	Ef incomplete/modular	Y								
B4157	Ef special metabolic inherit	Y								
B4158	Ef ped complete intact nut	Y								
B4159	Ef ped complete soy based	Y								
B4160	Ef ped caloric dense>/=0.7kc	Y								
B4161	Ef ped hydrolyzed/amino acid	Y								
B4162	Ef ped specmetabolic inherit	Y								
B4164	Parenteral 50% dextrose solu	Y								
B4168	Parenteral sol amino acid 3.	Y								
B4172	Parenteral sol amino acid 5.	Y								
B4176	Parenteral sol amino acid 7-	Y								
B4178	Parenteral sol amino acid >	Y								
B4180	Parenteral sol carb > 50%	Y								
B4185	Pn soln nos 10 grams lipids	B								
B4187	"Omegaven, 10 grams lipids"	B								
B4189	Parenteral sol amino acid &	Y								
B4193	Parenteral sol 52-73 gm prot	Y								
B4197	Parenteral sol 74-100 gm pro	Y								
B4199	Parenteral sol > 100gm prote	Y								
B4216	Parenteral nutrition additiv	Y								
B4220	Parenteral supply kit premix	Y								
B4222	Parenteral supply kit homemi	Y								
B4224	Parenteral administration ki	Y								
B5000	Parenteral sol renal-amirosy	Y								
B5100	Parenteral solution hepatic	Y								
B5200	Parenteral sol hepatic fream	Y								
B9002	Enter nutr inf pump any type	Y								
B9004	Parenteral infus pump portab	Y								
B9006	Parenteral infus pump statio	Y								
B9998	Enteral supp not otherwise c	Y								
B9999	Parenteral supp not othrws c	Y								
C1713	"Anchor/screw bn/bn,tis/bn"	N								
C1714	"Cath, trans atherectomy, dir"	N								
C1715	Brachytherapy needle	N								
C1716	"Brachytx, non-str, gold-198"	U	2645	1.4414	$116.46	.	$23.30			
C1717	"Brachytx, non-str,hdr ir-192"	U	2646	3.9857	$322.02	.	$64.41			
C1719	"Brachytx, ns, non-hdrir-192"	U	2647	0.7794	$62.97	.	$12.60			
C1721	"Aicd, dual chamber"	N								
C1722	"Aicd, single chamber"	N								
C1724	"Cath, trans atherec,rotation"	N								
C1725	"Cath, translumin non-laser"	N								
C1726	"Cath, bal dil, non-vascular"	N								
C1727	"Cath, bal tis dis, non-vas"	N								
C1728	"Cath, brachytx seed adm"	N								
C1729	"Cath, drainage"	N								
C1730	"Cath, ep, 19 or few elect"	N								
C1731	"Cath, ep, 20 or more elec"	N								
C1732	"Cath, ep, diag/abl, 3d/vect"	N								
C1733	"Cath, ep, othr than cool-tip"	N								
C1734	"Orth/devic/drug bn/bn,tis/bn "	H	2026							
C1748	"Endoscope, single, ugi"	H	2029							
C1749	"Endo, colon, retro imaging"	N								
C1750	"Cath, hemodialysis,long-term"	N								
C1751	"Cath, inf, per/cent/midline"	N								
C1752	"Cath,hemodialysis,short-term"	N								
C1753	"Cath, intravas ultrasound"	N								
C1754	"Catheter, intradiscal"	N								
C1755	"Catheter, intraspinal"	N								
C1756	"Cath, pacing, transesoph"	N								
C1757	"Cath, thrombectomy/embolect"	N								
C1758	"Catheter, ureteral"	N								
C1759	"Cath, intra echocardiography"	N								
C1760	"Closure dev, vasc"	N								
C1762	"Conn tiss, human(inc fascia)"	N								
C1763	"Conn tiss, non-human"	N								
C1764	"Event recorder, cardiac"	N								
C1765	Adhesion barrier	N								
C1766	"Intro/sheath,strble,non-peel"	N								
C1767	"Generator, neuro non-recharg"	N								
C1768	"Graft, vascular"	N								
C1769	Guide wire	N								
C1770	"Imaging coil, mr, insertable"	N								
C1771	"Rep dev, urinary, w/sling"	N								
C1772	"Infusion pump, programmable"	N								
C1773	"Ret dev, insertable"	N								
C1776	Joint device (implantable)	N								
C1777	"Lead, aicd, endo single coil"	N								
C1778	"Lead, neurostimulator"	N								
C1779	"Lead, pmkr, transvenous vdd"	N								
C1780	"Lens, intraocular (new tech)"	N								
C1781	Mesh (implantable)	N								
C1782	Morcellator	N								
C1783	"Ocular imp, aqueous drain de"	N								
C1784	"Ocular dev, intraop, det ret"	N								
C1785	"Pmkr, dual, rate-resp"	N								
C1786	"Pmkr, single, rate-resp"	N								
C1787	"Patient progr, neurostim"	N								
C1788	"Port, indwelling, imp"	N								
C1789	"Prosthesis, breast, imp"	N								
C1813	"Prosthesis, penile, inflatab"	N								
C1814	"Retinal tamp, silicone oil"	N								
C1815	"Pros, urinary sph, imp"	N								
C1816	"Receiver/transmitter, neuro"	N								
C1817	Septal defect imp sys	N								
C1818	Integrated keratoprosthesis	N								
C1819	Tissue localization-excision	N								
C1820	Generator neuro rechg bat sy	N								
C1821	Interspinous implant	N								
C1822	"Gen, neuro, hf, rechg bat"	N								
C1823	"Gen, neuro, trans sen/stim"	H	2993							
C1824	"Generator, ccm, implant"	H	2024							
C1830	Power bone marrow bx needle	N								
C1839	Iris prosthesis	H	2028							
C1840	Telescopic intraocular lens	N								
C1841	Retinal prosth int/ext comp	N								
C1842	"Retinal prosth, add-on"	E1								
C1849	"Skin substitute, synthetic"	N								
C1874	"Stent, coated/cov w/del sys"	N								
C1875	"Stent, coated/cov w/o del sy"	N								
C1876	"Stent, non-coa/non-cov w/del"	N								
C1877	"Stent, non-coat/cov w/o del"	N								
C1878	Matrl for vocal cord	N								
C1880	Vena cava filter	N								
C1881	Dialysis access system	N								
C1882	"Aicd, other than sing/dual"	N								
C1883	"Adapt/ext, pacing/neuro lead"	N								
C1884	Embolization protect syst	N								
C1885	"Cath, translumin angio laser"	N								
C1886	"Catheter, ablation"	N								
C1887	"Catheter, guiding"	N								
C1888	Endovas non-cardiac abl cath	N								
C1889	"Implant/insert device, noc"	N								
C1890	No device w/dev-intensive px	E1								
C1891	"Infusion pump,non-prog, perm"	N								
C1892	"Intro/sheath,fixed,peel-away"	N								
C1893	"Intro/sheath, fixed,non-peel"	N								
C1894	"Intro/sheath, non-laser"	N								
C1895	"Lead, aicd, endo dual coil"	N								
C1896	"Lead, aicd, non sing/dual"	N								
C1897	"Lead, neurostim test kit"	N								
C1898	"Lead, pmkr, other than trans"	N								
C1899	"Lead, pmkr/aicd combination"	N								
C1900	"Lead, coronary venous"	N								
C1982	"Cath, pressure,valve-occlu"	H	2025							
C2596	"Probe, robotic, water-jet"	H	2027							
C2613	Lung bx plug w/del sys	N								
C2614	"Probe, perc lumb disc"	N								
C2615	"Sealant, pulmonary, liquid"	N								
C2616	"Brachytx, non-str,yttrium-90"	U	2616	211.5476	"$17,091.57"	.	"$3,418.32"	*		
C2617	"Stent, non-cor, tem w/o del"	N								
C2618	"Probe/needle, cryo"	N								
C2619	"Pmkr, dual, non rate-resp"	N								
C2620	"Pmkr, single, non rate-resp"	N								
C2621	"Pmkr, other than sing/dual"	N								
C2622	"Prosthesis, penile, non-inf"	N								
C2623	"Cath, translumin, drug-coat"	N								
C2624	Wireless pressure sensor 	N								
C2625	"Stent, non-cor, tem w/del sy"	N								
C2626	"Infusion pump, non-prog,temp"	N								
C2627	"Cath, suprapubic/cystoscopic"	N								
C2628	"Catheter, occlusion"	N								
C2629	"Intro/sheath, laser"	N								
C2630	"Cath, ep, cool-tip"	N								
C2631	"Rep dev, urinary, w/o sling"	N								
C2634	"Brachytx, non-str, ha, i-125"	U	2634	2.2515	$181.91	.	$36.39			
C2635	"Brachytx, non-str, ha, p-103"	U	2635	0.6978	$56.38	.	$11.28			
C2636	"Brachy linear, non-str,p-103"	U	2636	0.4460	$36.03	.	$7.21			
C2637	"Brachy,non-str,ytterbium-169"	B								
C2638	"Brachytx, stranded, i-125"	U	2638	0.4276	$34.55	.	$6.91			
C2639	"Brachytx, non-stranded,i-125"	U	2639	0.4411	$35.64	.	$7.13			
C2640	"Brachytx, stranded, p-103"	U	2640	1.0347	$83.60	.	$16.72			
C2641	"Brachytx, non-stranded,p-103"	U	2641	0.8589	$69.39	.	$13.88			
C2642	"Brachytx, stranded, c-131"	U	2642	0.9495	$76.71	.	$15.35			
C2643	"Brachytx, non-stranded,c-131"	U	2643	1.1847	$95.72	.	$19.15			
C2644	Brachytx cesium-131 chloride	E2								
C2645	"Brachytx planar, p-103"	U	2648	0.0580	$4.69	.	$0.94			
C2698	"Brachytx, stranded, nos"	U	2698	0.4276	$34.55	.	$6.91			
C2699	"Brachytx, non-stranded, nos"	U	2699	0.4411	$35.64	.	$7.13			
C5271	Low cost skin substitute app	T	5053	6.1518	$497.02	.	$99.41			
C5272	Low cost skin substitute app	N								
C5273	Low cost skin substitute app	T	5054	20.0852	"$1,622.74"	.	$324.55			
C5274	Low cost skin substitute app	N								
C5275	Low cost skin substitute app	T	5053	6.1518	$497.02	.	$99.41			
C5276	Low cost skin substitute app	N								
C5277	Low cost skin substitute app	T	5053	6.1518	$497.02	.	$99.41			
C5278	Low cost skin substitute app	N								
C8900	"Mra w/cont, abd"	Q3	5572	4.7263	$381.85	.	$76.37			
C8901	"Mra w/o cont, abd"	Q3	5523	2.8844	$233.04	.	$46.61			
C8902	"Mra w/o fol w/cont, abd"	Q3	5572	4.7263	$381.85	.	$76.37			
C8903	"Mri w/cont, breast,  uni"	Q3	5571	2.2554	$182.22	.	$36.45			
C8905	"Mri w/o fol w/cont, brst, un"	Q3	5572	4.7263	$381.85	.	$76.37			
C8906	"Mri w/cont, breast,  bi"	Q3	5572	4.7263	$381.85	.	$76.37			
C8908	"Mri w/o fol w/cont, breast,"	Q3	5572	4.7263	$381.85	.	$76.37			
C8909	"Mra w/cont, chest"	Q3	5572	4.7263	$381.85	.	$76.37			
C8910	"Mra w/o cont, chest"	Q3	5523	2.8844	$233.04	.	$46.61			
C8911	"Mra w/o fol w/cont, chest"	Q3	5572	4.7263	$381.85	.	$76.37			
C8912	"Mra w/cont, lwr ext"	Q3	5572	4.7263	$381.85	.	$76.37			
C8913	"Mra w/o cont, lwr ext"	Q3	5523	2.8844	$233.04	.	$46.61			
C8914	"Mra w/o fol w/cont, lwr ext"	Q3	5572	4.7263	$381.85	.	$76.37			
C8918	"Mra w/cont, pelvis"	Q3	5572	4.7263	$381.85	.	$76.37			
C8919	"Mra w/o cont, pelvis"	Q3	5523	2.8844	$233.04	.	$46.61			
C8920	"Mra w/o fol w/cont, pelvis"	Q3	5572	4.7263	$381.85	.	$76.37			
C8921	"Tte w or w/o fol w/cont, com"	S	5573	8.4267	$680.82	.	$136.17			
C8922	"Tte w or w/o fol w/cont, f/u"	S	5573	8.4267	$680.82	.	$136.17			
C8923	"2d tte w or w/o fol w/con,co"	S	5573	8.4267	$680.82	.	$136.17			
C8924	"2d tte w or w/o fol w/con,fu"	S	5572	4.7263	$381.85	.	$76.37			
C8925	"2d tee w or w/o fol w/con,in"	S	5573	8.4267	$680.82	.	$136.17			
C8926	"Tee w or w/o fol w/cont,cong"	S	5573	8.4267	$680.82	.	$136.17			
C8927	"Tee w or w/o fol w/cont, mon"	S	5573	8.4267	$680.82	.	$136.17			
C8928	"Tte w or w/o fol w/con,stres"	S	5573	8.4267	$680.82	.	$136.17			
C8929	"Tte w or wo fol wcon,doppler"	S	5573	8.4267	$680.82	.	$136.17			
C8930	"Tte w or w/o contr, cont ecg"	S	5573	8.4267	$680.82	.	$136.17			
C8931	"Mra, w/dye, spinal canal"	Q3	5572	4.7263	$381.85	.	$76.37			
C8932	"Mra, w/o dye, spinal canal"	Q3	5523	2.8844	$233.04	.	$46.61			
C8933	"Mra, w/o&w/dye, spinal canal"	Q3	5572	4.7263	$381.85	.	$76.37			
C8934	"Mra, w/dye, upper extremity"	Q3	5572	4.7263	$381.85	.	$76.37			
C8935	"Mra, w/o dye, upper extr"	Q3	5523	2.8844	$233.04	.	$46.61			
C8936	"Mra, w/o&w/dye, upper extr"	Q3	5572	4.7263	$381.85	.	$76.37			
C8937	Cad breast mri	N								
C8957	"Prolonged iv inf, req pump"	S	5694	3.8320	$309.60	.	$61.92			
C9046	Cocaine hcl nasal solution	G	9307		$1.230	.	$0.25		*	
C9047	"Injection, caplacizumab-yhdp"	G	9199		$690.680	.	$138.14		*	
C9060	Fluoroestradiol f18	G	9370		$0.752		$0.00		*	
C9062	Daratumumab hyaluronidase	G	9378		$43.340		$8.67		*	
C9064	Mitomycin pyelocalyceal inst	G	9374		$275.216		$55.05		*	
C9065	Romidepsin non-lyophilized	G	9379		$329.456		$65.90		*	
C9066	Sacituzumab govitecan-hziy	G	9376		$28.790		$5.76		*	
C9067	Gallium ga-68 dotatoc	G	9323		$8.640		$0.00		*	
C9113	"Inj pantoprazole sodium, via"	N								
C9122	Mometasone furoate (sinuva)	G	9346		$10.252		$2.06		*	
C9132	"Kcentra, per i.u."	K	9132		$2.091	.	$0.42		*	
C9248	"Inj, clevidipine butyrate"	N								
C9250	Artiss fibrin sealant	K	1848		$156.842	.	$31.37		*	
C9254	"Injection, lacosamide"	N								
C9257	Bevacizumab injection	K	1281		$1.909	.	$0.39		*	
C9285	"Patch, lidocaine/tetracaine"	N								
C9290	"Inj, bupivacaine liposome"	N								
C9293	"Injection, glucarpidase"	N								
C9352	"Neuragen nerve guide, per cm"	N								
C9353	"Neurawrap nerve protector,cm"	N								
C9354	"Veritas collagen matrix, cm2"	N								
C9355	"Neuromatrix nerve cuff, cm"	N								
C9356	"Tenoglide tendon prot, cm2"	N								
C9358	"Surgimend, fetal"	N								
C9359	"Implnt,bon void filler-putty"	N								
C9360	"Surgimend, neonatal"	N								
C9361	Neuromend nerve wrap	N								
C9362	"Implnt,bon void filler-strip"	N								
C9363	Integra meshed bil wound mat	N								
C9364	"Porcine implant, permacol"	N								
C9399	Unclassified drugs or biolog	A								
C9460	"Injection, cangrelor"	K	9460		$15.320	.	$3.07		*	
C9462	"Injection, delafloxacin"	G	9462		$0.278	.	$0.06		*	
C9482	Sotalol hydrochloride iv	K	9482		$15.999	.	$3.20			
C9488	Conivaptan hcl	K	9488		$32.571	.	$6.52		*	
C9600	Perc drug-el cor stent sing	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
C9601	Perc drug-el cor stent bran	N								
C9602	Perc d-e cor stent ather s	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
C9603	Perc d-e cor stent ather br	N								
C9604	Perc d-e cor revasc t cabg s	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
C9605	Perc d-e cor revasc t cabg b	N								
C9606	Perc d-e cor revasc w ami s	C								
C9607	Perc d-e cor revasc chro sin	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
C9608	Perc d-e cor revasc chro add	N								
C9725	Place endorectal app	T	5311	9.4548	$763.88	.	$152.78			
C9726	Rxt breast appl place/remov	N								
C9727	Insert palate implants	J1	5163	16.7012	"$1,349.34"	.	$269.87			
C9728	"Place device/marker, non pro"	S	5613	15.4140	"$1,245.34"	.	$249.07			
C9733	Non-ophthalmic fva	Q2	5572	4.7263	$381.85	.	$76.37			
C9734	"U/s trtmt, not leiomyomata"	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
C9738	Blue light cysto imag agent	N								
C9739	Cystoscopy prostatic imp 1-3	J1	5375	52.3761	"$4,231.62"	.	$846.33			
C9740	Cysto impl 4 or more	J1	5376	99.8593	"$8,067.93"	.	"$1,613.59"	*		
C9745	Nasal endo eustachian tube	J1	5165	60.0365	"$4,850.53"	.	$970.11			
C9747	"Ablation, hifu, prostate"	J1	5375	52.3761	"$4,231.62"	.	$846.33			
C9749	Repair nasal stenosis w/imp	J1	5165	60.0365	"$4,850.53"	.	$970.11			
C9751	"Microwave bronch, 3d, ebus"	T	1571		"$8,250.50"	.	"$1,650.10"	*		
C9752	Intraosseous des lumb/sacrum	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
C9753	Intraosseous destruct add'l	N								
C9756	Fluorescence lymph map w/icg	N								
C9757	Spine/lumbar disk surgery	J1	5115	147.2988	"$11,900.71"	.	"$2,380.15"	*		
C9758	Blind interatrial shunt ide	T	1589		"$12,500.50"	.	"$2,500.10"	*		
C9759	Transcath intraop microinf   	N								
C9760	Non-blind interatrial shunt	T	1589		"$12,500.50"	.	"$2,500.10"	*	*	
C9761	"Cysto, litho, vacuum kidney"	J1	5375	52.3761	"$4,231.62"	.	$846.33		*	
C9762	Cardiac MRI seg dys strain	Q3	5524	5.9607	$481.58	.	$96.32			
C9763	Cardiac MRI seg dys stress	Q3	5524	5.9607	$481.58	.	$96.32			
C9764	Revasc intravasc lithotripsy	J1	5192	61.3161	"$4,953.91"	.	$990.79			
C9765	Revasc intra lithotrip-stent	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
C9766	Revasc intra lithotrip-ather	J1	5193	122.6403	"$9,908.48"	.	"$1,981.70"	*		
C9767	Revasc lithotrip-stent-ather	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
C9768	Endo us-guide hep porto grad	N							*	
C9769	Cysto w/temp pros implant	J1	5375	52.3761	"$4,231.62"	.	$846.33		*	
C9803	Hopd covid-19 spec collect	Q1	5731	0.2845	$22.99	.	$4.60			
C9898	Inpnt stay radiolabeled item	N								
C9899	"Inpt implant pros dev,no cov"	A								
D0120	Periodic oral evaluation	E1								
D0140	Limit oral eval problm focus	E1								
D0145	"Oral evaluation, pt < 3yrs"	E1								
D0150	Comprehensve oral evaluation	S	5871	12.0688	$975.07	.	$195.02			
D0160	Extensv oral eval prob focus	E1								
D0170	"Re-eval,est pt,problem focus"	E1								
D0171	Re-eval post-op visit	E1								
D0180	Comp periodontal evaluation	E1								
D0190	Screening of a patient	E1								
D0191	Assessment of a patient	E1								
D0210	Intraor complete film series	E1								
D0220	Intraoral periapical first	E1								
D0230	Intraoral periapical ea add	E1								
D0240	Intraoral occlusal film	S	5871	12.0688	$975.07	.	$195.02			
D0250	Extraoral 2d project image	S	5871	12.0688	$975.07	.	$195.02			
D0251	Extraoral posterior image	Q1	5521	0.9878	$79.81	.	$15.97			
D0270	Dental bitewing single image	S	5871	12.0688	$975.07	.	$195.02			
D0272	Dental bitewings two images	S	5871	12.0688	$975.07	.	$195.02			
D0273	Bitewings - three images	E1								
D0274	Bitewings four images	S	5871	12.0688	$975.07	.	$195.02			
D0277	Vert bitewings 7 to 8 images	S	5871	12.0688	$975.07	.	$195.02			
D0310	Dental saliography	E1								
D0320	Dental tmj arthrogram incl i	E1								
D0321	Other tmj images by report	E1								
D0322	Dental tomographic survey	E1								
D0330	Panoramic image	E1								
D0340	2d cephalometric image	E1								
D0350	Oral/facial photo images	E1								
D0351	3d photographic image	E1								
D0364	Cone beam ct capt & interp	E1								
D0365	Cone beam ct interprete man	E1								
D0366	Cone beam ct interprete max	E1								
D0367	Cone beam ct interp both jaw	E1								
D0368	Cone beam ct interprete tmj	E1								
D0369	Max mri capture & interprete	E1								
D0370	Max ultrasound capt & interp	E1								
D0371	Sialoendoscopy capt & interp	E1								
D0380	Cone beam ct capture limited	E1								
D0381	Cone beam ct capt mandible	E1								
D0382	Cone beam ct capt maxilla	E1								
D0383	Cone beam ct both jaws	E1								
D0384	Cone beam ct capture tmj	E1								
D0385	Max mri image capture	E1								
D0386	Max ultrasound image capture	E1								
D0391	Imterprete diagnostic image	E1								
D0393	Trtmnt simulation 3d image	E1								
D0394	Digital sub 2 or more images	E1								
D0395	Fusion 2 or more 3d images	E1								
D0411	Hba1c in office testing	E1								
D0412	Blood glucose level test	E1								
D0414	Lab process microbial spec	E1								
D0415	Collection of microorganisms	E1								
D0416	Viral culture	B								
D0417	Collect & prep saliva sample	E1								
D0418	Analysis of saliva sample	E1								
D0419	Assess of salivary flow	E1								
D0422	Collect & prep genetic samp	E1								
D0423	Genetic test spec analysis	E1								
D0425	Caries susceptibility test	E1								
D0431	Diag tst detect mucos abnorm	B								
D0460	Pulp vitality test	S	5871	12.0688	$975.07	.	$195.02			
D0470	Diagnostic casts	E1								
D0472	"Gross exam, prep & report"	B								
D0473	"Micro exam, prep & report"	B								
D0474	Micro w exam of surg margins	B								
D0475	Decalcification procedure	B								
D0476	Spec stains for microorganis	B								
D0477	Spec stains not for microorg	B								
D0478	Immunohistochemical stains	B								
D0479	Tissue in-situ hybridization	B								
D0480	Cytopath smear prep & report	B								
D0481	Electron microscopy	B								
D0482	Direct immunofluorescence	B								
D0483	Indirect immunofluorescence	B								
D0484	Consult slides prep elsewher	B								
D0485	Consult inc prep of slides	B								
D0486	Access of transep cytol samp	E1								
D0502	Other oral pathology procedu	B								
D0600	Non-ionizing diag proc	S	5871	12.0688	$975.07	.	$195.02			
D0601	Caries risk assess low risk	E1								
D0602	Caries risk assess mod risk	E1								
D0603	Caries risk assess high risk	E1								
D0999	Unspecified diagnostic proce	B								
D1110	Dental prophylaxis adult	E1								
D1120	Dental prophylaxis child	E1								
D1206	Topical fluoride varnish	E1								
D1208	Topical app fluorid ex vrnsh	E1								
D1310	Nutri counsel-control caries	E1								
D1320	Tobacco counseling	E1								
D1330	Oral hygiene instruction	E1								
D1351	Dental sealant per tooth	E1								
D1352	"Prev resin rest, perm tooth"	E1								
D1353	Sealant repair per tooth	E1								
D1354	Int caries med app per tooth	E1								
D1510	Space maintainer fxd unilat	S	5871	12.0688	$975.07	.	$195.02			
D1516	"Fixed bilat space maint, max"	S	5871	12.0688	$975.07	.	$195.02			
D1517	"Fixed bilat space maint, man"	S	5871	12.0688	$975.07	.	$195.02			
D1520	Remove unilat space maintain	S	5871	12.0688	$975.07	.	$195.02			
D1526	"Remove bilat space main, max"	S	5871	12.0688	$975.07	.	$195.02			
D1527	"Remove bilat space main, man"	S	5871	12.0688	$975.07	.	$195.02			
D1551	Recement space maint - max	S	5871	12.0688	$975.07	.	$195.02			
D1552	Recement space maint - man	S	5871	12.0688	$975.07	.	$195.02			
D1553	Recement unilat space maint	S	5871	12.0688	$975.07	.	$195.02			
D1556	Rem fixed unilat space maint	E1								
D1557	Remove fixed bilat maint max	E1								
D1558	Remove fixed bilat man	E1								
D1575	"Dist space maint, fixed unil"	S	5871	12.0688	$975.07	.	$195.02			
D1999	Unspecified preventive proc	E1								
D2140	Amalgam one surface permanen	E1								
D2150	Amalgam two surfaces permane	E1								
D2160	Amalgam three surfaces perma	E1								
D2161	Amalgam 4 or > surfaces perm	E1								
D2330	Resin one surface-anterior	E1								
D2331	Resin two surfaces-anterior	E1								
D2332	Resin three surfaces-anterio	E1								
D2335	Resin 4/> surf or w incis an	E1								
D2390	Ant resin-based cmpst crown	E1								
D2391	Post 1 srfc resinbased cmpst	E1								
D2392	Post 2 srfc resinbased cmpst	E1								
D2393	Post 3 srfc resinbased cmpst	E1								
D2394	Post >=4srfc resinbase cmpst	E1								
D2410	Dental gold foil one surface	E1								
D2420	Dental gold foil two surface	E1								
D2430	Dental gold foil three surfa	E1								
D2510	Dental inlay metalic 1 surf	E1								
D2520	Dental inlay metallic 2 surf	E1								
D2530	Dental inlay metl 3/more sur	E1								
D2542	Dental onlay metallic 2 surf	E1								
D2543	Dental onlay metallic 3 surf	E1								
D2544	Dental onlay metl 4/more sur	E1								
D2610	Inlay porcelain/ceramic 1 su	E1								
D2620	Inlay porcelain/ceramic 2 su	E1								
D2630	Dental onlay porc 3/more sur	E1								
D2642	Dental onlay porcelin 2 surf	E1								
D2643	Dental onlay porcelin 3 surf	E1								
D2644	Dental onlay porc 4/more sur	E1								
D2650	Inlay composite/resin one su	E1								
D2651	Inlay composite/resin two su	E1								
D2652	Dental inlay resin 3/mre sur	E1								
D2662	Dental onlay resin 2 surface	E1								
D2663	Dental onlay resin 3 surface	E1								
D2664	Dental onlay resin 4/mre sur	E1								
D2710	Crown resin-based indirect	E1								
D2712	Crown 3/4 resin-based compos	E1								
D2720	Crown resin w/ high noble me	E1								
D2721	Crown resin w/ base metal	E1								
D2722	Crown resin w/ noble metal	E1								
D2740	Crown porcelain/ceramic	E1								
D2750	Crown porcelain w/ h noble m	E1								
D2751	Crown porcelain fused base m	E1								
D2752	Crown porcelain w/ noble met	E1								
D2753	Crown porc fused to titanium	E1								
D2780	Crown 3/4 cast hi noble met	E1								
D2781	Crown 3/4 cast base metal	E1								
D2782	Crown 3/4 cast noble metal	E1								
D2783	Crown 3/4 porcelain/ceramic	E1								
D2790	Crown full cast high noble m	E1								
D2791	Crown full cast base metal	E1								
D2792	Crown full cast noble metal	E1								
D2794	Crown-titanium	E1								
D2799	Provisional crown	E1								
D2910	Recement inlay onlay or part	E1								
D2915	Recement cast or prefab post	E1								
D2920	Re-cement or re-bond crown	E1								
D2921	Reattach tooth fragment	E1								
D2929	Prefab porc/ceram crown pri	E1								
D2930	Prefab stnlss steel crwn pri	E1								
D2931	Prefab stnlss steel crown pe	E1								
D2932	Prefabricated resin crown	E1								
D2933	Prefab stainless steel crown	E1								
D2934	Prefab steel crown primary	E1								
D2940	Protective restoration	E1								
D2941	Int therapeutic restoration	E1								
D2949	Restorative foundation	E1								
D2950	Core build-up incl any pins	E1								
D2951	Tooth pin retention	E1								
D2952	Post and core cast + crown	E1								
D2953	Each addtnl cast post	E1								
D2954	Prefab post/core + crown	E1								
D2955	Post removal	E1								
D2957	Each addtnl prefab post	E1								
D2960	Laminate labial veneer	E1								
D2961	Lab labial veneer resin	E1								
D2962	Lab labial veneer porcelain	E1								
D2971	Add proc construct new crown	E1								
D2975	Coping	E1								
D2980	Crown repair	E1								
D2981	Inlay repair	E1								
D2982	Onlay repair	E1								
D2983	Veneer repair	E1								
D2990	Resin infiltration of lesion	E1								
D2999	Dental unspec restorative pr	S	5871	12.0688	$975.07	.	$195.02			
D3110	Pulp cap direct	E1								
D3120	Pulp cap indirect	E1								
D3220	Therapeutic pulpotomy	E1								
D3221	Gross pulpal debridement	E1								
D3222	Part pulp for apexogenesis	E1								
D3230	Pulpal therapy anterior prim	E1								
D3240	Pulpal therapy posterior pri	E1								
D3310	"End thxpy, anterior tooth"	E1								
D3320	"End thxpy, premolar tooth"	E1								
D3330	"End thxpy, molar tooth"	E1								
D3331	Non-surg tx root canal obs	E1								
D3332	Incomplete endodontic tx	E1								
D3333	Internal root repair	E1								
D3346	Retreat root canal anterior	E1								
D3347	Retreat root canal premolar	E1								
D3348	Retreat root canal molar	E1								
D3351	Apexification/recalc initial	E1								
D3352	Apexification/recalc interim	E1								
D3353	Apexification/recalc final	E1								
D3355	Pulpal regeneration initial	E1								
D3356	Pulpal regeneration interim	E1								
D3357	Pulpal regeneration complete	E1								
D3410	Apicoectomy - anterior	E1								
D3421	Root surgery premolar	E1								
D3425	Root surgery molar	E1								
D3426	Root surgery ea add root	E1								
D3427	Periradicular surgery	E1								
D3428	Bone graft peri per tooth	E1								
D3429	Bone graft peri each addl	E1								
D3430	Retrograde filling	E1								
D3431	Biological materials	E1								
D3432	Guided tissue regeneration	E1								
D3450	Root amputation	E1								
D3460	Endodontic endosseous implan	S	5871	12.0688	$975.07	.	$195.02			
D3470	Intentional replantation	E1								
D3910	Isolation- tooth w rubb dam	E1								
D3920	Tooth splitting	E1								
D3950	Canal prep/fitting of dowel	E1								
D3999	Endodontic procedure	S	5871	12.0688	$975.07	.	$195.02			
D4210	Gingivectomy/plasty 4 or mor	E1								
D4211	Gingivectomy/plasty 1 to 3	E1								
D4212	Gingivectomy/plasty rest	E1								
D4230	Ana crown exp 4 or> per quad	E1								
D4231	Ana crown exp 1-3 per quad	E1								
D4240	Gingival flap proc w/ planin	E1								
D4241	Gngvl flap w rootplan 1-3 th	E1								
D4245	Apically positioned flap	E1								
D4249	Crown lengthen hard tissue	E1								
D4260	Osseous surgery 4 or more	S	5871	12.0688	$975.07	.	$195.02			
D4261	Osseous surg 1 to 3 teeth	E1								
D4263	Bone replce graft first site	S	5871	12.0688	$975.07	.	$195.02			
D4264	Bone replce graft each add	S	5871	12.0688	$975.07	.	$195.02			
D4265	Bio mtrls to aid soft/os reg	E1								
D4266	Guided tiss regen resorble	E1								
D4267	Guided tiss regen nonresorb	E1								
D4268	Surgical revision procedure	S	5871	12.0688	$975.07	.	$195.02			
D4270	Pedicle soft tissue graft pr	S	5871	12.0688	$975.07	.	$195.02			
D4273	Auto tissue graft 1st tooth	S	5871	12.0688	$975.07	.	$195.02			
D4274	Mesial/distal wedge proc	E1								
D4275	Non-auto graft 1st tooth	E1								
D4276	Con tissue w dble ped graft	E1								
D4277	Soft tissue graft firsttooth	E1								
D4278	Soft tissue graft addl tooth	E1								
D4283	Auto tissue graft addl tooth	E1								
D4285	Non-auto graft addl tooth	E1								
D4320	Provision splnt intracoronal	E1								
D4321	Provisional splint extracoro	E1								
D4341	Periodontal scaling & root	E1								
D4342	Periodontal scaling 1-3teeth	E1								
D4346	Scaling gingiv inflammation	E1								
D4355	Full mouth debridement	S	5871	12.0688	$975.07	.	$195.02			
D4381	Localized delivery antimicro	S	5871	12.0688	$975.07	.	$195.02			
D4910	Periodontal maint procedures	E1								
D4920	Unscheduled dressing change	E1								
D4921	Gingival irrigation per quad	E1								
D4999	Unspecified periodontal proc	E1								
D5110	Dentures complete maxillary	E1								
D5120	Dentures complete mandible	E1								
D5130	Dentures immediat maxillary	E1								
D5140	Dentures immediat mandible	E1								
D5211	Dentures maxill part resin	E1								
D5212	Dentures mand part resin	E1								
D5213	Dentures maxill part metal	E1								
D5214	Dentures mandibl part metal	E1								
D5221	Immed max part denture resin	E1								
D5222	Immed man part denture resin	E1								
D5223	Immed max part dent metal	E1								
D5224	Immed mand part dent metal	E1								
D5225	Maxillary part denture flex	E1								
D5226	Mandibular part denture flex	E1								
D5282	"Remove unil part denture,max"	E1								
D5283	"Remove unil part denture,man"	E1								
D5284	Rem unilat dent flex base	E1								
D5286	Rem unilat dent 1 pc resin	E1								
D5410	Dentures adjust cmplt maxil	E1								
D5411	Dentures adjust cmplt mand	E1								
D5421	Dentures adjust part maxill	E1								
D5422	Dentures adjust part mandbl	E1								
D5511	Rep broke comp dent base man	E1								
D5512	Rep broke comp dent base max	E1								
D5520	Replace denture teeth complt	E1								
D5611	Rep resin part dent base man	E1								
D5612	Rep resin part dent base max	E1								
D5621	Rep cast part frame man	E1								
D5622	Rep cast part frame max	E1								
D5630	Rep partial denture clasp	E1								
D5640	Replace part denture teeth	E1								
D5650	Add tooth to partial denture	E1								
D5660	Add clasp to partial denture	E1								
D5670	Replc tth&acrlc on mtl frmwk	E1								
D5671	Replc tth&acrlc mandibular	E1								
D5710	Dentures rebase cmplt maxil	E1								
D5711	Dentures rebase cmplt mand	E1								
D5720	Dentures rebase part maxill	E1								
D5721	Dentures rebase part mandbl	E1								
D5730	Denture reln cmplt maxil ch	E1								
D5731	Denture reln cmplt mand chr	E1								
D5740	Denture reln part maxil chr	E1								
D5741	Denture reln part mand chr	E1								
D5750	Denture reln cmplt max lab	E1								
D5751	Denture reln cmplt mand lab	E1								
D5760	Denture reln part maxil lab	E1								
D5761	Denture reln part mand lab	E1								
D5810	Denture interm cmplt maxill	E1								
D5811	Denture interm cmplt mandbl	E1								
D5820	Denture interm part maxill	E1								
D5821	Denture interm part mandbl	E1								
D5850	Denture tiss conditn maxill	E1								
D5851	Denture tiss condtin mandbl	E1								
D5862	Precision attachment	E1								
D5863	Overdenture complete max	E1								
D5864	Overdenture partial max	E1								
D5865	Overdenture complete mandib	E1								
D5866	Overdenture partial mandib	E1								
D5867	Replacement of precision att	E1								
D5875	Prosthesis modification	E1								
D5876	Add metal sub to acrylc dent	E1								
D5899	Removable prosthodontic proc	E1								
D5911	Facial moulage sectional	S	5871	12.0688	$975.07	.	$195.02			
D5912	Facial moulage complete	S	5871	12.0688	$975.07	.	$195.02			
D5913	Nasal prosthesis	E1								
D5914	Auricular prosthesis	E1								
D5915	Orbital prosthesis	E1								
D5916	Ocular prosthesis	E1								
D5919	Facial prosthesis	E1								
D5922	Nasal septal prosthesis	E1								
D5923	Ocular prosthesis interim	E1								
D5924	Cranial prosthesis	E1								
D5925	Facial augmentation implant	E1								
D5926	Replacement nasal prosthesis	E1								
D5927	Auricular replacement	E1								
D5928	Orbital replacement	E1								
D5929	Facial replacement	E1								
D5931	Surgical obturator	E1								
D5932	Postsurgical obturator	E1								
D5933	Refitting of obturator	E1								
D5934	Mandibular flange prosthesis	E1								
D5935	Mandibular denture prosth	E1								
D5936	Temp obturator prosthesis	E1								
D5937	Trismus appliance	E1								
D5951	Feeding aid	E1								
D5952	Pediatric speech aid	E1								
D5953	Adult speech aid	E1								
D5954	Superimposed prosthesis	E1								
D5955	Palatal lift prosthesis	E1								
D5958	Intraoral con def inter plt	E1								
D5959	Intraoral con def mod palat	E1								
D5960	Modify speech aid prosthesis	E1								
D5982	Surgical stent	E1								
D5983	Radiation applicator	S	5871	12.0688	$975.07	.	$195.02			
D5984	Radiation shield	S	5871	12.0688	$975.07	.	$195.02			
D5985	Radiation cone locator	S	5871	12.0688	$975.07	.	$195.02			
D5986	Fluoride applicator	E1								
D5987	Commissure splint	S	5871	12.0688	$975.07	.	$195.02			
D5988	Surgical splint	E1								
D5991	Vesiculobullous disease carr	E1								
D5992	Adjust max prost appliance	E1								
D5993	Main/clean max prosthesis	E1								
D5994	Peridontal medicament	E1								
D5999	Maxillofacial prosthesis	E1								
D6010	Odontics endosteal implant	E1								
D6011	Second stage implant surgery	E1								
D6012	Endosteal implant	E1								
D6013	Surgical place mini implant	E1								
D6040	Odontics eposteal implant	E1								
D6050	Odontics transosteal implnt	E1								
D6051	Interim abutment	E1								
D6052	Semi precision attach abut	E1								
D6055	Implant connecting bar	E1								
D6056	Prefabricated abutment	E1								
D6057	Custom abutment	E1								
D6058	Abutment supported crown	E1								
D6059	Abutment supported mtl crown	E1								
D6060	Abutment supported mtl crown	E1								
D6061	Abutment supported mtl crown	E1								
D6062	Abutment supported mtl crown	E1								
D6063	Abutment supported mtl crown	E1								
D6064	Abutment supported mtl crown	E1								
D6065	Implant supported crown	E1								
D6066	Implant supported mtl crown	E1								
D6067	Implant supported mtl crown	E1								
D6068	Abutment supported retainer	E1								
D6069	Abutment supported retainer	E1								
D6070	Abutment supported retainer	E1								
D6071	Abutment supported retainer	E1								
D6072	Abutment supported retainer	E1								
D6073	Abutment supported retainer	E1								
D6074	Abutment supported retainer	E1								
D6075	Implant supported retainer	E1								
D6076	Implant supported retainer	E1								
D6077	Implant supported retainer	E1								
D6080	Implant maintenance	E1								
D6081	"Scale & debride, single imp"	E1								
D6082	Imp crown porc to base alloy	E1								
D6083	Imp crown porc to noble allo	E1								
D6084	Imp crown porc to titanium	E1								
D6085	Provisional implant crown	E1								
D6086	Imp crown base alloys	E1								
D6087	Implant crown noble alloys	E1								
D6088	Imp crown titanium alloys	E1								
D6090	Repair implant	E1								
D6091	Repl semi/precision attach	E1								
D6092	Recement supp crown	E1								
D6093	Recement supp part denture	E1								
D6094	Abut support crown titanium	E1								
D6095	Odontics repr abutment	E1								
D6096	Remove broken imp ret screw	E1								
D6097	Abut crown porc to titanium	E1								
D6098	Imp retain porc to base allo	E1								
D6099	Imp retainer for fpd	E1								
D6100	Removal of implant	E1								
D6101	Debridement of a periimplant	E1								
D6102	Debridement & contouring	E1								
D6103	Bone graft repair perimplant	E1								
D6104	Bone graft time of implant	E1								
D6110	Implnt/abut remov dent max	E1								
D6111	Implnt/abut remov dent mand	E1								
D6112	Imp/abut rem dent part max	E1								
D6113	Imp/abut rem dent part mand	E1								
D6114	Implnt/abut fixed dent max	E1								
D6115	Implnt/abut fixed dent mand	E1								
D6116	Imp/abut fixed dent part max	E1								
D6117	Imp/abut fixed dent part man	E1								
D6118	Imp/abut int fixed dent man	E1								
D6119	Int/abut int fixed dent max	E1								
D6120	Imp retain porc to titanium	E1								
D6121	Retain metal fpd base alloys	E1								
D6122	Retain metal fpd noble alloy	E1								
D6123	Retain metal fpd titanium	E1								
D6190	Radio/surgical implant index	E1								
D6194	Abut support retainer titani	E1								
D6195	Abut retain porc to titanium	E1								
D6199	Implant procedure	E1								
D6205	Pontic-indirect resin based	E1								
D6210	Prosthodont high noble metal	E1								
D6211	Bridge base metal cast	E1								
D6212	Bridge noble metal cast	E1								
D6214	Pontic titanium	E1								
D6240	Bridge porcelain high noble	E1								
D6241	Bridge porcelain base metal	E1								
D6242	Bridge porcelain nobel metal	E1								
D6243	Pontic porcelain to titanium	E1								
D6245	Bridge porcelain/ceramic	E1								
D6250	Bridge resin w/high noble	E1								
D6251	Bridge resin base metal	E1								
D6252	Bridge resin w/noble metal	E1								
D6253	Provisional pontic	E1								
D6545	Dental retainr cast metl	E1								
D6548	Porcelain/ceramic retainer	E1								
D6549	Resin retainer	E1								
D6600	Porcelain/ceramic inlay 2srf	E1								
D6601	Porc/ceram inlay >= 3 surfac	E1								
D6602	Cst hgh nble mtl inlay 2 srf	E1								
D6603	Cst hgh nble mtl inlay >=3sr	E1								
D6604	Cst bse mtl inlay 2 surfaces	E1								
D6605	Cst bse mtl inlay >= 3 surfa	E1								
D6606	Cast noble metal inlay 2 sur	E1								
D6607	Cst noble mtl inlay >=3 surf	E1								
D6608	Onlay porc/crmc 2 surfaces	E1								
D6609	Onlay porc/crmc >=3 surfaces	E1								
D6610	Onlay cst hgh nbl mtl 2 srfc	E1								
D6611	Onlay cst hgh nbl mtl >=3srf	E1								
D6612	Onlay cst base mtl 2 surface	E1								
D6613	Onlay cst base mtl >=3 surfa	E1								
D6614	Onlay cst nbl mtl 2 surfaces	E1								
D6615	Onlay cst nbl mtl >=3 surfac	E1								
D6624	Inlay titanium	E1								
D6634	Onlay titanium	E1								
D6710	Crown-indirect resin based	E1								
D6720	Retain crown resin w hi nble	E1								
D6721	Crown resin w/base metal	E1								
D6722	Crown resin w/noble metal	E1								
D6740	Crown porcelain/ceramic	E1								
D6750	Crown porcelain high noble	E1								
D6751	Crown porcelain base metal	E1								
D6752	Crown porcelain noble metal	E1								
D6753	Retain crown porc to titaniu	E1								
D6780	Crown 3/4 high noble metal	E1								
D6781	Crown 3/4 cast based metal	E1								
D6782	Crown 3/4 cast noble metal	E1								
D6783	Crown 3/4 porcelain/ceramic	E1								
D6784	Retainer crown 3/4 titanium	E1								
D6790	Crown full high noble metal	E1								
D6791	Crown full base metal cast	E1								
D6792	Crown full noble metal cast	E1								
D6793	Provisional retainer crown	E1								
D6794	Crown titanium	E1								
D6920	Dental connector bar	S	5871	12.0688	$975.07	.	$195.02			
D6930	Recement/bond part denture	E1								
D6940	Stress breaker	E1								
D6950	Precision attachment	E1								
D6980	Fixed partial repair	E1								
D6985	Pediatric partial denture fx	E1								
D6999	Fixed prosthodontic proc	E1								
D7111	Extraction coronal remnants	S	5871	12.0688	$975.07	.	$195.02			
D7140	Extraction erupted tooth/exr	S	5871	12.0688	$975.07	.	$195.02			
D7210	Rem imp tooth w mucoper flp	S	5871	12.0688	$975.07	.	$195.02			
D7220	Impact tooth remov soft tiss	S	5871	12.0688	$975.07	.	$195.02			
D7230	Impact tooth remov part bony	S	5871	12.0688	$975.07	.	$195.02			
D7240	Impact tooth remov comp bony	S	5871	12.0688	$975.07	.	$195.02			
D7241	Impact tooth rem bony w/comp	S	5871	12.0688	$975.07	.	$195.02			
D7250	Tooth root removal	S	5871	12.0688	$975.07	.	$195.02			
D7251	Coronectomy	E1								
D7260	Oral antral fistula closure	S	5871	12.0688	$975.07	.	$195.02			
D7261	Primary closure sinus perf	S	5871	12.0688	$975.07	.	$195.02			
D7270	Tooth reimplantation	E1								
D7272	Tooth transplantation	E1								
D7280	Exposure of unerupted tooth	E1								
D7282	Mobilize erupted/malpos toot	E1								
D7283	Place device impacted tooth	B								
D7285	Biopsy of oral tissue hard	E1								
D7286	Biopsy of oral tissue soft	E1								
D7287	Exfoliative cytolog collect	E1								
D7288	Brush biopsy	B								
D7290	Repositioning of teeth	E1								
D7291	Transseptal fiberotomy	S	5871	12.0688	$975.07	.	$195.02			
D7292	Screw retained plate	E1								
D7293	Temp anchorage dev w flap	E1								
D7294	Temp anchorage dev w/o flap	E1								
D7295	"Bone harvest,auto graft proc"	E1								
D7296	"Corticotomy, 1-3 teeth"	E1								
D7297	"Corticotomy, 4 or more teeth"	E1								
D7310	Alveoplasty w/ extraction	E1								
D7311	Alveoloplasty w/extract 1-3	E1								
D7320	Alveoplasty w/o extraction	E1								
D7321	Alveoloplasty not w/extracts	B								
D7340	Vestibuloplasty ridge extens	E1								
D7350	Vestibuloplasty exten graft	E1								
D7410	Rad exc lesion up to 1.25 cm	E1								
D7411	Excision benign lesion>1.25c	E1								
D7412	Excision benign lesion compl	E1								
D7413	Excision malig lesion<=1.25c	E1								
D7414	Excision malig lesion>1.25cm	E1								
D7415	Excision malig les complicat	E1								
D7440	Malig tumor exc to 1.25 cm	E1								
D7441	Malig tumor > 1.25 cm	E1								
D7450	Rem odontogen cyst to 1.25cm	E1								
D7451	Rem odontogen cyst > 1.25 cm	E1								
D7460	Rem nonodonto cyst to 1.25cm	E1								
D7461	Rem nonodonto cyst > 1.25 cm	E1								
D7465	Lesion destruction	E1								
D7471	Rem exostosis any site	E1								
D7472	Removal of torus palatinus	E1								
D7473	Remove torus mandibularis	E1								
D7485	Surg reduct osseoustuberosit	E1								
D7490	Maxilla or mandible resectio	E1								
D7510	I&d absc intraoral soft tiss	E1								
D7511	Incision/drain abscess intra	B								
D7520	I&d abscess extraoral	E1								
D7521	Incision/drain abscess extra	B								
D7530	Removal fb skin/areolar tiss	E1								
D7540	Removal of fb reaction	E1								
D7550	Removal of sloughed off bone	E1								
D7560	Maxillary sinusotomy	E1								
D7610	Maxilla open reduct simple	E1								
D7620	Clsd reduct simpl maxilla fx	E1								
D7630	Open red simpl mandible fx	E1								
D7640	Clsd red simpl mandible fx	E1								
D7650	Open red simp malar/zygom fx	E1								
D7660	Clsd red simp malar/zygom fx	E1								
D7670	Closd rductn splint alveolus	E1								
D7671	Alveolus open reduction	E1								
D7680	Reduct simple facial bone fx	E1								
D7710	Maxilla open reduct compound	E1								
D7720	Clsd reduct compd maxilla fx	E1								
D7730	Open reduct compd mandble fx	E1								
D7740	Clsd reduct compd mandble fx	E1								
D7750	Open red comp malar/zygma fx	E1								
D7760	Clsd red comp malar/zygma fx	E1								
D7770	Open reduc compd alveolus fx	E1								
D7771	Alveolus clsd reduc stblz te	E1								
D7780	Reduct compnd facial bone fx	E1								
D7810	Tmj open reduct-dislocation	E1								
D7820	Closed tmp manipulation	E1								
D7830	Tmj manipulation under anest	E1								
D7840	Removal of tmj condyle	E1								
D7850	Tmj meniscectomy	E1								
D7852	Tmj repair of joint disc	E1								
D7854	Tmj excisn of joint membrane	E1								
D7856	Tmj cutting of a muscle	E1								
D7858	Tmj reconstruction	E1								
D7860	Tmj cutting into joint	E1								
D7865	Tmj reshaping components	E1								
D7870	Tmj aspiration joint fluid	E1								
D7871	Lysis + lavage w catheters	E1								
D7872	Tmj diagnostic arthroscopy	E1								
D7873	Tmj arthroscopy lysis adhesn	E1								
D7874	Tmj arthroscopy disc reposit	E1								
D7875	Tmj arthroscopy synovectomy	E1								
D7876	Tmj arthroscopy discectomy	E1								
D7877	Tmj arthroscopy debridement	E1								
D7880	Occlusal orthotic appliance	E1								
D7881	Occ orthotic device adjust	E1								
D7899	Tmj unspecified therapy	E1								
D7910	Dent sutur recent wnd to 5cm	E1								
D7911	Dental suture wound to 5 cm	E1								
D7912	Suture complicate wnd > 5 cm	E1								
D7920	Dental skin graft	E1								
D7921	Collect & appl blood product	E1								
D7922	Place intra-socket bio dress	E1								
D7940	Reshaping bone orthognathic	S	5871	12.0688	$975.07	.	$195.02			
D7941	Bone cutting ramus closed	E1								
D7943	Cutting ramus open w/graft	E1								
D7944	Bone cutting segmented	E1								
D7945	Bone cutting body mandible	E1								
D7946	Reconstruction maxilla total	E1								
D7947	Reconstruct maxilla segment	E1								
D7948	Reconstruct midface no graft	E1								
D7949	Reconstruct midface w/graft	E1								
D7950	Mandible graft	E1								
D7951	Sinus aug w bone or bone sub	E1								
D7952	Sinus augmentation vertical	E1								
D7953	Bone replacement graft	E1								
D7955	Repair maxillofacial defects	E1								
D7960	Frenulectomy/frenectomy	E1								
D7963	Frenuloplasty	E1								
D7970	Excision hyperplastic tissue	E1								
D7971	Excision pericoronal gingiva	E1								
D7972	Surg redct fibrous tuberosit	E1								
D7979	Non-surgical sialolithotomy	E1								
D7980	Surgical sialolithotomy	E1								
D7981	Excision of salivary gland	E1								
D7982	Sialodochoplasty	E1								
D7983	Closure of salivary fistula	E1								
D7990	Emergency tracheotomy	E1								
D7991	Dental coronoidectomy	E1								
D7995	Synthetic graft facial bones	E1								
D7996	Implant mandible for augment	E1								
D7997	Appliance removal	E1								
D7998	Intraoral place of fix dev	E1								
D7999	Oral surgery procedure	E1								
D8010	Limited dental tx primary	E1								
D8020	Limited dental tx transition	E1								
D8030	Limited dental tx adolescent	E1								
D8040	Limited dental tx adult	E1								
D8050	Intercep dental tx primary	E1								
D8060	Intercep dental tx transitn	E1								
D8070	Compre dental tx transition	E1								
D8080	Compre dental tx adolescent	E1								
D8090	Compre dental tx adult	E1								
D8210	Orthodontic rem appliance tx	E1								
D8220	Fixed appliance therapy habt	E1								
D8660	Preorthodontic tx visit	E1								
D8670	Periodic orthodontc tx visit	E1								
D8680	Orthodontic retention	E1								
D8681	Removable retainer adjust	E1								
D8690	Orthodontic treatment	E1								
D8695	Remove fixed ortho appliance	E1								
D8696	Rep of ortho appliance max	E1								
D8697	Rep of ortho appliance man	E1								
D8698	Recement fixed retainer max	E1								
D8699	Recement fixed retainer man	E1								
D8701	Repair fixed retainer max	E1								
D8702	Repair of fixed retainer man	E1								
D8703	Replace broken retainer max	E1								
D8704	Replace broken retainer man	E1								
D8999	Orthodontic procedure	E1								
D9110	Tx dental pain minor proc	N								
D9120	Fix partial denture section	E1								
D9130	Temporomandibular joint dysf	E1								
D9210	Dent anesthesia w/o surgery	E1								
D9211	Regional block anesthesia	E1								
D9212	Trigeminal block anesthesia	E1								
D9215	Local anesthesia	E1								
D9219	Eval mod/deep sed/gen anest	E1								
D9222	"Deep anest, 1st 15 min"	E1								
D9223	General anesth ea addl 15 mi	E1								
D9230	Analgesia	N								
D9239	"Iv mod sedation, 1st 15 min"	E1								
D9243	Iv sedation ea addl 15m	E1								
D9248	Sedation (non-iv)	N								
D9310	Dental consultation	E1								
D9311	Consult w/med hlth care prof	E1								
D9410	Dental house call	E1								
D9420	Hospital/asc call	E1								
D9430	Office visit during hours	E1								
D9440	Office visit after hours	E1								
D9450	Case presentation tx plan	E1								
D9610	Dent therapeutic drug inject	E1								
D9612	Thera par drugs 2 or > admin	E1								
D9613	Infiltration thera drug	E1								
D9630	Drugs/meds disp for home use	B								
D9910	Dent appl desensitizing med	E1								
D9911	Appl desensitizing resin	E1								
D9920	Behavior management	E1								
D9930	Treatment of complications	S	5871	12.0688	$975.07	.	$195.02			
D9932	Clean & inspect rem dent max	E1								
D9933	Clean & inspect rem dent man	E1								
D9934	Clean rem part denture max	E1								
D9935	Clean rem part denture mand	E1								
D9941	Fabrication athletic guard	E1								
D9942	Repair/reline occlusal guard	E1								
D9943	Occlusal guard adjustment	E1								
D9944	"Occ guard, hard, full arch"	S	5871	12.0688	$975.07	.	$195.02			
D9945	"Occ guard, soft, full arch"	S	5871	12.0688	$975.07	.	$195.02			
D9946	"Occ guard, hard, part arch"	S	5871	12.0688	$975.07	.	$195.02			
D9950	Occlusion analysis	S	5871	12.0688	$975.07	.	$195.02			
D9951	Limited occlusal adjustment	S	5871	12.0688	$975.07	.	$195.02			
D9952	Complete occlusal adjustment	S	5871	12.0688	$975.07	.	$195.02			
D9961	Dup/copy patient's records	E1								
D9970	Enamel microabrasion	E1								
D9971	Odontoplasty 1-2 teeth	E1								
D9972	Extrnl bleaching per arch	E1								
D9973	Extrnl bleaching per tooth	E1								
D9974	Intrnl bleaching per tooth	E1								
D9975	External bleaching home app	E1								
D9985	Sales tax	E1								
D9986	Missed appointment	E1								
D9987	Cancelled appointment	E1								
D9990	Trans or sign language svcs	E1								
D9991	"Case mgmt, appt barriers"	E1								
D9992	"Case mgmt, care coordination"	E1								
D9993	"Case mgmt, interviewing"	E1								
D9994	"Case mgmt, pt education"	E1								
D9995	Teledentistry real-time	E1								
D9996	Teledentistry dent review	E1								
D9997	Dent case mgmt special needs	E1								
D9999	Adjunctive procedure	E1								
E0100	Cane adjust/fixed with tip	Y								
E0105	Cane adjust/fixed quad/3 pro	Y								
E0110	Crutch forearm pair	Y								
E0111	Crutch forearm each	Y								
E0112	Crutch underarm pair wood	Y								
E0113	Crutch underarm each wood	Y								
E0114	Crutch underarm pair no wood	Y								
E0116	Crutch underarm each no wood	Y								
E0117	Underarm springassist crutch	Y								
E0118	Crutch substitute	E1								
E0130	Walker rigid adjust/fixed ht	Y								
E0135	Walker folding adjust/fixed	Y								
E0140	Walker w trunk support	Y								
E0141	Rigid wheeled walker adj/fix	Y								
E0143	Walker folding wheeled w/o s	Y								
E0144	Enclosed walker w rear seat	Y								
E0147	Walker variable wheel resist	Y								
E0148	Heavyduty walker no wheels	Y								
E0149	Heavy duty wheeled walker	Y								
E0153	Forearm crutch platform atta	Y								
E0154	Walker platform attachment	Y								
E0155	"Walker wheel attachment,pair"	Y								
E0156	Walker seat attachment	Y								
E0157	Walker crutch attachment	Y								
E0158	Walker leg extenders set of4	Y								
E0159	Brake for wheeled walker	Y								
E0160	Sitz type bath or equipment	Y								
E0161	Sitz bath/equipment w/faucet	Y								
E0162	Sitz bath chair	Y								
E0163	Commode chair with fixed arm	Y								
E0165	Commode chair with detacharm	Y								
E0167	Commode chair pail or pan	Y								
E0168	Heavyduty/wide commode chair	Y								
E0170	Commode chair electric	Y								
E0171	Commode chair non-electric	Y								
E0172	Seat lift mechanism toilet	E1								
E0175	Commode chair foot rest	Y								
E0181	Press pad alternating w/ pum	Y								
E0182	"Replace pump, alt press pad"	Y								
E0184	Dry pressure mattress	Y								
E0185	Gel pressure mattress pad	Y								
E0186	Air pressure mattress	Y								
E0187	Water pressure mattress	Y								
E0188	Synthetic sheepskin pad	Y								
E0189	Lambswool sheepskin pad	Y								
E0190	Positioning cushion	E1								
E0191	Protector heel or elbow	Y								
E0193	Powered air flotation bed	Y								
E0194	Air fluidized bed	Y								
E0196	Gel pressure mattress	Y								
E0197	Air pressure pad for mattres	Y								
E0198	Water pressure pad for mattr	Y								
E0199	Dry pressure pad for mattres	Y								
E0200	Heat lamp without stand	Y								
E0202	Phototherapy light w/ photom	Y								
E0203	Therapeutic lightbox tabletp	E1								
E0205	Heat lamp with stand	Y								
E0210	Electric heat pad standard	Y								
E0215	Electric heat pad moist	Y								
E0217	Water circ heat pad w pump	Y								
E0218	Fluid circ cold pad w pump	Y								
E0221	Infrared heating pad system	Y								
E0225	Hydrocollator unit	Y								
E0231	Wound warming device	E1								
E0232	Warming card for nwt	E1								
E0235	Paraffin bath unit portable	Y								
E0236	Pump for water circulating p	Y								
E0239	Hydrocollator unit portable	Y								
E0240	Bath/shower chair	E1								
E0241	Bath tub wall rail	E1								
E0242	Bath tub rail floor	E1								
E0243	Toilet rail	E1								
E0244	Toilet seat raised	E1								
E0245	Tub stool or bench	E1								
E0246	Transfer tub rail attachment	E1								
E0247	Trans bench w/wo comm open	E1								
E0248	Hdtrans bench w/wo comm open	E1								
E0249	Pad water circulating heat u	Y								
E0250	Hosp bed fixed ht w/ mattres	Y								
E0251	Hosp bed fixd ht w/o mattres	Y								
E0255	Hospital bed var ht w/ mattr	Y								
E0256	Hospital bed var ht w/o matt	Y								
E0260	Hosp bed semi-electr w/ matt	Y								
E0261	Hosp bed semi-electr w/o mat	Y								
E0265	Hosp bed total electr w/ mat	Y								
E0266	Hosp bed total elec w/o matt	Y								
E0270	Hospital bed institutional t	E1								
E0271	Mattress innerspring	Y								
E0272	Mattress foam rubber	Y								
E0273	Bed board	E1								
E0274	Over-bed table	E1								
E0275	Bed pan standard	Y								
E0276	Bed pan fracture	Y								
E0277	Powered pres-redu air mattrs	Y								
E0280	Bed cradle	Y								
E0290	Hosp bed fx ht w/o rails w/m	Y								
E0291	Hosp bed fx ht w/o rail w/o	Y								
E0292	Hosp bed var ht no sr w/matt	Y								
E0293	Hosp bed var ht no sr no mat	Y								
E0294	Hosp bed semi-elect w/ mattr	Y								
E0295	Hosp bed semi-elect w/o matt	Y								
E0296	Hosp bed total elect w/ matt	Y								
E0297	Hosp bed total elect w/o mat	Y								
E0300	Enclosed ped crib hosp grade	Y								
E0301	"Hd hosp bed, 350-600 lbs"	Y								
E0302	Ex hd hosp bed > 600 lbs	Y								
E0303	Hosp bed hvy dty xtra wide	Y								
E0304	Hosp bed xtra hvy dty x wide	Y								
E0305	Rails bed side half length	Y								
E0310	Rails bed side full length	Y								
E0315	Bed accessory brd/tbl/supprt	E1								
E0316	Bed safety enclosure	Y								
E0325	Urinal male jug-type	Y								
E0326	Urinal female jug-type	Y								
E0328	"Ped hospital bed, manual"	Y								
E0329	Ped hospital bed semi/elect	Y								
E0350	Control unit bowel system	E1								
E0352	Disposable pack w/bowel syst	E1								
E0370	Air elevator for heel	E1								
E0371	Nonpower mattress overlay	Y								
E0372	Powered air mattress overlay	Y								
E0373	Nonpowered pressure mattress	Y								
E0424	Stationary compressed gas 02	Y								
E0425	Gas system stationary compre	E1								
E0430	Oxygen system gas portable	E1								
E0431	Portable gaseous 02	Y								
E0433	Portable liquid oxygen sys	Y								
E0434	Portable liquid 02	Y								
E0435	Oxygen system liquid portabl	E1								
E0439	Stationary liquid 02	Y								
E0440	Oxygen system liquid station	E1								
E0441	"Stationary o2 contents, gas"	Y								
E0442	"Stationary o2 contents, liq"	Y								
E0443	"Portable 02 contents, gas"	Y								
E0444	"Portable 02 contents, liquid"	Y								
E0445	Oximeter non-invasive	N								
E0446	"Topical ox deliver sys, nos"	A								
E0447	"Port o2 cont, liq over 4 lpm"	Y								
E0455	Oxygen tent excl croup/ped t	Y								
E0457	Chest shell	E1								
E0459	Chest wrap	E1								
E0462	Rocking bed w/ or w/o side r	Y								
E0465	Home vent invasive interface	Y								
E0466	Home vent non-invasive inter	Y								
E0467	Home vent multi-function	Y								
E0470	Rad w/o backup non-inv intfc	Y								
E0471	Rad w/backup non inv intrfc	Y								
E0472	Rad w backup invasive intrfc	Y								
E0480	Percussor elect/pneum home m	Y								
E0481	Intrpulmnry percuss vent sys	E1								
E0482	Cough stimulating device	Y								
E0483	Hi freq chest wall oscil sys	Y								
E0484	Non-elec oscillatory pep dvc	Y								
E0485	Oral device/appliance prefab	Y								
E0486	Oral device/appliance cusfab	Y								
E0487	Electronic spirometer	N								
E0500	Ippb all types	Y								
E0550	Humidif extens supple w ippb	Y								
E0555	Humidifier for use w/ regula	Y								
E0560	Humidifier supplemental w/ i	Y								
E0561	Humidifier nonheated w pap	Y								
E0562	Humidifier heated used w pap	Y								
E0565	Compressor air power source	Y								
E0570	Nebulizer with compression	Y								
E0572	Aerosol compressor adjust pr	Y								
E0574	Ultrasonic generator w svneb	Y								
E0575	Nebulizer ultrasonic	Y								
E0580	Nebulizer for use w/ regulat	Y								
E0585	Nebulizer w/ compressor & he	Y								
E0600	Suction pump portab hom modl	Y								
E0601	Cont airway pressure device	Y								
E0602	Manual breast pump	Y								
E0603	Electric breast pump	N								
E0604	Hosp grade elec breast pump	A								
E0605	Vaporizer room type	Y								
E0606	Drainage board postural	Y								
E0607	Blood glucose monitor home	Y								
E0610	Pacemaker monitr audible/vis	Y								
E0615	Pacemaker monitr digital/vis	Y								
E0616	Cardiac event recorder	N								
E0617	Automatic ext defibrillator	Y								
E0618	Apnea monitor	Y								
E0619	Apnea monitor w recorder	Y								
E0620	Cap bld skin piercing laser	Y								
E0621	Patient lift sling or seat	Y								
E0625	Patient lift bathroom or toi	E1								
E0627	"Seat lift mech, electric any"	Y								
E0629	"Seat lift mech, non-electric"	Y								
E0630	Patient lift hydraulic	Y								
E0635	Patient lift electric	Y								
E0636	Pt support & positioning sys	Y								
E0637	Combination sit to stand sys	E1								
E0638	Standing frame sys	E1								
E0639	Moveable patient lift system	E1								
E0640	Fixed patient lift system	E1								
E0641	Multi-position stnd fram sys	E1								
E0642	Dynamic standing frame	E1								
E0650	Pneuma compresor non-segment	Y								
E0651	Pneum compressor segmental	Y								
E0652	Pneum compres w/cal pressure	Y								
E0655	Pneumatic appliance half arm	Y								
E0656	Segmental pneumatic trunk	Y								
E0657	Segmental pneumatic chest	Y								
E0660	Pneumatic appliance full leg	Y								
E0665	Pneumatic appliance full arm	Y								
E0666	Pneumatic appliance half leg	Y								
E0667	Seg pneumatic appl full leg	Y								
E0668	Seg pneumatic appl full arm	Y								
E0669	Seg pneumatic appli half leg	Y								
E0670	Seg pneum int legs/trunk	Y								
E0671	Pressure pneum appl full leg	Y								
E0672	Pressure pneum appl full arm	Y								
E0673	Pressure pneum appl half leg	Y								
E0675	Pneumatic compression device	Y								
E0676	Inter limb compress dev nos	Y								
E0691	Uvl pnl 2 sq ft or less	Y								
E0692	Uvl sys panel 4 ft	Y								
E0693	Uvl sys panel 6 ft	Y								
E0694	Uvl md cabinet sys 6 ft	Y								
E0700	Safety equipment	E1								
E0705	Transfer device	B								
E0710	Restraints any type	E1								
E0720	Tens two lead	Y								
E0730	Tens four lead	Y								
E0731	Conductive garment for tens/	Y								
E0740	Non-implant pelv flr e-stim	Y								
E0744	Neuromuscular stim for scoli	Y								
E0745	Neuromuscular stim for shock	Y								
E0746	Electromyograph biofeedback	N								
E0747	Elec osteogen stim not spine	Y								
E0748	Elec osteogen stim spinal	Y								
E0749	Elec osteogen stim implanted	N								
E0755	Electronic salivary reflex s	E1								
E0760	Osteogen ultrasound stimltor	Y								
E0761	Nontherm electromgntc device	E1								
E0762	Trans elec jt stim dev sys	B								
E0764	Functional neuromuscularstim	Y								
E0765	Nerve stimulator for tx n&v	Y								
E0766	Elec stim cancer treatment	Y								
E0769	Electric wound treatment dev	B								
E0770	Functional electric stim nos	Y								
E0776	Iv pole	Y								
E0779	Amb infusion pump mechanical	Y								
E0780	Mech amb infusion pump <8hrs	Y								
E0781	External ambulatory infus pu	Y								
E0782	Non-programble infusion pump	N								
E0783	Programmable infusion pump	N								
E0784	Ext amb infusn pump insulin	Y								
E0785	Replacement impl pump cathet	N								
E0786	Implantable pump replacement	N								
E0787	Cgs dose adj insulin inf pmp	E1							*	
E0791	Parenteral infusion pump sta	Y								
E0830	Ambulatory traction device	N								
E0840	Tract frame attach headboard	Y								
E0849	Cervical pneum trac equip	Y								
E0850	Traction stand free standing	Y								
E0855	Cervical traction equipment	Y								
E0856	Cervic collar w air bladders	Y								
E0860	Tract equip cervical tract	Y								
E0870	Tract frame attach footboard	Y								
E0880	Trac stand free stand extrem	Y								
E0890	Traction frame attach pelvic	Y								
E0900	Trac stand free stand pelvic	Y								
E0910	Trapeze bar attached to bed	Y								
E0911	Hd trapeze bar attach to bed	Y								
E0912	Hd trapeze bar free standing	Y								
E0920	Fracture frame attached to b	Y								
E0930	Fracture frame free standing	Y								
E0935	Cont pas motion exercise dev	Y								
E0936	"Cpm device, other than knee"	E1								
E0940	Trapeze bar free standing	Y								
E0941	Gravity assisted traction de	Y								
E0942	Cervical head harness/halter	Y								
E0944	Pelvic belt/harness/boot	Y								
E0945	Belt/harness extremity	Y								
E0946	Fracture frame dual w cross	Y								
E0947	Fracture frame attachmnts pe	Y								
E0948	Fracture frame attachmnts ce	Y								
E0950	Tray	Y								
E0951	Loop heel	Y								
E0952	"Toe loop/holder, each"	Y								
E0953	W/c lateral thigh/knee sup	Y								
E0954	"Foot box, any type each foot"	Y								
E0955	Cushioned headrest	Y								
E0956	W/c lateral trunk/hip suppor	Y								
E0957	W/c medial thigh support	Y								
E0958	Whlchr att- conv 1 arm drive	Y								
E0959	Amputee adapter	B								
E0960	W/c shoulder harness/straps	Y								
E0961	Wheelchair brake extension	B								
E0966	Wheelchair head rest extensi	B								
E0967	Man wc rim/projection rep ea	Y								
E0968	Wheelchair commode seat	Y								
E0969	Wheelchair narrowing device	Y								
E0970	Wheelchair no. 2 footplates	E1								
E0971	Wheelchair anti-tipping devi	B								
E0973	W/ch access det adj armrest	B								
E0974	W/ch access anti-rollback	B								
E0978	"W/c acc,saf belt pelv strap"	B								
E0980	Wheelchair safety vest	Y								
E0981	"Seat upholstery, replacement"	Y								
E0982	"Back upholstery, replacement"	Y								
E0983	Add pwr joystick	Y								
E0984	Add pwr tiller	Y								
E0985	W/c seat lift mechanism	Y								
E0986	Man w/c push-rim powr system	Y								
E0988	Lever-activated wheel drive	Y								
E0990	Wheelchair elevating leg res	B								
E0992	Wheelchair solid seat insert	B								
E0994	Wheelchair arm rest	Y								
E0995	"Wc calf rest, pad replacemnt"	B								
E1002	Pwr seat tilt	Y								
E1003	Pwr seat recline	Y								
E1004	Pwr seat recline mech	Y								
E1005	Pwr seat recline pwr	Y								
E1006	Pwr seat combo w/o shear	Y								
E1007	Pwr seat combo w/shear	Y								
E1008	Pwr seat combo pwr shear	Y								
E1009	Add mech leg elevation	Y								
E1010	Add pwr leg elevation	Y								
E1011	Ped wc modify width adjustm	Y								
E1012	Ctr mount pwr elev leg rest	Y								
E1014	Reclining back add ped w/c	Y								
E1015	Shock absorber for man w/c	Y								
E1016	Shock absorber for power w/c	Y								
E1017	Hd shck absrbr for hd man wc	Y								
E1018	Hd shck absrber for hd powwc	Y								
E1020	Residual limb support system	Y								
E1028	W/c manual swingaway	Y								
E1029	W/c vent tray fixed	Y								
E1030	W/c vent tray gimbaled	Y								
E1031	Rollabout chair with casters	Y								
E1035	Patient transfer system <300	Y								
E1036	Patient transfer system >300	Y								
E1037	"Transport chair, ped size"	Y								
E1038	Transport chair pt wt<=300lb	Y								
E1039	Transport chair pt wt >300lb	Y								
E1050	Whelchr fxd full length arms	Y								
E1060	Wheelchair detachable arms	Y								
E1070	Wheelchair detachable foot r	Y								
E1083	Hemi-wheelchair fixed arms	Y								
E1084	Hemi-wheelchair detachable a	Y								
E1085	Hemi-wheelchair fixed arms	E1								
E1086	Hemi-wheelchair detachable a	E1								
E1087	Wheelchair lightwt fixed arm	Y								
E1088	Wheelchair lightweight det a	Y								
E1089	Wheelchair lightwt fixed arm	E1								
E1090	Wheelchair lightweight det a	E1								
E1092	Wheelchair wide w/ leg rests	Y								
E1093	Wheelchair wide w/ foot rest	Y								
E1100	Whchr s-recl fxd arm leg res	Y								
E1110	Wheelchair semi-recl detach	Y								
E1130	Whlchr stand fxd arm ft rest	E1								
E1140	Wheelchair standard detach a	E1								
E1150	Wheelchair standard w/ leg r	Y								
E1160	Wheelchair fixed arms	Y								
E1161	Manual adult wc w tiltinspac	Y								
E1170	Whlchr ampu fxd arm leg rest	Y								
E1171	Wheelchair amputee w/o leg r	Y								
E1172	Wheelchair amputee detach ar	Y								
E1180	Wheelchair amputee w/ foot r	Y								
E1190	Wheelchair amputee w/ leg re	Y								
E1195	Wheelchair amputee heavy dut	Y								
E1200	Wheelchair amputee fixed arm	Y								
E1220	Whlchr special size/constrc	Y								
E1221	Wheelchair spec size w foot	Y								
E1222	Wheelchair spec size w/ leg	Y								
E1223	Wheelchair spec size w foot	Y								
E1224	Wheelchair spec size w/ leg	Y								
E1225	Manual semi-reclining back	Y								
E1226	Manual fully reclining back	B								
E1227	Wheelchair spec sz spec ht a	Y								
E1228	Wheelchair spec sz spec ht b	Y								
E1229	Pediatric wheelchair nos	Y								
E1230	Power operated vehicle	Y								
E1231	Rigid ped w/c tilt-in-space	Y								
E1232	Folding ped wc tilt-in-space	Y								
E1233	Rig ped wc tltnspc w/o seat	Y								
E1234	Fld ped wc tltnspc w/o seat	Y								
E1235	Rigid ped wc adjustable	Y								
E1236	Folding ped wc adjustable	Y								
E1237	Rgd ped wc adjstabl w/o seat	Y								
E1238	Fld ped wc adjstabl w/o seat	Y								
E1239	Ped power wheelchair nos	Y								
E1240	Whchr litwt det arm leg rest	Y								
E1250	Wheelchair lightwt fixed arm	E1								
E1260	Wheelchair lightwt foot rest	E1								
E1270	Wheelchair lightweight leg r	Y								
E1280	Whchr h-duty det arm leg res	Y								
E1285	Wheelchair heavy duty fixed	E1								
E1290	Wheelchair hvy duty detach a	E1								
E1295	Wheelchair heavy duty fixed	Y								
E1296	Wheelchair special seat heig	Y								
E1297	Wheelchair special seat dept	Y								
E1298	Wheelchair spec seat depth/w	Y								
E1300	Whirlpool portable	E1								
E1310	Whirlpool non-portable	Y								
E1352	O2 flow reg pos inspir press	Y								
E1353	Oxygen supplies regulator	Y								
E1354	"Wheeled cart, port cyl/conc"	Y								
E1355	Oxygen supplies stand/rack	Y								
E1356	"Batt pack/cart, port conc"	Y								
E1357	"Battery charger, port conc"	Y								
E1358	"Dc power adapter, port conc"	Y								
E1372	Oxy suppl heater for nebuliz	Y								
E1390	Oxygen concentrator	Y								
E1391	"Oxygen concentrator, dual"	Y								
E1392	Portable oxygen concentrator	Y								
E1399	Durable medical equipment mi	Y								
E1405	O2/water vapor enrich w/heat	Y								
E1406	O2/water vapor enrich w/o he	Y								
E1500	Centrifuge	A								
E1510	Kidney dialysate delivry sys	A								
E1520	Heparin infusion pump	A								
E1530	Replacement air bubble detec	A								
E1540	Replacement pressure alarm	A								
E1550	Bath conductivity meter	A								
E1560	Replace blood leak detector	A								
E1570	Adjustable chair for esrd pt	A								
E1575	Transducer protect/fld bar	A								
E1580	Unipuncture control system	A								
E1590	Hemodialysis machine	A								
E1592	Auto interm peritoneal dialy	A								
E1594	Cycler dialysis machine	A								
E1600	Deli/install chrg hemo equip	A								
E1610	Reverse osmosis h2o puri sys	A								
E1615	Deionizer h2o puri system	A								
E1620	Replacement blood pump	A								
E1625	Water softening system	A								
E1630	Reciprocating peritoneal dia	A								
E1632	Wearable artificial kidney	A								
E1634	Peritoneal dialysis clamp	B								
E1635	Compact travel hemodialyzer	A								
E1636	Sorbent cartridges per 10	A								
E1637	"Hemostats for dialysis, each"	A								
E1639	"Scale, each"	A								
E1699	Dialysis equipment noc	A								
E1700	Jaw motion rehab system	Y								
E1701	Repl cushions for jaw motion	Y								
E1702	Repl measr scales jaw motion	Y								
E1800	Adjust elbow ext/flex device	Y								
E1801	Sps elbow device	Y								
E1802	Adjst forearm pro/sup device	Y								
E1805	Adjust wrist ext/flex device	Y								
E1806	Sps wrist device	Y								
E1810	Adjust knee ext/flex device	Y								
E1811	Sps knee device	Y								
E1812	Knee ext/flex w act res ctrl	Y								
E1815	Adjust ankle ext/flex device	Y								
E1816	Sps ankle device	Y								
E1818	Sps forearm device	Y								
E1820	Soft interface material	Y								
E1821	Replacement interface spsd	Y								
E1825	Adjust finger ext/flex devc	Y								
E1830	Adjust toe ext/flex device	Y								
E1831	Static str toe dev ext/flex	Y								
E1840	Adj shoulder ext/flex device	Y								
E1841	Static str shldr dev rom adj	Y								
E1902	Aac non-electronic board	Y								
E2000	Gastric suction pump hme mdl	Y								
E2100	Bld glucose monitor w voice	Y								
E2101	Bld glucose monitor w lance	Y								
E2120	Pulse gen sys tx endolymp fl	Y								
E2201	"Man w/ch acc seat w>=20""<24"""	Y								
E2202	Seat width 24-27 in	Y								
E2203	Frame depth less than 22 in	Y								
E2204	Frame depth 22 to 25 in	Y								
E2205	"Manual wc accessory, handrim"	Y								
E2206	Man wc whl lock comp repl ea	Y								
E2207	Crutch and cane holder	Y								
E2208	Cylinder tank carrier	Y								
E2209	Arm trough each	Y								
E2210	Wheelchair bearings	Y								
E2211	Pneumatic propulsion tire	Y								
E2212	Pneumatic prop tire tube	Y								
E2213	Pneumatic prop tire insert	Y								
E2214	Pneumatic caster tire each	Y								
E2215	Pneumatic caster tire tube	Y								
E2216	Foam filled propulsion tire	Y								
E2217	Foam filled caster tire each	Y								
E2218	Foam propulsion tire each	Y								
E2219	Foam caster tire any size ea	Y								
E2220	"Solid propuls tire, repl, ea"	Y								
E2221	"Solid caster tire repl, each"	Y								
E2222	"Solid caster integ whl, repl"	Y								
E2224	Propulsion whl excl tire rep	Y								
E2225	Caster wheel excludes tire	Y								
E2226	Caster fork replacement only	Y								
E2227	Gear reduction drive wheel	Y								
E2228	"Mwc acc, wheelchair brake"	Y								
E2230	Manual standing system	Y								
E2231	Solid seat support base	Y								
E2291	Planar back for ped size wc	Y								
E2292	Planar seat for ped size wc	Y								
E2293	Contour back for ped size wc	Y								
E2294	Contour seat for ped size wc	Y								
E2295	Ped dynamic seating frame	Y								
E2300	Pwr seat elevation sys	Y								
E2301	Pwr standing	Y								
E2310	Electro connect btw control	Y								
E2311	Electro connect btw 2 sys	Y								
E2312	Mini-prop remote joystick	Y								
E2313	"Pwc harness, expand control"	Y								
E2321	Hand interface joystick	Y								
E2322	Mult mech switches	Y								
E2323	Special joystick handle	Y								
E2324	Chin cup interface	Y								
E2325	Sip and puff interface	Y								
E2326	Breath tube kit	Y								
E2327	Head control interface mech	Y								
E2328	Head/extremity control inter	Y								
E2329	Head control nonproportional	Y								
E2330	Head control proximity switc	Y								
E2331	Attendant control	Y								
E2340	W/c wdth 20-23 in seat frame	Y								
E2341	W/c wdth 24-27 in seat frame	Y								
E2342	W/c dpth 20-21 in seat frame	Y								
E2343	W/c dpth 22-25 in seat frame	Y								
E2351	Electronic sgd interface	Y								
E2358	Gr 34 nonsealed leadacid	Y								
E2359	Gr34 sealed leadacid battery	Y								
E2360	22nf nonsealed leadacid	Y								
E2361	22nf sealed leadacid battery	Y								
E2362	Gr24 nonsealed leadacid	Y								
E2363	Gr24 sealed leadacid battery	Y								
E2364	U1nonsealed leadacid battery	Y								
E2365	U1 sealed leadacid battery	Y								
E2366	"Battery charger, single mode"	Y								
E2367	"Battery charger, dual mode"	Y								
E2368	Pwr wc drivewheel motor repl	Y								
E2369	Pwr wc drivewheel gear repl	Y								
E2370	Pwr wc dr wh motor/gear comb	Y								
E2371	Gr27 sealed leadacid battery	Y								
E2372	Gr27 non-sealed leadacid	Y								
E2373	Hand/chin ctrl spec joystick	Y								
E2374	Hand/chin ctrl std joystick	Y								
E2375	Non-expandable controller	Y								
E2376	"Expandable controller, repl"	Y								
E2377	"Expandable controller, initl"	Y								
E2378	Pw actuator replacement	Y								
E2381	Pneum drive wheel tire	Y								
E2382	"Tube, pneum wheel drive tire"	Y								
E2383	"Insert, pneum wheel drive"	Y								
E2384	Pneumatic caster tire	Y								
E2385	"Tube, pneumatic caster tire"	Y								
E2386	Foam filled drive wheel tire	Y								
E2387	Foam filled caster tire	Y								
E2388	Foam drive wheel tire	Y								
E2389	Foam caster tire	Y								
E2390	Solid drive wheel tire	Y								
E2391	Solid caster tire	Y								
E2392	"Solid caster tire, integrate"	Y								
E2394	Drive wheel excludes tire	Y								
E2395	Caster wheel excludes tire	Y								
E2396	Caster fork	Y								
E2397	"Pwc acc, lith-based battery"	Y								
E2398	Wc dynamic pos back hardware	Y								
E2402	Neg press wound therapy pump	Y								
E2500	Sgd digitized pre-rec <=8min	Y								
E2502	Sgd prerec msg >8min <=20min	Y								
E2504	Sgd prerec msg>20min <=40min	Y								
E2506	Sgd prerec msg > 40 min	Y								
E2508	Sgd spelling phys contact	Y								
E2510	Sgd w multi methods msg/accs	Y								
E2511	Sgd sftwre prgrm for pc/pda	Y								
E2512	"Sgd accessory, mounting sys"	Y								
E2599	Sgd accessory noc	Y								
E2601	Gen w/c cushion wdth < 22 in	Y								
E2602	Gen w/c cushion wdth >=22 in	Y								
E2603	Skin protect wc cus wd <22in	Y								
E2604	Skin protect wc cus wd>=22in	Y								
E2605	Position wc cush wdth <22 in	Y								
E2606	Position wc cush wdth>=22 in	Y								
E2607	Skin pro/pos wc cus wd <22in	Y								
E2608	Skin pro/pos wc cus wd>=22in	Y								
E2609	Custom fabricate w/c cushion	Y								
E2610	Powered w/c cushion	B								
E2611	Gen use back cush wdth <22in	Y								
E2612	Gen use back cush wdth>=22in	Y								
E2613	Position back cush wd <22in	Y								
E2614	Position back cush wd>=22in	Y								
E2615	Pos back post/lat wdth <22in	Y								
E2616	Pos back post/lat wdth>=22in	Y								
E2617	Custom fab w/c back cushion	Y								
E2619	Replace cover w/c seat cush	Y								
E2620	Wc planar back cush wd <22in	Y								
E2621	Wc planar back cush wd>=22in	Y								
E2622	Adj skin pro w/c cus wd<22in	Y								
E2623	Adj skin pro wc cus wd>=22in	Y								
E2624	Adj skin pro/pos cus<22in	Y								
E2625	Adj skin pro/pos wc cus>=22	Y								
E2626	Seo mobile arm sup att to wc	Y								
E2627	Arm supp att to wc rancho ty	Y								
E2628	Mobile arm supports reclinin	Y								
E2629	Friction dampening arm supp	Y								
E2630	Monosuspension arm/hand supp	Y								
E2631	Elevat proximal arm support	Y								
E2632	Offset/lat rocker arm w/ela	Y								
E2633	Mobile arm support supinator	Y								
E8000	Posterior gait trainer	E1								
E8001	Upright gait trainer	E1								
E8002	Anterior gait trainer	E1								
G0008	Admin influenza virus vac	S	5691	0.4717	$38.11	$0.00	$0.00			
G0009	Admin pneumococcal vaccine	S	5691	0.4717	$38.11	$0.00	$0.00			
G0010	Admin hepatitis b vaccine	S	5691	0.4717	$38.11	$0.00	$0.00			
G0027	Semen analysis	Q4								
G0068	Adm of infusion drug in home	A								
G0069	Adm of immune drug in home	A								
G0070	Adm of chemo drug in home	A								
G0071	Comm svcs by rhc/fqhc 5 min	A								
G0076	Care manag h vst new pt 20 m	B								
G0077	Care manag h vst new pt 30 m	B								
G0078	Care manag h vst new pt 45 m	B								
G0079	Care manag h vst new pt 60 m	B								
G0080	Care manag h vst new pt 75 m	B								
G0081	Care man h v ext pt 20 mi	B								
G0082	Care man h v ext pt 30 m	B								
G0083	Care man h v ext pt 45 m	B								
G0084	Care man h v ext pt 60 m	B								
G0085	Care man h v ext pt 75 m	B								
G0086	Care man home care plan 30 m	B								
G0087	Care man home care plan 60 m	B								
G0101	Ca screen;pelvic/breast exam	S	5822	0.9721	$78.54	$0.00	$0.00			
G0102	Prostate ca screening; dre	N								
G0103	Psa screening	A								
G0104	Ca screen;flexi sigmoidscope	T	5311	9.4548	$763.88	$0.00	$0.00			
G0105	Colorectal scrn; hi risk ind	T	5311	9.4548	$763.88	$0.00	$0.00			
G0106	Colon ca screen;barium enema	S	5571	2.2554	$182.22	$0.00	$0.00			
G0108	Diab manage trn  per indiv	A								
G0109	Diab manage trn ind/group	A								
G0117	Glaucoma scrn hgh risk direc	S	5731	0.2845	$22.99	.	$4.60			
G0118	Glaucoma scrn hgh risk direc	S	5732	0.4138	$33.43	.	$6.69			
G0120	Colon ca scrn; barium enema	S	5572	4.7263	$381.85	$0.00	$0.00			
G0121	Colon ca scrn not hi rsk ind	T	5311	9.4548	$763.88	$0.00	$0.00			
G0122	Colon ca scrn; barium enema	E1								
G0123	Screen cerv/vag thin layer	A								
G0124	Screen c/v thin layer by md	B								
G0127	Trim nail(s)	Q1	5733	0.6809	$55.01	.	$11.01			
G0128	Corf skilled nursing service	B								
G0129	Partial hosp prog service	P								
G0130	Single energy x-ray study	S	5522	1.3873	$112.08	$0.00	$0.00			
G0141	"Scr c/v cyto,autosys and md"	B								
G0143	"Scr c/v cyto,thinlayer,rescr"	A								
G0144	"Scr c/v cyto,thinlayer,rescr"	A								
G0145	"Scr c/v cyto,thinlayer,rescr"	A								
G0147	"Scr c/v cyto, automated sys"	A								
G0148	"Scr c/v cyto, autosys, rescr"	A								
G0151	"Hhcp-serv of pt,ea 15 min"	B								
G0152	"Hhcp-serv of ot,ea 15 min"	B								
G0153	"Hhcp-svs of s/l path,ea 15mn"	B								
G0155	"Hhcp-svs of csw,ea 15 min"	B								
G0156	"Hhcp-svs of aide,ea 15 min"	B								
G0157	Hhc pt assistant ea 15	B								
G0158	Hhc ot assistant ea 15	B								
G0159	Hhc pt maint ea 15 min	B								
G0160	Hhc occup therapy ea 15	B								
G0161	Hhc slp ea 15 min	B								
G0162	"Hhc rn e&m plan svs, 15 min"	B								
G0166	"Extrnl counterpulse, per tx"	Q1	5734	1.3495	$109.03	.	$21.81			
G0168	Wound closure by adhesive	B								
G0175	"Opps service,sched team conf"	V	5024	4.3542	$351.79	.	$70.36			
G0176	Opps/php;activity therapy	P								
G0177	Opps/php; train & educ serv	N								
G0179	Md recertification hha pt	M								
G0180	Md certification hha patient	M								
G0181	Home health care supervision	M								
G0182	Hospice care supervision	M								
G0186	"Dstry eye lesn,fdr vssl tech"	T	5481	6.2744	$506.93	$101.51	$101.39			
G0219	Pet img wholbod melano nonco	E1								
G0235	Pet not otherwise specified	E1								
G0237	Therapeutic procd strg endur	S	5731	0.2845	$22.99	.	$4.60			
G0238	"Oth resp proc, indiv"	S	5731	0.2845	$22.99	.	$4.60			
G0239	"Oth resp proc, group"	S	5732	0.4138	$33.43	.	$6.69			
G0245	Initial foot exam pt lops	V	5012	1.4349	$115.93	.	$23.19			
G0246	Followup eval of foot pt lop	V	5012	1.4349	$115.93	.	$23.19			
G0247	Routine footcare pt w lops	Q1	5051	2.1627	$174.73	.	$34.95			
G0248	Demonstrate use home inr mon	V	5012	1.4349	$115.93	.	$23.19			
G0249	Provide inr test mater/equip	V	5012	1.4349	$115.93	.	$23.19			
G0250	Md inr test revie inter mgmt	M								
G0252	Pet imaging initial dx	E1								
G0255	Current percep threshold tst	E1								
G0257	Unsched dialysis esrd pt hos	S	5401	7.9219	$640.03	.	$128.01			
G0259	Inject for sacroiliac joint	N								
G0260	Inj for sacroiliac jt anesth	T	5442	7.7364	$625.05	.	$125.01			
G0268	Removal of impacted wax md	N								
G0269	Occlusive device in vein art	N								
G0270	Mnt subs tx for change dx	A								
G0271	Group mnt 2 or more 30 mins	A								
G0276	Pild/placebo control clin tr	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
G0277	"Hbot, full body chamber, 30m"	S	5061	1.4241	$115.06	.	$23.02			
G0278	"Iliac art angio,cardiac cath"	N								
G0279	"Tomosynthesis, mammo "	A								
G0281	Elec stim unattend for press	A								
G0282	Elect stim wound care not pd	E1								
G0283	Elec stim other than wound	A								
G0288	"Recon, cta for surg plan"	N								
G0289	"Arthro, loose body + chondro"	N								
G0293	"Non-cov surg proc,clin trial"	Q1	5732	0.4138	$33.43	.	$6.69			
G0294	"Non-cov proc, clinical trial"	Q1	5732	0.4138	$33.43	.	$6.69			
G0295	Electromagnetic therapy onc	E1								
G0296	Visit to determ ldct elig	S	5822	0.9721	$78.54	$0.00	$0.00			
G0297	Ldct for lung ca screen	S	5521	0.9878	$79.81	$0.00	$0.00			
G0299	Hhs/hospice of rn ea 15 min	B								
G0300	Hhs/hospice of lpn ea 15 min	B								
G0302	Pre-op service lvrs complete	S	5723	6.0105	$485.61	.	$97.13			
G0303	Pre-op service lvrs 10-15dos	S	5721	1.7124	$138.35	.	$27.67			
G0304	Pre-op service lvrs 1-9 dos	S	5723	6.0105	$485.61	.	$97.13			
G0305	Post op service lvrs min 6	S	5723	6.0105	$485.61	.	$97.13			
G0306	Cbc/diffwbc w/o platelet	Q4								
G0307	Cbc without platelet	Q4								
G0328	Fecal blood scrn immunoassay	A								
G0329	Electromagntic tx for ulcers	A								
G0333	Dispense fee initial 30 day	M								
G0337	Hospice evaluation preelecti	B								
G0339	"Robot lin-radsurg com, first"	B								
G0340	Robt lin-radsurg fractx 2-5	B								
G0341	Percutaneous islet celltrans	C								
G0342	Laparoscopy islet cell trans	C								
G0343	Laparotomy islet cell transp	C								
G0372	Md service required for pmd	M								
G0378	Hospital observation per hr	N								
G0379	Direct refer hospital observ	J2	5025	6.2445	$504.51	.	$100.91			
G0380	Lev 1 hosp type b ed visit	J2	5031	0.8177	$66.06	.	$13.22			
G0381	Lev 2 hosp type b ed visit	J2	5032	1.1188	$90.39	.	$18.08			
G0382	Lev 3 hosp type b ed visit	J2	5033	1.9536	$157.84	.	$31.57			
G0383	Lev 4 hosp type b ed visit	J2	5034	2.5118	$202.94	.	$40.59			
G0384	Lev 5 hosp type b ed visit	J2	5035	3.8243	$308.98	.	$61.80			
G0390	Trauma respons w/hosp criti	S	5045	11.0301	$891.15	.	$178.23			
G0396	Alcohol/subs interv 15-30mn	S	5821	0.3382	$27.32	.	$5.47			
G0397	Alcohol/subs interv >30 min	S	5822	0.9721	$78.54	.	$15.71			
G0398	Home sleep test/type 2 porta	S	5721	1.7124	$138.35	.	$27.67			
G0399	Home sleep test/type 3 porta	S	5721	1.7124	$138.35	.	$27.67			
G0400	Home sleep test/type 4 porta	S	5721	1.7124	$138.35	.	$27.67			
G0402	Initial preventive exam	V	5012	1.4349	$115.93	$0.00	$0.00			
G0403	Ekg for initial prevent exam	M								
G0404	Ekg tracing for initial prev	S	5731	0.2845	$22.99	.	$4.60			
G0405	Ekg interpret & report preve	B								
G0406	Inpt/tele follow up 15	B								
G0407	Inpt/tele follow up 25	B								
G0408	Inpt/tele follow up 35	B								
G0409	Corf related serv 15 mins ea	B								
G0410	Grp psych partial hosp 45-50	P								
G0411	Inter active grp psych parti	P								
G0412	Open tx iliac spine uni/bil	C								
G0413	Pelvic ring fracture uni/bil	J1	5114	74.0404	"$5,981.95"	.	"$1,196.39"			
G0414	Pelvic ring fx treat int fix	C								
G0415	Open tx post pelvic fxcture	C								
G0416	"Prostate biopsy, any mthd"	Q2	5673	3.5078	$283.41	.	$56.69			
G0420	Ed svc ckd ind per session	A								
G0421	Ed svc ckd grp per session	A								
G0422	Intens cardiac rehab w/exerc	S	5771	1.3619	$110.03	.	$22.01			
G0423	Intens cardiac rehab no exer	S	5771	1.3619	$110.03	.	$22.01			
G0424	Pulmonary rehab w exer	S	5733	0.6809	$55.01	.	$11.01			
G0425	Inpt/ed teleconsult30	B								
G0426	Inpt/ed teleconsult50	B								
G0427	Inpt/ed teleconsult70	B								
G0428	Collagen meniscus implant	E1								
G0429	Dermal filler injection(s)	T	5054	20.0852	"$1,622.74"	.	$324.55			
G0432	Eia hiv-1/hiv-2 screen	A								
G0433	Elisa hiv-1/hiv-2 screen	A								
G0435	Oral hiv-1/hiv-2 screen	A								
G0438	"Ppps, initial visit"	A								
G0439	"Ppps, subseq visit"	A								
G0442	Annual alcohol screen 15 min	S	5821	0.3382	$27.32	$0.00	$0.00			
G0443	Brief alcohol misuse counsel	S	5822	0.9721	$78.54	$0.00	$0.00			
G0444	Depression screen annual	S	5821	0.3382	$27.32	$0.00	$0.00			
G0445	High inten beh couns std 30m	S	5822	0.9721	$78.54	$0.00	$0.00			
G0446	Intens behave ther cardio dx	S	5821	0.3382	$27.32	$0.00	$0.00			
G0447	Behavior counsel obesity 15m	S	5822	0.9721	$78.54	$0.00	$0.00			
G0448	Place perm pacing cardiovert	B								
G0451	Devlopment test interpt&rep	Q3	5822	0.9721	$78.54	.	$15.71			
G0452	Molecular pathology interpr	B								
G0453	Cont intraop neuro monitor	N								
G0454	Md document visit by npp	B								
G0455	Fecal microbiota prep instil	Q1	5301	9.7276	$785.92	.	$157.19			
G0458	Ldr prostate brachy comp rat	B								
G0459	Telehealth inpt pharm mgmt	B								
G0460	Autologous prp for ulcers	T	5054	20.0852	"$1,622.74"	.	$324.55			
G0463	Hospital outpt clinic visit	J2	5012	1.4349	$115.93	.	$23.19			
G0466	Fqhc visit new patient	A								
G0467	"Fqhc visit, estab pt"	A								
G0468	"Fqhc visit, ippe or awv"	A								
G0469	"Fqhc visit, mh new pt"	A								
G0470	"Fqhc visit, mh estab pt"	A								
G0471	Ven blood coll snf/hha	A								
G0472	Hep c screen high risk/other	A								
G0473	Group behave couns 2-10 	S	5821	0.3382	$27.32	$0.00	$0.00			
G0475	Hiv combination assay	A								
G0476	Hpv combo assay ca screen	A								
G0480	Drug test def 1-7 classes	Q4								
G0481	Drug test def 8-14 classes	Q4								
G0482	Drug test def 15-21 classes	Q4								
G0483	Drug test def 22+ classes	Q4								
G0490	"Home visit rn, lpn by rhc/fq"	A								
G0491	Dialysis acu kidney no esrd	B								
G0492	Md/oth eval acut kid no esrd	B								
G0493	Rn care ea 15 min hh/hospice	B								
G0494	Lpn care ea 15min hh/hospice	B								
G0495	Rn care train/edu in hh	B								
G0496	Lpn care train/edu in hh	B								
G0498	Chemo extend iv infus w/pump	S	5694	3.8320	$309.60	.	$61.92			
G0499	Hepb screen high risk indiv	A								
G0500	Mod sedat endo service >5yrs	N								
G0501	Resource-inten svc during ov	N								
G0506	Comp asses care plan ccm svc	N								
G0508	Crit care telehea consult 60	B								
G0509	Crit care telehea consult 50	B								
G0511	Ccm/bhi by rhc/fqhc 20min mo	A								
G0512	Cocm by rhc/fqhc 60 min mo	A								
G0513	"Prolong prev svcs, first 30m"	N								
G0514	"Prolong prev svcs, addl 30m"	N								
G0516	"Insert drug del implant, >=4"	Q1	5735	4.5003	$363.59	.	$72.72			
G0517	Remove drug implant	Q1	5735	4.5003	$363.59	.	$72.72			
G0518	Remove w insert drug implant 	Q1	5735	4.5003	$363.59	.	$72.72			
G0659	Drug test def simple all cl	Q4								
G0913	Improve visual funct	M								
G0914	Survey not complete	M								
G0915	No improve visual funct	M								
G0916	Satisfy with care	M								
G0917	Satisfy survey not complete	M								
G0918	No satisfy with care	M								
G1001	Cdsm evicore	E1								
G1002	Cdsm medcurrent	E1								
G1003	Cdsm medicalis	E1								
G1004	Cdsm ndsc	E1								
G1005	Cdsm nia	E1								
G1006	Cdsm test approp	E1								
G1007	Cdsm aim	E1								
G1008	Cdsm cranberry pk	E1								
G1009	Cdsm sage health	E1								
G1010	Cdsm stanson	E1								
G1011	Cdsm qualified nos	E1								
G1012	Cdsm agilemd	E1								
G1013	Cdsm evidencecare	E1								
G1014	Cdsm inveniqa	E1								
G1015	Cdsm reliant	E1								
G1016	Cdsm speed of care	E1								
G1017	Cdsm healthhelp	E1								
G1018	Cdsm infinx	E1								
G1019	Cdsm logicnets	E1								
G1020	Cdsm curbside	E1							*	
G1021	Cdsm ehealthline	E1							*	
G1022	Cdsm intermountain	E1							*	
G1023	Cdsm persivia	E1							*	
G2000	Blinded conv. tx mdd clin tr	S	5723	6.0105	$485.61	.	$97.13			
G2001	Post d/c h vst new pt 20 m	B								
G2002	Post-d/c h vst new pt 30 m	B								
G2003	Post-d/c h vst new pt 45 m	B								
G2004	Post-d/c h vst new pt 60 m	B								
G2005	Post-d/c h vst new pt 75 m	B								
G2006	Post-d/c h vst ext pt 20 m	B								
G2007	Post-d/c h vst ext pt 30 m	B								
G2008	Post-d/c h vst ext pt 45 m	B								
G2009	Post-d/c h vst ext pt 60 m	B								
G2010	Remot image submit by pt	A								
G2011	Alcohol/sub misuse assess	S	5731	0.2845	$22.99	.	$4.60			
G2012	Brief check in by md/qhp	A								
G2013	Post-d/c h vst ext pt 75 m	B								
G2014	Post-d/c care plan overs 30m	B								
G2015	Post-d/c care plan overs 60m	B								
G2021	Hea care pract tx in place	E1								
G2022	"Benef refuses service, mod"	E1								
G2023	Specimen collect covid-19	B								
G2024	Spec coll snf/lab covid-19	B								
G2025	Dis site tele svcs rhc/fqhc	A								
G2058	Ccm add 20min	N								
G2061	Qual nonmd est pt 5-10m	A								
G2062	Qual nonmd est pt 11-20m	A								
G2063	Qual nonmd est pt 21>min	A								
G2064	Md mang high risk dx 30	M								
G2065	Clin mang h risk dx 30	S	5822	0.9721	$78.54	.	$15.71			
G2066	Inter devc remote 30d	Q1	5741	0.4487	$36.25	.	$7.25			
G2067	Med assist tx meth wk	E1								
G2068	Med assist tx bupre oral 	E1								
G2069	Med assist tx inject	E1								
G2070	Med assist tx implant	E1								
G2071	Med tx remove implant	E1								
G2072	Med tx insert/remove imp	E1								
G2073	Med tx naltrexone	E1								
G2074	Med assist tx no drug 	E1								
G2075	Med tx meds nos	E1								
G2076	Intake act w/med exam	E1								
G2077	Periodic assessment	E1								
G2078	Take-home meth	E1								
G2079	Take-hom buprenorphine	E1								
G2080	Add 30 mins counsel 	E1								
G2081	Pt 66+ snp or ltc pos > 90d	M 								
G2082	Visit esketamine 56m or less	S	1508		$650.50	.	$130.10			
G2083	"Visit esketamine, > 56m"	S	1511		$950.50	.	$190.10			
G2086	Off base opioid tx 70min	S	5823	1.6259	$131.36	.	$26.28			
G2087	"Off base opioid tx, 60 m"	S	5823	1.6259	$131.36	.	$26.28			
G2088	"Off base opioid tx, add30"	N								
G2089	A1c level 7 to 9%	M 								
G2090	Pt 66+ frailty and med dem	M 								
G2091	Pt 66+ frailty and adv ill	M 								
G2092	Ace arb arni	M 								
G2093	Med doc rsn no ace arn arni	M 								
G2094	Pt rsn no ace arn arni	M 								
G2095	Sys rsn no ace arn arni	M 								
G2096	No rsn ace arb arni	M 								
G2097	Child dx uri 3d of other dx	M 								
G2098	Pt 66+ frailty and med dem	M 								
G2099	Pt 66+ frailty and adv ill	M 								
G2100	Pt 66+ frailty and med dem	M 								
G2101	Pt 66+ frailty and adv ill	M 								
G2102	Dil retinal eye exam	M 								
G2103	7 stereo photos interpret	M 								
G2104	Eye img valid w/7 stereo	M 								
G2105	Pt 66+ lt ints > 90	M 								
G2106	Pt 66+ lt ints > 90	M 								
G2107	Pt 66+ frailty and adv ill	M 								
G2108	Pt 66+ lt ints > 90	M 								
G2109	Pt 66+ frailty and med dem	M 								
G2110	Pt 66+ frailty and adv ill	M 								
G2112	Pred<=5 mg ra glu <6m	M 								
G2113	"Pred>5 mg >6m, no chg da"	M 								
G2114	Pt 66-80 frailty and med dem	M 								
G2115	Pt 66+ frailty and med dem	M 								
G2116	Pt 66+ frailty and adv ill	M 								
G2117	Pt 66-80 frailty and adv ill	M 								
G2118	Pt 81+ frailty	M 								
G2119	Calc vitd opt	M 								
G2120	No calc vitd opt	M 								
G2121	Psy dep anx ap and icd asse	M 								
G2122	Psy/dep/anx/apandicd noasse	M 								
G2123	Pt 66-80 frailty med dem	M 								
G2124	Pt 66-80 frailty adv ill	M 								
G2125	Pt 81+ frailty	M 								
G2126	Pt 66+ frailty adv ill	M 								
G2127	Pt 66+ frailty med dem	M 								
G2128	No aspirin med rsn	M 								
G2129	No bp outpt	M 								
G2130	Pt 66+ lt inst > 90	M 								
G2131	Pt 81+ frailty	M 								
G2132	Pt 66-80 frailty and med dem	M 								
G2133	Pt 66-80 frailty and adv ill	M 								
G2134	Pt 66+ frailty and med dem	M 								
G2135	Pt 66+ frailty and adv ill	M 								
G2136	Bk pain vas 6-20wk = 3	M 								
G2137	Bk pain vas 6-20wk > 3	M 								
G2138	Bk pain vas 9-15mo = 3	M 								
G2139	Bk pain vas 9-20mo > 3	M 								
G2140	Leg pain vas 6-20wk = 3	M 								
G2141	Leg pain vas 6-20wk > 3	M 								
G2142	Fs odi 9-15mo postop<= 22	M 								
G2143	Fs odi 9-15mo > 22	M 								
G2144	Fs odi 6-20wk postop > 22	M 								
G2145	Fsodi 6-20wk >22 or chg 30pt	M 								
G2146	Leg pain vas 9-15mo <= 3	M 								
G2147	Leg pain vas 9-15mo > 3	M 								
G2148	Mpm used	M 								
G2149	No mpm med rsn	M 								
G2150	No mpm	M 								
G2151	Dx degen neuro 	M 								
G2152	Res change sc =0	M 								
G2153	Hosp dur meas pd	M 								
G2154	Td 9 yrs start end meas	M 								
G2155	Hist contraindications	M 								
G2156	No prior td or hx contra	M 								
G2157	Pneum vacc 12 mo 60+	M 								
G2158	Pneum vacc adv rx	M 								
G2159	No pneum vacc 12 mo 60+	M 								
G2160	Herpzos 50+	M 								
G2161	Adv rx zos	M 								
G2162	No herpzos 50+	M 								
G2163	Infl vacc 07/01 to 06/30	M 								
G2164	Adv rx infl vacc	M 								
G2165	No infl vacc 07/01 to 06/30	M 								
G2166	No pt adm dx no neck fs prom	M 								
G2167	Res change sc < 0	M 								
G2168	Svs by pt in home health	B								
G2169	Svs by ot in home health	B								
G2170	Avf by tissue w thermal e	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
G2171	Avf use magnetic/art/ven	J1	5194	197.2940	"$15,939.97"	.	"$3,188.00"	*		
G6001	Echo guidance radiotherapy 	B								
G6002	Stereoscopic x-ray guidance 	B								
G6003	Radiation treatment delivery	B								
G6004	Radiation treatment delivery	B								
G6005	Radiation treatment delivery	B								
G6006	Radiation treatment delivery	B								
G6007	Radiation treatment delivery	B								
G6008	Radiation treatment delivery	B								
G6009	Radiation treatment delivery	B								
G6010	Radiation treatment delivery	B								
G6011	Radiation treatment delivery	B								
G6012	Radiation treatment delivery	B								
G6013	Radiation treatment delivery	B								
G6014	Radiation treatment delivery	B								
G6015	Radiation tx delivery imrt	B								
G6016	Delivery comp imrt	B								
G6017	Intrafraction track motion	B								
G8395	Lvef>=40% doc normal or mild	M								
G8396	Lvef not performed	M								
G8397	Dil macula/fundus exam/w doc	M								
G8398	Dil macular/fundus not perfo	M								
G8399	Pt w/dxa results document 	M								
G8400	Pt w/dxa no results doc 	M								
G8404	Low extemity neur exam docum	M								
G8405	Low extemity neur not perfor	M								
G8410	Eval on foot documented	M								
G8415	Eval on foot not performed	M								
G8416	Pt inelig footwear evaluatio	M								
G8417	Calc bmi abv up param f/u	M								
G8418	Calc bmi blw low param f/u	M								
G8419	Calc bmi out nrm param nof/u	M								
G8420	Calc bmi norm parameters	M								
G8421	Bmi not calculated	M								
G8422	Pt inelig bmi calculation	M								
G8427	Docrev cur meds by elig clin	M								
G8428	Cur meds not document	M								
G8430	Ec at doc medrec pt not elig	M								
G8431	Pos clin depres scrn f/u doc	M								
G8432	"Dep scr not doc, rng"	M								
G8433	Scr for dep not cpt doc rsn	M								
G8442	"Doc pain as nt perf, not elg"	M								
G8450	Beta-bloc rx pt w/abn lvef	M								
G8451	Pt w/abn lvef inelig b-bloc	M								
G8452	Pt w/abn lvef b-bloc no rx	M								
G8465	High risk recurrence pro ca	M								
G8473	Ace/arb thxpy rx'd	M								
G8474	Ace/arb not rx'd; doc reas	M								
G8475	Ace/arb thxpy not rx'd	M								
G8476	Bp sys <140 and dias <90	M								
G8477	Bp sys>=140 and/or dias >=90	M								
G8478	Bp not performed/doc	M								
G8482	Flu immunize order/admin	M								
G8483	Flu imm no admin doc rea	M								
G8484	Flu immunize no admin	M								
G8506	Pt rec ace/arb	M								
G8509	Pos pain assess no f/u doc	M								
G8510	"Scr dep neg, no plan reqd"	M								
G8511	"Scr dep pos, no plan doc rng"	M								
G8535	Eld maltreatment not doc	M								
G8536	No doc elder mal scrn	M								
G8539	Doc funct and care plan	M								
G8540	Foa not doc as being perf	M								
G8541	No doc cur funct assess	M								
G8542	Doc funct no deficiencies	M								
G8543	Cur funct asses; no care pln	M								
G8559	Pt ref doc oto eval	M								
G8560	Pt hx act drain prev 90 days	M								
G8561	Pt inelig for ref oto eval	M								
G8562	Pt no hx act drain 90 d	M								
G8563	Pt no ref oto reas no spec	M								
G8564	Pt ref oto eval	M								
G8565	Ver doc hear loss	M								
G8566	Pt inelig ref oto eval	M								
G8567	Pt no doc hear loss	M								
G8568	Pt no ref otolo no spec	M								
G8569	Prol intubation req	M								
G8570	No prol intub req	M								
G8571	Ster wd ifx 30 d postop	M								
G8572	No ster wd ifx	M								
G8573	Stk cabg	M								
G8574	No strk cabg	M								
G8575	Postop ren fail	M								
G8576	No postop ren fail	M								
G8577	Reop req bld grft oth	M								
G8578	No reop req bld grft oth	M								
G8598	Asa/antiplat ther used	M								
G8599	No asa/antiplat ther use rng	M								
G8600	Tpa initi w/in 3 hrs	M								
G8601	No elig tpa init w/in 3 hrs	M								
G8602	No tpa init w/in 3 hrs	M								
G8627	Surg proc w/in 30 days	M								
G8628	No surg proc w/in 30 days	M								
G8633	Pharm ther osteo rx	M								
G8635	No pharm ther osteo rx	M								
G8647	Rafscrs ki scor >= 0	M								
G8648	Rafscrs ki scor < 0	M								
G8650	Rafs crs ki no scor no surv	M								
G8651	Rafscrs hi scor >=0	M								
G8652	Rafscrs hi scor < 0	M								
G8654	Rafs crs hi no scor no surv	M								
G8655	Rafscrs llfai scor >= 0	M								
G8656	Rafscrs llfai scor < 0	M								
G8658	Rafscrs llfai no scor + surv	M								
G8659	Rafscrs lbi scor >= 0	M								
G8660	Rafscrs lbi scor < 0	M								
G8661	Rafscrs lbi no scor	M								
G8662	Rafs crs lbi no scor no surv	M								
G8663	Rafscrs si scor >= 0	M								
G8664	Rafscrs si scor < 0 	M								
G8666	Rafs crs si no scor no surv	M								
G8667	Rafscrs ewh scor >= 0	M								
G8668	Rafscrs ewh scor < 0	M								
G8670	Rafs crs ewh no scor no surv	M								
G8671	Rafscrs goi scor >= 0	M								
G8672	Rafscrs goi scor < 0	M								
G8674	"Rafscrs neck, no msr/no foto"	M								
G8694	Lvef <40%	M								
G8708	Antibiotic not pres	M								
G8709	Pt presc doc med rsn id uri	M								
G8710	Pt pres antibiotic	M								
G8711	Pres antibiotic	M								
G8712	Not pres antibiotic	M								
G8721	"Pt, pn, hist grade doc"	M								
G8722	"Med reas pt, pn, not doc"	M								
G8723	Spec sit not prim tumor	M								
G8724	"Pt, pn, hist grade not doc"	M								
G8730	Pain doc pos and plan	M								
G8731	Pain neg no plan	M								
G8732	No doc of pain	M								
G8733	Doc pos elder mal scrn plan	M								
G8734	Doc neg elder mal no plan	M								
G8735	Eld mal scrn pos no plan	M								
G8749	No signs melanoma	M								
G8752	Sys bp less 140	M								
G8753	Sys bp > or = 140	M								
G8754	Dias bp less 90	M								
G8755	Dias bp > or = 90	M								
G8756	No bp measure doc	M								
G8783	Bp scrn perf rec interval	M								
G8785	Bp scrn no perf at interval	M								
G8797	Specimen site not esophagus	M								
G8798	Specimen site not prostate	M								
G8806	Perf ultrsnd to lct preg doc	M								
G8807	No ta tv ultrasnd 	M								
G8808	"Ultrasound not perf, rng"	M								
G8809	Rh-immunoglobulin order	M								
G8810	Doc reas no rh-immuno	M								
G8811	No rh-immunoglobulin order	M								
G8815	Doc reas no statin therapy	M								
G8816	Statin med pres at disch	M								
G8817	Doc reas no statin med disch	M								
G8818	Pt disch to home by day#7	M								
G8825	Pt not disch to home day#7	M								
G8826	Pt disch home day #2 evar	M								
G8833	Pt not disch home day#2 evar	M								
G8834	Pt disch home day #2 cea	M								
G8838	Not disch home by day #2	M								
G8839	Sleep apnea assess	M								
G8840	Doc reas no sleep apnea	M								
G8841	No sleep apnea assess	M								
G8842	Ahi or rdi initial dx	M								
G8843	Doc reas no ahi or rdi	M								
G8844	No ahi or rdi initial dx	M								
G8845	Pos airway press prescribed	M								
G8846	Mod or severe osa	M								
G8849	Doc reas no pos air press	M								
G8850	No pap prescribed	M								
G8851	Adhere pos air press therapy	M								
G8852	Pos air press prescribe	M								
G8854	Reas no adhere pos air pres	M								
G8855	Pos air press adhere no perf	M								
G8856	Ref for oto eval	M								
G8857	No elig ref for oto eval	M								
G8858	Not ref for oto eval	M								
G8863	No assess bone loss	M								
G8864	Pneumococcal vaccine admin	M								
G8865	Doc med reas no pneumococcal	M								
G8866	Doc pt reas no pneumococcal	M								
G8867	No pneumococcal admin	M								
G8869	Doc immune hep b antitnf	M								
G8872	Intraop image confirm excise	M								
G8873	Specimen not intraop image	M								
G8874	Tissue not image intraop	M								
G8875	Breast cancer dx min invsive	M								
G8876	Doc reas no min inv dx	M								
G8877	No brst cncr dx min invasive	M								
G8878	Sent lymph node biopsy	M								
G8880	Sen lym p node biop not perf	M								
G8881	Brst cncr stage > t1n0m0	M								
G8882	No sent lymph node biopsy	M								
G8883	"Rev, comm, track, doc biopsy"	M								
G8884	Doc reas biopsy not review	M								
G8885	"No rev, comm, track biopsy"	M								
G8907	Pt doc no events on discharg	M								
G8908	Pt doc w burn prior to d/c	M								
G8909	Pt doc no burn prior to d/c	M								
G8910	Pt doc to have fall in asc	M								
G8911	Pt doc no fall in asc	M								
G8912	Pt doc with wrong event	M								
G8913	Pt doc no wrong event	M								
G8914	Pt trans to hosp post d/c	M								
G8915	Pt not trans to hosp at d/c	M								
G8916	Pt w iv ab given on time	M								
G8917	Pt w iv ab not given on time	M								
G8918	Pt w/o preop order iv ab pro	M								
G8923	Lvef < 40% or lvsd	M								
G8924	"Spir fev1/fvc<70%,fev<60%"	M								
G8925	Spir fev1/fvc>=60% & no copd	M								
G8926	Spiro no perf or doc	M								
G8934	Lvef <40% or dep lv sys fcn	M								
G8935	Rx ace or arb therapy	M								
G8936	Pt not eligible ace/arb	M								
G8937	No rx ace/arb therapy	M								
G8938	Bmi doc onl fup nt doc	M								
G8939	"Pain as doc positive, no f/u"	M								
G8941	Eld maltreatment doc as pos	M								
G8942	Doc fcn/care plan w/30 days	M								
G8944	Ajcc mel cnr stg 0 - iic	M								
G8946	Mibm but no dx of breast ca	M								
G8950	"Pre-htn or htn doc, f/u indc"	M								
G8952	"Pre-htn/htn, no f/u, not gvn"	M								
G8955	Most recent assess vol mgmt	M								
G8956	Pt rcv hedia outpt dyls fac	M								
G8958	Assess vol mgmt not doc	M								
G8959	Clin tx mdd comm to tx clin	M								
G8960	Clin tx mdd not comm	M								
G8961	Csit lowrisk surg pts preop	M								
G8962	Csit on pt any reas 30 days	M								
G8963	Csi per asx pt w/pci 2 yrs	M								
G8964	Csi any other than pci 2 yr	M								
G8965	Csit perf on low chd rsk	M								
G8966	Csit perf sx or high chd rsk	M								
G8967	Warf or other fda drug presc	M								
G8968	Doc med not presb	M								
G8969	Doc pt rsn no presc warf/fda	M								
G8970	No rsk fac or 1 mod risk te	M								
G8973	Mst rcnt hbb < 10g/dl	M								
G8974	Hgb not doc rns not gvn	M								
G8975	"Hgb <10g/dl, med rsn"	M								
G8976	Hgb >= 10 g/dl	M								
G9001	"Mccd, initial rate"	B								
G9002	"Mccd,maintenance rate"	B								
G9003	"Mccd, risk adj hi, initial"	B								
G9004	"Mccd, risk adj lo, initial"	B								
G9005	"Mccd, risk adj, maintenance"	B								
G9006	"Mccd, home monitoring"	B								
G9007	"Mccd, sch team conf"	B								
G9008	"Mccd,phys coor-care ovrsght"	B								
G9009	"Mccd, risk adj, level 3"	B								
G9010	"Mccd, risk adj, level 4"	B								
G9011	"Mccd, risk adj, level 5"	B								
G9012	Other specified case mgmt	B								
G9013	Esrd demo bundle level i	E1								
G9014	Esrd demo bundle-level ii	E1								
G9016	Demo-smoking cessation coun	E1								
G9050	Oncology work-up evaluation	E1								
G9051	Oncology tx decision-mgmt	E1								
G9052	Onc surveillance for disease	E1								
G9053	Onc expectant management pt	E1								
G9054	Onc supervision palliative	E1								
G9055	Onc visit unspecified nos	E1								
G9056	Onc prac mgmt adheres guide	E1								
G9057	Onc pract mgmt differs trial	E1								
G9058	Onc prac mgmt disagree w/gui	E1								
G9059	Onc prac mgmt pt opt alterna	E1								
G9060	Onc prac mgmt dif pt comorb	E1								
G9061	Onc prac cond noadd by guide	E1								
G9062	Onc prac guide differs nos	E1								
G9063	Onc dx nsclc stgi no progres	M								
G9064	Onc dx nsclc stg2 no progres	M								
G9065	Onc dx nsclc stg3a no progre	M								
G9066	Onc dx nsclc stg3b-4 metasta	M								
G9067	Onc dx nsclc dx unknown nos	M								
G9068	Onc dx sclc/nsclc limited	M								
G9069	Onc dx sclc/nsclc ext at dx	M								
G9070	Onc dx sclc/nsclc ext unknwn	M								
G9071	"Onc dx brst stg1-2b hr,nopro"	M								
G9072	Onc dx brst stg1-2 noprogres	M								
G9073	"Onc dx brst stg3-hr, no pro"	M								
G9074	Onc dx brst stg3-noprogress	M								
G9075	Onc dx brst metastic/ recur	M								
G9077	Onc dx prostate t1no progres	M								
G9078	Onc dx prostate t2no progres	M								
G9079	Onc dx prostate t3b-t4noprog	M								
G9080	Onc dx prostate w/rise psa	M								
G9083	Onc dx prostate unknwn nos	M								
G9084	"Onc dx colon t1-3,n1-2,no pr"	M								
G9085	"Onc dx colon t4, n0 w/o prog"	M								
G9086	Onc dx colon t1-4 no dx prog	M								
G9087	Onc dx colon metas evid dx	M								
G9088	Onc dx colon metas noevid dx	M								
G9089	Onc dx colon extent unknown	M								
G9090	Onc dx rectal t1-2 no progr	M								
G9091	Onc dx rectal t3 n0 no prog	M								
G9092	"Onc dx rectal t1-3,n1-2noprg"	M								
G9093	"Onc dx rectal t4,n,m0 no prg"	M								
G9094	Onc dx rectal m1 w/mets prog	M								
G9095	Onc dx rectal extent unknwn	M								
G9096	Onc dx esophag t1-t3 noprog	M								
G9097	Onc dx esophageal t4 no prog	M								
G9098	Onc dx esophageal mets recur	M								
G9099	Onc dx esophageal unknown	M								
G9100	Onc dx gastric no recurrence	M								
G9101	Onc dx gastric p r1-r2noprog	M								
G9102	Onc dx gastric unresectable	M								
G9103	Onc dx gastric recurrent	M								
G9104	Onc dx gastric unknown nos	M								
G9105	Onc dx pancreatc p r0 res no	M								
G9106	Onc dx pancreatc p r1/r2 no	M								
G9107	Onc dx pancreatic unresectab	M								
G9108	Onc dx pancreatic unknwn nos	M								
G9109	Onc dx head/neck t1-t2no prg	M								
G9110	Onc dx head/neck t3-4 noprog	M								
G9111	Onc dx head/neck m1 mets rec	M								
G9112	Onc dx head/neck ext unknown	M								
G9113	Onc dx ovarian stg1a-b no pr	M								
G9114	Onc dx ovarian stg1a-b or 2	M								
G9115	Onc dx ovarian stg3/4 noprog	M								
G9116	Onc dx ovarian recurrence	M								
G9117	Onc dx ovarian unknown nos	M								
G9123	Onc dx cml chronic phase	M								
G9124	Onc dx cml acceler phase	M								
G9125	Onc dx cml blast phase	M								
G9126	Onc dx cml remission	M								
G9128	Onc dx multi myeloma stage i	M								
G9129	Onc dx mult myeloma stg2 hig	M								
G9130	Onc dx multi myeloma unknown	M								
G9131	Onc dx brst unknown nos	M								
G9132	Onc dx prostate mets no cast	M								
G9133	Onc dx prostate clinical met	M								
G9134	Onc nhlstg 1-2 no relap no	M								
G9135	Onc dx nhl stg 3-4 not relap	M								
G9136	Onc dx nhl trans to lg bcell	M								
G9137	Onc dx nhl relapse/refractor	M								
G9138	Onc dx nhl stg unknown	M								
G9139	Onc dx cml dx status unknown	M								
G9140	Frontier extended stay demo	A								
G9143	Warfarin respon genetic test	N								
G9147	Outpt iv insulin tx any mea	E1								
G9148	Medical home level 1	M								
G9149	Medical home level ii	M								
G9150	Medical home level iii	M								
G9151	Mapcp demo state	M								
G9152	Mapcp demo community	M								
G9153	Mapcp demo physician	M								
G9156	Evaluation for wheelchair	M								
G9157	Transesoph doppl cardiac mon	B								
G9187	Bpci home visit	E1								
G9188	Beta not given no reason	M								
G9189	Beta pres or already taking	M								
G9190	Medical reason for no beta	M								
G9191	Pt reason for no beta	M								
G9192	System reason for no beta	M								
G9196	Med reason for no ceph	M								
G9197	Order for ceph	M								
G9198	No order for ceph no reason	M								
G9212	Doc of dsm-iv init eval	M								
G9213	No doc of dsm-iv	M								
G9223	Pjp proph ordered cd4 low	M								
G9225	Norsn no foot exam	M								
G9226	3 comp foot exam completed	M								
G9227	"Foa doc, care plan not doc"	M								
G9228	Gc chl syp documented	M								
G9229	Ptrsn no gc chl syp test	M								
G9230	Norsn for gc chl syp test	M								
G9231	Doc esrd dia trans preg	M								
G9232	Ptrsn no comm comorbid	M								
G9239	Doc rsn hemod & cath acc	M								
G9240	Doc pt w cath maint dia	M								
G9241	Doc pt w out cath maint dia	M								
G9242	Doc viral load >=200	M								
G9243	Doc viral load <200	M								
G9246	No med visit in 24mo	M								
G9247	1 med visit in 24mo	M								
G9250	Doc of pain comfort 48hr	M								
G9251	Doc no pain comfort 48hr	M								
G9254	Doc pt dischg >2d	M								
G9255	Doc pt dischg <=2d	M								
G9256	Doc of pat death after cas	M								
G9257	Doc of pat stroke after cas	M								
G9258	Doc of pat stroke after cea	M								
G9259	Survive/no stroke post cas	M								
G9260	Doc of pat death after cea	M								
G9261	Survive/no stroke post cea	M								
G9262	Doc of death post-aaa repair	M								
G9263	Doc of disch post-aaa repair	M								
G9264	Doc rsn hemod w/cath >=90d	M								
G9265	Doc cath >90d for maint dia	M								
G9266	Norsn pt cath >=90d	M								
G9267	Doc comp or mort w in 30d	M								
G9268	Doc comp or mort w in 90d	M								
G9269	Doc no comp or mort w in 30d	M								
G9270	Doc no comp or mort w in 90d	M								
G9273	Sys<140 and dia<90	M								
G9274	Bp out of nrml limits	M								
G9275	Doc of non tobacco user	M								
G9276	Doc of tobacco user	M								
G9277	Doc daily aspirin or contra	M								
G9278	Doc no daily aspirin	M								
G9279	Pne scrn done doc vac done	M								
G9280	Pne not given norsn	M								
G9281	Pne scrn done doc not ind	M								
G9282	Doc medrsn no histo type	M								
G9283	Hist type doc on report	M								
G9284	No hist type doc on report	M								
G9285	Site not small cell lung ca	M								
G9286	Antibio rx w in 10d of sympt	M								
G9287	No antibio w in 10d of sympt	M								
G9288	Doc medrsn no hist type rpt	M								
G9289	Doc type nsm lung ca	M								
G9290	No doc type nsm lung ca	M								
G9291	Not nsm lung ca	M								
G9292	Medrsn no pt category	M								
G9293	No pt category on report	M								
G9294	Pt cat and thck on report	M								
G9295	Non cutaneous loc	M								
G9296	Doc share dec prior proc	M								
G9297	No doc share dec prior proc	M								
G9298	Eval risk vte card 30d prior	M								
G9299	No eval riskk vte card prior	M								
G9300	Doc medrsn no compl antibio	M								
G9301	Doc compl inf antibio	M								
G9302	Norsn incomp inf antibio	M								
G9303	Norsn no pros info op rpt	M								
G9304	Pros info op rpt	M								
G9305	No interv req for leak	M								
G9306	Interv req for leak	M								
G9307	No ret for surg w in 30d	M								
G9308	Unpl ret or w/compl w/in 30d	M								
G9309	No unplnd hosp readm in 30d	M								
G9310	Unplnd hosp readm in 30d	M								
G9311	No surg site infection	M								
G9312	Surgical site infection	M								
G9313	Amoxic not presc as 1st line	M								
G9314	Norsn not first line amox	M								
G9315	Doc first line amox	M								
G9316	Doc comm risk calc	M								
G9317	No doc comm risk calc	M								
G9318	Image std nomenclature	M								
G9319	Image not std nomenclature	M								
G9321	Doc count of ct in 12mo	M								
G9322	No doc count of ct in 12mo	M								
G9326	"Ct done no rad ds index, nrg"	M								
G9327	Ct done rad ds index	M								
G9329	Norsn no dicom format doc	M								
G9340	Dicom format doc on rpt	M								
G9341	Srch for ct w in 12 mos	M								
G9342	No srch for ct in 12mo norsn	M								
G9344	Sysrsn no dicom srch	M								
G9345	Follow up pulm nod	M								
G9347	No follow up pulm nod norsn	M								
G9348	Doc rsn for ord ct scan	M								
G9349	Ct within 28 days	M								
G9350	No doc sinus ct 28d or dx	M								
G9351	Doc >1 sinus ct w 90d dx	M								
G9352	Not >1 sinus ct w 90d dx	M								
G9353	Medrsn >1 sinus ct w 90d dx	M								
G9354	1 or no ct sinus w/in 90d dx	M								
G9355	No early ind/delivery	M								
G9356	Early ind/delivery	M								
G9357	Pp eval/edu perf	M								
G9358	Pp eval/edu not perf	M								
G9359	Neg mgd pos tb notact	M								
G9360	No doc of neg or man pos tb	M								
G9361	Doc rsn elect c-sec/induct	M								
G9364	Sinus caus bac inx	M								
G9365	1high risk med ord	M								
G9366	1high risk no ord	M								
G9367	>= 2 same hi-rsk med ord	M								
G9368	>= 2 same hi-rsk med not ord	M								
G9380	Off assis eol iss	M								
G9382	No off assis eol	M								
G9383	Recd scrn hcv infec	M								
G9384	Doc med rsn no hcv scrn	M								
G9385	Doc pt reas not rec hcv srn	M								
G9386	Scrn hcv infec not recd	M								
G9389	Unpln rup post cap	M								
G9390	No unpln rup post cap	M								
G9393	Ini phq9 >9 remiss <5	M								
G9394	"Dx bipol, death, nhres, hosp"	M								
G9395	Ini phq9 >9 no remiss >=5	M								
G9396	Ini phq9 >9 not assess	M								
G9399	Doc disc tx choices	M								
G9400	Doc reas no disc tx opt	M								
G9401	No disc tx choices	M								
G9402	Recd f/u w/in 30d disch	M								
G9403	Doc reas no 30 day f/u	M								
G9404	No 30 day f/u	M								
G9405	Recd f/u w/in 7d dc	M								
G9406	Doc reas no 7d f/u	M								
G9407	No 7d f/u	M								
G9408	Card tamp w/in 30d	M								
G9409	No card tamp e/in 30d	M								
G9410	Admit w/in 180d req remov	M								
G9411	No admit w/in 180d req remov	M								
G9412	Admit w/in 180d req surg rev	M								
G9413	No admit req surg rev	M								
G9414	1dose menig vac btwn 11 & 13	M								
G9415	No 1dose meni vac btwn 11&13	M								
G9416	Pt 1 tdap betw 10-13 yrs	M								
G9417	Pt not 1 tdap betw 10-13 yrs	M								
G9418	Lungcx bx rpt docs class	M								
G9419	Med reas not incl histo type	M								
G9420	Spec site no lung	M								
G9421	Lung cx bx rpt no doc class	M								
G9422	Rpt doc class histo type	M								
G9423	Med reas rpt no histo type	M								
G9424	Site no lung or lung cx	M								
G9425	Spec rpt no doc class histo	M								
G9426	Impr med time edarr pain med	M								
G9427	No impro med time pain med	M								
G9428	Patho rpt incl pt ctg	M								
G9429	Doc med rsn no pt cat	M								
G9430	Spec site no cutaneous	M								
G9431	Patho rpt no pt ctg	M								
G9432	Asth controlled	M								
G9434	Asth not controlled	M								
G9448	Born 1945-1965	M								
G9449	Hx bld transf b/f 1992	M								
G9450	Hx injec drug use	M								
G9451	1x scrn hcv infect	M								
G9452	Doc med reas no scrn hcv	M								
G9453	Pt reas no hcv infect	M								
G9454	No scr hcv inf 12 mth rp	M								
G9455	"Abd imag w/us, ct or mri"	M								
G9456	Doc med pt reas no hcc scrn	M								
G9457	Pt no abd img no doc rsn 	M								
G9458	Tob user recd cess interv	M								
G9459	Tob non-user	M								
G9460	No tob assess or cess inter	M								
G9468	No recd cortico>=10mg/d >60d	M								
G9469	Rec cortico>90d or 1rx 900mg	M								
G9470	No rec cortico>60d 1rx 600mg	M								
G9471	W/in 2yr dxa not order	M								
G9473	Chap services at hospice	B								
G9474	Diet counsel at hospice	B								
G9475	Other counselor at hospice	B								
G9476	Volun service at hospice	B								
G9477	Care coord at hospice	B								
G9478	Othe therapist at hospice	B								
G9479	Pharmacist at hospice	B								
G9480	Admission to mccm	B								
G9481	Remote e/m new pt 10mins	B								
G9482	Remote e/m new pt 20mins	B								
G9483	Remote e/m new pt 30mins	B								
G9484	Remote e/m new pt 45mins	B								
G9485	Remote e/m new pt 60mins	B								
G9486	Remote e/m est. pt 10mins	B								
G9487	Remote e/m est. pt 15mins	B								
G9488	Remote e/m est. pt 25mins	B								
G9489	Remote e/m est. pt 40mins	B								
G9490	Cmmi mod home visit	B								
G9497	Rec inst no smoke day surg	M								
G9498	Abx reg prescribed	M								
G9500	Rad expos ind/exp tm doc	M								
G9501	Rad expos ind/exp tm no doc	M								
G9502	Med reas no perf foot exam	M								
G9503	Pt tk tams hcl	M								
G9504	Doc rsn hep b stat not asses	M								
G9505	Abx pres w/in 10 dys of symp	M								
G9506	Bio imm resp mod presc	M								
G9507	Doc reas on statin or contra	M								
G9508	Doc pt not on statin	M								
G9509	Adit mdd dys rem 12 mnths	M								
G9510	Remis12m not phq-9 score <5	M								
G9511	Idx evt dte phq>9 doc 12 mo	M								
G9512	Indiv pdc > 0.8	M								
G9513	Indiv pdc not > 0.8	M								
G9514	Req ret or w/in 90d of surg	M								
G9515	"No reas, no ret or w/in 90d"	M								
G9516	Impr vis acuit w/in 90d	M								
G9517	No impr vis acuit w/in 90d	M								
G9518	Doc active inj drug use	M								
G9519	Final ref +/- 1.0 w/in 90d	M								
G9520	Refract not +/- 1.0 w/in 90d	M								
G9521	Er and ip hosp <2 in 12 mos	M								
G9522	Er/ip hosp =/>2 in 12 mos	M								
G9523	D/c hemo or perit dialysis	M								
G9524	Refer to hospice	M								
G9525	Doc pt reas no hospice refer	M								
G9526	"No reason, no refer hospice"	M								
G9529	Minor blunt trauma w/head ct	M								
G9530	Pt mbht hd ct ord ec prov	M								
G9531	Pt doc	M								
G9532	Pt hd ct ord	M								
G9533	Indic for head ct not valid	M								
G9537	Doc sysm rsn img hd	M								
G9539	Intent pot remv time placemt	M								
G9540	Pt alive 3 mos post proc	M								
G9541	Filter rem 3 mon plmt	M								
G9542	Doc reass appr remo filt 3ms	M								
G9543	Doc 2x re-assess filt remov	M								
G9544	No filt remov w/in 3mos plcm	M								
G9547	Cys ren les or adren	M								
G9548	No f/u rec image study	M								
G9549	Doc med rsn for f/u imag	M								
G9550	Imag rec	M								
G9551	Imag no les	M								
G9552	Inc thyr node <1.0 in rpt	M								
G9553	Prior thyroid dise dx	M								
G9554	Ct/cta/mri/a chst foll rec	M								
G9555	Doc med rsn for follup image	M								
G9556	Ct/cta/mri/a no follup imag	M								
G9557	Ct/cta/mri/a no thyr <1.0cm	M								
G9558	Tx beta-lactam abx therapy	M								
G9559	Doc med reas no abx therapy	M								
G9560	"No beta-lactam abx ther, rng"	M								
G9561	Presc opiates >6 wks	M								
G9562	Foll-up eval q3mo opiod tx	M								
G9563	No f/u eval q3mo opiod tx	M								
G9573	Adl pt md or dys rem 6 mon	M								
G9574	Adl pt md dys no rem 6 mon	M								
G9577	Presc opiates >6 wks	M								
G9578	Doc opioid tx 1x during ther	M								
G9579	No doc opioid tx 1x at ther	M								
G9580	Door to punc time <2hrs	M								
G9582	"Door to punc time >2hr, nrg"	M								
G9583	Presc opiates >6 wks	M								
G9584	Eval opioid use instr/pt int	M								
G9585	No eval opi use instr/intv	M								
G9593	Low pecarn ped head trauma	M								
G9594	Pt mbht hd ct ord ec prov	M								
G9595	Doc shnt/tum/coag	M								
G9596	Ped pt hd ct ord 	M								
G9597	No low pecarn ped head traum	M								
G9598	Aor ane 5.5-5.9 cm max diam	M								
G9599	Aor ane >=6.0 cm max diam	M								
G9600	Symp aaa urgent repair	M								
G9601	Pt dchg home post op day 7	M								
G9602	Pt no dchg home postop day 7	M								
G9603	Pt surv improv bsline tx	M								
G9604	Pt surv results not avail	M								
G9605	Surv score no improv w/tx	M								
G9606	Intraop cyst eval trac inj	M								
G9607	Doc med rsn not perf cystosc	M								
G9608	Intraop cyst eval not done	M								
G9609	Doc order anti-plat 	M								
G9610	Doc md rsn no antipla	M								
G9611	No doc order anti-plat rng	M								
G9612	Phodoc 2 mr cec lndmk	M								
G9613	Doc post surg anatomy	M								
G9614	Photodoc < 2 cec lndmk	M								
G9615	Pre-op asst doc	M								
G9616	Doc rsn no preop assmt	M								
G9617	"Pre-op asst not doc, rng"	M								
G9618	Doc scr uter mal or us/samp	M								
G9620	No scr utr malig/us/samp rng	M								
G9621	Scr unheal etoh w/counsel	M								
G9622	No unheal etoh user	M								
G9623	Doc med rsn no scr etoh use	M								
G9624	Pt not scrn or no counseling	M								
G9625	Pt bl srg 30 day pst srg	M								
G9626	Med rsn no rpt baldder inj	M								
G9627	Pt no bl srg 30 day pst srg	M								
G9628	Pt bwli srg 30 day pst srg	M								
G9629	Med rsn no rpt bowel inj	M								
G9630	Pt no bwli srg 30 day srg	M								
G9631	Pt ui srg 30 day pst srg	M								
G9632	Med rsn for no rpt uret inj	M								
G9633	Pt no ui srg 30 day pst srg	M								
G9634	Qual life tool 2x same/impr	M								
G9635	No doc rsn do qual life assm	M								
G9636	No life asst 2x same/decr	M								
G9637	Doc >1 dose reduc tech	M								
G9638	No doc >1 dose reduc tech	M								
G9639	Amp no reqd in48h ieler proc	M								
G9640	Doc plan hybrid/stage proc	M								
G9641	Amp reqd w/in 48h ieler proc	M								
G9642	Current smoker	M								
G9643	Elective surgery	M								
G9644	No smok b/4 anes day of surg	M								
G9645	Had smoke b/4 anes day surg	M								
G9646	Pt w/90d mrs 0-2	M								
G9647	No mrs score in 90d followup	M								
G9648	Pt w/90d mrs >2	M								
G9649	Psor as doc spc bm	M								
G9651	Psor as doc no spc bm	M								
G9654	Mon anesth care	M								
G9655	Toc tool incl key elem	M								
G9656	Pt trans from anest to pacu	M								
G9658	Toc tool incl elem not used	M								
G9659	>85y no hx colo ca/rsn scope	M								
G9660	Doc med rsn scope pt >85y	M								
G9661	>85y scope othr rsn	M								
G9662	Prior dx/active clin ascvd	M								
G9663	Fast/dir ldl <= 190 mg/dl	M								
G9664	Taking statin or rec'd order	M								
G9665	No statin/no order statin	M								
G9666	Fas/dir ldl 70-189mg/dl mst	M								
G9674	Pt w/clin ascvd dx	M								
G9675	Pt w/fast/dir lab ldl-c >190	M								
G9676	40-75y w/type 1/2 w/ldl-c rs	M								
G9678	Oncology care model service	B								
G9679	Acute care pneumonia	B								
G9680	Acute care congestive heart 	B								
G9681	Acute care chronic obstruct 	B								
G9682	Acute care skin infection 	B								
G9683	Acute fluid/electro disorder	B								
G9684	Acute care urinary tract inf 	B								
G9685	Acute nursing facility care	M								
G9687	Hospice anytime msmt per	M								
G9688	Pt w/hosp anytime msmt per	M								
G9689	Inpt elect carotid intervent	M								
G9690	Pt in hos	M								
G9691	Pt hosp dur msmt period	M								
G9692	Hosp recd by pt dur msmt per	M								
G9693	Pt use hosp during msmt per	M								
G9694	Hosp srv used pt in msmt per	M								
G9695	Long act inhal bronchdil pre	M								
G9696	Med rsn no presc bronchdil	M								
G9697	Pt rsn no presc bronchdil	M								
G9698	Sys rsn no presc bronchdil	M								
G9699	Long inhal bronchdil no pres	M								
G9700	Pt is w/hosp during msmt per	M								
G9701	Child anbx 30 prior dx estab	M								
G9702	Pt use hosp during msmt per	M								
G9703	Child anbx 30 prior dx phary	M								
G9704	Ajcc br ca stg i: t1 mic/t1a	M								
G9705	Ajcc br ca stg ib	M								
G9706	Low recur prost ca	M								
G9707	Pt had hosp dur msmt per	M								
G9708	Bilat mast/hx bi /unilat mas	M								
G9709	Hosp srv used pt in msmt per	M								
G9710	Pt prov hosp srv msmt per	M								
G9711	Pt hx tot col or colon ca	M								
G9712	Doc med rsn presc anbx	M								
G9713	Pt use hosp during msmt per	M								
G9714	Pt is w/hosp during msmt per	M								
G9715	Pt w/hosp anytime msmt per	M								
G9716	Bmi doc onl fup not cmpltd	M								
G9717	Doc pt dx dep/bp f/u nt req	M								
G9718	Hospice anytime msmt per	M								
G9719	Pt not ambul/immob/wc	M								
G9720	Hospice anytime msmt per	M								
G9721	Pt not ambul/immob/wc	M								
G9722	Doc hx renal fail or cr+ >4	M								
G9723	Hosp recd by pt dur msmt per	M								
G9724	Pt w/doc use anticoag mst yr	M								
G9725	Pt w/hosp anytime msmt per	M								
G9726	Refused to participate	M								
G9727	Pt unable cmplt knee fs prom	M								
G9728	Refused to participate	M								
G9729	Pt unbl cmplt hip fs prom	M								
G9730	Refused to participate	M								
G9731	Pt unbl cmplt ft/ank fs prom	M								
G9732	Refused to participate	M								
G9733	Pt unbl cmplt lb fs prom	M								
G9734	Refused to participate	M								
G9735	Pt unbl cmplt shld fs prom	M								
G9736	Refused to participate	M								
G9737	Pt unbl cmplt ewh fs prom	M								
G9738	Refused to participate	M								
G9739	Pt unbl cmplt go fs prom	M								
G9740	Hosp srv to pt dur msmt per	M								
G9741	Pt w/hosp anytime msmt per	M								
G9744	Pt not eli d/t act dig htn	M								
G9745	Doc rsn no hbp scrn or f/u	M								
G9746	"Mit sten, valve or trans af"	M								
G9747	Pall dialysis with catheter	M								
G9748	App transpl lvg kidney donor	M								
G9749	Pall dialysis with catheter	M								
G9750	App transpl lvg kidney donor	M								
G9751	Pt died w/in 24 mos rpt time	M								
G9752	Urgent surgery	M								
G9753	"Doc no dicom, ct other fac"	M								
G9754	Incid pulm nodule	M								
G9755	Doc med rsn no fllw up	M								
G9756	Surg proc w/silicone oil	M								
G9757	Surg proc w/silicone oil	M								
G9758	Pt in hos	M								
G9759	Hx preop post cap rup	M								
G9760	Pt w/hosp anytime msmt per	M								
G9761	Pt w/hosp anytime msmt per	M								
G9762	Pt had >= 2-3 hpv vaccines	M								
G9763	Pt not have 2-3 hpv vaccines	M								
G9764	Pt treatd w/oral syst or bio	M								
G9765	Doc pat declined therapy	M								
G9766	Cva stroke dx tx transf fac	M								
G9767	Hosp new dx cva consid evst	M								
G9768	Pt w/hosp anytime msmt per	M								
G9769	Bn den 2yr/got ost med/ther	M								
G9770	Perip nerve block	M								
G9771	"Anes end, 1 temp >35.5(95.9)"	M								
G9772	Doc med rsn no temp >= 35.5	M								
G9773	1 bod temp >=35.5	M								
G9774	Pt had hyst	M								
G9775	Recd 2 anti-emet pre/intraop	M								
G9776	Doc med rsn no proph antiem	M								
G9777	Pt no antiemet pre/intraop	M								
G9778	Pts dx w/pregn	M								
G9779	Pts breastfeeding	M								
G9780	Pts dx w/rhabdomyolysis	M								
G9781	Doc rsn no statin	M								
G9782	Hx dx fam/pure hypercholes	M								
G9783	"Doc dx dm, fast <70, no stat"	M								
G9784	Path/derm prov 2nd biop opin	M								
G9785	Path report sent	M								
G9786	Path report not sent	M								
G9787	Pt alive 	M								
G9788	Most rct bp </= 140/90	M								
G9789	"Record bp ip, er, urg/self"	M								
G9790	Most rct bp >/= 140/90	M								
G9791	Most rct tob stat free	M								
G9792	Most rct tob stat not free	M								
G9793	Pt on daily asa/antiplat	M								
G9794	Doc med rsn no daily aspirin	M								
G9795	Pt no daily asa/antiplat	M								
G9796	Pt not currently on statin	M								
G9797	Pt currently on statin	M								
G9798	D/c ami btw 7/1-6/30 meas pd	M								
G9799	Med disp evt indic hx asth	M								
G9800	Pt id intol/alleg beta-block	M								
G9801	Nonacut transf from inpt	M								
G9802	Pt w/hosp anytime msmt per	M								
G9803	Pt presc 135 day trmt 	M								
G9804	Pt not presc 135 day trmt	M								
G9805	Pt w/hosp anytime msmt per	M								
G9806	Pt recd cerv cyto/hpv	M								
G9807	Pt no recd cerv cyto/hpv	M								
G9808	Pt no asthm cont med mst per	M								
G9809	Pt w/hosp anytime msmt per	M								
G9810	Pdc 75% w/asth cont med	M								
G9811	No pdc 75% w/asth cont med	M								
G9812	Pt died during inpt/30d aft	M								
G9813	Pt not died w/in 30d of proc	M								
G9814	Death during index hosp	M								
G9815	Death not during index hosp	M								
G9816	Death <30 day post discharge	M								
G9817	No death 30-days post-disch	M								
G9818	Doc sex activity	M								
G9819	Pt w/hosp anytime msmt per	M								
G9820	Doc chlam scr test w/follow	M								
G9821	No doc chlam scr ts w/follow	M								
G9822	Endo abl proc yr prev ind dt	M								
G9823	Endo smpl/hyst bx res doc	M								
G9824	Endo smpl/hyst bx res no doc	M								
G9825	"Her-2 neg,undoc/unkn"	M								
G9826	Transf pract aft init chemo	M								
G9827	Her-2 targ ther no init tx	M								
G9828	Her-2 targ ther dur init tx	M								
G9829	Breast adj chemo admin	M								
G9830	Her-2 pos	M								
G9831	Ajcc stg brt ca dx ii or iii	M								
G9832	"Brt ca dx i, no t1/t1a/t1b"	M								
G9833	Transf pract aft init chemo	M								
G9834	Pt met dis at dx	M								
G9835	Trastuz given w/in 12 mos dx	M								
G9836	Rsn no trast given doc	M								
G9837	Trastuz not in 12 mos dx	M								
G9838	Pt met dis at dx	M								
G9839	Anti-egfr mon anti ther	M								
G9840	Gene testing performed	M								
G9841	Gene testing not performed	M								
G9842	Pt met dis at dx	M								
G9843	Kras or nras gene mutation	M								
G9844	Pt no recd anti-egfr ther	M								
G9845	Pt recd anti-egfr ther	M								
G9846	Pt died from cancer	M								
G9847	Pt recd chemo last 14d life	M								
G9848	Pt no chemo last 14d life	M								
G9849	Pt died from cancer	M								
G9850	1/more ed last 30d life	M								
G9851	1/no ed visit last 30d life	M								
G9852	Pt died from cancer	M								
G9853	Icu stay last 30d life	M								
G9854	No icu stay last 30d life	M								
G9855	Pt died from cancer	M								
G9856	Pt no hospice	M								
G9857	Pt admit hospice	M								
G9858	Pt enroll hospice	M								
G9859	Pt died from cancer	M								
G9860	Pt less 3d hospice	M								
G9861	Pt more than 3d hospice	M								
G9862	Doc rsn no 10 yr follow	M								
G9868	Next gen aco model <10min	B								
G9869	Next gen aco model 10-20min	B								
G9870	Next gen aco model >20min	B								
G9873	1 em core session	M								
G9874	4 em core sessions	M								
G9875	9 em core sessions	M								
G9876	2 em core ms mo 7-9 no wl	M								
G9877	2 em core ms mo 10-12 no wl	M								
G9878	2 em core ms mo 7-9 wl	M								
G9879	2 em core ms mo 10-12 wl	M								
G9880	Em 5 percent wl	M								
G9881	Em 9 percent wl	M								
G9882	2 em ongoing ms mo 13-15 wl	M								
G9883	2 em ongoing ms mo 16-18 wl	M								
G9884	2 em ongoing ms mo 19-21 wl	M								
G9885	2 em ongoing ms mo 22-24 wl	M								
G9890	Em bridge payment	M								
G9891	Em session reporting	M								
G9892	Doc pt rsn no dil mac exam	M								
G9893	No mac exam	M								
G9894	Adr dep thrpy prescribed	M								
G9895	Doc med rsn no adr dep thrpy	M								
G9896	Doc pt rsn no adr dep thrpy	M								
G9897	Pt nt prsc adr dep thrpy rng	M								
G9898	Pt 66+ snp or ltc pos	M								
G9899	Scrn mam perf rslts doc	M								
G9900	Scrn mam perf rslts not doc	M								
G9901	Pt 66+ snp or ltc pos	M								
G9902	Pt scrn tbco and id as user	M								
G9903	Pt scrn tbco id as non user	M								
G9904	Doc med rsn no tbco scrn	M								
G9905	No pt tbco scrn rng	M								
G9906	Pt recv tbco cess interv	M								
G9907	Doc med rsn no tbco interv	M								
G9908	No pt tbco cess interv rng	M								
G9909	Doc med rsn no tbco interv	M								
G9910	Pt 66+ snp or ltc pos	M								
G9911	Node neg pre/post syst ther	M								
G9912	Hbv status assesed and int	M								
G9913	No hbv status assesd and int	M								
G9914	Pt receiving anti-tnf agent	M								
G9915	No documntd hbv results rcd	M								
G9916	Funct status past 12 months	M								
G9917	Adv dem crgvr limited	M								
G9918	"No funct stat perf, rsn nos"	M								
G9919	Scrn nd pos nd prov of rec	M								
G9920	Scrning perf and negative	M								
G9921	No or part scrn nd rng or os	M								
G9922	Sfty cncrns scrn nd mit recs	M								
G9923	Safty cncrns scrn and neg	M								
G9924	Doc med rsn no scrn or recs	M								
G9925	No scrn prov rsn nos	M								
G9926	Sfty cncrns scrn but no recs	M								
G9927	Doc no warf /fda  pt trial	M								
G9928	No warf or fda drug presc	M								
G9929	Trs/rev af	M								
G9930	Com care	M								
G9931	No chad or chad scr 0 or 1	M								
G9932	Doc pt rsn no tb scrn recrds	M								
G9933	Canc detectd during col scrn	M								
G9934	Doc rsn not detecting cancer	M								
G9935	Canc not detectd during srcn	M								
G9936	Pmh plyp/neo co/rect/jun/ans	M								
G9937	Dig or surv colsco	M								
G9938	Pt 66+ snp or ltc pos	M								
G9939	Same path/derm perf biopsy	M								
G9940	Doc reas no statin therapy	M								
G9942	Adtl spine proc on same date	M								
G9943	Bk pn nt msr vas scl pre/pst	M								
G9945	Pt w/cancer  scoliosis	M								
G9946	Bk pain no vas	M								
G9948	Adtl spine proc on same date	M								
G9949	Leg pain no vas	M								
G9954	Pt >2 rsk fac post-op vomit	M								
G9955	Inhlnt anesth only for induc	M								
G9956	Combo thrpy of >= 2 prophly 	M								
G9957	Doc med rsn no combo thrpy	M								
G9958	No combo prohpyl thrp for pt	M								
G9959	Systemic antimicro not presc	M								
G9960	Med rsn sys antimi nt rx	M								
G9961	Systemic antimicro presc	M								
G9962	Embolization doc separatly	M								
G9963	Embolization not doc separat	M								
G9964	Pt recv >=1 well-chld visit	M								
G9965	No well-chld vist recv by pt	M								
G9966	"Scrn, inter, report child "	M								
G9967	"No scrn, inter, reprt child "	M								
G9968	Pt refrd 2 pvdr/spclst in pp	M								
G9969	Pvdr rfrd pt rprt rcvd	M								
G9970	Pvdr rfrd pt no rprt rcvd	M								
G9974	Mac exam perf	M								
G9975	Doc med rsn no dil mac exam	M								
G9978	Remote e/m new pt 10mins	B								
G9979	Remote e/m new pt 20mins	B								
G9980	Remote e/m new pt 30 mins	B								
G9981	Remote e/m new pt 45mins	B								
G9982	Remote e/m new pt 60mins	B								
G9983	Remote e/m est. pt 10mins	B								
G9984	Remote e/m est. pt  15mins	B								
G9985	Remote e/m est. pt 25mins	B								
G9986	Remote e/m est. pt 40mins	B								
G9987	Bpci advanced in home visit	B								
J0120	Tetracyclin injection	N								
J0121	"Inj., omadacycline, 1 mg"	G	9311		$3.147	.	$0.63		*	
J0122	"Inj., eravacycline, 1 mg"	K	9325		$1.018	.	$0.21		*	
J0129	Abatacept injection	K	9230		$58.103	.	$11.63		*	
J0130	Abciximab injection	N								
J0131	Acetaminophen injection	N								
J0132	Acetylcysteine injection	N								
J0133	Acyclovir injection	N								
J0135	Adalimumab injection	K	1083		"$1,430.922"	.	$286.19		*	
J0153	Adenosine inj 1mg	N								
J0171	Adrenalin epinephrine inject	N								
J0178	Aflibercept injection	K	1420		$928.241	.	$185.65		*	
J0179	"Inj, brolucizumab-dbll, 1 mg"	G	9340		$311.994	.	$62.40		*	
J0180	Agalsidase beta injection	K	9208		$188.990	.	$37.80		*	
J0185	"Inj., aprepitant, 1 mg"	G	9463		$1.732	.	$0.35		*	
J0190	Inj biperiden lactate/5 mg	E2								
J0200	Alatrofloxacin mesylate	E2								
J0202	"Injection, alemtuzumab"	K	1809		"$1,984.320"	.	$396.87		*	
J0205	Alglucerase injection	E2								
J0207	Amifostine	K	7000		"$1,135.691"	.	$227.14			
J0210	Methyldopate hcl injection	N								
J0215	Alefacept	E2								
J0220	Alglucosidase alfa injection	K	9234		$73.810	.	$14.77		*	
J0221	Lumizyme injection	K	1413		$174.488	.	$34.90		*	
J0222	"Inj., patisiran, 0.1 mg"	G	9180		$97.843	.	$19.57		*	
J0223	Inj givosiran 0.5 mg	G	9343		$106.875		$21.38		*	
J0256	Alpha 1 proteinase inhibitor	K	0901		$4.358	.	$0.88		*	
J0257	Glassia injection	K	1415		$4.834	.	$0.97		*	
J0270	Alprostadil for injection	B								
J0275	Alprostadil urethral suppos	B								
J0278	Amikacin sulfate injection	N								
J0280	Aminophyllin 250 mg inj	N								
J0282	Amiodarone hcl	N								
J0285	Amphotericin b	N								
J0287	Amphotericin b lipid complex	K	9024		$9.358	.	$1.88		*	
J0288	Ampho b cholesteryl sulfate	E2								
J0289	Amphotericin b liposome inj	K	0736		$26.563	.	$5.32		*	
J0290	Ampicillin 500 mg inj	N								
J0291	"Inj., plazomicin, 5 mg"	G	9183		$3.105	.	$0.63		*	
J0295	Ampicillin sulbactam 1.5 gm	N								
J0300	Amobarbital 125 mg inj	K	1341		$95.160	.	$19.04		*	
J0330	Succinycholine chloride inj	N								
J0348	Anidulafungin injection	N								
J0350	Injection anistreplase 30 u	E2								
J0360	Hydralazine hcl injection	N								
J0364	Apomorphine hydrochloride	E2								
J0365	"Aprotonin, 10,000 kiu"	E2								
J0380	Inj metaraminol bitartrate	E2								
J0390	Chloroquine injection	N								
J0395	Arbutamine hcl injection	E2								
J0400	Aripiprazole injection	N								
J0401	Inj aripiprazole ext rel 1mg	K	1468		$5.700	.	$1.14		*	
J0456	Azithromycin	N								
J0461	Atropine sulfate injection	N								
J0470	Dimecaprol injection	N								
J0475	Baclofen 10 mg injection	K	9032		$171.593	.	$34.32		*	
J0476	Baclofen intrathecal trial	N								
J0480	Basiliximab	K	1683		"$4,005.187"	.	$801.04		*	
J0485	Belatacept injection	K	9286		$3.775	.	$0.76		*	
J0490	Belimumab injection	K	1353		$46.179	.	$9.24		*	
J0500	Dicyclomine injection	N								
J0515	Inj benztropine mesylate	N								
J0517	"Inj., benralizumab, 1 mg"	G	9466		$170.112	.	$34.03		*	
J0520	Bethanechol chloride inject	E2								
J0558	Peng benzathine/procaine inj	K	9088		$11.998	.	$2.40		*	
J0561	Penicillin g benzathine inj	K	1829		$15.158	.	$3.04		*	
J0565	"Inj, bezlotoxumab, 10 mg"	K	9490		$39.645	.	$7.93		*	
J0567	"Inj., cerliponase alfa 1 mg"	G	9014		$95.362	.	$19.08		*	
J0570	Buprenorphine implant 74.2mg	K	9058		"$1,207.160"	.	$241.44		*	
J0571	Buprenorphine oral 1mg	E1								
J0572	Bupren/nal up to 3mg bupreno	E1								
J0573	Bupren/nal 3.1 to 6mg bupren	E1								
J0574	Bupren/nal 6.1 to 10mg bupre	E1								
J0575	Bupren/nal over 10mg bupreno	E1								
J0583	Bivalirudin	N								
J0584	"Injection, burosumab-twza 1m"	K	9187		$361.895	.	$72.38		*	
J0585	"Injection,onabotulinumtoxina"	K	0902		$6.077	.	$1.22		*	
J0586	Abobotulinumtoxina	K	1289		$8.149	.	$1.63		*	
J0587	"Inj, rimabotulinumtoxinb"	K	9018		$11.929	.	$2.39		*	
J0588	Incobotulinumtoxin a	K	9278		$5.019	.	$1.01		*	
J0591	"Inj deoxycholic acid, 1 mg"	E1								
J0592	Buprenorphine hydrochloride	N								
J0593	"Inj., lanadelumab-flyo, 1 mg"	K	9326		$78.646	.	$15.73		*	
J0594	Busulfan injection	K	1178		$3.405	.	$0.69		*	
J0595	Butorphanol tartrate 1 mg	N								
J0596	"Injection, ruconest"	K	9445		$29.108	.	$5.83		*	
J0597	"C-1 esterase, berinert"	K	9269		$54.134	.	$10.83		*	
J0598	"C-1 esterase, cinryze"	K	9251		$56.199	.	$11.24		*	
J0599	"Inj., haegarda 10 units"	G	9015		$9.918	.	$1.99		*	
J0600	Edetate calcium disodium inj	K	1274		"$5,594.422"	.	"$1,118.89"		*	
J0604	"Cinacalcet, esrd on dialysis"	B								
J0606	"Inj, etelcalcetide, 0.1 mg"	K	9031		$2.145	.	$0.43		*	
J0610	Calcium gluconate injection	N								
J0620	Calcium glycer & lact/10 ml	N								
J0630	Calcitonin salmon injection	K	1433		"$2,839.223"	.	$567.85		*	
J0636	Inj calcitriol per 0.1 mcg	N								
J0637	Caspofungin acetate	N								
J0638	Canakinumab injection	K	1311		$113.238	.	$22.65		*	
J0640	Leucovorin calcium injection	N								
J0641	Inj levoleucovorin nos 0.5mg	K	1236		$0.280	.	$0.06		*	
J0642	"Injection, khapzory, 0.5 mg"	G	9334		$1.999	.	$0.40		*	
J0670	Inj mepivacaine hcl/10 ml	N								
J0690	Cefazolin sodium injection	N								
J0691	Inj lefamulin 1 mg	G	9332		$0.724		$0.15			
J0692	Cefepime hcl for injection	N								
J0694	Cefoxitin sodium injection	N								
J0695	Inj ceftolozane tazobactam	K	9452		$6.490	.	$1.30		*	
J0696	Ceftriaxone sodium injection	N								
J0697	Sterile cefuroxime injection	N								
J0698	Cefotaxime sodium injection	N								
J0702	Betamethasone acet&sod phosp	N								
J0706	Caffeine citrate injection	N								
J0710	Cephapirin sodium injection	E2								
J0712	Ceftaroline fosamil inj	K	1824		$3.322	.	$0.67		*	
J0713	Inj ceftazidime per 500 mg	N								
J0714	Ceftazidime and avibactam	K	1825		$92.002	.	$18.41		*	
J0715	Ceftizoxime sodium / 500 mg	N								
J0716	Centruroides immune f(ab)	K	1431		"$5,063.557"	.	"$1,012.72"		*	
J0717	Certolizumab pegol inj 1mg	K	1474		$8.161	.	$1.64		*	
J0720	Chloramphenicol sodium injec	N								
J0725	Chorionic gonadotropin/1000u	N								
J0735	Clonidine hydrochloride	N								
J0740	Cidofovir injection	K	9033		$666.250	.	$133.25		*	
J0742	Inj imip 4 cilas 4 releb 2mg	G	9362		$2.255		$0.46		*	
J0743	Cilastatin sodium injection	N								
J0744	Ciprofloxacin iv	N								
J0745	Inj codeine phosphate /30 mg	N								
J0770	Colistimethate sodium inj	N								
J0775	"Collagenase, clost hist inj"	K	1340		$52.388	.	$10.48		*	
J0780	Prochlorperazine injection	N								
J0791	Inj crizanlizumab-tmca 5mg	G	9359		$122.413		$24.49		*	
J0795	Corticorelin ovine triflutal	K	1684		$9.377	.	$1.88		*	
J0800	Corticotropin injection	K	9316		"$4,013.242"	.	$802.65		*	
J0834	"Inj., cosyntropin, 0.25 mg"	N								
J0840	Crotalidae poly immune fab	K	9274		"$3,043.750"	.	$608.75		*	
J0841	Inj crotalidae im f(ab')2 eq	K	9188		"$1,264.210"	.	$252.85		*	
J0850	Cytomegalovirus imm iv /vial	K	0903		"$1,496.953"	.	$299.40		*	
J0875	"Injection, dalbavancin"	K	1823		$15.386	.	$3.08		*	
J0878	Daptomycin injection	K	9124		$0.161	.	$0.04		*	
J0881	"Darbepoetin alfa, non-esrd"	K	1685		$3.716	.	$0.75		*	
J0882	"Darbepoetin alfa, esrd use"	K	1482		$3.716	.	$0.75		*	
J0883	Argatroban nonesrd use 1mg	K	1859		$1.307	.	$0.27		*	
J0884	Argatroban esrd dialysis 1mg	K	9065		$1.307	.	$0.27		*	
J0885	"Epoetin alfa, non-esrd"	K	1686		$9.109	.	$1.83		*	
J0887	Epoetin beta esrd use	N								
J0888	Epoetin beta non esrd	N								
J0890	Peginesatide injection	E1								
J0894	Decitabine injection	K	9231		$4.260	.	$0.86		*	
J0895	Deferoxamine mesylate inj	N								
J0896	Inj luspatercept-aamt 0.25mg	G	9347		$36.320		$7.27		*	
J0897	Denosumab injection	K	9272		$20.123	.	$4.03		*	
J0945	Brompheniramine maleate inj	N								
J1000	Depo-estradiol cypionate inj	N								
J1020	Methylprednisolone 20 mg inj	N								
J1030	Methylprednisolone 40 mg inj	N								
J1040	Methylprednisolone 80 mg inj	N								
J1050	Medroxyprogesterone acetate	N								
J1071	Inj testosterone cypionate	N								
J1094	Inj dexamethasone acetate	N								
J1095	"Injection, dexamethasone 9%"	G	9172		$1.106	.	$0.23		*	
J1096	Dexametha opth insert 0.1 mg	G	9308		$139.547	.	$27.91		*	
J1097	Phenylep ketorolac opth soln	N							*	
J1100	Dexamethasone sodium phos	N								
J1110	Inj dihydroergotamine mesylt	N								
J1120	Acetazolamid sodium injectio	N								
J1130	Inj diclofenac sodium 0.5mg	N								
J1160	Digoxin injection	N								
J1162	Digoxin immune fab (ovine)	K	1687		"$3,972.138"	.	$794.43		*	
J1165	Phenytoin sodium injection	N								
J1170	Hydromorphone injection	N								
J1180	Dyphylline injection	E2								
J1190	Dexrazoxane hcl injection	K	0726		$199.929	.	$39.99		*	
J1200	Diphenhydramine hcl injectio	N								
J1201	Inj. cetirizine hcl 0.5mg	G	9361		$15.448		$3.09		*	
J1205	Chlorothiazide sodium inj	N								
J1212	Dimethyl sulfoxide 50% 50 ml	K	1832		$635.667	.	$127.14		*	
J1230	Methadone injection	N								
J1240	Dimenhydrinate injection	N								
J1245	Dipyridamole injection	N								
J1250	Inj dobutamine hcl/250 mg	N								
J1260	Dolasetron mesylate	N								
J1265	Dopamine injection	N								
J1267	Doripenem injection	K	9317		$1.150	.	$0.23			
J1270	"Injection, doxercalciferol"	N								
J1290	Ecallantide injection	K	9263		$494.686	.	$98.94		*	
J1300	Eculizumab injection	K	9236		$230.479	.	$46.10		*	
J1301	"Injection, edaravone, 1 mg"	K	9493		$19.892	.	$3.98		*	
J1303	"Inj., ravulizumab-cwvz 10 mg"	G	9312		$226.275	.	$45.26		*	
J1320	Amitriptyline injection	N								
J1322	"Elosulfase alfa, injection"	K	1480		$246.196	.	$49.24		*	
J1324	Enfuvirtide injection	E2								
J1325	Epoprostenol injection	N								
J1327	Eptifibatide injection	K	1607		$4.514	.	$0.91		*	
J1330	Ergonovine maleate injection	E2								
J1335	Ertapenem injection	N								
J1364	Erythro lactobionate /500 mg	N								
J1380	Estradiol valerate 10 mg inj	N								
J1410	Inj estrogen conjugate 25 mg	K	9038		$325.621	.	$65.13		*	
J1428	"Inj, eteplirsen, 10 mg"	K	9484		$167.453	.	$33.50		*	
J1429             	Inj golodirsen 10 mg	G	9356		$166.326		$33.27		*	
J1430	Ethanolamine oleate 100 mg	K	1688		$444.099	.	$88.82		*	
J1435	Injection estrone per 1 mg	E2								
J1436	Etidronate disodium inj	E1								
J1437	Inj. fe derisomaltose 10 mg	K	9388		$25.382		$5.08		*	
J1438	Etanercept injection	K	1608		$736.295	.	$147.26		*	
J1439	Inj ferric carboxymaltos 1mg	K	9441		$1.106	.	$0.23		*	
J1442	Inj filgrastim excl biosimil	K	1469		$0.925	.	$0.19		*	
J1443	Inj ferric pyrophosphate cit	E2								
J1444	Fe pyro cit pow 0.1 mg iron	N 								
J1447	Inj tbo filgrastim 1 microg	K	1748		$0.470	.	$0.10		*	
J1450	Fluconazole	N								
J1451	"Fomepizole, 15 mg"	K	1689		$5.326	.	$1.07		*	
J1452	Intraocular fomivirsen na	E2								
J1453	Fosaprepitant injection	K	9242		$0.785	.	$0.16		*	
J1454	"Inj fosnetupitant, palonoset"	G	9099		$695.767	.	$139.16		*	
J1455	Foscarnet sodium injection	K	1849		$82.268	.	$16.46		*	
J1457	Gallium nitrate injection	E2								
J1458	Galsulfase injection	K	9224		$405.755	.	$81.16		*	
J1459	Inj ivig privigen 500 mg	K	1214		$41.503	.	$8.31		*	
J1460	Gamma globulin 1 cc inj	K	1850		$42.925	.	$8.59		*	
J1555	"Inj cuvitru, 100 mg"	K	9034		$14.022	.	$2.81		*	
J1556	"Inj, imm glob bivigam, 500mg"	N								
J1557	Gammaplex injection	K	9270		$53.662	.	$10.74		*	
J1558	"Inj. xembify, 100 mg"	K	9372		$14.223		$2.85		*	
J1559	Hizentra injection	K	1312		$10.855	.	$2.18		*	
J1560	Gamma globulin > 10 cc inj	K	1851		$429.255	.	$85.86		*	
J1561	Gamunex-c/gammaked	K	0948		$42.186	.	$8.44		*	
J1562	"Vivaglobin, inj"	E2								
J1566	"Immune globulin, powder"	K	2731		$68.303	.	$13.67		*	
J1568	Octagam injection	K	0943		$41.229	.	$8.25		*	
J1569	Gammagard liquid injection	K	0944		$43.201	.	$8.65		*	
J1570	Ganciclovir sodium injection	N								
J1571	Hepagam b im injection	K	0946		$63.403	.	$12.69		*	
J1572	Flebogamma injection	K	0947		$40.383	.	$8.08		*	
J1573	"Hepagam b intravenous, inj"	K	1138		$65.960	.	$13.20		*	
J1575	Hyqvia 100mg immuneglobulin	K	1826		$14.486	.	$2.90		*	
J1580	Garamycin gentamicin inj	N								
J1595	Injection glatiramer acetate	K	1015		$157.420	.	$31.49		*	
J1599	"Ivig non-lyophilized, nos"	N								
J1600	Gold sodium thiomaleate inj	E2								
J1602	Golimumab for iv use 1mg	K	1475		$18.997	.	$3.80		*	
J1610	Glucagon hydrochloride/1 mg	K	9042		$211.789	.	$42.36		*	
J1620	Gonadorelin hydroch/ 100 mcg	E2								
J1626	Granisetron hcl injection	N								
J1627	"Inj, granisetron, xr, 0.1 mg"	N								
J1628	"Inj., guselkumab, 1 mg"	G	9029		$93.123	.	$18.63		*	
J1630	Haloperidol injection	N								
J1631	Haloperidol decanoate inj	N								
J1632	"Inj., brexanolone, 1 mg"	G	9333		$76.91		$15.39		*	
J1640	"Hemin, 1 mg"	K	1690		$24.436	.	$4.89		*	
J1642	Inj heparin sodium per 10 u	N								
J1644	Inj heparin sodium per 1000u	N								
J1645	Dalteparin sodium	N								
J1650	Inj enoxaparin sodium	N								
J1652	Fondaparinux sodium	N								
J1655	Tinzaparin sodium injection	N								
J1670	Tetanus immune globulin inj	K	1670		$476.569	.	$95.32		*	
J1675	Histrelin acetate	B								
J1700	Hydrocortisone acetate inj	N								
J1710	Hydrocortisone sodium ph inj	N								
J1720	Hydrocortisone sodium succ i	N								
J1726	"Makena, 10 mg"	K	9074		$15.881	.	$3.18		*	
J1729	Inj hydroxyprogst capoat nos	K	9318		$10.810	.	$2.17		*	
J1730	Diazoxide injection	E2								
J1738	Inj. meloxicam 1 mg	G	9371		$3.26		$0.00		*	
J1740	Ibandronate sodium injection	K	9229		$50.999	.	$10.20		*	
J1741	Ibuprofen injection	N								
J1742	Ibutilide fumarate injection	K	9044		$316.198	.	$63.24		*	
J1743	Idursulfase injection	K	9232		$542.917	.	$108.59		*	
J1744	Icatibant injection	K	1443		$276.567	.	$55.32		*	
J1745	Infliximab not biosimil 10mg	K	7043		$47.620	.	$9.53		*	
J1746	"Inj., ibalizumab-uiyk, 10 mg"	K	9189		$63.624	.	$12.73		*	
J1750	Inj iron dextran	K	1237		$15.010	.	$3.01		*	
J1756	Iron sucrose injection	N								
J1786	Imuglucerase injection	K	1327		$43.377	.	$8.68		*	
J1790	Droperidol injection	N								
J1800	Propranolol injection	N								
J1810	Droperidol/fentanyl inj	E1								
J1815	Insulin injection	N								
J1817	Insulin for insulin pump use	N								
J1826	Interferon beta-1a inj	K	1852		"$2,276.610"	.	$455.33		*	
J1830	Interferon beta-1b / .25 mg	K	0910		$393.833	.	$78.77		*	
J1833	"Injection, isavuconazonium"	K	9456		$0.783	.	$0.16		*	
J1835	Itraconazole injection	E2								
J1840	Kanamycin sulfate 500 mg inj	N								
J1850	Kanamycin sulfate 75 mg inj	N								
J1885	Ketorolac tromethamine inj	N								
J1890	Cephalothin sodium injection	N								
J1930	Lanreotide injection	K	9237		$68.475	.	$13.70		*	
J1931	Laronidase injection	K	9209		$33.102	.	$6.63		*	
J1940	Furosemide injection	N								
J1943	"Inj., aristada initio, 1 mg"	G	9179		$2.858	.	$0.58		*	
J1944	Aripirazole lauroxil 1 mg	K 	9470		$2.847	.	$0.57		*	
J1945	Lepirudin	E2								
J1950	Leuprolide acetate /3.75 mg	K	0800		"$1,347.559"	.	$269.52		*	
J1953	Levetiracetam injection	N								
J1955	Inj levocarnitine per 1 gm	B								
J1956	Levofloxacin injection	N								
J1960	Levorphanol tartrate inj	N								
J1980	Hyoscyamine sulfate inj	N								
J1990	Chlordiazepoxide injection	N								
J2001	Lidocaine injection	N								
J2010	Lincomycin injection	N								
J2020	Linezolid injection	N								
J2060	Lorazepam injection	N								
J2062	Loxapine for inhalation 1 mg	N								
J2150	Mannitol injection	N								
J2170	Mecasermin injection	N								
J2175	Meperidine hydrochl /100 mg	N								
J2180	Meperidine/promethazine inj	N								
J2182	"Injection, mepolizumab, 1mg"	K	9473		$28.704	.	$5.75		*	
J2185	Meropenem	N								
J2186	"Inj., meropenem, vaborbactam"	K	9178		$1.780	.	$0.36		*	
J2210	Methylergonovin maleate inj	N								
J2212	Methylnaltrexone injection	N								
J2248	Micafungin sodium injection	N								
J2250	Inj midazolam hydrochloride	N								
J2260	Inj milrinone lactate / 5 mg	N								
J2265	Minocycline hydrochloride	K	1853		$1.988	.	$0.40		*	
J2270	Morphine sulfate injection	N								
J2274	Inj morphine pf epid ithc	N								
J2278	Ziconotide injection	K	1694		$8.171	.	$1.64		*	
J2280	"Inj, moxifloxacin 100 mg"	N								
J2300	Inj nalbuphine hydrochloride	N								
J2310	Inj naloxone hydrochloride	N								
J2315	"Naltrexone, depot form"	K	0759		$3.261	.	$0.66		*	
J2320	Nandrolone decanoate 50 mg	N								
J2323	Natalizumab injection	K	9126		$21.630	.	$4.33		*	
J2325	Nesiritide injection	E1							*	
J2326	"Inj, nusinersen, 0.1mg"	K	9489		"$1,122.512"	.	$224.51		*	
J2350	"Injection, ocrelizumab, 1 mg"	K	9494		$57.383	.	$11.48		*	
J2353	"Octreotide injection, depot"	K	1207		$205.878	.	$41.18		*	
J2354	"Octreotide inj, non-depot"	N								
J2355	Oprelvekin injection	K	7011		$1.340	.	$0.27		*	
J2357	Omalizumab injection	K	9300		$37.699	.	$7.54		*	
J2358	Olanzapine long-acting inj	N								
J2360	Orphenadrine injection	N								
J2370	Phenylephrine hcl injection	N								
J2400	Chloroprocaine hcl injection	N								
J2405	Ondansetron hcl injection	N								
J2407	"Injection, oritavancin"	K	1660		$23.797	.	$4.76		*	
J2410	Oxymorphone hcl injection	N								
J2425	Palifermin injection	K	1696		$22.812	.	$4.57		*	
J2426	Paliperidone palmitate inj	K	9255		$12.102	.	$2.43		*	
J2430	Pamidronate disodium /30 mg	N								
J2440	Papaverin hcl injection	N								
J2460	Oxytetracycline injection	E2								
J2469	Palonosetron hcl	N								
J2501	Paricalcitol	N								
J2502	"Inj, pasireotide long acting"	K	9454		$332.591	.	$66.52		*	
J2503	Pegaptanib sodium injection	N								
J2504	"Pegademase bovine, 25 iu"	K	1739		"$1,471.845"	.	$294.37		*	
J2505	"Injection, pegfilgrastim 6mg"	K	9119		"$3,571.681"	.	$714.34		*	
J2507	Pegloticase injection	K	9281		"$2,801.076"	.	$560.22		*	
J2510	Penicillin g procaine inj	N								
J2513	Pentastarch 10% solution	E2								
J2515	Pentobarbital sodium inj	K	1854		$33.926	.	$6.79		*	
J2540	Penicillin g potassium inj	N								
J2543	Piperacillin/tazobactam	N								
J2545	Pentamidine non-comp unit	B								
J2547	"Injection, peramivir"	K	9451		$1.596	.	$0.32		*	
J2550	Promethazine hcl injection	N								
J2560	Phenobarbital sodium inj	N								
J2562	Plerixafor injection	K	9252		$365.294	.	$73.06		*	
J2590	Oxytocin injection	N								
J2597	Inj desmopressin acetate	K	1440		$10.453	.	$2.10		*	
J2650	Prednisolone acetate inj	N								
J2670	Totazoline hcl injection	E2								
J2675	Inj progesterone per 50 mg	N								
J2680	Fluphenazine decanoate 25 mg	N								
J2690	Procainamide hcl injection	N								
J2700	Oxacillin sodium injeciton	N								
J2704	"Inj, propofol, 10 mg"	N								
J2710	Neostigmine methylslfte inj	N								
J2720	Inj protamine sulfate/10 mg	N								
J2724	Protein c concentrate	K	1139		$15.064	.	$3.02			
J2725	Inj protirelin per 250 mcg	E2								
J2730	Pralidoxime chloride inj	N								
J2760	Phentolaine mesylate inj	K	1458		$359.137	.	$71.83		*	
J2765	Metoclopramide hcl injection	N								
J2770	Quinupristin/dalfopristin	K	2770		$458.041	.	$91.61		*	
J2778	Ranibizumab injection	K	9233		$324.272	.	$64.86		*	
J2780	Ranitidine hydrochloride inj	N								
J2783	Rasburicase	K	0738		$300.937	.	$60.19		*	
J2785	Regadenoson injection	N								
J2786	"Injection, reslizumab, 1mg"	K	9481		$9.758	.	$1.96		*	
J2787	Riboflavin 5'phos opth<=3ml	N								
J2788	Rho d immune globulin 50 mcg	N								
J2790	Rho d immune globulin inj	N								
J2791	Rhophylac injection	N								
J2792	"Rho(d) immune globulin h, sd"	K	1609		$36.366	.	$7.28		*	
J2793	Rilonacept injection	E2								
J2794	"Inj risperdal consta, 0.5 mg"	K	9125		$10.532	.	$2.11		*	
J2795	Ropivacaine hcl injection	N								
J2796	Romiplostim injection	K	9245		$78.428	.	$15.69		*	
J2797	"Inj., rolapitant, 0.5 mg"	E1							*	
J2798	"Inj., perseris, 0.5 mg"	G	9181		$10.181	.	$2.04		*	
J2800	Methocarbamol injection	N								
J2805	Sincalide injection	N								
J2810	Inj theophylline per 40 mg	N								
J2820	Sargramostim injection	K	0731		$48.122	.	$9.63		*	
J2840	Inj sebelipase alfa 1 mg	K	9478		$541.130	.	$108.23		*	
J2850	Inj secretin synthetic human	K	1700		$34.781	.	$6.96		*	
J2860	"Injection, siltuximab"	K	9455		$111.935	.	$22.39		*	
J2910	Aurothioglucose injeciton	N								
J2916	Na ferric gluconate complex	N								
J2920	Methylprednisolone injection	N								
J2930	Methylprednisolone injection	N								
J2940	Somatrem injection	E2								
J2941	Somatropin injection	K	9319		$84.130	.	$16.83		*	
J2950	Promazine hcl injection	N								
J2993	Reteplase injection	N								
J2995	Inj streptokinase /250000 iu	E2								
J2997	Alteplase recombinant	K	7048		$87.154	.	$17.44		*	
J3000	Streptomycin injection	N								
J3010	Fentanyl citrate injection	N								
J3030	Sumatriptan succinate / 6 mg	N								
J3031	"Inj., fremanezumab-vfrm 1 mg"	G	9197		$2.249	.	$0.45		*	
J3032	Inj. eptinezumab-jjmr 1 mg	G	9357		$15.399		$3.08		*	
J3060	"Inj, taliglucerase alfa 10 u"	K	9294		$40.857	.	$8.18		*	
J3070	Pentazocine injection	N								
J3090	Inj tedizolid phosphate	K	1662		$1.590	.	$0.32		*	
J3095	Telavancin injection	K	9258		$5.138	.	$1.03		*	
J3101	Tenecteplase injection	K	9002		$129.255	.	$25.86		*	
J3105	Terbutaline sulfate inj	N								
J3110	Teriparatide injection	B								
J3111	Inj. romosozumab-aqqg 1 mg	G	9327		$9.014	.	$1.81		*	
J3121	Inj testostero enanthate 1mg	N								
J3145	Testosterone undecanoate 1mg	K	9078		$1.543	.	$0.31		*	
J3230	Chlorpromazine hcl injection	N								
J3240	Thyrotropin injection	K	9108		"$1,740.225"	.	$348.05		*	
J3241	Inj. teprotumumab-trbw 10 mg	G	9355		$315.880		$63.18		*	
J3243	Tigecycline injection	K	9228		$1.378	.	$0.28		*	
J3245	"Inj., tildrakizumab, 1 mg"	G	9306		$135.673	.	$27.14		*	
J3246	Tirofiban hcl	K	7041		$2.191	.	$0.44		*	
J3250	Trimethobenzamide hcl inj	N								
J3260	Tobramycin sulfate injection	N								
J3262	Tocilizumab injection	K	9264		$5.401	.	$1.09		*	
J3265	Injection torsemide 10 mg/ml	N								
J3280	Thiethylperazine maleate inj	E2								
J3285	Treprostinil injection	K	1701		$62.806	.	$12.57		*	
J3300	Triamcinolone a inj prs-free	N								
J3301	Triamcinolone acet inj nos	N								
J3302	Triamcinolone diacetate inj	N								
J3303	Triamcinolone hexacetonl inj	N								
J3304	Inj triamcinolone ace xr 1mg	G	9469		$18.204	.	$3.65		*	
J3305	Inj trimetrexate glucoronate	E2								
J3310	Perphenazine injeciton	N								
J3315	Triptorelin pamoate	K	9122		$385.610	.	$77.13		*	
J3316	"Inj., triptorelin xr 3.75 mg"	G	9016		"$3,044.011"	.	$608.81		*	
J3320	Spectinomycn di-hcl inj	E2								
J3350	Urea injection	E2								
J3355	"Urofollitropin, 75 iu"	E2								
J3357	"Ustekinumab sub cu inj, 1 mg"	K	9261		$184.359	.	$36.88		*	
J3358	"Ustekinumab, iv inject, 1 mg"	K	9487		$12.033	.	$2.41		*	
J3360	Diazepam injection	N								
J3364	Urokinase 5000 iu injection	N								
J3365	"Urokinase 250,000 iu inj"	E2								
J3370	Vancomycin hcl injection	N								
J3380	"Injection, vedolizumab"	K	1489		$20.297	.	$4.06		*	
J3385	Velaglucerase alfa	K	9271		$346.147	.	$69.23		*	
J3396	Verteporfin injection	K	1203		$11.227	.	$2.25		*	
J3397	"Inj., vestronidase alfa-vjbk"	K	9190		$223.012	.	$44.61		*	
J3398	Inj luxturna 1 billion vec g	G	9070		"$2,883.200"	.	$576.64		*	
J3399	Inj onase abepar-xioi treat	K	9373		"$2,213,634.284"		"$442,726.86"	*	*	
J3400	Triflupromazine hcl inj	E2								
J3410	Hydroxyzine hcl injection	N								
J3411	Thiamine hcl 100 mg	N								
J3415	Pyridoxine hcl 100 mg	N								
J3420	Vitamin b12 injection	N								
J3430	Vitamin k phytonadione inj	N								
J3465	"Injection, voriconazole"	N								
J3470	Hyaluronidase injection	N								
J3471	"Ovine, up to 999 usp units"	N								
J3472	"Ovine, 1000 usp units"	N								
J3473	Hyaluronidase recombinant	N								
J3475	Inj magnesium sulfate	N								
J3480	Inj potassium chloride	N								
J3485	Zidovudine	N								
J3486	Ziprasidone mesylate	N								
J3489	Zoledronic acid 1mg	N								
J3490	Drugs unclassified injection	N								
J3520	Edetate disodium per 150 mg	E1								
J3530	Nasal vaccine inhalation	N								
J3535	Metered dose inhaler drug	E1								
J3570	Laetrile amygdalin vit b17	E1								
J3590	Unclassified biologics	N								
J3591	Esrd on dialysi drug/bio noc	B								
J7030	Normal saline solution infus	N								
J7040	Normal saline solution infus	N								
J7042	5% dextrose/normal saline	N								
J7050	Normal saline solution infus	N								
J7060	5% dextrose/water	N								
J7070	D5w infusion	N								
J7100	Dextran 40 infusion	N								
J7110	Dextran 75 infusion	N								
J7120	Ringers lactate infusion	N								
J7121	5% dextrose in lac ringers	N								
J7131	Hypertonic saline sol	N								
J7169	"Inj andexxa, 10 mg"	G	9198		$291.500		$58.30			
J7170	"Inj., emicizumab-kxwh 0.5 mg"	G	9257		$47.467	.	$9.50		*	
J7175	"Inj, factor x, (human), 1iu"	K	1857		$7.879	.	$1.58			
J7177	"Inj., fibryga, 1 mg"	K	9191		$1.074	.	$0.22		*	
J7178	Inj human fibrinogen con nos	K	1478		$1.243	.	$0.25		*	
J7179	Vonvendi inj 1 iu vwf:rco	K	9059		$1.783	.	$0.36		*	
J7180	Factor xiii anti-hem factor	K	1416		$8.773	.	$1.76		*	
J7181	Factor xiii recomb a-subunit	K	1746		$15.526	.	$3.11		*	
J7182	Factor viii recomb novoeight	K	1856		$1.325	.	$0.27		*	
J7183	Wilate injection	K	1352		$1.023	.	$0.21		*	
J7185	Xyntha inj	K	1268		$1.306	.	$0.27		*	
J7186	Antihemophilic viii/vwf comp	K	1213		$1.136	.	$0.23		*	
J7187	"Humate-p, inj"	K	1704		$1.207	.	$0.25		*	
J7188	Factor viii recomb obizur	K	1827		$3.186	.	$0.64		*	
J7189	Factor viia	K	1705		$2.250	.	$0.45		*	
J7190	Factor viii	K	0925		$1.015	.	$0.21		*	
J7191	Factor viii (porcine)	E2								
J7192	Factor viii recombinant nos	K	0927		$1.378	.	$0.28		*	
J7193	Factor ix non-recombinant	K	0931		$1.164	.	$0.24		*	
J7194	Factor ix complex	K	0928		$1.491	.	$0.30		*	
J7195	Factor ix recombinant nos	K	0932		$1.534	.	$0.31		*	
J7196	Antithrombin recombinant	K	9177		$103.350	.	$20.67		*	
J7197	Antithrombin iii injection	K	1263		$3.504	.	$0.71		*	
J7198	Anti-inhibitor	K	0929		$2.051	.	$0.42		*	
J7199	Hemophilia clot factor noc	B								
J7200	Factor ix recombinan rixubis	K	1467		$1.456	.	$0.30		*	
J7201	Factor ix alprolix recomb	K	1486		$3.252	.	$0.66		*	
J7202	Factor ix idelvion inj	K	9171		$4.438	.	$0.89		*	
J7203	Factor ix recomb gly rebinyn	G	9468		$4.009	.	$0.81		*	
J7204           	Inj recombin esperoct per iu	G	9354		$2.286		$0.46		*	
J7205	Factor viii fc fusion recomb	K	1656		$2.167	.	$0.44		*	
J7207	Factor viii pegylated recomb	K	1844		$1.874	.	$0.38		*	
J7208	Inj. jivi 1 iu	G	9299		$2.020	.	$0.41		*	
J7209	Factor viii nuwiq recomb 1iu	K	1846		$1.355	.	$0.28		*	
J7210	"Inj, afstyla, 1 i.u."	K	9043		$1.338	.	$0.27		*	
J7211	"Inj, kovaltry, 1 i.u."	N								
J7296	"Kyleena, 19.5 mg"	E1								
J7297	"Liletta, 52 mg"	E1								
J7298	"Mirena, 52 mg"	E1								
J7300	Intraut copper contraceptive	E1								
J7301	"Skyla, 13.5 mg"	E1								
J7303	Contraceptive vaginal ring	E1								
J7304	Contraceptive hormone patch	E1								
J7306	Levonorgestrel implant sys	E1								
J7307	Etonogestrel implant system	E1								
J7308	Aminolevulinic acid hcl top	K	7308		$394.752	.	$78.96		*	
J7309	"Methyl aminolevulinate, top"	E2								
J7310	Ganciclovir long act implant	E2								
J7311	"Inj., retisert, 0.01 mg"	K	9225		$340.622	.	$68.13		*	
J7312	Dexamethasone intra implant	K	9256		$199.756	.	$39.96		*	
J7313	"Inj., iluvien, 0.01 mg"	K	9450		$490.873	.	$98.18		*	
J7314	"Inj., yutiq, 0.01 mg"	K	9328		$491.133	.	$98.23		*	
J7315	Ophthalmic mitomycin	N								
J7316	"Inj, ocriplasmin, 0.125 mg"	K	9298		"$1,046.927"	.	$209.39		*	
J7318	"Inj, durolane 1 mg"	G	9174		$17.225	.	$3.45		*	
J7320	"Genvisc 850, inj, 1mg"	K	9079		$16.918	.	$3.39		*	
J7321	Hyalgan or supartz inj dose	N								
J7322	Hymovis injection 1 mg	K	9471		$31.668	.	$6.34		*	
J7323	Euflexxa inj per dose	K	0875		$140.312	.	$28.07		*	
J7324	Orthovisc inj per dose	K	0877		$128.409	.	$25.69		*	
J7325	Synvisc or synvisc-one	K	0874		$10.218	.	$2.05		*	
J7326	Gel-one	K	1417		"$1,219.000"	.	$243.80		*	
J7327	Monovisc inj per dose	K	1747		$694.582	.	$138.92		*	
J7328	Gelsyn-3 injection 0.1 mg	K	1862		$2.177	.	$0.44		*	
J7329	"Inj, trivisc 1 mg"	K	9196		$7.195	.	$1.44		*	
J7330	Cultured chondrocytes implnt	B								
J7331	"Synojoynt, inj., 1 mg"	G	9337		$4.394	.	$0.88		*	
J7332	"Inj., triluron, 1 mg"	K	9338		$25.917	.	$5.19		*	
J7333	Visco-3 inj dose	N								
J7336	Capsaicin 8% patch	K	9071		$3.250	.	$0.65		*	
J7340	Carbidopa levodopa ent 100ml	K	9320		$213.095	.	$42.62		*	
J7342	Ciprofloxacin otic susp 6 mg	K	9479		$29.968	.	$6.00		*	
J7345	"Aminolevulinic acid, 10% gel"	G	9301		$1.525	.	$0.31		*	
J7351	Inj bimatoprost itc imp 1mcg	G	9351		$200.850		$40.17		*	
J7401	Mometasone furoate sinus imp	N 								
J7500	Azathioprine oral 50mg	N								
J7501	Azathioprine parenteral	K	0887		$227.933	.	$45.59		*	
J7502	Cyclosporine oral 100 mg	N								
J7503	Tacrol envarsus ex rel oral	N								
J7504	Lymphocyte immune globulin	K	0890		"$2,257.665"	.	$451.54		*	
J7505	Monoclonal antibodies	N								
J7507	Tacrolimus imme rel oral 1mg	N								
J7508	Tacrol astagraf ex rel oral	N								
J7509	Methylprednisolone oral	N								
J7510	Prednisolone oral per 5 mg	N								
J7511	Antithymocyte globuln rabbit	K	9104		$817.122	.	$163.43		*	
J7512	Prednisone ir or dr oral 1mg	N								
J7513	"Daclizumab, parenteral"	E2								
J7515	Cyclosporine oral 25 mg	N								
J7516	Cyclosporin parenteral 250mg	N								
J7517	Mycophenolate mofetil oral	N								
J7518	Mycophenolic acid	N								
J7520	"Sirolimus, oral"	N								
J7525	Tacrolimus injection	K	9006		$211.974	.	$42.40		*	
J7527	Oral everolimus	N								
J7599	Immunosuppressive drug noc	N								
J7604	Acetylcysteine comp unit	M								
J7605	Arformoterol non-comp unit	M								
J7606	"Formoterol fumarate, inh"	M								
J7607	Levalbuterol comp con	M								
J7608	Acetylcysteine non-comp unit	M								
J7609	Albuterol comp unit	M								
J7610	Albuterol comp con	M								
J7611	Albuterol non-comp con	M								
J7612	Levalbuterol non-comp con	M								
J7613	Albuterol non-comp unit	M								
J7614	Levalbuterol non-comp unit	M								
J7615	Levalbuterol comp unit	M								
J7620	Albuterol ipratrop non-comp	M								
J7622	Beclomethasone comp unit	M								
J7624	Betamethasone comp unit	M								
J7626	Budesonide non-comp unit	M								
J7627	Budesonide comp unit	M								
J7628	Bitolterol mesylate comp con	M								
J7629	Bitolterol mesylate comp unt	M								
J7631	Cromolyn sodium noncomp unit	M								
J7632	Cromolyn sodium comp unit	M								
J7633	Budesonide non-comp con	M								
J7634	Budesonide comp con	M								
J7635	Atropine comp con	M								
J7636	Atropine comp unit	M								
J7637	Dexamethasone comp con	M								
J7638	Dexamethasone comp unit	M								
J7639	Dornase alfa non-comp unit	M								
J7640	Formoterol comp unit	E1								
J7641	Flunisolide comp unit	M								
J7642	Glycopyrrolate comp con	M								
J7643	Glycopyrrolate comp unit	M								
J7644	Ipratropium bromide non-comp	M								
J7645	Ipratropium bromide comp	M								
J7647	Isoetharine comp con	M								
J7648	Isoetharine non-comp con	M								
J7649	Isoetharine non-comp unit	M								
J7650	Isoetharine comp unit	M								
J7657	Isoproterenol comp con	M								
J7658	Isoproterenol non-comp con	M								
J7659	Isoproterenol non-comp unit	M								
J7660	Isoproterenol comp unit	M								
J7665	Mannitol for inhaler	N								
J7667	Metaproterenol comp con	M								
J7668	Metaproterenol non-comp con	M								
J7669	Metaproterenol non-comp unit	M								
J7670	Metaproterenol comp unit	M								
J7674	"Methacholine chloride, neb"	N								
J7676	Pentamidine comp unit dose	M								
J7677	Revefenacin inh non-com 1mcg	M								
J7680	Terbutaline sulf comp con	M								
J7681	Terbutaline sulf comp unit	M								
J7682	Tobramycin non-comp unit	M								
J7683	Triamcinolone comp con	M								
J7684	Triamcinolone comp unit	M								
J7685	Tobramycin comp unit	M								
J7686	"Treprostinil, non-comp unit"	M								
J7699	Inhalation solution for dme	M								
J7799	Non-inhalation drug for dme	N								
J7999	"Compounded drug, noc"	N								
J8498	Antiemetic rectal/supp nos	B								
J8499	Oral prescrip drug non chemo	E1								
J8501	Oral aprepitant	N								
J8510	Oral busulfan	K 	9335		$23.810	.	$4.77		*	
J8515	"Cabergoline, oral 0.25mg"	E1								
J8520	"Capecitabine, oral, 150 mg"	N								
J8521	"Capecitabine, oral, 500 mg"	N								
J8530	Cyclophosphamide oral 25 mg	N								
J8540	Oral dexamethasone	N								
J8560	Etoposide oral 50 mg	K	0802		$75.493	.	$15.10		*	
J8562	Oral fludarabine phosphate	N								
J8565	Gefitinib oral	E2								
J8597	Antiemetic drug oral nos	N								
J8600	Melphalan oral 2 mg	N								
J8610	Methotrexate oral 2.5 mg	N								
J8650	Nabilone oral	E2								
J8655	"Oral netupitant, palonosetro"	K	9448		$270.102	.	$54.03		*	
J8670	"Rolapitant, oral, 1mg"	K	1761		$2.266	.	$0.46		*	
J8700	Temozolomide	N								
J8705	Topotecan oral	N								
J8999	Oral prescription drug chemo	B								
J9000	Doxorubicin hcl injection	N								
J9015	Aldesleukin injection	K	0807		"$4,964.616"	.	$992.93		*	
J9017	Arsenic trioxide injection	K	9012		$22.063	.	$4.42		*	
J9019	Erwinaze injection	K	9289		$427.269	.	$85.46		*	
J9020	"Asparaginase, nos"	E2								
J9022	"Inj, atezolizumab,10 mg"	K	9483		$78.279	.	$15.66		*	
J9023	"Injection, avelumab, 10 mg"	K	9491		$84.700	.	$16.94		*	
J9025	Azacitidine injection	K	1709		$0.801	.	$0.17		*	
J9027	Clofarabine injection	K	1710		$52.637	.	$10.53		*	
J9030	Bcg live intravesical 1mg	K	9322		$2.793	.	$0.56		*	
J9032	"Injection, belinostat, 10mg"	K	1658		$42.794	.	$8.56		*	
J9033	"Inj., treanda 1 mg"	K	9243		$24.693	.	$4.94		*	
J9034	"Inj., bendeka 1 mg"	K	1861		$20.273	.	$4.06		*	
J9035	Bevacizumab injection	K	9214		$76.361	.	$15.28		*	
J9036	Inj. belrapzo/bendamustine	G	9313		$21.612	.	$4.33		*	
J9039	"Injection, blinatumomab"	K	9449		$118.586	.	$23.72		*	
J9040	Bleomycin sulfate injection	N								
J9041	"Inj., velcade 0.1 mg"	K	9207		$44.973	.	$9.00		*	
J9042	Brentuximab vedotin inj	K	9287		$175.282	.	$35.06		*	
J9043	Cabazitaxel injection	K	9276		$181.509	.	$36.31		*	
J9044	"Inj, bortezomib, nos, 0.1 mg"	K	9192		$22.036	.	$4.41		*	
J9045	Carboplatin injection	N								
J9047	"Injection, carfilzomib, 1 mg"	K	9295		$39.198	.	$7.84		*	
J9050	Carmustine injection	K	0812		"$2,016.270"	.	$403.26		*	
J9055	Cetuximab injection	K	9215		$64.286	.	$12.86		*	
J9057	"Inj., copanlisib, 1 mg"	G	9030		$78.989	.	$15.80		*	
J9060	Cisplatin 10 mg injection	N								
J9065	Inj cladribine per 1 mg	K	0858		$19.573	.	$3.92		*	
J9070	Cyclophosphamide 100 mg inj	K	1408		$29.672	.	$5.94		*	
J9098	Cytarabine liposome inj	K	1166		$492.920	.	$98.59		*	
J9100	Cytarabine hcl 100 mg inj	N								
J9118	Inj. calaspargase pegol-mknl	E2								
J9119	"Inj., cemiplimab-rwlc, 1 mg"	G	9304		$27.401	.	$5.49		*	
J9120	Dactinomycin injection	K	0752		"$1,044.534"	.	$208.91		*	
J9130	Dacarbazine 100 mg inj	N								
J9145	"Injection, daratumumab 10 mg"	K	9476		$56.286	.	$11.26		*	
J9150	Daunorubicin injection	K	0820		$43.838	.	$8.77		*	
J9151	Daunorubicin citrate inj	N								
J9153	"Inj daunorubicin, cytarabine"	G	9302		$197.794	.	$39.56		*	
J9155	Degarelix injection	K	1296		$3.842	.	$0.77		*	
J9160	Denileukin diftitox inj	E2								
J9165	Diethylstilbestrol injection	E2								
J9171	Docetaxel injection	K	0823		$0.851	.	$0.18		*	
J9173	"Inj., durvalumab, 10 mg"	K	9492		$76.023	.	$15.21		*	
J9175	Elliotts b solution per ml	N								
J9176	"Injection, elotuzumab, 1mg"	K	9477		$6.671	.	$1.34			
J9177	Inj enfort vedo-ejfv 0.25mg	G	9364		$27.958		$5.60			
J9178	"Inj, epirubicin hcl, 2 mg"	N								
J9179	Eribulin mesylate injection	K	1426		$117.663	.	$23.54		*	
J9181	Etoposide injection	N								
J9185	Fludarabine phosphate inj	N								
J9190	Fluorouracil injection	N								
J9198	"Inj. infugem, 100 mg"	N								
J9200	Floxuridine injection	N								
J9201	In gemcitabine hcl nos 200mg	N								
J9202	Goserelin acetate implant	K	0810		$503.586	.	$100.72		*	
J9203	Gemtuzumab ozogamicin 0.1 mg	G	9495		$205.380	.	$41.08		*	
J9204	"Inj mogamulizumab-kpkc, 1 mg"	G	9182		$203.883	.	$40.78		*	
J9205	Inj irinotecan liposome 1 mg	K	9474		$54.331	.	$10.87		*	
J9206	Irinotecan injection	N								
J9207	Ixabepilone injection	K	9240		$101.189	.	$20.24		*	
J9208	Ifosfamide injection	N								
J9209	Mesna injection	N								
J9210	"Inj., emapalumab-lzsg, 1 mg"	G	9310		$441.593	.	$88.32		*	
J9211	Idarubicin hcl injection	N								
J9212	Interferon alfacon-1 inj	E2								
J9213	Interferon alfa-2a inj	K	9092		$407.240	.	$81.45		*	
J9214	Interferon alfa-2b inj	K	0836		$34.346	.	$6.87		*	
J9215	Interferon alfa-n3 inj	E2								
J9216	Interferon gamma 1-b inj	E2								
J9217	Leuprolide acetate suspnsion	K	9217		$224.452	.	$44.90		*	
J9218	Leuprolide acetate injeciton	N								
J9219	Leuprolide acetate implant	E2								
J9225	Vantas implant	K	1711		"$4,558.133"	.	$911.63		*	
J9226	Supprelin la implant	K	1142		"$40,237.001"	.	"$8,047.41"	*	*	
J9227	Inj. isatuximab-irfc 10 mg	G	9377		$66.670		$13.34		*	
J9228	Ipilimumab injection	K	9284		$157.382	.	$31.48		*	
J9229	Inj inotuzumab ozogam 0.1 mg	G	9028		"$2,341.499"	.	$468.30		*	
J9230	Mechlorethamine hcl inj	K	0751		$328.290	.	$65.66		*	
J9245	Inj melpha hydroch nos 50 mg	K	0840		$260.376	.	$52.08		*	
J9246	"Inj., evomela, 1 mg"	K	9375		$26.959		$5.40		*	
J9250	Methotrexate sodium inj	N								
J9260	Methotrexate sodium inj	N								
J9261	Nelarabine injection	K	0825		$152.151	.	$30.44		*	
J9262	"Inj, omacetaxine mep, 0.01mg"	K	9297		$2.976	.	$0.60		*	
J9263	Oxaliplatin	N								
J9264	Paclitaxel protein bound	K	1712		$13.298	.	$2.66		*	
J9266	Pegaspargase injection	K	0843		"$19,717.763"	.	"$3,943.56"	*	*	
J9267	Paclitaxel injection	N								
J9268	Pentostatin injection	K	0844		"$2,060.277"	.	$412.06		*	
J9269	Inj. tagraxofusp-erzs 10 mcg	G	9309		$270.585	.	$54.12		*	
J9270	Plicamycin (mithramycin) inj	N								
J9271	Inj pembrolizumab	K	1490		$50.846	.	$10.17		*	
J9280	Mitomycin injection	K	1232		$49.879	.	$9.98		*	
J9285	"Inj, olaratumab, 10 mg"	K	9485		$52.067	.	$10.42		*	
J9293	Mitoxantrone hydrochl / 5 mg	K	0864		$28.688	.	$5.74		*	
J9295	"Injection, necitumumab, 1 mg"	K	9475		$5.731	.	$1.15		*	
J9299	"Injection, nivolumab"	K	9453		$28.559	.	$5.72		*	
J9301	Obinutuzumab inj	K	1476		$63.736	.	$12.75		*	
J9302	Ofatumumab injection	K	9260		$61.942	.	$12.39		*	
J9303	Panitumumab injection	K	9235		$123.553	.	$24.72		*	
J9304	"Inj. pemetrexed, 10 mg"	E2							*	
J9305	Inj. pemetrexed nos 10mg	K	9213		$71.811	.	$14.37		*	
J9306	"Injection, pertuzumab, 1 mg"	K	1471		$12.945	.	$2.59		*	
J9307	Pralatrexate injection	K	9259		$311.224	.	$62.25		*	
J9308	"Injection, ramucirumab"	K	1488		$60.709	.	$12.15		*	
J9309	"Inj, polatuzumab vedotin 1mg"	G	9331		$110.717	.	$22.15		*	
J9311	"Inj rituximab, hyaluronidase"	G	9467		$41.140	.	$8.23		*	
J9312	"Inj., rituximab, 10 mg"	K	9186		$92.556	.	$18.52		*	
J9313	"Inj., lumoxiti, 0.01 mg"	G	9305		$22.460	.	$4.50		*	
J9315	Romidepsin injection	K	9265		$336.542	.	$67.31		*	
J9320	Streptozocin injection	K	0850		$349.537	.	$69.91		*	
J9325	Inj talimogene laherparepvec	K	9472		$53.923	.	$10.79		*	
J9328	Temozolomide injection	K	9253		$10.377	.	$2.08		*	
J9330	Temsirolimus injection	K	1168		$44.989	.	$9.00		*	
J9340	Thiotepa injection	K	0851		$475.392	.	$95.08		*	
J9351	Topotecan injection	N								
J9352	Injection trabectedin 0.1mg	K	9480		$318.927	.	$63.79		*	
J9354	"Inj, ado-trastuzumab emt 1mg"	K	9131		$32.789	.	$6.56		*	
J9355	Inj trastuzumab excl biosimi	K	1613		$99.675	.	$19.94		*	
J9356	"Inj. herceptin hylecta, 10mg"	G	9314		$75.084	.	$15.02		*	
J9357	Valrubicin injection	K	1235		"$1,403.170"	.	$280.64		*	
J9358 	Inj fam-trastu deru-nxki 1mg	G	9353		$24.142		$4.83		*	
J9360	Vinblastine sulfate inj	N								
J9370	Vincristine sulfate 1 mg inj	N								
J9371	"Inj, vincristine sul lip 1mg"	K	1466		"$3,320.169"	.	$664.04		*	
J9390	Vinorelbine tartrate inj	N								
J9395	"Injection, fulvestrant"	K	9120		$52.737	.	$10.55		*	
J9400	"Inj, ziv-aflibercept, 1mg"	K	9296		$8.073	.	$1.62		*	
J9600	Porfimer sodium injection	K	0856		"$21,856.352"	.	"$4,371.28"	*	*	
J9999	Chemotherapy drug	N								
K0001	Standard wheelchair	Y								
K0002	Stnd hemi (low seat) whlchr	Y								
K0003	Lightweight wheelchair	Y								
K0004	High strength ltwt whlchr	Y								
K0005	Ultralightweight wheelchair	Y								
K0006	Heavy duty wheelchair	Y								
K0007	Extra heavy duty wheelchair	Y								
K0008	Cstm manual wheelchair/base	Y								
K0009	Other manual wheelchair/base	Y								
K0010	Stnd wt frame power whlchr	Y								
K0011	Stnd wt pwr whlchr w control	Y								
K0012	Ltwt portbl power whlchr	Y								
K0013	Custom power whlchr base	Y								
K0014	Other power whlchr base	Y								
K0015	Detach non-adj ht armrst rep	Y								
K0017	Detach adjust armrest base	Y								
K0018	Detach adjust armrst upper	Y								
K0019	"Arm pad repl, each"	Y								
K0020	Fixed adjust armrest pair	Y								
K0037	Hi mount flip-up footrest ea	Y								
K0038	Leg strap each	Y								
K0039	Leg strap h style each	Y								
K0040	Adjustable angle footplate	Y								
K0041	Large size footplate each	Y								
K0042	Standard size ftplate rep ea	Y								
K0043	Ftrst lowr exten tube rep ea	Y								
K0044	Ftrst upr hanger brac rep ea	Y								
K0045	Ftrst compl assembly repl ea	Y								
K0046	Elev lgrst lwr exten repl ea	Y								
K0047	Elev legrst upr hangr rep ea	Y								
K0050	Ratchet assembly replacement	Y								
K0051	Cam rel asm ft/legrst rep ea	Y								
K0052	Swingaway detach ftrest repl	Y								
K0053	Elevate footrest articulate	Y								
K0056	Seat ht <17 or >=21 ltwt wc	Y								
K0065	Spoke protectors	Y								
K0069	Rr whl compl sol tire rep ea	Y								
K0070	Rr whl compl pne tire rep ea	Y								
K0071	Fr cstr comp pne tire rep ea	Y								
K0072	Fr cstr semi-pne tire rep ea	Y								
K0073	Caster pin lock each	Y								
K0077	Fr cstr asmb sol tire rep ea	Y								
K0098	"Drive belt for pwc, repl"	Y								
K0105	Iv hanger	Y								
K0108	W/c component-accessory nos	Y								
K0195	Elevating whlchair leg rests	Y								
K0455	Pump uninterrupted infusion	Y								
K0462	Temporary replacement eqpmnt	Y								
K0552	Sup/ext non-ins inf pump syr	Y								
K0553	Ther cgm supply allowance 	Y								
K0554	Ther cgm receiver/monitor 	Y								
K0601	Repl batt silver oxide 1.5 v	Y								
K0602	Repl batt silver oxide 3 v	Y								
K0603	Repl batt alkaline 1.5 v	Y								
K0604	Repl batt lithium 3.6 v	Y								
K0605	Repl batt lithium 4.5 v	Y								
K0606	Aed garment w elec analysis	Y								
K0607	Repl batt for aed	Y								
K0608	Repl garment for aed	Y								
K0609	Repl electrode for aed	Y								
K0669	Seat/back cus no dmepdac ver	Y								
K0672	Removable soft interface le	A								
K0730	Ctrl dose inh drug deliv sys	Y								
K0733	12-24hr sealed lead acid	Y								
K0738	Portable gas oxygen system	Y								
K0739	Repair/svc dme non-oxygen eq	Y								
K0740	Repair/svc oxygen equipment	E1								
K0743	Portable home suction pump	Y								
K0744	Absorp drg <= 16 suc pump	A								
K0745	Absorp drg >16<=48 suc pump	A								
K0746	Absorp drg >48 suc pump	A								
K0800	Pov group 1 std up to 300lbs	Y								
K0801	Pov group 1 hd 301-450 lbs	Y								
K0802	Pov group 1 vhd 451-600 lbs	Y								
K0806	Pov group 2 std up to 300lbs	Y								
K0807	Pov group 2 hd 301-450 lbs	Y								
K0808	Pov group 2 vhd 451-600 lbs	Y								
K0812	Power operated vehicle noc	Y								
K0813	Pwc gp 1 std port seat/back	Y								
K0814	Pwc gp 1 std port cap chair	Y								
K0815	Pwc gp 1 std seat/back	Y								
K0816	Pwc gp 1 std cap chair	Y								
K0820	Pwc gp 2 std port seat/back	Y								
K0821	Pwc gp 2 std port cap chair	Y								
K0822	Pwc gp 2 std seat/back	Y								
K0823	Pwc gp 2 std cap chair	Y								
K0824	Pwc gp 2 hd seat/back	Y								
K0825	Pwc gp 2 hd cap chair	Y								
K0826	Pwc gp 2 vhd seat/back	Y								
K0827	Pwc gp vhd cap chair	Y								
K0828	Pwc gp 2 xtra hd seat/back	Y								
K0829	Pwc gp 2 xtra hd cap chair	Y								
K0830	Pwc gp2 std seat elevate s/b	Y								
K0831	Pwc gp2 std seat elevate cap	Y								
K0835	Pwc gp2 std sing pow opt s/b	Y								
K0836	Pwc gp2 std sing pow opt cap	Y								
K0837	Pwc gp 2 hd sing pow opt s/b	Y								
K0838	Pwc gp 2 hd sing pow opt cap	Y								
K0839	Pwc gp2 vhd sing pow opt s/b	Y								
K0840	Pwc gp2 xhd sing pow opt s/b	Y								
K0841	Pwc gp2 std mult pow opt s/b	Y								
K0842	Pwc gp2 std mult pow opt cap	Y								
K0843	Pwc gp2 hd mult pow opt s/b	Y								
K0848	Pwc gp 3 std seat/back	Y								
K0849	Pwc gp 3 std cap chair	Y								
K0850	Pwc gp 3 hd seat/back	Y								
K0851	Pwc gp 3 hd cap chair	Y								
K0852	Pwc gp 3 vhd seat/back	Y								
K0853	Pwc gp 3 vhd cap chair	Y								
K0854	Pwc gp 3 xhd seat/back	Y								
K0855	Pwc gp 3 xhd cap chair	Y								
K0856	Pwc gp3 std sing pow opt s/b	Y								
K0857	Pwc gp3 std sing pow opt cap	Y								
K0858	Pwc gp3 hd sing pow opt s/b	Y								
K0859	Pwc gp3 hd sing pow opt cap	Y								
K0860	Pwc gp3 vhd sing pow opt s/b	Y								
K0861	Pwc gp3 std mult pow opt s/b	Y								
K0862	Pwc gp3 hd mult pow opt s/b	Y								
K0863	Pwc gp3 vhd mult pow opt s/b	Y								
K0864	Pwc gp3 xhd mult pow opt s/b	Y								
K0868	Pwc gp 4 std seat/back	Y								
K0869	Pwc gp 4 std cap chair	Y								
K0870	Pwc gp 4 hd seat/back	Y								
K0871	Pwc gp 4 vhd seat/back	Y								
K0877	Pwc gp4 std sing pow opt s/b	Y								
K0878	Pwc gp4 std sing pow opt cap	Y								
K0879	Pwc gp4 hd sing pow opt s/b	Y								
K0880	Pwc gp4 vhd sing pow opt s/b	Y								
K0884	Pwc gp4 std mult pow opt s/b	Y								
K0885	Pwc gp4 std mult pow opt cap	Y								
K0886	Pwc gp4 hd mult pow s/b	Y								
K0890	Pwc gp5 ped sing pow opt s/b	Y								
K0891	Pwc gp5 ped mult pow opt s/b	Y								
K0898	Power wheelchair noc	Y								
K0899	Pow mobil dev no dmepdac	Y								
K0900	Cstm dme other than wheelchr	Y								
K1001	Electronic posa treatment	Y								
K1002	Ces system w/supplies access	E1								
K1003	Whirlpool tub walkin portabl	Y								
K1004	Lo freq us diathermy device	Y								
K1005	Disp col sto bag breast milk	Y								
K1006	Suct pum ext urine mgmt sys	Y							*	
K1007	Bil hkaf pc s/d micro sensor	Y							*	
K1009	Speech volume modulation sys	Y							*	
K1010	Intraurethral drainag device	Y							*	
K1011	Acti intraurethral drainage	Y							*	
K1012	Charger base station intraur	Y							*	
L0112	Cranial cervical orthosis	A								
L0113	Cranial cervical torticollis	A								
L0120	Cerv flex n/adj foam pre ots	A								
L0130	Flex thermoplastic collar mo	A								
L0140	Cervical semi-rigid adjustab	A								
L0150	Cerv semi-rig adj molded chn	A								
L0160	Cerv sr wire occ/man pre ots	A								
L0170	Cervical collar molded to pt	A								
L0172	Cerv col sr foam 2pc pre ots	A								
L0174	Cerv sr 2pc thor ext pre ots	A								
L0180	Cer post col occ/man sup adj	A								
L0190	Cerv collar supp adj cerv ba	A								
L0200	Cerv col supp adj bar & thor	A								
L0220	Thor rib belt custom fabrica	A								
L0450	Tlso flex trunk/thor pre ots	A								
L0452	Tlso flex custom fab thoraci	A								
L0454	Tlso trnk sj-t9 pre cst	A								
L0455	Tlso flex trnk sj-t9 pre ots	A								
L0456	Tlso flex trnk sj-ss pre cst	A								
L0457	Tlso flex trnk sj-ss pre ots	A								
L0458	Tlso 2mod symphis-xipho pre	A								
L0460	Tlso 2 shl symphys-stern cst	A								
L0462	Tlso 3mod sacro-scap pre	A								
L0464	Tlso 4mod sacro-scap pre	A								
L0466	Tlso r fram soft ant pre cst	A								
L0467	Tlso r fram soft pre ots	A								
L0468	Tlso rig fram pelvic pre cst	A								
L0469	Tlso rig fram pelvic pre ots	A								
L0470	Tlso rigid frame pre subclav	A								
L0472	Tlso rigid frame hyperex pre	A								
L0480	Tlso rigid plastic custom fa	A								
L0482	Tlso rigid lined custom fab	A								
L0484	Tlso rigid plastic cust fab	A								
L0486	Tlso rigidlined cust fab two	A								
L0488	Tlso rigid lined pre one pie	A								
L0490	Tlso rigid plastic pre one	A								
L0491	Tlso 2 piece rigid shell	A								
L0492	Tlso 3 piece rigid shell	A								
L0621	Sio flex pelvic/sacr pre ots	A								
L0622	Sio flex pelvisacral custom	A								
L0623	Sio rig pnl pelv/sac pre ots	A								
L0624	Sio panel custom	A								
L0625	Lo flex l1-below l5 pre ots	A								
L0626	Lo sag rig pnl stays pre cst	A								
L0627	Lo sag ri an/pos pnl pre cst	A								
L0628	Lso flex no ri stays pre ots	A								
L0629	Lso flex w/rigid stays cust	A								
L0630	Lso r post pnl sj-t9 pre cst	A								
L0631	Lso sag r an/pos pnl pre cst	A								
L0632	Lso sag rigid frame cust	A								
L0633	Lso sc r pos/lat pnl pre cst	A								
L0634	Lso flexion control custom	A								
L0635	Lso sagit rigid panel prefab	A								
L0636	Lso sagittal rigid panel cus	A								
L0637	Lso sc r ant/pos pnl pre cst	A								
L0638	Lso sag-coronal panel custom	A								
L0639	Lso s/c shell/panel prefab	A								
L0640	Lso s/c shell/panel custom	A								
L0641	Lo rig pos pnl l1-l5 pre ots	A								
L0642	Lo sag ri an/pos pnl pre ots	A								
L0643	Lso sag ctr rigi pos pre ots	A								
L0648	Lso sag r an/pos pnl pre ots	A								
L0649	Lso sc r pos/lat pnl pre ots	A								
L0650	Lso sc r ant/pos pnl pre ots	A								
L0651	Lso sag-co shell pnl pre ots	A								
L0700	Ctlso a-p-l control molded	A								
L0710	Ctlso a-p-l control w/ inter	A								
L0810	Halo cervical into jckt vest	A								
L0820	Halo cervical into body jack	A								
L0830	Halo cerv into milwaukee typ	A								
L0859	Mri compatible system	A								
L0861	Halo repl liner/interface	A								
L0970	Tlso corset front	A								
L0972	Lso corset front	A								
L0974	Tlso full corset	A								
L0976	Lso full corset	A								
L0978	Axillary crutch extension	A								
L0980	Peroneal straps pair pre ots	A								
L0982	Stocking sup grips 4 pre ots	A								
L0984	Protect body sock ea pre ots	A								
L0999	Add to spinal orthosis nos	A								
L1000	Ctlso milwauke initial model	A								
L1001	Ctlso infant immobilizer	A								
L1005	Tension based scoliosis orth	A								
L1010	Ctlso axilla sling	A								
L1020	Kyphosis pad	A								
L1025	Kyphosis pad floating	A								
L1030	Lumbar bolster pad	A								
L1040	Lumbar or lumbar rib pad	A								
L1050	Sternal pad	A								
L1060	Thoracic pad	A								
L1070	Trapezius sling	A								
L1080	Outrigger	A								
L1085	Outrigger bil w/ vert extens	A								
L1090	Lumbar sling	A								
L1100	Ring flange plastic/leather	A								
L1110	Ring flange plas/leather mol	A								
L1120	Covers for upright each	A								
L1200	Furnsh initial orthosis only	A								
L1210	Lateral thoracic extension	A								
L1220	Anterior thoracic extension	A								
L1230	Milwaukee type superstructur	A								
L1240	Lumbar derotation pad	A								
L1250	Anterior asis pad	A								
L1260	Anterior thoracic derotation	A								
L1270	Abdominal pad	A								
L1280	Rib gusset (elastic) each	A								
L1290	Lateral trochanteric pad	A								
L1300	Body jacket mold to patient	A								
L1310	Post-operative body jacket	A								
L1499	Spinal orthosis nos	A								
L1600	Ho flex frejka w/cov pre cst	A								
L1610	Ho frejka cov only pre cst	A								
L1620	Ho flex pavlik harns pre cst	A								
L1630	Abduct control hip semi-flex	A								
L1640	Pelv band/spread bar thigh c	A								
L1650	Ho abduction hip adjustable	A								
L1652	Ho bi thighcuffs w sprdr bar	A								
L1660	Ho abduction static plastic	A								
L1680	Pelvic & hip control thigh c	A								
L1685	Post-op hip abduct custom fa	A								
L1686	Ho post-op hip abduction	A								
L1690	Combination bilateral ho	A								
L1700	Leg perthes orth toronto typ	A								
L1710	Legg perthes orth newington	A								
L1720	Legg perthes orthosis trilat	A								
L1730	Legg perthes orth scottish r	A								
L1755	Legg perthes patten bottom t	A								
L1810	Ko elastic with joints	A								
L1812	Ko elastic w/joints pre ots	A								
L1820	Ko elas w/ condyle pads & jo	A								
L1830	Ko immob canvas long pre ots	A								
L1831	Knee orth pos locking joint	A								
L1832	Ko adj jnt pos r sup pre cst	A								
L1833	Ko adj jnt pos r sup pre ots	A								
L1834	Ko w/0 joint rigid molded to	A								
L1836	Ko rigid w/o joints pre ots	A								
L1840	Ko derot ant cruciate custom	A								
L1843	Ko single upright pre cst	A								
L1844	Ko w/adj jt rot cntrl molded	A								
L1845	Ko double upright pre cst	A								
L1846	Ko w adj flex/ext rotat mold	A								
L1847	Ko dbl upright w/air pre cst	A								
L1848	Ko dbl upright w/air pre ots	A								
L1850	Ko swedish type pre ots	A								
L1851	Ko single upright prefab ots	A								
L1852	Ko double upright prefab ots	A								
L1860	Ko supracondylar socket mold	A								
L1900	Afo sprng wir drsflx calf bd	A								
L1902	Afo ankle gauntlet pre ots	A								
L1904	Afo molded ankle gauntlet	A								
L1906	Afo multilig ank sup pre ots	A								
L1907	Afo supramalleolar custom	A								
L1910	Afo sing bar clasp attach sh	A								
L1920	Afo sing upright w/ adjust s	A								
L1930	Afo plastic	A								
L1932	Afo rig ant tib prefab tcf/=	A								
L1940	Afo molded to patient plasti	A								
L1945	Afo molded plas rig ant tib	A								
L1950	Afo spiral molded to pt plas	A								
L1951	Afo spiral prefabricated	A								
L1960	Afo pos solid ank plastic mo	A								
L1970	Afo plastic molded w/ankle j	A								
L1971	"Afo w/ankle joint, prefab"	A								
L1980	Afo sing solid stirrup calf	A								
L1990	Afo doub solid stirrup calf	A								
L2000	Kafo sing fre stirr thi/calf	A								
L2005	Kafo sng/dbl mechanical act	A								
L2006	Kaf sng/dbl swg/stn mcpr cus	A								
L2010	Kafo sng solid stirrup w/o j	A								
L2020	Kafo dbl solid stirrup band/	A								
L2030	Kafo dbl solid stirrup w/o j	A								
L2034	Kafo pla sin up w/wo k/a cus	A								
L2035	Kafo plastic pediatric size	A								
L2036	Kafo plas doub free knee mol	A								
L2037	Kafo plas sing free knee mol	A								
L2038	Kafo w/o joint multi-axis an	A								
L2040	Hkafo torsion bil rot straps	A								
L2050	Hkafo torsion cable hip pelv	A								
L2060	Hkafo torsion ball bearing j	A								
L2070	Hkafo torsion unilat rot str	A								
L2080	Hkafo unilat torsion cable	A								
L2090	Hkafo unilat torsion ball br	A								
L2106	Afo tib fx cast plaster mold	A								
L2108	Afo tib fx cast molded to pt	A								
L2112	Afo tibial fracture soft	A								
L2114	Afo tib fx semi-rigid	A								
L2116	Afo tibial fracture rigid	A								
L2126	Kafo fem fx cast thermoplas	A								
L2128	Kafo fem fx cast molded to p	A								
L2132	Kafo femoral fx cast soft	A								
L2134	Kafo fem fx cast semi-rigid	A								
L2136	Kafo femoral fx cast rigid	A								
L2180	Plas shoe insert w ank joint	A								
L2182	Drop lock knee	A								
L2184	Limited motion knee joint	A								
L2186	Adj motion knee jnt lerman t	A								
L2188	Quadrilateral brim	A								
L2190	Waist belt	A								
L2192	Pelvic band & belt thigh fla	A								
L2200	Limited ankle motion ea jnt	A								
L2210	Dorsiflexion assist each joi	A								
L2220	Dorsi & plantar flex ass/res	A								
L2230	Split flat caliper stirr & p	A								
L2232	"Rocker bottom, contact afo"	A								
L2240	Round caliper and plate atta	A								
L2250	Foot plate molded stirrup at	A								
L2260	Reinforced solid stirrup	A								
L2265	Long tongue stirrup	A								
L2270	Varus/valgus strap padded/li	A								
L2275	Plastic mod low ext pad/line	A								
L2280	Molded inner boot	A								
L2300	Abduction bar jointed adjust	A								
L2310	Abduction bar-straight	A								
L2320	Non-molded lacer	A								
L2330	Lacer molded to patient mode	A								
L2335	Anterior swing band	A								
L2340	Pre-tibial shell molded to p	A								
L2350	Prosthetic type socket molde	A								
L2360	Extended steel shank	A								
L2370	Patten bottom	A								
L2375	Torsion ank & half solid sti	A								
L2380	Torsion straight knee joint	A								
L2385	Straight knee joint heavy du	A								
L2387	Add le poly knee custom kafo	A								
L2390	Offset knee joint each	A								
L2395	Offset knee joint heavy duty	A								
L2397	Suspension sleeve lower ext	A								
L2405	Knee joint drop lock ea jnt	A								
L2415	Knee joint cam lock each joi	A								
L2425	Knee disc/dial lock/adj flex	A								
L2430	Knee jnt ratchet lock ea jnt	A								
L2492	Knee lift loop drop lock rin	A								
L2500	Thi/glut/ischia wgt bearing	A								
L2510	Th/wght bear quad-lat brim m	A								
L2520	Th/wght bear quad-lat brim c	A								
L2525	Th/wght bear nar m-l brim mo	A								
L2526	Th/wght bear nar m-l brim cu	A								
L2530	Thigh/wght bear lacer non-mo	A								
L2540	Thigh/wght bear lacer molded	A								
L2550	Thigh/wght bear high roll cu	A								
L2570	Hip clevis type 2 posit jnt	A								
L2580	Pelvic control pelvic sling	A								
L2600	Hip clevis/thrust bearing fr	A								
L2610	Hip clevis/thrust bearing lo	A								
L2620	Pelvic control hip heavy dut	A								
L2622	Hip joint adjustable flexion	A								
L2624	Hip adj flex ext abduct cont	A								
L2627	Plastic mold recipro hip & c	A								
L2628	Metal frame recipro hip & ca	A								
L2630	Pelvic control band & belt u	A								
L2640	Pelvic control band & belt b	A								
L2650	Pelv & thor control gluteal	A								
L2660	Thoracic control thoracic ba	A								
L2670	Thorac cont paraspinal uprig	A								
L2680	Thorac cont lat support upri	A								
L2750	Plating chrome/nickel pr bar	A								
L2755	Carbon graphite lamination	A								
L2760	Extension per extension per	A								
L2768	Ortho sidebar disconnect	A								
L2780	Non-corrosive finish	A								
L2785	Drop lock retainer each	A								
L2795	Knee control full kneecap	A								
L2800	Knee cap medial or lateral p	A								
L2810	Knee control condylar pad	A								
L2820	Soft interface below knee se	A								
L2830	Soft interface above knee se	A								
L2840	Tibial length sock fx or equ	A								
L2850	Femoral lgth sock fx or equa	A								
L2861	Torsion mechanism knee/ankle	E1								
L2999	Lower extremity orthosis nos	A								
L3000	Ft insert ucb berkeley shell	A								
L3001	Foot insert remov molded spe	A								
L3002	Foot insert plastazote or eq	A								
L3003	Foot insert silicone gel eac	A								
L3010	Foot longitudinal arch suppo	A								
L3020	Foot longitud/metatarsal sup	A								
L3030	Foot arch support remov prem	A								
L3031	Foot lamin/prepreg composite	A								
L3040	Ft arch suprt premold longit	A								
L3050	Foot arch supp premold metat	A								
L3060	Foot arch supp longitud/meta	A								
L3070	Arch suprt att to sho longit	A								
L3080	Arch supp att to shoe metata	A								
L3090	Arch supp att to shoe long/m	A								
L3100	Hallus-valgus nt dyn pre ots	A								
L3140	Abduction rotation bar shoe	A								
L3150	Abduct rotation bar w/o shoe	A								
L3160	Shoe styled positioning dev	A								
L3170	Foot plas heel stabi pre ots	A								
L3201	Oxford w supinat/pronat inf	A								
L3202	Oxford w/ supinat/pronator c	A								
L3203	Oxford w/ supinator/pronator	A								
L3204	Hightop w/ supp/pronator inf	A								
L3206	Hightop w/ supp/pronator chi	A								
L3207	Hightop w/ supp/pronator jun	A								
L3208	Surgical boot each infant	A								
L3209	Surgical boot each child	A								
L3211	Surgical boot each junior	A								
L3212	Benesch boot pair infant	A								
L3213	Benesch boot pair child	A								
L3214	Benesch boot pair junior	A								
L3215	Orthopedic ftwear ladies oxf	E1								
L3216	Orthoped ladies shoes dpth i	E1								
L3217	Ladies shoes hightop depth i	E1								
L3219	Orthopedic mens shoes oxford	E1								
L3221	Orthopedic mens shoes dpth i	E1								
L3222	Mens shoes hightop depth inl	E1								
L3224	Woman's shoe oxford brace	A								
L3225	Man's shoe oxford brace	A								
L3230	Custom shoes depth inlay	A								
L3250	Custom mold shoe remov prost	A								
L3251	Shoe molded to pt silicone s	A								
L3252	Shoe molded plastazote cust	A								
L3253	Shoe molded plastazote cust	A								
L3254	Orth foot non-stndard size/w	A								
L3255	Orth foot non-standard size/	A								
L3257	Orth foot add charge split s	A								
L3260	Ambulatory surgical boot eac	E1								
L3265	Plastazote sandal each	A								
L3300	Sho lift taper to metatarsal	A								
L3310	Shoe lift elev heel/sole neo	A								
L3320	Shoe lift elev heel/sole cor	A								
L3330	Lifts elevation metal extens	A								
L3332	Shoe lifts tapered to one-ha	A								
L3334	Shoe lifts elevation heel /i	A								
L3340	Shoe wedge sach	A								
L3350	Shoe heel wedge	A								
L3360	Shoe sole wedge outside sole	A								
L3370	Shoe sole wedge between sole	A								
L3380	Shoe clubfoot wedge	A								
L3390	Shoe outflare wedge	A								
L3400	Shoe metatarsal bar wedge ro	A								
L3410	Shoe metatarsal bar between	A								
L3420	Full sole/heel wedge btween	A								
L3430	Sho heel count plast reinfor	A								
L3440	Heel leather reinforced	A								
L3450	Shoe heel sach cushion type	A								
L3455	Shoe heel new leather standa	A								
L3460	Shoe heel new rubber standar	A								
L3465	Shoe heel thomas with wedge	A								
L3470	Shoe heel thomas extend to b	A								
L3480	Shoe heel pad & depress for	A								
L3485	Shoe heel pad removable for	A								
L3500	Ortho shoe add leather insol	A								
L3510	Orthopedic shoe add rub insl	A								
L3520	O shoe add felt w leath insl	A								
L3530	Ortho shoe add half sole	A								
L3540	Ortho shoe add full sole	A								
L3550	O shoe add standard toe tap	A								
L3560	O shoe add horseshoe toe tap	A								
L3570	O shoe add instep extension	A								
L3580	O shoe add instep velcro clo	A								
L3590	O shoe convert to sof counte	A								
L3595	Ortho shoe add march bar	A								
L3600	Trans shoe calip plate exist	A								
L3610	Trans shoe caliper plate new	A								
L3620	Trans shoe solid stirrup exi	A								
L3630	Trans shoe solid stirrup new	A								
L3640	Shoe dennis browne splint bo	A								
L3649	Orthopedic shoe modifica nos	A								
L3650	So 8 abd restraint pre ots	A								
L3660	So 8 ab rstr can/web pre ots	A								
L3670	So acro/clav can web pre ots	A								
L3671	So cap design w/o jnts cf	A								
L3674	So airplane w/wo joint cf	A								
L3675	So vest canvas/web pre ots	A								
L3677	So hard plas stabili pre cst	A								
L3678	So hard plas stabili pre ots	A								
L3702	Eo w/o joints cf	A								
L3710	Eo elas w/metal jnts pre ots	A								
L3720	Forearm/arm cuffs free motio	A								
L3730	Forearm/arm cuffs ext/flex a	A								
L3740	Cuffs adj lock w/ active con	A								
L3760	Eo adj jt prefab custom fit	A								
L3761	"Eo, adj lock joint prefab ot"	A								
L3762	Eo rigid w/o joints pre ots	A								
L3763	Ewho rigid w/o jnts cf	A								
L3764	Ewho w/joint(s) cf	A								
L3765	Ewhfo rigid w/o jnts cf	A								
L3766	Ewhfo w/joint(s) cf	A								
L3806	Whfo w/joint(s) custom fab	A								
L3807	Whfo w/o joints pre cst	A								
L3808	"Whfo, rigid w/o joints"	A								
L3809	Whfo w/o joints pre ots	A								
L3891	Torsion mechanism wrist/elbo	E1								
L3900	Hinge extension/flex wrist/f	A								
L3901	Hinge ext/flex wrist finger	A								
L3904	Whfo electric custom fitted	A								
L3905	Who w/nontorsion jnt(s) cf	A								
L3906	Who w/o joints cf	A								
L3908	Who cock-up nonmolde pre ots	A								
L3912	Hfo flexion glove pre ots	A								
L3913	Hfo w/o joints cf	A								
L3915	Who nontorsion jnts pre cst	A								
L3916	Who nontorsion jnts pre ots	A								
L3917	Metacarp fx orthosis pre cst	A								
L3918	Metacarp fx orthosis pre ots	A								
L3919	Ho w/o joints cf	A								
L3921	Hfo w/joint(s) cf	A								
L3923	Hfo without joints pre cst	A								
L3924	Hfo without joints pre ots	A								
L3925	Fo pip dip jnt/sprng pre ots	A								
L3927	Fo pip dip no jt spr pre ots	A								
L3929	Hfo nontorsion jnts pre cst	A								
L3930	Hfo nontorsion jnts pre ots	A								
L3931	Whfo nontorsion joint prefab	A								
L3933	Fo w/o joints cf	A								
L3935	Fo nontorsion joint cf	A								
L3956	Add joint upper ext orthosis	A								
L3960	Sewho airplan desig abdu pos	A								
L3961	Sewho cap design w/o jnts cf	A								
L3962	Sewho erbs palsey design abd	A								
L3967	Sewho airplane w/o jnts cf	A								
L3971	Sewho cap design w/jnt(s) cf	A								
L3973	Sewho airplane w/jnt(s) cf	A								
L3975	Sewhfo cap design w/o jnt cf	A								
L3976	Sewhfo airplane w/o jnts cf	A								
L3977	Sewhfo cap desgn w/jnt(s) cf	A								
L3978	Sewhfo airplane w/jnt(s) cf	A								
L3980	Up ext fx orthos humeral nos	A								
L3981	Ue fx orth shoul cap forearm	A								
L3982	Upper ext fx orthosis rad/ul	A								
L3984	Upper ext fx orthosis wrist	A								
L3995	Sock fracture or equal each	A								
L3999	Upper limb orthosis nos	A								
L4000	Repl girdle milwaukee orth	A								
L4002	"Replace strap, any orthosis"	A								
L4010	Replace trilateral socket br	A								
L4020	Replace quadlat socket brim	A								
L4030	Replace socket brim cust fit	A								
L4040	Replace molded thigh lacer	A								
L4045	Replace non-molded thigh lac	A								
L4050	Replace molded calf lacer	A								
L4055	Replace non-molded calf lace	A								
L4060	Replace high roll cuff	A								
L4070	Replace prox & dist upright	A								
L4080	Repl met band kafo-afo prox	A								
L4090	Repl met band kafo-afo calf/	A								
L4100	Repl leath cuff kafo prox th	A								
L4110	Repl leath cuff kafo-afo cal	A								
L4130	Replace pretibial shell	A								
L4205	Ortho dvc repair per 15 min	A								
L4210	Orth dev repair/repl minor p	A								
L4350	Ankle control ortho pre ots	A								
L4360	Pneumat walking boot pre cst	A								
L4361	Pneuma/vac walk boot pre ots	A								
L4370	Pneum full leg splnt pre ots	A								
L4386	Non-pneum walk boot pre cst	A								
L4387	Non-pneum walk boot pre ots	A								
L4392	Replace afo soft interface	A								
L4394	Replace foot drop spint	A								
L4396	Static or dynami afo pre cst	A								
L4397	Static or dynami afo pre ots	A								
L4398	Foot drop splint pre ots	A								
L4631	"Afo, walk boot type, cus fab"	A								
L5000	Sho insert w arch toe filler	A								
L5010	Mold socket ank hgt w/ toe f	A								
L5020	Tibial tubercle hgt w/ toe f	A								
L5050	Ank symes mold sckt sach ft	A								
L5060	Symes met fr leath socket ar	A								
L5100	Molded socket shin sach foot	A								
L5105	Plast socket jts/thgh lacer	A								
L5150	Mold sckt ext knee shin sach	A								
L5160	Mold socket bent knee shin s	A								
L5200	Kne sing axis fric shin sach	A								
L5210	No knee/ankle joints w/ ft b	A								
L5220	No knee joint with artic ali	A								
L5230	Fem focal defic constant fri	A								
L5250	Hip canad sing axi cons fric	A								
L5270	Tilt table locking hip sing	A								
L5280	Hemipelvect canad sing axis	A								
L5301	Bk mold socket sach ft endo	A								
L5312	"Knee disart, sach ft, endo"	A								
L5321	Ak open end sach	A								
L5331	Hip disart canadian sach ft	A								
L5341	Hemipelvectomy canadian sach	A								
L5400	Postop dress & 1 cast chg bk	A								
L5410	Postop dsg bk ea add cast ch	A								
L5420	Postop dsg & 1 cast chg ak/d	A								
L5430	Postop dsg ak ea add cast ch	A								
L5450	Postop app non-wgt bear dsg	A								
L5460	Postop app non-wgt bear dsg	A								
L5500	Init bk ptb plaster direct	A								
L5505	Init ak ischal plstr direct	A								
L5510	Prep bk ptb plaster molded	A								
L5520	Perp bk ptb thermopls direct	A								
L5530	Prep bk ptb thermopls molded	A								
L5535	Prep bk ptb open end socket	A								
L5540	Prep bk ptb laminated socket	A								
L5560	Prep ak ischial plast molded	A								
L5570	Prep ak ischial direct form	A								
L5580	Prep ak ischial thermo mold	A								
L5585	Prep ak ischial open end	A								
L5590	Prep ak ischial laminated	A								
L5595	Hip disartic sach thermopls	A								
L5600	Hip disart sach laminat mold	A								
L5610	Above knee hydracadence	A								
L5611	Ak 4 bar link w/fric swing	A								
L5613	Ak 4 bar ling w/hydraul swig	A								
L5614	4-bar link above knee w/swng	A								
L5616	Ak univ multiplex sys frict	A								
L5617	Ak/bk self-aligning unit ea	A								
L5618	Test socket symes	A								
L5620	Test socket below knee	A								
L5622	Test socket knee disarticula	A								
L5624	Test socket above knee	A								
L5626	Test socket hip disarticulat	A								
L5628	Test socket hemipelvectomy	A								
L5629	Below knee acrylic socket	A								
L5630	Syme typ expandabl wall sckt	A								
L5631	Ak/knee disartic acrylic soc	A								
L5632	Symes type ptb brim design s	A								
L5634	Symes type poster opening so	A								
L5636	Symes type medial opening so	A								
L5637	Below knee total contact	A								
L5638	Below knee leather socket	A								
L5639	Below knee wood socket	A								
L5640	Knee disarticulat leather so	A								
L5642	Above knee leather socket	A								
L5643	Hip flex inner socket ext fr	A								
L5644	Above knee wood socket	A								
L5645	Bk flex inner socket ext fra	A								
L5646	Below knee cushion socket	A								
L5647	Below knee suction socket	A								
L5648	Above knee cushion socket	A								
L5649	Isch containmt/narrow m-l so	A								
L5650	Tot contact ak/knee disart s	A								
L5651	Ak flex inner socket ext fra	A								
L5652	Suction susp ak/knee disart	A								
L5653	Knee disart expand wall sock	A								
L5654	Socket insert symes	A								
L5655	Socket insert below knee	A								
L5656	Socket insert knee articulat	A								
L5658	Socket insert above knee	A								
L5661	Multi-durometer symes	A								
L5665	Multi-durometer below knee	A								
L5666	Below knee cuff suspension	A								
L5668	Bk molded distal cushion	A								
L5670	Bk molded supracondylar susp	A								
L5671	Bk/ak locking mechanism	A								
L5672	Bk removable medial brim sus	A								
L5673	Socket insert w lock mech	A								
L5676	Bk knee joints single axis p	A								
L5677	Bk knee joints polycentric p	A								
L5678	Bk joint covers pair	A								
L5679	Socket insert w/o lock mech	A								
L5680	Bk thigh lacer non-molded	A								
L5681	Intl custm cong/latyp insert	A								
L5682	Bk thigh lacer glut/ischia m	A								
L5683	Initial custom socket insert	A								
L5684	Bk fork strap	A								
L5685	Below knee sus/seal sleeve	A								
L5686	Bk back check	A								
L5688	Bk waist belt webbing	A								
L5690	Bk waist belt padded and lin	A								
L5692	Ak pelvic control belt light	A								
L5694	Ak pelvic control belt pad/l	A								
L5695	Ak sleeve susp neoprene/equa	A								
L5696	Ak/knee disartic pelvic join	A								
L5697	Ak/knee disartic pelvic band	A								
L5698	Ak/knee disartic silesian ba	A								
L5699	Shoulder harness	A								
L5700	Replace socket below knee	A								
L5701	Replace socket above knee	A								
L5702	Replace socket hip	A								
L5703	Symes ankle w/o (sach) foot	A								
L5704	Custom shape cover bk	A								
L5705	Custom shape cover ak	A								
L5706	Custom shape cvr knee disart	A								
L5707	Custom shape cvr hip disart	A								
L5710	Kne-shin exo sng axi mnl loc	A								
L5711	Knee-shin exo mnl lock ultra	A								
L5712	Knee-shin exo frict swg & st	A								
L5714	Knee-shin exo variable frict	A								
L5716	Knee-shin exo mech stance ph	A								
L5718	Knee-shin exo frct swg & sta	A								
L5722	Knee-shin pneum swg frct exo	A								
L5724	Knee-shin exo fluid swing ph	A								
L5726	Knee-shin ext jnts fld swg e	A								
L5728	Knee-shin fluid swg & stance	A								
L5780	Knee-shin pneum/hydra pneum	A								
L5781	Lower limb pros vacuum pump	A								
L5782	Hd low limb pros vacuum pump	A								
L5785	Exoskeletal bk ultralt mater	A								
L5790	Exoskeletal ak ultra-light m	A								
L5795	Exoskel hip ultra-light mate	A								
L5810	Endoskel knee-shin mnl lock	A								
L5811	Endo knee-shin mnl lck ultra	A								
L5812	Endo knee-shin frct swg & st	A								
L5814	Endo knee-shin hydral swg ph	A								
L5816	Endo knee-shin polyc mch sta	A								
L5818	Endo knee-shin frct swg & st	A								
L5822	Endo knee-shin pneum swg frc	A								
L5824	Endo knee-shin fluid swing p	A								
L5826	Miniature knee joint	A								
L5828	Endo knee-shin fluid swg/sta	A								
L5830	Endo knee-shin pneum/swg pha	A								
L5840	Multi-axial knee/shin system	A								
L5845	Knee-shin sys stance flexion	A								
L5848	Knee-shin sys hydraul stance	A								
L5850	Endo ak/hip knee extens assi	A								
L5855	Mech hip extension assist	A								
L5856	Elec knee-shin swing/stance	A								
L5857	Elec knee-shin swing only	A								
L5858	Stance phase only	A								
L5859	Knee-shin pro flex/ext cont	A								
L5910	Endo below knee alignable sy	A								
L5920	Endo ak/hip alignable system	A								
L5925	Above knee manual lock	A								
L5930	High activity knee frame	A								
L5940	Endo bk ultra-light material	A								
L5950	Endo ak ultra-light material	A								
L5960	Endo hip ultra-light materia	A								
L5961	"Endo poly hip, pneu/hyd/rot"	A								
L5962	Below knee flex cover system	A								
L5964	Above knee flex cover system	A								
L5966	Hip flexible cover system	A								
L5968	Multiaxial ankle w dorsiflex	A								
L5969	Ak/ft power asst incl motors	A								
L5970	Foot external keel sach foot	A								
L5971	"Sach foot, replacement"	A								
L5972	Flexible keel foot	A								
L5973	Ank-foot sys dors-plant flex	A								
L5974	Foot single axis ankle/foot	A								
L5975	Combo ankle/foot prosthesis	A								
L5976	Energy storing foot	A								
L5978	Ft prosth multiaxial ankl/ft	A								
L5979	Multi-axial ankle/ft prosth	A								
L5980	Flex foot system	A								
L5981	Flex-walk sys low ext prosth	A								
L5982	Exoskeletal axial rotation u	A								
L5984	Endoskeletal axial rotation	A								
L5985	Lwr ext dynamic prosth pylon	A								
L5986	Multi-axial rotation unit	A								
L5987	Shank ft w vert load pylon	A								
L5988	Vertical shock reducing pylo	A								
L5990	User adjustable heel height	A								
L5999	Lowr extremity prosthes nos	A								
L6000	Part hand thumb rem	A								
L6010	Part hand little/ring	A								
L6020	Part hand no fingers	A								
L6026	Part hand myo exclu term dev	A								
L6050	Wrst mld sck flx hng tri pad	A								
L6055	Wrst mold sock w/exp interfa	A								
L6100	Elb mold sock flex hinge pad	A								
L6110	Elbow mold sock suspension t	A								
L6120	Elbow mold doub splt soc ste	A								
L6130	Elbow stump activated lock h	A								
L6200	Elbow mold outsid lock hinge	A								
L6205	Elbow molded w/ expand inter	A								
L6250	Elbow inter loc elbow forarm	A								
L6300	Shlder disart int lock elbow	A								
L6310	Shoulder passive restor comp	A								
L6320	Shoulder passive restor cap	A								
L6350	Thoracic intern lock elbow	A								
L6360	Thoracic passive restor comp	A								
L6370	Thoracic passive restor cap	A								
L6380	Postop dsg cast chg wrst/elb	A								
L6382	Postop dsg cast chg elb dis/	A								
L6384	Postop dsg cast chg shlder/t	A								
L6386	Postop ea cast chg & realign	A								
L6388	Postop applicat rigid dsg on	A								
L6400	Below elbow prosth tiss shap	A								
L6450	Elb disart prosth tiss shap	A								
L6500	Above elbow prosth tiss shap	A								
L6550	Shldr disar prosth tiss shap	A								
L6570	Scap thorac prosth tiss shap	A								
L6580	Wrist/elbow bowden cable mol	A								
L6582	Wrist/elbow bowden cbl dir f	A								
L6584	Elbow fair lead cable molded	A								
L6586	Elbow fair lead cable dir fo	A								
L6588	Shdr fair lead cable molded	A								
L6590	Shdr fair lead cable direct	A								
L6600	Polycentric hinge pair	A								
L6605	Single pivot hinge pair	A								
L6610	Flexible metal hinge pair	A								
L6611	"Additional switch, ext power"	A								
L6615	Disconnect locking wrist uni	A								
L6616	Disconnect insert locking wr	A								
L6620	Flexion/extension wrist unit	A								
L6621	Flex/ext wrist w/wo friction	A								
L6623	Spring-ass rot wrst w/ latch	A								
L6624	Flex/ext/rotation wrist unit	A								
L6625	Rotation wrst w/ cable lock	A								
L6628	Quick disconn hook adapter o	A								
L6629	Lamination collar w/ couplin	A								
L6630	Stainless steel any wrist	A								
L6632	Latex suspension sleeve each	A								
L6635	Lift assist for elbow	A								
L6637	Nudge control elbow lock	A								
L6638	Elec lock on manual pw elbow	A								
L6640	Shoulder abduction joint pai	A								
L6641	Excursion amplifier pulley t	A								
L6642	Excursion amplifier lever ty	A								
L6645	Shoulder flexion-abduction j	A								
L6646	Multipo locking shoulder jnt	A								
L6647	Shoulder lock actuator	A								
L6648	Ext pwrd shlder lock/unlock	A								
L6650	Shoulder universal joint	A								
L6655	Standard control cable extra	A								
L6660	Heavy duty control cable	A								
L6665	Teflon or equal cable lining	A								
L6670	Hook to hand cable adapter	A								
L6672	Harness chest/shlder saddle	A								
L6675	Harness figure of 8 sing con	A								
L6676	Harness figure of 8 dual con	A								
L6677	Ue triple control harness	A								
L6680	Test sock wrist disart/bel e	A								
L6682	Test sock elbw disart/above	A								
L6684	Test socket shldr disart/tho	A								
L6686	Suction socket	A								
L6687	Frame typ socket bel elbow/w	A								
L6688	Frame typ sock above elb/dis	A								
L6689	Frame typ socket shoulder di	A								
L6690	Frame typ sock interscap-tho	A								
L6691	Removable insert each	A								
L6692	Silicone gel insert or equal	A								
L6693	Lockingelbow forearm cntrbal	A								
L6694	Elbow socket ins use w/lock	A								
L6695	Elbow socket ins use w/o lck	A								
L6696	Cus elbo skt in for con/atyp	A								
L6697	Cus elbo skt in not con/atyp	A								
L6698	Below/above elbow lock mech	A								
L6703	"Term dev, passive hand mitt"	A								
L6704	"Term dev, sport/rec/work att"	A								
L6706	Term dev mech hook vol open	A								
L6707	Term dev mech hook vol close	A								
L6708	Term dev mech hand vol open	A								
L6709	Term dev mech hand vol close	A								
L6711	"Ped term dev, hook, vol open"	A								
L6712	"Ped term dev, hook, vol clos"	A								
L6713	"Ped term dev, hand, vol open"	A								
L6714	"Ped term dev, hand, vol clos"	A								
L6715	"Term device, multi art digit"	A								
L6721	"Hook/hand, hvy dty, vol open"	A								
L6722	"Hook/hand, hvy dty, vol clos"	A								
L6805	Term dev modifier wrist unit	A								
L6810	Term dev precision pinch dev	A								
L6880	Elec hand ind art digits	A								
L6881	Term dev auto grasp feature	A								
L6882	Microprocessor control uplmb	A								
L6883	Replc sockt below e/w disa	A								
L6884	Replc sockt above elbow disa	A								
L6885	Replc sockt shldr dis/interc	A								
L6890	Prefab glove for term device	A								
L6895	Custom glove for term device	A								
L6900	Hand restorat thumb/1 finger	A								
L6905	Hand restoration multiple fi	A								
L6910	Hand restoration no fingers	A								
L6915	Hand restoration replacmnt g	A								
L6920	Wrist disarticul switch ctrl	A								
L6925	Wrist disart myoelectronic c	A								
L6930	Below elbow switch control	A								
L6935	Below elbow myoelectronic ct	A								
L6940	Elbow disarticulation switch	A								
L6945	Elbow disart myoelectronic c	A								
L6950	Above elbow switch control	A								
L6955	Above elbow myoelectronic ct	A								
L6960	Shldr disartic switch contro	A								
L6965	Shldr disartic myoelectronic	A								
L6970	Interscapular-thor switch ct	A								
L6975	Interscap-thor myoelectronic	A								
L7007	Adult electric hand	A								
L7008	Pediatric electric hand	A								
L7009	Adult electric hook	A								
L7040	Prehensile actuator	A								
L7045	Pediatric electric hook	A								
L7170	Electronic elbow hosmer swit	A								
L7180	Electronic elbow sequential	A								
L7181	Electronic elbo simultaneous	A								
L7185	Electron elbow adolescent sw	A								
L7186	Electron elbow child switch	A								
L7190	Elbow adolescent myoelectron	A								
L7191	Elbow child myoelectronic ct	A								
L7259	Electronic wrist rotator any	A								
L7360	Six volt bat otto bock/eq ea	A								
L7362	Battery chrgr six volt otto	A								
L7364	Twelve volt battery utah/equ	A								
L7366	Battery chrgr 12 volt utah/e	A								
L7367	Replacemnt lithium ionbatter	A								
L7368	Lithium ion battery charger	A								
L7400	"Add ue prost be/wd, ultlite"	A								
L7401	Add ue prost a/e ultlite mat	A								
L7402	Add ue prost s/d ultlite mat	A								
L7403	Add ue prost b/e acrylic	A								
L7404	Add ue prost a/e acrylic	A								
L7405	Add ue prost s/d acrylic	A								
L7499	Upper extremity prosthes nos	A								
L7510	Prosthetic device repair rep	A								
L7520	Repair prosthesis per 15 min	A								
L7600	Prosthetic donning sleeve	E1								
L7700	Pros soc insert gasket/seal	A								
L7900	Male vacuum erection system	E1								
L7902	"Tension ring, vac erect dev"	E1								
L8000	Mastectomy bra	A								
L8001	Breast prosthesis bra & form	A								
L8002	Brst prsth bra & bilat form	A								
L8010	Mastectomy sleeve	A								
L8015	Ext breastprosthesis garment	A								
L8020	Mastectomy form	A								
L8030	Breast prosthes w/o adhesive	A								
L8031	Breast prosthesis w adhesive	A								
L8032	Reusable nipple prosthesis	A								
L8033	"Nipple prosthesis custom, ea"	A								
L8035	Custom breast prosthesis	A								
L8039	Breast prosthesis nos	A								
L8040	Nasal prosthesis	A								
L8041	Midfacial prosthesis	A								
L8042	Orbital prosthesis	A								
L8043	Upper facial prosthesis	A								
L8044	Hemi-facial prosthesis	A								
L8045	Auricular prosthesis	A								
L8046	Partial facial prosthesis	A								
L8047	Nasal septal prosthesis	A								
L8048	Unspec maxillofacial prosth	A								
L8049	Repair maxillofacial prosth	A								
L8300	Truss single w/ standard pad	A								
L8310	Truss double w/ standard pad	A								
L8320	Truss addition to std pad wa	A								
L8330	Truss add to std pad scrotal	A								
L8400	Sheath below knee	A								
L8410	Sheath above knee	A								
L8415	Sheath upper limb	A								
L8417	Pros sheath/sock w gel cushn	A								
L8420	Prosthetic sock multi ply bk	A								
L8430	Prosthetic sock multi ply ak	A								
L8435	Pros sock multi ply upper lm	A								
L8440	Shrinker below knee	A								
L8460	Shrinker above knee	A								
L8465	Shrinker upper limb	A								
L8470	Pros sock single ply bk	A								
L8480	Pros sock single ply ak	A								
L8485	Pros sock single ply upper l	A								
L8499	Unlisted misc prosthetic ser	A								
L8500	Artificial larynx	A								
L8501	Tracheostomy speaking valve	A								
L8505	"Artificial larynx, accessory"	A								
L8507	Trach-esoph voice pros pt in	A								
L8509	Trach-esoph voice pros md in	A								
L8510	Voice amplifier	A								
L8511	Indwelling trach insert	A								
L8512	Gel cap for trach voice pros	A								
L8513	Trach pros cleaning device	A								
L8514	Repl trach puncture dilator	A								
L8515	Gel cap app device for trach	A								
L8600	Implant breast silicone/eq	N								
L8603	Collagen imp urinary 2.5 ml	N								
L8604	Dextranomer/hyaluronic acid	N								
L8605	Inj bulking agent anal canal	N								
L8606	Synthetic implnt urinary 1ml	N								
L8607	Inj vocal cord bulking agent	N								
L8608	Arg ii ext com/sup/acc misc	N								
L8609	Artificial cornea	N								
L8610	Ocular implant	N								
L8612	Aqueous shunt prosthesis	N								
L8613	Ossicular implant	N								
L8614	Cochlear device	N								
L8615	Coch implant headset replace	A								
L8616	Coch implant microphone repl	A								
L8617	Coch implant trans coil repl	A								
L8618	Coch implant tran cable repl	A								
L8619	Coch imp ext proc/contr rplc	A								
L8621	Repl zinc air battery	A								
L8622	Repl alkaline battery	A								
L8623	"Lith ion batt cid,non-earlvl"	A								
L8624	"Lith ion batt cid, ear level"	A								
L8625	Charger coch impl/aoi battry	A								
L8627	Cid ext speech process repl	A								
L8628	Cid ext controller repl	A								
L8629	Cid transmit coil and cable	A								
L8630	Metacarpophalangeal implant	N								
L8631	Mcp joint repl 2 pc or more	N								
L8641	Metatarsal joint implant	N								
L8642	Hallux implant	N								
L8658	Interphalangeal joint spacer	N								
L8659	Interphalangeal joint repl	N								
L8670	"Vascular graft, synthetic"	N								
L8679	Imp neurosti pls gn any type	N								
L8680	Implt neurostim elctr each	E1								
L8681	Pt prgrm for implt neurostim	A								
L8682	Implt neurostim radiofq rec	N								
L8683	Radiofq trsmtr for implt neu	A								
L8684	Radiof trsmtr implt scrl neu	A								
L8685	Implt nrostm pls gen sng rec	E1								
L8686	Implt nrostm pls gen sng non	E1								
L8687	Implt nrostm pls gen dua rec	E1								
L8688	Implt nrostm pls gen dua non	E1								
L8689	External recharg sys intern	A								
L8690	"Aud osseo dev, int/ext comp"	N								
L8691	Aoi snd proc repl excl actua	A								
L8692	Non-osseointegrated snd proc	E1								
L8693	"Aud osseo dev, abutment"	A								
L8694	Aoi transducer/actuator repl	A								
L8695	External recharg sys extern	A								
L8696	Ext antenna phren nerve stim	A								
L8698	Misc used with tot art heart	A								
L8699	Prosthetic implant nos	N								
L8701	Ewh s/d uprt micro sensor	A								
L8702	Ewhf s/d uprt micro sensor	A								
L9900	O&p supply/accessory/service	N								
M0075	Cellular therapy	E1								
M0076	Prolotherapy	E1								
M0100	Intragastric hypothermia	E1								
M0300	Iv chelationtherapy	E1								
M0301	Fabric wrapping of aneurysm	E1								
M1003	Tb scr 12 mo pri fst bio dz	M								
M1004	Doc med rsn no srn tb	M								
M1005	Tb scr no perf	M								
M1006	"Dz not ases, no rsn"	M								
M1007	>=50% total pt outpt ra enct	M								
M1008	<50% total pt outpt ra encts	M								
M1009	Dc eoc doc med rec	M								
M1010	Dc eoc doc med rec	M								
M1011	Dc eoc doc med rec	M								
M1012	Dc eoc doc med rec	M								
M1013	Dc eoc doc med rec	M								
M1014	Dc epi care doc medrec	M								
M1015	Dc eoc doc med rec	M								
M1016	Pt dx meop or sur steri	M								
M1017	Pt admt to palitve serv	M								
M1018	Pt dx hst cr pt sk lg cr scr	M								
M1019	Adl pt mj dep ds rs 12 phq<5	M								
M1020	Adl pt mj dep ds no rs 12 mo 	M								
M1021	Pt uc in pp	M								
M1022	Pt hospice during perf pd	M								
M1023	Adl pt mj dep ds rs 6 phq<5	M								
M1024	Adl pt mj dep ds no rs 6 mo	M								
M1025	Pt hospice during perf pd	M								
M1026	Pt hospice during perf pd	M								
M1027	Img head (ct or mri) obtnd	M								
M1028	Doc of pt prm hda dx and otr	M								
M1029	Doc sysm rsn img hd	M								
M1031	Pt clin ind img hd	M								
M1032	Adt tkng pharmthry for oud	M								
M1033	Pharmthry for oud afr 6.30	M								
M1034	Adt 180 dys pharmthry oud	M								
M1035	Adt pd out mat pr 180 dys tx	M								
M1036	Adt no 180 dys pharmthry oud	M								
M1037	Pt dx lum sp reg cacr	M								
M1038	Pt dx lum sp reg fract	M								
M1039	Pt dx lum sp reg inf	M								
M1040	Pt dx lum idi or cong scol	M								
M1041	Pt cr ft inf lm or pt id sl	M								
M1043	Fs no odi 9-15mo	M								
M1045	Fs oks 9-15mo = 37	M								
M1046	Fs oks 9-15mo = 37	M								
M1049	Fs wth scr no odi pre and p	M								
M1051	Pt w/cancer scoliosis	M								
M1052	Lg pn not meas w/ vas 1yr po	M								
M1054	Pt uc in pp	M								
M1055	Aspirin used	M								
M1056	Presc antico med in pp	M								
M1057	"Aspirin not used, no rsn"	M								
M1058	Pt prm nurs hm res in pp	M								
M1059	Pt no prm nurs hm res in pp	M								
M1060	Pt died in pp	M								
M1061	Pt preg	M								
M1062	Pt imcomprmd	M								
M1063	Pt rec hg dos imsup thpy	M								
M1064	Shing vac doc adm or pv rec	M								
M1065	Shing vac no adm clinc rsn	M								
M1066	Shing vac no doc no rsn	M								
M1067	Hspc pt prv time meam per	M								
M1068	Pt not ambulatory 	M								
M1069	Pt scr ft fall rsk	M								
M1070	Pt not scrn fut fall no rsn	M								
M1071	Pt had add'l sp pcr perf	M								
M1106	Start eoc doc med rec	M								
M1107	Docu dx degen neuro 	M								
M1108	Oc ni pt 1-2 vis	M								
M1109	Oc ni pt dc 1-2 vis	M								
M1110	Oc ni pt selfdc 1-2 vis	M								
M1111	Start eoc doc med rec	M								
M1112	Docu dx degen neuro 	M								
M1113	Oc ni pt 1-2 vis	M								
M1114	Oc ni pt dc 1-2 vis	M								
M1115	Oc ni pt selfdc 1-2 vis	M								
M1116	Start eoc doc med rec	M								
M1117	Docu dx degen neuro 	M								
M1118	Oc ni pt 1-2 vis	M								
M1119	Oc ni pt dc 1-2 vis	M								
M1120	Oc ni pt selfdc 1-2 vis	M								
M1121	Start eoc doc med rec	M								
M1122	Docu dx degen neuro 	M								
M1123	Oc ni pt 1-2 vis	M								
M1124	Oc ni pt dc 1-2 vis	M								
M1125	Oc ni pt selfdc 1-2 vis	M								
M1126	Start eoc doc med rec	M								
M1127	Docu dx degen neuro 	M								
M1128	Oc ni pt 1-2 vis	M								
M1129	Oc ni pt dc 1-2 vis	M								
M1130	Oc ni pt self dc 1-2 vis	M								
M1131	Docu dx degen neuro 	M								
M1132	Oc ni pt 1-2 vis	M								
M1133	Oc ni pt dc 1-2 vis	M								
M1134	Oc ni pt self dc 1-2 vis	M								
M1135	Start eoc doc med rec	M								
M1136	Start eoc doc med rec	M								
M1137	Docu dx degen neuro 	M								
M1138	Oc ni pt 1-2 vis	M								
M1139	Oc ni pt self dc 1-2 vis	M								
M1140	Oc ni pt dc 1-2 vis	M								
M1141	Fs no oks	M								
M1142	Emerge cases	M								
M1143	Ni rehab med chiro	M								
M1144	Oc no ind pt 1-2 vis	M								
P2028	Cephalin floculation test	A								
P2029	Congo red blood test	A								
P2031	Hair analysis	E1								
P2033	Blood thymol turbidity	A								
P2038	Blood mucoprotein	A								
P3000	Screen pap by tech w md supv	A								
P3001	Screening pap smear by phys	B								
P7001	Culture bacterial urine	E1								
P9010	Whole blood for transfusion	R	9510	1.5744	$127.20	.	$25.44			
P9011	Blood split unit	R	9520	1.6645	$134.48	.	$26.90			
P9012	Cryoprecipitate each unit	R	9511	0.6243	$50.44	.	$10.09			
P9016	Rbc leukocytes reduced	R	9512	2.3313	$188.35	.	$37.67			
P9017	Plasma 1 donor frz w/in 8 hr	R	9508	1.0366	$83.75	.	$16.75			
P9019	"Platelets, each unit"	R	9515	1.3372	$108.04	.	$21.61			
P9020	Plaelet rich plasma unit	R	9516	1.7481	$141.23	.	$28.25			
P9021	Red blood cells unit	R	9517	1.7299	$139.76	.	$27.96			
P9022	Washed red blood cells unit	R	9518	4.7000	$379.73	.	$75.95			
P9023	"Frozen plasma, pooled, sd"	R	9509	0.9919	$80.14	.	$16.03			
P9031	Platelets leukocytes reduced	R	9526	1.5639	$126.35	.	$25.27			
P9032	"Platelets, irradiated"	R	9500	1.7285	$139.65	.	$27.93			
P9033	Platelets leukoreduced irrad	R	9521	2.6874	$217.12	.	$43.43			
P9034	"Platelets, pheresis"	R	9507	4.0105	$324.02	.	$64.81			
P9035	Platelet pheres leukoreduced	R	9501	6.1838	$499.61	.	$99.93			
P9036	Platelet pheresis irradiated	R	9502	8.5698	$692.38	.	$138.48			
P9037	Plate pheres leukoredu irrad	R	9530	7.8558	$634.69	.	$126.94			
P9038	Rbc irradiated	R	9505	2.3618	$190.82	.	$38.17			
P9039	Rbc deglycerolized	R	9504	3.9664	$320.46	.	$64.10			
P9040	Rbc leukoreduced irradiated	R	9522	3.2523	$262.76	.	$52.56			
P9041	"Albumin (human),5%, 50ml"	K	0961		$10.490	.	$2.10		*	
P9043	"Plasma protein fract,5%,50ml"	R	9514	0.2281	$18.43	.	$3.69			
P9044	Cryoprecipitatereducedplasma	R	9523	1.1314	$91.41	.	$18.29			
P9045	"Albumin (human), 5%, 250 ml"	K	0963		$52.450	.	$10.49		*	
P9046	"Albumin (human), 25%, 20 ml"	K	0964		$20.980	.	$4.20		*	
P9047	"Albumin (human), 25%, 50ml"	K	0965		$52.450	.	$10.49		*	
P9048	"Plasmaprotein fract,5%,250ml"	R	9519	1.3825	$111.70	.	$22.34			
P9050	"Granulocytes, pheresis unit"	E2								
P9051	"Blood, l/r, cmv-neg"	R	9524	2.3283	$188.11	.	$37.63			
P9052	"Platelets, hla-m, l/r, unit"	R	9525	10.5754	$854.42	.	$170.89			
P9053	"Plt, pher, l/r cmv-neg, irr"	R	9531	6.2164	$502.24	.	$100.45			
P9054	"Blood, l/r, froz/degly/wash"	R	9527	3.4793	$281.10	.	$56.22			
P9055	"Plt, aph/pher, l/r, cmv-neg"	R	9528	6.0051	$485.17	.	$97.04			
P9056	"Blood, l/r, irradiated"	R	9529	2.5167	$203.33	.	$40.67			
P9057	"Rbc, frz/deg/wsh, l/r, irrad"	R	9532	2.9909	$241.64	.	$48.33			
P9058	"Rbc, l/r, cmv-neg, irrad"	R	9533	3.0548	$246.81	.	$49.37			
P9059	"Plasma, frz between 8-24hour"	R	9513	0.9396	$75.91	.	$15.19			
P9060	Fr frz plasma donor retested	R	9503	0.6187	$49.99	.	$10.00			
P9070	Pathogen reduced plasma pool	R	9534	0.3998	$32.30	.	$6.46			
P9071	Pathogen reduced plasma sing	R	9535	0.9915	$80.11	.	$16.03			
P9073	Platelets pheresis path redu	R	9536	7.5750	$612.01	.	$122.41			
P9099	Blood component/product noc	E2								
P9100	Pathogen test for platelets	S	1494		$35.50	.	$7.10			
P9603	One-way allow prorated miles	A								
P9604	One-way allow prorated trip	A								
P9612	Catheterize for urine spec	A								
P9615	Urine specimen collect mult	N								
Q0035	Cardiokymography	Q1	5732	0.4138	$33.43	.	$6.69			
Q0081	Infusion ther other than che	B								
Q0083	Chemo by other than infusion	B								
Q0084	Chemotherapy by infusion	B								
Q0085	Chemo by both infusion and o	B								
Q0091	Obtaining screen pap smear	S	5731	0.2845	$22.99	$0.00	$0.00			
Q0092	Set up port xray equipment	N								
Q0111	Wet mounts/ w preparations	A								
Q0112	Potassium hydroxide preps	A								
Q0113	Pinworm examinations	A								
Q0114	Fern test	A								
Q0115	Post-coital mucous exam	A								
Q0138	"Ferumoxytol, non-esrd"	K	1297		$0.983	.	$0.20		*	
Q0139	"Ferumoxytol, esrd use"	K	1485		$0.983	.	$0.20		*	
Q0144	"Azithromycin dihydrate, oral"	E1								
Q0161	Chlorpromazine hcl 5mg oral	N								
Q0162	Ondansetron oral	N								
Q0163	Diphenhydramine hcl 50mg	N								
Q0164	Prochlorperazine maleate 5mg	N								
Q0166	Granisetron hcl 1 mg oral	N								
Q0167	Dronabinol 2.5mg oral	N								
Q0169	Promethazine hcl 12.5mg oral	N								
Q0173	Trimethobenzamide hcl 250mg	N								
Q0174	Thiethylperazine maleate10mg	E2								
Q0175	Perphenazine 4mg oral	N								
Q0177	Hydroxyzine pamoate 25mg	N								
Q0180	Dolasetron mesylate oral	N								
Q0181	Unspecified oral anti-emetic	N								
Q0477	Pwr module pt cable lvad rpl	A								
Q0478	"Power adapter, combo vad"	A								
Q0479	"Power module combo vad, rep"	A								
Q0480	"Driver pneumatic vad, rep"	A								
Q0481	"Microprcsr cu elec vad, rep"	A								
Q0482	"Microprcsr cu combo vad, rep"	A								
Q0483	"Monitor elec vad, rep"	A								
Q0484	Monitor elec or comb vad rep	A								
Q0485	"Monitor cable elec vad, rep"	A								
Q0486	Mon cable elec/pneum vad rep	A								
Q0487	"Leads any type vad, rep only"	A								
Q0488	"Pwr pack base elec vad, rep"	A								
Q0489	"Pwr pck base combo vad, rep"	A								
Q0490	"Emr pwr source elec vad, rep"	A								
Q0491	Emr pwr source combo vad rep	A								
Q0492	"Emr pwr cbl elec vad, rep"	A								
Q0493	"Emr pwr cbl combo vad, rep"	A								
Q0494	"Emr hd pmp elec/combo, rep"	A								
Q0495	"Charger elec/combo vad, rep"	A								
Q0496	"Battery elec/combo vad, rep"	A								
Q0497	"Bat clps elec/comb vad, rep"	A								
Q0498	"Holster elec/combo vad, rep"	A								
Q0499	Belt/vest elec/combo vad rep	A								
Q0500	"Filters elec/combo vad, rep"	A								
Q0501	"Shwr cov elec/combo vad, rep"	A								
Q0502	"Mobility cart pneum vad, rep"	A								
Q0503	Battery pneum vad replacemnt	A								
Q0504	"Pwr adpt pneum vad, rep veh"	A								
Q0506	Lith-ion batt elec/pneum vad	A								
Q0507	Misc sup/acc ext vad	A								
Q0508	Mis sup/acc imp vad	A								
Q0509	Mis sup/ac imp vad nopay med	A								
Q0510	Dispens fee immunosupressive	B								
Q0511	"Sup fee antiem,antica,immuno"	B								
Q0512	Px sup fee anti-can sub pres	B								
Q0513	Disp fee inhal drugs/30 days	B								
Q0514	Disp fee inhal drugs/90 days	B								
Q0515	Sermorelin acetate injection	E2								
Q1004	Ntiol category 4	E1								
Q1005	Ntiol category 5	E1								
Q2004	Bladder calculi irrig sol	N								
Q2009	Fosphenytoin inj pe	K	9321		$1.613	.	$0.33		*	
Q2017	"Teniposide, 50 mg"	K	7035		"$2,645.707"	.	$529.15		*	
Q2026	Radiesse injection	K	9094		$222.090	.	$44.42		*	
Q2028	"Inj, sculptra, 0.5mg"	K	9095		$3.190	.	$0.64		*	
Q2034	Agriflu vaccine	L								
Q2035	"Afluria vacc, 3 yrs & >, im"	L								
Q2036	"Flulaval vacc, 3 yrs & >, im"	L								
Q2037	"Fluvirin vacc, 3 yrs & >, im"	L								
Q2038	"Fluzone vacc, 3 yrs & >, im"	L								
Q2039	"Influenza virus vaccine, nos"	L								
Q2041	Axicabtagene ciloleucel car+ 	G	9035		"$395,380.000"	.	"$79,076.00"	*	*	
Q2042	Tisagenlecleucel car-pos t	G	9194		"$429,813.310"	.	"$85,962.67"	*	*	
Q2043	Sipuleucel-t auto cd54+	K	9273		"$49,671.772"	.	"$9,934.36"	*	*	
Q2049	Imported lipodox inj	K	1421		$482.060	.	$96.42		*	
Q2050	Doxorubicin inj 10mg	K	7046		$315.731	.	$63.15		*	
Q2052	"Ivig demo, services/supplies"	E1								
Q3001	Brachytherapy radioelements	B								
Q3014	Telehealth facility fee	A								
Q3027	Inj beta interferon im 1 mcg	K	1472		$54.322	.	$10.87		*	
Q3028	Inj beta interferon sq 1 mcg	E1								
Q3031	Collagen skin test	N								
Q4001	Cast sup body cast plaster	B								
Q4002	Cast sup body cast fiberglas	B								
Q4003	Cast sup shoulder cast plstr	B								
Q4004	Cast sup shoulder cast fbrgl	B								
Q4005	Cast sup long arm adult plst	B								
Q4006	Cast sup long arm adult fbrg	B								
Q4007	Cast sup long arm ped plster	B								
Q4008	Cast sup long arm ped fbrgls	B								
Q4009	Cast sup sht arm adult plstr	B								
Q4010	Cast sup sht arm adult fbrgl	B								
Q4011	Cast sup sht arm ped plaster	B								
Q4012	Cast sup sht arm ped fbrglas	B								
Q4013	Cast sup gauntlet plaster	B								
Q4014	Cast sup gauntlet fiberglass	B								
Q4015	Cast sup gauntlet ped plster	B								
Q4016	Cast sup gauntlet ped fbrgls	B								
Q4017	Cast sup lng arm splint plst	B								
Q4018	Cast sup lng arm splint fbrg	B								
Q4019	Cast sup lng arm splnt ped p	B								
Q4020	Cast sup lng arm splnt ped f	B								
Q4021	Cast sup sht arm splint plst	B								
Q4022	Cast sup sht arm splint fbrg	B								
Q4023	Cast sup sht arm splnt ped p	B								
Q4024	Cast sup sht arm splnt ped f	B								
Q4025	Cast sup hip spica plaster	B								
Q4026	Cast sup hip spica fiberglas	B								
Q4027	Cast sup hip spica ped plstr	B								
Q4028	Cast sup hip spica ped fbrgl	B								
Q4029	Cast sup long leg plaster	B								
Q4030	Cast sup long leg fiberglass	B								
Q4031	Cast sup lng leg ped plaster	B								
Q4032	Cast sup lng leg ped fbrgls	B								
Q4033	Cast sup lng leg cylinder pl	B								
Q4034	Cast sup lng leg cylinder fb	B								
Q4035	Cast sup lngleg cylndr ped p	B								
Q4036	Cast sup lngleg cylndr ped f	B								
Q4037	Cast sup shrt leg plaster	B								
Q4038	Cast sup shrt leg fiberglass	B								
Q4039	Cast sup shrt leg ped plster	B								
Q4040	Cast sup shrt leg ped fbrgls	B								
Q4041	Cast sup lng leg splnt plstr	B								
Q4042	Cast sup lng leg splnt fbrgl	B								
Q4043	Cast sup lng leg splnt ped p	B								
Q4044	Cast sup lng leg splnt ped f	B								
Q4045	Cast sup sht leg splnt plstr	B								
Q4046	Cast sup sht leg splnt fbrgl	B								
Q4047	Cast sup sht leg splnt ped p	B								
Q4048	Cast sup sht leg splnt ped f	B								
Q4049	"Finger splint, static"	B								
Q4050	Cast supplies unlisted	B								
Q4051	Splint supplies misc	B								
Q4074	Iloprost non-comp unit dose	Y								
Q4081	"Epoetin alfa, 100 units esrd"	N								
Q4082	Drug/bio noc part b drug cap	B								
Q4100	"Skin substitute, nos"	N								
Q4101	Apligraf	N								
Q4102	Oasis wound matrix	N								
Q4103	Oasis burn matrix	N								
Q4104	Integra bmwd	N								
Q4105	Integra drt or omnigraft	N								
Q4106	Dermagraft	N								
Q4107	Graftjacket	N								
Q4108	Integra matrix	N								
Q4110	Primatrix	N								
Q4111	Gammagraft	N								
Q4112	Cymetra injectable	N								
Q4113	Graftjacket xpress	N								
Q4114	Integra flowable wound matri	N								
Q4115	Alloskin	N								
Q4116	Alloderm	N								
Q4117	Hyalomatrix	N								
Q4118	Matristem micromatrix	N								
Q4121	Theraskin	N								
Q4122	"Dermacell, awm, porous sq cm"	N								
Q4123	Alloskin	N								
Q4124	Oasis tri-layer wound matrix	N								
Q4125	Arthroflex	N								
Q4126	Memoderm/derma/tranz/integup	N								
Q4127	Talymed	N								
Q4128	Flexhd/allopatchhd/matrixhd	N								
Q4130	Strattice tm	N								
Q4132	"Grafix core, grafixpl core"	N								
Q4133	Grafix stravix prime pl sqcm	N								
Q4134	Hmatrix	N								
Q4135	Mediskin	N								
Q4136	Ezderm	N								
Q4137	Amnioexcel biodexcel 1sq cm	N								
Q4138	"Biodfence dryflex, 1cm"	N								
Q4139	"Amnio or biodmatrix, inj 1cc"	N								
Q4140	Biodfence 1cm	N								
Q4141	"Alloskin ac, 1 cm"	N								
Q4142	Xcm biologic tiss matrix 1cm	N								
Q4143	"Repriza, 1cm"	N								
Q4145	"Epifix, inj, 1mg"	N								
Q4146	"Tensix, 1cm"	N								
Q4147	Architect ecm px fx 1 sq cm	N								
Q4148	Neox neox rt or clarix cord	N								
Q4149	"Excellagen, 0.1 cc"	N								
Q4150	Allowrap ds or dry 1 sq cm	N								
Q4151	"Amnioband, guardian 1 sq cm"	N								
Q4152	Dermapure 1 square cm	N								
Q4153	"Dermavest, plurivest sq cm"	N								
Q4154	Biovance 1 square cm	N								
Q4155	Neoxflo or clarixflo 1 mg	N								
Q4156	Neox 100 or clarix 100	N								
Q4157	Revitalon 1 square cm	N								
Q4158	"Kerecis omega3, per sq cm"	N								
Q4159	Affinity1 square cm	N								
Q4160	Nushield 1 square cm	N								
Q4161	Bio-connekt per square cm	N								
Q4162	"Wndex flw, bioskn flw, 0.5cc"	N								
Q4163	"Woundex, bioskin, per sq cm"	N								
Q4164	"Helicoll, per square cm"	N								
Q4165	"Keramatrix, kerasorb sq cm"	N								
Q4166	"Cytal, per square centimeter"	N								
Q4167	"Truskin, per sq centimeter"	N								
Q4168	"Amnioband, 1 mg"	N								
Q4169	"Artacent wound, per sq cm"	N								
Q4170	"Cygnus, per sq cm"	N								
Q4171	"Interfyl, 1 mg"	N								
Q4173	Palingen or palingen xplus	N								
Q4174	Palingen or promatrx	N								
Q4175	Miroderm	N								
Q4176	"Neopatch or therion, 1 sq cm"	N								
Q4177	"Floweramnioflo, 0.1 cc"	N								
Q4178	"Floweramniopatch, per sq cm"	N								
Q4179	"Flowerderm, per sq cm"	N								
Q4180	"Revita, per sq cm"	N								
Q4181	"Amnio wound, per square cm"	N								
Q4182	"Transcyte, per sq centimeter"	N								
Q4183	"Surgigraft, 1 sq cm"	N								
Q4184	Cellesta or duo per sq cm	N								
Q4185	Cellesta flowab amnion 0.5cc	N								
Q4186	Epifix 1 sq cm	N								
Q4187	Epicord 1 sq cm	N								
Q4188	Amnioarmor 1 sq cm	N								
Q4189	"Artacent ac, 1 mg"	N								
Q4190	Artacent ac 1 sq cm	N								
Q4191	Restorigin 1 sq cm	N								
Q4192	"Restorigin, 1 cc"	N								
Q4193	Coll-e-derm 1 sq cm	N								
Q4194	Novachor 1 sq cm	N								
Q4195	Puraply 1 sq cm	N							*	
Q4196	Puraply am 1 sq cm	N							*	
Q4197	Puraply xt 1 sq cm	N								
Q4198	Genesis amnio membrane 1sqcm	N								
Q4200	Skin te 1 sq cm	N								
Q4201	Matrion 1 sq cm	N								
Q4202	"Keroxx (2.5g/cc), 1cc"	N								
Q4203	"Derma-gide, 1 sq cm"	N								
Q4204	Xwrap 1 sq cm	N								
Q4205	Membrane graft or wrap sq cm	N								
Q4206	Fluid flow or fluid gf 1 cc	N								
Q4208	Novafix per sq cm	N								
Q4209	Surgraft per sq cm	N								
Q4210	Axolotl graf dualgraf sq cm	N								
Q4211	Amnion bio or axobio sq cm	N								
Q4212	"Allogen, per cc"	N								
Q4213	"Ascent, 0.5 mg"	N								
Q4214	Cellesta cord per sq cm	N								
Q4215	"Axolotl ambient, cryo 0.1 mg"	N								
Q4216	Artacent cord per sq cm	N								
Q4217	Woundfix biowound plus xplus	N								
Q4218	Surgicord per sq cm	N								
Q4219	Surgigraft dual per sq cm	N								
Q4220	"Bellacell hd, surederm sq cm"	N								
Q4221	Amniowrap2 per sq cm	N								
Q4222	"Progenamatrix, per sq cm"	N								
Q4226	Myown harv prep proc sq cm	N								
Q4227	Amniocore per sq cm	N								
Q4228	"Bionextpatch, per sq cm"	N								
Q4229	Cogenex amnio memb per sq cm	N								
Q4230	Cogenex flow amnion 0.5 cc	N								
Q4231	"Corplex p, per cc"	N								
Q4232	"Corplex, per sq cm"	N								
Q4233	Surfactor /nudyn per 0.5 cc	N								
Q4234	"Xcellerate, per sq cm"	N								
Q4235	Amniorepair or altiply sq cm	N								
Q4236	Carepatch per sq cm	N								
Q4237	"cryo-cord, per sq cm"	N								
Q4238	"Derm-maxx, per sq cm"	N								
Q4239	Amnio-maxx or lite per sq cm	N								
Q4240	Corecyte topical only 0.5 cc	N								
Q4241	"Polycyte, topical only 0.5cc"	N								
Q4242	"Amniocyte plus, per 0.5 cc"	N								
Q4244	"Procenta, per 200 mg"	N								
Q4245	"Amniotext, per cc"	N								
Q4246	"Coretext or protext, per cc"	N								
Q4247	"Amniotext patch, per sq cm"	N								
Q4248	Dermacyte Amn mem allo sq cm	N								
Q4249	"Amniply, per sq cm"	N							*	
Q4250	AmnioAMP-MP per sq cm	N							*	
Q4254	Novafix dl per sq cm	N							*	
Q4255	"Reguard, topical use per sq"	N							*	
Q5001	Hospice or home hlth in home	B								
Q5002	Hospice/home hlth in asst lv	B								
Q5003	Hospice in lt/non-skilled nf	B								
Q5004	Hospice in snf	B								
Q5005	"Hospice, inpatient hospital"	B								
Q5006	Hospice in hospice facility	B								
Q5007	Hospice in ltch	B								
Q5008	Hospice in inpatient psych	B								
Q5009	"Hospice/home hlth, place nos"	B								
Q5010	Hospice home care in hospice	B								
Q5101	"Injection, zarxio"	K	1822		$0.468	.	$0.10		*	
Q5103	"Injection, inflectra"	K	1847		$43.724	.	$8.75		*	
Q5104	"Injection, renflexis"	G	9036		$44.547	.	$8.91		*	
Q5105	Inj retacrit esrd on dialysi	G	9096		$0.861	.	$0.18		*	
Q5106	Inj retacrit non-esrd use	G	9097		$8.612	.	$1.73		*	
Q5107	Inj mvasi 10 mg	G	9329		$60.939	.	$12.19		*	
Q5108	"Injection, fulphila"	G	9173		$269.041	.	$53.81		*	
Q5109	"Injection, ixifi, 10 mg"	E2								
Q5110	Nivestym	G	9193		$0.621	.	$0.13		*	
Q5111	"Injection, udenyca 0.5 mg"	G	9195		$286.674	.	$57.34		*	
Q5112	Inj ontruzant 10 mg	G	9382		$92.296		$18.46		*	
Q5113	Inj herzuma 10 mg	G	9349		$91.523		$18.31		*	
Q5114	Inj ogivri 10 mg	G	9341		$76.407		$15.29		*	
Q5115	Inj truxima 10 mg	G	9336		$68.799		$13.76		*	
Q5116	"Inj., trazimera, 10 mg"	G	9350		$83.104		$16.63		*	
Q5117	"Inj., kanjinti, 10 mg"	G	9330		$78.723	.	$15.75		*	
Q5118	"Inj., zirabev, 10 mg"	G	9348		$62.235		$12.45		*	
Q5119	"Inj ruxience, 10 mg"	G	9367		$70.900		$14.18		*	
Q5120	Inj pegfilgrastim-bmez 0.5mg	G	9345		$305.552		$61.12		*	
Q5121	"Inj. avsola, 10 mg"	G	9381		$51.50		$10.30		*	
Q9001	VA chaplain assessment	E1							*	
Q9002	VA chaplain counsel individu	E1							*	
Q9003	VA chaplain counsel group	E1							*	
Q9950	Inj sulf hexa lipid microsph	N							*	
Q9951	"Locm >= 400 mg/ml iodine,1ml"	N								
Q9953	"Inj fe-based mr contrast,1ml"	N								
Q9954	"Oral mr contrast, 100 ml"	N								
Q9955	"Inj perflexane lip micros,ml"	N								
Q9956	"Inj octafluoropropane mic,ml"	N								
Q9957	"Inj perflutren lip micros,ml"	N								
Q9958	"Hocm <=149 mg/ml iodine, 1ml"	N								
Q9959	"Hocm 150-199mg/ml iodine,1ml"	N								
Q9960	"Hocm 200-249mg/ml iodine,1ml"	N								
Q9961	"Hocm 250-299mg/ml iodine,1ml"	N								
Q9962	"Hocm 300-349mg/ml iodine,1ml"	N								
Q9963	"Hocm 350-399mg/ml iodine,1ml"	N								
Q9964	"Hocm>= 400mg/ml iodine, 1ml"	N								
Q9965	"Locm 100-199mg/ml iodine,1ml"	N								
Q9966	"Locm 200-299mg/ml iodine,1ml"	N								
Q9967	"Locm 300-399mg/ml iodine,1ml"	N								
Q9968	Visualization adjunct	K	1446		$7.552	.	$1.52		*	
Q9969	Non-heu tc-99m add-on/dose	K	1442		$10.000	.	$2.00			
Q9982	Flutemetamol f18 diagnostic	N							*	
Q9983	Florbetaben f18 diagnostic	N							*	
Q9991	Buprenorph xr 100 mg or less	G	9073		"$1,743.482"	.	$348.70		*	
Q9992	Buprenorphine xr over 100 mg	G	9239		"$1,743.482"	.	$348.70		*	
R0070	Transport portable x-ray	B								
R0075	Transport port x-ray multipl	B								
R0076	Transport portable ekg	B								
U0001	2019 –nCoV diagnostic P	A								
U0002	Covid-19 lab test non-cdc	A								
U0003	Cov-19 amp prb hgh thruput	A								
U0004	Cov-19 test non-cdc hgh thru	A								
V2020	Vision svcs frames purchases	A								
V2025	Eyeglasses delux frames	E1								
V2100	Lens spher single plano 4.00	A								
V2101	Single visn sphere 4.12-7.00	A								
V2102	Singl visn sphere 7.12-20.00	A								
V2103	Spherocylindr 4.00d/12-2.00d	A								
V2104	Spherocylindr 4.00d/2.12-4d	A								
V2105	Spherocylinder 4.00d/4.25-6d	A								
V2106	Spherocylinder 4.00d/>6.00d	A								
V2107	Spherocylinder 4.25d/12-2d	A								
V2108	Spherocylinder 4.25d/2.12-4d	A								
V2109	Spherocylinder 4.25d/4.25-6d	A								
V2110	Spherocylinder 4.25d/over 6d	A								
V2111	Spherocylindr 7.25d/.25-2.25	A								
V2112	Spherocylindr 7.25d/2.25-4d	A								
V2113	Spherocylindr 7.25d/4.25-6d	A								
V2114	Spherocylinder over 12.00d	A								
V2115	Lens lenticular bifocal	A								
V2118	Lens aniseikonic single	A								
V2121	"Lenticular lens, single"	A								
V2199	Lens single vision not oth c	A								
V2200	Lens spher bifoc plano 4.00d	A								
V2201	Lens sphere bifocal 4.12-7.0	A								
V2202	Lens sphere bifocal 7.12-20.	A								
V2203	Lens sphcyl bifocal 4.00d/.1	A								
V2204	Lens sphcy bifocal 4.00d/2.1	A								
V2205	Lens sphcy bifocal 4.00d/4.2	A								
V2206	Lens sphcy bifocal 4.00d/ove	A								
V2207	Lens sphcy bifocal 4.25-7d/.	A								
V2208	Lens sphcy bifocal 4.25-7/2.	A								
V2209	Lens sphcy bifocal 4.25-7/4.	A								
V2210	Lens sphcy bifocal 4.25-7/ov	A								
V2211	Lens sphcy bifo 7.25-12/.25-	A								
V2212	Lens sphcyl bifo 7.25-12/2.2	A								
V2213	Lens sphcyl bifo 7.25-12/4.2	A								
V2214	Lens sphcyl bifocal over 12.	A								
V2215	Lens lenticular bifocal	A								
V2218	Lens aniseikonic bifocal	A								
V2219	Lens bifocal seg width over	A								
V2220	Lens bifocal add over 3.25d	A								
V2221	"Lenticular lens, bifocal"	A								
V2299	Lens bifocal speciality	A								
V2300	Lens sphere trifocal 4.00d	A								
V2301	Lens sphere trifocal 4.12-7.	A								
V2302	Lens sphere trifocal 7.12-20	A								
V2303	Lens sphcy trifocal 4.0/.12-	A								
V2304	Lens sphcy trifocal 4.0/2.25	A								
V2305	Lens sphcy trifocal 4.0/4.25	A								
V2306	Lens sphcyl trifocal 4.00/>6	A								
V2307	Lens sphcy trifocal 4.25-7/.	A								
V2308	Lens sphc trifocal 4.25-7/2.	A								
V2309	Lens sphc trifocal 4.25-7/4.	A								
V2310	Lens sphc trifocal 4.25-7/>6	A								
V2311	Lens sphc trifo 7.25-12/.25-	A								
V2312	Lens sphc trifo 7.25-12/2.25	A								
V2313	Lens sphc trifo 7.25-12/4.25	A								
V2314	Lens sphcyl trifocal over 12	A								
V2315	Lens lenticular trifocal	A								
V2318	Lens aniseikonic trifocal	A								
V2319	Lens trifocal seg width > 28	A								
V2320	Lens trifocal add over 3.25d	A								
V2321	"Lenticular lens, trifocal"	A								
V2399	Lens trifocal speciality	A								
V2410	Lens variab asphericity sing	A								
V2430	Lens variable asphericity bi	A								
V2499	Variable asphericity lens	A								
V2500	Contact lens pmma spherical	A								
V2501	Cntct lens pmma-toric/prism	A								
V2502	Contact lens pmma bifocal	A								
V2503	Cntct lens pmma color vision	A								
V2510	Cntct gas permeable sphericl	A								
V2511	Cntct toric prism ballast	A								
V2512	Cntct lens gas permbl bifocl	A								
V2513	Contact lens extended wear	A								
V2520	Contact lens hydrophilic	A								
V2521	Cntct lens hydrophilic toric	A								
V2522	Cntct lens hydrophil bifocl	A								
V2523	Cntct lens hydrophil extend	A								
V2524	Cntct lens hydrophil photoch	A							*	
V2530	Contact lens gas impermeable	A								
V2531	Contact lens gas permeable	A								
V2599	Contact lens/es other type	A								
V2600	Hand held low vision aids	A								
V2610	Single lens spectacle mount	A								
V2615	Telescop/othr compound lens	A								
V2623	Plastic eye prosth custom	A								
V2624	Polishing artifical eye	A								
V2625	Enlargemnt of eye prosthesis	A								
V2626	Reduction of eye prosthesis	A								
V2627	Scleral cover shell	A								
V2628	Fabrication & fitting	A								
V2629	Prosthetic eye other type	A								
V2630	Anter chamber intraocul lens	N								
V2631	Iris support intraoclr lens	N								
V2632	Post chmbr intraocular lens	N								
V2700	Balance lens	A								
V2702	Deluxe lens feature	E1								
V2710	Glass/plastic slab off prism	A								
V2715	Prism lens/es	A								
V2718	Fresnell prism press-on lens	A								
V2730	Special base curve	A								
V2744	Tint photochromatic lens/es	A								
V2745	"Tint, any color/solid/grad"	A								
V2750	Anti-reflective coating	A								
V2755	Uv lens/es	A								
V2756	Eye glass case	E1								
V2760	Scratch resistant coating	E1								
V2761	Mirror coating	B								
V2762	"Polarization, any lens"	E1								
V2770	Occluder lens/es	A								
V2780	Oversize lens/es	A								
V2781	Progressive lens per lens	B								
V2782	"Lens, 1.54-1.65 p/1.60-1.79g"	A								
V2783	"Lens, >= 1.66 p/>=1.80 g"	A								
V2784	Lens polycarb or equal	A								
V2785	Corneal tissue processing	F								
V2786	Occupational multifocal lens	E1								
V2787	Astigmatism-correct function	E1								
V2788	Presbyopia-correct function	E1								
V2790	Amniotic membrane	N								
V2797	Vis item/svc in other code	E1								
V2799	Misc vision item or service	A								
V5008	Hearing screening	E1								
V5010	Assessment for hearing aid	E1								
V5011	Hearing aid fitting/checking	E1								
V5014	Hearing aid repair/modifying	E1								
V5020	Conformity evaluation	E1								
V5030	Body-worn hearing aid air	E1								
V5040	Body-worn hearing aid bone	E1								
V5050	Hearing aid monaural in ear	E1								
V5060	Behind ear hearing aid	E1								
V5070	Glasses air conduction	E1								
V5080	Glasses bone conduction	E1								
V5090	Hearing aid dispensing fee	E1								
V5095	Implant mid ear hearing pros	E1								
V5100	Body-worn bilat hearing aid	E1								
V5110	Hearing aid dispensing fee	E1								
V5120	Body-worn binaur hearing aid	E1								
V5130	In ear binaural hearing aid	E1								
V5140	Behind ear binaur hearing ai	E1								
V5150	Glasses binaural hearing aid	E1								
V5160	Dispensing fee binaural	E1								
V5171	Hearing aid monaural ite	E1								
V5172	Hearing aid monaural itc	E1								
V5181	Hearing aid monaural bte	E1								
V5190	Hearing aid monaural glasses	E1								
V5200	Disp fee contralateral monau	E1								
V5211	Hearing aid binaural ite/ite	E1								
V5212	Hearing aid binaural ite/itc	E1								
V5213	Hearing aid binaural ite/bte	E1								
V5214	Hearing aid binaural itc/itc	E1								
V5215	Hearing aid binaural itc/bte	E1								
V5221	Hearing aid binaural bte/bte	E1								
V5230	Hearing aid binaural glasses	E1								
V5240	Disp fee contralateral binau	E1								
V5241	"Dispensing fee, monaural"	E1								
V5242	"Hearing aid, monaural, cic"	E1								
V5243	"Hearing aid, monaural, itc"	E1								
V5244	"Hearing aid, prog, mon, cic"	E1								
V5245	"Hearing aid, prog, mon, itc"	E1								
V5246	"Hearing aid, prog, mon, ite"	E1								
V5247	"Hearing aid, prog, mon, bte"	E1								
V5248	"Hearing aid, binaural, cic"	E1								
V5249	"Hearing aid, binaural, itc"	E1								
V5250	"Hearing aid, prog, bin, cic"	E1								
V5251	"Hearing aid, prog, bin, itc"	E1								
V5252	"Hearing aid, prog, bin, ite"	E1								
V5253	"Hearing aid, prog, bin, bte"	E1								
V5254	"Hearing id, digit, mon, cic"	E1								
V5255	"Hearing aid, digit, mon, itc"	E1								
V5256	"Hearing aid, digit, mon, ite"	E1								
V5257	"Hearing aid, digit, mon, bte"	E1								
V5258	"Hearing aid, digit, bin, cic"	E1								
V5259	"Hearing aid, digit, bin, itc"	E1								
V5260	"Hearing aid, digit, bin, ite"	E1								
V5261	"Hearing aid, digit, bin, bte"	E1								
V5262	"Hearing aid, disp, monaural"	E1								
V5263	"Hearing aid, disp, binaural"	E1								
V5264	Ear mold/insert	E1								
V5265	"Ear mold/insert, disp"	E1								
V5266	Battery for hearing device	E1								
V5267	Hearing aid sup/access/dev	E1								
V5268	Ald telephone amplifier	E1								
V5269	"Alerting device, any type"	E1								
V5270	"Ald, tv amplifier, any type"	E1								
V5271	"Ald, tv caption decoder"	E1								
V5272	Tdd	E1								
V5273	Ald for cochlear implant	E1								
V5274	Ald unspecified	E1								
V5275	Ear impression	E1								
V5281	"Ald fm/dm system, monaural"	E1								
V5282	Ald fm/dm system binaural	E1								
V5283	"Ald neck, loop ind receiver"	E1								
V5284	Ald fm/dm ear level receiver	E1								
V5285	Ald fm/dm aud input receiver	E1								
V5286	Ald blu tooth fm/dm receiver	E1								
V5287	"Ald fm/dm receiver, nos"	E1								
V5288	Ald fm/dm transmitter ald	E1								
V5289	Ald fm/dm adapt/boot couplin	E1								
V5290	Ald transmitter microphone	E1								
V5298	Hearing aid noc	E1								
V5299	Hearing service	B								
V5336	Repair communication device	E1								
V5362	Speech screening	E1								
V5363	Language screening	E1								
V5364	Dysphagia screening	E1								
