	Addendum B.-Final OPPS Payment by HCPCS Code for CY 2014																																																																																																												
	CPT codes and descriptions only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. Dental codes (D codes) are copyright 2012 American Dental Association. All Rights Reserved.																																																																																																												
HCPCS Code	Short Descriptor	SI	APC	Relative Weight	Payment Rate 	National Unadjusted Copayment 	Minimum Unadjusted Copayment 	* Indicates a Change 																																																																																																					
0001F	"	Heart failure composite"	E																																																																																																											
0001M	Infectious dis hcv 6 assays	E						*																																																																																																					
0002M	Liver dis 10 assays w/ash	E						*																																																																																																					
0003M	Liver dis 10 assays w/nash	E						*																																																																																																					
0004M	Scoliosis dna alys	E						*																																																																																																					
0005F	"	Osteoarthritis composite"	E																																																																																																											
0006M	Onc hep gene risk classifier	E						*																																																																																																					
0007M	Onc gastro 51 gene nomogram	E						*																																																																																																					
0008M	Onc breast risk score	E						*																																																																																																					
00100	"	Anesth salivary gland"	N																																																																																																											
00102	"	Anesth repair of cleft lip"	N																																																																																																											
00103	"	Anesth blepharoplasty"	N																																																																																																											
00104	"	Anesth electroshock"	N																																																																																																											
00120	"	Anesth ear surgery"	N																																																																																																											
00124	"	Anesth ear exam"	N																																																																																																											
00126	"	Anesth tympanotomy"	N																																																																																																											
0012F	"	Cap bacterial assess"	E																																																																																																											
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"	E																																																																																																											
0015F	"	Melan follow-up complete"	E																																																																																																											
00160	"	Anesth nose/sinus surgery"	N																																																																																																											
00162	"	Anesth nose/sinus surgery"	N																																																																																																											
00164	"	Anesth biopsy of nose"	N																																																																																																											
00170	"	Anesth procedure on mouth"	N																																																																																																											
00172	"	Anesth cleft palate repair"	N																																																																																																											
00174	"	Anesth pharyngeal surgery"	N																																																																																																											
00176	"	Anesth pharyngeal surgery"	C																																																																																																											
00190	"	Anesth face/skull bone surg"	N																																																																																																											
00192	"	Anesth facial bone surgery"	C																																																																																																											
0019T	"	Extracorp shock wv tx ms nos"	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																																																																																																											
00220	"	Anesth intrcrn nerve"	N																																																																																																											
00222	"	Anesth head nerve surgery"	N																																																																																																											
00300	"	Anesth head/neck/ptrunk"	N																																																																																																											
00320	"	Anesth neck organ 1yr/>"	N																																																																																																											
00322	"	Anesth biopsy of thyroid"	N																																																																																																											
00326	"	Anesth larynx/trach < 1 yr"	N																																																																																																											
00350	"	Anesth neck vessel surgery"	N																																																																																																											
00352	"	Anesth neck vessel surgery"	N																																																																																																											
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																																																																																																											
00410	"	Anesth correct heart rhythm"	N																																																																																																											
0042T	"	Ct perfusion w/contrast cbf"	N																																																																																																											
00450	"	Anesth surgery of shoulder"	N																																																																																																											
00452	"	Anesth surgery of shoulder"	C																																																																																																											
00454	"	Anesth collar bone biopsy"	N																																																																																																											
00470	"	Anesth removal of rib"	N																																																																																																											
00472	"	Anesth chest wall repair"	N																																																																																																											
00474	"	Anesth surgery of rib"	C																																																																																																											
00500	"	Anesth esophageal surgery"	N																																																																																																											
0051T	"	Implant total heart system"	C																																																																																																											
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																																																																																																											
0052T	"	Replace thrc unit hrt syst"	C																																																																																																											
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																																																																																																											
0053T	"	Replace implantable hrt syst"	C																																																																																																											
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																																																																																																											
00550	"	Anesth sternal debridement"	N																																																																																																											
0055T	"	Bone srgry cmptr ct/mri imag"	N																																																																																																											
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																																																																																																											
00580	"	Anesth heart/lung transplnt"	C																																																																																																											
0058T	"	Cryopreservation ovary tiss"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
0059T	"	Cryopreservation oocyte"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
00600	"	Anesth spine cord surgery"	N																																																																																																											
00604	"	Anesth sitting procedure"	C																																																																																																											
00620	"	Anesth spine cord surgery"	N																																																																																																											
00622	"	Anesth removal of nerves"	C																																																																																																											
00625	"	Anes spine tranthor w/o vent"	N																																																																																																											
00626	"	Anes spine transthor w/vent"	N																																																																																																											
00630	"	Anesth spine cord surgery"	N																																																																																																											
00632	"	Anesth removal of nerves"	C																																																																																																											
00634	"	Anesth for chemonucleolysis"	N																																																																																																											
00635	"	Anesth lumbar puncture"	N																																																																																																											
00640	"	Anesth spine manipulation"	N																																																																																																											
00670	"	Anesth spine cord surgery"	C																																																																																																											
00700	"	Anesth abdominal wall surg"	N																																																																																																											
00702	"	Anesth for liver biopsy"	N																																																																																																											
0071T	"	U/s leiomyomata ablate <200"	S	0065	17.1769	"$1,248.28"	.	$249.66																																																																																																						
0072T	"	U/s leiomyomata ablate >200"	S	0065	17.1769	"$1,248.28"	.	$249.66																																																																																																						
00730	"	Anesth abdominal wall surg"	N																																																																																																											
0073T	"	Delivery comp imrt"	S	0412	7.0241	$510.46	.	$102.10																																																																																																						
00740	"	Anesth upper gi visualize"	N																																																																																																											
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																																																																																																											
0076T	"	S&i stent/chest vert art"	C																																																																																																											
00770	"	Anesth blood vessel repair"	N																																																																																																											
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																																																																																																											
00800	"	Anesth abdominal wall surg"	N																																																																																																											
00802	"	Anesth fat layer removal"	C																																																																																																											
00810	"	Anesth low intestine scope"	N																																																																																																											
00820	"	Anesth abdominal wall surg"	N																																																																																																											
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																																																																																																											
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																																																																																																											
00851	"	Anesth tubal ligation"	N																																																																																																											
0085T	"	Breath test heart reject"	E																																																																																																											
00860	"	Anesth surgery of abdomen"	N																																																																																																											
00862	"	Anesth kidney/ureter surg"	N																																																																																																											
00864	"	Anesth removal of bladder"	C																																																																																																											
00865	"	Anesth removal of prostate"	C																																																																																																											
00866	"	Anesth removal of adrenal"	C																																																																																																											
00868	"	Anesth kidney transplant"	C																																																																																																											
00870	"	Anesth bladder stone surg"	N																																																																																																											
00872	"	Anesth kidney stone destruct"	N																																																																																																											
00873	"	Anesth kidney stone destruct"	N																																																																																																											
00880	"	Anesth abdomen vessel surg"	N																																																																																																											
00882	"	Anesth major vein ligation"	C																																																																																																											
00902	"	Anesth anorectal surgery"	N																																																																																																											
00904	"	Anesth perineal surgery"	C																																																																																																											
00906	"	Anesth removal of vulva"	N																																																																																																											
00908	"	Anesth removal of prostate"	C																																																																																																											
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																																																																																																											
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																																																																																																											
0092T	"	Artific disc addl cervical"	C																																																																																																											
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																																																																																																											
00940	"	Anesth vaginal procedures"	N																																																																																																											
00942	"	Anesth surg on vag/urethral"	N																																																																																																											
00944	"	Anesth vaginal hysterectomy"	C																																																																																																											
00948	"	Anesth repair of cervix"	N																																																																																																											
00950	"	Anesth vaginal endoscopy"	N																																																																																																											
00952	"	Anesth hysteroscope/graph"	N																																																																																																											
0095T	"	Rmvl artific disc addl crvcl"	C																																																																																																											
0098T	"	Rev artific disc addl"	C																																																																																																											
0099T	"	Implant corneal ring"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
0100T	"	Prosth retina receive&gen"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
0101T	"	Extracorp shockwv tx hi enrg"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
0102T	"	Extracorp shockwv tx anesth"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
0103T	"	Holotranscobalamin"	A																																																																																																											
0106T	"	Touch quant sensory test"	X	0341	0.1720	$12.50	.	$2.50																																																																																																						
0107T	"	Vibrate quant sensory test"	X	0341	0.1720	$12.50	.	$2.50																																																																																																						
0108T	"	Cool quant sensory test"	X	0341	0.1720	$12.50	.	$2.50																																																																																																						
0109T	"	Heat quant sensory test"	X	0341	0.1720	$12.50	.	$2.50																																																																																																						
0110T	"	Nos quant sensory test"	X	0341	0.1720	$12.50	.	$2.50																																																																																																						
01112	"	Anesth bone aspirate/bx"	N																																																																																																											
0111T	"	Rbc membranes fatty acids"	A																																																																																																											
01120	"	Anesth pelvis surgery"	N																																																																																																											
01130	"	Anesth body cast procedure"	N																																																																																																											
01140	"	Anesth amputation at pelvis"	C																																																																																																											
01150	"	Anesth pelvic tumor surgery"	C																																																																																																											
01160	"	Anesth pelvis procedure"	N																																																																																																											
01170	"	Anesth pelvis surgery"	N																																																																																																											
01173	"	Anesth fx repair pelvis"	N																																																																																																											
01180	"	Anesth pelvis nerve removal"	N																																																																																																											
01190	"	Anesth pelvis nerve removal"	N																																																																																																											
01200	"	Anesth hip joint procedure"	N																																																																																																											
01202	"	Anesth arthroscopy of hip"	N																																																																																																											
01210	"	Anesth hip joint surgery"	N																																																																																																											
01212	"	Anesth hip disarticulation"	C																																																																																																											
01214	"	Anesth hip arthroplasty"	C																																																																																																											
01215	"	Anesth revise hip repair"	N																																																																																																											
01220	"	Anesth procedure on femur"	N																																																																																																											
01230	"	Anesth surgery of femur"	N																																																																																																											
01232	"	Anesth amputation of femur"	C																																																																																																											
01234	"	Anesth radical femur surg"	C																																																																																																											
0123T	"	Scleral fistulization"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
01250	"	Anesth upper leg surgery"	N																																																																																																											
01260	"	Anesth upper leg veins surg"	N																																																																																																											
0126T	"	Chd risk imt study"	Q1	0340	0.7353	$53.44	.	$10.69																																																																																																						
01270	"	Anesth thigh arteries surg"	N																																																																																																											
01272	"	Anesth femoral artery surg"	C																																																																																																											
01274	"	Anesth femoral embolectomy"	C																																																																																																											
01320	"	Anesth knee area surgery"	N																																																																																																											
01340	"	Anesth knee area procedure"	N																																																																																																											
01360	"	Anesth knee area surgery"	N																																																																																																											
01380	"	Anesth knee joint procedure"	N																																																																																																											
01382	"	Anesth dx knee arthroscopy"	N																																																																																																											
01390	"	Anesth knee area procedure"	N																																																																																																											
01392	"	Anesth knee area surgery"	N																																																																																																											
01400	"	Anesth knee joint surgery"	N																																																																																																											
01402	"	Anesth knee arthroplasty"	C																																																																																																											
01404	"	Anesth amputation at knee"	C																																																																																																											
01420	"	Anesth knee joint casting"	N																																																																																																											
01430	"	Anesth knee veins surgery"	N																																																																																																											
01432	"	Anesth knee vessel surg"	N																																																																																																											
01440	"	Anesth knee arteries surg"	N																																																																																																											
01442	"	Anesth knee artery surg"	C																																																																																																											
01444	"	Anesth knee artery repair"	C																																																																																																											
01462	"	Anesth lower leg procedure"	N																																																																																																											
01464	"	Anesth ankle/ft arthroscopy"	N																																																																																																											
01470	"	Anesth lower leg surgery"	N																																																																																																											
01472	"	Anesth achilles tendon surg"	N																																																																																																											
01474	"	Anesth lower leg surgery"	N																																																																																																											
01480	"	Anesth lower leg bone surg"	N																																																																																																											
01482	"	Anesth radical leg surgery"	N																																																																																																											
01484	"	Anesth lower leg revision"	N																																																																																																											
01486	"	Anesth ankle replacement"	C																																																																																																											
01490	"	Anesth lower leg casting"	N																																																																																																											
01500	"	Anesth leg arteries surg"	N																																																																																																											
01502	"	Anesth lwr leg embolectomy"	C																																																																																																											
01520	"	Anesth lower leg vein surg"	N																																																																																																											
01522	"	Anesth lower leg vein surg"	N																																																																																																											
0159T	"	Cad breast mri"	N																																																																																																											
01610	"	Anesth surgery of shoulder"	N																																																																																																											
01620	"	Anesth shoulder procedure"	N																																																																																																											
01622	"	Anes dx shoulder arthroscopy"	N																																																																																																											
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																																																																																																											
0164T	"	Remove lumb artif disc addl"	C																																																																																																											
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																																																																																																											
01670	"	Anesth shoulder vein surg"	N																																																																																																											
01680	"	Anesth shoulder casting"	N																																																																																																											
01682	"	Anesth airplane cast"	N																																																																																																											
0169T	"	Place stereo cath brain"	C																																																																																																											
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																																																																																																											
0171T	"	Lumbar spine proces distract"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
0172T	"	Lumbar spine process addl"	N																																																																																																											
01730	"	Anesth uppr arm procedure"	N																																																																																																											
01732	"	Anesth dx elbow arthroscopy"	N																																																																																																											
01740	"	Anesth upper arm surgery"	N																																																																																																											
01742	"	Anesth humerus surgery"	N																																																																																																											
01744	"	Anesth humerus repair"	N																																																																																																											
0174T	"	Cad cxr with interp"	N																																																																																																											
01756	"	Anesth radical humerus surg"	C																																																																																																											
01758	"	Anesth humeral lesion surg"	N																																																																																																											
0175T	"	Cad cxr remote"	N																																																																																																											
01760	"	Anesth elbow replacement"	N																																																																																																											
01770	"	Anesth uppr arm artery surg"	N																																																																																																											
01772	"	Anesth uppr arm embolectomy"	N																																																																																																											
01780	"	Anesth upper arm vein surg"	N																																																																																																											
01782	"	Anesth uppr arm vein repair"	N																																																																																																											
0178T	"	64 lead ecg w/i&r"	B																																																																																																											
0179T	"	64 lead ecg w/tracing"	X	0100	3.3604	$244.21	.	$48.85																																																																																																						
0180T	"	64 lead ecg w/i&r only"	B																																																																																																											
01810	"	Anesth lower arm surgery"	N																																																																																																											
0181T	"	Corneal hysteresis"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
01820	"	Anesth lower arm procedure"	N																																																																																																											
01829	"	Anesth dx wrist arthroscopy"	N																																																																																																											
0182T	"	Hdr elect brachytherapy"	S	0313	10.0974	$733.80	$259.86	$146.76																																																																																																						
01830	"	Anesth lower arm surgery"	N																																																																																																											
01832	"	Anesth wrist replacement"	N																																																																																																											
01840	"	Anesth lwr arm artery surg"	N																																																																																																											
01842	"	Anesth lwr arm embolectomy"	N																																																																																																											
01844	"	Anesth vascular shunt surg"	N																																																																																																											
0184T	"	Exc rectal tumor endoscopic"	T	0150	34.4192	"$2,501.31"	.	$500.27																																																																																																						
01850	"	Anesth lower arm vein surg"	N																																																																																																											
01852	"	Anesth lwr arm vein repair"	N																																																																																																											
01860	"	Anesth lower arm casting"	N																																																																																																											
0188T	"	Videoconf crit care 74 min"	M																																																																																																											
0189T	"	Videoconf crit care addl 30"	M																																																																																																											
0190T	"	Place intraoc radiation src"	N																																																																																																											
01916	"	Anesth dx arteriography"	N																																																																																																											
0191T	"	Insert ant segment drain int"	T	0673	41.7956	"$3,037.37"	$635.64	$607.48																																																																																																						
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																																																																																																											
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																																																																																																											
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																																																																																																											
0195T	"	Prescrl fuse w/o instr l5/s1"	C																																																																																																											
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																																																																																																											
0196T	"	Prescrl fuse w/o instr l4/l5"	C																																																																																																											
0197T	"	Intrafraction track motion"	N																																																																																																											
0198T	"	Ocular blood flow measure"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
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																																																																																																											
0199T	"	Physiologic tremor record"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
0200T	"	Perq sacral augmt unilat inj"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
0201T	"	Perq sacral augmt bilat inj"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
0202T	"	Post vert arthrplst 1 lumbar"	C																																																																																																											
0205T	"	Inirs each vessel add-on"	N																																																																																																											
0206T	"	Cptr dbs alys car elec dta"	Q1	0420	1.3520	$98.25	.	$19.65																																																																																																						
0207T	"	Clear eyelid gland w/heat"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
0208T	"	Audiometry air only"	X	0035	0.3042	$22.11	.	$4.43																																																																																																						
0209T	"	Audiometry air & bone"	X	0035	0.3042	$22.11	.	$4.43																																																																																																						
0210T	"	Speech audiometry threshold"	X	0035	0.3042	$22.11	.	$4.43																																																																																																						
0211T	"	Speech audiom thresh & recog"	X	0035	0.3042	$22.11	.	$4.43																																																																																																						
0212T	"	Compre audiometry evaluation"	X	0365	1.0561	$76.75	.	$15.35																																																																																																						
0213T	"	Njx paravert w/us cer/thor"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
0214T	"	Njx paravert w/us cer/thor"	N																																																																																																											
0215T	"	Njx paravert w/us cer/thor"	N																																																																																																											
0216T	"	Njx paravert w/us lumb/sac"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
0217T	"	Njx paravert w/us lumb/sac"	N																																																																																																											
0218T	"	Njx paravert w/us lumb/sac"	N																																																																																																											
0219T	"	Plmt post facet implt cerv"	C																																																																																																											
0220T	"	Plmt post facet implt thor"	C																																																																																																											
0221T	"	Plmt post facet implt lumb"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
0222T	"	Plmt post facet implt addl"	N																																																																																																											
0223T	"	Acoustic ecg w/i&r"	S	0099	0.3732	$27.12	.	$5.43																																																																																																						
0224T	"	Acoustic ecg 1+ analysis"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
0225T	"	Acoustic ecg analy & reprog"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
0226T	"	Anoscopy hra w/spec collect"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
0227T	"	Anoscopy hra w/biopsy"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
0228T	"	Njx tfrml eprl w/us cer/thor"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
0229T	"	Njx tfrml eprl w/us cer/thor"	N																																																																																																											
0230T	"	Njx tfrml eprl w/us lumb/sac"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
0231T	"	Njx tfrml eprl w/us lumb/sac"	N																																																																																																											
0232T	"	Njx platelet plasma"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
0233T	"	Skin glycation spectroscopy"	A																																																																																																											
0234T	"	Trluml perip athrc renal art"	T	0082	121.6791	"$8,842.66"	.	"$1,768.54"																																																																																																						
0235T	"	Trluml perip athrc visceral"	C																																																																																																											
0236T	"	Trluml perip athrc abd aorta"	T	0082	121.6791	"$8,842.66"	.	"$1,768.54"																																																																																																						
0237T	"	Trluml perip athrc brchiocph"	T	0082	121.6791	"$8,842.66"	.	"$1,768.54"																																																																																																						
0238T	"	Trluml perip athrc iliac art"	T	0082	121.6791	"$8,842.66"	.	"$1,768.54"																																																																																																						
0239T	"	Bioimpedance spectroscopy"	S	0097	0.9657	$70.18	.	$14.04																																																																																																						
0240T	"	Esoph motility 3d topography"	X	0361	4.4489	$323.31	$83.23	$64.67																																																																																																						
0241T	"	Esoph motility w/stim/perf"	N																																																																																																											
0243T	"	Intm msr bronchodil wheeze"	S	0078	1.8631	$135.40	.	$27.08																																																																																																						
0244T	"	Cont msr bronchodil wheeze"	X	0369	3.3536	$243.71	.	$48.75																																																																																																						
0245T	"	Open tx rib fx 1-2 ribs"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
0246T	"	Opn tx rib fx 3-4 ribs"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
0247T	"	Opn tx rib fx 5-6 ribs"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
0248T	"	Open tx rib fx 7/> ribs"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
0249T	"	Ligation hemorrhoid w/us"	T	0150	34.4192	"$2,501.31"	.	$500.27																																																																																																						
0253T	"	Insert aqueous drain device"	T	0673	41.7956	"$3,037.37"	$635.64	$607.48																																																																																																						
0254T	"	Evasc rpr iliac art bifur"	C																																																																																																											
0255T	"	Evasc rpr iliac art bifr s&i"	C																																																																																																											
0262T	"	Impltj pulm vlv evasc appr"	C																																																																																																											
0263T	"	Im b1 mrw cel ther cmpl"	S	0112	42.1852	"$3,065.68"	.	$613.14																																																																																																						
0264T	"	Im b1 mrw cel ther xcl hrvst"	S	0112	42.1852	"$3,065.68"	.	$613.14																																																																																																						
0265T	"	Im b1 mrw cel ther hrvst onl"	S	0112	42.1852	"$3,065.68"	.	$613.14																																																																																																						
0266T	"	Implt/rpl crtd sns dev total"	C																																																																																																											
0267T	"	Implt/rpl crtd sns dev lead"	T	0687	23.5410	"$1,710.77"	$389.48	$342.16																																																																																																						
0268T	"	Implt/rpl crtd sns dev gen"	S	0039	237.1326	"$17,232.90"	.	"$3,446.58"																																																																																																						
0269T	"	Rev/remvl crtd sns dev total"	Q2	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
0270T	"	Rev/remvl crtd sns dev lead"	Q2	0687	23.5410	"$1,710.77"	$389.48	$342.16																																																																																																						
0271T	"	Rev/remvl crtd sns dev gen"	Q2	0688	30.5781	"$2,222.17"	$657.64	$444.44																																																																																																						
0272T	"	Interrogate crtd sns dev"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
0273T	"	Interrogate crtd sns w/pgrmg"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
0274T	"	Perq lamot/lam crv/thrc"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
0275T	"	Perq lamot/lam lumbar"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
0278T	"	Tempr"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
0281T	"	Laa closure w/implant"	C																																																																																																											
0282T	"	Periph field stimul trial"	S	0040	63.6628	"$4,626.50"	.	$925.30																																																																																																						
0283T	"	Periph field stimul perm"	S	0318	380.1966	"$27,629.65"	"$9,121.76"	"$5,525.93"																																																																																																						
0284T	"	Periph field stimul revise"	Q2	0687	23.5410	"$1,710.77"	$389.48	$342.16																																																																																																						
0285T	"	Periph field stimul analys"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
0286T	"	Near ifr spectrsc of wounds"	N																																																																																																											
0287T	"	Near ifr guide of vasc site"	N																																																																																																											
0288T	"	Anoscopy w/rf delivery"	T	0150	34.4192	"$2,501.31"	.	$500.27																																																																																																						
0289T	"	Laser inc for pkp/lkp donor"	N																																																																																																											
0290T	"	Laser inc for pkp/lkp recip"	N																																																																																																											
0291T	"	Iv oct for proc init vessel"	N																																																																																																											
0292T	"	Iv oct for proc addl vessel"	N																																																																																																											
0293T	"	Ins lt atrl press monitor"	C																																																																																																											
0294T	"	Ins lt atrl mont pres lead"	C																																																																																																											
0295T	"	Ext ecg complete"	M																																																																																																											
0296T	"	Ext ecg recording"	S	0097	0.9657	$70.18	.	$14.04																																																																																																						
0297T	"	Ext ecg scan w/report"	S	0097	0.9657	$70.18	.	$14.04																																																																																																						
0298T	"	Ext ecg review and interp"	M																																																																																																											
0299T	"	Esw wound healing init wound"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
0300T	"	Esw wound healing addl wound"	N																																																																																																											
0301T	"	Mw therapy for breast tumor"	S	0065	17.1769	"$1,248.28"	.	$249.66																																																																																																						
0302T	"	Icar ischm mntrng sys compl"	T	0089	120.9586	"$8,790.30"	.	"$1,758.06"																																																																																																						
0303T	"	Icar ischm mntrng sys eltrd"	T	0106	63.3253	"$4,601.98"	.	$920.40																																																																																																						
0304T	"	Icar ischm mntrng sys device"	T	0090	101.1821	"$7,353.11"	"$1,593.50"	"$1,470.63"																																																																																																						
0305T	"	Icar ischm mntrng prgrm eval"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
0306T	"	Icar ischm mntr interr eval"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
0307T	"	Rmvl icar ischm mntrng dvce"	Q2	0105	31.8926	"$2,317.70"	.	$463.54																																																																																																						
0308T	"	Insj ocular telescope prosth"	T	0351	213.9921	"$15,551.23"	"$3,226.34"	"$3,110.25"																																																																																																						
0309T	"	Prescrl fuse w/ instr l4/l5"	C																																																																																																											
0310T	"	Motor function mapping ntms"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
0311T	"	Cal & alys cntrl artl press"	S	0099	0.3732	$27.12	.	$5.43																																																																																																						
0312T	"	Laps impltj nstim vagus"	C																																																																																																											
0313T	"	Laps rmvl nstim array vagus"	T	0687	23.5410	"$1,710.77"	$389.48	$342.16																																																																																																						
0314T	"	Laps rmvl vgl arry & pls gen"	Q2	0688	30.5781	"$2,222.17"	$657.64	$444.44																																																																																																						
0315T	"	Rmvl vagus nerve pls gen"	Q2	0688	30.5781	"$2,222.17"	$657.64	$444.44																																																																																																						
0316T	"	Replc vagus nerve pls gen"	S	0039	237.1326	"$17,232.90"	.	"$3,446.58"																																																																																																						
0317T	"	Elec alys vagus nrv pls gen"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
0319T	"	Insert subq defib w/eltrd"	T	0107	344.2616	"$25,018.18"	.	"$5,003.64"																																																																																																						
0320T	"	Insert subq defib electrode"	T	0106	63.3253	"$4,601.98"	.	$920.40																																																																																																						
0321T	"	Insert subq defib pls gen"	T	0107	344.2616	"$25,018.18"	.	"$5,003.64"																																																																																																						
0322T	"	Rmvl subq defib pls gen"	Q2	0105	31.8926	"$2,317.70"	.	$463.54																																																																																																						
0323T	"	Rmvl & replc subq pls gen"	Q2	0107	344.2616	"$25,018.18"	.	"$5,003.64"																																																																																																						
0324T	"	Rmvl subq defib electrode"	Q2	0105	31.8926	"$2,317.70"	.	$463.54																																																																																																						
0325T	"	Repos subq defib eltrd &/gen"	T	0105	31.8926	"$2,317.70"	.	$463.54																																																																																																						
0326T	"	Ephys eval subq implt defib"	N																																																																																																											
0327T	"	Implt subq defib interogat"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
0328T	"	Implt subq defib sys dev evl"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
0329T	"	Mntr io press 24hrs/> uni/bi"	E																																																																																																											
0330T	"	Tear film img uni/bi w/i&r"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
0331T	"	Heart symp image plnr"	S	0377	15.8743	"$1,153.62"	.	$230.73																																																																																																						
0332T	"	Heart symp image plnr spect"	S	0377	15.8743	"$1,153.62"	.	$230.73																																																																																																						
0333T	"	Visual ep acuity screen auto"	E																																																																																																											
0334T	"	Perq stablj sacroiliac joint"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
0335T	"	Extraosseous joint stblztion"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
0336T	"	Lap ablat uterine fibroids"	T	0174	118.2491	"$8,593.40"	"$1,911.61"	"$1,718.68"																																																																																																						
0337T	"	Endothel fxnassmnt non-invas"	S	0097	0.9657	$70.18	.	$14.04																																																																																																						
0338T	"	Trnscth renal symp denrv unl"	S	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
0339T	"	Trnscth renal symp denrv bil"	S	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
0340T	"	Ablate pulm tumors + extnsn"	T	0423	56.5030	"$4,106.19"	.	$821.24																																																																																																						
0341T	"	Quant pupillometry w/ rprt"	N																																																																																																											
0342T	Thxp apheresis w/hdl delip	S	0112	42.1852	"$3,065.68"	.	$613.14																																																																																																						
0343T	"	Transcath mtral vlve repair"	C																																																																																																											
0344T	"	Transcath mtral vlve repair"	C																																																																																																											
0345T	Transcath mtral vlve repair	C																																																																																																											
0346T	"	Ultrasound elastography"	N																																																																																																											
0347T	Ins bone device for rsa	Q2	0420	1.3520	$98.25	.	$19.65																																																																																																						
0348T	RSA spine exam	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
0349T	RSA upper extr exam	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
0350T	RSA lower extr exam	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
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	T	0142	11.5200	$837.18	.	$167.44																																																																																																						
0356T	Insrt drug device for iop	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
0358T	BIA whole body	Q1	0340	0.7353	$53.44	.	$10.69																																																																																																						
0359T	Behavioral id assessment	V	0632	1.3283	$96.53	.	$19.31																																																																																																						
0360T	Observ behav assessment	V	0632	1.3283	$96.53	.	$19.31																																																																																																						
0361T	Observ behav assess addl	N																																																																																																											
0362T	Expose behav assessment	V	0632	1.3283	$96.53	.	$19.31																																																																																																						
0363T	Expose behav assess addl	N																																																																																																											
0364T	Behavior treatment	S	0322	1.1613	$84.39	.	$16.88																																																																																																						
0365T	Behavior treatment addl	N																																																																																																											
0366T	Group behavior treatment	S	0325	0.9541	$69.34	.	$13.87																																																																																																						
0367T	Group behav treatment addl	N																																																																																																											
0368T	Behavior treatment modified	S	0322	1.1613	$84.39	.	$16.88																																																																																																						
0369T	Behav treatment modify addl	N																																																																																																											
0370T	Fam behav treatment guidance	S	0324	1.7784	$129.24	.	$25.85																																																																																																						
0371T	Mult fam behav treat guide	S	0324	1.7784	$129.24	.	$25.85																																																																																																						
0372T	Social skills training group	S	0325	0.9541	$69.34	.	$13.87																																																																																																						
0373T	Exposure behavior treatment	S	0323	1.5807	$114.87	.	$22.98																																																																																																						
0374T	Expose behav treatment addl	N																																																																																																											
0500F	"	Initial prenatal care visit"	E																																																																																																											
0501F	"	Prenatal flow sheet"	E																																																																																																											
0502F	"	Subsequent prenatal care"	E																																																																																																											
0503F	"	Postpartum care visit"	E																																																																																																											
0505F	"	Hemodialysis plan docd"	E																																																																																																											
0507F	"	Periton dialysis plan docd"	E																																																																																																											
0509F	"	Urine incon plan docd"	M																																																																																																											
0513F	"	Elev bp plan of care docd"	M																																																																																																											
0514F	"	Care plan hgb docd esa pt"	E																																																																																																											
0516F	"	Anemia plan of care docd"	E																																																																																																											
0517F	"	Glaucoma plan of care docd"	M																																																																																																											
0518F	"	Fall plan of care docd"	M																																																																																																											
0519F	"	Pland chemo docd b/4 txmnt"	E																																																																																																											
0520F	"	Rad dos limts b/4 3d rad"	M																																																																																																											
0521F	"	Plan of care 4 pain docd"	M																																																																																																											
0525F	"	Initial visit for episode"	E																																																																																																											
0526F	"	Subs visit for episode"	M																																																																																																											
0528F	"	Rcmnd flw-up 10 yrs docd"	M																																																																																																											
0529F	"	Intrvl 3/>yr pts clnscp docd"	M																																																																																																											
0535F	"	Dyspnea mngmnt plan docd"	E																																																																																																											
0540F	"	Gluco mngmnt plan docd"	M																																																																																																											
0545F	"	Follow up care plan mdd docd"	E																																																																																																											
0550F	"	Cytopath report nongyn spcmn"	E																																																																																																											
0551F	"	Cytopath report non routine"	E																																																																																																											
0555F	"	Symptom mgmnt plan care docd"	E																																																																																																											
0556F	"	Plan care lipid control docd"	M																																																																																																											
0557F	"	Plan caremng angnl symptdocd"	M																																																																																																											
0575F	"	Hiv rna plan care docd"	E																																																																																																											
0580F	"	Multidisciplinary care plan"	E																																																																																																											
0581F	"	Pt trnsfrd from anesth to cc"	E																																																																																																											
0582F	"	No trnsfr from anesth to cc"	E																																																																																																											
0583F	"	Transfer care checklist used"	E																																																																																																											
0584F	"	No transfercare chklist used"	E																																																																																																											
1000F	"	Tobacco use assessed"	E																																																																																																											
10021	"	Fna w/o image"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
10022	"	Fna w/image"	T	0004	5.6589	$411.24	.	$82.25																																																																																																						
1002F	"	Assess anginal symptom/level"	E																																																																																																											
10030	"	Guide cathet fluid drainage"	T	0006	2.1970	$159.66	.	$31.94																																																																																																						
1003F	"	Level of activity assess"	E																																																																																																											
10040	"	Acne surgery"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
1004F	"	Clin symp vol ovrld assess"	E																																																																																																											
1005F	"	Asthma symptoms evaluate"	E																																																																																																											
10060	"	Drainage of skin abscess"	T	0006	2.1970	$159.66	.	$31.94																																																																																																						
10061	"	Drainage of skin abscess"	T	0006	2.1970	$159.66	.	$31.94																																																																																																						
1006F	"	Osteoarthritis assess"	M																																																																																																											
1007F	"	Anti-inflm/anlgsc otc assess"	M																																																																																																											
10080	"	Drainage of pilonidal cyst"	T	0006	2.1970	$159.66	.	$31.94																																																																																																						
10081	"	Drainage of pilonidal cyst"	T	0007	11.6214	$844.55	.	$168.91																																																																																																						
1008F	"	Gi/renal risk assess"	E																																																																																																											
1010F	"	Severity angina by actvty"	M																																																																																																											
1011F	"	Angina present"	M																																																																																																											
10120	"	Remove foreign body"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
10121	"	Remove foreign body"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
1012F	"	Angina absent"	M																																																																																																											
10140	"	Drainage of hematoma/fluid"	T	0007	11.6214	$844.55	.	$168.91																																																																																																						
1015F	"	Copd symptoms assess"	E																																																																																																											
10160	"	Puncture drainage of lesion"	T	0006	2.1970	$159.66	.	$31.94																																																																																																						
10180	"	Complex drainage wound"	T	0008	21.5968	"$1,569.48"	.	$313.90																																																																																																						
1018F	"	Assess dyspnea not present"	E																																																																																																											
1019F	"	Assess dyspnea present"	E																																																																																																											
1022F	"	Pneumo imm status assess"	E																																																																																																											
1026F	"	Co-morbid condition assess"	E																																																																																																											
1030F	"	Influenza imm status assess"	E																																																																																																											
1031F	"	Smoking & 2nd hand assessed"	M																																																																																																											
1032F	"	Smoker/exposed 2nd hnd smoke"	M																																																																																																											
1033F	"	Tobacco nonsmoker nor 2ndhnd"	M																																																																																																											
1034F	"	Current tobacco smoker"	E																																																																																																											
1035F	"	Smokeless tobacco user"	E																																																																																																											
1036F	"	Tobacco non-user"	M																																																																																																											
1038F	"	Persistent asthma"	M																																																																																																											
1039F	"	Intermittent asthma"	M																																																																																																											
1040F	"	Dsm-5 info mdd docd"	E																																																																																																											
1050F	"	History of mole changes"	E																																																																																																											
1052F	"	Type location activityassess"	E																																																																																																											
1055F	"	Visual funct status assess"	E																																																																																																											
1060F	"	Doc perm/cont/parox atr fib"	E																																																																																																											
1061F	"	Doc lack perm+cont+parox fib"	E																																																																																																											
1065F	"	Ischm stroke symp lt3 hrsb/4"	E																																																																																																											
1066F	"	Ischm stroke symp ge3 hrsb/4"	E																																																																																																											
1070F	"	Alarm symp assessed-absent"	E																																																																																																											
1071F	"	Alarm symp assessed-1+ prsnt"	E																																																																																																											
1090F	"	Pres/absn urine incon assess"	M																																																																																																											
1091F	"	Urine incon characterized"	M																																																																																																											
11000	"	Debride infected skin"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
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	0020	8.8192	$640.91	.	$128.19																																																																																																						
11011	"	Debride skin musc at fx site"	T	0019	4.3867	$318.79	.	$63.76																																																																																																						
11012	"	Deb skin bone at fx site"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
1101F	"	Pt falls assess-docd le1/yr"	M																																																																																																											
11042	"	Deb subq tissue 20 sq cm/<"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
11043	"	Deb musc/fascia 20 sq cm/<"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
11044	"	Deb bone 20 sq cm/<"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11045	"	Deb subq tissue add-on"	N																																																																																																											
11046	"	Deb musc/fascia add-on"	N																																																																																																											
11047	"	Deb bone add-on"	N																																																																																																											
11055	"	Trim skin lesion"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
11056	"	Trim skin lesions 2 to 4"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
11057	"	Trim skin lesions over 4"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
11100	"	Biopsy skin lesion"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
11101	"	Biopsy skin add-on"	N																																																																																																											
1110F	"	Pt lft inpt fac w/in 60 days"	E																																																																																																											
1111F	"	Dschrg med/current med merge"	M																																																																																																											
1116F	"	Auric/peri pain assessed"	E																																																																																																											
1118F	"	Gerd symps assessed 12 month"	E																																																																																																											
1119F	"	Init eval for condition"	M																																																																																																											
11200	"	Removal of skin tags <w/15"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
11201	"	Remove skin tags add-on"	N																																																																																																											
1121F	"	Subs eval for condition"	E																																																																																																											
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"	E																																																																																																											
1128F	"	Subs episode for condition"	E																																																																																																											
11300	"	Shave skin lesion 0.5 cm/<"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
11301	"	Shave skin lesion 0.6-1.0 cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
11302	"	Shave skin lesion 1.1-2.0 cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
11303	"	Shave skin lesion >2.0 cm"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
11305	"	Shave skin lesion 0.5 cm/<"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
11306	"	Shave skin lesion 0.6-1.0 cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
11307	"	Shave skin lesion 1.1-2.0 cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
11308	"	Shave skin lesion >2.0 cm"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
1130F	"	Bk pain & fxn assessed"	M																																																																																																											
11310	"	Shave skin lesion 0.5 cm/<"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
11311	"	Shave skin lesion 0.6-1.0 cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
11312	"	Shave skin lesion 1.1-2.0 cm"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
11313	"	Shave skin lesion >2.0 cm"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
1134F	"	Epsd bk pain for 6 wks/<"	E																																																																																																											
1135F	"	Epsd bk pain for >6 wks"	E																																																																																																											
1136F	"	Epsd bk pain for 12 wks/<"	E																																																																																																											
1137F	"	Epsd bk pain for >12 wks"	E																																																																																																											
11400	"	Exc tr-ext b9+marg 0.5 cm<"	T	0019	4.3867	$318.79	.	$63.76																																																																																																						
11401	"	Exc tr-ext b9+marg 0.6-1 cm"	T	0019	4.3867	$318.79	.	$63.76																																																																																																						
11402	"	Exc tr-ext b9+marg 1.1-2 cm"	T	0019	4.3867	$318.79	.	$63.76																																																																																																						
11403	"	Exc tr-ext b9+marg 2.1-3cm/<"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11404	"	Exc tr-ext b9+marg 3.1-4 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
11406	"	Exc tr-ext b9+marg >4.0 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
11420	"	Exc h-f-nk-sp b9+marg 0.5/<"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11421	"	Exc h-f-nk-sp b9+marg 0.6-1"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11422	"	Exc h-f-nk-sp b9+marg 1.1-2"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11423	"	Exc h-f-nk-sp b9+marg 2.1-3"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
11424	"	Exc h-f-nk-sp b9+marg 3.1-4"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
11426	"	Exc h-f-nk-sp b9+marg >4 cm"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
11440	"	Exc face-mm b9+marg 0.5 cm/<"	T	0019	4.3867	$318.79	.	$63.76																																																																																																						
11441	"	Exc face-mm b9+marg 0.6-1 cm"	T	0019	4.3867	$318.79	.	$63.76																																																																																																						
11442	"	Exc face-mm b9+marg 1.1-2 cm"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11443	"	Exc face-mm b9+marg 2.1-3 cm"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11444	"	Exc face-mm b9+marg 3.1-4 cm"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11446	"	Exc face-mm b9+marg >4 cm"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
11450	"	Removal sweat gland lesion"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
11451	"	Removal sweat gland lesion"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
11462	"	Removal sweat gland lesion"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
11463	"	Removal sweat gland lesion"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
11470	"	Removal sweat gland lesion"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
11471	"	Removal sweat gland lesion"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
1150F	"	Doc pt rsk death w/in 1yr"	E																																																																																																											
1151F	"	Doc no pt rsk death w/in 1yr"	E																																																																																																											
1152F	"	Doc advncd dis comfort 1st"	E																																																																																																											
1153F	"	Doc advncd dis cmfrt not 1st"	E																																																																																																											
1157F	"	Advnc care plan in rcrd"	E																																																																																																											
1158F	"	Advnc care plan tlk docd"	M																																																																																																											
1159F	"	Med list docd in rcrd"	E																																																																																																											
11600	"	Exc tr-ext mal+marg 0.5 cm/<"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11601	"	Exc tr-ext mal+marg 0.6-1 cm"	T	0019	4.3867	$318.79	.	$63.76																																																																																																						
11602	"	Exc tr-ext mal+marg 1.1-2 cm"	T	0019	4.3867	$318.79	.	$63.76																																																																																																						
11603	"	Exc tr-ext mal+marg 2.1-3 cm"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11604	"	Exc tr-ext mal+marg 3.1-4 cm"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11606	"	Exc tr-ext mal+marg >4 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
1160F	"	Rvw meds by rx/dr in rcrd"	E																																																																																																											
11620	"	Exc h-f-nk-sp mal+marg 0.5/<"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11621	"	Exc s/n/h/f/g mal+mrg 0.6-1"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11622	"	Exc s/n/h/f/g mal+mrg 1.1-2"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11623	"	Exc s/n/h/f/g mal+mrg 2.1-3"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11624	"	Exc s/n/h/f/g mal+mrg 3.1-4"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
11626	"	Exc s/n/h/f/g mal+mrg >4 cm"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
11640	"	Exc f/e/e/n/l mal+mrg 0.5cm<"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11641	"	Exc f/e/e/n/l mal+mrg 0.6-1"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11642	"	Exc f/e/e/n/l mal+mrg 1.1-2"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11643	"	Exc f/e/e/n/l mal+mrg 2.1-3"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
11644	"	Exc f/e/e/n/l mal+mrg 3.1-4"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
11646	"	Exc f/e/e/n/l mal+mrg >4 cm"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
1170F	"	Fxnl status assessed"	M																																																																																																											
11719	"	Trim nail(s) any number"	T	0012	0.8370	$60.83	.	$12.17																																																																																																						
11720	"	Debride nail 1-5"	T	0012	0.8370	$60.83	.	$12.17																																																																																																						
11721	"	Debride nail 6 or more"	T	0012	0.8370	$60.83	.	$12.17																																																																																																						
11730	"	Removal of nail plate"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
11732	"	Remove nail plate add-on"	N																																																																																																											
11740	"	Drain blood from under nail"	T	0012	0.8370	$60.83	.	$12.17																																																																																																						
11750	"	Removal of nail bed"	T	0019	4.3867	$318.79	.	$63.76																																																																																																						
11752	"	Remove nail bed/finger tip"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
11755	"	Biopsy nail unit"	T	0019	4.3867	$318.79	.	$63.76																																																																																																						
1175F	"	Function stat assessed rvwd"	M																																																																																																											
11760	"	Repair of nail bed"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
11762	"	Reconstruction of nail bed"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
11765	"	Excision of nail fold toe"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
11770	"	Remove pilonidal cyst simple"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
11771	"	Remove pilonidal cyst exten"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
11772	"	Remove pilonidal cyst compl"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
1180F	"	Thromboemb risk assessed"	E																																																																																																											
1181F	"	Neuropsychia sympts assessed"	M																																																																																																											
1182F	"	Neuropsychi sympt 1+present"	E																																																																																																											
1183F	"	Neuropsychiatric symp absent"	E																																																																																																											
11900	"	Inject skin lesions </w 7"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
11901	"	Inject skin lesions >7"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
11920	"	Correct skin color 6.0 cm/<"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
11921	"	Corect skin color 6.1-20.0cm"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
11922	"	Correct skin color ea 20.0cm"	N																																																																																																											
11950	"	Tx contour defects 1 cc/<"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
11951	"	Tx contour defects 1.1-5.0cc"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
11952	"	Tx contour defects 5.1-10cc"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
11954	"	Tx contour defects >10.0 cc"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
11960	"	Insert tissue expander(s)"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
11970	"	Replace tissue expander"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
11971	"	Remove tissue expander(s)"	Q2	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
11976	"	Remove contraceptive capsule"	Q2	0019	4.3867	$318.79	.	$63.76																																																																																																						
11980	"	Implant hormone pellet(s)"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
11981	"	Insert drug implant device"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
11982	"	Remove drug implant device"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
11983	"	Remove/insert drug implant"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
12001	"	Rpr s/n/ax/gen/trnk 2.5cm/<"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
12002	"	Rpr s/n/ax/gen/trnk2.6-7.5cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
12004	"	Rpr s/n/ax/gen/trk7.6-12.5cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
12005	"	Rpr s/n/a/gen/trk12.6-20.0cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
12006	"	Rpr s/n/a/gen/trk20.1-30.0cm"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12007	"	Rpr s/n/ax/gen/trnk >30.0 cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
1200F	"	Seizure type& frequ docd"	M																																																																																																											
12011	"	Rpr f/e/e/n/l/m 2.5 cm/<"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
12013	"	Rpr f/e/e/n/l/m 2.6-5.0 cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
12014	"	Rpr f/e/e/n/l/m 5.1-7.5 cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
12015	"	Rpr f/e/e/n/l/m 7.6-12.5 cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
12016	"	Rpr fe/e/en/l/m 12.6-20.0 cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
12017	"	Rpr fe/e/en/l/m 20.1-30.0 cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
12018	"	Rpr f/e/e/n/l/m >30.0 cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
12020	"	Closure of split wound"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
12021	"	Closure of split wound"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12031	"	Intmd rpr s/a/t/ext 2.5 cm/<"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12032	"	Intmd rpr s/a/t/ext 2.6-7.5"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12034	"	Intmd rpr s/tr/ext 7.6-12.5"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12035	"	Intmd rpr s/a/t/ext 12.6-20"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
12036	"	Intmd rpr s/a/t/ext 20.1-30"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
12037	"	Intmd rpr s/tr/ext >30.0 cm"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
12041	"	Intmd rpr n-hf/genit 2.5cm/<"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12042	"	Intmd rpr n-hf/genit2.6-7.5"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12044	"	Intmd rpr n-hf/genit7.6-12.5"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12045	"	Intmd rpr n-hf/genit12.6-20"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12046	"	Intmd rpr n-hf/genit20.1-30"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12047	"	Intmd rpr n-hf/genit >30.0cm"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
12051	"	Intmd rpr face/mm 2.5 cm/<"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12052	"	Intmd rpr face/mm 2.6-5.0 cm"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12053	"	Intmd rpr face/mm 5.1-7.5 cm"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12054	"	Intmd rpr face/mm 7.6-12.5cm"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12055	"	Intmd rpr face/mm 12.6-20 cm"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12056	"	Intmd rpr face/mm 20.1-30.0"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
12057	"	Intmd rpr face/mm >30.0 cm"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
1205F	"	Epi etiol synd rvwd and docd"	M																																																																																																											
1220F	"	Pt screened for depression"	M																																																																																																											
13100	"	Cmplx rpr trunk 1.1-2.5 cm"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
13101	"	Cmplx rpr trunk 2.6-7.5 cm"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
13102	"	Cmplx rpr trunk addl 5cm/<"	N																																																																																																											
13120	"	Cmplx rpr s/a/l 1.1-2.5 cm"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
13121	"	Cmplx rpr s/a/l 2.6-7.5 cm"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
13122	"	Cmplx rpr s/a/l addl 5 cm/>"	N																																																																																																											
13131	"	Cmplx rpr f/c/c/m/n/ax/g/h/f"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
13132	"	Cmplx rpr f/c/c/m/n/ax/g/h/f"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
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	0327	5.6337	$409.41	.	$81.89																																																																																																						
13152	"	Cmplx rpr e/n/e/l 2.6-7.5 cm"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
13153	"	Cmplx rpr e/n/e/l addl 5cm/<"	N																																																																																																											
13160	"	Late closure of wound"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
14000	"	Tis trnfr trunk 10 sq cm/<"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
14001	"	Tis trnfr trunk 10.1-30sqcm"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
1400F	"	Prkns diag rviewed"	M																																																																																																											
14020	"	Tis trnfr s/a/l 10 sq cm/<"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
14021	"	Tis trnfr s/a/l 10.1-30 sqcm"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
14040	"	Tis trnfr f/c/c/m/n/a/g/h/f"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
14041	"	Tis trnfr f/c/c/m/n/a/g/h/f"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
14060	"	Tis trnfr e/n/e/l 10 sq cm/<"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
14061	"	Tis trnfr e/n/e/l10.1-30sqcm"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
14301	"	Tis trnfr any 30.1-60 sq cm"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
14302	"	Tis trnfr addl 30 sq cm/<"	N																																																																																																											
14350	"	Filleted finger/toe flap"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
1450F	"	Symptoms improved/consist"	E																																																																																																											
1451F	"	Sympt show clin import drop"	E																																																																																																											
1460F	"	Qual card diag prior 12 mons"	M																																																																																																											
1461F	"	No qual card diag prior12mon"	M																																																																																																											
1490F	"	Dem severity classified mild"	M																																																																																																											
1491F	"	Dem severity classified mod"	M																																																																																																											
1493F	"	Dem severity class severe"	M																																																																																																											
1494F	"	Cognit assessed and reviewed"	M																																																																																																											
15002	"	Wound prep trk/arm/leg"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
15003	"	Wound prep addl 100 cm"	N																																																																																																											
15004	"	Wound prep f/n/hf/g"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
15005	"	Wnd prep f/n/hf/g addl cm"	N																																																																																																											
1500F	"	Symptom+sign symm polyneuro"	E																																																																																																											
1501F	"	Not initial eval for cond"	E																																																																																																											
1502F	"	Pt queried pain fxn w/ instr"	E																																																																																																											
1503F	"	Pt queried symp resp insuff"	E																																																																																																											
15040	"	Harvest cultured skin graft"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
1504F	"	Pt has resp insufficiency"	E																																																																																																											
15050	"	Skin pinch graft"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
1505F	"	Pt has no resp insufficiency"	E																																																																																																											
15100	"	Skin splt grft trnk/arm/leg"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15101	"	Skin splt grft t/a/l add-on"	N																																																																																																											
15110	"	Epidrm autogrft trnk/arm/leg"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15111	"	Epidrm autogrft t/a/l add-on"	N																																																																																																											
15115	"	Epidrm a-grft face/nck/hf/g"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15116	"	Epidrm a-grft f/n/hf/g addl"	N																																																																																																											
15120	"	Skn splt a-grft fac/nck/hf/g"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15121	"	Skn splt a-grft f/n/hf/g add"	N																																																																																																											
15130	"	Derm autograft trnk/arm/leg"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15131	"	Derm autograft t/a/l add-on"	N																																																																																																											
15135	"	Derm autograft face/nck/hf/g"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15136	"	Derm autograft f/n/hf/g add"	N																																																																																																											
15150	"	Cult skin grft t/arm/leg"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
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	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15156	"	Cult skin grft f/n/hfg add"	N																																																																																																											
15157	"	Cult epiderm grft f/n/hfg +%"	N																																																																																																											
15200	"	Skin full graft trunk"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15201	"	Skin full graft trunk add-on"	N																																																																																																											
15220	"	Skin full graft sclp/arm/leg"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15221	"	Skin full graft add-on"	N																																																																																																											
15240	"	Skin full grft face/genit/hf"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15241	"	Skin full graft add-on"	N																																																																																																											
15260	"	Skin full graft een & lips"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15261	"	Skin full graft add-on"	N																																																																																																											
15271	"	Skin sub graft trnk/arm/leg"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15272	"	Skin sub graft t/a/l add-on"	N																																																																																																											
15273	"	Skin sub grft t/arm/lg child"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15274	"	Skn sub grft t/a/l child add"	N																																																																																																											
15275	"	Skin sub graft face/nk/hf/g"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15276	"	Skin sub graft f/n/hf/g addl"	N																																																																																																											
15277	"	Skn sub grft f/n/hf/g child"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15278	"	Skn sub grft f/n/hf/g ch add"	N																																																																																																											
15570	"	Skin pedicle flap trunk"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15572	"	Skin pedicle flap arms/legs"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15574	"	Pedcle fh/ch/ch/m/n/ax/g/h/f"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15576	"	Pedicle e/n/e/l/ntroral"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15600	"	Delay flap trunk"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15610	"	Delay flap arms/legs"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15620	"	Delay flap f/c/c/n/ax/g/h/f"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15630	"	Delay flap eye/nos/ear/lip"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15650	"	Transfer skin pedicle flap"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15731	"	Forehead flap w/vasc pedicle"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15732	"	Muscle-skin graft head/neck"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15734	"	Muscle-skin graft trunk"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15736	"	Muscle-skin graft arm"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15738	"	Muscle-skin graft leg"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15740	"	Island pedicle flap graft"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15750	"	Neurovascular pedicle flap"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15756	"	Free myo/skin flap microvasc"	C																																																																																																											
15757	"	Free skin flap microvasc"	C																																																																																																											
15758	"	Free fascial flap microvasc"	C																																																																																																											
15760	"	Composite skin graft"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15770	"	Derma-fat-fascia graft"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15775	"	Hair trnspl 1-15 punch grfts"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
15776	"	Hair trnspl >15 punch grafts"	T	0326	2.7388	$199.03	.	$39.81																																																																																																						
15777	"	Acellular derm matrix implt"	N																																																																																																											
15780	"	Dermabrasion total face"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
15781	"	Dermabrasion segmental face"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
15782	"	Dermabrasion other than face"	T	0019	4.3867	$318.79	.	$63.76																																																																																																						
15783	"	Dermabrasion suprfl any site"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
15786	"	Abrasion lesion single"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
15787	"	Abrasion lesions add-on"	N																																																																																																											
15788	"	Chemical peel face epiderm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
15789	"	Chemical peel face dermal"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
15792	"	Chemical peel nonfacial"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
15793	"	Chemical peel nonfacial"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
15819	"	Plastic surgery neck"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15820	"	Revision of lower eyelid"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15821	"	Revision of lower eyelid"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15822	"	Revision of upper eyelid"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15823	"	Revision of upper eyelid"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15824	"	Removal of forehead wrinkles"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15825	"	Removal of neck wrinkles"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15826	"	Removal of brow wrinkles"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15828	"	Removal of face wrinkles"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15829	"	Removal of skin wrinkles"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15830	"	Exc skin abd"	T	0030	49.3559	"$3,586.79"	$747.07	$717.36																																																																																																						
15832	"	Excise excessive skin thigh"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
15833	"	Excise excessive skin leg"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
15834	"	Excise excessive skin hip"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
15835	"	Excise excessive skin buttck"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
15836	"	Excise excessive skin arm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
15837	"	Excise excess skin arm/hand"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
15838	"	Excise excess skin fat pad"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
15839	"	Excise excess skin & tissue"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
15840	"	Nerve palsy fascial graft"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15841	"	Nerve palsy muscle graft"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15842	"	Nerve palsy microsurg graft"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15845	"	Skin and muscle repair face"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15847	"	Exc skin abd add-on"	N																																																																																																											
15850	"	Remove sutures same surgeon"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
15851	"	Remove sutures diff surgeon"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
15852	"	Dressing change not for burn"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
15860	"	Test for blood flow in graft"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
15876	"	Suction lipectomy head&neck"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15877	"	Suction lipectomy trunk"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15878	"	Suction lipectomy upr extrem"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15879	"	Suction lipectomy lwr extrem"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15920	"	Removal of tail bone ulcer"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
15922	"	Removal of tail bone ulcer"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15931	"	Remove sacrum pressure sore"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
15933	"	Remove sacrum pressure sore"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
15934	"	Remove sacrum pressure sore"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15935	"	Remove sacrum pressure sore"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15936	"	Remove sacrum pressure sore"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15937	"	Remove sacrum pressure sore"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15940	"	Remove hip pressure sore"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
15941	"	Remove hip pressure sore"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
15944	"	Remove hip pressure sore"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15945	"	Remove hip pressure sore"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
15946	"	Remove hip pressure sore"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15950	"	Remove thigh pressure sore"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
15951	"	Remove thigh pressure sore"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
15952	"	Remove thigh pressure sore"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15953	"	Remove thigh pressure sore"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15956	"	Remove thigh pressure sore"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
15958	"	Remove thigh pressure sore"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
15999	"	Removal of pressure sore"	T	0019	4.3867	$318.79	.	$63.76																																																																																																						
16000	"	Initial treatment of burn(s)"	T	0012	0.8370	$60.83	.	$12.17																																																																																																						
16020	"	Dress/debrid p-thick burn s"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
16025	"	Dress/debrid p-thick burn m"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
16030	"	Dress/debrid p-thick burn l"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
16035	"	Incision of burn scab initi"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
16036	"	Escharotomy addl incision"	C																																																																																																											
17000	"	Destruct premalg lesion"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
17003	"	Destruct premalg les 2-14"	N																																																																																																											
17004	"	Destroy premal lesions 15/>"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
17106	"	Destruction of skin lesions"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
17107	"	Destruction of skin lesions"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
17108	"	Destruction of skin lesions"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
17110	"	Destruct b9 lesion 1-14"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
17111	"	Destruct lesion 15 or more"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
17250	"	Chemical cautery tissue"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
17260	"	Destruction of skin lesions"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
17261	"	Destruction of skin lesions"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
17262	"	Destruction of skin lesions"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
17263	"	Destruction of skin lesions"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
17264	"	Destruction of skin lesions"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
17266	"	Destruction of skin lesions"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
17270	"	Destruction of skin lesions"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
17271	"	Destruction of skin lesions"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
17272	"	Destruction of skin lesions"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
17273	"	Destruction of skin lesions"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
17274	"	Destruction of skin lesions"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
17276	"	Destruction of skin lesions"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
17280	"	Destruction of skin lesions"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
17281	"	Destruction of skin lesions"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
17282	"	Destruction of skin lesions"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
17283	"	Destruction of skin lesions"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
17284	"	Destruction of skin lesions"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
17286	"	Destruction of skin lesions"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
17311	"	Mohs 1 stage h/n/hf/g"	T	0694	6.0024	$436.21	$88.07	$87.25																																																																																																						
17312	"	Mohs addl stage"	N																																																																																																											
17313	"	Mohs 1 stage t/a/l"	T	0694	6.0024	$436.21	$88.07	$87.25																																																																																																						
17314	"	Mohs addl stage t/a/l"	N																																																																																																											
17315	"	Mohs surg addl block"	N																																																																																																											
17340	"	Cryotherapy of skin"	T	0012	0.8370	$60.83	.	$12.17																																																																																																						
17360	"	Skin peel therapy"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
17380	"	Hair removal by electrolysis"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
17999	"	Skin tissue procedure"	T	0012	0.8370	$60.83	.	$12.17																																																																																																						
19000	"	Drainage of breast lesion"	T	0004	5.6589	$411.24	.	$82.25																																																																																																						
19001	"	Drain breast lesion add-on"	N																																																																																																											
19020	"	Incision of breast lesion"	T	0008	21.5968	"$1,569.48"	.	$313.90																																																																																																						
19030	"	Injection for breast x-ray"	N																																																																																																											
19081	"	Bx breast 1st lesion strtctc"	T	0005	9.6609	$702.08	.	$140.42																																																																																																						
19082	"	Bx breast add lesion strtctc"	N																																																																																																											
19083	"	Bx breast 1st lesion us imag"	T	0005	9.6609	$702.08	.	$140.42																																																																																																						
19084	"	Bx breast add lesion us imag"	N																																																																																																											
19085	"	Bx breast 1st lesion mr imag"	T	0005	9.6609	$702.08	.	$140.42																																																																																																						
19086	"	Bx breast add lesion mr imag"	N																																																																																																											
19100	"	Bx breast percut w/o image"	T	0004	5.6589	$411.24	.	$82.25																																																																																																						
19101	"	Biopsy of breast open"	T	0028	27.1667	"$1,974.26"	.	$394.86																																																																																																						
19105	"	Cryosurg ablate fa each"	T	0029	36.5419	"$2,655.57"	$581.52	$531.12																																																																																																						
19110	"	Nipple exploration"	T	0028	27.1667	"$1,974.26"	.	$394.86																																																																																																						
19112	"	Excise breast duct fistula"	T	0028	27.1667	"$1,974.26"	.	$394.86																																																																																																						
19120	"	Removal of breast lesion"	T	0028	27.1667	"$1,974.26"	.	$394.86																																																																																																						
19125	"	Excision breast lesion"	T	0028	27.1667	"$1,974.26"	.	$394.86																																																																																																						
19126	"	Excision addl breast lesion"	N																																																																																																											
19260	"	Removal of chest wall lesion"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
19271	"	Revision of chest wall"	C																																																																																																											
19272	"	Extensive chest wall surgery"	C																																																																																																											
19281	"	Perq device breast 1st imag"	Q2	0420	1.3520	$98.25	.	$19.65																																																																																																						
19282	"	Perq device breast ea imag"	N																																																																																																											
19283	"	Perq dev breast 1st strtctc"	Q2	0420	1.3520	$98.25	.	$19.65																																																																																																						
19284	"	Perq dev breast add strtctc"	N																																																																																																											
19285	"	Perq dev breast 1st us imag"	Q2	0420	1.3520	$98.25	.	$19.65																																																																																																						
19286	"	Perq dev breast add us imag"	N																																																																																																											
19287	"	Perq dev breast 1st mr guide"	Q2	0420	1.3520	$98.25	.	$19.65																																																																																																						
19288	"	Perq dev breast add mr guide"	N																																																																																																											
19296	"	Place po breast cath for rad"	T	0648	66.6929	"$4,846.71"	.	$969.35																																																																																																						
19297	"	Place breast cath for rad"	T	0648	66.6929	"$4,846.71"	.	$969.35																																																																																																						
19298	"	Place breast rad tube/caths"	T	0648	66.6929	"$4,846.71"	.	$969.35																																																																																																						
19300	"	Removal of breast tissue"	T	0028	27.1667	"$1,974.26"	.	$394.86																																																																																																						
19301	"	Partial mastectomy"	T	0028	27.1667	"$1,974.26"	.	$394.86																																																																																																						
19302	"	P-mastectomy w/ln removal"	T	0030	49.3559	"$3,586.79"	$747.07	$717.36																																																																																																						
19303	"	Mast simple complete"	T	0029	36.5419	"$2,655.57"	$581.52	$531.12																																																																																																						
19304	"	Mast subq"	T	0029	36.5419	"$2,655.57"	$581.52	$531.12																																																																																																						
19305	"	Mast radical"	C																																																																																																											
19306	"	Mast rad urban type"	C																																																																																																											
19307	"	Mast mod rad"	T	0030	49.3559	"$3,586.79"	$747.07	$717.36																																																																																																						
19316	"	Suspension of breast"	T	0029	36.5419	"$2,655.57"	$581.52	$531.12																																																																																																						
19318	"	Reduction of large breast"	T	0030	49.3559	"$3,586.79"	$747.07	$717.36																																																																																																						
19324	"	Enlarge breast"	T	0030	49.3559	"$3,586.79"	$747.07	$717.36																																																																																																						
19325	"	Enlarge breast with implant"	T	0648	66.6929	"$4,846.71"	.	$969.35																																																																																																						
19328	"	Removal of breast implant"	Q2	0029	36.5419	"$2,655.57"	$581.52	$531.12																																																																																																						
19330	"	Removal of implant material"	Q2	0029	36.5419	"$2,655.57"	$581.52	$531.12																																																																																																						
19340	"	Immediate breast prosthesis"	T	0030	49.3559	"$3,586.79"	$747.07	$717.36																																																																																																						
19342	"	Delayed breast prosthesis"	T	0648	66.6929	"$4,846.71"	.	$969.35																																																																																																						
19350	"	Breast reconstruction"	T	0028	27.1667	"$1,974.26"	.	$394.86																																																																																																						
19355	"	Correct inverted nipple(s)"	T	0029	36.5419	"$2,655.57"	$581.52	$531.12																																																																																																						
19357	"	Breast reconstruction"	T	0648	66.6929	"$4,846.71"	.	$969.35																																																																																																						
19361	"	Breast reconstr w/lat flap"	C																																																																																																											
19364	"	Breast reconstruction"	C																																																																																																											
19366	"	Breast reconstruction"	T	0029	36.5419	"$2,655.57"	$581.52	$531.12																																																																																																						
19367	"	Breast reconstruction"	C																																																																																																											
19368	"	Breast reconstruction"	C																																																																																																											
19369	"	Breast reconstruction"	C																																																																																																											
19370	"	Surgery of breast capsule"	T	0029	36.5419	"$2,655.57"	$581.52	$531.12																																																																																																						
19371	"	Removal of breast capsule"	T	0029	36.5419	"$2,655.57"	$581.52	$531.12																																																																																																						
19380	"	Revise breast reconstruction"	T	0030	49.3559	"$3,586.79"	$747.07	$717.36																																																																																																						
19396	"	Design custom breast implant"	T	0029	36.5419	"$2,655.57"	$581.52	$531.12																																																																																																						
19499	"	Breast surgery procedure"	T	0028	27.1667	"$1,974.26"	.	$394.86																																																																																																						
20005	"	I&d abscess subfascial"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
2000F	"	Blood pressure measure"	M																																																																																																											
2001F	"	Weight record"	E																																																																																																											
2002F	"	Clin sign vol ovrld assess"	E																																																																																																											
2004F	"	Initial exam involved joints"	E																																																																																																											
20100	"	Explore wound neck"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
20101	"	Explore wound chest"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
20102	"	Explore wound abdomen"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
20103	"	Explore wound extremity"	T	0007	11.6214	$844.55	.	$168.91																																																																																																						
2010F	"	Vital signs recorded"	M																																																																																																											
2014F	"	Mental status assess"	E																																																																																																											
20150	"	Excise epiphyseal bar"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
2015F	"	Asthma impairment assessed"	M																																																																																																											
2016F	"	Asthma risk assessed"	M																																																																																																											
2018F	"	Hydration status assess"	E																																																																																																											
2019F	"	Dilated macul exam done"	M																																																																																																											
20200	"	Muscle biopsy"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
20205	"	Deep muscle biopsy"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
20206	"	Needle biopsy muscle"	T	0005	9.6609	$702.08	.	$140.42																																																																																																						
2020F	"	Dilated fundus eval done"	E																																																																																																											
2021F	"	Dilat maculor exam done"	M																																																																																																											
20220	"	Bone biopsy trocar/needle"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
20225	"	Bone biopsy trocar/needle"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
2022F	"	Dil retina exam interp rev"	M																																																																																																											
20240	"	Bone biopsy excisional"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
20245	"	Bone biopsy excisional"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
2024F	"	7 field photo interp doc rev"	M																																																																																																											
20250	"	Open bone biopsy"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
20251	"	Open bone biopsy"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
2026F	"	Eye image valid to dx rev"	M																																																																																																											
2027F	"	Optic nerve head eval done"	M																																																																																																											
2028F	"	Foot exam performed"	E																																																																																																											
2029F	"	Complete phys skin exam done"	E																																																																																																											
2030F	"	H2o stat docd normal"	E																																																																																																											
2031F	"	H2o stat docd dehydrated"	E																																																																																																											
2035F	"	Tymp memb motion examd"	E																																																																																																											
2040F	"	Bk pn xm on init visit date"	M																																																																																																											
2044F	"	Doc mntl tst b/4 bk trxmnt"	E																																																																																																											
20500	"	Injection of sinus tract"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
20501	"	Inject sinus tract for x-ray"	N																																																																																																											
2050F	"	Wound char size etc docd"	E																																																																																																											
20520	"	Removal of foreign body"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
20525	"	Removal of foreign body"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
20526	"	Ther injection carp tunnel"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
20527	"	Inj dupuytren cord w/enzyme"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
20550	"	Inj tendon sheath/ligament"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
20551	"	Inj tendon origin/insertion"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
20552	"	Inj trigger point 1/2 muscl"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
20553	"	Inject trigger points 3/>"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
20555	"	Place ndl musc/tis for rt"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
20600	"	Drain/inject joint/bursa"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
20605	"	Drain/inject joint/bursa"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
2060F	"	Pt talk eval hlthwkr re mdd"	E																																																																																																											
20610	"	Drain/inject joint/bursa"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
20612	"	Aspirate/inj ganglion cyst"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
20615	"	Treatment of bone cyst"	T	0004	5.6589	$411.24	.	$82.25																																																																																																						
20650	"	Insert and remove bone pin"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
20660	"	Apply rem fixation device"	Q2	0139	6.1774	$448.92	.	$89.79																																																																																																						
20661	"	Application of head brace"	C																																																																																																											
20662	"	Application of pelvis brace"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
20663	"	Application of thigh brace"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
20664	"	Application of halo"	C																																																																																																											
20665	"	Removal of fixation device"	Q2	0420	1.3520	$98.25	.	$19.65																																																																																																						
20670	"	Removal of support implant"	Q2	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
20680	"	Removal of support implant"	Q2	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
20690	"	Apply bone fixation device"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
20692	"	Apply bone fixation device"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
20693	"	Adjust bone fixation device"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
20694	"	Remove bone fixation device"	Q2	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
20696	"	Comp multiplane ext fixation"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
20697	"	Comp ext fixate strut change"	T	0139	6.1774	$448.92	.	$89.79																																																																																																						
20802	"	Replantation arm complete"	C																																																																																																											
20805	"	Replant forearm complete"	C																																																																																																											
20808	"	Replantation hand complete"	C																																																																																																											
20816	"	Replantation digit complete"	C																																																																																																											
20822	"	Replantation digit complete"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
20824	"	Replantation thumb complete"	C																																																																																																											
20827	"	Replantation thumb complete"	C																																																																																																											
20838	"	Replantation foot complete"	C																																																																																																											
20900	"	Removal of bone for graft"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
20902	"	Removal of bone for graft"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
20910	"	Remove cartilage for graft"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
20912	"	Remove cartilage for graft"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
20920	"	Removal of fascia for graft"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
20922	"	Removal of fascia for graft"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
20924	"	Removal of tendon for graft"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
20926	"	Removal of tissue for graft"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
20930	"	Sp bone algrft morsel add-on"	N																																																																																																											
20931	"	Sp bone algrft struct add-on"	N																																																																																																											
20936	"	Sp bone agrft local add-on"	C																																																																																																											
20937	"	Sp bone agrft morsel add-on"	C																																																																																																											
20938	"	Sp bone agrft struct add-on"	C																																																																																																											
20950	"	Fluid pressure muscle"	T	0006	2.1970	$159.66	.	$31.94																																																																																																						
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"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
20973	"	Bone/skin graft great toe"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
20974	"	Electrical bone stimulation"	A																																																																																																											
20975	"	Electrical bone stimulation"	N																																																																																																											
20979	"	Us bone stimulation"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
20982	"	Ablate bone tumor(s) perq"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
20985	"	Cptr-asst dir ms px"	N																																																																																																											
20999	"	Musculoskeletal surgery"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
21010	"	Incision of jaw joint"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21011	"	Exc face les sc <2 cm"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
21012	"	Exc face les sbq 2 cm/<"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
21013	"	Exc face tum deep < 2 cm"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
21014	"	Exc face tum deep 2 cm/>"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
21015	"	Resect face/scalp tum < 2 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
21016	"	Resect face/scalp tum 2 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
21025	"	Excision of bone lower jaw"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21026	"	Excision of facial bone(s)"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21029	"	Contour of face bone lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21030	"	Excise max/zygoma b9 tumor"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21031	"	Remove exostosis mandible"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21032	"	Remove exostosis maxilla"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21034	"	Excise max/zygoma mal tumor"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21040	"	Excise mandible lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21044	"	Removal of jaw bone lesion"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21045	"	Extensive jaw surgery"	C																																																																																																											
21046	"	Remove mandible cyst complex"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21047	"	Excise lwr jaw cyst w/repair"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21048	"	Remove maxilla cyst complex"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21049	"	Excis uppr jaw cyst w/repair"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21050	"	Removal of jaw joint"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21060	"	Remove jaw joint cartilage"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21070	"	Remove coronoid process"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21073	"	Mnpj of tmj w/anesth"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21076	"	Prepare face/oral prosthesis"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21077	"	Prepare face/oral prosthesis"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21079	"	Prepare face/oral prosthesis"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21080	"	Prepare face/oral prosthesis"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21081	"	Prepare face/oral prosthesis"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21082	"	Prepare face/oral prosthesis"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21083	"	Prepare face/oral prosthesis"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21084	"	Prepare face/oral prosthesis"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21085	"	Prepare face/oral prosthesis"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
21086	"	Prepare face/oral prosthesis"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21087	"	Prepare face/oral prosthesis"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21088	"	Prepare face/oral prosthesis"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21089	"	Prepare face/oral prosthesis"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
21100	"	Maxillofacial fixation"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21110	"	Interdental fixation"	Q2	0252	7.5014	$545.14	.	$109.03																																																																																																						
21116	"	Injection jaw joint x-ray"	N																																																																																																											
21120	"	Reconstruction of chin"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21121	"	Reconstruction of chin"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21122	"	Reconstruction of chin"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21123	"	Reconstruction of chin"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21125	"	Augmentation lower jaw bone"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21127	"	Augmentation lower jaw bone"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21137	"	Reduction of forehead"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21138	"	Reduction of forehead"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21139	"	Reduction of forehead"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
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"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
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"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21175	"	Reconstruct orbit/forehead"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21179	"	Reconstruct entire forehead"	C																																																																																																											
21180	"	Reconstruct entire forehead"	C																																																																																																											
21181	"	Contour cranial bone lesion"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
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"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21194	"	Reconst lwr jaw w/graft"	C																																																																																																											
21195	"	Reconst lwr jaw w/o fixation"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21196	"	Reconst lwr jaw w/fixation"	C																																																																																																											
21198	"	Reconstr lwr jaw segment"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21199	"	Reconstr lwr jaw w/advance"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21206	"	Reconstruct upper jaw bone"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21208	"	Augmentation of facial bones"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21209	"	Reduction of facial bones"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21210	"	Face bone graft"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21215	"	Lower jaw bone graft"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21230	"	Rib cartilage graft"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21235	"	Ear cartilage graft"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
21240	"	Reconstruction of jaw joint"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21242	"	Reconstruction of jaw joint"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21243	"	Reconstruction of jaw joint"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21244	"	Reconstruction of lower jaw"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21245	"	Reconstruction of jaw"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21246	"	Reconstruction of jaw"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21247	"	Reconstruct lower jaw bone"	C																																																																																																											
21248	"	Reconstruction of jaw"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21249	"	Reconstruction of jaw"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21255	"	Reconstruct lower jaw bone"	C																																																																																																											
21256	"	Reconstruction of orbit"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21260	"	Revise eye sockets"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21261	"	Revise eye sockets"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21263	"	Revise eye sockets"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21267	"	Revise eye sockets"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21268	"	Revise eye sockets"	C																																																																																																											
21270	"	Augmentation cheek bone"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21275	"	Revision orbitofacial bones"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21280	"	Revision of eyelid"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21282	"	Revision of eyelid"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
21295	"	Revision of jaw muscle/bone"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
21296	"	Revision of jaw muscle/bone"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21299	"	Cranio/maxillofacial surgery"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
21310	"	Closed tx nose fx w/o manj"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
21315	"	Closed tx nose fx w/o stablj"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
21320	"	Closed tx nose fx w/ stablj"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
21325	"	Open tx nose fx uncomplicatd"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21330	"	Open tx nose fx w/skele fixj"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21335	"	Open tx nose & septal fx"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21336	"	Open tx septal fx w/wo stabj"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
21337	"	Closed tx septal&nose fx"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
21338	"	Open nasoethmoid fx w/o fixj"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21339	"	Open nasoethmoid fx w/ fixj"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21340	"	Perq tx nasoethmoid fx"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21343	"	Open tx dprsd front sinus fx"	C																																																																																																											
21344	"	Open tx compl front sinus fx"	C																																																																																																											
21345	"	Closed tx nose/jaw fx"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21346	"	Opn tx nasomax fx w/fixj"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21347	"	Opn tx nasomax fx multple"	C																																																																																																											
21348	"	Opn tx nasomax fx w/graft"	C																																																																																																											
21355	"	Perq tx malar fracture"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21356	"	Opn tx dprsd zygomatic arch"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21360	"	Opn tx dprsd malar fracture"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21365	"	Opn tx complx malar fx"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21366	"	Opn tx complx malar w/grft"	C																																																																																																											
21385	"	Opn tx orbit fx transantral"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21386	"	Opn tx orbit fx periorbital"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21387	"	Opn tx orbit fx combined"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21390	"	Opn tx orbit periorbtl implt"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21395	"	Opn tx orbit periorbt w/grft"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21400	"	Closed tx orbit w/o manipulj"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
21401	"	Closed tx orbit w/ manipulj"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
21406	"	Opn tx orbit fx w/o implant"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21407	"	Opn tx orbit fx w/implant"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21408	"	Opn tx orbit fx w/bone grft"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21421	"	Treat mouth roof fracture"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
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"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21445	"	Treat dental ridge fracture"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21450	"	Treat lower jaw fracture"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
21451	"	Treat lower jaw fracture"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
21452	"	Treat lower jaw fracture"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
21453	"	Treat lower jaw fracture"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21454	"	Treat lower jaw fracture"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21461	"	Treat lower jaw fracture"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21462	"	Treat lower jaw fracture"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21465	"	Treat lower jaw fracture"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21470	"	Treat lower jaw fracture"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21480	"	Reset dislocated jaw"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
21485	"	Reset dislocated jaw"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21490	"	Repair dislocated jaw"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
21495	"	Treat hyoid bone fracture"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
21497	"	Interdental wiring"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
21499	"	Head surgery procedure"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
21501	"	Drain neck/chest lesion"	T	0008	21.5968	"$1,569.48"	.	$313.90																																																																																																						
21502	"	Drain chest lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
21510	"	Drainage of bone lesion"	C																																																																																																											
21550	"	Biopsy of neck/chest"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
21552	"	Exc neck les sc 3 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
21554	"	Exc neck tum deep 5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
21555	"	Exc neck les sc < 3 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
21556	"	Exc neck tum deep < 5 cm"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
21557	"	Resect neck thorax tumor<5cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
21558	"	Resect neck tumor 5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
21600	"	Partial removal of rib"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
21610	"	Partial removal of rib"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
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"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
21700	"	Revision of neck muscle"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
21705	"	Revision of neck muscle/rib"	C																																																																																																											
21720	"	Revision of neck muscle"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
21725	"	Revision of neck muscle"	T	0006	2.1970	$159.66	.	$31.94																																																																																																						
21740	"	Reconstruction of sternum"	C																																																																																																											
21742	"	Repair stern/nuss w/o scope"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
21743	"	Repair sternum/nuss w/scope"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
21750	"	Repair of sternum separation"	C																																																																																																											
21800	"	Treatment of rib fracture"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
21805	"	Treatment of rib fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
21810	"	Treatment of rib fracture(s)"	C																																																																																																											
21820	"	Treat sternum fracture"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
21825	"	Treat sternum fracture"	C																																																																																																											
21899	"	Neck/chest surgery procedure"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
21920	"	Biopsy soft tissue of back"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
21925	"	Biopsy soft tissue of back"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
21930	"	Exc back les sc < 3 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
21931	"	Exc back les sc 3 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
21932	"	Exc back tum deep < 5 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
21933	"	Exc back tum deep 5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
21935	"	Resect back tum < 5 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
21936	"	Resect back tum 5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
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"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
22101	"	Remove part thorax vertebra"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
22102	"	Remove part lumbar vertebra"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
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"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
22224	"	Incis w/discectomy lumbar"	C																																																																																																											
22226	"	Revise extra spine segment"	C																																																																																																											
22305	"	Closed tx spine process fx"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
22310	"	Closed tx vert fx w/o manj"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
22315	"	Closed tx vert fx w/manj"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
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"	T	0045	15.8858	"$1,154.45"	$257.70	$230.89																																																																																																						
22520	"	Percut vertebroplasty thor"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
22521	"	Percut vertebroplasty lumb"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
22522	"	Percut vertebroplasty addl"	N																																																																																																											
22523	"	Percut kyphoplasty thor"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
22524	"	Percut kyphoplasty lumbar"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
22525	"	Percut kyphoplasty add-on"	N																																																																																																											
22526	"	Idet single level"	E																																																																																																											
22527	"	Idet 1 or more levels"	E																																																																																																											
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"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
22552	"	Addl neck spine fusion"	C																																																																																																											
22554	"	Neck spine fusion"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
22556	"	Thorax spine fusion"	C																																																																																																											
22558	"	Lumbar spine fusion"	C																																																																																																											
22585	"	Additional spinal fusion"	C																																																																																																											
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"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
22614	"	Spine fusion extra segment"	N																																																																																																											
22630	"	Lumbar spine fusion"	C																																																																																																											
22632	"	Spine fusion extra segment"	C																																																																																																											
22633	"	Lumbar spine fusion combined"	C																																																																																																											
22634	"	Spine fusion extra segment"	C																																																																																																											
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"	C																																																																																																											
22841	"	Insert spine fixation device"	C																																																																																																											
22842	"	Insert spine fixation device"	C																																																																																																											
22843	"	Insert spine fixation device"	C																																																																																																											
22844	"	Insert spine fixation device"	C																																																																																																											
22845	"	Insert spine fixation device"	C																																																																																																											
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																																																																																																											
22851	"	Apply spine prosth device"	N																																																																																																											
22852	"	Remove spine fixation device"	C																																																																																																											
22855	"	Remove spine fixation device"	C																																																																																																											
22856	"	Cerv artific diskectomy"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
22857	"	Lumbar artif diskectomy"	C																																																																																																											
22861	"	Revise cerv artific disc"	C																																																																																																											
22862	"	Revise lumbar artif disc"	C																																																																																																											
22864	"	Remove cerv artif disc"	C																																																																																																											
22865	"	Remove lumb artif disc"	C																																																																																																											
22899	"	Spine surgery procedure"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
22900	"	Exc abdl tum deep < 5 cm"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
22901	"	Exc abdl tum deep 5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
22902	"	Exc abd les sc < 3 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
22903	"	Exc abd les sc 3 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
22904	"	Radical resect abd tumor<5cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
22905	"	Rad resect abd tumor 5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
22999	"	Abdomen surgery procedure"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
23000	"	Removal of calcium deposits"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
23020	"	Release shoulder joint"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23030	"	Drain shoulder lesion"	T	0008	21.5968	"$1,569.48"	.	$313.90																																																																																																						
23031	"	Drain shoulder bursa"	T	0008	21.5968	"$1,569.48"	.	$313.90																																																																																																						
23035	"	Drain shoulder bone lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
23040	"	Exploratory shoulder surgery"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23044	"	Exploratory shoulder surgery"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23065	"	Biopsy shoulder tissues"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
23066	"	Biopsy shoulder tissues"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
23071	"	Exc shoulder les sc 3 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
23073	"	Exc shoulder tum deep 5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
23075	"	Exc shoulder les sc < 3 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
23076	"	Exc shoulder tum deep < 5 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
23077	"	Resect shoulder tumor < 5 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
23078	"	Resect shoulder tumor 5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
23100	"	Biopsy of shoulder joint"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
23101	"	Shoulder joint surgery"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23105	"	Remove shoulder joint lining"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23106	"	Incision of collarbone joint"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23107	"	Explore treat shoulder joint"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23120	"	Partial removal collar bone"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23125	"	Removal of collar bone"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23130	"	Remove shoulder bone part"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
23140	"	Removal of bone lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
23145	"	Removal of bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23146	"	Removal of bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23150	"	Removal of humerus lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23155	"	Removal of humerus lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23156	"	Removal of humerus lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23170	"	Remove collar bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23172	"	Remove shoulder blade lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23174	"	Remove humerus lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23180	"	Remove collar bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23182	"	Remove shoulder blade lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23184	"	Remove humerus lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23190	"	Partial removal of scapula"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23195	"	Removal of head of humerus"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23200	"	Resect clavicle tumor"	C																																																																																																											
23210	"	Resect scapula tumor"	C																																																																																																											
23220	"	Resect prox humerus tumor"	C																																																																																																											
23330	"	Remove shoulder foreign body"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
23333	"	Remove shoulder fb deep"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
23334	"	Shoulder prosthesis removal"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
23335	"	Shoulder prosthesis removal"	C																																																																																																											
23350	"	Injection for shoulder x-ray"	N																																																																																																											
23395	"	Muscle transfer shoulder/arm"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
23397	"	Muscle transfers"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
23400	"	Fixation of shoulder blade"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23405	"	Incision of tendon & muscle"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23406	"	Incise tendon(s) & muscle(s)"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23410	"	Repair rotator cuff acute"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
23412	"	Repair rotator cuff chronic"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
23415	"	Release of shoulder ligament"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
23420	"	Repair of shoulder"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
23430	"	Repair biceps tendon"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
23440	"	Remove/transplant tendon"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
23450	"	Repair shoulder capsule"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
23455	"	Repair shoulder capsule"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
23460	"	Repair shoulder capsule"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
23462	"	Repair shoulder capsule"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
23465	"	Repair shoulder capsule"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
23466	"	Repair shoulder capsule"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
23470	"	Reconstruct shoulder joint"	T	0425	133.9177	"$9,732.07"	.	"$1,946.42"																																																																																																						
23472	"	Reconstruct shoulder joint"	C																																																																																																											
23473	"	Revis reconst shoulder joint"	T	0425	133.9177	"$9,732.07"	.	"$1,946.42"																																																																																																						
23474	"	Revis reconst shoulder joint"	C																																																																																																											
23480	"	Revision of collar bone"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
23485	"	Revision of collar bone"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
23490	"	Reinforce clavicle"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
23491	"	Reinforce shoulder bones"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
23500	"	Treat clavicle fracture"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
23505	"	Treat clavicle fracture"	T	0139	6.1774	$448.92	.	$89.79																																																																																																						
23515	"	Treat clavicle fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
23520	"	Treat clavicle dislocation"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
23525	"	Treat clavicle dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
23530	"	Treat clavicle dislocation"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
23532	"	Treat clavicle dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
23540	"	Treat clavicle dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
23545	"	Treat clavicle dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
23550	"	Treat clavicle dislocation"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
23552	"	Treat clavicle dislocation"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
23570	"	Treat shoulder blade fx"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
23575	"	Treat shoulder blade fx"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
23585	"	Treat scapula fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
23600	"	Treat humerus fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
23605	"	Treat humerus fracture"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
23615	"	Treat humerus fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
23616	"	Treat humerus fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
23620	"	Treat humerus fracture"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
23625	"	Treat humerus fracture"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
23630	"	Treat humerus fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
23650	"	Treat shoulder dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
23655	"	Treat shoulder dislocation"	T	0045	15.8858	"$1,154.45"	$257.70	$230.89																																																																																																						
23660	"	Treat shoulder dislocation"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
23665	"	Treat dislocation/fracture"	T	0139	6.1774	$448.92	.	$89.79																																																																																																						
23670	"	Treat dislocation/fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
23675	"	Treat dislocation/fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
23680	"	Treat dislocation/fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
23700	"	Fixation of shoulder"	T	0045	15.8858	"$1,154.45"	$257.70	$230.89																																																																																																						
23800	"	Fusion of shoulder joint"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
23802	"	Fusion of shoulder joint"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
23900	"	Amputation of arm & girdle"	C																																																																																																											
23920	"	Amputation at shoulder joint"	C																																																																																																											
23921	"	Amputation follow-up surgery"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
23929	"	Shoulder surgery procedure"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
23930	"	Drainage of arm lesion"	T	0008	21.5968	"$1,569.48"	.	$313.90																																																																																																						
23931	"	Drainage of arm bursa"	T	0007	11.6214	$844.55	.	$168.91																																																																																																						
23935	"	Drain arm/elbow bone lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
24000	"	Exploratory elbow surgery"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24006	"	Release elbow joint"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24065	"	Biopsy arm/elbow soft tissue"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
24066	"	Biopsy arm/elbow soft tissue"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
24071	"	Exc arm/elbow les sc 3 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
24073	"	Ex arm/elbow tum deep 5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
24075	"	Exc arm/elbow les sc < 3 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
24076	"	Ex arm/elbow tum deep < 5 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
24077	"	Resect arm/elbow tum < 5 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
24079	"	Resect arm/elbow tum 5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
24100	"	Biopsy elbow joint lining"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
24101	"	Explore/treat elbow joint"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24102	"	Remove elbow joint lining"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24105	"	Removal of elbow bursa"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
24110	"	Remove humerus lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
24115	"	Remove/graft bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24116	"	Remove/graft bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24120	"	Remove elbow lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
24125	"	Remove/graft bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24126	"	Remove/graft bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24130	"	Removal of head of radius"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24134	"	Removal of arm bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24136	"	Remove radius bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24138	"	Remove elbow bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24140	"	Partial removal of arm bone"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24145	"	Partial removal of radius"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24147	"	Partial removal of elbow"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24149	"	Radical resection of elbow"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24150	"	Resect distal humerus tumor"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
24152	"	Resect radius tumor"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
24155	"	Removal of elbow joint"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24160	"	Remove elbow joint implant"	Q2	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24164	"	Remove radius head implant"	Q2	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24200	"	Removal of arm foreign body"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
24201	"	Removal of arm foreign body"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
24220	"	Injection for elbow x-ray"	N																																																																																																											
24300	"	Manipulate elbow w/anesth"	T	0045	15.8858	"$1,154.45"	$257.70	$230.89																																																																																																						
24301	"	Muscle/tendon transfer"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24305	"	Arm tendon lengthening"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24310	"	Revision of arm tendon"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
24320	"	Repair of arm tendon"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24330	"	Revision of arm muscles"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
24331	"	Revision of arm muscles"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
24332	"	Tenolysis triceps"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24340	"	Repair of biceps tendon"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
24341	"	Repair arm tendon/muscle"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
24342	"	Repair of ruptured tendon"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
24343	"	Repr elbow lat ligmnt w/tiss"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24344	"	Reconstruct elbow lat ligmnt"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
24345	"	Repr elbw med ligmnt w/tissu"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24346	"	Reconstruct elbow med ligmnt"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
24357	"	Repair elbow perc"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24358	"	Repair elbow w/deb open"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24359	"	Repair elbow deb/attch open"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24360	"	Reconstruct elbow joint"	T	0047	42.9663	"$3,122.45"	.	$624.49																																																																																																						
24361	"	Reconstruct elbow joint"	T	0425	133.9177	"$9,732.07"	.	"$1,946.42"																																																																																																						
24362	"	Reconstruct elbow joint"	T	0048	63.8333	"$4,638.89"	.	$927.78																																																																																																						
24363	"	Replace elbow joint"	T	0425	133.9177	"$9,732.07"	.	"$1,946.42"																																																																																																						
24365	"	Reconstruct head of radius"	T	0047	42.9663	"$3,122.45"	.	$624.49																																																																																																						
24366	"	Reconstruct head of radius"	T	0425	133.9177	"$9,732.07"	.	"$1,946.42"																																																																																																						
24370	"	Revise reconst elbow joint"	T	0425	133.9177	"$9,732.07"	.	"$1,946.42"																																																																																																						
24371	"	Revise reconst elbow joint"	T	0425	133.9177	"$9,732.07"	.	"$1,946.42"																																																																																																						
24400	"	Revision of humerus"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
24410	"	Revision of humerus"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
24420	"	Revision of humerus"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
24430	"	Repair of humerus"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
24435	"	Repair humerus with graft"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
24470	"	Revision of elbow joint"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
24495	"	Decompression of forearm"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
24498	"	Reinforce humerus"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
24500	"	Treat humerus fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
24505	"	Treat humerus fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
24515	"	Treat humerus fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
24516	"	Treat humerus fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
24530	"	Treat humerus fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
24535	"	Treat humerus fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
24538	"	Treat humerus fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
24545	"	Treat humerus fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
24546	"	Treat humerus fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
24560	"	Treat humerus fracture"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
24565	"	Treat humerus fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
24566	"	Treat humerus fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
24575	"	Treat humerus fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
24576	"	Treat humerus fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
24577	"	Treat humerus fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
24579	"	Treat humerus fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
24582	"	Treat humerus fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
24586	"	Treat elbow fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
24587	"	Treat elbow fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
24600	"	Treat elbow dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
24605	"	Treat elbow dislocation"	T	0045	15.8858	"$1,154.45"	$257.70	$230.89																																																																																																						
24615	"	Treat elbow dislocation"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
24620	"	Treat elbow fracture"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
24635	"	Treat elbow fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
24640	"	Treat elbow dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
24650	"	Treat radius fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
24655	"	Treat radius fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
24665	"	Treat radius fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
24666	"	Treat radius fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
24670	"	Treat ulnar fracture"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
24675	"	Treat ulnar fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
24685	"	Treat ulnar fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
24800	"	Fusion of elbow joint"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
24802	"	Fusion/graft of elbow joint"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
24900	"	Amputation of upper arm"	C																																																																																																											
24920	"	Amputation of upper arm"	C																																																																																																											
24925	"	Amputation follow-up surgery"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
24930	"	Amputation follow-up surgery"	C																																																																																																											
24931	"	Amputate upper arm & implant"	C																																																																																																											
24935	"	Revision of amputation"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
24940	"	Revision of upper arm"	C																																																																																																											
24999	"	Upper arm/elbow surgery"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
25000	"	Incision of tendon sheath"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25001	"	Incise flexor carpi radialis"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25020	"	Decompress forearm 1 space"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25023	"	Decompress forearm 1 space"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25024	"	Decompress forearm 2 spaces"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25025	"	Decompress forearm 2 spaces"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25028	"	Drainage of forearm lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25031	"	Drainage of forearm bursa"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25035	"	Treat forearm bone lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25040	"	Explore/treat wrist joint"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25065	"	Biopsy forearm soft tissues"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
25066	"	Biopsy forearm soft tissues"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
25071	"	Exc forearm les sc 3 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
25073	"	Exc forearm tum deep 3 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
25075	"	Exc forearm les sc < 3 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
25076	"	Exc forearm tum deep < 3 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
25077	"	Resect forearm/wrist tum<3cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
25078	"	Resect forarm/wrist tum 3cm>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
25085	"	Incision of wrist capsule"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25100	"	Biopsy of wrist joint"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25101	"	Explore/treat wrist joint"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25105	"	Remove wrist joint lining"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25107	"	Remove wrist joint cartilage"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25109	"	Excise tendon forearm/wrist"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25110	"	Remove wrist tendon lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25111	"	Remove wrist tendon lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25112	"	Reremove wrist tendon lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25115	"	Remove wrist/forearm lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25116	"	Remove wrist/forearm lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25118	"	Excise wrist tendon sheath"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25119	"	Partial removal of ulna"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25120	"	Removal of forearm lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25125	"	Remove/graft forearm lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25126	"	Remove/graft forearm lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25130	"	Removal of wrist lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25135	"	Remove & graft wrist lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25136	"	Remove & graft wrist lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25145	"	Remove forearm bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25150	"	Partial removal of ulna"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25151	"	Partial removal of radius"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25170	"	Resect radius/ulnar tumor"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25210	"	Removal of wrist bone"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25215	"	Removal of wrist bones"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25230	"	Partial removal of radius"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25240	"	Partial removal of ulna"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25246	"	Injection for wrist x-ray"	N																																																																																																											
25248	"	Remove forearm foreign body"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25250	"	Removal of wrist prosthesis"	Q2	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25251	"	Removal of wrist prosthesis"	Q2	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25259	"	Manipulate wrist w/anesthes"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
25260	"	Repair forearm tendon/muscle"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25263	"	Repair forearm tendon/muscle"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25265	"	Repair forearm tendon/muscle"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25270	"	Repair forearm tendon/muscle"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25272	"	Repair forearm tendon/muscle"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25274	"	Repair forearm tendon/muscle"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25275	"	Repair forearm tendon sheath"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25280	"	Revise wrist/forearm tendon"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25290	"	Incise wrist/forearm tendon"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25295	"	Release wrist/forearm tendon"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25300	"	Fusion of tendons at wrist"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25301	"	Fusion of tendons at wrist"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25310	"	Transplant forearm tendon"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25312	"	Transplant forearm tendon"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25315	"	Revise palsy hand tendon(s)"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25316	"	Revise palsy hand tendon(s)"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
25320	"	Repair/revise wrist joint"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25332	"	Revise wrist joint"	T	0047	42.9663	"$3,122.45"	.	$624.49																																																																																																						
25335	"	Realignment of hand"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25337	"	Reconstruct ulna/radioulnar"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25350	"	Revision of radius"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25355	"	Revision of radius"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25360	"	Revision of ulna"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25365	"	Revise radius & ulna"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25370	"	Revise radius or ulna"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25375	"	Revise radius & ulna"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25390	"	Shorten radius or ulna"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25391	"	Lengthen radius or ulna"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25392	"	Shorten radius & ulna"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
25393	"	Lengthen radius & ulna"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25394	"	Repair carpal bone shorten"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25400	"	Repair radius or ulna"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25405	"	Repair/graft radius or ulna"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
25415	"	Repair radius & ulna"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
25420	"	Repair/graft radius & ulna"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
25425	"	Repair/graft radius or ulna"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25426	"	Repair/graft radius & ulna"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25430	"	Vasc graft into carpal bone"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25431	"	Repair nonunion carpal bone"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25440	"	Repair/graft wrist bone"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25441	"	Reconstruct wrist joint"	T	0425	133.9177	"$9,732.07"	.	"$1,946.42"																																																																																																						
25442	"	Reconstruct wrist joint"	T	0425	133.9177	"$9,732.07"	.	"$1,946.42"																																																																																																						
25443	"	Reconstruct wrist joint"	T	0048	63.8333	"$4,638.89"	.	$927.78																																																																																																						
25444	"	Reconstruct wrist joint"	T	0048	63.8333	"$4,638.89"	.	$927.78																																																																																																						
25445	"	Reconstruct wrist joint"	T	0048	63.8333	"$4,638.89"	.	$927.78																																																																																																						
25446	"	Wrist replacement"	T	0425	133.9177	"$9,732.07"	.	"$1,946.42"																																																																																																						
25447	"	Repair wrist joints"	T	0047	42.9663	"$3,122.45"	.	$624.49																																																																																																						
25449	"	Remove wrist joint implant"	T	0047	42.9663	"$3,122.45"	.	$624.49																																																																																																						
25450	"	Revision of wrist joint"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25455	"	Revision of wrist joint"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25490	"	Reinforce radius"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25491	"	Reinforce ulna"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25492	"	Reinforce radius and ulna"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25500	"	Treat fracture of radius"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
25505	"	Treat fracture of radius"	T	0139	6.1774	$448.92	.	$89.79																																																																																																						
25515	"	Treat fracture of radius"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
25520	"	Treat fracture of radius"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
25525	"	Treat fracture of radius"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
25526	"	Treat fracture of radius"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
25530	"	Treat fracture of ulna"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
25535	"	Treat fracture of ulna"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
25545	"	Treat fracture of ulna"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
25560	"	Treat fracture radius & ulna"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
25565	"	Treat fracture radius & ulna"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
25574	"	Treat fracture radius & ulna"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
25575	"	Treat fracture radius/ulna"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
25600	"	Treat fracture radius/ulna"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
25605	"	Treat fracture radius/ulna"	T	0139	6.1774	$448.92	.	$89.79																																																																																																						
25606	"	Treat fx distal radial"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
25607	"	Treat fx rad extra-articul"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
25608	"	Treat fx rad intra-articul"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
25609	"	Treat fx radial 3+ frag"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
25622	"	Treat wrist bone fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
25624	"	Treat wrist bone fracture"	T	0139	6.1774	$448.92	.	$89.79																																																																																																						
25628	"	Treat wrist bone fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
25630	"	Treat wrist bone fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
25635	"	Treat wrist bone fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
25645	"	Treat wrist bone fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
25650	"	Treat wrist bone fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
25651	"	Pin ulnar styloid fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
25652	"	Treat fracture ulnar styloid"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
25660	"	Treat wrist dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
25670	"	Treat wrist dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
25671	"	Pin radioulnar dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
25675	"	Treat wrist dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
25676	"	Treat wrist dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
25680	"	Treat wrist fracture"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
25685	"	Treat wrist fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
25690	"	Treat wrist dislocation"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
25695	"	Treat wrist dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
25800	"	Fusion of wrist joint"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
25805	"	Fusion/graft of wrist joint"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
25810	"	Fusion/graft of wrist joint"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
25820	"	Fusion of hand bones"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25825	"	Fuse hand bones with graft"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
25830	"	Fusion radioulnar jnt/ulna"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
25900	"	Amputation of forearm"	C																																																																																																											
25905	"	Amputation of forearm"	C																																																																																																											
25907	"	Amputation follow-up surgery"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25909	"	Amputation follow-up surgery"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25915	"	Amputation of forearm"	C																																																																																																											
25920	"	Amputate hand at wrist"	C																																																																																																											
25922	"	Amputate hand at wrist"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25924	"	Amputation follow-up surgery"	C																																																																																																											
25927	"	Amputation of hand"	C																																																																																																											
25929	"	Amputation follow-up surgery"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
25931	"	Amputation follow-up surgery"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
25999	"	Forearm or wrist surgery"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
26010	"	Drainage of finger abscess"	T	0006	2.1970	$159.66	.	$31.94																																																																																																						
26011	"	Drainage of finger abscess"	T	0007	11.6214	$844.55	.	$168.91																																																																																																						
26020	"	Drain hand tendon sheath"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26025	"	Drainage of palm bursa"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26030	"	Drainage of palm bursas"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26034	"	Treat hand bone lesion"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26035	"	Decompress fingers/hand"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26037	"	Decompress fingers/hand"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26040	"	Release palm contracture"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26045	"	Release palm contracture"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26055	"	Incise finger tendon sheath"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26060	"	Incision of finger tendon"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26070	"	Explore/treat hand joint"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26075	"	Explore/treat finger joint"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26080	"	Explore/treat finger joint"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26100	"	Biopsy hand joint lining"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26105	"	Biopsy finger joint lining"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26110	"	Biopsy finger joint lining"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26111	"	Exc hand les sc 1.5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
26113	"	Exc hand tum deep 1.5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
26115	"	Exc hand les sc < 1.5 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
26116	"	Exc hand tum deep < 1.5 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
26117	"	Rad resect hand tumor < 3 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
26118	"	Rad resect hand tumor 3 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
26121	"	Release palm contracture"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26123	"	Release palm contracture"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26125	"	Release palm contracture"	N																																																																																																											
26130	"	Remove wrist joint lining"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26135	"	Revise finger joint each"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26140	"	Revise finger joint each"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26145	"	Tendon excision palm/finger"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26160	"	Remove tendon sheath lesion"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26170	"	Removal of palm tendon each"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26180	"	Removal of finger tendon"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26185	"	Remove finger bone"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26200	"	Remove hand bone lesion"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26205	"	Remove/graft bone lesion"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26210	"	Removal of finger lesion"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26215	"	Remove/graft finger lesion"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26230	"	Partial removal of hand bone"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26235	"	Partial removal finger bone"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26236	"	Partial removal finger bone"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26250	"	Extensive hand surgery"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26260	"	Resect prox finger tumor"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26262	"	Resect distal finger tumor"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26320	"	Removal of implant from hand"	Q2	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
26340	"	Manipulate finger w/anesth"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
26341	"	Manipulat palm cord post inj"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
26350	"	Repair finger/hand tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26352	"	Repair/graft hand tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26356	"	Repair finger/hand tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26357	"	Repair finger/hand tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26358	"	Repair/graft hand tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26370	"	Repair finger/hand tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26372	"	Repair/graft hand tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26373	"	Repair finger/hand tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26390	"	Revise hand/finger tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26392	"	Repair/graft hand tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26410	"	Repair hand tendon"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26412	"	Repair/graft hand tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26415	"	Excision hand/finger tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26416	"	Graft hand or finger tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26418	"	Repair finger tendon"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26420	"	Repair/graft finger tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26426	"	Repair finger/hand tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26428	"	Repair/graft finger tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26432	"	Repair finger tendon"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26433	"	Repair finger tendon"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26434	"	Repair/graft finger tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26437	"	Realignment of tendons"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26440	"	Release palm/finger tendon"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26442	"	Release palm & finger tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26445	"	Release hand/finger tendon"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26449	"	Release forearm/hand tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26450	"	Incision of palm tendon"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26455	"	Incision of finger tendon"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26460	"	Incise hand/finger tendon"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26471	"	Fusion of finger tendons"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26474	"	Fusion of finger tendons"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26476	"	Tendon lengthening"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26477	"	Tendon shortening"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26478	"	Lengthening of hand tendon"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26479	"	Shortening of hand tendon"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26480	"	Transplant hand tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26483	"	Transplant/graft hand tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26485	"	Transplant palm tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26489	"	Transplant/graft palm tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26490	"	Revise thumb tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26492	"	Tendon transfer with graft"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26494	"	Hand tendon/muscle transfer"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26496	"	Revise thumb tendon"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26497	"	Finger tendon transfer"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26498	"	Finger tendon transfer"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26499	"	Revision of finger"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26500	"	Hand tendon reconstruction"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26502	"	Hand tendon reconstruction"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26508	"	Release thumb contracture"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26510	"	Thumb tendon transfer"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26516	"	Fusion of knuckle joint"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26517	"	Fusion of knuckle joints"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26518	"	Fusion of knuckle joints"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26520	"	Release knuckle contracture"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26525	"	Release finger contracture"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26530	"	Revise knuckle joint"	T	0047	42.9663	"$3,122.45"	.	$624.49																																																																																																						
26531	"	Revise knuckle with implant"	T	0048	63.8333	"$4,638.89"	.	$927.78																																																																																																						
26535	"	Revise finger joint"	T	0047	42.9663	"$3,122.45"	.	$624.49																																																																																																						
26536	"	Revise/implant finger joint"	T	0048	63.8333	"$4,638.89"	.	$927.78																																																																																																						
26540	"	Repair hand joint"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26541	"	Repair hand joint with graft"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26542	"	Repair hand joint with graft"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26545	"	Reconstruct finger joint"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26546	"	Repair nonunion hand"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26548	"	Reconstruct finger joint"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26550	"	Construct thumb replacement"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26551	"	Great toe-hand transfer"	C																																																																																																											
26553	"	Single transfer toe-hand"	C																																																																																																											
26554	"	Double transfer toe-hand"	C																																																																																																											
26555	"	Positional change of finger"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26556	"	Toe joint transfer"	C																																																																																																											
26560	"	Repair of web finger"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26561	"	Repair of web finger"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26562	"	Repair of web finger"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26565	"	Correct metacarpal flaw"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26567	"	Correct finger deformity"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26568	"	Lengthen metacarpal/finger"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26580	"	Repair hand deformity"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26587	"	Reconstruct extra finger"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26590	"	Repair finger deformity"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26591	"	Repair muscles of hand"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26593	"	Release muscles of hand"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26596	"	Excision constricting tissue"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26600	"	Treat metacarpal fracture"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
26605	"	Treat metacarpal fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
26607	"	Treat metacarpal fracture"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
26608	"	Treat metacarpal fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
26615	"	Treat metacarpal fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
26641	"	Treat thumb dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
26645	"	Treat thumb fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
26650	"	Treat thumb fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
26665	"	Treat thumb fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
26670	"	Treat hand dislocation"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
26675	"	Treat hand dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
26676	"	Pin hand dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
26685	"	Treat hand dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
26686	"	Treat hand dislocation"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
26700	"	Treat knuckle dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
26705	"	Treat knuckle dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
26706	"	Pin knuckle dislocation"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
26715	"	Treat knuckle dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
26720	"	Treat finger fracture each"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
26725	"	Treat finger fracture each"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
26727	"	Treat finger fracture each"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
26735	"	Treat finger fracture each"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
26740	"	Treat finger fracture each"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
26742	"	Treat finger fracture each"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
26746	"	Treat finger fracture each"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
26750	"	Treat finger fracture each"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
26755	"	Treat finger fracture each"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
26756	"	Pin finger fracture each"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
26765	"	Treat finger fracture each"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
26770	"	Treat finger dislocation"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
26775	"	Treat finger dislocation"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
26776	"	Pin finger dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
26785	"	Treat finger dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
26820	"	Thumb fusion with graft"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26841	"	Fusion of thumb"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26842	"	Thumb fusion with graft"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26843	"	Fusion of hand joint"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26844	"	Fusion/graft of hand joint"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26850	"	Fusion of knuckle"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26852	"	Fusion of knuckle with graft"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26860	"	Fusion of finger joint"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26861	"	Fusion of finger jnt add-on"	N																																																																																																											
26862	"	Fusion/graft of finger joint"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26863	"	Fuse/graft added joint"	N																																																																																																											
26910	"	Amputate metacarpal bone"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
26951	"	Amputation of finger/thumb"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26952	"	Amputation of finger/thumb"	T	0053	17.2090	"$1,250.61"	.	$250.13																																																																																																						
26989	"	Hand/finger surgery"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
26990	"	Drainage of pelvis lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
26991	"	Drainage of pelvis bursa"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
26992	"	Drainage of bone lesion"	C																																																																																																											
27000	"	Incision of hip tendon"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27001	"	Incision of hip tendon"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27003	"	Incision of hip tendon"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27005	"	Incision of hip tendon"	C																																																																																																											
27006	"	Incision of hip tendons"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27025	"	Incision of hip/thigh fascia"	C																																																																																																											
27027	"	Buttock fasciotomy"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27030	"	Drainage of hip joint"	C																																																																																																											
27033	"	Exploration of hip joint"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27035	"	Denervation of hip joint"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27036	"	Excision of hip joint/muscle"	C																																																																																																											
27040	"	Biopsy of soft tissues"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
27041	"	Biopsy of soft tissues"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
27043	"	Exc hip pelvis les sc 3 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
27045	"	Exc hip/pelv tum deep 5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
27047	"	Exc hip/pelvis les sc < 3 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
27048	"	Exc hip/pelv tum deep < 5 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
27049	"	Resect hip/pelv tum < 5 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
27050	"	Biopsy of sacroiliac joint"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27052	"	Biopsy of hip joint"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27054	"	Removal of hip joint lining"	C																																																																																																											
27057	"	Buttock fasciotomy w/dbrdmt"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27059	"	Resect hip/pelv tum 5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
27060	"	Removal of ischial bursa"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27062	"	Remove femur lesion/bursa"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27065	"	Remove hip bone les super"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27066	"	Remove hip bone les deep"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27067	"	Remove/graft hip bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
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"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27086	"	Remove hip foreign body"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
27087	"	Remove hip foreign body"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
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"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27098	"	Transfer tendon to pelvis"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27100	"	Transfer of abdominal muscle"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27105	"	Transfer of spinal muscle"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27110	"	Transfer of iliopsoas muscle"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27111	"	Transfer of iliopsoas muscle"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27120	"	Reconstruction of hip socket"	C																																																																																																											
27122	"	Reconstruction of hip socket"	C																																																																																																											
27125	"	Partial hip replacement"	C																																																																																																											
27130	"	Total hip arthroplasty"	C																																																																																																											
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"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
27181	"	Treat slipped epiphysis"	C																																																																																																											
27185	"	Revision of femur epiphysis"	C																																																																																																											
27187	"	Reinforce hip bones"	C																																																																																																											
27193	"	Treat pelvic ring fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27194	"	Treat pelvic ring fracture"	T	0139	6.1774	$448.92	.	$89.79																																																																																																						
27200	"	Treat tail bone fracture"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
27202	"	Treat tail bone fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27215	"	Treat pelvic fracture(s)"	E																																																																																																											
27216	"	Treat pelvic ring fracture"	E																																																																																																											
27217	"	Treat pelvic ring fracture"	E																																																																																																											
27218	"	Treat pelvic ring fracture"	E																																																																																																											
27220	"	Treat hip socket fracture"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
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	0138	2.3869	$173.46	.	$34.70																																																																																																						
27232	"	Treat thigh fracture"	C																																																																																																											
27235	"	Treat thigh fracture"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27236	"	Treat thigh fracture"	C																																																																																																											
27238	"	Treat thigh fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27240	"	Treat thigh fracture"	C																																																																																																											
27244	"	Treat thigh fracture"	C																																																																																																											
27245	"	Treat thigh fracture"	C																																																																																																											
27246	"	Treat thigh fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27248	"	Treat thigh fracture"	C																																																																																																											
27250	"	Treat hip dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27252	"	Treat hip dislocation"	T	0139	6.1774	$448.92	.	$89.79																																																																																																						
27253	"	Treat hip dislocation"	C																																																																																																											
27254	"	Treat hip dislocation"	C																																																																																																											
27256	"	Treat hip dislocation"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
27257	"	Treat hip dislocation"	T	0139	6.1774	$448.92	.	$89.79																																																																																																						
27258	"	Treat hip dislocation"	C																																																																																																											
27259	"	Treat hip dislocation"	C																																																																																																											
27265	"	Treat hip dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27266	"	Treat hip dislocation"	T	0045	15.8858	"$1,154.45"	$257.70	$230.89																																																																																																						
27267	"	Cltx thigh fx"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
27268	"	Cltx thigh fx w/mnpj"	C																																																																																																											
27269	"	Optx thigh fx"	C																																																																																																											
27275	"	Manipulation of hip joint"	T	0045	15.8858	"$1,154.45"	$257.70	$230.89																																																																																																						
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	0129	1.4885	$108.17	.	$21.64																																																																																																						
27301	"	Drain thigh/knee lesion"	T	0008	21.5968	"$1,569.48"	.	$313.90																																																																																																						
27303	"	Drainage of bone lesion"	C																																																																																																											
27305	"	Incise thigh tendon & fascia"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27306	"	Incision of thigh tendon"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27307	"	Incision of thigh tendons"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27310	"	Exploration of knee joint"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27323	"	Biopsy thigh soft tissues"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
27324	"	Biopsy thigh soft tissues"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
27325	"	Neurectomy hamstring"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
27326	"	Neurectomy popliteal"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
27327	"	Exc thigh/knee les sc < 3 cm"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
27328	"	Exc thigh/knee tum deep <5cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
27329	"	Resect thigh/knee tum < 5 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
27330	"	Biopsy knee joint lining"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27331	"	Explore/treat knee joint"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27332	"	Removal of knee cartilage"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27333	"	Removal of knee cartilage"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27334	"	Remove knee joint lining"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27335	"	Remove knee joint lining"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27337	"	Exc thigh/knee les sc 3 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
27339	"	Exc thigh/knee tum dep 5cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
27340	"	Removal of kneecap bursa"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27345	"	Removal of knee cyst"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27347	"	Remove knee cyst"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27350	"	Removal of kneecap"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27355	"	Remove femur lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27356	"	Remove femur lesion/graft"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27357	"	Remove femur lesion/graft"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27358	"	Remove femur lesion/fixation"	N																																																																																																											
27360	"	Partial removal leg bone(s)"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27364	"	Resect thigh/knee tum 5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
27365	"	Resect femur/knee tumor"	C																																																																																																											
27370	"	Injection for knee x-ray"	N																																																																																																											
27372	"	Removal of foreign body"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
27380	"	Repair of kneecap tendon"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27381	"	Repair/graft kneecap tendon"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27385	"	Repair of thigh muscle"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27386	"	Repair/graft of thigh muscle"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27390	"	Incision of thigh tendon"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27391	"	Incision of thigh tendons"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27392	"	Incision of thigh tendons"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27393	"	Lengthening of thigh tendon"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27394	"	Lengthening of thigh tendons"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27395	"	Lengthening of thigh tendons"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27396	"	Transplant of thigh tendon"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27397	"	Transplants of thigh tendons"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27400	"	Revise thigh muscles/tendons"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27403	"	Repair of knee cartilage"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27405	"	Repair of knee ligament"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27407	"	Repair of knee ligament"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
27409	"	Repair of knee ligaments"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27412	"	Autochondrocyte implant knee"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
27415	"	Osteochondral knee allograft"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
27416	"	Osteochondral knee autograft"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27418	"	Repair degenerated kneecap"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27420	"	Revision of unstable kneecap"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27422	"	Revision of unstable kneecap"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27424	"	Revision/removal of kneecap"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27425	"	Lat retinacular release open"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27427	"	Reconstruction knee"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
27428	"	Reconstruction knee"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
27429	"	Reconstruction knee"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
27430	"	Revision of thigh muscles"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27435	"	Incision of knee joint"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27437	"	Revise kneecap"	T	0047	42.9663	"$3,122.45"	.	$624.49																																																																																																						
27438	"	Revise kneecap with implant"	T	0048	63.8333	"$4,638.89"	.	$927.78																																																																																																						
27440	"	Revision of knee joint"	T	0047	42.9663	"$3,122.45"	.	$624.49																																																																																																						
27441	"	Revision of knee joint"	T	0047	42.9663	"$3,122.45"	.	$624.49																																																																																																						
27442	"	Revision of knee joint"	T	0047	42.9663	"$3,122.45"	.	$624.49																																																																																																						
27443	"	Revision of knee joint"	T	0047	42.9663	"$3,122.45"	.	$624.49																																																																																																						
27445	"	Revision of knee joint"	C																																																																																																											
27446	"	Revision of knee joint"	T	0425	133.9177	"$9,732.07"	.	"$1,946.42"																																																																																																						
27447	"	Total knee arthroplasty"	C																																																																																																											
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"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27477	"	Surgery to stop leg growth"	C																																																																																																											
27479	"	Surgery to stop leg growth"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27485	"	Surgery to stop leg growth"	C																																																																																																											
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"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27497	"	Decompression of thigh/knee"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27498	"	Decompression of thigh/knee"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27499	"	Decompression of thigh/knee"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27500	"	Treatment of thigh fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27501	"	Treatment of thigh fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27502	"	Treatment of thigh fracture"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
27503	"	Treatment of thigh fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27506	"	Treatment of thigh fracture"	C																																																																																																											
27507	"	Treatment of thigh fracture"	C																																																																																																											
27508	"	Treatment of thigh fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27509	"	Treatment of thigh fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
27510	"	Treatment of thigh fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
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	0129	1.4885	$108.17	.	$21.64																																																																																																						
27517	"	Treat thigh fx growth plate"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27519	"	Treat thigh fx growth plate"	C																																																																																																											
27520	"	Treat kneecap fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27524	"	Treat kneecap fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27530	"	Treat knee fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27532	"	Treat knee fracture"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
27535	"	Treat knee fracture"	C																																																																																																											
27536	"	Treat knee fracture"	C																																																																																																											
27538	"	Treat knee fracture(s)"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27540	"	Treat knee fracture"	C																																																																																																											
27550	"	Treat knee dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27552	"	Treat knee dislocation"	T	0045	15.8858	"$1,154.45"	$257.70	$230.89																																																																																																						
27556	"	Treat knee dislocation"	C																																																																																																											
27557	"	Treat knee dislocation"	C																																																																																																											
27558	"	Treat knee dislocation"	C																																																																																																											
27560	"	Treat kneecap dislocation"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
27562	"	Treat kneecap dislocation"	T	0139	6.1774	$448.92	.	$89.79																																																																																																						
27566	"	Treat kneecap dislocation"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27570	"	Fixation of knee joint"	T	0045	15.8858	"$1,154.45"	$257.70	$230.89																																																																																																						
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"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27596	"	Amputation follow-up surgery"	C																																																																																																											
27598	"	Amputate lower leg at knee"	C																																																																																																											
27599	"	Leg surgery procedure"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
27600	"	Decompression of lower leg"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27601	"	Decompression of lower leg"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27602	"	Decompression of lower leg"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27603	"	Drain lower leg lesion"	T	0008	21.5968	"$1,569.48"	.	$313.90																																																																																																						
27604	"	Drain lower leg bursa"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27605	"	Incision of achilles tendon"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
27606	"	Incision of achilles tendon"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27607	"	Treat lower leg bone lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27610	"	Explore/treat ankle joint"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27612	"	Exploration of ankle joint"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27613	"	Biopsy lower leg soft tissue"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
27614	"	Biopsy lower leg soft tissue"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
27615	"	Resect leg/ankle tum < 5 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
27616	"	Resect leg/ankle tum 5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
27618	"	Exc leg/ankle tum < 3 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
27619	"	Exc leg/ankle tum deep <5 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
27620	"	Explore/treat ankle joint"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27625	"	Remove ankle joint lining"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27626	"	Remove ankle joint lining"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27630	"	Removal of tendon lesion"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27632	"	Exc leg/ankle les sc 3 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
27634	"	Exc leg/ankle tum dep 5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
27635	"	Remove lower leg bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27637	"	Remove/graft leg bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27638	"	Remove/graft leg bone lesion"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27640	"	Partial removal of tibia"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27641	"	Partial removal of fibula"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27645	"	Resect tibia tumor"	C																																																																																																											
27646	"	Resect fibula tumor"	C																																																																																																											
27647	"	Resect talus/calcaneus tum"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27648	"	Injection for ankle x-ray"	N																																																																																																											
27650	"	Repair achilles tendon"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27652	"	Repair/graft achilles tendon"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27654	"	Repair of achilles tendon"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27656	"	Repair leg fascia defect"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27658	"	Repair of leg tendon each"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27659	"	Repair of leg tendon each"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27664	"	Repair of leg tendon each"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27665	"	Repair of leg tendon each"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27675	"	Repair lower leg tendons"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27676	"	Repair lower leg tendons"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27680	"	Release of lower leg tendon"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27681	"	Release of lower leg tendons"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27685	"	Revision of lower leg tendon"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27686	"	Revise lower leg tendons"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27687	"	Revision of calf tendon"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27690	"	Revise lower leg tendon"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27691	"	Revise lower leg tendon"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27692	"	Revise additional leg tendon"	N																																																																																																											
27695	"	Repair of ankle ligament"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27696	"	Repair of ankle ligaments"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27698	"	Repair of ankle ligament"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27700	"	Revision of ankle joint"	T	0047	42.9663	"$3,122.45"	.	$624.49																																																																																																						
27702	"	Reconstruct ankle joint"	C																																																																																																											
27703	"	Reconstruction ankle joint"	C																																																																																																											
27704	"	Removal of ankle implant"	Q2	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27705	"	Incision of tibia"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27707	"	Incision of fibula"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27709	"	Incision of tibia & fibula"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27712	"	Realignment of lower leg"	C																																																																																																											
27715	"	Revision of lower leg"	C																																																																																																											
27720	"	Repair of tibia"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27722	"	Repair/graft of tibia"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
27724	"	Repair/graft of tibia"	C																																																																																																											
27725	"	Repair of lower leg"	C																																																																																																											
27726	"	Repair fibula nonunion"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27727	"	Repair of lower leg"	C																																																																																																											
27730	"	Repair of tibia epiphysis"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27732	"	Repair of fibula epiphysis"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27734	"	Repair lower leg epiphyses"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27740	"	Repair of leg epiphyses"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27742	"	Repair of leg epiphyses"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
27745	"	Reinforce tibia"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
27750	"	Treatment of tibia fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27752	"	Treatment of tibia fracture"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
27756	"	Treatment of tibia fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
27758	"	Treatment of tibia fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27759	"	Treatment of tibia fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
27760	"	Cltx medial ankle fx"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27762	"	Cltx med ankle fx w/mnpj"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
27766	"	Optx medial ankle fx"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27767	"	Cltx post ankle fx"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
27768	"	Cltx post ankle fx w/mnpj"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
27769	"	Optx post ankle fx"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27780	"	Treatment of fibula fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27781	"	Treatment of fibula fracture"	T	0139	6.1774	$448.92	.	$89.79																																																																																																						
27784	"	Treatment of fibula fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27786	"	Treatment of ankle fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27788	"	Treatment of ankle fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27792	"	Treatment of ankle fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27808	"	Treatment of ankle fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27810	"	Treatment of ankle fracture"	T	0139	6.1774	$448.92	.	$89.79																																																																																																						
27814	"	Treatment of ankle fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27816	"	Treatment of ankle fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27818	"	Treatment of ankle fracture"	T	0139	6.1774	$448.92	.	$89.79																																																																																																						
27822	"	Treatment of ankle fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27823	"	Treatment of ankle fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
27824	"	Treat lower leg fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27825	"	Treat lower leg fracture"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
27826	"	Treat lower leg fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27827	"	Treat lower leg fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
27828	"	Treat lower leg fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
27829	"	Treat lower leg joint"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27830	"	Treat lower leg dislocation"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
27831	"	Treat lower leg dislocation"	T	0139	6.1774	$448.92	.	$89.79																																																																																																						
27832	"	Treat lower leg dislocation"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27840	"	Treat ankle dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
27842	"	Treat ankle dislocation"	T	0045	15.8858	"$1,154.45"	$257.70	$230.89																																																																																																						
27846	"	Treat ankle dislocation"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27848	"	Treat ankle dislocation"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
27860	"	Fixation of ankle joint"	T	0045	15.8858	"$1,154.45"	$257.70	$230.89																																																																																																						
27870	"	Fusion of ankle joint open"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
27871	"	Fusion of tibiofibular joint"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
27880	"	Amputation of lower leg"	C																																																																																																											
27881	"	Amputation of lower leg"	C																																																																																																											
27882	"	Amputation of lower leg"	C																																																																																																											
27884	"	Amputation follow-up surgery"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
27886	"	Amputation follow-up surgery"	C																																																																																																											
27888	"	Amputation of foot at ankle"	C																																																																																																											
27889	"	Amputation of foot at ankle"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27892	"	Decompression of leg"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27893	"	Decompression of leg"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27894	"	Decompression of leg"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
27899	"	Leg/ankle surgery procedure"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
28001	"	Drainage of bursa of foot"	T	0007	11.6214	$844.55	.	$168.91																																																																																																						
28002	"	Treatment of foot infection"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
28003	"	Treatment of foot infection"	T	0049	22.5544	"$1,639.07"	.	$327.82																																																																																																						
28005	"	Treat foot bone lesion"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28008	"	Incision of foot fascia"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28010	"	Incision of toe tendon"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28011	"	Incision of toe tendons"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28020	"	Exploration of foot joint"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28022	"	Exploration of foot joint"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28024	"	Exploration of toe joint"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28035	"	Decompression of tibia nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
28039	"	Exc foot/toe tum sc 1.5 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
28041	"	Exc foot/toe tum dep 1.5cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
28043	"	Exc foot/toe tum sc < 1.5 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
28045	"	Exc foot/toe tum deep <1.5cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
28046	"	Resect foot/toe tumor < 3 cm"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
28047	"	Resect foot/toe tumor 3 cm/>"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
28050	"	Biopsy of foot joint lining"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28052	"	Biopsy of foot joint lining"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28054	"	Biopsy of toe joint lining"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28055	"	Neurectomy foot"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
28060	"	Partial removal foot fascia"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28062	"	Removal of foot fascia"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28070	"	Removal of foot joint lining"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28072	"	Removal of foot joint lining"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28080	"	Removal of foot lesion"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28086	"	Excise foot tendon sheath"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28088	"	Excise foot tendon sheath"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28090	"	Removal of foot lesion"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28092	"	Removal of toe lesions"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28100	"	Removal of ankle/heel lesion"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28102	"	Remove/graft foot lesion"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28103	"	Remove/graft foot lesion"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28104	"	Removal of foot lesion"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28106	"	Remove/graft foot lesion"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28107	"	Remove/graft foot lesion"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28108	"	Removal of toe lesions"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28110	"	Part removal of metatarsal"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28111	"	Part removal of metatarsal"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28112	"	Part removal of metatarsal"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28113	"	Part removal of metatarsal"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28114	"	Removal of metatarsal heads"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28116	"	Revision of foot"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28118	"	Removal of heel bone"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28119	"	Removal of heel spur"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28120	"	Part removal of ankle/heel"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28122	"	Partial removal of foot bone"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28124	"	Partial removal of toe"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28126	"	Partial removal of toe"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28130	"	Removal of ankle bone"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28140	"	Removal of metatarsal"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28150	"	Removal of toe"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28153	"	Partial removal of toe"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28160	"	Partial removal of toe"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28171	"	Resect tarsal tumor"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28173	"	Resect metatarsal tumor"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28175	"	Resect phalanx of toe tumor"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28190	"	Removal of foot foreign body"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
28192	"	Removal of foot foreign body"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
28193	"	Removal of foot foreign body"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
28200	"	Repair of foot tendon"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28202	"	Repair/graft of foot tendon"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28208	"	Repair of foot tendon"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28210	"	Repair/graft of foot tendon"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28220	"	Release of foot tendon"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28222	"	Release of foot tendons"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28225	"	Release of foot tendon"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28226	"	Release of foot tendons"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28230	"	Incision of foot tendon(s)"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28232	"	Incision of toe tendon"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28234	"	Incision of foot tendon"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28238	"	Revision of foot tendon"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28240	"	Release of big toe"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28250	"	Revision of foot fascia"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28260	"	Release of midfoot joint"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28261	"	Revision of foot tendon"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28262	"	Revision of foot and ankle"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28264	"	Release of midfoot joint"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28270	"	Release of foot contracture"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28272	"	Release of toe joint each"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28280	"	Fusion of toes"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28285	"	Repair of hammertoe"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28286	"	Repair of hammertoe"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28288	"	Partial removal of foot bone"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28289	"	Repair hallux rigidus"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28290	"	Correction of bunion"	T	0057	35.9716	"$2,614.13"	.	$522.83																																																																																																						
28292	"	Correction of bunion"	T	0057	35.9716	"$2,614.13"	.	$522.83																																																																																																						
28293	"	Correction of bunion"	T	0057	35.9716	"$2,614.13"	.	$522.83																																																																																																						
28294	"	Correction of bunion"	T	0057	35.9716	"$2,614.13"	.	$522.83																																																																																																						
28296	"	Correction of bunion"	T	0057	35.9716	"$2,614.13"	.	$522.83																																																																																																						
28297	"	Correction of bunion"	T	0057	35.9716	"$2,614.13"	.	$522.83																																																																																																						
28298	"	Correction of bunion"	T	0057	35.9716	"$2,614.13"	.	$522.83																																																																																																						
28299	"	Correction of bunion"	T	0057	35.9716	"$2,614.13"	.	$522.83																																																																																																						
28300	"	Incision of heel bone"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28302	"	Incision of ankle bone"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28304	"	Incision of midfoot bones"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28305	"	Incise/graft midfoot bones"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28306	"	Incision of metatarsal"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28307	"	Incision of metatarsal"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28308	"	Incision of metatarsal"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28309	"	Incision of metatarsals"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28310	"	Revision of big toe"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28312	"	Revision of toe"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28313	"	Repair deformity of toe"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28315	"	Removal of sesamoid bone"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28320	"	Repair of foot bones"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28322	"	Repair of metatarsals"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28340	"	Resect enlarged toe tissue"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28341	"	Resect enlarged toe"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28344	"	Repair extra toe(s)"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28345	"	Repair webbed toe(s)"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28360	"	Reconstruct cleft foot"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28400	"	Treatment of heel fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
28405	"	Treatment of heel fracture"	T	0139	6.1774	$448.92	.	$89.79																																																																																																						
28406	"	Treatment of heel fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28415	"	Treat heel fracture"	T	0064	74.0813	"$5,383.64"	.	"$1,076.73"																																																																																																						
28420	"	Treat/graft heel fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
28430	"	Treatment of ankle fracture"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
28435	"	Treatment of ankle fracture"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
28436	"	Treatment of ankle fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28445	"	Treat ankle fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
28446	"	Osteochondral talus autogrft"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28450	"	Treat midfoot fracture each"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
28455	"	Treat midfoot fracture each"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
28456	"	Treat midfoot fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28465	"	Treat midfoot fracture each"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
28470	"	Treat metatarsal fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
28475	"	Treat metatarsal fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
28476	"	Treat metatarsal fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28485	"	Treat metatarsal fracture"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
28490	"	Treat big toe fracture"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
28495	"	Treat big toe fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
28496	"	Treat big toe fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28505	"	Treat big toe fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28510	"	Treatment of toe fracture"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
28515	"	Treatment of toe fracture"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
28525	"	Treat toe fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28530	"	Treat sesamoid bone fracture"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
28531	"	Treat sesamoid bone fracture"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28540	"	Treat foot dislocation"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
28545	"	Treat foot dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28546	"	Treat foot dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28555	"	Repair foot dislocation"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
28570	"	Treat foot dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
28575	"	Treat foot dislocation"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
28576	"	Treat foot dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28585	"	Repair foot dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28600	"	Treat foot dislocation"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
28605	"	Treat foot dislocation"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
28606	"	Treat foot dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28615	"	Repair foot dislocation"	T	0063	56.7594	"$4,124.82"	.	$824.97																																																																																																						
28630	"	Treat toe dislocation"	T	0138	2.3869	$173.46	.	$34.70																																																																																																						
28635	"	Treat toe dislocation"	T	0431	17.2302	"$1,252.15"	.	$250.43																																																																																																						
28636	"	Treat toe dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28645	"	Repair toe dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28660	"	Treat toe dislocation"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
28665	"	Treat toe dislocation"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
28666	"	Treat toe dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28675	"	Repair of toe dislocation"	T	0062	27.6887	"$2,012.19"	.	$402.44																																																																																																						
28705	"	Fusion of foot bones"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28715	"	Fusion of foot bones"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
28725	"	Fusion of foot bones"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28730	"	Fusion of foot bones"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28735	"	Fusion of foot bones"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28737	"	Revision of foot bones"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28740	"	Fusion of foot bones"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28750	"	Fusion of big toe joint"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28755	"	Fusion of big toe joint"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28760	"	Fusion of big toe joint"	T	0056	67.0037	"$4,869.29"	.	$973.86																																																																																																						
28800	"	Amputation of midfoot"	C																																																																																																											
28805	"	Amputation thru metatarsal"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28810	"	Amputation toe & metatarsal"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28820	"	Amputation of toe"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28825	"	Partial amputation of toe"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
28890	"	Hi enrgy eswt plantar fascia"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
28899	"	Foot/toes surgery procedure"	T	0129	1.4885	$108.17	.	$21.64																																																																																																						
29000	"	Application of body cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29010	"	Application of body cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29015	"	Application of body cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29020	"	Application of body cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29025	"	Application of body cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29035	"	Application of body cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29040	"	Application of body cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29044	"	Application of body cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29046	"	Application of body cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29049	"	Application of figure eight"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29055	"	Application of shoulder cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29058	"	Application of shoulder cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29065	"	Application of long arm cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29075	"	Application of forearm cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29085	"	Apply hand/wrist cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29086	"	Apply finger cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29105	"	Apply long arm splint"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29125	"	Apply forearm splint"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29126	"	Apply forearm splint"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29130	"	Application of finger splint"	S	0059	0.7685	$55.85	.	$11.17																																																																																																						
29131	"	Application of finger splint"	S	0059	0.7685	$55.85	.	$11.17																																																																																																						
29200	"	Strapping of chest"	S	0059	0.7685	$55.85	.	$11.17																																																																																																						
29240	"	Strapping of shoulder"	S	0059	0.7685	$55.85	.	$11.17																																																																																																						
29260	"	Strapping of elbow or wrist"	S	0059	0.7685	$55.85	.	$11.17																																																																																																						
29280	"	Strapping of hand or finger"	S	0059	0.7685	$55.85	.	$11.17																																																																																																						
29305	"	Application of hip cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29325	"	Application of hip casts"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29345	"	Application of long leg cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29355	"	Application of long leg cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29358	"	Apply long leg cast brace"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29365	"	Application of long leg cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29405	"	Apply short leg cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29425	"	Apply short leg cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29435	"	Apply short leg cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29440	"	Addition of walker to cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29445	"	Apply rigid leg cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29450	"	Application of leg cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29505	"	Application long leg splint"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29515	"	Application lower leg splint"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29520	"	Strapping of hip"	S	0059	0.7685	$55.85	.	$11.17																																																																																																						
29530	"	Strapping of knee"	S	0059	0.7685	$55.85	.	$11.17																																																																																																						
29540	"	Strapping of ankle and/or ft"	S	0059	0.7685	$55.85	.	$11.17																																																																																																						
29550	"	Strapping of toes"	S	0059	0.7685	$55.85	.	$11.17																																																																																																						
29580	"	Application of paste boot"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29581	"	Apply multlay comprs lwr leg"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29582	"	Apply multlay comprs upr leg"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29583	"	Apply multlay comprs upr arm"	S	0059	0.7685	$55.85	.	$11.17																																																																																																						
29584	"	Appl multlay comprs arm/hand"	S	0059	0.7685	$55.85	.	$11.17																																																																																																						
29700	"	Removal/revision of cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29705	"	Removal/revision of cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29710	"	Removal/revision of cast"	S	0426	1.9032	$138.31	.	$27.67																																																																																																						
29715	"	Removal/revision of cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29720	"	Repair of body cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29730	"	Windowing of cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29740	"	Wedging of cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29750	"	Wedging of clubfoot cast"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29799	"	Casting/strapping procedure"	S	0058	1.3789	$100.21	.	$20.05																																																																																																						
29800	"	Jaw arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29804	"	Jaw arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29805	"	Shoulder arthroscopy dx"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29806	"	Shoulder arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29807	"	Shoulder arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29819	"	Shoulder arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29820	"	Shoulder arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29821	"	Shoulder arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29822	"	Shoulder arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29823	"	Shoulder arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29824	"	Shoulder arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29825	"	Shoulder arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29826	"	Shoulder arthroscopy/surgery"	N																																																																																																											
29827	"	Arthroscop rotator cuff repr"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29828	"	Arthroscopy biceps tenodesis"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29830	"	Elbow arthroscopy"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29834	"	Elbow arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29835	"	Elbow arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29836	"	Elbow arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29837	"	Elbow arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29838	"	Elbow arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29840	"	Wrist arthroscopy"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29843	"	Wrist arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29844	"	Wrist arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29845	"	Wrist arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29846	"	Wrist arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29847	"	Wrist arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29848	"	Wrist endoscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29850	"	Knee arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29851	"	Knee arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29855	"	Tibial arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29856	"	Tibial arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29860	"	Hip arthroscopy dx"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29861	"	Hip arthro w/fb removal"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29862	"	Hip arthr0 w/debridement"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29863	"	Hip arthr0 w/synovectomy"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29866	"	Autgrft implnt knee w/scope"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29867	"	Allgrft implnt knee w/scope"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29868	"	Meniscal trnspl knee w/scpe"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29870	"	Knee arthroscopy dx"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29871	"	Knee arthroscopy/drainage"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29873	"	Knee arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29874	"	Knee arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29875	"	Knee arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29876	"	Knee arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29877	"	Knee arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29879	"	Knee arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29880	"	Knee arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29881	"	Knee arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29882	"	Knee arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29883	"	Knee arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29884	"	Knee arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29885	"	Knee arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29886	"	Knee arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29887	"	Knee arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29888	"	Knee arthroscopy/surgery"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
29889	"	Knee arthroscopy/surgery"	T	0052	89.5388	"$6,506.96"	.	"$1,301.40"																																																																																																						
29891	"	Ankle arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29892	"	Ankle arthroscopy/surgery"	T	0051	52.0371	"$3,781.64"	.	$756.33																																																																																																						
29893	"	Scope plantar fasciotomy"	T	0055	23.1692	"$1,683.75"	$353.37	$336.75																																																																																																						
29894	"	Ankle arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29895	"	Ankle arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29897	"	Ankle arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29898	"	Ankle arthroscopy/surgery"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29899	"	Ankle arthroscopy/surgery"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29900	"	Mcp joint arthroscopy dx"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29901	"	Mcp joint arthroscopy surg"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29902	"	Mcp joint arthroscopy surg"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29904	"	Subtalar arthro w/fb rmvl"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29905	"	Subtalar arthro w/exc"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29906	"	Subtalar arthro w/deb"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
29907	"	Subtalar arthro w/fusion"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29914	"	Hip arthro w/femoroplasty"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29915	"	Hip arthro acetabuloplasty"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29916	"	Hip arthro w/labral repair"	T	0042	58.6059	"$4,259.01"	.	$851.81																																																																																																						
29999	"	Arthroscopy of joint"	T	0041	29.6630	"$2,155.67"	.	$431.14																																																																																																						
30000	"	Drainage of nose lesion"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
30020	"	Drainage of nose lesion"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
3006F	"	Cxr doc rev"	E																																																																																																											
3008F	"	Body mass index docd"	E																																																																																																											
30100	"	Intranasal biopsy"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
30110	"	Removal of nose polyp(s)"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
30115	"	Removal of nose polyp(s)"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
30117	"	Removal of intranasal lesion"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
30118	"	Removal of intranasal lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
3011F	"	Lipid panel doc rev"	E																																																																																																											
30120	"	Revision of nose"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
30124	"	Removal of nose lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
30125	"	Removal of nose lesion"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
30130	"	Excise inferior turbinate"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
30140	"	Resect inferior turbinate"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
3014F	"	Screen mammo doc rev"	M																																																																																																											
30150	"	Partial removal of nose"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
3015F	"	Cerv cancer screen docd"	E																																																																																																											
30160	"	Removal of nose"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
3016F	"	Pt scrnd unhlthy oh use"	M																																																																																																											
3017F	"	Colorectal ca screen doc rev"	M																																																																																																											
3018F	"	Pre-prxd rsk et al docd"	E																																																																																																											
3019F	"	Lvef assess planpost dschrge"	E																																																																																																											
30200	"	Injection treatment of nose"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
3020F	"	Lvf assess"	E																																																																																																											
30210	"	Nasal sinus therapy"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
3021F	"	Lvef mod/sever deprs syst"	M																																																																																																											
30220	"	Insert nasal septal button"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
3022F	"	Lvef >/=40% systolic"	M																																																																																																											
3023F	"	Spirom doc rev"	M																																																																																																											
3025F	"	Spirom fev/fvc <70% w/copd"	E																																																																																																											
3027F	"	Spirom fev/fvc>/=70%/w/ocopd"	E																																																																																																											
3028F	"	O2 saturation doc rev"	E																																																																																																											
30300	"	Remove nasal foreign body"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
30310	"	Remove nasal foreign body"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
30320	"	Remove nasal foreign body"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
3035F	"	O2 saturation</=88%/pao</=55"	E																																																																																																											
3037F	"	O2 saturation >88%/pao>55 hg"	E																																																																																																											
3038F	"	Pulm fx w/in 12 mon b/4 surg"	M																																																																																																											
30400	"	Reconstruction of nose"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
3040F	"	Fev <40% predicted value"	E																																																																																																											
30410	"	Reconstruction of nose"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
30420	"	Reconstruction of nose"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
3042F	"	Fev >/=40% predicted value"	E																																																																																																											
30430	"	Revision of nose"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
30435	"	Revision of nose"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
3044F	"	Hg a1c level lt 7.0%"	M																																																																																																											
30450	"	Revision of nose"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
3045F	"	Hg a1c level 7.0-9.0%"	M																																																																																																											
30460	"	Revision of nose"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
30462	"	Revision of nose"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
30465	"	Repair nasal stenosis"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
3046F	"	Hemoglobin a1c level >9.0%"	M																																																																																																											
3048F	"	Ldl-c <100 mg/dl"	M																																																																																																											
3049F	"	Ldl-c 100-129 mg/dl"	M																																																																																																											
3050F	"	Ldl-c >/= 130 mg/dl"	M																																																																																																											
30520	"	Repair of nasal septum"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
30540	"	Repair nasal defect"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
30545	"	Repair nasal defect"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
3055F	"	Lvef less than/equal to 35%"	E																																																																																																											
30560	"	Release of nasal adhesions"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
3056F	"	Lvef greater than 35%"	E																																																																																																											
30580	"	Repair upper jaw fistula"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
30600	"	Repair mouth/nose fistula"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
3060F	"	Pos microalbuminuria rev"	M																																																																																																											
3061F	"	Neg microalbuminuria rev"	M																																																																																																											
30620	"	Intranasal reconstruction"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
3062F	"	Pos macroalbuminuria rev"	M																																																																																																											
30630	"	Repair nasal septum defect"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
3066F	"	Nephropathy doc tx"	M																																																																																																											
3072F	"	Low risk for retinopathy"	M																																																																																																											
3073F	"	Pre-surg eye measures docd"	E																																																																																																											
3074F	"	Syst bp lt 130 mm hg"	E																																																																																																											
3075F	"	Syst bp ge 130 - 139mm hg"	E																																																																																																											
3077F	"	Syst bp >/= 140 mm hg"	E																																																																																																											
3078F	"	Diast bp <80 mm hg"	E																																																																																																											
3079F	"	Diast bp 80-89 mm hg"	E																																																																																																											
30801	"	Ablate inf turbinate superf"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
30802	"	Ablate inf turbinate submuc"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
3080F	"	Diast bp >/= 90 mm hg"	E																																																																																																											
3082F	"	Kt/v <1.2"	E																																																																																																											
3083F	"	Kt/v =/> 1.2 & <1.7"	E																																																																																																											
3084F	"	Kt/v ge 1.7"	E																																																																																																											
3085F	"	Suicide risk assessed"	E																																																																																																											
3088F	"	Mdd mild"	E																																																																																																											
3089F	"	Mdd moderate"	E																																																																																																											
30901	"	Control of nosebleed"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
30903	"	Control of nosebleed"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
30905	"	Control of nosebleed"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
30906	"	Repeat control of nosebleed"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
3090F	"	Mdd severe w/o psych"	E																																																																																																											
30915	"	Ligation nasal sinus artery"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
3091F	"	Mdd severe w/psych"	E																																																																																																											
30920	"	Ligation upper jaw artery"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
3092F	"	Mdd in remission"	E																																																																																																											
30930	"	Ther fx nasal inf turbinate"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
3093F	"	Doc new diag 1st/addl mdd"	E																																																																																																											
3095F	"	Central dexa results docd"	M																																																																																																											
3096F	"	Central dexa ordered"	M																																																																																																											
30999	"	Nasal surgery procedure"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
31000	"	Irrigation maxillary sinus"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
31002	"	Irrigation sphenoid sinus"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
3100F	"	Image test ref carot diam"	M																																																																																																											
31020	"	Exploration maxillary sinus"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
31030	"	Exploration maxillary sinus"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31032	"	Explore sinus remove polyps"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31040	"	Exploration behind upper jaw"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
31050	"	Exploration sphenoid sinus"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31051	"	Sphenoid sinus surgery"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31070	"	Exploration of frontal sinus"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31075	"	Exploration of frontal sinus"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31080	"	Removal of frontal sinus"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31081	"	Removal of frontal sinus"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31084	"	Removal of frontal sinus"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31085	"	Removal of frontal sinus"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31086	"	Removal of frontal sinus"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31087	"	Removal of frontal sinus"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31090	"	Exploration of sinuses"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
3110F	"	Pres/absn hmrhg/lesion docd"	E																																																																																																											
3111F	"	Ct/mri brain done w/in 24hrs"	E																																																																																																											
3112F	"	Ct/mri brain done 24 hrs"	E																																																																																																											
3115F	"	Quant results activity &symp"	E																																																																																																											
3117F	"	Hf assessment tool completed"	E																																																																																																											
3118F	"	Ny heart assoc class docd"	E																																																																																																											
3119F	"	No eval activity clin symp"	E																																																																																																											
31200	"	Removal of ethmoid sinus"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31201	"	Removal of ethmoid sinus"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
31205	"	Removal of ethmoid sinus"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
3120F	"	12-lead ecg performed"	M																																																																																																											
31225	"	Removal of upper jaw"	C																																																																																																											
31230	"	Removal of upper jaw"	C																																																																																																											
31231	"	Nasal endoscopy dx"	T	0071	2.0698	$150.42	.	$30.09																																																																																																						
31233	"	Nasal/sinus endoscopy dx"	T	0072	5.0854	$369.57	.	$73.92																																																																																																						
31235	"	Nasal/sinus endoscopy dx"	T	0073	16.7369	"$1,216.30"	.	$243.26																																																																																																						
31237	"	Nasal/sinus endoscopy surg"	T	0073	16.7369	"$1,216.30"	.	$243.26																																																																																																						
31238	"	Nasal/sinus endoscopy surg"	T	0073	16.7369	"$1,216.30"	.	$243.26																																																																																																						
31239	"	Nasal/sinus endoscopy surg"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
31240	"	Nasal/sinus endoscopy surg"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
31254	"	Revision of ethmoid sinus"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
31255	"	Removal of ethmoid sinus"	T	0075	41.9936	"$3,051.76"	.	$610.36																																																																																																						
31256	"	Exploration maxillary sinus"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
3125F	"	Esoph bx rprt w/dyspl info"	M																																																																																																											
31267	"	Endoscopy maxillary sinus"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
31276	"	Sinus endoscopy surgical"	T	0075	41.9936	"$3,051.76"	.	$610.36																																																																																																						
31287	"	Nasal/sinus endoscopy surg"	T	0075	41.9936	"$3,051.76"	.	$610.36																																																																																																						
31288	"	Nasal/sinus endoscopy surg"	T	0075	41.9936	"$3,051.76"	.	$610.36																																																																																																						
31290	"	Nasal/sinus endoscopy surg"	C																																																																																																											
31291	"	Nasal/sinus endoscopy surg"	C																																																																																																											
31292	"	Nasal/sinus endoscopy surg"	T	0075	41.9936	"$3,051.76"	.	$610.36																																																																																																						
31293	"	Nasal/sinus endoscopy surg"	T	0075	41.9936	"$3,051.76"	.	$610.36																																																																																																						
31294	"	Nasal/sinus endoscopy surg"	T	0075	41.9936	"$3,051.76"	.	$610.36																																																																																																						
31295	"	Sinus endo w/balloon dil"	T	0075	41.9936	"$3,051.76"	.	$610.36																																																																																																						
31296	"	Sinus endo w/balloon dil"	T	0075	41.9936	"$3,051.76"	.	$610.36																																																																																																						
31297	"	Sinus endo w/balloon dil"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
31299	"	Sinus surgery procedure"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
31300	"	Removal of larynx lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
3130F	"	Upper gi endoscopy performed"	E																																																																																																											
31320	"	Diagnostic incision larynx"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
3132F	"	Doc ref upper gi endoscopy"	E																																																																																																											
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"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
3140F	"	Upper gi endo shows barrtts"	E																																																																																																											
3141F	"	Upper gi endo not barrtts"	E																																																																																																											
31420	"	Removal of epiglottis"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
3142F	"	Barium swallow test ordered"	E																																																																																																											
31500	"	Insert emergency airway"	S	0094	2.1968	$159.65	$43.48	$31.93																																																																																																						
31502	"	Change of windpipe airway"	S	0078	1.8631	$135.40	.	$27.08																																																																																																						
31505	"	Diagnostic laryngoscopy"	T	0071	2.0698	$150.42	.	$30.09																																																																																																						
3150F	"	Forceps esoph biopsy done"	E																																																																																																											
31510	"	Laryngoscopy with biopsy"	T	0073	16.7369	"$1,216.30"	.	$243.26																																																																																																						
31511	"	Remove foreign body larynx"	T	0071	2.0698	$150.42	.	$30.09																																																																																																						
31512	"	Removal of larynx lesion"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
31513	"	Injection into vocal cord"	T	0072	5.0854	$369.57	.	$73.92																																																																																																						
31515	"	Laryngoscopy for aspiration"	T	0073	16.7369	"$1,216.30"	.	$243.26																																																																																																						
31520	"	Dx laryngoscopy newborn"	T	0072	5.0854	$369.57	.	$73.92																																																																																																						
31525	"	Dx laryngoscopy excl nb"	T	0073	16.7369	"$1,216.30"	.	$243.26																																																																																																						
31526	"	Dx laryngoscopy w/oper scope"	T	0073	16.7369	"$1,216.30"	.	$243.26																																																																																																						
31527	"	Laryngoscopy for treatment"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
31528	"	Laryngoscopy and dilation"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
31529	"	Laryngoscopy and dilation"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
31530	"	Laryngoscopy w/fb removal"	T	0073	16.7369	"$1,216.30"	.	$243.26																																																																																																						
31531	"	Laryngoscopy w/fb & op scope"	T	0073	16.7369	"$1,216.30"	.	$243.26																																																																																																						
31535	"	Laryngoscopy w/biopsy"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
31536	"	Laryngoscopy w/bx & op scope"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
31540	"	Laryngoscopy w/exc of tumor"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
31541	"	Larynscop w/tumr exc + scope"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
31545	"	Remove vc lesion w/scope"	T	0073	16.7369	"$1,216.30"	.	$243.26																																																																																																						
31546	"	Remove vc lesion scope/graft"	T	0075	41.9936	"$3,051.76"	.	$610.36																																																																																																						
3155F	"	Cytogen test marrow b/4 tx"	M																																																																																																											
31560	"	Laryngoscop w/arytenoidectom"	T	0075	41.9936	"$3,051.76"	.	$610.36																																																																																																						
31561	"	Larynscop remve cart + scop"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
31570	"	Laryngoscope w/vc inj"	T	0073	16.7369	"$1,216.30"	.	$243.26																																																																																																						
31571	"	Laryngoscop w/vc inj + scope"	T	0074	25.8756	"$1,880.43"	.	$376.09																																																																																																						
31575	"	Diagnostic laryngoscopy"	T	0071	2.0698	$150.42	.	$30.09																																																																																																						
31576	"	Laryngoscopy with biopsy"	T	0073	16.7369	"$1,216.30"	.	$243.26																																																																																																						
31577	"	Remove foreign body larynx"	T	0072	5.0854	$369.57	.	$73.92																																																																																																						
31578	"	Removal of larynx lesion"	T	0073	16.7369	"$1,216.30"	.	$243.26																																																																																																						
31579	"	Diagnostic laryngoscopy"	T	0072	5.0854	$369.57	.	$73.92																																																																																																						
31580	"	Revision of larynx"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31582	"	Revision of larynx"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31584	"	Treat larynx fracture"	C																																																																																																											
31587	"	Revision of larynx"	C																																																																																																											
31588	"	Revision of larynx"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31590	"	Reinnervate larynx"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31595	"	Larynx nerve surgery"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31599	"	Larynx surgery procedure"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
31600	"	Incision of windpipe"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
31601	"	Incision of windpipe"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
31603	"	Incision of windpipe"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
31605	"	Incision of windpipe"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
3160F	"	Doc fe+ stores b/4 epo thx"	M																																																																																																											
31610	"	Incision of windpipe"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31611	"	Surgery/speech prosthesis"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
31612	"	Puncture/clear windpipe"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31613	"	Repair windpipe opening"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
31614	"	Repair windpipe opening"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31615	"	Visualization of windpipe"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
31620	"	Endobronchial us add-on"	N																																																																																																											
31622	"	Dx bronchoscope/wash"	T	0076	13.0947	$951.62	.	$190.33																																																																																																						
31623	"	Dx bronchoscope/brush"	T	0076	13.0947	$951.62	.	$190.33																																																																																																						
31624	"	Dx bronchoscope/lavage"	T	0076	13.0947	$951.62	.	$190.33																																																																																																						
31625	"	Bronchoscopy w/biopsy(s)"	T	0076	13.0947	$951.62	.	$190.33																																																																																																						
31626	"	Bronchoscopy w/markers"	T	0415	27.5263	"$2,000.39"	.	$400.08																																																																																																						
31627	"	Navigational bronchoscopy"	N																																																																																																											
31628	"	Bronchoscopy/lung bx each"	T	0076	13.0947	$951.62	.	$190.33																																																																																																						
31629	"	Bronchoscopy/needle bx each"	T	0415	27.5263	"$2,000.39"	.	$400.08																																																																																																						
31630	"	Bronchoscopy dilate/fx repr"	T	0415	27.5263	"$2,000.39"	.	$400.08																																																																																																						
31631	"	Bronchoscopy dilate w/stent"	T	0415	27.5263	"$2,000.39"	.	$400.08																																																																																																						
31632	"	Bronchoscopy/lung bx addl"	N																																																																																																											
31633	"	Bronchoscopy/needle bx addl"	N																																																																																																											
31634	"	Bronch w/balloon occlusion"	T	0415	27.5263	"$2,000.39"	.	$400.08																																																																																																						
31635	"	Bronchoscopy w/fb removal"	T	0076	13.0947	$951.62	.	$190.33																																																																																																						
31636	"	Bronchoscopy bronch stents"	T	0415	27.5263	"$2,000.39"	.	$400.08																																																																																																						
31637	"	Bronchoscopy stent add-on"	N																																																																																																											
31638	"	Bronchoscopy revise stent"	T	0415	27.5263	"$2,000.39"	.	$400.08																																																																																																						
31640	"	Bronchoscopy w/tumor excise"	T	0415	27.5263	"$2,000.39"	.	$400.08																																																																																																						
31641	"	Bronchoscopy treat blockage"	T	0415	27.5263	"$2,000.39"	.	$400.08																																																																																																						
31643	"	Diag bronchoscope/catheter"	T	0076	13.0947	$951.62	.	$190.33																																																																																																						
31645	"	Bronchoscopy clear airways"	T	0076	13.0947	$951.62	.	$190.33																																																																																																						
31646	"	Bronchoscopy reclear airway"	T	0076	13.0947	$951.62	.	$190.33																																																																																																						
31647	"	Bronchial valve init insert"	T	0415	27.5263	"$2,000.39"	.	$400.08																																																																																																						
31648	"	Bronchial valve remov init"	T	0415	27.5263	"$2,000.39"	.	$400.08																																																																																																						
31649	"	Bronchial valve remov addl"	Q2	0076	13.0947	$951.62	.	$190.33																																																																																																						
31651	"	Bronchial valve addl insert"	N																																																																																																											
31660	"	Bronch thermoplsty 1 lobe"	T	0415	27.5263	"$2,000.39"	.	$400.08																																																																																																						
31661	"	Bronch thermoplsty 2/> lobes"	T	0415	27.5263	"$2,000.39"	.	$400.08																																																																																																						
3170F	"	Flow cyto done b/4 tx"	M																																																																																																											
31717	"	Bronchial brush biopsy"	T	0072	5.0854	$369.57	.	$73.92																																																																																																						
31720	"	Clearance of airways"	S	0102	1.0759	$78.19	.	$15.64																																																																																																						
31725	"	Clearance of airways"	C																																																																																																											
31730	"	Intro windpipe wire/tube"	T	0072	5.0854	$369.57	.	$73.92																																																																																																						
31750	"	Repair of windpipe"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
31755	"	Repair of windpipe"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
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"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
31786	"	Remove windpipe lesion"	C																																																																																																											
31800	"	Repair of windpipe injury"	C																																																																																																											
31805	"	Repair of windpipe injury"	C																																																																																																											
31820	"	Closure of windpipe lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
31825	"	Repair of windpipe defect"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
31830	"	Revise windpipe scar"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
31899	"	Airways surgical procedure"	T	0076	13.0947	$951.62	.	$190.33																																																																																																						
3200F	"	Barium swallow test not req"	E																																																																																																											
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"	M																																																																																																											
32160	"	Open chest heart massage"	C																																																																																																											
3216F	"	Pt immunity to hep b docd"	E																																																																																																											
3218F	"	Rna tstng hep c docd done"	E																																																																																																											
32200	"	Drain open lung lesion"	C																																																																																																											
3220F	"	Hep c quant rna tstng docd"	E																																																																																																											
32215	"	Treat chest lining"	C																																																																																																											
32220	"	Release of lung"	C																																																																																																											
32225	"	Partial release of lung"	C																																																																																																											
3230F	"	Note hring tst w/in 6 mon"	E																																																																																																											
32310	"	Removal of chest lining"	C																																																																																																											
32320	"	Free/remove chest lining"	C																																																																																																											
32400	"	Needle biopsy chest lining"	T	0685	10.4271	$757.76	.	$151.56																																																																																																						
32405	"	Percut bx lung/mediastinum"	T	0685	10.4271	$757.76	.	$151.56																																																																																																						
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"	T	0652	33.2571	"$2,416.86"	.	$483.38																																																																																																						
32551	"	Insertion of chest tube"	T	0070	6.6765	$485.19	.	$97.04																																																																																																						
32552	"	Remove lung catheter"	Q2	0070	6.6765	$485.19	.	$97.04																																																																																																						
32553	"	Ins mark thor for rt perq"	X	0310	14.2612	"$1,036.39"	$325.27	$207.28																																																																																																						
32554	"	Aspirate pleura w/o imaging"	T	0070	6.6765	$485.19	.	$97.04																																																																																																						
32555	"	Aspirate pleura w/ imaging"	T	0070	6.6765	$485.19	.	$97.04																																																																																																						
32556	"	Insert cath pleura w/o image"	T	0070	6.6765	$485.19	.	$97.04																																																																																																						
32557	"	Insert cath pleura w/ image"	T	0070	6.6765	$485.19	.	$97.04																																																																																																						
32560	"	Treat pleurodesis w/agent"	T	0070	6.6765	$485.19	.	$97.04																																																																																																						
32561	"	Lyse chest fibrin init day"	T	0070	6.6765	$485.19	.	$97.04																																																																																																						
32562	"	Lyse chest fibrin subq day"	T	0070	6.6765	$485.19	.	$97.04																																																																																																						
32601	"	Thoracoscopy diagnostic"	T	0069	36.3292	"$2,640.12"	$591.64	$528.03																																																																																																						
32604	"	Thoracoscopy wbx sac"	T	0069	36.3292	"$2,640.12"	$591.64	$528.03																																																																																																						
32606	"	Thoracoscopy w/bx med space"	T	0069	36.3292	"$2,640.12"	$591.64	$528.03																																																																																																						
32607	"	Thoracoscopy w/bx infiltrate"	T	0069	36.3292	"$2,640.12"	$591.64	$528.03																																																																																																						
32608	"	Thoracoscopy w/bx nodule"	T	0069	36.3292	"$2,640.12"	$591.64	$528.03																																																																																																						
32609	"	Thoracoscopy w/bx pleura"	T	0069	36.3292	"$2,640.12"	$591.64	$528.03																																																																																																						
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"	M																																																																																																											
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"	E																																																																																																											
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"	E																																																																																																											
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"	M																																																																																																											
3272F	"	Med risk prostate cancer"	M																																																																																																											
3273F	"	High risk prostate cancer"	M																																																																																																											
3274F	"	Prost cncr rsk not lw/md/hgh"	M																																																																																																											
3278F	"	Serum lvls ca/ipth/lpd ord"	E																																																																																																											
3279F	"	Hgb lvl >/= 13 g/dl"	E																																																																																																											
32800	"	Repair lung hernia"	C																																																																																																											
3280F	"	Hgb lvl 11-12.9 g/dl"	E																																																																																																											
32810	"	Close chest after drainage"	C																																																																																																											
32815	"	Close bronchial fistula"	C																																																																																																											
3281F	"	Hgb lvl <11 g/dl"	E																																																																																																											
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"	E																																																																																																											
3291F	"	Pt=d(rh)+ or sensitized"	E																																																																																																											
3292F	"	Hiv tstng asked/docd/revwd"	E																																																																																																											
3293F	"	Abo rh blood typing docd"	E																																																																																																											
32940	"	Revision of lung"	C																																																																																																											
3294F	"	Grp b strep screening docd"	E																																																																																																											
32960	"	Therapeutic pneumothorax"	T	0070	6.6765	$485.19	.	$97.04																																																																																																						
32997	"	Total lung lavage"	C																																																																																																											
32998	"	Perq rf ablate tx pul tumor"	T	0423	56.5030	"$4,106.19"	.	$821.24																																																																																																						
32999	"	Chest surgery procedure"	T	0070	6.6765	$485.19	.	$97.04																																																																																																						
3300F	"	Ajcc stage docd b/4 thxpy"	M																																																																																																											
33010	"	Drainage of heart sac"	T	0070	6.6765	$485.19	.	$97.04																																																																																																						
33011	"	Repeat drainage of heart sac"	T	0070	6.6765	$485.19	.	$97.04																																																																																																						
33015	"	Incision of heart sac"	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"	M																																																																																																											
3316F	"	Er- or pr- breast cancer"	M																																																																																																											
3317F	"	Path rpt malig cancer docd"	E																																																																																																											
3318F	"	Path rpt malig cancer docd"	E																																																																																																											
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"	T	0089	120.9586	"$8,790.30"	.	"$1,758.06"																																																																																																						
33207	"	Insert heart pm ventricular"	T	0089	120.9586	"$8,790.30"	.	"$1,758.06"																																																																																																						
33208	"	Insrt heart pm atrial & vent"	T	0655	145.7012	"$10,588.40"	.	"$2,117.68"																																																																																																						
3320F	"	No xray/ct/ et al ordd"	M																																																																																																											
33210	"	Insert electrd/pm cath sngl"	T	0106	63.3253	"$4,601.98"	.	$920.40																																																																																																						
33211	"	Insert card electrodes dual"	T	0106	63.3253	"$4,601.98"	.	$920.40																																																																																																						
33212	"	Insert pulse gen sngl lead"	T	0090	101.1821	"$7,353.11"	"$1,593.50"	"$1,470.63"																																																																																																						
33213	"	Insert pulse gen dual leads"	T	0654	115.4162	"$8,387.53"	.	"$1,677.51"																																																																																																						
33214	"	Upgrade of pacemaker system"	T	0655	145.7012	"$10,588.40"	.	"$2,117.68"																																																																																																						
33215	"	Reposition pacing-defib lead"	T	0103	20.9727	"$1,524.13"	.	$304.83																																																																																																						
33216	"	Insert 1 electrode pm-defib"	T	0106	63.3253	"$4,601.98"	.	$920.40																																																																																																						
33217	"	Insert 2 electrode pm-defib"	T	0106	63.3253	"$4,601.98"	.	$920.40																																																																																																						
33218	"	Repair lead pace-defib one"	T	0105	31.8926	"$2,317.70"	.	$463.54																																																																																																						
3321F	"	Ajcc cncr 0/ia melan docd"	M																																																																																																											
33220	"	Repair lead pace-defib dual"	T	0105	31.8926	"$2,317.70"	.	$463.54																																																																																																						
33221	"	Insert pulse gen mult leads"	T	0654	115.4162	"$8,387.53"	.	"$1,677.51"																																																																																																						
33222	"	Relocation pocket pacemaker"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
33223	"	Relocate pocket for defib"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
33224	"	Insert pacing lead & connect"	T	0655	145.7012	"$10,588.40"	.	"$2,117.68"																																																																																																						
33225	"	L ventric pacing lead add-on"	Q3	0655	145.7012	"$10,588.40"	.	"$2,117.68"																																																																																																						
33226	"	Reposition l ventric lead"	T	0103	20.9727	"$1,524.13"	.	$304.83																																																																																																						
33227	"	Remove&replace pm gen singl"	T	0090	101.1821	"$7,353.11"	"$1,593.50"	"$1,470.63"																																																																																																						
33228	"	Remv&replc pm gen dual lead"	T	0654	115.4162	"$8,387.53"	.	"$1,677.51"																																																																																																						
33229	"	Remv&replc pm gen mult leads"	T	0654	115.4162	"$8,387.53"	.	"$1,677.51"																																																																																																						
3322F	"	Melanomaajcc stage 0 or ia"	M																																																																																																											
33230	"	Insrt pulse gen w/dual leads"	T	0107	344.2616	"$25,018.18"	.	"$5,003.64"																																																																																																						
33231	"	Insrt pulse gen w/mult leads"	T	0107	344.2616	"$25,018.18"	.	"$5,003.64"																																																																																																						
33233	"	Removal of pm generator"	Q2	0105	31.8926	"$2,317.70"	.	$463.54																																																																																																						
33234	"	Removal of pacemaker system"	Q2	0105	31.8926	"$2,317.70"	.	$463.54																																																																																																						
33235	"	Removal pacemaker electrode"	Q2	0105	31.8926	"$2,317.70"	.	$463.54																																																																																																						
33236	"	Remove electrode/thoracotomy"	C																																																																																																											
33237	"	Remove electrode/thoracotomy"	C																																																																																																											
33238	"	Remove electrode/thoracotomy"	C																																																																																																											
3323F	"	Clin node stgng docdb/4 surg"	M																																																																																																											
33240	"	Insrt pulse gen w/singl lead"	T	0107	344.2616	"$25,018.18"	.	"$5,003.64"																																																																																																						
33241	"	Remove pulse generator"	Q2	0105	31.8926	"$2,317.70"	.	$463.54																																																																																																						
33243	"	Remove eltrd/thoracotomy"	C																																																																																																											
33244	"	Remove eltrd transven"	Q2	0105	31.8926	"$2,317.70"	.	$463.54																																																																																																						
33249	"	Nsert pace-defib w/lead"	Q3	0108	442.3292	"$32,144.95"	.	"$6,428.99"																																																																																																						
3324F	"	Mri ct scan ord rvwd rqstd"	E																																																																																																											
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"	E																																																																																																											
33261	"	Ablate heart dysrhythm focus"	C																																																																																																											
33262	"	Remv&replc cvd gen sing lead"	T	0107	344.2616	"$25,018.18"	.	"$5,003.64"																																																																																																						
33263	"	Remv&replc cvd gen dual lead"	T	0107	344.2616	"$25,018.18"	.	"$5,003.64"																																																																																																						
33264	"	Remv&replc cvd gen mult lead"	T	0107	344.2616	"$25,018.18"	.	"$5,003.64"																																																																																																						
33265	"	Ablate atria lmtd endo"	C																																																																																																											
33266	"	Ablate atria x10sv endo"	C																																																																																																											
33282	"	Implant pat-active ht record"	S	0680	85.6249	"$6,222.53"	.	"$1,244.51"																																																																																																						
33284	"	Remove pat-active ht record"	Q2	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
3328F	"	Prfrmnc docd 2 wks b/4 surg"	M																																																																																																											
33300	"	Repair of heart wound"	C																																																																																																											
33305	"	Repair of heart wound"	C																																																																																																											
3330F	"	Imaging study ordered (bkp)"	E																																																																																																											
33310	"	Exploratory heart surgery"	C																																																																																																											
33315	"	Exploratory heart surgery"	C																																																																																																											
3331F	"	Bk imaging tst not ordered"	E																																																																																																											
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																																																																																																											
33332	"	Insert major vessel graft"	C																																																																																																											
33335	"	Insert major vessel graft"	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																																																																																																											
33400	"	Repair of aortic valve"	C																																																																																																											
33401	"	Valvuloplasty open"	C																																																																																																											
33403	"	Valvuloplasty w/cp bypass"	C																																																																																																											
33404	"	Prepare heart-aorta conduit"	C																																																																																																											
33405	"	Replacement of aortic valve"	C																																																																																																											
33406	"	Replacement of aortic valve"	C																																																																																																											
3340F	"	Mammo assess inc xray docd"	M																																																																																																											
33410	"	Replacement of aortic valve"	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																																																																																																											
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																																																																																																											
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																																																																																																											
33472	"	Revision of pulmonary valve"	C																																																																																																											
33474	"	Revision of pulmonary valve"	C																																																																																																											
33475	"	Replacement pulmonary valve"	C																																																																																																											
33476	"	Revision of heart chamber"	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"	E																																																																																																											
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"	E																																																																																																											
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"	E																																																																																																											
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"	E																																																																																																											
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"	M																																																																																																											
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"	M																																																																																																											
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"	M																																																																																																											
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"	M																																																																																																											
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"	M																																																																																																											
33800	"	Aortic suspension"	C																																																																																																											
33802	"	Repair vessel defect"	C																																																																																																											
33803	"	Repair vessel defect"	C																																																																																																											
3380F	"	Ajcc brstcncr stage 4 docd"	M																																																																																																											
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"	M																																																																																																											
33840	"	Remove aorta constriction"	C																																																																																																											
33845	"	Remove aorta constriction"	C																																																																																																											
3384F	"	Ajcc cln cncr stage 1 docd"	M																																																																																																											
33851	"	Remove aorta constriction"	C																																																																																																											
33852	"	Repair septal defect"	C																																																																																																											
33853	"	Repair septal defect"	C																																																																																																											
33860	"	Ascending aortic graft"	C																																																																																																											
33863	"	Ascending aortic graft"	C																																																																																																											
33864	"	Ascending aortic graft"	C																																																																																																											
3386F	"	Ajcc cln cncr stage 2 docd"	M																																																																																																											
33870	"	Transverse aortic arch graft"	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"	M																																																																																																											
33891	"	Car-car bp grft/endovas taa"	C																																																																																																											
3390F	"	Ajcc cln cncr stage 4 docd"	M																																																																																																											
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																																																																																																											
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																																																																																																											
3394F	"	Quant her2 ihc eval brst cx"	M																																																																																																											
3395F	"	Quant nonher2 ihc brst cx"	M																																																																																																											
33960	"	External circulation assist"	C																																																																																																											
33961	"	External circulation assist"	C																																																																																																											
33967	"	Insert ia percut device"	C																																																																																																											
33968	"	Remove aortic assist device"	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																																																																																																											
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	0070	6.6765	$485.19	.	$97.04																																																																																																						
34001	"	Removal of artery clot"	C																																																																																																											
34051	"	Removal of artery clot"	C																																																																																																											
34101	"	Removal of artery clot"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
34111	"	Removal of arm artery clot"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
34151	"	Removal of artery clot"	C																																																																																																											
34201	"	Removal of artery clot"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
34203	"	Removal of leg artery clot"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
34401	"	Removal of vein clot"	C																																																																																																											
34421	"	Removal of vein clot"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
34451	"	Removal of vein clot"	C																																																																																																											
34471	"	Removal of vein clot"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
34490	"	Removal of vein clot"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
34501	"	Repair valve femoral vein"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
34502	"	Reconstruct vena cava"	C																																																																																																											
3450F	"	Dyspnea scrnd no-mild dysp"	E																																																																																																											
34510	"	Transposition of vein valve"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
3451F	"	Dyspnea scrnd mod-high dysp"	E																																																																																																											
34520	"	Cross-over vein graft"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
3452F	"	Dyspnea not screened"	E																																																																																																											
34530	"	Leg vein fusion"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
3455F	"	Tb scrng done-interpd 6mon"	M																																																																																																											
3470F	"	Ra disease activity low"	M																																																																																																											
3471F	"	Ra disease activity mod"	M																																																																																																											
3472F	"	Ra disease activity high"	M																																																																																																											
3475F	"	Disease progn ra poor docd"	M																																																																																																											
3476F	"	Disease progn ra good docd"	M																																																																																																											
34800	"	Endovas aaa repr w/sm tube"	C																																																																																																											
34802	"	Endovas aaa repr w/2-p part"	C																																																																																																											
34803	"	Endovas aaa repr w/3-p part"	C																																																																																																											
34804	"	Endovas aaa repr w/1-p part"	C																																																																																																											
34805	"	Endovas aaa repr w/long tube"	C																																																																																																											
34806	"	Aneurysm press sensor add-on"	C																																																																																																											
34808	"	Endovas iliac a device addon"	C																																																																																																											
34812	"	Xpose for endoprosth femorl"	C																																																																																																											
34813	"	Femoral endovas graft add-on"	C																																																																																																											
34820	"	Xpose for endoprosth iliac"	C																																																																																																											
34825	"	Endovasc extend prosth init"	C																																																																																																											
34826	"	Endovasc exten prosth addl"	C																																																																																																											
34830	"	Open aortic tube prosth repr"	C																																																																																																											
34831	"	Open aortoiliac prosth repr"	C																																																																																																											
34832	"	Open aortofemor prosth repr"	C																																																																																																											
34833	"	Xpose for endoprosth iliac"	C																																																																																																											
34834	"	Xpose endoprosth brachial"	C																																																																																																											
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																																																																																																											
34900	"	Endovasc iliac repr w/graft"	C																																																																																																											
3490F	"	History aids-defining cond"	E																																																																																																											
3491F	"	Hiv unsure baby of hiv+moms"	E																																																																																																											
3492F	"	History cd4+ cell count <350"	E																																																																																																											
3493F	"	No hist cd4+ cell count <350"	E																																																																																																											
3494F	"	Cd4+cell count <200cells/mm3"	M																																																																																																											
3495F	"	Cd4+cell cnt 200-499 cells"	M																																																																																																											
3496F	"	Cd4+ cell count + 500 cells"	M																																																																																																											
3497F	"	Cd4+ cell percentage <15%"	E																																																																																																											
3498F	"	Cd4+ cell =15% (hiv)"	E																																																																																																											
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"	E																																																																																																											
35011	"	Repair defect of artery"	T	0653	42.4215	"$3,082.86"	.	$616.58																																																																																																						
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"	E																																																																																																											
3503F	"	Hiv rna vrl ldnot<lmts quntf"	E																																																																																																											
35045	"	Repair defect of arm artery"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
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"	M																																																																																																											
35111	"	Repair defect of artery"	C																																																																																																											
35112	"	Repair artery rupture spleen"	C																																																																																																											
3511F	"	Chlmyd/gonrh tsts docd done"	E																																																																																																											
35121	"	Repair defect of artery"	C																																																																																																											
35122	"	Repair artery rupture belly"	C																																																																																																											
3512F	"	Syph scrng docd as done"	E																																																																																																											
35131	"	Repair defect of artery"	C																																																																																																											
35132	"	Repair artery rupture groin"	C																																																																																																											
3513F	"	Hep b scrng docd as done"	E																																																																																																											
35141	"	Repair defect of artery"	C																																																																																																											
35142	"	Repair artery rupture thigh"	C																																																																																																											
3514F	"	Hep c scrng docd as done"	E																																																																																																											
35151	"	Repair defect of artery"	C																																																																																																											
35152	"	Repair ruptd popliteal art"	C																																																																																																											
3515F	"	Pt has docd immun to hep c"	E																																																																																																											
3517F	"	Hbv assess&results intrp 1yr"	M																																																																																																											
35180	"	Repair blood vessel lesion"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
35182	"	Repair blood vessel lesion"	C																																																																																																											
35184	"	Repair blood vessel lesion"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
35188	"	Repair blood vessel lesion"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
35189	"	Repair blood vessel lesion"	C																																																																																																											
35190	"	Repair blood vessel lesion"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
35201	"	Repair blood vessel lesion"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
35206	"	Repair blood vessel lesion"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
35207	"	Repair blood vessel lesion"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
3520F	"	Cdifficile testing performed"	E																																																																																																											
35211	"	Repair blood vessel lesion"	C																																																																																																											
35216	"	Repair blood vessel lesion"	C																																																																																																											
35221	"	Repair blood vessel lesion"	C																																																																																																											
35226	"	Repair blood vessel lesion"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
35231	"	Repair blood vessel lesion"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
35236	"	Repair blood vessel lesion"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
35241	"	Repair blood vessel lesion"	C																																																																																																											
35246	"	Repair blood vessel lesion"	C																																																																																																											
35251	"	Repair blood vessel lesion"	C																																																																																																											
35256	"	Repair blood vessel lesion"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
35261	"	Repair blood vessel lesion"	T	0653	42.4215	"$3,082.86"	.	$616.58																																																																																																						
35266	"	Repair blood vessel lesion"	T	0653	42.4215	"$3,082.86"	.	$616.58																																																																																																						
35271	"	Repair blood vessel lesion"	C																																																																																																											
35276	"	Repair blood vessel lesion"	C																																																																																																											
35281	"	Repair blood vessel lesion"	C																																																																																																											
35286	"	Repair blood vessel lesion"	T	0653	42.4215	"$3,082.86"	.	$616.58																																																																																																						
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"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
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																																																																																																											
35450	"	Repair arterial blockage"	C																																																																																																											
35452	"	Repair arterial blockage"	C																																																																																																											
35458	"	Repair arterial blockage"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
35460	"	Repair venous blockage"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
35471	"	Repair arterial blockage"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
35472	"	Repair arterial blockage"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
35475	"	Repair arterial blockage"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
35476	"	Repair venous blockage"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
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"	E																																																																																																											
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"	E																																																																																																											
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"	E																																																																																																											
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"	E																																																																																																											
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	"	Exploration carotid artery"	C																																																																																																											
3570F	"	Rprt bone scint xref w xray"	M																																																																																																											
35721	"	Exploration femoral artery"	C																																																																																																											
3572F	"	Pt consid poss risk fx"	E																																																																																																											
3573F	"	Pt not consid poss risk fx"	E																																																																																																											
35741	"	Exploration popliteal artery"	C																																																																																																											
35761	"	Exploration of artery/vein"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
35800	"	Explore neck vessels"	C																																																																																																											
35820	"	Explore chest vessels"	C																																																																																																											
35840	"	Explore abdominal vessels"	C																																																																																																											
35860	"	Explore limb vessels"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
35870	"	Repair vessel graft defect"	C																																																																																																											
35875	"	Removal of clot in graft"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
35876	"	Removal of clot in graft"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
35879	"	Revise graft w/vein"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
35881	"	Revise graft w/vein"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
35883	"	Revise graft w/nonauto graft"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
35884	"	Revise graft w/vein"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
35901	"	Excision graft neck"	C																																																																																																											
35903	"	Excision graft extremity"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
35905	"	Excision graft thorax"	C																																																																																																											
35907	"	Excision graft abdomen"	C																																																																																																											
36000	"	Place needle in vein"	N																																																																																																											
36002	"	Pseudoaneurysm injection trt"	S	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
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																																																																																																											
36120	"	Establish access to artery"	N																																																																																																											
36140	"	Establish access to artery"	N																																																																																																											
36147	"	Access av dial grft for eval"	T	0668	11.3792	$826.95	.	$165.39																																																																																																						
36148	"	Access av dial grft for proc"	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	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
36222	"	Place cath carotid/inom art"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
36223	"	Place cath carotid/inom art"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
36224	"	Place cath carotd art"	Q2	0280	62.1095	"$4,513.62"	.	$902.73																																																																																																						
36225	"	Place cath subclavian art"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
36226	"	Place cath vertebral art"	Q2	0280	62.1095	"$4,513.62"	.	$902.73																																																																																																						
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	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
36252	"	Ins cath ren art 1st bilat"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
36253	"	Ins cath ren art 2nd+ unilat"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
36254	"	Ins cath ren art 2nd+ bilat"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
36260	"	Insertion of infusion pump"	T	0623	32.2881	"$2,346.44"	.	$469.29																																																																																																						
36261	"	Revision of infusion pump"	T	0105	31.8926	"$2,317.70"	.	$463.54																																																																																																						
36262	"	Removal of infusion pump"	Q2	0105	31.8926	"$2,317.70"	.	$463.54																																																																																																						
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"	N																																																																																																											
36416	"	Capillary blood draw"	N																																																																																																											
36420	"	Vein access cutdown < 1 yr"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
36425	"	Vein access cutdown > 1 yr"	X	0035	0.3042	$22.11	.	$4.43																																																																																																						
36430	"	Blood transfusion service"	S	0110	3.9241	$285.17	.	$57.04																																																																																																						
36440	"	Bl push transfuse 2 yr/<"	S	0110	3.9241	$285.17	.	$57.04																																																																																																						
36450	"	Bl exchange/transfuse nb"	S	0110	3.9241	$285.17	.	$57.04																																																																																																						
36455	"	Bl exchange/transfuse non-nb"	S	0110	3.9241	$285.17	.	$57.04																																																																																																						
36460	"	Transfusion service fetal"	S	0110	3.9241	$285.17	.	$57.04																																																																																																						
36468	"	Injection(s) spider veins"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
36469	"	Injection(s) spider veins"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
36470	"	Injection therapy of vein"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
36471	"	Injection therapy of veins"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
36475	"	Endovenous rf 1st vein"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
36476	"	Endovenous rf vein add-on"	N																																																																																																											
36478	"	Endovenous laser 1st vein"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
36479	"	Endovenous laser vein addon"	N																																																																																																											
36481	"	Insertion of catheter vein"	N																																																																																																											
36500	"	Insertion of catheter vein"	N																																																																																																											
3650F	"	Eeg ordered rvwd reqstd"	E																																																																																																											
36510	"	Insertion of catheter vein"	N																																																																																																											
36511	"	Apheresis wbc"	S	0111	14.9351	"$1,085.36"	.	$217.08																																																																																																						
36512	"	Apheresis rbc"	S	0111	14.9351	"$1,085.36"	.	$217.08																																																																																																						
36513	"	Apheresis platelets"	S	0111	14.9351	"$1,085.36"	.	$217.08																																																																																																						
36514	"	Apheresis plasma"	S	0111	14.9351	"$1,085.36"	.	$217.08																																																																																																						
36515	"	Apheresis adsorp/reinfuse"	S	0112	42.1852	"$3,065.68"	.	$613.14																																																																																																						
36516	"	Apheresis selective"	S	0112	42.1852	"$3,065.68"	.	$613.14																																																																																																						
36522	"	Photopheresis"	S	0112	42.1852	"$3,065.68"	.	$613.14																																																																																																						
36555	"	Insert non-tunnel cv cath"	T	0621	11.6924	$849.71	.	$169.95																																																																																																						
36556	"	Insert non-tunnel cv cath"	T	0621	11.6924	$849.71	.	$169.95																																																																																																						
36557	"	Insert tunneled cv cath"	T	0622	26.4748	"$1,923.98"	.	$384.80																																																																																																						
36558	"	Insert tunneled cv cath"	T	0622	26.4748	"$1,923.98"	.	$384.80																																																																																																						
36560	"	Insert tunneled cv cath"	T	0623	32.2881	"$2,346.44"	.	$469.29																																																																																																						
36561	"	Insert tunneled cv cath"	T	0623	32.2881	"$2,346.44"	.	$469.29																																																																																																						
36563	"	Insert tunneled cv cath"	T	0623	32.2881	"$2,346.44"	.	$469.29																																																																																																						
36565	"	Insert tunneled cv cath"	T	0623	32.2881	"$2,346.44"	.	$469.29																																																																																																						
36566	"	Insert tunneled cv cath"	T	0623	32.2881	"$2,346.44"	.	$469.29																																																																																																						
36568	"	Insert picc cath"	T	0621	11.6924	$849.71	.	$169.95																																																																																																						
36569	"	Insert picc cath"	T	0621	11.6924	$849.71	.	$169.95																																																																																																						
36570	"	Insert picvad cath"	T	0622	26.4748	"$1,923.98"	.	$384.80																																																																																																						
36571	"	Insert picvad cath"	T	0622	26.4748	"$1,923.98"	.	$384.80																																																																																																						
36575	"	Repair tunneled cv cath"	T	0121	6.4191	$466.49	.	$93.30																																																																																																						
36576	"	Repair tunneled cv cath"	T	0621	11.6924	$849.71	.	$169.95																																																																																																						
36578	"	Replace tunneled cv cath"	T	0622	26.4748	"$1,923.98"	.	$384.80																																																																																																						
36580	"	Replace cvad cath"	T	0621	11.6924	$849.71	.	$169.95																																																																																																						
36581	"	Replace tunneled cv cath"	T	0622	26.4748	"$1,923.98"	.	$384.80																																																																																																						
36582	"	Replace tunneled cv cath"	T	0623	32.2881	"$2,346.44"	.	$469.29																																																																																																						
36583	"	Replace tunneled cv cath"	T	0623	32.2881	"$2,346.44"	.	$469.29																																																																																																						
36584	"	Replace picc cath"	T	0621	11.6924	$849.71	.	$169.95																																																																																																						
36585	"	Replace picvad cath"	T	0622	26.4748	"$1,923.98"	.	$384.80																																																																																																						
36589	"	Removal tunneled cv cath"	Q2	0121	6.4191	$466.49	.	$93.30																																																																																																						
36590	"	Removal tunneled cv cath"	Q2	0621	11.6924	$849.71	.	$169.95																																																																																																						
36591	"	Draw blood off venous device"	Q1	0624	1.1143	$80.98	.	$16.20																																																																																																						
36592	"	Collect blood from picc"	Q1	0624	1.1143	$80.98	.	$16.20																																																																																																						
36593	"	Declot vascular device"	T	0676	2.5286	$183.76	.	$36.76																																																																																																						
36595	"	Mech remov tunneled cv cath"	T	0622	26.4748	"$1,923.98"	.	$384.80																																																																																																						
36596	"	Mech remov tunneled cv cath"	T	0621	11.6924	$849.71	.	$169.95																																																																																																						
36597	"	Reposition venous catheter"	T	0621	11.6924	$849.71	.	$169.95																																																																																																						
36598	"	Inj w/fluor eval cv device"	T	0676	2.5286	$183.76	.	$36.76																																																																																																						
36600	"	Withdrawal of arterial blood"	Q3	0420	1.3520	$98.25	.	$19.65																																																																																																						
36620	"	Insertion catheter artery"	N																																																																																																											
36625	"	Insertion catheter artery"	N																																																																																																											
36640	"	Insertion catheter artery"	T	0623	32.2881	"$2,346.44"	.	$469.29																																																																																																						
36660	"	Insertion catheter artery"	C																																																																																																											
36680	"	Insert needle bone cavity"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
36800	"	Insertion of cannula"	T	0115	39.1123	"$2,842.37"	.	$568.48																																																																																																						
36810	"	Insertion of cannula"	T	0115	39.1123	"$2,842.37"	.	$568.48																																																																																																						
36815	"	Insertion of cannula"	T	0115	39.1123	"$2,842.37"	.	$568.48																																																																																																						
36818	"	Av fuse uppr arm cephalic"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
36819	"	Av fuse uppr arm basilic"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
36820	"	Av fusion/forearm vein"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
36821	"	Av fusion direct any site"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
36822	"	Insertion of cannula(s)"	C																																																																																																											
36823	"	Insertion of cannula(s)"	C																																																																																																											
36825	"	Artery-vein autograft"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
36830	"	Artery-vein nonautograft"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
36831	"	Open thrombect av fistula"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
36832	"	Av fistula revision open"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
36833	"	Av fistula revision"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
36835	"	Artery to vein shunt"	T	0115	39.1123	"$2,842.37"	.	$568.48																																																																																																						
36838	"	Dist revas ligation hemo"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
36860	"	External cannula declotting"	T	0676	2.5286	$183.76	.	$36.76																																																																																																						
36861	"	Cannula declotting"	T	0115	39.1123	"$2,842.37"	.	$568.48																																																																																																						
36870	"	Percut thrombect av fistula"	T	0653	42.4215	"$3,082.86"	.	$616.58																																																																																																						
3700F	"	Psych disorders assessed"	M																																																																																																											
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)"	T	0229	125.4912	"$9,119.70"	.	"$1,823.94"																																																																																																						
37184	"	Prim art mech thrombectomy"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
37185	"	Prim art m-thrombect add-on"	N																																																																																																											
37186	"	Sec art m-thrombect add-on"	N																																																																																																											
37187	"	Venous mech thrombectomy"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
37188	"	Venous m-thrombectomy add-on"	T	0088	45.0181	"$3,271.56"	$655.22	$654.32																																																																																																						
37191	"	Ins endovas vena cava filtr"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
37192	"	Redo endovas vena cava filtr"	T	0623	32.2881	"$2,346.44"	.	$469.29																																																																																																						
37193	"	Rem endovas vena cava filter"	Q2	0623	32.2881	"$2,346.44"	.	$469.29																																																																																																						
37195	"	Thrombolytic therapy stroke"	T	0676	2.5286	$183.76	.	$36.76																																																																																																						
37197	"	Remove intrvas foreign body"	T	0623	32.2881	"$2,346.44"	.	$469.29																																																																																																						
37200	"	Transcatheter biopsy"	T	0623	32.2881	"$2,346.44"	.	$469.29																																																																																																						
37202	"	Transcatheter therapy infuse"	T	0103	20.9727	"$1,524.13"	.	$304.83																																																																																																						
3720F	"	Cognit impairment assessed"	M																																																																																																											
37211	"	Thrombolytic art therapy"	T	0621	11.6924	$849.71	.	$169.95																																																																																																						
37212	"	Thrombolytic venous therapy"	T	0621	11.6924	$849.71	.	$169.95																																																																																																						
37213	"	Thromblytic art/ven therapy"	T	0622	26.4748	"$1,923.98"	.	$384.80																																																																																																						
37214	"	Cessj therapy cath removal"	T	0622	26.4748	"$1,923.98"	.	$384.80																																																																																																						
37215	"	Transcath stent cca w/eps"	C																																																																																																											
37216	"	Transcath stent cca w/o eps"	E																																																																																																											
37217	"	Stent placemt retro carotid"	C																																																																																																											
37220	"	Iliac revasc"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
37221	"	Iliac revasc w/stent"	T	0229	125.4912	"$9,119.70"	.	"$1,823.94"																																																																																																						
37222	"	Iliac revasc add-on"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
37223	"	Iliac revasc w/stent add-on"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
37224	"	Fem/popl revas w/tla"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
37225	"	Fem/popl revas w/ather"	T	0229	125.4912	"$9,119.70"	.	"$1,823.94"																																																																																																						
37226	"	Fem/popl revasc w/stent"	T	0229	125.4912	"$9,119.70"	.	"$1,823.94"																																																																																																						
37227	"	Fem/popl revasc stnt & ather"	T	0319	213.4246	"$15,509.99"	"$5,559.48"	"$3,102.00"																																																																																																						
37228	"	Tib/per revasc w/tla"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
37229	"	Tib/per revasc w/ather"	T	0229	125.4912	"$9,119.70"	.	"$1,823.94"																																																																																																						
37230	"	Tib/per revasc w/stent"	T	0229	125.4912	"$9,119.70"	.	"$1,823.94"																																																																																																						
37231	"	Tib/per revasc stent & ather"	T	0319	213.4246	"$15,509.99"	"$5,559.48"	"$3,102.00"																																																																																																						
37232	"	Tib/per revasc add-on"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
37233	"	Tibper revasc w/ather add-on"	T	0229	125.4912	"$9,119.70"	.	"$1,823.94"																																																																																																						
37234	"	Revsc opn/prq tib/pero stent"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
37235	"	Tib/per revasc stnt & ather"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
37236	"	Open/perq place stent 1st"	T	0229	125.4912	"$9,119.70"	.	"$1,823.94"																																																																																																						
37237	"	Open/perq place stent ea add"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
37238	"	Open/perq place stent same"	T	0229	125.4912	"$9,119.70"	.	"$1,823.94"																																																																																																						
37239	"	Open/perq place stent ea add"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
37241	"	Vasc embolize/occlude venous"	T	0082	121.6791	"$8,842.66"	.	"$1,768.54"																																																																																																						
37242	"	Vasc embolize/occlude artery"	T	0082	121.6791	"$8,842.66"	.	"$1,768.54"																																																																																																						
37243	"	Vasc embolize/occlude organ"	T	0082	121.6791	"$8,842.66"	.	"$1,768.54"																																																																																																						
37244	"	Vasc embolize/occlude bleed"	T	0082	121.6791	"$8,842.66"	.	"$1,768.54"																																																																																																						
37250	"	Iv us first vessel add-on"	N																																																																																																											
37251	"	Iv us each add vessel add-on"	N																																																																																																											
3725F	"	Screen depression performed"	M																																																																																																											
37500	"	Endoscopy ligate perf veins"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37501	"	Vascular endoscopy procedure"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
3750F	"	Ptnotrcvngsteroid>/=10mg/day"	M																																																																																																											
3751F	"	Electrodiag polyneuro 6 mn"	E																																																																																																											
3752F	"	No electrodiag polyneuro 6mn"	E																																																																																																											
3753F	"	Pt has symp&signs neuropathy"	E																																																																																																											
3754F	"	Screening tests dm done"	E																																																																																																											
3755F	"	Cog&behav imprmnt scrng done"	E																																																																																																											
37565	"	Ligation of neck vein"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
3756F	"	Pt w/pseudobulb affect/als"	E																																																																																																											
3757F	"	Pt w/o pseudobulbaffect/als"	E																																																																																																											
3758F	"	Pt ref pulm fx test/peakflow"	E																																																																																																											
3759F	"	Pt scrn dysphag/wt loss/nutr"	E																																																																																																											
37600	"	Ligation of neck artery"	T	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
37605	"	Ligation of neck artery"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37606	"	Ligation of neck artery"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37607	"	Ligation of a-v fistula"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37609	"	Temporal artery procedure"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
3760F	"	Pt w/ dysphag/wt loss/nutr"	E																																																																																																											
37615	"	Ligation of neck artery"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37616	"	Ligation of chest artery"	C																																																																																																											
37617	"	Ligation of abdomen artery"	C																																																																																																											
37618	"	Ligation of extremity artery"	C																																																																																																											
37619	"	Ligation of inf vena cava"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
3761F	"	Pt w/o dysphag/wt loss/nutr"	E																																																																																																											
3762F	"	Patient is dysarthric"	E																																																																																																											
3763F	"	Patient is not dysarthric"	E																																																																																																											
37650	"	Revision of major vein"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37660	"	Revision of major vein"	C																																																																																																											
37700	"	Revise leg vein"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37718	"	Ligate/strip short leg vein"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37722	"	Ligate/strip long leg vein"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37735	"	Removal of leg veins/lesion"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37760	"	Ligate leg veins radical"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37761	"	Ligate leg veins open"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37765	"	Stab phleb veins xtr 10-20"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37766	"	Phleb veins - extrem 20+"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37780	"	Revision of leg vein"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37785	"	Ligate/divide/excise vein"	T	0219	29.4349	"$2,139.09"	.	$427.82																																																																																																						
37788	"	Revascularization penis"	C																																																																																																											
37790	"	Penile venous occlusion"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
37799	"	Vascular surgery procedure"	X	0624	1.1143	$80.98	.	$16.20																																																																																																						
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"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
38129	"	Laparoscope proc spleen"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
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	0111	14.9351	"$1,085.36"	.	$217.08																																																																																																						
38207	"	Cryopreserve stem cells"	S	0110	3.9241	$285.17	.	$57.04																																																																																																						
38208	"	Thaw preserved stem cells"	S	0110	3.9241	$285.17	.	$57.04																																																																																																						
38209	"	Wash harvest stem cells"	S	0110	3.9241	$285.17	.	$57.04																																																																																																						
38210	"	T-cell depletion of harvest"	S	0393	7.7877	$565.95	.	$113.19																																																																																																						
38211	"	Tumor cell deplete of harvst"	S	0393	7.7877	$565.95	.	$113.19																																																																																																						
38212	"	Rbc depletion of harvest"	S	0393	7.7877	$565.95	.	$113.19																																																																																																						
38213	"	Platelet deplete of harvest"	S	0393	7.7877	$565.95	.	$113.19																																																																																																						
38214	"	Volume deplete of harvest"	S	0393	7.7877	$565.95	.	$113.19																																																																																																						
38215	"	Harvest stem cell concentrte"	S	0393	7.7877	$565.95	.	$113.19																																																																																																						
38220	"	Bone marrow aspiration"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
38221	"	Bone marrow biopsy"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
38230	"	Bone marrow harvest allogen"	S	0112	42.1852	"$3,065.68"	.	$613.14																																																																																																						
38232	"	Bone marrow harvest autolog"	S	0112	42.1852	"$3,065.68"	.	$613.14																																																																																																						
38240	"	Transplt allo hct/donor"	S	0112	42.1852	"$3,065.68"	.	$613.14																																																																																																						
38241	"	Transplt autol hct/donor"	S	0112	42.1852	"$3,065.68"	.	$613.14																																																																																																						
38242	"	Transplt allo lymphocytes"	S	0111	14.9351	"$1,085.36"	.	$217.08																																																																																																						
38243	"	Transplj hematopoietic boost"	S	0111	14.9351	"$1,085.36"	.	$217.08																																																																																																						
38300	"	Drainage lymph node lesion"	T	0007	11.6214	$844.55	.	$168.91																																																																																																						
38305	"	Drainage lymph node lesion"	T	0008	21.5968	"$1,569.48"	.	$313.90																																																																																																						
38308	"	Incision of lymph channels"	T	0113	27.8917	"$2,026.95"	.	$405.39																																																																																																						
38380	"	Thoracic duct procedure"	C																																																																																																											
38381	"	Thoracic duct procedure"	C																																																																																																											
38382	"	Thoracic duct procedure"	C																																																																																																											
38500	"	Biopsy/removal lymph nodes"	T	0113	27.8917	"$2,026.95"	.	$405.39																																																																																																						
38505	"	Needle biopsy lymph nodes"	T	0005	9.6609	$702.08	.	$140.42																																																																																																						
38510	"	Biopsy/removal lymph nodes"	T	0113	27.8917	"$2,026.95"	.	$405.39																																																																																																						
38520	"	Biopsy/removal lymph nodes"	T	0113	27.8917	"$2,026.95"	.	$405.39																																																																																																						
38525	"	Biopsy/removal lymph nodes"	T	0113	27.8917	"$2,026.95"	.	$405.39																																																																																																						
38530	"	Biopsy/removal lymph nodes"	T	0113	27.8917	"$2,026.95"	.	$405.39																																																																																																						
38542	"	Explore deep node(s) neck"	T	0114	54.6762	"$3,973.43"	.	$794.69																																																																																																						
38550	"	Removal neck/armpit lesion"	T	0113	27.8917	"$2,026.95"	.	$405.39																																																																																																						
38555	"	Removal neck/armpit lesion"	T	0113	27.8917	"$2,026.95"	.	$405.39																																																																																																						
38562	"	Removal pelvic lymph nodes"	C																																																																																																											
38564	"	Removal abdomen lymph nodes"	C																																																																																																											
38570	"	Laparoscopy lymph node biop"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
38571	"	Laparoscopy lymphadenectomy"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
38572	"	Laparoscopy lymphadenectomy"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
38589	"	Laparoscope proc lymphatic"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
38700	"	Removal of lymph nodes neck"	T	0113	27.8917	"$2,026.95"	.	$405.39																																																																																																						
38720	"	Removal of lymph nodes neck"	T	0113	27.8917	"$2,026.95"	.	$405.39																																																																																																						
38724	"	Removal of lymph nodes neck"	C																																																																																																											
38740	"	Remove armpit lymph nodes"	T	0114	54.6762	"$3,973.43"	.	$794.69																																																																																																						
38745	"	Remove armpit lymph nodes"	T	0114	54.6762	"$3,973.43"	.	$794.69																																																																																																						
38746	"	Remove thoracic lymph nodes"	C																																																																																																											
38747	"	Remove abdominal lymph nodes"	C																																																																																																											
38760	"	Remove groin lymph nodes"	T	0113	27.8917	"$2,026.95"	.	$405.39																																																																																																						
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	0392	3.5423	$257.43	.	$51.49																																																																																																						
38794	"	Access thoracic lymph duct"	N																																																																																																											
38900	"	Io map of sent lymph node"	N																																																																																																											
38999	"	Blood/lymph system procedure"	S	0110	3.9241	$285.17	.	$57.04																																																																																																						
39000	"	Exploration of chest"	C																																																																																																											
39010	"	Exploration of chest"	C																																																																																																											
39200	"	Resect mediastinal cyst"	C																																																																																																											
39220	"	Resect mediastinal tumor"	C																																																																																																											
39400	"	Mediastinoscopy incl biopsy"	T	0069	36.3292	"$2,640.12"	$591.64	$528.03																																																																																																						
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"	M																																																																																																											
4001F	"	Tobacco use txmnt pharmacol"	M																																																																																																											
4003F	"	Pt ed write/oral pts w/ hf"	E																																																																																																											
4004F	"	Pt tobacco screen rcvd tlk"	M																																																																																																											
4005F	"	Pharm thx for op rxd"	M																																																																																																											
4008F	"	Beta-blocker therapy rxd/tkn"	M																																																																																																											
4010F	"	Ace/arb therapy rxd/taken"	M																																																																																																											
4011F	"	Oral antiplatelet therapy rx"	E																																																																																																											
4012F	"	Warfarin therapy rx"	E																																																																																																											
4013F	"	Statin therapy/currently tkn"	M																																																																																																											
4014F	"	Written discharge instr prvd"	E																																																																																																											
4015F	"	Persist asthma medicine ctrl"	E																																																																																																											
4016F	"	Anti-inflm/anlgsc agent rx"	E																																																																																																											
4017F	"	Gi prophylaxis for nsaid rx"	E																																																																																																											
4018F	"	Therapy exercise joint rx"	E																																																																																																											
4019F	"	Doc recpt counsl vit d/calc+"	E																																																																																																											
4025F	"	Inhaled bronchodilator rx"	M																																																																																																											
4030F	"	Oxygen therapy rx"	E																																																																																																											
4033F	"	Pulmonary rehab rec"	E																																																																																																											
4035F	"	Influenza imm rec"	M																																																																																																											
4037F	"	Influenza imm order/admin"	M																																																																																																											
4040F	"	Pneumoc vac/admin/rcvd"	M																																																																																																											
4041F	"	Doc order cefazolin/cefurox"	E																																																																																																											
4042F	"	Doc antibio not given"	M																																																																																																											
4043F	"	Doc order given stop antibio"	M																																																																																																											
4044F	"	Doc order given vte prophylx"	M																																																																																																											
4045F	"	Empiric antibiotic rx"	M																																																																																																											
4046F	"	Doc antibio given b/4 surg"	M																																																																																																											
4047F	"	Doc antibio given b/4 surg"	M																																																																																																											
4048F	"	Doc antibio given b/4 surg"	M																																																																																																											
40490	"	Biopsy of lip"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
4049F	"	Doc order given stop antibio"	M																																																																																																											
40500	"	Partial excision of lip"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
4050F	"	Ht care plan doc"	E																																																																																																											
40510	"	Partial excision of lip"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
4051F	"	Referred for an av fistula"	E																																																																																																											
40520	"	Partial excision of lip"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
40525	"	Reconstruct lip with flap"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
40527	"	Reconstruct lip with flap"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
4052F	"	Hemodialysis via av fistula"	E																																																																																																											
40530	"	Partial removal of lip"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
4053F	"	Hemodialysis via av graft"	E																																																																																																											
4054F	"	Hemodialysis via catheter"	E																																																																																																											
4055F	"	Pt rcvng periton dialysis"	E																																																																																																											
4056F	"	Approp oral rehyd recommd"	E																																																																																																											
4058F	"	Ped gastro ed given caregvr"	E																																																																																																											
4060F	"	Psych svcs provided"	E																																																																																																											
4062F	"	Pt referral psych docd"	E																																																																																																											
4063F	"	Antidepres rxthxpy not rxd"	E																																																																																																											
4064F	"	Antidepressant rx"	E																																																																																																											
40650	"	Repair lip"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
40652	"	Repair lip"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
40654	"	Repair lip"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
4065F	"	Antipsychotic rx"	E																																																																																																											
4066F	"	Ect provided"	E																																																																																																											
4067F	"	Pt referral for ect docd"	E																																																																																																											
4069F	"	Vte prophylaxis rcvd"	E																																																																																																											
40700	"	Repair cleft lip/nasal"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
40701	"	Repair cleft lip/nasal"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
40702	"	Repair cleft lip/nasal"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
4070F	"	Dvt prophylx recvd day 2"	E																																																																																																											
40720	"	Repair cleft lip/nasal"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
4073F	"	Oral antiplat thx rx dischrg"	E																																																																																																											
4075F	"	Anticoag thx rx at dischrg"	M																																																																																																											
40761	"	Repair cleft lip/nasal"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
4077F	"	Doc t-pa admin considered"	E																																																																																																											
40799	"	Lip surgery procedure"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
4079F	"	Doc rehab svcs considered"	E																																																																																																											
40800	"	Drainage of mouth lesion"	T	0006	2.1970	$159.66	.	$31.94																																																																																																						
40801	"	Drainage of mouth lesion"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
40804	"	Removal foreign body mouth"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
40805	"	Removal foreign body mouth"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
40806	"	Incision of lip fold"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
40808	"	Biopsy of mouth lesion"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
40810	"	Excision of mouth lesion"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
40812	"	Excise/repair mouth lesion"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
40814	"	Excise/repair mouth lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
40816	"	Excision of mouth lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
40818	"	Excise oral mucosa for graft"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
40819	"	Excise lip or cheek fold"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
40820	"	Treatment of mouth lesion"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
40830	"	Repair mouth laceration"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
40831	"	Repair mouth laceration"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
40840	"	Reconstruction of mouth"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
40842	"	Reconstruction of mouth"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
40843	"	Reconstruction of mouth"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
40844	"	Reconstruction of mouth"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
40845	"	Reconstruction of mouth"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
4084F	"	Aspirin recvd w/in 24 hrs"	M																																																																																																											
4086F	"	Aspirin/clopidogrel rxd"	M																																																																																																											
40899	"	Mouth surgery procedure"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
4090F	"	Pt rcvng epo thxpy"	M																																																																																																											
4095F	"	Pt not rcvng epo thxpy"	M																																																																																																											
41000	"	Drainage of mouth lesion"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
41005	"	Drainage of mouth lesion"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
41006	"	Drainage of mouth lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
41007	"	Drainage of mouth lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
41008	"	Drainage of mouth lesion"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
41009	"	Drainage of mouth lesion"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
4100F	"	Biphos thxpy vein ord/recvd"	M																																																																																																											
41010	"	Incision of tongue fold"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
41015	"	Drainage of mouth lesion"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
41016	"	Drainage of mouth lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
41017	"	Drainage of mouth lesion"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
41018	"	Drainage of mouth lesion"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
41019	"	Place needles h&n for rt"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
41100	"	Biopsy of tongue"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
41105	"	Biopsy of tongue"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
41108	"	Biopsy of floor of mouth"	T	0020	8.8192	$640.91	.	$128.19																																																																																																						
4110F	"	Int mam art used for cabg"	M																																																																																																											
41110	"	Excision of tongue lesion"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
41112	"	Excision of tongue lesion"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
41113	"	Excision of tongue lesion"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
41114	"	Excision of tongue lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
41115	"	Excision of tongue fold"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
41116	"	Excision of mouth lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
41120	"	Partial removal of tongue"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
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"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
41251	"	Repair tongue laceration"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
41252	"	Repair tongue laceration"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
4130F	"	Topical prep rx aoe"	M																																																																																																											
4131F	"	Syst antimicrobial thx rx"	M																																																																																																											
4132F	"	No syst antimicrobial thx rx"	M																																																																																																											
4133F	"	Antihist/decong rx/recom"	E																																																																																																											
4134F	"	No antihist/decong rx/recom"	E																																																																																																											
4135F	"	Systemic corticosteroids rx"	E																																																																																																											
4136F	"	Syst corticosteroids not rx"	E																																																																																																											
4140F	"	Inhaled corticosteroids rxd"	M																																																																																																											
4142F	"	Corticoster sparng thrpy rxd"	M																																																																																																											
4144F	"	Alt long-term cntrl med rxd"	M																																																																																																											
4145F	"	2+ anti-hyprtnsv agents tkn"	E																																																																																																											
4148F	"	Hep a vac injxn admin/recvd"	M																																																																																																											
4149F	"	Hep b vac injxn admin/recvd"	E																																																																																																											
41500	"	Fixation of tongue"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
4150F	"	Pt recvng antivir txmnt hepc"	E																																																																																																											
41510	"	Tongue to lip surgery"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
41512	"	Tongue suspension"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
4151F	"	Pt not recvng antiv hep c"	M																																																																																																											
41520	"	Reconstruction tongue fold"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
41530	"	Tongue base vol reduction"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
4153F	"	Combo pegintf/rib rx"	E																																																																																																											
4155F	"	Hep a vac series prev recvd"	E																																																																																																											
4157F	"	Hep b vac series prev recvd"	E																																																																																																											
4158F	"	Pt edu re alcoh drnkng done"	E																																																																																																											
41599	"	Tongue and mouth surgery"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
4159F	"	Contrcp talk b/4 antiv txmnt"	E																																																																																																											
4163F	"	Pt couns 4 txmnt opt prost"	E																																																																																																											
4164F	"	Adjv hrmnl thxpy rxd"	M																																																																																																											
4165F	"	3d-crt/imrt received"	E																																																																																																											
4167F	"	Hd bed tilted 1st day vent"	E																																																																																																											
4168F	"	Pt care icu&vent w/in 24hrs"	E																																																																																																											
4169F	"	No pt care icu/vent in 24hrs"	E																																																																																																											
4171F	"	Pt rcvng esa thxpy"	M																																																																																																											
4172F	"	Pt not rcvng esa thxpy"	M																																																																																																											
4174F	"	Couns potent glauc impct"	E																																																																																																											
4175F	"	Vis 20/40/> w/in 90 days"	M																																																																																																											
4176F	"	Talk re uv light pt/crgvr"	E																																																																																																											
4177F	"	Talk pt/crgvr re areds prev"	M																																																																																																											
4178F	"	Antid glbln rcvd w/in 26wks"	E																																																																																																											
4179F	"	Tamoxifen/ai prescribed"	M																																																																																																											
41800	"	Drainage of gum lesion"	T	0006	2.1970	$159.66	.	$31.94																																																																																																						
41805	"	Removal foreign body gum"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
41806	"	Removal foreign body jawbone"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
4180F	"	Adjv thxpyrxd/rcvd colon ca"	E																																																																																																											
4181F	"	Conformal radn thxpy rcvd"	E																																																																																																											
41820	"	Excision gum each quadrant"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
41821	"	Excision of gum flap"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
41822	"	Excision of gum lesion"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
41823	"	Excision of gum lesion"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
41825	"	Excision of gum lesion"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
41826	"	Excision of gum lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
41827	"	Excision of gum lesion"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
41828	"	Excision of gum lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
4182F	"	No conformal radn thxpy"	E																																																																																																											
41830	"	Removal of gum tissue"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
41850	"	Treatment of gum lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
4185F	"	Continuous ppi or h2ra rcvd"	E																																																																																																											
4186F	"	No cont ppi or h2ra rcvd"	E																																																																																																											
41870	"	Gum graft"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
41872	"	Repair gum"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
41874	"	Repair tooth socket"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
4187F	"	Anti rheum drugthxpyrxd/gvn"	M																																																																																																											
4188F	"	Approp ace/arb tstng done"	E																																																																																																											
41899	"	Dental surgery procedure"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
4189F	"	Approp digoxin tstng done"	E																																																																																																											
4190F	"	Approp diuretic tstng done"	E																																																																																																											
4191F	"	Approp anticonvuls tstng"	E																																																																																																											
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	0251	3.5927	$261.09	.	$52.22																																																																																																						
4200F	"	External beam to prost only"	E																																																																																																											
4201F	"	Extrnl beam other than prost"	E																																																																																																											
42100	"	Biopsy roof of mouth"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
42104	"	Excision lesion mouth roof"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
42106	"	Excision lesion mouth roof"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
42107	"	Excision lesion mouth roof"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
4210F	"	Ace/arb thxpy for mos/>"	E																																																																																																											
42120	"	Remove palate/lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42140	"	Excision of uvula"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
42145	"	Repair palate pharynx/uvula"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42160	"	Treatment mouth roof lesion"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
42180	"	Repair palate"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
42182	"	Repair palate"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42200	"	Reconstruct cleft palate"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42205	"	Reconstruct cleft palate"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
4220F	"	Digoxin thxpy for 6 mos/>"	E																																																																																																											
42210	"	Reconstruct cleft palate"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42215	"	Reconstruct cleft palate"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
4221F	"	Diuretic thxpy for 6 mos/>"	E																																																																																																											
42220	"	Reconstruct cleft palate"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42225	"	Reconstruct cleft palate"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42226	"	Lengthening of palate"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42227	"	Lengthening of palate"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42235	"	Repair palate"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42260	"	Repair nose to lip fistula"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42280	"	Preparation palate mold"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
42281	"	Insertion palate prosthesis"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
42299	"	Palate/uvula surgery"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
42300	"	Drainage of salivary gland"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
42305	"	Drainage of salivary gland"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
4230F	"	Anticonv thxpy for 6 mos/>"	E																																																																																																											
42310	"	Drainage of salivary gland"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
42320	"	Drainage of salivary gland"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
42330	"	Removal of salivary stone"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
42335	"	Removal of salivary stone"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42340	"	Removal of salivary stone"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
42400	"	Biopsy of salivary gland"	T	0005	9.6609	$702.08	.	$140.42																																																																																																						
42405	"	Biopsy of salivary gland"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42408	"	Excision of salivary cyst"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42409	"	Drainage of salivary cyst"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
4240F	"	Instr xrcz back pain 12 wks"	E																																																																																																											
42410	"	Excise parotid gland/lesion"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42415	"	Excise parotid gland/lesion"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42420	"	Excise parotid gland/lesion"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42425	"	Excise parotid gland/lesion"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42426	"	Excise parotid gland/lesion"	C																																																																																																											
4242F	"	Sprvsd xrcz back pn >12 wks"	E																																																																																																											
42440	"	Excise submaxillary gland"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42450	"	Excise sublingual gland"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
4245F	"	Pt instr nrml lifest"	M																																																																																																											
4248F	"	Pt instr no bd rest 4 days/>"	M																																																																																																											
42500	"	Repair salivary duct"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42505	"	Repair salivary duct"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42507	"	Parotid duct diversion"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42508	"	Parotid duct diversion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42509	"	Parotid duct diversion"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
4250F	"	Wrmng 4 surg normothermia"	M																																																																																																											
42510	"	Parotid duct diversion"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42550	"	Injection for salivary x-ray"	N																																																																																																											
4255F	"	Anesth 60 min/> as docd"	M																																																																																																											
4256F	"	Anesthe <60 min as docd"	M																																																																																																											
42600	"	Closure of salivary fistula"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
4260F	"	Wound srfc culturetech used"	M																																																																																																											
4261F	"	Tech other than surfc cultr"	M																																																																																																											
42650	"	Dilation of salivary duct"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
4265F	"	Wet-dry dressings rx recmd"	M																																																																																																											
42660	"	Dilation of salivary duct"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
42665	"	Ligation of salivary duct"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
4266F	"	No wet-dry drssings rx recmd"	M																																																																																																											
4267F	"	Comprssion thxpy prescribed"	E																																																																																																											
4268F	"	Pt ed re comp thxpy rcvd"	E																																																																																																											
42699	"	Salivary surgery procedure"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
4269F	"	Appropos mthd offloading rxd"	E																																																																																																											
42700	"	Drainage of tonsil abscess"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
4270F	"	Pt rcvng anti r-viral thxpy"	E																																																																																																											
4271F	"	Pt rcvng anti r-viral thxpy"	E																																																																																																											
42720	"	Drainage of throat abscess"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
42725	"	Drainage of throat abscess"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
4274F	"	Flu immuno admind rcvd"	E																																																																																																											
4276F	"	Potent antivir thxpy rxd"	E																																																																																																											
4279F	"	Pcp prophylaxis rxd"	E																																																																																																											
42800	"	Biopsy of throat"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
42804	"	Biopsy of upper nose/throat"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
42806	"	Biopsy of upper nose/throat"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42808	"	Excise pharynx lesion"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42809	"	Remove pharynx foreign body"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
4280F	"	Pcp prophylax rxd 3mon low %"	E																																																																																																											
42810	"	Excision of neck cyst"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42815	"	Excision of neck cyst"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42820	"	Remove tonsils and adenoids"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42821	"	Remove tonsils and adenoids"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42825	"	Removal of tonsils"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42826	"	Removal of tonsils"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42830	"	Removal of adenoids"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42831	"	Removal of adenoids"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42835	"	Removal of adenoids"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42836	"	Removal of adenoids"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42842	"	Extensive surgery of throat"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42844	"	Extensive surgery of throat"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42845	"	Extensive surgery of throat"	C																																																																																																											
42860	"	Excision of tonsil tags"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42870	"	Excision of lingual tonsil"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42890	"	Partial removal of pharynx"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42892	"	Revision of pharyngeal walls"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42894	"	Revision of pharyngeal walls"	C																																																																																																											
42900	"	Repair throat wound"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
4290F	"	Pt scrned for inj drug use"	E																																																																																																											
4293F	"	Pt scrnd hgh-risk sex behav"	E																																																																																																											
42950	"	Reconstruction of throat"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
42953	"	Repair throat esophagus"	C																																																																																																											
42955	"	Surgical opening of throat"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42960	"	Control throat bleeding"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
42961	"	Control throat bleeding"	C																																																																																																											
42962	"	Control throat bleeding"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
42970	"	Control nose/throat bleeding"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
42971	"	Control nose/throat bleeding"	C																																																																																																											
42972	"	Control nose/throat bleeding"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
42999	"	Throat surgery procedure"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
4300F	"	Pt rcvng warf thxpy"	E																																																																																																											
4301F	"	Pt not rcvng warf thxpy"	E																																																																																																											
43020	"	Incision of esophagus"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
43030	"	Throat muscle surgery"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
43045	"	Incision of esophagus"	C																																																																																																											
4305F	"	Pt ed re ft care inspct rcvd"	E																																																																																																											
4306F	"	Pt tlk psych & rx opd addic"	E																																																																																																											
43100	"	Excision of esophagus lesion"	C																																																																																																											
43101	"	Excision of esophagus lesion"	C																																																																																																											
43107	"	Removal of esophagus"	C																																																																																																											
43108	"	Removal of esophagus"	C																																																																																																											
43112	"	Removal of esophagus"	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"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
43135	"	Removal of esophagus pouch"	C																																																																																																											
43191	"	Esophagoscopy rigid trnso dx"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43192	"	Esophagoscp rig trnso inject"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43193	"	Esophagoscp rig trnso biopsy"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43194	"	Esophagoscp rig trnso rem fb"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43195	"	Esophagoscopy rigid balloon"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43196	"	Esophagoscp guide wire dilat"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43197	"	Esophagoscopy flex dx brush"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43198	Esophagosc flex trnsn biopy	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43200	"	Esophagoscopy flexible brush"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43201	"	Esoph scope w/submucous inj"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43202	"	Esophagoscopy flex biopsy"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43204	"	Esoph scope w/sclerosis inj"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43205	"	Esophagus endoscopy/ligation"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43206	"	Esoph optical endomicroscopy"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
4320F	"	Pt talk psychsoc&rx oh dpnd"	M																																																																																																											
43211	"	Esophagoscop mucosal resect"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43212	"	Esophagoscop stent placement"	T	0384	32.6316	"$2,371.40"	.	$474.28																																																																																																						
43213	"	Esophagoscopy retro balloon"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43214	"	Esophagosc dilate balloon 30"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43215	"	Esophagoscopy flex remove fb"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43216	"	Esophagoscopy lesion removal"	T	0422	27.0909	"$1,968.75"	.	$393.75																																																																																																						
43217	"	Esophagoscopy snare les remv"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43220	"	Esophagoscopy balloon <30mm"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43226	"	Esoph endoscopy dilation"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43227	"	Esophagoscopy control bleed"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43229	"	Esophagoscopy lesion ablate"	T	0422	27.0909	"$1,968.75"	.	$393.75																																																																																																						
4322F	"	Crgvr prov w/ ed addl rsrcs"	M																																																																																																											
43231	"	Esophagoscop ultrasound exam"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43232	"	Esophagoscopy w/us needle bx"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43233	"	Egd balloon dil esoph30 mm/>"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43235	"	Egd diagnostic brush wash"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43236	"	Uppr gi scope w/submuc inj"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43237	"	Endoscopic us exam esoph"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43238	"	Egd us fine needle bx/aspir"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43239	"	Egd biopsy single/multiple"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43240	"	Egd w/transmural drain cyst"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43241	"	Egd tube/cath insertion"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43242	"	Egd us fine needle bx/aspir"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43243	"	Egd injection varices"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43244	"	Egd varices ligation"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43245	"	Egd dilate stricture"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43246	"	Egd place gastrostomy tube"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43247	"	Egd remove foreign body"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43248	"	Egd guide wire insertion"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43249	"	Esoph egd dilation <30 mm"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
4324F	"	Pt queried prkns complic"	E																																																																																																											
43250	"	Egd cautery tumor polyp"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43251	"	Egd remove lesion snare"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43252	"	Egd optical endomicroscopy"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43253	"	Egd us transmural injxn/mark"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43254	"	Egd endo mucosal resection"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43255	"	Egd control bleeding any"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43257	"	Egd w/thrml txmnt gerd"	T	0422	27.0909	"$1,968.75"	.	$393.75																																																																																																						
43259	"	Egd us exam duodenum/jejunum"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
4325F	"	Med txmnt options rvwd w/pt"	M																																																																																																											
43260	"	Ercp w/specimen collection"	T	0151	26.6085	"$1,933.69"	.	$386.74																																																																																																						
43261	"	Endo cholangiopancreatograph"	T	0151	26.6085	"$1,933.69"	.	$386.74																																																																																																						
43262	"	Endo cholangiopancreatograph"	T	0151	26.6085	"$1,933.69"	.	$386.74																																																																																																						
43263	"	Ercp sphincter pressure meas"	T	0151	26.6085	"$1,933.69"	.	$386.74																																																																																																						
43264	"	Ercp remove duct calculi"	T	0151	26.6085	"$1,933.69"	.	$386.74																																																																																																						
43265	"	Ercp lithotripsy calculi"	T	0151	26.6085	"$1,933.69"	.	$386.74																																																																																																						
43266	"	Egd endoscopic stent place"	T	0384	32.6316	"$2,371.40"	.	$474.28																																																																																																						
4326F	"	Pt asked re symp auto dysfxn"	E																																																																																																											
43270	"	Egd lesion ablation"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43273	"	Endoscopic pancreatoscopy"	N																																																																																																											
43274	"	Ercp duct stent placement"	T	0151	26.6085	"$1,933.69"	.	$386.74																																																																																																						
43275	"	Ercp remove forgn body duct"	T	0151	26.6085	"$1,933.69"	.	$386.74																																																																																																						
43276	"	Ercp stent exchange w/dilate"	T	0151	26.6085	"$1,933.69"	.	$386.74																																																																																																						
43277	"	Ercp ea duct/ampulla dilate"	T	0151	26.6085	"$1,933.69"	.	$386.74																																																																																																						
43278	"	Ercp lesion ablate w/dilate"	T	0151	26.6085	"$1,933.69"	.	$386.74																																																																																																						
43279	"	Lap myotomy heller"	C																																																																																																											
43280	"	Laparoscopy fundoplasty"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
43281	"	Lap paraesophag hern repair"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
43282	"	Lap paraesoph her rpr w/mesh"	C																																																																																																											
43283	"	Lap esoph lengthening"	C																																																																																																											
43289	"	Laparoscope proc esoph"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
4328F	"	Pt asked re sleep disturb"	M																																																																																																											
43300	"	Repair of esophagus"	C																																																																																																											
43305	"	Repair esophagus and fistula"	C																																																																																																											
4330F	"	Cnslng epi spec sfty issues"	E																																																																																																											
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																																																																																																											
43350	"	Surgical opening esophagus"	C																																																																																																											
43351	"	Surgical opening esophagus"	C																																																																																																											
43352	"	Surgical opening esophagus"	C																																																																																																											
43360	"	Gastrointestinal repair"	C																																																																																																											
43361	"	Gastrointestinal repair"	C																																																																																																											
43400	"	Ligate esophagus veins"	C																																																																																																											
43401	"	Esophagus surgery for 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"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
43425	"	Repair esophagus opening"	C																																																																																																											
43450	"	Dilate esophagus 1/mult pass"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43453	"	Dilate esophagus"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
43460	"	Pressure treatment esophagus"	C																																																																																																											
43496	"	Free jejunum flap microvasc"	C																																																																																																											
43499	"	Esophagus surgery procedure"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43500	"	Surgical opening of stomach"	C																																																																																																											
43501	"	Surgical repair of stomach"	C																																																																																																											
43502	"	Surgical repair of stomach"	C																																																																																																											
4350F	"	Cnslng provided symp mngmnt"	E																																																																																																											
43510	"	Surgical opening of stomach"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
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"	S	0061	102.1644	"$7,424.49"	.	"$1,484.90"																																																																																																						
43648	"	Lap revise/remv eltrd antrum"	Q2	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
43651	"	Laparoscopy vagus nerve"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
43652	"	Laparoscopy vagus nerve"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
43653	"	Laparoscopy gastrostomy"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
43659	"	Laparoscope proc stom"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
43752	Nasal/orogastric w/tube plmt	Q3	0277	2.0810	$151.23	$46.51	$30.25																																																																																																						
43753	"	Tx gastro intub w/asp"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
43754	"	Dx gastr intub w/asp spec"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
43755	"	Dx gastr intub w/asp specs"	S	0096	1.8035	$131.06	$36.86	$26.22																																																																																																						
43756	"	Dx duod intub w/asp spec"	X	0272	2.1559	$156.67	.	$31.34																																																																																																						
43757	"	Dx duod intub w/asp specs"	X	0272	2.1559	$156.67	.	$31.34																																																																																																						
43760	"	Change gastrostomy tube"	T	0676	2.5286	$183.76	.	$36.76																																																																																																						
43761	"	Reposition gastrostomy tube"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43770	"	Lap place gastr adj device"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
43771	"	Lap revise gastr adj device"	C																																																																																																											
43772	"	Lap rmvl gastr adj device"	C																																																																																																											
43773	"	Lap replace gastr adj device"	C																																																																																																											
43774	"	Lap rmvl gastr adj all parts"	C																																																																																																											
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"	T	0422	27.0909	"$1,968.75"	.	$393.75																																																																																																						
43831	"	Place gastrostomy tube"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
43832	"	Place gastrostomy tube"	C																																																																																																											
43840	"	Repair of stomach lesion"	C																																																																																																											
43842	"	V-band gastroplasty"	E																																																																																																											
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"	T	0422	27.0909	"$1,968.75"	.	$393.75																																																																																																						
43880	"	Repair stomach-bowel fistula"	C																																																																																																											
43881	"	Impl/redo electrd antrum"	C																																																																																																											
43882	"	Revise/remove electrd antrum"	C																																																																																																											
43886	"	Revise gastric port open"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
43887	"	Remove gastric port open"	Q2	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
43888	"	Change gastric port open"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
43999	"	Stomach surgery procedure"	T	0141	9.2260	$670.47	$138.69	$134.10																																																																																																						
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	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
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"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
44186	"	Lap jejunostomy"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
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"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
44300	"	Open bowel to skin"	C																																																																																																											
44310	"	Ileostomy/jejunostomy"	C																																																																																																											
44312	"	Revision of ileostomy"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
44314	"	Revision of ileostomy"	C																																																																																																											
44316	"	Devise bowel pouch"	C																																																																																																											
44320	"	Colostomy"	C																																																																																																											
44322	"	Colostomy with biopsies"	C																																																																																																											
44340	"	Revision of colostomy"	T	0329	31.1050	"$2,260.46"	.	$452.10																																																																																																						
44345	"	Revision of colostomy"	C																																																																																																											
44346	"	Revision of colostomy"	C																																																																																																											
44360	"	Small bowel endoscopy"	T	0142	11.5200	$837.18	.	$167.44																																																																																																						
44361	"	Small bowel endoscopy/biopsy"	T	0142	11.5200	$837.18	.	$167.44																																																																																																						
44363	"	Small bowel endoscopy"	T	0142	11.5200	$837.18	.	$167.44																																																																																																						
44364	"	Small bowel endoscopy"	T	0424	16.9672	"$1,233.04"	.	$246.61																																																																																																						
44365	"	Small bowel endoscopy"	T	0424	16.9672	"$1,233.04"	.	$246.61																																																																																																						
44366	"	Small bowel endoscopy"	T	0424	16.9672	"$1,233.04"	.	$246.61																																																																																																						
44369	"	Small bowel endoscopy"	T	0424	16.9672	"$1,233.04"	.	$246.61																																																																																																						
44370	"	Small bowel endoscopy/stent"	T	0384	32.6316	"$2,371.40"	.	$474.28																																																																																																						
44372	"	Small bowel endoscopy"	T	0424	16.9672	"$1,233.04"	.	$246.61																																																																																																						
44373	"	Small bowel endoscopy"	T	0424	16.9672	"$1,233.04"	.	$246.61																																																																																																						
44376	"	Small bowel endoscopy"	T	0142	11.5200	$837.18	.	$167.44																																																																																																						
44377	"	Small bowel endoscopy/biopsy"	T	0424	16.9672	"$1,233.04"	.	$246.61																																																																																																						
44378	"	Small bowel endoscopy"	T	0424	16.9672	"$1,233.04"	.	$246.61																																																																																																						
44379	"	S bowel endoscope w/stent"	T	0384	32.6316	"$2,371.40"	.	$474.28																																																																																																						
44380	"	Small bowel endoscopy"	T	0142	11.5200	$837.18	.	$167.44																																																																																																						
44382	"	Small bowel endoscopy"	T	0142	11.5200	$837.18	.	$167.44																																																																																																						
44383	"	Ileoscopy w/stent"	T	0384	32.6316	"$2,371.40"	.	$474.28																																																																																																						
44385	"	Endoscopy of bowel pouch"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
44386	"	Endoscopy bowel pouch/biop"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
44388	"	Colonoscopy"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
44389	"	Colonoscopy with biopsy"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
44390	"	Colonoscopy for foreign body"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
44391	"	Colonoscopy for bleeding"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
44392	"	Colonoscopy & polypectomy"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
44393	"	Colonoscopy lesion removal"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
44394	"	Colonoscopy w/snare"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
44397	"	Colonoscopy w/stent"	T	0384	32.6316	"$2,371.40"	.	$474.28																																																																																																						
44500	"	Intro gastrointestinal tube"	T	0121	6.4191	$466.49	.	$93.30																																																																																																						
4450F	"	Self-care ed provided to pt"	E																																																																																																											
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"	E																																																																																																											
44715	"	Prepare donor intestine"	C																																																																																																											
44720	"	Prep donor intestine/venous"	C																																																																																																											
44721	"	Prep donor intestine/artery"	C																																																																																																											
44799	"	Unlisted procedure intestine"	T	0153	25.2695	"$1,836.39"	.	$367.28																																																																																																						
44800	"	Excision of bowel pouch"	C																																																																																																											
4480F	"	Pt rcvng ace/arb b-blockertx"	E																																																																																																											
4481F	"	Pt rcvng ace/arb blker >3mos"	E																																																																																																											
44820	"	Excision of mesentery lesion"	C																																																																																																											
44850	"	Repair of mesentery"	C																																																																																																											
44899	"	Bowel surgery procedure"	C																																																																																																											
44900	"	Drain appendix abscess open"	C																																																																																																											
44950	"	Appendectomy"	T	0153	25.2695	"$1,836.39"	.	$367.28																																																																																																						
44955	"	Appendectomy add-on"	N																																																																																																											
44960	"	Appendectomy"	C																																																																																																											
44970	"	Laparoscopy appendectomy"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
44979	"	Laparoscope proc app"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
45000	"	Drainage of pelvic abscess"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
45005	"	Drainage of rectal abscess"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
4500F	"	Ref to outpt card rehab prog"	M																																																																																																											
45020	"	Drainage of rectal abscess"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
45100	"	Biopsy of rectum"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
45108	"	Removal of anorectal lesion"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
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	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
45160	"	Excision of rectal lesion"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
45171	"	Exc rect tum transanal part"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
45172	"	Exc rect tum transanal full"	T	0150	34.4192	"$2,501.31"	.	$500.27																																																																																																						
45190	"	Destruction rectal tumor"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
4525F	"	Neuropsychia interven order"	M																																																																																																											
4526F	"	Neuropsychia interven rcvd"	M																																																																																																											
45300	"	Proctosigmoidoscopy dx"	T	0146	6.3436	$461.00	.	$92.20																																																																																																						
45303	"	Proctosigmoidoscopy dilate"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
45305	"	Proctosigmoidoscopy w/bx"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
45307	"	Proctosigmoidoscopy fb"	T	0428	22.8029	"$1,657.13"	.	$331.43																																																																																																						
45308	"	Proctosigmoidoscopy removal"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
45309	"	Proctosigmoidoscopy removal"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
45315	"	Proctosigmoidoscopy removal"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
45317	"	Proctosigmoidoscopy bleed"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
45320	"	Proctosigmoidoscopy ablate"	T	0428	22.8029	"$1,657.13"	.	$331.43																																																																																																						
45321	"	Proctosigmoidoscopy volvul"	T	0428	22.8029	"$1,657.13"	.	$331.43																																																																																																						
45327	"	Proctosigmoidoscopy w/stent"	T	0384	32.6316	"$2,371.40"	.	$474.28																																																																																																						
45330	"	Diagnostic sigmoidoscopy"	T	0146	6.3436	$461.00	.	$92.20																																																																																																						
45331	"	Sigmoidoscopy and biopsy"	T	0146	6.3436	$461.00	.	$92.20																																																																																																						
45332	"	Sigmoidoscopy w/fb removal"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
45333	"	Sigmoidoscopy & polypectomy"	T	0146	6.3436	$461.00	.	$92.20																																																																																																						
45334	"	Sigmoidoscopy for bleeding"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
45335	"	Sigmoidoscopy w/submuc inj"	T	0146	6.3436	$461.00	.	$92.20																																																																																																						
45337	"	Sigmoidoscopy & decompress"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
45338	"	Sigmoidoscopy w/tumr remove"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
45339	"	Sigmoidoscopy w/ablate tumr"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
45340	"	Sig w/balloon dilation"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
45341	"	Sigmoidoscopy w/ultrasound"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
45342	"	Sigmoidoscopy w/us guide bx"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
45345	"	Sigmoidoscopy w/stent"	T	0384	32.6316	"$2,371.40"	.	$474.28																																																																																																						
45355	"	Surgical colonoscopy"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
45378	"	Diagnostic colonoscopy"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
45379	"	Colonoscopy w/fb removal"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
45380	"	Colonoscopy and biopsy"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
45381	"	Colonoscopy submucous inj"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
45382	"	Colonoscopy/control bleeding"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
45383	"	Lesion removal colonoscopy"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
45384	"	Lesion remove colonoscopy"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
45385	"	Lesion removal colonoscopy"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
45386	"	Colonoscopy dilate stricture"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
45387	"	Colonoscopy w/stent"	T	0384	32.6316	"$2,371.40"	.	$474.28																																																																																																						
45391	"	Colonoscopy w/endoscope us"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
45392	"	Colonoscopy w/endoscopic fnb"	T	0143	10.1393	$736.84	$186.06	$147.37																																																																																																						
45395	"	Lap removal of rectum"	C																																																																																																											
45397	"	Lap remove rectum w/pouch"	C																																																																																																											
45400	"	Laparoscopic proc"	C																																																																																																											
45402	"	Lap proctopexy w/sig resect"	C																																																																																																											
4540F	"	Disease modif pharmacothxpy"	E																																																																																																											
4541F	"	Pt offered tx for pseudobulb"	E																																																																																																											
45499	"	Laparoscope proc rectum"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
45500	"	Repair of rectum"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
45505	"	Repair of rectum"	T	0150	34.4192	"$2,501.31"	.	$500.27																																																																																																						
4550F	"	Noninvas resp support talk"	E																																																																																																											
4551F	"	Nutritional support offered"	E																																																																																																											
45520	"	Treatment of rectal prolapse"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
4552F	"	Pt ref for speech lang path"	E																																																																																																											
4553F	"	Pt asst re end life issues"	E																																																																																																											
45540	"	Correct rectal prolapse"	C																																																																																																											
45541	"	Correct rectal prolapse"	T	0150	34.4192	"$2,501.31"	.	$500.27																																																																																																						
4554F	"	Pt recvd inhal anesthetic"	E																																																																																																											
45550	"	Repair rectum/remove sigmoid"	C																																																																																																											
4555F	"	Pt recvd no inhal anesthic"	E																																																																																																											
45560	"	Repair of rectocele"	T	0150	34.4192	"$2,501.31"	.	$500.27																																																																																																						
45562	"	Exploration/repair of rectum"	C																																																																																																											
45563	"	Exploration/repair of rectum"	C																																																																																																											
4556F	"	Pt w/ 3+ post-op nausea&vom"	E																																																																																																											
4557F	"	Pt w/o 3+ post-opnausea&vom"	E																																																																																																											
4558F	"	Pt recvd 2 rx anti-emet agt"	E																																																																																																											
4559F	"	1 bodytemp >=35.5cw/in 30min"	E																																																																																																											
4560F	"	Anesth w/o gen/neurax anesth"	E																																																																																																											
4561F	"	Pt w/ coronary artery stent"	E																																																																																																											
4562F	"	Pt w/o coronary artery stent"	E																																																																																																											
4563F	"	Pt recvd aspirin w/in 24 hrs"	E																																																																																																											
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	0148	6.5068	$472.86	.	$94.58																																																																																																						
45905	"	Dilation of anal sphincter"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
45910	"	Dilation of rectal narrowing"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
45915	"	Remove rectal obstruction"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
45990	"	Surg dx exam anorectal"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
45999	"	Rectum surgery procedure"	T	0148	6.5068	$472.86	.	$94.58																																																																																																						
46020	"	Placement of seton"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46030	"	Removal of rectal marker"	T	0148	6.5068	$472.86	.	$94.58																																																																																																						
46040	"	Incision of rectal abscess"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
46045	"	Incision of rectal abscess"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46050	"	Incision of anal abscess"	T	0148	6.5068	$472.86	.	$94.58																																																																																																						
46060	"	Incision of rectal abscess"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
46070	"	Incision of anal septum"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
46080	"	Incision of anal sphincter"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
46083	"	Incise external hemorrhoid"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
46200	"	Removal of anal fissure"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46220	"	Excise anal ext tag/papilla"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
46221	"	Ligation of hemorrhoid(s)"	T	0148	6.5068	$472.86	.	$94.58																																																																																																						
46230	"	Removal of anal tags"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
46250	"	Remove ext hem groups 2+"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46255	"	Remove int/ext hem 1 group"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46257	"	Remove in/ex hem grp & fiss"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46258	"	Remove in/ex hem grp w/fistu"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46260	"	Remove in/ex hem groups 2+"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46261	"	Remove in/ex hem grps & fiss"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46262	"	Remove in/ex hem grps w/fist"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46270	"	Remove anal fist subq"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46275	"	Remove anal fist inter"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46280	"	Remove anal fist complex"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46285	"	Remove anal fist 2 stage"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46288	"	Repair anal fistula"	T	0150	34.4192	"$2,501.31"	.	$500.27																																																																																																						
46320	"	Removal of hemorrhoid clot"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
46500	"	Injection into hemorrhoid(s)"	T	0148	6.5068	$472.86	.	$94.58																																																																																																						
46505	"	Chemodenervation anal musc"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
46600	"	Diagnostic anoscopy"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
46604	"	Anoscopy and dilation"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
46606	"	Anoscopy and biopsy"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
46608	"	Anoscopy remove for body"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
46610	"	Anoscopy remove lesion"	T	0428	22.8029	"$1,657.13"	.	$331.43																																																																																																						
46611	"	Anoscopy"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
46612	"	Anoscopy remove lesions"	T	0428	22.8029	"$1,657.13"	.	$331.43																																																																																																						
46614	"	Anoscopy control bleeding"	T	0147	10.7242	$779.35	.	$155.87																																																																																																						
46615	"	Anoscopy"	T	0428	22.8029	"$1,657.13"	.	$331.43																																																																																																						
46700	"	Repair of anal stricture"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46705	"	Repair of anal stricture"	C																																																																																																											
46706	"	Repr of anal fistula w/glue"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46707	"	Repair anorectal fist w/plug"	T	0150	34.4192	"$2,501.31"	.	$500.27																																																																																																						
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"	T	0150	34.4192	"$2,501.31"	.	$500.27																																																																																																						
46751	"	Repair of anal sphincter"	C																																																																																																											
46753	"	Reconstruction of anus"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46754	"	Removal of suture from anus"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
46760	"	Repair of anal sphincter"	T	0150	34.4192	"$2,501.31"	.	$500.27																																																																																																						
46761	"	Repair of anal sphincter"	T	0150	34.4192	"$2,501.31"	.	$500.27																																																																																																						
46762	"	Implant artificial sphincter"	T	0150	34.4192	"$2,501.31"	.	$500.27																																																																																																						
46900	"	Destruction anal lesion(s)"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
46910	"	Destruction anal lesion(s)"	T	0017	20.7931	"$1,511.08"	.	$302.22																																																																																																						
46916	"	Cryosurgery anal lesion(s)"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
46917	"	Laser surgery anal lesions"	T	0017	20.7931	"$1,511.08"	.	$302.22																																																																																																						
46922	"	Excision of anal lesion(s)"	T	0017	20.7931	"$1,511.08"	.	$302.22																																																																																																						
46924	"	Destruction anal lesion(s)"	T	0017	20.7931	"$1,511.08"	.	$302.22																																																																																																						
46930	"	Destroy internal hemorrhoids"	T	0148	6.5068	$472.86	.	$94.58																																																																																																						
46940	"	Treatment of anal fissure"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
46942	"	Treatment of anal fissure"	T	0148	6.5068	$472.86	.	$94.58																																																																																																						
46945	"	Remove by ligat int hem grp"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46946	"	Remove by ligat int hem grps"	T	0149	26.2718	"$1,909.22"	.	$381.85																																																																																																						
46947	"	Hemorrhoidopexy by stapling"	T	0150	34.4192	"$2,501.31"	.	$500.27																																																																																																						
46999	"	Anus surgery procedure"	T	0148	6.5068	$472.86	.	$94.58																																																																																																						
47000	"	Needle biopsy of liver"	T	0685	10.4271	$757.76	.	$151.56																																																																																																						
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																																																																																																											
47136	"	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"	T	0174	118.2491	"$8,593.40"	"$1,911.61"	"$1,718.68"																																																																																																						
47371	"	Laparo ablate liver cryosurg"	T	0174	118.2491	"$8,593.40"	"$1,911.61"	"$1,718.68"																																																																																																						
47379	"	Laparoscope procedure liver"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
47380	"	Open ablate liver tumor rf"	C																																																																																																											
47381	"	Open ablate liver tumor cryo"	C																																																																																																											
47382	"	Percut ablate liver rf"	T	0423	56.5030	"$4,106.19"	.	$821.24																																																																																																						
47399	"	Liver surgery procedure"	T	0004	5.6589	$411.24	.	$82.25																																																																																																						
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"	T	0152	24.6087	"$1,788.36"	.	$357.68																																																																																																						
47500	"	Injection for liver x-rays"	N																																																																																																											
47505	"	Injection for liver x-rays"	N																																																																																																											
47510	"	Insert catheter bile duct"	T	0152	24.6087	"$1,788.36"	.	$357.68																																																																																																						
47511	"	Insert bile duct drain"	T	0423	56.5030	"$4,106.19"	.	$821.24																																																																																																						
47525	"	Change bile duct catheter"	T	0427	17.9738	"$1,306.19"	.	$261.24																																																																																																						
47530	"	Revise/reinsert bile tube"	T	0427	17.9738	"$1,306.19"	.	$261.24																																																																																																						
47550	"	Bile duct endoscopy add-on"	C																																																																																																											
47552	"	Biliary endo perq dx w/speci"	T	0152	24.6087	"$1,788.36"	.	$357.68																																																																																																						
47553	"	Biliary endoscopy thru skin"	T	0423	56.5030	"$4,106.19"	.	$821.24																																																																																																						
47554	"	Biliary endoscopy thru skin"	T	0152	24.6087	"$1,788.36"	.	$357.68																																																																																																						
47555	"	Biliary endoscopy thru skin"	T	0152	24.6087	"$1,788.36"	.	$357.68																																																																																																						
47556	"	Biliary endoscopy thru skin"	T	0423	56.5030	"$4,106.19"	.	$821.24																																																																																																						
47560	"	Laparoscopy w/cholangio"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
47561	"	Laparo w/cholangio/biopsy"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
47562	"	Laparoscopic cholecystectomy"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
47563	"	Laparo cholecystectomy/graph"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
47564	"	Laparo cholecystectomy/explr"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
47570	"	Laparo cholecystoenterostomy"	C																																																																																																											
47579	"	Laparoscope proc biliary"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
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																																																																																																											
47630	"	Remove bile duct stone"	T	0152	24.6087	"$1,788.36"	.	$357.68																																																																																																						
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	0152	24.6087	"$1,788.36"	.	$357.68																																																																																																						
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"	T	0685	10.4271	$757.76	.	$151.56																																																																																																						
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"	E																																																																																																											
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"	E																																																																																																											
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	0004	5.6589	$411.24	.	$82.25																																																																																																						
49000	"	Exploration of abdomen"	C																																																																																																											
49002	"	Reopening of abdomen"	C																																																																																																											
49010	"	Exploration behind abdomen"	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	0070	6.6765	$485.19	.	$97.04																																																																																																						
49083	"	Abd paracentesis w/imaging"	T	0070	6.6765	$485.19	.	$97.04																																																																																																						
49084	"	Peritoneal lavage"	T	0070	6.6765	$485.19	.	$97.04																																																																																																						
49180	"	Biopsy abdominal mass"	T	0685	10.4271	$757.76	.	$151.56																																																																																																						
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"	T	0153	25.2695	"$1,836.39"	.	$367.28																																																																																																						
49255	"	Removal of omentum"	C																																																																																																											
49320	"	Diag laparo separate proc"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
49321	"	Laparoscopy biopsy"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
49322	"	Laparoscopy aspiration"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
49323	"	Laparo drain lymphocele"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
49324	"	Lap insert tunnel ip cath"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
49325	"	Lap revision perm ip cath"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
49326	"	Lap w/omentopexy add-on"	N																																																																																																											
49327	"	Lap ins device for rt"	N																																																																																																											
49329	"	Laparo proc abdm/per/oment"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
49400	"	Air injection into abdomen"	N																																																																																																											
49402	"	Remove foreign body adbomen"	T	0153	25.2695	"$1,836.39"	.	$367.28																																																																																																						
49405	"	Image cath fluid colxn visc"	T	0037	16.8325	"$1,223.25"	.	$244.65																																																																																																						
49406	"	Image cath fluid peri/retro"	T	0037	16.8325	"$1,223.25"	.	$244.65																																																																																																						
49407	"	Image cath fluid trns/vgnl"	T	0685	10.4271	$757.76	.	$151.56																																																																																																						
49411	"	Ins mark abd/pel for rt perq"	X	0310	14.2612	"$1,036.39"	$325.27	$207.28																																																																																																						
49412	"	Ins device for rt guide open"	C																																																																																																											
49418	"	Insert tun ip cath perc"	T	0652	33.2571	"$2,416.86"	.	$483.38																																																																																																						
49419	"	Insert tun ip cath w/port"	T	0115	39.1123	"$2,842.37"	.	$568.48																																																																																																						
49421	"	Ins tun ip cath for dial opn"	T	0652	33.2571	"$2,416.86"	.	$483.38																																																																																																						
49422	"	Remove tunneled ip cath"	Q2	0103	20.9727	"$1,524.13"	.	$304.83																																																																																																						
49423	"	Exchange drainage catheter"	T	0427	17.9738	"$1,306.19"	.	$261.24																																																																																																						
49424	"	Assess cyst contrast inject"	N																																																																																																											
49425	"	Insert abdomen-venous drain"	C																																																																																																											
49426	"	Revise abdomen-venous shunt"	T	0153	25.2695	"$1,836.39"	.	$367.28																																																																																																						
49427	"	Injection abdominal shunt"	N																																																																																																											
49428	"	Ligation of shunt"	C																																																																																																											
49429	"	Removal of shunt"	Q2	0103	20.9727	"$1,524.13"	.	$304.83																																																																																																						
49435	"	Insert subq exten to ip cath"	T	0427	17.9738	"$1,306.19"	.	$261.24																																																																																																						
49436	"	Embedded ip cath exit-site"	T	0427	17.9738	"$1,306.19"	.	$261.24																																																																																																						
49440	"	Place gastrostomy tube perc"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
49441	"	Place duod/jej tube perc"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
49442	"	Place cecostomy tube perc"	T	0155	19.5389	"$1,419.93"	.	$283.99																																																																																																						
49446	"	Change g-tube to g-j perc"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
49450	"	Replace g/c tube perc"	T	0121	6.4191	$466.49	.	$93.30																																																																																																						
49451	"	Replace duod/jej tube perc"	T	0121	6.4191	$466.49	.	$93.30																																																																																																						
49452	"	Replace g-j tube perc"	T	0121	6.4191	$466.49	.	$93.30																																																																																																						
49460	"	Fix g/colon tube w/device"	T	0121	6.4191	$466.49	.	$93.30																																																																																																						
49465	"	Fluoro exam of g/colon tube"	Q1	0277	2.0810	$151.23	$46.51	$30.25																																																																																																						
49491	"	Rpr hern preemie reduc"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49492	"	Rpr ing hern premie blocked"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49495	"	Rpr ing hernia baby reduc"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49496	"	Rpr ing hernia baby blocked"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49500	"	Rpr ing hernia init reduce"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49501	"	Rpr ing hernia init blocked"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49505	"	Prp i/hern init reduc >5 yr"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49507	"	Prp i/hern init block >5 yr"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49520	"	Rerepair ing hernia reduce"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49521	"	Rerepair ing hernia blocked"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49525	"	Repair ing hernia sliding"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49540	"	Repair lumbar hernia"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49550	"	Rpr rem hernia init reduce"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49553	"	Rpr fem hernia init blocked"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49555	"	Rerepair fem hernia reduce"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49557	"	Rerepair fem hernia blocked"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49560	"	Rpr ventral hern init reduc"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49561	"	Rpr ventral hern init block"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49565	"	Rerepair ventrl hern reduce"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49566	"	Rerepair ventrl hern block"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49568	"	Hernia repair w/mesh"	N																																																																																																											
49570	"	Rpr epigastric hern reduce"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49572	"	Rpr epigastric hern blocked"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49580	"	Rpr umbil hern reduc < 5 yr"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49582	"	Rpr umbil hern block < 5 yr"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49585	"	Rpr umbil hern reduc > 5 yr"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49587	"	Rpr umbil hern block > 5 yr"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49590	"	Repair spigelian hernia"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
49600	"	Repair umbilical lesion"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
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"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
49651	"	Lap ing hernia repair recur"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
49652	"	Lap vent/abd hernia repair"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
49653	"	Lap vent/abd hern proc comp"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
49654	"	Lap inc hernia repair"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
49655	"	Lap inc hern repair comp"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
49656	"	Lap inc hernia repair recur"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
49657	"	Lap inc hern recur comp"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
49659	"	Laparo proc hernia repair"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
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	0153	25.2695	"$1,836.39"	.	$367.28																																																																																																						
50010	"	Exploration of kidney"	C																																																																																																											
50020	"	Renal abscess open drain"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
50040	"	Drainage of kidney"	C																																																																																																											
50045	"	Exploration of kidney"	C																																																																																																											
5005F	"	Pt counsld on exam for moles"	E																																																																																																											
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"	T	0429	45.4686	"$3,304.29"	.	$660.86																																																																																																						
50081	"	Removal of kidney stone"	T	0429	45.4686	"$3,304.29"	.	$660.86																																																																																																						
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"	T	0685	10.4271	$757.76	.	$151.56																																																																																																						
50205	"	Renal biopsy open"	C																																																																																																											
5020F	"	Txmnts 2 phys/qhp by 1 mon"	E																																																																																																											
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"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
50384	"	Remove ureter stent percut"	Q2	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
50385	"	Change stent via transureth"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
50386	"	Remove stent via transureth"	Q2	0160	7.4170	$539.01	.	$107.81																																																																																																						
50387	"	Change ext/int ureter stent"	T	0427	17.9738	"$1,306.19"	.	$261.24																																																																																																						
50389	"	Remove renal tube w/fluoro"	Q2	0160	7.4170	$539.01	.	$107.81																																																																																																						
50390	"	Drainage of kidney lesion"	T	0685	10.4271	$757.76	.	$151.56																																																																																																						
50391	"	Instll rx agnt into rnal tub"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
50392	"	Insert kidney drain"	T	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
50393	"	Insert ureteral tube"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
50394	"	Injection for kidney x-ray"	N																																																																																																											
50395	"	Create passage to kidney"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
50396	"	Measure kidney pressure"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
50398	"	Change kidney tube"	T	0427	17.9738	"$1,306.19"	.	$261.24																																																																																																						
50400	"	Revision of kidney/ureter"	C																																																																																																											
50405	"	Revision of kidney/ureter"	C																																																																																																											
50500	"	Repair of kidney wound"	C																																																																																																											
5050F	"	Plan 2 main dr by 1 month"	M																																																																																																											
50520	"	Close kidney-skin fistula"	C																																																																																																											
50525	"	Repair renal-abdomen fistula"	C																																																																																																											
50526	"	Repair renal-abdomen fistula"	C																																																																																																											
50540	"	Revision of horseshoe kidney"	C																																																																																																											
50541	"	Laparo ablate renal cyst"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
50542	"	Laparo ablate renal mass"	T	0174	118.2491	"$8,593.40"	"$1,911.61"	"$1,718.68"																																																																																																						
50543	"	Laparo partial nephrectomy"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
50544	"	Laparoscopy pyeloplasty"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
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"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
50551	"	Kidney endoscopy"	T	0160	7.4170	$539.01	.	$107.81																																																																																																						
50553	"	Kidney endoscopy"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
50555	"	Kidney endoscopy & biopsy"	T	0160	7.4170	$539.01	.	$107.81																																																																																																						
50557	"	Kidney endoscopy & treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
50561	"	Kidney endoscopy & treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
50562	"	Renal scope w/tumor resect"	T	0160	7.4170	$539.01	.	$107.81																																																																																																						
50570	"	Kidney endoscopy"	T	0160	7.4170	$539.01	.	$107.81																																																																																																						
50572	"	Kidney endoscopy"	T	0160	7.4170	$539.01	.	$107.81																																																																																																						
50574	"	Kidney endoscopy & biopsy"	T	0160	7.4170	$539.01	.	$107.81																																																																																																						
50575	"	Kidney endoscopy"	T	0163	39.9743	"$2,905.01"	.	$581.01																																																																																																						
50576	"	Kidney endoscopy & treatment"	T	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
50580	"	Kidney endoscopy & treatment"	T	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
50590	"	Fragmenting of kidney stone"	T	0169	41.1594	"$2,991.14"	$979.42	$598.23																																																																																																						
50592	"	Perc rf ablate renal tumor"	T	0423	56.5030	"$4,106.19"	.	$821.24																																																																																																						
50593	"	Perc cryo ablate renal tum"	T	0423	56.5030	"$4,106.19"	.	$821.24																																																																																																						
50600	"	Exploration of ureter"	C																																																																																																											
50605	"	Insert ureteral support"	C																																																																																																											
5060F	"	Fndngs mammo 2pt w/in 3 days"	E																																																																																																											
50610	"	Removal of ureter stone"	C																																																																																																											
50620	"	Removal of ureter stone"	C																																																																																																											
5062F	"	Mammo result com to pt 5 day"	E																																																																																																											
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"	T	0126	1.0909	$79.28	.	$15.86																																																																																																						
50688	"	Change of ureter tube/stent"	T	0427	17.9738	"$1,306.19"	.	$261.24																																																																																																						
50690	"	Injection for ureter x-ray"	N																																																																																																											
50700	"	Revision of ureter"	C																																																																																																											
50715	"	Release of ureter"	C																																																																																																											
50722	"	Release of ureter"	C																																																																																																											
50725	"	Release/revise ureter"	C																																																																																																											
50727	"	Revise ureter"	T	0165	19.5262	"$1,419.01"	.	$283.81																																																																																																						
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"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
50947	"	Laparo new ureter/bladder"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
50948	"	Laparo new ureter/bladder"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
50949	"	Laparoscope proc ureter"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
50951	"	Endoscopy of ureter"	T	0160	7.4170	$539.01	.	$107.81																																																																																																						
50953	"	Endoscopy of ureter"	T	0160	7.4170	$539.01	.	$107.81																																																																																																						
50955	"	Ureter endoscopy & biopsy"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
50957	"	Ureter endoscopy & treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
50961	"	Ureter endoscopy & treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
50970	"	Ureter endoscopy"	T	0160	7.4170	$539.01	.	$107.81																																																																																																						
50972	"	Ureter endoscopy & catheter"	T	0160	7.4170	$539.01	.	$107.81																																																																																																						
50974	"	Ureter endoscopy & biopsy"	T	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
50976	"	Ureter endoscopy & treatment"	T	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
50980	"	Ureter endoscopy & treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
5100F	"	Rsk fx ref w/n 24 hrs xray"	E																																																																																																											
51020	"	Incise & treat bladder"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
51030	"	Incise & treat bladder"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
51040	"	Incise & drain bladder"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
51045	"	Incise bladder/drain ureter"	T	0160	7.4170	$539.01	.	$107.81																																																																																																						
51050	"	Removal of bladder stone"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
51060	"	Removal of ureter stone"	T	0163	39.9743	"$2,905.01"	.	$581.01																																																																																																						
51065	"	Remove ureter calculus"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
51080	"	Drainage of bladder abscess"	T	0008	21.5968	"$1,569.48"	.	$313.90																																																																																																						
51100	"	Drain bladder by needle"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
51101	"	Drain bladder by trocar/cath"	T	0126	1.0909	$79.28	.	$15.86																																																																																																						
51102	"	Drain bl w/cath insertion"	T	0165	19.5262	"$1,419.01"	.	$283.81																																																																																																						
51500	"	Removal of bladder cyst"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
51520	"	Removal of bladder lesion"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
51525	"	Removal of bladder lesion"	C																																																																																																											
51530	"	Removal of bladder lesion"	C																																																																																																											
51535	"	Repair of ureter lesion"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
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	0164	2.9049	$211.10	.	$42.22																																																																																																						
51701	"	Insert bladder catheter"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
51702	"	Insert temp bladder cath"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
51703	"	Insert bladder cath complex"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
51705	"	Change of bladder tube"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
51710	"	Change of bladder tube"	T	0121	6.4191	$466.49	.	$93.30																																																																																																						
51715	"	Endoscopic injection/implant"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
51720	"	Treatment of bladder lesion"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
51725	"	Simple cystometrogram"	T	0156	5.7679	$419.16	.	$83.84																																																																																																						
51726	"	Complex cystometrogram"	T	0156	5.7679	$419.16	.	$83.84																																																																																																						
51727	"	Cystometrogram w/up"	T	0156	5.7679	$419.16	.	$83.84																																																																																																						
51728	"	Cystometrogram w/vp"	T	0156	5.7679	$419.16	.	$83.84																																																																																																						
51729	"	Cystometrogram w/vp&up"	T	0156	5.7679	$419.16	.	$83.84																																																																																																						
51736	"	Urine flow measurement"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
51741	"	Electro-uroflowmetry first"	T	0126	1.0909	$79.28	.	$15.86																																																																																																						
51784	"	Anal/urinary muscle study"	T	0126	1.0909	$79.28	.	$15.86																																																																																																						
51785	"	Anal/urinary muscle study"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
51792	"	Urinary reflex study"	T	0126	1.0909	$79.28	.	$15.86																																																																																																						
51797	"	Intraabdominal pressure test"	N																																																																																																											
51798	"	Us urine capacity measure"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
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"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
51860	"	Repair of bladder wound"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
51865	"	Repair of bladder wound"	C																																																																																																											
51880	"	Repair of bladder opening"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
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"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
51992	"	Laparo sling operation"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
51999	"	Laparoscope proc bla"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
52000	"	Cystoscopy"	T	0160	7.4170	$539.01	.	$107.81																																																																																																						
52001	"	Cystoscopy removal of clots"	T	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
52005	"	Cystoscopy & ureter catheter"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52007	"	Cystoscopy and biopsy"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
5200F	"	Eval appros surg thxpy epi"	E																																																																																																											
52010	"	Cystoscopy & duct catheter"	T	0160	7.4170	$539.01	.	$107.81																																																																																																						
52204	"	Cystoscopy w/biopsy(s)"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52214	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52224	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52234	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52235	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52240	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52250	"	Cystoscopy and radiotracer"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52260	"	Cystoscopy and treatment"	T	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
52265	"	Cystoscopy and treatment"	T	0160	7.4170	$539.01	.	$107.81																																																																																																						
52270	"	Cystoscopy & revise urethra"	T	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
52275	"	Cystoscopy & revise urethra"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52276	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52277	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52281	"	Cystoscopy and treatment"	T	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
52282	"	Cystoscopy implant stent"	T	0163	39.9743	"$2,905.01"	.	$581.01																																																																																																						
52283	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52285	"	Cystoscopy and treatment"	T	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
52287	"	Cystoscopy chemodenervation"	T	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
52290	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52300	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52301	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52305	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52310	"	Cystoscopy and treatment"	T	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
52315	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52317	"	Remove bladder stone"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52318	"	Remove bladder stone"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52320	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52325	"	Cystoscopy stone removal"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52327	"	Cystoscopy inject material"	T	0163	39.9743	"$2,905.01"	.	$581.01																																																																																																						
52330	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52332	"	Cystoscopy and treatment"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52334	"	Create passage to kidney"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52341	"	Cysto w/ureter stricture tx"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52342	"	Cysto w/up stricture tx"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52343	"	Cysto w/renal stricture tx"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52344	"	Cysto/uretero stricture tx"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52345	"	Cysto/uretero w/up stricture"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52346	"	Cystouretero w/renal strict"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52351	"	Cystouretero & or pyeloscope"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52352	"	Cystouretero w/stone remove"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52353	"	Cystouretero w/lithotripsy"	T	0163	39.9743	"$2,905.01"	.	$581.01																																																																																																						
52354	"	Cystouretero w/biopsy"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52355	"	Cystouretero w/excise tumor"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52356	"	Cysto/uretero w/lithotripsy"	T	0429	45.4686	"$3,304.29"	.	$660.86																																																																																																						
52400	"	Cystouretero w/congen repr"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52402	"	Cystourethro cut ejacul duct"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52450	"	Incision of prostate"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52500	"	Revision of bladder neck"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
5250F	"	Asthma discharge plan presnt"	E																																																																																																											
52601	"	Prostatectomy (turp)"	T	0163	39.9743	"$2,905.01"	.	$581.01																																																																																																						
52630	"	Remove prostate regrowth"	T	0163	39.9743	"$2,905.01"	.	$581.01																																																																																																						
52640	"	Relieve bladder contracture"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
52647	"	Laser surgery of prostate"	T	0429	45.4686	"$3,304.29"	.	$660.86																																																																																																						
52648	"	Laser surgery of prostate"	T	0429	45.4686	"$3,304.29"	.	$660.86																																																																																																						
52649	"	Prostate laser enucleation"	T	0429	45.4686	"$3,304.29"	.	$660.86																																																																																																						
52700	"	Drainage of prostate abscess"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
53000	"	Incision of urethra"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53010	"	Incision of urethra"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53020	"	Incision of urethra"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53025	"	Incision of urethra"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53040	"	Drainage of urethra abscess"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53060	"	Drainage of urethra abscess"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53080	"	Drainage of urinary leakage"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53085	"	Drainage of urinary leakage"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53200	"	Biopsy of urethra"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53210	"	Removal of urethra"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53215	"	Removal of urethra"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53220	"	Treatment of urethra lesion"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53230	"	Removal of urethra lesion"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53235	"	Removal of urethra lesion"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53240	"	Surgery for urethra pouch"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53250	"	Removal of urethra gland"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53260	"	Treatment of urethra lesion"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53265	"	Treatment of urethra lesion"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53270	"	Removal of urethra gland"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53275	"	Repair of urethra defect"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53400	"	Revise urethra stage 1"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53405	"	Revise urethra stage 2"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53410	"	Reconstruction of urethra"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53415	"	Reconstruction of urethra"	C																																																																																																											
53420	"	Reconstruct urethra stage 1"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53425	"	Reconstruct urethra stage 2"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53430	"	Reconstruction of urethra"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53431	"	Reconstruct urethra/bladder"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53440	"	Male sling procedure"	S	0385	114.1752	"$8,297.34"	.	"$1,659.47"																																																																																																						
53442	"	Remove/revise male sling"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53444	"	Insert tandem cuff"	S	0385	114.1752	"$8,297.34"	.	"$1,659.47"																																																																																																						
53445	"	Insert uro/ves nck sphincter"	S	0386	186.0767	"$13,522.57"	.	"$2,704.52"																																																																																																						
53446	"	Remove uro sphincter"	Q2	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53447	"	Remove/replace ur sphincter"	S	0386	186.0767	"$13,522.57"	.	"$2,704.52"																																																																																																						
53448	"	Remov/replc ur sphinctr comp"	C																																																																																																											
53449	"	Repair uro sphincter"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53450	"	Revision of urethra"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53460	"	Revision of urethra"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53500	"	Urethrlys transvag w/ scope"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53502	"	Repair of urethra injury"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53505	"	Repair of urethra injury"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53510	"	Repair of urethra injury"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53515	"	Repair of urethra injury"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53520	"	Repair of urethra defect"	T	0168	34.8886	"$2,535.42"	.	$507.09																																																																																																						
53600	"	Dilate urethra stricture"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
53601	"	Dilate urethra stricture"	T	0126	1.0909	$79.28	.	$15.86																																																																																																						
53605	"	Dilate urethra stricture"	T	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
53620	"	Dilate urethra stricture"	T	0165	19.5262	"$1,419.01"	.	$283.81																																																																																																						
53621	"	Dilate urethra stricture"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
53660	"	Dilation of urethra"	T	0126	1.0909	$79.28	.	$15.86																																																																																																						
53661	"	Dilation of urethra"	T	0126	1.0909	$79.28	.	$15.86																																																																																																						
53665	"	Dilation of urethra"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
53850	"	Prostatic microwave thermotx"	T	0429	45.4686	"$3,304.29"	.	$660.86																																																																																																						
53852	"	Prostatic rf thermotx"	T	0429	45.4686	"$3,304.29"	.	$660.86																																																																																																						
53855	"	Insert prost urethral stent"	T	0160	7.4170	$539.01	.	$107.81																																																																																																						
53860	"	Transurethral rf treatment"	T	0165	19.5262	"$1,419.01"	.	$283.81																																																																																																						
53899	"	Urology surgery procedure"	T	0126	1.0909	$79.28	.	$15.86																																																																																																						
54000	"	Slitting of prepuce"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
54001	"	Slitting of prepuce"	T	0166	21.0424	"$1,529.19"	.	$305.84																																																																																																						
54015	"	Drain penis lesion"	T	0008	21.5968	"$1,569.48"	.	$313.90																																																																																																						
54050	"	Destruction penis lesion(s)"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
54055	"	Destruction penis lesion(s)"	T	0017	20.7931	"$1,511.08"	.	$302.22																																																																																																						
54056	"	Cryosurgery penis lesion(s)"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
54057	"	Laser surg penis lesion(s)"	T	0017	20.7931	"$1,511.08"	.	$302.22																																																																																																						
54060	"	Excision of penis lesion(s)"	T	0017	20.7931	"$1,511.08"	.	$302.22																																																																																																						
54065	"	Destruction penis lesion(s)"	T	0017	20.7931	"$1,511.08"	.	$302.22																																																																																																						
54100	"	Biopsy of penis"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
54105	"	Biopsy of penis"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
54110	"	Treatment of penis lesion"	T	0205	48.8969	"$3,553.44"	.	$710.69																																																																																																						
54111	"	Treat penis lesion graft"	T	0205	48.8969	"$3,553.44"	.	$710.69																																																																																																						
54112	"	Treat penis lesion graft"	T	0205	48.8969	"$3,553.44"	.	$710.69																																																																																																						
54115	"	Treatment of penis lesion"	T	0008	21.5968	"$1,569.48"	.	$313.90																																																																																																						
54120	"	Partial removal of penis"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54125	"	Removal of penis"	C																																																																																																											
54130	"	Remove penis & nodes"	C																																																																																																											
54135	"	Remove penis & nodes"	C																																																																																																											
54150	"	Circumcision w/regionl block"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54160	"	Circumcision neonate"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54161	"	Circum 28 days or older"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54162	"	Lysis penil circumic lesion"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54163	"	Repair of circumcision"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54164	"	Frenulotomy of penis"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54200	"	Treatment of penis lesion"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
54205	"	Treatment of penis lesion"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54220	"	Treatment of penis lesion"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
54230	"	Prepare penis study"	N																																																																																																											
54231	"	Dynamic cavernosometry"	T	0165	19.5262	"$1,419.01"	.	$283.81																																																																																																						
54235	"	Penile injection"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
54240	"	Penis study"	T	0126	1.0909	$79.28	.	$15.86																																																																																																						
54250	"	Penis study"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
54300	"	Revision of penis"	T	0205	48.8969	"$3,553.44"	.	$710.69																																																																																																						
54304	"	Revision of penis"	T	0205	48.8969	"$3,553.44"	.	$710.69																																																																																																						
54308	"	Reconstruction of urethra"	T	0205	48.8969	"$3,553.44"	.	$710.69																																																																																																						
54312	"	Reconstruction of urethra"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54316	"	Reconstruction of urethra"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54318	"	Reconstruction of urethra"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54322	"	Reconstruction of urethra"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54324	"	Reconstruction of urethra"	T	0205	48.8969	"$3,553.44"	.	$710.69																																																																																																						
54326	"	Reconstruction of urethra"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54328	"	Revise penis/urethra"	T	0205	48.8969	"$3,553.44"	.	$710.69																																																																																																						
54332	"	Revise penis/urethra"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54336	"	Revise penis/urethra"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54340	"	Secondary urethral surgery"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54344	"	Secondary urethral surgery"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54348	"	Secondary urethral surgery"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54352	"	Reconstruct urethra/penis"	T	0205	48.8969	"$3,553.44"	.	$710.69																																																																																																						
54360	"	Penis plastic surgery"	T	0205	48.8969	"$3,553.44"	.	$710.69																																																																																																						
54380	"	Repair penis"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54385	"	Repair penis"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54390	"	Repair penis and bladder"	C																																																																																																											
54400	"	Insert semi-rigid prosthesis"	S	0385	114.1752	"$8,297.34"	.	"$1,659.47"																																																																																																						
54401	"	Insert self-contd prosthesis"	S	0386	186.0767	"$13,522.57"	.	"$2,704.52"																																																																																																						
54405	"	Insert multi-comp penis pros"	S	0386	186.0767	"$13,522.57"	.	"$2,704.52"																																																																																																						
54406	"	Remove muti-comp penis pros"	Q2	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54408	"	Repair multi-comp penis pros"	T	0205	48.8969	"$3,553.44"	.	$710.69																																																																																																						
54410	"	Remove/replace penis prosth"	S	0386	186.0767	"$13,522.57"	.	"$2,704.52"																																																																																																						
54411	"	Remov/replc penis pros comp"	C																																																																																																											
54415	"	Remove self-contd penis pros"	Q2	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54416	"	Remv/repl penis contain pros"	S	0386	186.0767	"$13,522.57"	.	"$2,704.52"																																																																																																						
54417	"	Remv/replc penis pros compl"	C																																																																																																											
54420	"	Revision of penis"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54430	"	Revision of penis"	C																																																																																																											
54435	"	Revision of penis"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54440	"	Repair of penis"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54450	"	Preputial stretching"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
54500	"	Biopsy of testis"	T	0037	16.8325	"$1,223.25"	.	$244.65																																																																																																						
54505	"	Biopsy of testis"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54512	"	Excise lesion testis"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54520	"	Removal of testis"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54522	"	Orchiectomy partial"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54530	"	Removal of testis"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
54535	"	Extensive testis surgery"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
54550	"	Exploration for testis"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
54560	"	Exploration for testis"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54600	"	Reduce testis torsion"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54620	"	Suspension of testis"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54640	"	Suspension of testis"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
54650	"	Orchiopexy (fowler-stephens)"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
54660	"	Revision of testis"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54670	"	Repair testis injury"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54680	"	Relocation of testis(es)"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54690	"	Laparoscopy orchiectomy"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
54692	"	Laparoscopy orchiopexy"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
54699	"	Laparoscope proc testis"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
54700	"	Drainage of scrotum"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54800	"	Biopsy of epididymis"	T	0004	5.6589	$411.24	.	$82.25																																																																																																						
54830	"	Remove epididymis lesion"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54840	"	Remove epididymis lesion"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54860	"	Removal of epididymis"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54861	"	Removal of epididymis"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54865	"	Explore epididymis"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54900	"	Fusion of spermatic ducts"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
54901	"	Fusion of spermatic ducts"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
55000	"	Drainage of hydrocele"	T	0004	5.6589	$411.24	.	$82.25																																																																																																						
55040	"	Removal of hydrocele"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
55041	"	Removal of hydroceles"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
55060	"	Repair of hydrocele"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
55100	"	Drainage of scrotum abscess"	T	0007	11.6214	$844.55	.	$168.91																																																																																																						
55110	"	Explore scrotum"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
55120	"	Removal of scrotum lesion"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
55150	"	Removal of scrotum"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
55175	"	Revision of scrotum"	T	0205	48.8969	"$3,553.44"	.	$710.69																																																																																																						
55180	"	Revision of scrotum"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
55200	"	Incision of sperm duct"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
55250	"	Removal of sperm duct(s)"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
55300	"	Prepare sperm duct x-ray"	N																																																																																																											
55400	"	Repair of sperm duct"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
55450	"	Ligation of sperm duct"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
55500	"	Removal of hydrocele"	T	0181	29.9333	"$2,175.31"	.	$435.07																																																																																																						
55520	"	Removal of sperm cord lesion"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
55530	"	Revise spermatic cord veins"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
55535	"	Revise spermatic cord veins"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
55540	"	Revise hernia & sperm veins"	T	0154	35.7723	"$2,599.64"	.	$519.93																																																																																																						
55550	"	Laparo ligate spermatic vein"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
55559	"	Laparo proc spermatic cord"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
55600	"	Incise sperm duct pouch"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
55605	"	Incise sperm duct pouch"	C																																																																																																											
55650	"	Remove sperm duct pouch"	C																																																																																																											
55680	"	Remove sperm pouch lesion"	T	0183	23.8784	"$1,735.29"	.	$347.06																																																																																																						
55700	"	Biopsy of prostate"	T	0184	14.6135	"$1,061.99"	.	$212.40																																																																																																						
55705	"	Biopsy of prostate"	T	0184	14.6135	"$1,061.99"	.	$212.40																																																																																																						
55706	"	Prostate saturation sampling"	T	0184	14.6135	"$1,061.99"	.	$212.40																																																																																																						
55720	"	Drainage of prostate abscess"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
55725	"	Drainage of prostate abscess"	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
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"	T	0165	19.5262	"$1,419.01"	.	$283.81																																																																																																						
55862	"	Extensive prostate surgery"	C																																																																																																											
55865	"	Extensive prostate surgery"	C																																																																																																											
55866	"	Laparo radical prostatectomy"	C																																																																																																											
55870	"	Electroejaculation"	T	0192	5.0798	$369.16	.	$73.84																																																																																																						
55873	"	Cryoablate prostate"	T	0674	112.8868	"$8,203.71"	.	"$1,640.75"																																																																																																						
55875	"	Transperi needle place pros"	Q3	0163	39.9743	"$2,905.01"	.	$581.01																																																																																																						
55876	"	Place rt device/marker pros"	X	0310	14.2612	"$1,036.39"	$325.27	$207.28																																																																																																						
55899	"	Genital surgery procedure"	T	0126	1.0909	$79.28	.	$15.86																																																																																																						
55920	"	Place needles pelvic for rt"	T	0153	25.2695	"$1,836.39"	.	$367.28																																																																																																						
55970	"	Sex transformation m to f"	T	0193	18.9234	"$1,375.20"	.	$275.04	*																																																																																																					
55980	"	Sex transformation f to m"	T	0205	48.8969	"$3,553.44"	.	$710.69	*																																																																																																					
56405	"	I & d of vulva/perineum"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
56420	"	Drainage of gland abscess"	T	0188	1.7430	$126.67	.	$25.34																																																																																																						
56440	"	Surgery for vulva lesion"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
56441	"	Lysis of labial lesion(s)"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
56442	"	Hymenotomy"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
56501	"	Destroy vulva lesions sim"	T	0017	20.7931	"$1,511.08"	.	$302.22																																																																																																						
56515	"	Destroy vulva lesion/s compl"	T	0017	20.7931	"$1,511.08"	.	$302.22																																																																																																						
56605	"	Biopsy of vulva/perineum"	T	0192	5.0798	$369.16	.	$73.84																																																																																																						
56606	"	Biopsy of vulva/perineum"	N																																																																																																											
56620	"	Partial removal of vulva"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
56625	"	Complete removal of vulva"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
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"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
56740	"	Remove vagina gland lesion"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
56800	"	Repair of vagina"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
56805	"	Repair clitoris"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
56810	"	Repair of perineum"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
56820	"	Exam of vulva w/scope"	T	0188	1.7430	$126.67	.	$25.34																																																																																																						
56821	"	Exam/biopsy of vulva w/scope"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
57000	"	Exploration of vagina"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57010	"	Drainage of pelvic abscess"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
57020	"	Drainage of pelvic fluid"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57022	"	I & d vaginal hematoma pp"	T	0007	11.6214	$844.55	.	$168.91																																																																																																						
57023	"	I & d vag hematoma non-ob"	T	0008	21.5968	"$1,569.48"	.	$313.90																																																																																																						
57061	"	Destroy vag lesions simple"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
57065	"	Destroy vag lesions complex"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57100	"	Biopsy of vagina"	T	0192	5.0798	$369.16	.	$73.84																																																																																																						
57105	"	Biopsy of vagina"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
57106	"	Remove vagina wall partial"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57107	"	Remove vagina tissue part"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57109	"	Vaginectomy partial w/nodes"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57110	"	Remove vagina wall complete"	C																																																																																																											
57111	"	Remove vagina tissue compl"	C																																																																																																											
57112	"	Vaginectomy w/nodes compl"	C																																																																																																											
57120	"	Closure of vagina"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57130	"	Remove vagina lesion"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57135	"	Remove vagina lesion"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
57150	"	Treat vagina infection"	T	0188	1.7430	$126.67	.	$25.34																																																																																																						
57155	"	Insert uteri tandem/ovoids"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
57156	"	Ins vag brachytx device"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
57160	"	Insert pessary/other device"	T	0188	1.7430	$126.67	.	$25.34																																																																																																						
57170	"	Fitting of diaphragm/cap"	T	0191	0.1421	$10.33	.	$2.07																																																																																																						
57180	"	Treat vaginal bleeding"	T	0188	1.7430	$126.67	.	$25.34																																																																																																						
57200	"	Repair of vagina"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57210	"	Repair vagina/perineum"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57220	"	Revision of urethra"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
57230	"	Repair of urethral lesion"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57240	"	Repair bladder & vagina"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57250	"	Repair rectum & vagina"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57260	"	Repair of vagina"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57265	"	Extensive repair of vagina"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
57267	"	Insert mesh/pelvic flr addon"	N																																																																																																											
57268	"	Repair of bowel bulge"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57270	"	Repair of bowel pouch"	C																																																																																																											
57280	"	Suspension of vagina"	C																																																																																																											
57282	"	Colpopexy extraperitoneal"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
57283	"	Colpopexy intraperitoneal"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
57284	"	Repair paravag defect open"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
57285	"	Repair paravag defect vag"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
57287	"	Revise/remove sling repair"	Q2	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57288	"	Repair bladder defect"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
57289	"	Repair bladder & vagina"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57291	"	Construction of vagina"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57292	"	Construct vagina with graft"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57295	"	Revise vag graft via vagina"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57296	"	Revise vag graft open abd"	C																																																																																																											
57300	"	Repair rectum-vagina fistula"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57305	"	Repair rectum-vagina fistula"	C																																																																																																											
57307	"	Fistula repair & colostomy"	C																																																																																																											
57308	"	Fistula repair transperine"	C																																																																																																											
57310	"	Repair urethrovaginal lesion"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
57311	"	Repair urethrovaginal lesion"	C																																																																																																											
57320	"	Repair bladder-vagina lesion"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57330	"	Repair bladder-vagina lesion"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57335	"	Repair vagina"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57400	"	Dilation of vagina"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
57410	"	Pelvic examination"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
57415	"	Remove vaginal foreign body"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
57420	"	Exam of vagina w/scope"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
57421	"	Exam/biopsy of vag w/scope"	T	0192	5.0798	$369.16	.	$73.84																																																																																																						
57423	"	Repair paravag defect lap"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
57425	"	Laparoscopy surg colpopexy"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
57426	"	Revise prosth vag graft lap"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57452	"	Exam of cervix w/scope"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
57454	"	Bx/curett of cervix w/scope"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
57455	"	Biopsy of cervix w/scope"	T	0192	5.0798	$369.16	.	$73.84																																																																																																						
57456	"	Endocerv curettage w/scope"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
57460	"	Bx of cervix w/scope leep"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
57461	"	Conz of cervix w/scope leep"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
57500	"	Biopsy of cervix"	T	0192	5.0798	$369.16	.	$73.84																																																																																																						
57505	"	Endocervical curettage"	T	0192	5.0798	$369.16	.	$73.84																																																																																																						
57510	"	Cauterization of cervix"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
57511	"	Cryocautery of cervix"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
57513	"	Laser surgery of cervix"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
57520	"	Conization of cervix"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57522	"	Conization of cervix"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
57530	"	Removal of cervix"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57531	"	Removal of cervix radical"	C																																																																																																											
57540	"	Removal of residual cervix"	C																																																																																																											
57545	"	Remove cervix/repair pelvis"	C																																																																																																											
57550	"	Removal of residual cervix"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57555	"	Remove cervix/repair vagina"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57556	"	Remove cervix repair bowel"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
57558	"	D&c of cervical stump"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
57700	"	Revision of cervix"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
57720	"	Revision of cervix"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
57800	"	Dilation of cervical canal"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
58100	"	Biopsy of uterus lining"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
58110	"	Bx done w/colposcopy add-on"	N																																																																																																											
58120	"	Dilation and curettage"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
58140	"	Myomectomy abdom method"	C																																																																																																											
58145	"	Myomectomy vag method"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
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"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
58262	"	Vag hyst including t/o"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
58263	"	Vag hyst w/t/o & vag repair"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
58267	"	Vag hyst w/urinary repair"	C																																																																																																											
58270	"	Vag hyst w/enterocele repair"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
58275	"	Hysterectomy/revise vagina"	C																																																																																																											
58280	"	Hysterectomy/revise vagina"	C																																																																																																											
58285	"	Extensive hysterectomy"	C																																																																																																											
58290	"	Vag hyst complex"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
58291	"	Vag hyst incl t/o complex"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
58292	"	Vag hyst t/o & repair compl"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
58293	"	Vag hyst w/uro repair compl"	C																																																																																																											
58294	"	Vag hyst w/enterocele compl"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
58300	"	Insert intrauterine device"	E																																																																																																											
58301	"	Remove intrauterine device"	Q2	0189	2.6066	$189.43	.	$37.89																																																																																																						
58321	"	Artificial insemination"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
58322	"	Artificial insemination"	T	0188	1.7430	$126.67	.	$25.34																																																																																																						
58323	"	Sperm washing"	T	0188	1.7430	$126.67	.	$25.34																																																																																																						
58340	"	Catheter for hysterography"	N																																																																																																											
58345	"	Reopen fallopian tube"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
58346	"	Insert heyman uteri capsule"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
58350	"	Reopen fallopian tube"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
58353	"	Endometr ablate thermal"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
58356	"	Endometrial cryoablation"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
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"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
58542	"	Lsh w/t/o ut 250 g or less"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
58543	"	Lsh uterus above 250 g"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
58544	"	Lsh w/t/o uterus above 250 g"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
58545	"	Laparoscopic myomectomy"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
58546	"	Laparo-myomectomy complex"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
58548	"	Lap radical hyst"	C																																																																																																											
58550	"	Laparo-asst vag hysterectomy"	T	0132	73.8306	"$5,365.42"	"$1,236.99"	"$1,073.09"																																																																																																						
58552	"	Laparo-vag hyst incl t/o"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
58553	"	Laparo-vag hyst complex"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
58554	"	Laparo-vag hyst w/t/o compl"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
58555	"	Hysteroscopy dx sep proc"	T	0190	24.2648	"$1,763.37"	$424.28	$352.68																																																																																																						
58558	"	Hysteroscopy biopsy"	T	0190	24.2648	"$1,763.37"	$424.28	$352.68																																																																																																						
58559	"	Hysteroscopy lysis"	T	0190	24.2648	"$1,763.37"	$424.28	$352.68																																																																																																						
58560	"	Hysteroscopy resect septum"	T	0387	38.7710	"$2,817.57"	$654.35	$563.52																																																																																																						
58561	"	Hysteroscopy remove myoma"	T	0387	38.7710	"$2,817.57"	$654.35	$563.52																																																																																																						
58562	"	Hysteroscopy remove fb"	T	0190	24.2648	"$1,763.37"	$424.28	$352.68																																																																																																						
58563	"	Hysteroscopy ablation"	T	0387	38.7710	"$2,817.57"	$654.35	$563.52																																																																																																						
58565	"	Hysteroscopy sterilization"	T	0202	49.1097	"$3,568.90"	$981.50	$713.78																																																																																																						
58570	"	Tlh uterus 250 g or less"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
58571	"	Tlh w/t/o 250 g or less"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
58572	"	Tlh uterus over 250 g"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
58573	"	Tlh w/t/o uterus over 250 g"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
58578	"	Laparo proc uterus"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
58579	"	Hysteroscope procedure"	T	0190	24.2648	"$1,763.37"	$424.28	$352.68																																																																																																						
58600	"	Division of fallopian tube"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
58605	"	Division of fallopian tube"	C																																																																																																											
58611	"	Ligate oviduct(s) add-on"	C																																																																																																											
58615	"	Occlude fallopian tube(s)"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
58660	"	Laparoscopy lysis"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
58661	"	Laparoscopy remove adnexa"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
58662	"	Laparoscopy excise lesions"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
58670	"	Laparoscopy tubal cautery"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
58671	"	Laparoscopy tubal block"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
58672	"	Laparoscopy fimbrioplasty"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
58673	"	Laparoscopy salpingostomy"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
58679	"	Laparo proc oviduct-ovary"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
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"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
58800	"	Drainage of ovarian cyst(s)"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
58805	"	Drainage of ovarian cyst(s)"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
58820	"	Drain ovary abscess open"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
58822	"	Drain ovary abscess percut"	C																																																																																																											
58825	"	Transposition ovary(s)"	C																																																																																																											
58900	"	Biopsy of ovary(s)"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
58920	"	Partial removal of ovary(s)"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
58925	"	Removal of ovarian cyst(s)"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
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	0192	5.0798	$369.16	.	$73.84																																																																																																						
58974	"	Transfer of embryo"	T	0192	5.0798	$369.16	.	$73.84																																																																																																						
58976	"	Transfer of embryo"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
58999	"	Genital surgery procedure"	T	0191	0.1421	$10.33	.	$2.07																																																																																																						
59000	"	Amniocentesis diagnostic"	T	0192	5.0798	$369.16	.	$73.84																																																																																																						
59001	"	Amniocentesis therapeutic"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
59012	"	Fetal cord puncture prenatal"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
59015	"	Chorion biopsy"	T	0192	5.0798	$369.16	.	$73.84																																																																																																						
59020	"	Fetal contract stress test"	T	0188	1.7430	$126.67	.	$25.34																																																																																																						
59025	"	Fetal non-stress test"	T	0188	1.7430	$126.67	.	$25.34																																																																																																						
59030	"	Fetal scalp blood sample"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
59050	"	Fetal monitor w/report"	M																																																																																																											
59051	"	Fetal monitor/interpret only"	B																																																																																																											
59070	"	Transabdom amnioinfus w/us"	T	0192	5.0798	$369.16	.	$73.84																																																																																																						
59072	"	Umbilical cord occlud w/us"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
59074	"	Fetal fluid drainage w/us"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
59076	"	Fetal shunt placement w/us"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
59100	"	Remove uterus lesion"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
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"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
59151	"	Treat ectopic pregnancy"	T	0131	50.2049	"$3,648.49"	"$1,001.89"	$729.70																																																																																																						
59160	"	D & c after delivery"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
59200	"	Insert cervical dilator"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
59300	"	Episiotomy or vaginal repair"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
59320	"	Revision of cervix"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
59325	"	Revision of cervix"	C																																																																																																											
59350	"	Repair of uterus"	C																																																																																																											
59400	"	Obstetrical care"	B																																																																																																											
59409	"	Obstetrical care"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
59410	"	Obstetrical care"	B																																																																																																											
59412	"	Antepartum manipulation"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
59414	"	Deliver placenta"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
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"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
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"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
59820	"	Care of miscarriage"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
59821	"	Treatment of miscarriage"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
59830	"	Treat uterus infection"	C																																																																																																											
59840	"	Abortion"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
59841	"	Abortion"	T	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
59850	"	Abortion"	C																																																																																																											
59851	"	Abortion"	C																																																																																																											
59852	"	Abortion"	C																																																																																																											
59855	"	Abortion"	C																																																																																																											
59856	"	Abortion"	C																																																																																																											
59857	"	Abortion"	C																																																																																																											
59866	"	Abortion (mpr)"	T	0189	2.6066	$189.43	.	$37.89																																																																																																						
59870	"	Evacuate mole of uterus"	T	0195	34.7118	"$2,522.58"	.	$504.52																																																																																																						
59871	"	Remove cerclage suture"	Q2	0193	18.9234	"$1,375.20"	.	$275.04																																																																																																						
59897	"	Fetal invas px w/us"	T	0191	0.1421	$10.33	.	$2.07																																																																																																						
59898	"	Laparo proc ob care/deliver"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
59899	"	Maternity care procedure"	T	0191	0.1421	$10.33	.	$2.07																																																																																																						
60000	"	Drain thyroid/tongue cyst"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
6005F	"	Care level rationale doc"	E																																																																																																											
60100	"	Biopsy of thyroid"	T	0004	5.6589	$411.24	.	$82.25																																																																																																						
6010F	"	Dysphag test done b/4 eating"	M																																																																																																											
6015F	"	Dysphag test done b/4 eating"	M																																																																																																											
60200	"	Remove thyroid lesion"	T	0114	54.6762	"$3,973.43"	.	$794.69																																																																																																						
6020F	"	Npo (nothing-mouth) ordered"	M																																																																																																											
60210	"	Partial thyroid excision"	T	0114	54.6762	"$3,973.43"	.	$794.69																																																																																																						
60212	"	Partial thyroid excision"	T	0114	54.6762	"$3,973.43"	.	$794.69																																																																																																						
60220	"	Partial removal of thyroid"	T	0114	54.6762	"$3,973.43"	.	$794.69																																																																																																						
60225	"	Partial removal of thyroid"	T	0114	54.6762	"$3,973.43"	.	$794.69																																																																																																						
60240	"	Removal of thyroid"	T	0114	54.6762	"$3,973.43"	.	$794.69																																																																																																						
60252	"	Removal of thyroid"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
60254	"	Extensive thyroid surgery"	C																																																																																																											
60260	"	Repeat thyroid surgery"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
60270	"	Removal of thyroid"	C																																																																																																											
60271	"	Removal of thyroid"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
60280	"	Remove thyroid duct lesion"	T	0114	54.6762	"$3,973.43"	.	$794.69																																																																																																						
60281	"	Remove thyroid duct lesion"	T	0114	54.6762	"$3,973.43"	.	$794.69																																																																																																						
60300	"	Aspir/inj thyroid cyst"	T	0004	5.6589	$411.24	.	$82.25																																																																																																						
6030F	"	Max sterile barriers follwd"	M																																																																																																											
6040F	"	Appro rad ds dvcs techs docd"	E																																																																																																											
6045F	"	Radxps in end rprt4fluro pxd"	M																																																																																																											
60500	"	Explore parathyroid glands"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
60502	"	Re-explore parathyroids"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
60505	"	Explore parathyroid glands"	C																																																																																																											
60512	"	Autotransplant parathyroid"	N																																																																																																											
60520	"	Removal of thymus gland"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
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"	T	0130	40.3317	"$2,930.99"	$659.53	$586.20																																																																																																						
60699	"	Endocrine surgery procedure"	T	0114	54.6762	"$3,973.43"	.	$794.69																																																																																																						
6070F	"	Pt asked/cnsld aed effects"	E																																																																																																											
6080F	"	Pt/caregiver queried falls"	E																																																																																																											
6090F	"	Pt/caregiver counsel safety"	E																																																																																																											
61000	"	Remove cranial cavity fluid"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
61001	"	Remove cranial cavity fluid"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
6100F	"	Verify pt site pxd docd"	E																																																																																																											
6101F	"	Safety counseling dementia"	M																																																																																																											
61020	"	Remove brain cavity fluid"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
61026	"	Injection into brain canal"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
6102F	"	Safety counseling dem order"	M																																																																																																											
61050	"	Remove brain canal fluid"	T	0203	21.2609	"$1,545.07"	.	$309.02																																																																																																						
61055	"	Injection into brain canal"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
61070	"	Brain canal shunt procedure"	T	0121	6.4191	$466.49	.	$93.30																																																																																																						
61105	"	Twist drill hole"	C																																																																																																											
61107	"	Drill skull for implantation"	C																																																																																																											
61108	"	Drill skull for drainage"	C																																																																																																											
6110F	"	Counsel prov driving risks"	M																																																																																																											
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"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
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"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
61332	"	Explore/biopsy eye socket"	C																																																																																																											
61333	"	Explore orbit/remove lesion"	C																																																																																																											
61334	"	Explore orbit/remove object"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
61340	"	Subtemporal decompression"	C																																																																																																											
61343	"	Incise skull (press relief)"	C																																																																																																											
61345	"	Relieve cranial pressure"	C																																																																																																											
61440	"	Incise skull for surgery"	C																																																																																																											
61450	"	Incise skull for surgery"	C																																																																																																											
61458	"	Incise skull for brain wound"	C																																																																																																											
61460	"	Incise skull for surgery"	C																																																																																																											
61470	"	Incise skull for surgery"	C																																																																																																											
61480	"	Incise skull for surgery"	C																																																																																																											
61490	"	Incise skull for surgery"	C																																																																																																											
61500	"	Removal of skull lesion"	C																																																																																																											
61501	"	Remove infected skull bone"	C																																																																																																											
6150F	"	Pt notrcvng1st antitnf txmnt"	M																																																																																																											
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																																																																																																											
61542	"	Removal 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																																																																																																											
61609	"	Transect artery sinus"	C																																																																																																											
61610	"	Transect artery sinus"	C																																																																																																											
61611	"	Transect artery sinus"	C																																																																																																											
61612	"	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"	T	0082	121.6791	"$8,842.66"	.	"$1,768.54"																																																																																																						
61624	"	Transcath occlusion cns"	C																																																																																																											
61626	"	Transcath occlusion non-cns"	T	0082	121.6791	"$8,842.66"	.	"$1,768.54"																																																																																																						
61630	"	Intracranial angioplasty"	C																																																																																																											
61635	"	Intracran angioplsty w/stent"	C																																																																																																											
61640	"	Dilate ic vasospasm init"	E																																																																																																											
61641	"	Dilate ic vasospasm add-on"	E																																																																																																											
61642	"	Dilate ic vasospasm add-on"	E																																																																																																											
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"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
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"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
61781	"	Scan proc cranial intra"	N																																																																																																											
61782	"	Scan proc cranial extra"	N																																																																																																											
61783	"	Scan proc spinal"	N																																																																																																											
61790	"	Treat trigeminal nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
61791	"	Treat trigeminal tract"	T	0203	21.2609	"$1,545.07"	.	$309.02																																																																																																						
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																																																																																																											
61875	"	Implant neuroelectrodes"	C																																																																																																											
61880	"	Revise/remove neuroelectrode"	Q2	0687	23.5410	"$1,710.77"	$389.48	$342.16																																																																																																						
61885	"	Insrt/redo neurostim 1 array"	S	0039	237.1326	"$17,232.90"	.	"$3,446.58"																																																																																																						
61886	"	Implant neurostim arrays"	S	0315	317.7731	"$23,093.21"	.	"$4,618.65"																																																																																																						
61888	"	Revise/remove neuroreceiver"	Q2	0688	30.5781	"$2,222.17"	$657.64	$444.44																																																																																																						
62000	"	Treat skull fracture"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
62005	"	Treat skull fracture"	C																																																																																																											
62010	"	Treatment of head injury"	C																																																																																																											
62100	"	Repair brain fluid leakage"	C																																																																																																											
62115	"	Reduction of skull defect"	C																																																																																																											
62116	"	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"	T	0203	21.2609	"$1,545.07"	.	$309.02																																																																																																						
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"	T	0427	17.9738	"$1,306.19"	.	$261.24																																																																																																						
62230	"	Replace/revise brain shunt"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
62252	"	Csf shunt reprogram"	S	0692	1.5938	$115.82	.	$23.17																																																																																																						
62256	"	Remove brain cavity shunt"	C																																																																																																											
62258	"	Replace brain cavity shunt"	C																																																																																																											
62263	"	Epidural lysis mult sessions"	T	0203	21.2609	"$1,545.07"	.	$309.02																																																																																																						
62264	"	Epidural lysis on single day"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
62267	"	Interdiscal perq aspir dx"	T	0004	5.6589	$411.24	.	$82.25																																																																																																						
62268	"	Drain spinal cord cyst"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
62269	"	Needle biopsy spinal cord"	T	0685	10.4271	$757.76	.	$151.56																																																																																																						
62270	"	Spinal fluid tap diagnostic"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
62272	"	Drain cerebro spinal fluid"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
62273	"	Inject epidural patch"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
62280	"	Treat spinal cord lesion"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
62281	"	Treat spinal cord lesion"	T	0203	21.2609	"$1,545.07"	.	$309.02																																																																																																						
62282	"	Treat spinal canal lesion"	T	0203	21.2609	"$1,545.07"	.	$309.02																																																																																																						
62284	"	Injection for myelogram"	N																																																																																																											
62287	"	Percutaneous diskectomy"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
62290	"	Inject for spine disk x-ray"	N																																																																																																											
62291	"	Inject for spine disk x-ray"	N																																																																																																											
62292	"	Injection into disk lesion"	T	0203	21.2609	"$1,545.07"	.	$309.02																																																																																																						
62294	"	Injection into spinal artery"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
62310	"	Inject spine cerv/thoracic"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
62311	"	Inject spine lumbar/sacral"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
62318	"	Inject spine w/cath crv/thrc"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
62319	"	Inject spine w/cath lmb/scrl"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
62350	"	Implant spinal canal cath"	T	0224	47.0009	"$3,415.65"	.	$683.13																																																																																																						
62351	"	Implant spinal canal cath"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
62355	"	Remove spinal canal catheter"	Q2	0203	21.2609	"$1,545.07"	.	$309.02																																																																																																						
62360	"	Insert spine infusion device"	T	0224	47.0009	"$3,415.65"	.	$683.13																																																																																																						
62361	"	Implant spine infusion pump"	T	0227	201.5875	"$14,649.77"	.	"$2,929.96"																																																																																																						
62362	"	Implant spine infusion pump"	T	0227	201.5875	"$14,649.77"	.	"$2,929.96"																																																																																																						
62365	"	Remove spine infusion device"	Q2	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
62367	"	Analyze spine infus pump"	S	0691	3.7962	$275.88	.	$55.18																																																																																																						
62368	"	Analyze sp inf pump w/reprog"	S	0691	3.7962	$275.88	.	$55.18																																																																																																						
62369	"	Anal sp inf pmp w/reprg&fill"	S	0691	3.7962	$275.88	.	$55.18																																																																																																						
62370	"	Anl sp inf pmp w/mdreprg&fil"	S	0691	3.7962	$275.88	.	$55.18																																																																																																						
63001	"	Remove spine lamina 1/2 crvl"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63003	"	Remove spine lamina 1/2 thrc"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63005	"	Remove spine lamina 1/2 lmbr"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63011	"	Remove spine lamina 1/2 scrl"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63012	"	Remove lamina/facets lumbar"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63015	"	Remove spine lamina >2 crvcl"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63016	"	Remove spine lamina >2 thrc"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63017	"	Remove spine lamina >2 lmbr"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63020	"	Neck spine disk surgery"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63030	"	Low back disk surgery"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63035	"	Spinal disk surgery add-on"	N																																																																																																											
63040	"	Laminotomy single cervical"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63042	"	Laminotomy single lumbar"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63043	"	Laminotomy addl cervical"	C																																																																																																											
63044	"	Laminotomy addl lumbar"	C																																																																																																											
63045	"	Remove spine lamina 1 crvl"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63046	"	Remove spine lamina 1 thrc"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63047	"	Remove spine lamina 1 lmbr"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
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"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63056	"	Decompress spinal cord lmbr"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63057	"	Decompress spine cord add-on"	N																																																																																																											
63064	"	Decompress spinal cord thrc"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
63066	"	Decompress spine cord add-on"	N																																																																																																											
63075	"	Neck spine disk surgery"	T	0208	55.0874	"$4,003.31"	.	$800.67																																																																																																						
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"	C																																																																																																											
63266	"	Excise intrspinl lesion thrc"	C																																																																																																											
63267	"	Excise intrspinl lesion lmbr"	C																																																																																																											
63268	"	Excise intrspinl lesion scrl"	C																																																																																																											
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"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
63610	"	Stimulation of spinal cord"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
63615	"	Remove lesion of spinal cord"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
63620	"	Srs spinal lesion"	B																																																																																																											
63621	"	Srs spinal lesion addl"	B																																																																																																											
63650	"	Implant neuroelectrodes"	S	0040	63.6628	"$4,626.50"	.	$925.30																																																																																																						
63655	"	Implant neuroelectrodes"	S	0061	102.1644	"$7,424.49"	.	"$1,484.90"																																																																																																						
63661	"	Remove spine eltrd perq aray"	Q2	0687	23.5410	"$1,710.77"	$389.48	$342.16																																																																																																						
63662	"	Remove spine eltrd plate"	Q2	0687	23.5410	"$1,710.77"	$389.48	$342.16																																																																																																						
63663	"	Revise spine eltrd perq aray"	S	0040	63.6628	"$4,626.50"	.	$925.30																																																																																																						
63664	"	Revise spine eltrd plate"	S	0040	63.6628	"$4,626.50"	.	$925.30																																																																																																						
63685	"	Insrt/redo spine n generator"	S	0039	237.1326	"$17,232.90"	.	"$3,446.58"																																																																																																						
63688	"	Revise/remove neuroreceiver"	Q2	0688	30.5781	"$2,222.17"	$657.64	$444.44																																																																																																						
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"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
63744	"	Revision of spinal shunt"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
63746	"	Removal of spinal shunt"	Q2	0203	21.2609	"$1,545.07"	.	$309.02																																																																																																						
64400	"	N block inj trigeminal"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
64402	"	N block inj facial"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
64405	"	N block inj occipital"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64408	"	N block inj vagus"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
64410	"	N block inj phrenic"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
64412	"	N block inj spinal accessor"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64413	"	N block inj cervical plexus"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64415	"	N block inj brachial plexus"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64416	"	N block cont infuse b plex"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
64417	"	N block inj axillary"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64418	"	N block inj suprascapular"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64420	"	N block inj intercost sng"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64421	"	N block inj intercost mlt"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
64425	"	N block inj ilio-ing/hypogi"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64430	"	N block inj pudendal"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
64435	"	N block inj paracervical"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64445	"	N block inj sciatic sng"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
64446	"	N blk inj sciatic cont inf"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
64447	"	N block inj fem single"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64448	"	N block inj fem cont inf"	T	0203	21.2609	"$1,545.07"	.	$309.02																																																																																																						
64449	"	N block inj lumbar plexus"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
64450	"	N block other peripheral"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64455	"	N block inj plantar digit"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
64479	"	Inj foramen epidural c/t"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
64480	"	Inj foramen epidural add-on"	N																																																																																																											
64483	"	Inj foramen epidural l/s"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
64484	"	Inj foramen epidural add-on"	N																																																																																																											
64490	"	Inj paravert f jnt c/t 1 lev"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
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	0207	9.2183	$669.91	.	$133.99																																																																																																						
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	0204	2.7825	$202.21	.	$40.45																																																																																																						
64508	"	N block carotid sinus s/p"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
64510	"	N block stellate ganglion"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
64517	"	N block inj hypogas plxs"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
64520	"	N block lumbar/thoracic"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
64530	"	N block inj celiac pelus"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
64550	"	Apply neurostimulator"	A																																																																																																											
64553	"	Implant neuroelectrodes"	S	0040	63.6628	"$4,626.50"	.	$925.30																																																																																																						
64555	"	Implant neuroelectrodes"	S	0040	63.6628	"$4,626.50"	.	$925.30																																																																																																						
64561	"	Implant neuroelectrodes"	S	0040	63.6628	"$4,626.50"	.	$925.30																																																																																																						
64565	"	Implant neuroelectrodes"	S	0040	63.6628	"$4,626.50"	.	$925.30																																																																																																						
64566	"	Neuroeltrd stim post tibial"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
64568	"	Inc for vagus n elect impl"	S	0318	380.1966	"$27,629.65"	"$9,121.76"	"$5,525.93"																																																																																																						
64569	"	Revise/repl vagus n eltrd"	S	0040	63.6628	"$4,626.50"	.	$925.30																																																																																																						
64570	"	Remove vagus n eltrd"	Q2	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64575	"	Implant neuroelectrodes"	S	0061	102.1644	"$7,424.49"	.	"$1,484.90"																																																																																																						
64580	"	Implant neuroelectrodes"	S	0061	102.1644	"$7,424.49"	.	"$1,484.90"																																																																																																						
64581	"	Implant neuroelectrodes"	S	0061	102.1644	"$7,424.49"	.	"$1,484.90"																																																																																																						
64585	"	Revise/remove neuroelectrode"	Q2	0687	23.5410	"$1,710.77"	$389.48	$342.16																																																																																																						
64590	"	Insrt/redo pn/gastr stimul"	S	0039	237.1326	"$17,232.90"	.	"$3,446.58"																																																																																																						
64595	"	Revise/rmv pn/gastr stimul"	Q2	0688	30.5781	"$2,222.17"	$657.64	$444.44																																																																																																						
64600	"	Injection treatment of nerve"	T	0203	21.2609	"$1,545.07"	.	$309.02																																																																																																						
64605	"	Injection treatment of nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64610	"	Injection treatment of nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64611	"	Chemodenerv saliv glands"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
64612	"	Destroy nerve face muscle"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
64615	"	Chemodenerv musc migraine"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
64616	"	Chemodenerv musc neck dyston"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
64617	"	Chemodener muscle larynx emg"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64620	"	Injection treatment of nerve"	T	0203	21.2609	"$1,545.07"	.	$309.02																																																																																																						
64630	"	Injection treatment of nerve"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
64632	"	N block inj common digit"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
64633	"	Destroy cerv/thor facet jnt"	T	0203	21.2609	"$1,545.07"	.	$309.02																																																																																																						
64634	"	Destroy c/th facet jnt addl"	N																																																																																																											
64635	"	Destroy lumb/sac facet jnt"	T	0203	21.2609	"$1,545.07"	.	$309.02																																																																																																						
64636	"	Destroy l/s facet jnt addl"	N																																																																																																											
64640	"	Injection treatment of nerve"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
64642	"	Chemodenerv 1 extremity 1-4"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64643	"	Chemodenerv 1 extrem 1-4 ea"	N																																																																																																											
64644	"	Chemodenerv 1 extrem 5/> mus"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64645	"	Chemodenerv 1 extrem 5/> ea"	N																																																																																																											
64646	"	Chemodenerv trunk musc 1-5"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64647	"	Chemodenerv trunk musc 6/>"	T	0206	4.8710	$353.99	.	$70.80																																																																																																						
64650	"	Chemodenerv eccrine glands"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
64653	"	Chemodenerv eccrine glands"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
64680	"	Injection treatment of nerve"	T	0203	21.2609	"$1,545.07"	.	$309.02																																																																																																						
64681	"	Injection treatment of nerve"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
64702	"	Revise finger/toe nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64704	"	Revise hand/foot nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64708	"	Revise arm/leg nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64712	"	Revision of sciatic nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64713	"	Revision of arm nerve(s)"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64714	"	Revise low back nerve(s)"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64716	"	Revision of cranial nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64718	"	Revise ulnar nerve at elbow"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64719	"	Revise ulnar nerve at wrist"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64721	"	Carpal tunnel surgery"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64722	"	Relieve pressure on nerve(s)"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64726	"	Release foot/toe nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64727	"	Internal nerve revision"	N																																																																																																											
64732	"	Incision of brow nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64734	"	Incision of cheek nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64736	"	Incision of chin nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64738	"	Incision of jaw nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64740	"	Incision of tongue nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64742	"	Incision of facial nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64744	"	Incise nerve back of head"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64746	"	Incise diaphragm nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64752	"	Incision of vagus nerve"	C																																																																																																											
64755	"	Incision of stomach nerves"	C																																																																																																											
64760	"	Incision of vagus nerve"	C																																																																																																											
64761	"	Incision of pelvis nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64763	"	Incise hip/thigh nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64766	"	Incise hip/thigh nerve"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64771	"	Sever cranial nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64772	"	Incision of spinal nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64774	"	Remove skin nerve lesion"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64776	"	Remove digit nerve lesion"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64778	"	Digit nerve surgery add-on"	N																																																																																																											
64782	"	Remove limb nerve lesion"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64783	"	Limb nerve surgery add-on"	N																																																																																																											
64784	"	Remove nerve lesion"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64786	"	Remove sciatic nerve lesion"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64787	"	Implant nerve end"	N																																																																																																											
64788	"	Remove skin nerve lesion"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64790	"	Removal of nerve lesion"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64792	"	Removal of nerve lesion"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64795	"	Biopsy of nerve"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64802	"	Sympathectomy cervical"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64804	"	Remove sympathetic nerves"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64809	"	Remove sympathetic nerves"	C																																																																																																											
64818	"	Remove sympathetic nerves"	C																																																																																																											
64820	"	Sympathectomy digital artery"	T	0220	19.0430	"$1,383.89"	.	$276.78																																																																																																						
64821	"	Remove sympathetic nerves"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
64822	"	Remove sympathetic nerves"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
64823	"	Sympathectomy supfc palmar"	T	0054	30.6686	"$2,228.75"	.	$445.75																																																																																																						
64831	"	Repair of digit nerve"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64832	"	Repair nerve add-on"	N																																																																																																											
64834	"	Repair of hand or foot nerve"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64835	"	Repair of hand or foot nerve"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64836	"	Repair of hand or foot nerve"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64837	"	Repair nerve add-on"	N																																																																																																											
64840	"	Repair of leg nerve"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64856	"	Repair/transpose nerve"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64857	"	Repair arm/leg nerve"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64858	"	Repair sciatic nerve"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64859	"	Nerve surgery"	N																																																																																																											
64861	"	Repair of arm nerves"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64862	"	Repair of low back nerves"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64864	"	Repair of facial nerve"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64865	"	Repair of facial nerve"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64866	"	Fusion of facial/other nerve"	C																																																																																																											
64868	"	Fusion of facial/other nerve"	C																																																																																																											
64870	"	Fusion of facial/other nerve"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
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"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64886	"	Nerve graft head/neck >4 cm"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64890	"	Nerve graft hand/foot </4 cm"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64891	"	Nerve graft hand/foot >4 cm"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64892	"	Nerve graft arm/leg <4 cm"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64893	"	Nerve graft arm/leg >4 cm"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64895	"	Nerve graft hand/foot </4 cm"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64896	"	Nerve graft hand/foot >4 cm"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64897	"	Nerve graft arm/leg </4 cm"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64898	"	Nerve graft arm/leg >4 cm"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64901	"	Nerve graft add-on"	N																																																																																																											
64902	"	Nerve graft add-on"	N																																																																																																											
64905	"	Nerve pedicle transfer"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64907	"	Nerve pedicle transfer"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64910	"	Nerve repair w/allograft"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64911	"	Neurorraphy w/vein autograft"	T	0221	39.4068	"$2,863.77"	.	$572.76																																																																																																						
64999	"	Nervous system surgery"	T	0204	2.7825	$202.21	.	$40.45																																																																																																						
65091	"	Revise eye"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
65093	"	Revise eye with implant"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
65101	"	Removal of eye"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
65103	"	Remove eye/insert implant"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
65105	"	Remove eye/attach implant"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
65110	"	Removal of eye"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
65112	"	Remove eye/revise socket"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
65114	"	Remove eye/revise socket"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
65125	"	Revise ocular implant"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
65130	"	Insert ocular implant"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
65135	"	Insert ocular implant"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
65140	"	Attach ocular implant"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
65150	"	Revise ocular implant"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
65155	"	Reinsert ocular implant"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
65175	"	Removal of ocular implant"	Q2	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
65205	"	Remove foreign body from eye"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
65210	"	Remove foreign body from eye"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
65220	"	Remove foreign body from eye"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
65222	"	Remove foreign body from eye"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
65235	"	Remove foreign body from eye"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
65260	"	Remove foreign body from eye"	T	0235	5.9113	$429.59	.	$85.92																																																																																																						
65265	"	Remove foreign body from eye"	T	0237	23.5977	"$1,714.89"	.	$342.98																																																																																																						
65270	"	Repair of eye wound"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
65272	"	Repair of eye wound"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
65273	"	Repair of eye wound"	C																																																																																																											
65275	"	Repair of eye wound"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
65280	"	Repair of eye wound"	T	0237	23.5977	"$1,714.89"	.	$342.98																																																																																																						
65285	"	Repair of eye wound"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
65286	"	Repair of eye wound"	T	0255	10.2636	$745.88	.	$149.18																																																																																																						
65290	"	Repair of eye socket wound"	T	0243	26.7931	"$1,947.11"	$412.25	$389.43																																																																																																						
65400	"	Removal of eye lesion"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
65410	"	Biopsy of cornea"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
65420	"	Removal of eye lesion"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
65426	"	Removal of eye lesion"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
65430	"	Corneal smear"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
65435	"	Curette/treat cornea"	T	0239	8.8578	$643.71	.	$128.75																																																																																																						
65436	"	Curette/treat cornea"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
65450	"	Treatment of corneal lesion"	S	0231	2.5031	$181.91	.	$36.39																																																																																																						
65600	"	Revision of cornea"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
65710	"	Corneal transplant"	T	0244	44.4209	"$3,228.16"	$794.86	$645.64																																																																																																						
65730	"	Corneal transplant"	T	0244	44.4209	"$3,228.16"	$794.86	$645.64																																																																																																						
65750	"	Corneal transplant"	T	0244	44.4209	"$3,228.16"	$794.86	$645.64																																																																																																						
65755	"	Corneal transplant"	T	0244	44.4209	"$3,228.16"	$794.86	$645.64																																																																																																						
65756	"	Corneal trnspl endothelial"	T	0244	44.4209	"$3,228.16"	$794.86	$645.64																																																																																																						
65757	"	Prep corneal endo allograft"	N																																																																																																											
65760	"	Revision of cornea"	E																																																																																																											
65765	"	Revision of cornea"	E																																																																																																											
65767	"	Corneal tissue transplant"	E																																																																																																											
65770	"	Revise cornea with implant"	T	0293	105.9269	"$7,697.92"	.	"$1,539.59"																																																																																																						
65771	"	Radial keratotomy"	E																																																																																																											
65772	"	Correction of astigmatism"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
65775	"	Correction of astigmatism"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
65778	"	Cover eye w/membrane"	Q2	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
65779	"	Cover eye w/membrane suture"	Q2	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
65780	"	Ocular reconst transplant"	T	0244	44.4209	"$3,228.16"	$794.86	$645.64																																																																																																						
65781	"	Ocular reconst transplant"	T	0244	44.4209	"$3,228.16"	$794.86	$645.64																																																																																																						
65782	"	Ocular reconst transplant"	T	0244	44.4209	"$3,228.16"	$794.86	$645.64																																																																																																						
65800	"	Drainage of eye"	T	0255	10.2636	$745.88	.	$149.18																																																																																																						
65810	"	Drainage of eye"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
65815	"	Drainage of eye"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
65820	"	Relieve inner eye pressure"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
65850	"	Incision of eye"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
65855	"	Laser surgery of eye"	T	0247	5.8928	$428.24	$102.26	$85.65																																																																																																						
65860	"	Incise inner eye adhesions"	T	0247	5.8928	$428.24	$102.26	$85.65																																																																																																						
65865	"	Incise inner eye adhesions"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
65870	"	Incise inner eye adhesions"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
65875	"	Incise inner eye adhesions"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
65880	"	Incise inner eye adhesions"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
65900	"	Remove eye lesion"	T	0232	2.3720	$172.38	.	$34.48																																																																																																						
65920	"	Remove implant of eye"	Q2	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
65930	"	Remove blood clot from eye"	T	0673	41.7956	"$3,037.37"	$635.64	$607.48																																																																																																						
66020	"	Injection treatment of eye"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
66030	"	Injection treatment of eye"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
66130	"	Remove eye lesion"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
66150	"	Glaucoma surgery"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
66155	"	Glaucoma surgery"	T	0673	41.7956	"$3,037.37"	$635.64	$607.48																																																																																																						
66160	"	Glaucoma surgery"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
66165	"	Glaucoma surgery"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
66170	"	Glaucoma surgery"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
66172	"	Incision of eye"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
66174	"	Translum dil eye canal"	T	0673	41.7956	"$3,037.37"	$635.64	$607.48																																																																																																						
66175	"	Trnslum dil eye canal w/stnt"	T	0673	41.7956	"$3,037.37"	$635.64	$607.48																																																																																																						
66180	"	Implant eye shunt"	T	0673	41.7956	"$3,037.37"	$635.64	$607.48																																																																																																						
66183	"	Insert ant drainage device"	T	0673	41.7956	"$3,037.37"	$635.64	$607.48																																																																																																						
66185	"	Revise eye shunt"	T	0673	41.7956	"$3,037.37"	$635.64	$607.48																																																																																																						
66220	"	Repair eye lesion"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
66225	"	Repair/graft eye lesion"	T	0673	41.7956	"$3,037.37"	$635.64	$607.48																																																																																																						
66250	"	Follow-up surgery of eye"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
66500	"	Incision of iris"	T	0232	2.3720	$172.38	.	$34.48																																																																																																						
66505	"	Incision of iris"	T	0255	10.2636	$745.88	.	$149.18																																																																																																						
66600	"	Remove iris and lesion"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
66605	"	Removal of iris"	T	0673	41.7956	"$3,037.37"	$635.64	$607.48																																																																																																						
66625	"	Removal of iris"	T	0255	10.2636	$745.88	.	$149.18																																																																																																						
66630	"	Removal of iris"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
66635	"	Removal of iris"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
66680	"	Repair iris & ciliary body"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
66682	"	Repair iris & ciliary body"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
66700	"	Destruction ciliary body"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
66710	"	Ciliary transsleral therapy"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
66711	"	Ciliary endoscopic ablation"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
66720	"	Destruction ciliary body"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
66740	"	Destruction ciliary body"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
66761	"	Revision of iris"	T	0247	5.8928	$428.24	$102.26	$85.65																																																																																																						
66762	"	Revision of iris"	T	0247	5.8928	$428.24	$102.26	$85.65																																																																																																						
66770	"	Removal of inner eye lesion"	T	0247	5.8928	$428.24	$102.26	$85.65																																																																																																						
66820	"	Incision secondary cataract"	T	0255	10.2636	$745.88	.	$149.18																																																																																																						
66821	"	After cataract laser surgery"	T	0247	5.8928	$428.24	$102.26	$85.65																																																																																																						
66825	"	Reposition intraocular lens"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
66830	"	Removal of lens lesion"	T	0255	10.2636	$745.88	.	$149.18																																																																																																						
66840	"	Removal of lens material"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
66850	"	Removal of lens material"	T	0249	29.6448	"$2,154.35"	$499.26	$430.87																																																																																																						
66852	"	Removal of lens material"	T	0249	29.6448	"$2,154.35"	$499.26	$430.87																																																																																																						
66920	"	Extraction of lens"	T	0249	29.6448	"$2,154.35"	$499.26	$430.87																																																																																																						
66930	"	Extraction of lens"	T	0249	29.6448	"$2,154.35"	$499.26	$430.87																																																																																																						
66940	"	Extraction of lens"	T	0255	10.2636	$745.88	.	$149.18																																																																																																						
66982	"	Cataract surgery complex"	T	0246	24.3011	"$1,766.01"	$490.32	$353.21																																																																																																						
66983	"	Cataract surg w/iol 1 stage"	T	0246	24.3011	"$1,766.01"	$490.32	$353.21																																																																																																						
66984	"	Cataract surg w/iol 1 stage"	T	0246	24.3011	"$1,766.01"	$490.32	$353.21																																																																																																						
66985	"	Insert lens prosthesis"	T	0246	24.3011	"$1,766.01"	$490.32	$353.21																																																																																																						
66986	"	Exchange lens prosthesis"	T	0246	24.3011	"$1,766.01"	$490.32	$353.21																																																																																																						
66990	"	Ophthalmic endoscope add-on"	N																																																																																																											
66999	"	Eye surgery procedure"	T	0232	2.3720	$172.38	.	$34.48																																																																																																						
67005	"	Partial removal of eye fluid"	T	0237	23.5977	"$1,714.89"	.	$342.98																																																																																																						
67010	"	Partial removal of eye fluid"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
67015	"	Release of eye fluid"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
67025	"	Replace eye fluid"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
67027	"	Implant eye drug system"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
67028	"	Injection eye drug"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
67030	"	Incise inner eye strands"	T	0237	23.5977	"$1,714.89"	.	$342.98																																																																																																						
67031	"	Laser surgery eye strands"	T	0247	5.8928	$428.24	$102.26	$85.65																																																																																																						
67036	"	Removal of inner eye fluid"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
67039	"	Laser treatment of retina"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
67040	"	Laser treatment of retina"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
67041	"	Vit for macular pucker"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
67042	"	Vit for macular hole"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
67043	"	Vit for membrane dissect"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
67101	"	Repair detached retina"	T	0237	23.5977	"$1,714.89"	.	$342.98																																																																																																						
67105	"	Repair detached retina"	T	0247	5.8928	$428.24	$102.26	$85.65																																																																																																						
67107	"	Repair detached retina"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
67108	"	Repair detached retina"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
67110	"	Repair detached retina"	T	0237	23.5977	"$1,714.89"	.	$342.98																																																																																																						
67112	"	Rerepair detached retina"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
67113	"	Repair retinal detach cplx"	T	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
67115	"	Release encircling material"	T	0237	23.5977	"$1,714.89"	.	$342.98																																																																																																						
67120	"	Remove eye implant material"	Q2	0237	23.5977	"$1,714.89"	.	$342.98																																																																																																						
67121	"	Remove eye implant material"	Q2	0672	42.1116	"$3,060.33"	.	$612.07																																																																																																						
67141	"	Treatment of retina"	T	0235	5.9113	$429.59	.	$85.92																																																																																																						
67145	"	Treatment of retina"	T	0247	5.8928	$428.24	$102.26	$85.65																																																																																																						
67208	"	Treatment of retinal lesion"	T	0235	5.9113	$429.59	.	$85.92																																																																																																						
67210	"	Treatment of retinal lesion"	T	0247	5.8928	$428.24	$102.26	$85.65																																																																																																						
67218	"	Treatment of retinal lesion"	T	0237	23.5977	"$1,714.89"	.	$342.98																																																																																																						
67220	"	Treatment of choroid lesion"	T	0247	5.8928	$428.24	$102.26	$85.65																																																																																																						
67221	"	Ocular photodynamic ther"	T	0235	5.9113	$429.59	.	$85.92																																																																																																						
67225	"	Eye photodynamic ther add-on"	N																																																																																																											
67227	"	Treatment of retinal lesion"	T	0237	23.5977	"$1,714.89"	.	$342.98																																																																																																						
67228	"	Treatment of retinal lesion"	T	0247	5.8928	$428.24	$102.26	$85.65																																																																																																						
67229	"	Tr retinal les preterm inf"	T	0247	5.8928	$428.24	$102.26	$85.65																																																																																																						
67250	"	Reinforce eye wall"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67255	"	Reinforce/graft eye wall"	T	0237	23.5977	"$1,714.89"	.	$342.98																																																																																																						
67299	"	Eye surgery procedure"	T	0235	5.9113	$429.59	.	$85.92																																																																																																						
67311	"	Revise eye muscle"	T	0243	26.7931	"$1,947.11"	$412.25	$389.43																																																																																																						
67312	"	Revise two eye muscles"	T	0243	26.7931	"$1,947.11"	$412.25	$389.43																																																																																																						
67314	"	Revise eye muscle"	T	0243	26.7931	"$1,947.11"	$412.25	$389.43																																																																																																						
67316	"	Revise two eye muscles"	T	0243	26.7931	"$1,947.11"	$412.25	$389.43																																																																																																						
67318	"	Revise eye muscle(s)"	T	0243	26.7931	"$1,947.11"	$412.25	$389.43																																																																																																						
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"	T	0243	26.7931	"$1,947.11"	$412.25	$389.43																																																																																																						
67345	"	Destroy nerve of eye muscle"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
67346	"	Biopsy eye muscle"	T	0699	16.4654	"$1,196.57"	.	$239.32																																																																																																						
67399	"	Eye muscle surgery procedure"	T	0243	26.7931	"$1,947.11"	$412.25	$389.43																																																																																																						
67400	"	Explore/biopsy eye socket"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67405	"	Explore/drain eye socket"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
67412	"	Explore/treat eye socket"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67413	"	Explore/treat eye socket"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
67414	"	Explr/decompress eye socket"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
67415	"	Aspiration orbital contents"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67420	"	Explore/treat eye socket"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
67430	"	Explore/treat eye socket"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
67440	"	Explore/drain eye socket"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
67445	"	Explr/decompress eye socket"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
67450	"	Explore/biopsy eye socket"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
67500	"	Inject/treat eye socket"	S	0231	2.5031	$181.91	.	$36.39																																																																																																						
67505	"	Inject/treat eye socket"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
67515	"	Inject/treat eye socket"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
67550	"	Insert eye socket implant"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
67560	"	Revise eye socket implant"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
67570	"	Decompress optic nerve"	T	0242	42.9732	"$3,122.95"	.	$624.59																																																																																																						
67599	"	Orbit surgery procedure"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
67700	"	Drainage of eyelid abscess"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
67710	"	Incision of eyelid"	T	0239	8.8578	$643.71	.	$128.75																																																																																																						
67715	"	Incision of eyelid fold"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67800	"	Remove eyelid lesion"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
67801	"	Remove eyelid lesions"	T	0239	8.8578	$643.71	.	$128.75																																																																																																						
67805	"	Remove eyelid lesions"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
67808	"	Remove eyelid lesion(s)"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67810	"	Biopsy eyelid & lid margin"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
67820	"	Revise eyelashes"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
67825	"	Revise eyelashes"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
67830	"	Revise eyelashes"	T	0239	8.8578	$643.71	.	$128.75																																																																																																						
67835	"	Revise eyelashes"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67840	"	Remove eyelid lesion"	T	0239	8.8578	$643.71	.	$128.75																																																																																																						
67850	"	Treat eyelid lesion"	T	0239	8.8578	$643.71	.	$128.75																																																																																																						
67875	"	Closure of eyelid by suture"	T	0239	8.8578	$643.71	.	$128.75																																																																																																						
67880	"	Revision of eyelid"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
67882	"	Revision of eyelid"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67900	"	Repair brow defect"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
67901	"	Repair eyelid defect"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67902	"	Repair eyelid defect"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
67903	"	Repair eyelid defect"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67904	"	Repair eyelid defect"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67906	"	Repair eyelid defect"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67908	"	Repair eyelid defect"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67909	"	Revise eyelid defect"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67911	"	Revise eyelid defect"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67912	"	Correction eyelid w/implant"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67914	"	Repair eyelid defect"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67915	"	Repair eyelid defect"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67916	"	Repair eyelid defect"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67917	"	Repair eyelid defect"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67921	"	Repair eyelid defect"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67922	"	Repair eyelid defect"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67923	"	Repair eyelid defect"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67924	"	Repair eyelid defect"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67930	"	Repair eyelid wound"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67935	"	Repair eyelid wound"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67938	"	Remove eyelid foreign body"	S	0231	2.5031	$181.91	.	$36.39																																																																																																						
67950	"	Revision of eyelid"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67961	"	Revision of eyelid"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67966	"	Revision of eyelid"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67971	"	Reconstruction of eyelid"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67973	"	Reconstruction of eyelid"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
67974	"	Reconstruction of eyelid"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67975	"	Reconstruction of eyelid"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
67999	"	Revision of eyelid"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
68020	"	Incise/drain eyelid lining"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
68040	"	Treatment of eyelid lesions"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
68100	"	Biopsy of eyelid lining"	T	0239	8.8578	$643.71	.	$128.75																																																																																																						
68110	"	Remove eyelid lining lesion"	T	0699	16.4654	"$1,196.57"	.	$239.32																																																																																																						
68115	"	Remove eyelid lining lesion"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
68130	"	Remove eyelid lining lesion"	T	0233	16.4184	"$1,193.16"	.	$238.64																																																																																																						
68135	"	Remove eyelid lining lesion"	T	0239	8.8578	$643.71	.	$128.75																																																																																																						
68200	"	Treat eyelid by injection"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
68320	"	Revise/graft eyelid lining"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
68325	"	Revise/graft eyelid lining"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
68326	"	Revise/graft eyelid lining"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
68328	"	Revise/graft eyelid lining"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
68330	"	Revise eyelid lining"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
68335	"	Revise/graft eyelid lining"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
68340	"	Separate eyelid adhesions"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
68360	"	Revise eyelid lining"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
68362	"	Revise eyelid lining"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
68371	"	Harvest eye tissue alograft"	T	0234	24.0664	"$1,748.95"	.	$349.79																																																																																																						
68399	"	Eyelid lining surgery"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
68400	"	Incise/drain tear gland"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
68420	"	Incise/drain tear sac"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
68440	"	Incise tear duct opening"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
68500	"	Removal of tear gland"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
68505	"	Partial removal tear gland"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
68510	"	Biopsy of tear gland"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
68520	"	Removal of tear sac"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
68525	"	Biopsy of tear sac"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
68530	"	Clearance of tear duct"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
68540	"	Remove tear gland lesion"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
68550	"	Remove tear gland lesion"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
68700	"	Repair tear ducts"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
68705	"	Revise tear duct opening"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
68720	"	Create tear sac drain"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
68745	"	Create tear duct drain"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
68750	"	Create tear duct drain"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
68760	"	Close tear duct opening"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
68761	"	Close tear duct opening"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
68770	"	Close tear system fistula"	T	0241	27.3406	"$1,986.90"	.	$397.38																																																																																																						
68801	"	Dilate tear duct opening"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
68810	"	Probe nasolacrimal duct"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
68811	"	Probe nasolacrimal duct"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
68815	"	Probe nasolacrimal duct"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
68816	"	Probe nl duct w/balloon"	T	0240	19.9516	"$1,449.92"	$294.00	$289.99																																																																																																						
68840	"	Explore/irrigate tear ducts"	S	0231	2.5031	$181.91	.	$36.39																																																																																																						
68850	"	Injection for tear sac x-ray"	N																																																																																																											
68899	"	Tear duct system surgery"	T	0238	3.5139	$255.36	.	$51.08																																																																																																						
69000	"	Drain external ear lesion"	T	0006	2.1970	$159.66	.	$31.94																																																																																																						
69005	"	Drain external ear lesion"	T	0007	11.6214	$844.55	.	$168.91																																																																																																						
69020	"	Drain outer ear canal lesion"	T	0006	2.1970	$159.66	.	$31.94																																																																																																						
69090	"	Pierce earlobes"	E																																																																																																											
69100	"	Biopsy of external ear"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
69105	"	Biopsy of external ear canal"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
69110	"	Remove external ear partial"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
69120	"	Removal of external ear"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
69140	"	Remove ear canal lesion(s)"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69145	"	Remove ear canal lesion(s)"	T	0021	15.7741	"$1,146.34"	.	$229.27																																																																																																						
69150	"	Extensive ear canal surgery"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
69155	"	Extensive ear/neck surgery"	C																																																																																																											
69200	"	Clear outer ear canal"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
69205	"	Clear outer ear canal"	T	0022	23.8955	"$1,736.53"	$350.78	$347.31																																																																																																						
69210	"	Remove impacted ear wax uni"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
69220	"	Clean out mastoid cavity"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
69222	"	Clean out mastoid cavity"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
69300	"	Revise external ear"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
69310	"	Rebuild outer ear canal"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69320	"	Rebuild outer ear canal"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69399	"	Outer ear surgery procedure"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
69400	"	Inflate middle ear canal"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
69401	"	Inflate middle ear canal"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
69405	"	Catheterize middle ear canal"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
69420	"	Incision of eardrum"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
69421	"	Incision of eardrum"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
69424	"	Remove ventilating tube"	Q2	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
69433	"	Create eardrum opening"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
69436	"	Create eardrum opening"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
69440	"	Exploration of middle ear"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69450	"	Eardrum revision"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69501	"	Mastoidectomy"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69502	"	Mastoidectomy"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69505	"	Remove mastoid structures"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69511	"	Extensive mastoid surgery"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69530	"	Extensive mastoid surgery"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69535	"	Remove part of temporal bone"	C																																																																																																											
69540	"	Remove ear lesion"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
69550	"	Remove ear lesion"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69552	"	Remove ear lesion"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69554	"	Remove ear lesion"	C																																																																																																											
69601	"	Mastoid surgery revision"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69602	"	Mastoid surgery revision"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69603	"	Mastoid surgery revision"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69604	"	Mastoid surgery revision"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69605	"	Mastoid surgery revision"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69610	"	Repair of eardrum"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
69620	"	Repair of eardrum"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
69631	"	Repair eardrum structures"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69632	"	Rebuild eardrum structures"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69633	"	Rebuild eardrum structures"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69635	"	Repair eardrum structures"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69636	"	Rebuild eardrum structures"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69637	"	Rebuild eardrum structures"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69641	"	Revise middle ear & mastoid"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69642	"	Revise middle ear & mastoid"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69643	"	Revise middle ear & mastoid"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69644	"	Revise middle ear & mastoid"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69645	"	Revise middle ear & mastoid"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69646	"	Revise middle ear & mastoid"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69650	"	Release middle ear bone"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69660	"	Revise middle ear bone"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69661	"	Revise middle ear bone"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69662	"	Revise middle ear bone"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69666	"	Repair middle ear structures"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
69667	"	Repair middle ear structures"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
69670	"	Remove mastoid air cells"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69676	"	Remove middle ear nerve"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
69700	"	Close mastoid fistula"	T	0254	25.5846	"$1,859.28"	.	$371.86																																																																																																						
69710	"	Implant/replace hearing aid"	E																																																																																																											
69711	"	Remove/repair hearing aid"	Q2	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69714	"	Implant temple bone w/stimul"	T	0425	133.9177	"$9,732.07"	.	"$1,946.42"																																																																																																						
69715	"	Temple bne implnt w/stimulat"	T	0425	133.9177	"$9,732.07"	.	"$1,946.42"																																																																																																						
69717	"	Temple bone implant revision"	T	0425	133.9177	"$9,732.07"	.	"$1,946.42"																																																																																																						
69718	"	Revise temple bone implant"	T	0425	133.9177	"$9,732.07"	.	"$1,946.42"																																																																																																						
69720	"	Release facial nerve"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69725	"	Release facial nerve"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69740	"	Repair facial nerve"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69745	"	Repair facial nerve"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69799	"	Middle ear surgery procedure"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
69801	"	Incise inner ear"	T	0253	16.7579	"$1,217.83"	.	$243.57																																																																																																						
69805	"	Explore inner ear"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69806	"	Explore inner ear"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69820	"	Establish inner ear window"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69840	"	Revise inner ear window"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69905	"	Remove inner ear"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69910	"	Remove inner ear & mastoid"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69915	"	Incise inner ear nerve"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69930	"	Implant cochlear device"	T	0259	423.2920	"$30,761.48"	"$7,921.74"	"$6,152.30"																																																																																																						
69949	"	Inner ear surgery procedure"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
69950	"	Incise inner ear nerve"	C																																																																																																											
69955	"	Release facial nerve"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69960	"	Release inner ear canal"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69970	"	Remove inner ear lesion"	T	0256	49.0518	"$3,564.69"	.	$712.94																																																																																																						
69979	"	Temporal bone surgery"	T	0250	1.1575	$84.12	$24.11	$16.83																																																																																																						
69990	"	Microsurgery add-on"	N																																																																																																											
70010	"	Contrast x-ray of brain"	Q2	0274	8.2207	$597.41	.	$119.49																																																																																																						
70015	"	Contrast x-ray of brain"	Q2	0274	8.2207	$597.41	.	$119.49																																																																																																						
70030	"	X-ray eye for foreign body"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
70100	"	X-ray exam of jaw <4views"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
7010F	"	Pt info into recall system"	M																																																																																																											
70110	"	X-ray exam of jaw 4/> views"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
70120	"	X-ray exam of mastoids"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
70130	"	X-ray exam of mastoids"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
70134	"	X-ray exam of middle ear"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
70140	"	X-ray exam of facial bones"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
70150	"	X-ray exam of facial bones"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
70160	"	X-ray exam of nasal bones"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
70170	"	X-ray exam of tear duct"	Q2	0263	4.3746	$317.91	.	$63.59																																																																																																						
70190	"	X-ray exam of eye sockets"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
70200	"	X-ray exam of eye sockets"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
7020F	"	Mammo assess cat in dbase"	E																																																																																																											
70210	"	X-ray exam of sinuses"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
70220	"	X-ray exam of sinuses"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
70240	"	X-ray exam pituitary saddle"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
70250	"	X-ray exam of skull"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
7025F	"	Pt infosys alarm 4 nxt mammo"	M																																																																																																											
70260	"	X-ray exam of skull"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
70300	"	X-ray exam of teeth"	X	0262	0.5866	$42.63	.	$8.53																																																																																																						
70310	"	X-ray exam of teeth"	X	0262	0.5866	$42.63	.	$8.53																																																																																																						
70320	"	Full mouth x-ray of teeth"	X	0262	0.5866	$42.63	.	$8.53																																																																																																						
70328	"	X-ray exam of jaw joint"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
70330	"	X-ray exam of jaw joints"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
70332	"	X-ray exam of jaw joint"	Q2	0275	4.6693	$339.33	$68.90	$67.87																																																																																																						
70336	"	Magnetic image jaw joint"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
70350	"	X-ray head for orthodontia"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
70355	"	Panoramic x-ray of jaws"	X	0262	0.5866	$42.63	.	$8.53																																																																																																						
70360	"	X-ray exam of neck"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
70370	"	Throat x-ray & fluoroscopy"	X	0272	2.1559	$156.67	.	$31.34																																																																																																						
70371	"	Speech evaluation complex"	X	0272	2.1559	$156.67	.	$31.34																																																																																																						
70373	"	Contrast x-ray of larynx"	Q2	0263	4.3746	$317.91	.	$63.59																																																																																																						
70380	"	X-ray exam of salivary gland"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
70390	"	X-ray exam of salivary duct"	Q2	0263	4.3746	$317.91	.	$63.59																																																																																																						
70450	"	Ct head/brain w/o dye"	Q3	0332	1.7403	$126.47	$48.90	$25.30																																																																																																						
70460	"	Ct head/brain w/dye"	Q3	0283	3.4263	$249.00	$79.99	$49.80																																																																																																						
70470	"	Ct head/brain w/o & w/dye"	Q3	0333	3.8584	$280.40	$97.38	$56.08																																																																																																						
70480	"	Ct orbit/ear/fossa w/o dye"	Q3	0332	1.7403	$126.47	$48.90	$25.30																																																																																																						
70481	"	Ct orbit/ear/fossa w/dye"	Q3	0283	3.4263	$249.00	$79.99	$49.80																																																																																																						
70482	"	Ct orbit/ear/fossa w/o&w/dye"	Q3	0333	3.8584	$280.40	$97.38	$56.08																																																																																																						
70486	"	Ct maxillofacial w/o dye"	Q3	0332	1.7403	$126.47	$48.90	$25.30																																																																																																						
70487	"	Ct maxillofacial w/dye"	Q3	0283	3.4263	$249.00	$79.99	$49.80																																																																																																						
70488	"	Ct maxillofacial w/o & w/dye"	Q3	0333	3.8584	$280.40	$97.38	$56.08																																																																																																						
70490	"	Ct soft tissue neck w/o dye"	Q3	0332	1.7403	$126.47	$48.90	$25.30																																																																																																						
70491	"	Ct soft tissue neck w/dye"	Q3	0283	3.4263	$249.00	$79.99	$49.80																																																																																																						
70492	"	Ct sft tsue nck w/o & w/dye"	Q3	0333	3.8584	$280.40	$97.38	$56.08																																																																																																						
70496	"	Ct angiography head"	Q3	0662	4.0175	$291.96	$98.43	$58.40																																																																																																						
70498	"	Ct angiography neck"	Q3	0662	4.0175	$291.96	$98.43	$58.40																																																																																																						
70540	"	Mri orbit/face/neck w/o dye"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
70542	"	Mri orbit/face/neck w/dye"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
70543	"	Mri orbt/fac/nck w/o &w/dye"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
70544	"	Mr angiography head w/o dye"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
70545	"	Mr angiography head w/dye"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
70546	"	Mr angiograph head w/o&w/dye"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
70547	"	Mr angiography neck w/o dye"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
70548	"	Mr angiography neck w/dye"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
70549	"	Mr angiograph neck w/o&w/dye"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
70551	"	Mri brain stem w/o dye"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
70552	"	Mri brain stem w/dye"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
70553	"	Mri brain stem w/o & w/dye"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
70554	"	Fmri brain by tech"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
70555	"	Fmri brain by phys/psych"	S	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
70557	"	Mri brain w/o dye"	S	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
70558	"	Mri brain w/dye"	S	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
70559	"	Mri brain w/o & w/dye"	S	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
71010	"	Chest x-ray 1 view frontal"	Q3	0260	0.7891	$57.35	.	$11.47																																																																																																						
71015	"	Chest x-ray stereo frontal"	Q3	0260	0.7891	$57.35	.	$11.47																																																																																																						
71020	"	Chest x-ray 2vw frontal&latl"	Q3	0260	0.7891	$57.35	.	$11.47																																																																																																						
71021	"	Chest x-ray frnt lat lordotc"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
71022	"	Chest x-ray frnt lat oblique"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
71023	"	Chest x-ray and fluoroscopy"	X	0272	2.1559	$156.67	.	$31.34																																																																																																						
71030	"	Chest x-ray 4/> views"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
71034	"	Chest x-ray&fluoro 4/> views"	X	0272	2.1559	$156.67	.	$31.34																																																																																																						
71035	"	Chest x-ray special views"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
71100	"	X-ray exam ribs uni 2 views"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
71101	"	X-ray exam unilat ribs/chest"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
71110	"	X-ray exam ribs bil 3 views"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
71111	"	X-ray exam ribs/chest4/> vws"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
71120	"	X-ray exam breastbone 2/>vws"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
71130	"	X-ray strenoclavic jt 3/>vws"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
71250	"	Ct thorax w/o dye"	Q3	0332	1.7403	$126.47	$48.90	$25.30																																																																																																						
71260	"	Ct thorax w/dye"	Q3	0283	3.4263	$249.00	$79.99	$49.80																																																																																																						
71270	"	Ct thorax w/o & w/dye"	Q3	0333	3.8584	$280.40	$97.38	$56.08																																																																																																						
71275	"	Ct angiography chest"	Q3	0662	4.0175	$291.96	$98.43	$58.40																																																																																																						
71550	"	Mri chest w/o dye"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
71551	"	Mri chest w/dye"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
71552	"	Mri chest w/o & w/dye"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
71555	"	Mri angio chest w or w/o dye"	B																																																																																																											
72010	"	X-ray exam spine ap&lat"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
72020	"	X-ray exam of spine 1 view"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
72040	"	X-ray exam neck spine 2-3 vw"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
72050	"	X-ray exam neck spine 4/5vws"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
72052	"	X-ray exam neck spine 6/>vws"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
72069	"	X-ray exam trunk spine stand"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
72070	"	X-ray exam thorac spine 2vws"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
72072	"	X-ray exam thorac spine 3vws"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
72074	"	X-ray exam thorac spine4/>vw"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
72080	"	X-ray exam trunk spine 2 vws"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
72090	"	X-ray exam scloiosis erect"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
72100	"	X-ray exam l-s spine 2/3 vws"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
72110	"	X-ray exam l-2 spine 4/>vws"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
72114	"	X-ray exam l-s spine bending"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
72120	"	X-ray bend only l-s spine"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
72125	"	Ct neck spine w/o dye"	Q3	0332	1.7403	$126.47	$48.90	$25.30																																																																																																						
72126	"	Ct neck spine w/dye"	Q3	0283	3.4263	$249.00	$79.99	$49.80																																																																																																						
72127	"	Ct neck spine w/o & w/dye"	Q3	0333	3.8584	$280.40	$97.38	$56.08																																																																																																						
72128	"	Ct chest spine w/o dye"	Q3	0332	1.7403	$126.47	$48.90	$25.30																																																																																																						
72129	"	Ct chest spine w/dye"	Q3	0283	3.4263	$249.00	$79.99	$49.80																																																																																																						
72130	"	Ct chest spine w/o & w/dye"	Q3	0333	3.8584	$280.40	$97.38	$56.08																																																																																																						
72131	"	Ct lumbar spine w/o dye"	Q3	0332	1.7403	$126.47	$48.90	$25.30																																																																																																						
72132	"	Ct lumbar spine w/dye"	Q3	0283	3.4263	$249.00	$79.99	$49.80																																																																																																						
72133	"	Ct lumbar spine w/o & w/dye"	Q3	0333	3.8584	$280.40	$97.38	$56.08																																																																																																						
72141	"	Mri neck spine w/o dye"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
72142	"	Mri neck spine w/dye"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
72146	"	Mri chest spine w/o dye"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
72147	"	Mri chest spine w/dye"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
72148	"	Mri lumbar spine w/o dye"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
72149	"	Mri lumbar spine w/dye"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
72156	"	Mri neck spine w/o & w/dye"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
72157	"	Mri chest spine w/o & w/dye"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
72158	"	Mri lumbar spine w/o & w/dye"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
72159	"	Mr angio spine w/o&w/dye"	B																																																																																																											
72170	"	X-ray exam of pelvis"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
72190	"	X-ray exam of pelvis"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
72191	"	Ct angiograph pelv w/o&w/dye"	Q3	0662	4.0175	$291.96	$98.43	$58.40																																																																																																						
72192	"	Ct pelvis w/o dye"	Q3	0332	1.7403	$126.47	$48.90	$25.30																																																																																																						
72193	"	Ct pelvis w/dye"	Q3	0283	3.4263	$249.00	$79.99	$49.80																																																																																																						
72194	"	Ct pelvis w/o & w/dye"	Q3	0333	3.8584	$280.40	$97.38	$56.08																																																																																																						
72195	"	Mri pelvis w/o dye"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
72196	"	Mri pelvis w/dye"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
72197	"	Mri pelvis w/o & w/dye"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
72198	"	Mr angio pelvis w/o & w/dye"	B																																																																																																											
72200	"	X-ray exam si joints"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
72202	"	X-ray exam si joints 3/> vws"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
72220	"	X-ray exam sacrum tailbone"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
72240	"	Myelography neck spine"	Q2	0274	8.2207	$597.41	.	$119.49																																																																																																						
72255	"	Myelography thoracic spine"	Q2	0274	8.2207	$597.41	.	$119.49																																																																																																						
72265	"	Myelography l-s spine"	Q2	0274	8.2207	$597.41	.	$119.49																																																																																																						
72270	"	Myelogphy 2/> spine regions"	Q2	0274	8.2207	$597.41	.	$119.49																																																																																																						
72275	"	Epidurography"	N																																																																																																											
72285	"	Discography cerv/thor spine"	Q2	0388	37.9928	"$2,761.01"	.	$552.21																																																																																																						
72291	"	Perq verte/sacroplsty fluor"	N																																																																																																											
72292	"	Perq verte/sacroplsty ct"	N																																																																																																											
72295	"	X-ray of lower spine disk"	Q2	0388	37.9928	"$2,761.01"	.	$552.21																																																																																																						
73000	"	X-ray exam of collar bone"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73010	"	X-ray exam of shoulder blade"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73020	"	X-ray exam of shoulder"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73030	"	X-ray exam of shoulder"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73040	"	Contrast x-ray of shoulder"	Q2	0275	4.6693	$339.33	$68.90	$67.87																																																																																																						
73050	"	X-ray exam of shoulders"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73060	"	X-ray exam of humerus"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73070	"	X-ray exam of elbow"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73080	"	X-ray exam of elbow"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73085	"	Contrast x-ray of elbow"	Q2	0275	4.6693	$339.33	$68.90	$67.87																																																																																																						
73090	"	X-ray exam of forearm"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73092	"	X-ray exam of arm infant"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
73100	"	X-ray exam of wrist"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73110	"	X-ray exam of wrist"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73115	"	Contrast x-ray of wrist"	Q2	0275	4.6693	$339.33	$68.90	$67.87																																																																																																						
73120	"	X-ray exam of hand"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73130	"	X-ray exam of hand"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73140	"	X-ray exam of finger(s)"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73200	"	Ct upper extremity w/o dye"	Q3	0332	1.7403	$126.47	$48.90	$25.30																																																																																																						
73201	"	Ct upper extremity w/dye"	Q3	0283	3.4263	$249.00	$79.99	$49.80																																																																																																						
73202	"	Ct uppr extremity w/o&w/dye"	Q3	0333	3.8584	$280.40	$97.38	$56.08																																																																																																						
73206	"	Ct angio upr extrm w/o&w/dye"	Q3	0662	4.0175	$291.96	$98.43	$58.40																																																																																																						
73218	"	Mri upper extremity w/o dye"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
73219	"	Mri upper extremity w/dye"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
73220	"	Mri uppr extremity w/o&w/dye"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
73221	"	Mri joint upr extrem w/o dye"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
73222	"	Mri joint upr extrem w/dye"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
73223	"	Mri joint upr extr w/o&w/dye"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
73225	"	Mr angio upr extr w/o&w/dye"	B																																																																																																											
73500	"	X-ray exam of hip"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73510	"	X-ray exam of hip"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73520	"	X-ray exam of hips"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
73525	"	Contrast x-ray of hip"	Q2	0275	4.6693	$339.33	$68.90	$67.87																																																																																																						
73530	"	X-ray exam of hip"	N																																																																																																											
73540	"	X-ray exam of pelvis & hips"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73550	"	X-ray exam of thigh"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73560	"	X-ray exam of knee 1 or 2"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73562	"	X-ray exam of knee 3"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73564	"	X-ray exam knee 4 or more"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73565	"	X-ray exam of knees"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73580	"	Contrast x-ray of knee joint"	Q2	0275	4.6693	$339.33	$68.90	$67.87																																																																																																						
73590	"	X-ray exam of lower leg"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73592	"	X-ray exam of leg infant"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73600	"	X-ray exam of ankle"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73610	"	X-ray exam of ankle"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73615	"	Contrast x-ray of ankle"	Q2	0275	4.6693	$339.33	$68.90	$67.87																																																																																																						
73620	"	X-ray exam of foot"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73630	"	X-ray exam of foot"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73650	"	X-ray exam of heel"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73660	"	X-ray exam of toe(s)"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
73700	"	Ct lower extremity w/o dye"	Q3	0332	1.7403	$126.47	$48.90	$25.30																																																																																																						
73701	"	Ct lower extremity w/dye"	Q3	0283	3.4263	$249.00	$79.99	$49.80																																																																																																						
73702	"	Ct lwr extremity w/o&w/dye"	Q3	0333	3.8584	$280.40	$97.38	$56.08																																																																																																						
73706	"	Ct angio lwr extr w/o&w/dye"	Q3	0662	4.0175	$291.96	$98.43	$58.40																																																																																																						
73718	"	Mri lower extremity w/o dye"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
73719	"	Mri lower extremity w/dye"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
73720	"	Mri lwr extremity w/o&w/dye"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
73721	"	Mri jnt of lwr extre w/o dye"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
73722	"	Mri joint of lwr extr w/dye"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
73723	"	Mri joint lwr extr w/o&w/dye"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
73725	"	Mr ang lwr ext w or w/o dye"	B																																																																																																											
74000	"	X-ray exam of abdomen"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
74010	"	X-ray exam of abdomen"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
74020	"	X-ray exam of abdomen"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
74022	"	X-ray exam series abdomen"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
74150	"	Ct abdomen w/o dye"	Q3	0332	1.7403	$126.47	$48.90	$25.30																																																																																																						
74160	"	Ct abdomen w/dye"	Q3	0283	3.4263	$249.00	$79.99	$49.80																																																																																																						
74170	"	Ct abdomen w/o & w/dye"	Q3	0333	3.8584	$280.40	$97.38	$56.08																																																																																																						
74174	"	Ct angio abd&pelv w/o&w/dye"	S	0334	5.3683	$390.13	$125.73	$78.03																																																																																																						
74175	"	Ct angio abdom w/o & w/dye"	Q3	0662	4.0175	$291.96	$98.43	$58.40																																																																																																						
74176	"	Ct abd & pelvis w/o contrast"	Q3	0331	3.3271	$241.79	$93.48	$48.36																																																																																																						
74177	"	Ct abd & pelv w/contrast"	Q3	0334	5.3683	$390.13	$125.73	$78.03																																																																																																						
74178	"	Ct abd & pelv 1/> regns"	Q3	0334	5.3683	$390.13	$125.73	$78.03																																																																																																						
74181	"	Mri abdomen w/o dye"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
74182	"	Mri abdomen w/dye"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
74183	"	Mri abdomen w/o & w/dye"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
74185	"	Mri angio abdom w orw/o dye"	B																																																																																																											
74190	"	X-ray exam of peritoneum"	Q2	0317	10.1647	$738.69	.	$147.74																																																																																																						
74210	"	Contrst x-ray exam of throat"	S	0276	1.4014	$101.84	$32.84	$20.37																																																																																																						
74220	"	Contrast x-ray esophagus"	S	0276	1.4014	$101.84	$32.84	$20.37																																																																																																						
74230	"	Cine/vid x-ray throat/esoph"	S	0276	1.4014	$101.84	$32.84	$20.37																																																																																																						
74235	"	Remove esophagus obstruction"	N																																																																																																											
74240	"	X-ray upper gi delay w/o kub"	S	0277	2.0810	$151.23	$46.51	$30.25																																																																																																						
74241	"	X-rayupper gi delay w/kub"	S	0277	2.0810	$151.23	$46.51	$30.25																																																																																																						
74245	"	X-ray upper gi&small intest"	S	0277	2.0810	$151.23	$46.51	$30.25																																																																																																						
74246	"	Contrst x-ray uppr gi tract"	S	0277	2.0810	$151.23	$46.51	$30.25																																																																																																						
74247	"	Contrst x-ray uppr gi tract"	S	0277	2.0810	$151.23	$46.51	$30.25																																																																																																						
74249	"	Contrst x-ray uppr gi tract"	S	0277	2.0810	$151.23	$46.51	$30.25																																																																																																						
74250	"	X-ray exam of small bowel"	S	0276	1.4014	$101.84	$32.84	$20.37																																																																																																						
74251	"	X-ray exam of small bowel"	S	0277	2.0810	$151.23	$46.51	$30.25																																																																																																						
74260	"	X-ray exam of small bowel"	S	0276	1.4014	$101.84	$32.84	$20.37																																																																																																						
74261	"	Ct colonography dx"	Q3	0332	1.7403	$126.47	$48.90	$25.30																																																																																																						
74262	"	Ct colonography dx w/dye"	Q3	0283	3.4263	$249.00	$79.99	$49.80																																																																																																						
74263	"	Ct colonography screening"	E																																																																																																											
74270	"	Contrast x-ray exam of colon"	S	0277	2.0810	$151.23	$46.51	$30.25																																																																																																						
74280	"	Contrast x-ray exam of colon"	S	0277	2.0810	$151.23	$46.51	$30.25																																																																																																						
74283	"	Contrast x-ray exam of colon"	S	0277	2.0810	$151.23	$46.51	$30.25																																																																																																						
74290	"	Contrast x-ray gallbladder"	S	0276	1.4014	$101.84	$32.84	$20.37																																																																																																						
74291	"	Contrast x-rays gallbladder"	S	0276	1.4014	$101.84	$32.84	$20.37																																																																																																						
74300	"	X-ray bile ducts/pancreas"	N																																																																																																											
74301	"	X-rays at surgery add-on"	N																																																																																																											
74305	"	X-ray bile ducts/pancreas"	Q2	0263	4.3746	$317.91	.	$63.59																																																																																																						
74320	"	Contrast x-ray of bile ducts"	Q2	0317	10.1647	$738.69	.	$147.74																																																																																																						
74327	"	X-ray bile stone removal"	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	0278	3.5447	$257.60	$58.44	$51.52																																																																																																						
74410	"	Contrst x-ray urinary tract"	S	0278	3.5447	$257.60	$58.44	$51.52																																																																																																						
74415	"	Contrst x-ray urinary tract"	S	0278	3.5447	$257.60	$58.44	$51.52																																																																																																						
74420	"	Contrst x-ray urinary tract"	S	0278	3.5447	$257.60	$58.44	$51.52																																																																																																						
74425	"	Contrst x-ray urinary tract"	Q2	0278	3.5447	$257.60	$58.44	$51.52																																																																																																						
74430	"	Contrast x-ray bladder"	Q2	0278	3.5447	$257.60	$58.44	$51.52																																																																																																						
74440	"	X-ray male genital tract"	Q2	0278	3.5447	$257.60	$58.44	$51.52																																																																																																						
74445	"	X-ray exam of penis"	Q2	0278	3.5447	$257.60	$58.44	$51.52																																																																																																						
74450	"	X-ray urethra/bladder"	Q2	0278	3.5447	$257.60	$58.44	$51.52																																																																																																						
74455	"	X-ray urethra/bladder"	Q2	0278	3.5447	$257.60	$58.44	$51.52																																																																																																						
74470	"	X-ray exam of kidney lesion"	Q2	0317	10.1647	$738.69	.	$147.74																																																																																																						
74475	"	X-ray control cath insert"	Q2	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
74480	"	X-ray control cath insert"	Q2	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
74485	"	X-ray guide gu dilation"	Q2	0161	16.5786	"$1,204.80"	.	$240.96																																																																																																						
74710	"	X-ray measurement of pelvis"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
74740	"	X-ray female genital tract"	Q2	0263	4.3746	$317.91	.	$63.59																																																																																																						
74742	"	X-ray fallopian tube"	N																																																																																																											
74775	"	X-ray exam of perineum"	S	0278	3.5447	$257.60	$58.44	$51.52																																																																																																						
75557	"	Cardiac mri for morph"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
75559	"	Cardiac mri w/stress img"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
75561	"	Cardiac mri for morph w/dye"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
75563	"	Card mri w/stress img & dye"	Q3	0377	15.8743	"$1,153.62"	.	$230.73																																																																																																						
75565	"	Card mri veloc flow mapping"	N																																																																																																											
75571	"	Ct hrt w/o dye w/ca test"	X	0035	0.3042	$22.11	.	$4.43																																																																																																						
75572	"	Ct hrt w/3d image"	S	0383	3.0549	$222.01	.	$44.41																																																																																																						
75573	"	Ct hrt w/3d image congen"	S	0383	3.0549	$222.01	.	$44.41																																																																																																						
75574	"	Ct angio hrt w/3d image"	S	0383	3.0549	$222.01	.	$44.41																																																																																																						
75600	"	Contrast exam thoracic aorta"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75605	"	Contrast exam thoracic aorta"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75625	"	Contrast exam abdominl aorta"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75630	"	X-ray aorta leg arteries"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75635	"	Ct angio abdominal arteries"	Q2	0662	4.0175	$291.96	$98.43	$58.40																																																																																																						
75658	"	Artery x-rays arm"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75705	"	Artery x-rays spine"	Q2	0280	62.1095	"$4,513.62"	.	$902.73																																																																																																						
75710	"	Artery x-rays arm/leg"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75716	"	Artery x-rays arms/legs"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75726	"	Artery x-rays abdomen"	Q2	0280	62.1095	"$4,513.62"	.	$902.73																																																																																																						
75731	"	Artery x-rays adrenal gland"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75733	"	Artery x-rays adrenals"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75736	"	Artery x-rays pelvis"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75741	"	Artery x-rays lung"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75743	"	Artery x-rays lungs"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75746	"	Artery x-rays lung"	Q2	0668	11.3792	$826.95	.	$165.39																																																																																																						
75756	"	Artery x-rays chest"	Q2	0668	11.3792	$826.95	.	$165.39																																																																																																						
75774	"	Artery x-ray each vessel"	N																																																																																																											
75791	"	Av dialysis shunt imaging"	Q2	0668	11.3792	$826.95	.	$165.39																																																																																																						
75801	"	Lymph vessel x-ray arm/leg"	Q2	0263	4.3746	$317.91	.	$63.59																																																																																																						
75803	"	Lymph vessel x-ray arms/legs"	Q2	0317	10.1647	$738.69	.	$147.74																																																																																																						
75805	"	Lymph vessel x-ray trunk"	Q2	0317	10.1647	$738.69	.	$147.74																																																																																																						
75807	"	Lymph vessel x-ray trunk"	Q2	0317	10.1647	$738.69	.	$147.74																																																																																																						
75809	"	Nonvascular shunt x-ray"	Q2	0261	1.2507	$90.89	.	$18.18																																																																																																						
75810	"	Vein x-ray spleen/liver"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75820	"	Vein x-ray arm/leg"	Q2	0668	11.3792	$826.95	.	$165.39																																																																																																						
75822	"	Vein x-ray arms/legs"	Q2	0317	10.1647	$738.69	.	$147.74																																																																																																						
75825	"	Vein x-ray trunk"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75827	"	Vein x-ray chest"	Q2	0668	11.3792	$826.95	.	$165.39																																																																																																						
75831	"	Vein x-ray kidney"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75833	"	Vein x-ray kidneys"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75840	"	Vein x-ray adrenal gland"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75842	"	Vein x-ray adrenal glands"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75860	"	Vein x-ray neck"	Q2	0668	11.3792	$826.95	.	$165.39																																																																																																						
75870	"	Vein x-ray skull"	Q2	0263	4.3746	$317.91	.	$63.59																																																																																																						
75872	"	Vein x-ray skull epidural"	Q2	0668	11.3792	$826.95	.	$165.39																																																																																																						
75880	"	Vein x-ray eye socket"	Q2	0668	11.3792	$826.95	.	$165.39																																																																																																						
75885	"	Vein x-ray liver w/hemodynam"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75887	"	Vein x-ray liver w/o hemodyn"	Q2	0668	11.3792	$826.95	.	$165.39																																																																																																						
75889	"	Vein x-ray liver w/hemodynam"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75891	"	Vein x-ray liver"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75893	"	Venous sampling by catheter"	Q2	0279	35.4530	"$2,576.44"	.	$515.29																																																																																																						
75894	"	X-rays transcath therapy"	N																																																																																																											
75896	"	X-rays transcath therapy"	N																																																																																																											
75898	"	Follow-up angiography"	Q1	0668	11.3792	$826.95	.	$165.39																																																																																																						
75901	"	Remove cva device obstruct"	N																																																																																																											
75902	"	Remove cva lumen obstruct"	N																																																																																																											
75945	"	Intravascular us"	Q2	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
75946	"	Intravascular us add-on"	N																																																																																																											
75952	"	Endovasc repair abdom aorta"	C																																																																																																											
75953	"	Abdom aneurysm endovas rpr"	C																																																																																																											
75954	"	Iliac aneurysm endovas rpr"	C																																																																																																											
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																																																																																																											
75962	"	Repair arterial blockage"	N																																																																																																											
75964	"	Repair artery blockage each"	N																																																																																																											
75966	"	Repair arterial blockage"	N																																																																																																											
75968	"	Repair artery blockage each"	N																																																																																																											
75970	"	Vascular biopsy"	N																																																																																																											
75978	"	Repair venous blockage"	Q2	0093	39.1718	"$2,846.69"	.	$569.34																																																																																																						
75980	"	Contrast xray exam bile duct"	N																																																																																																											
75982	"	Contrast xray exam bile duct"	N																																																																																																											
75984	"	Xray control catheter change"	N																																																																																																											
75989	"	Abscess drainage under x-ray"	N																																																																																																											
76000	"	Fluoroscope examination"	Q1	0272	2.1559	$156.67	.	$31.34																																																																																																						
76001	"	Fluoroscope exam extensive"	N																																																																																																											
76010	"	X-ray nose to rectum"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
76080	"	X-ray exam of fistula"	Q2	0263	4.3746	$317.91	.	$63.59																																																																																																						
76098	"	X-ray exam breast specimen"	Q2	0263	4.3746	$317.91	.	$63.59																																																																																																						
76100	"	X-ray exam of body section"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
76101	"	Complex body section x-ray"	X	0263	4.3746	$317.91	.	$63.59																																																																																																						
76102	"	Complex body section x-rays"	X	0263	4.3746	$317.91	.	$63.59																																																																																																						
76120	"	Cine/video x-rays"	X	0272	2.1559	$156.67	.	$31.34																																																																																																						
76125	"	Cine/video x-rays add-on"	N																																																																																																											
76140	"	X-ray consultation"	E																																																																																																											
76376	"	3d render w/intrp postproces"	N																																																																																																											
76377	"	3d render w/intrp postproces"	N																																																																																																											
76380	"	Cat scan follow-up study"	S	0282	1.0948	$79.56	$26.51	$15.92																																																																																																						
76390	"	Mr spectroscopy"	E																																																																																																											
76496	"	Fluoroscopic procedure"	X	0272	2.1559	$156.67	.	$31.34																																																																																																						
76497	"	Ct procedure"	S	0282	1.0948	$79.56	$26.51	$15.92																																																																																																						
76498	"	Mri procedure"	S	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
76499	"	Radiographic procedure"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
76506	"	Echo exam of head"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76510	"	Ophth us b & quant a"	T	0232	2.3720	$172.38	.	$34.48																																																																																																						
76511	"	Ophth us quant a only"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76512	"	Ophth us b w/non-quant a"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76513	"	Echo exam of eye water bath"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76514	"	Echo exam of eye thickness"	X	0035	0.3042	$22.11	.	$4.43																																																																																																						
76516	"	Echo exam of eye"	S	0265	1.2391	$90.05	$22.26	$18.01																																																																																																						
76519	"	Echo exam of eye"	S	0265	1.2391	$90.05	$22.26	$18.01																																																																																																						
76529	"	Echo exam of eye"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76536	"	Us exam of head and neck"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76604	"	Us exam chest"	Q3	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76645	"	Us exam breast(s)"	S	0265	1.2391	$90.05	$22.26	$18.01																																																																																																						
76700	"	Us exam abdom complete"	Q3	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76705	"	Echo exam of abdomen"	Q3	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76770	"	Us exam abdo back wall comp"	Q3	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76775	"	Us exam abdo back wall lim"	Q3	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76776	"	Us exam k transpl w/doppler"	Q3	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76800	"	Us exam spinal canal"	S	0265	1.2391	$90.05	$22.26	$18.01																																																																																																						
76801	"	Ob us < 14 wks single fetus"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76802	"	Ob us < 14 wks addl fetus"	N																																																																																																											
76805	"	Ob us >/= 14 wks sngl fetus"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76810	"	Ob us >/= 14 wks addl fetus"	N																																																																																																											
76811	"	Ob us detailed sngl fetus"	S	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
76812	"	Ob us detailed addl fetus"	N																																																																																																											
76813	"	Ob us nuchal meas 1 gest"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76814	"	Ob us nuchal meas add-on"	N																																																																																																											
76815	"	Ob us limited fetus(s)"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76816	"	Ob us follow-up per fetus"	S	0265	1.2391	$90.05	$22.26	$18.01																																																																																																						
76817	"	Transvaginal us obstetric"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76818	"	Fetal biophys profile w/nst"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76819	"	Fetal biophys profil w/o nst"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76820	"	Umbilical artery echo"	S	0265	1.2391	$90.05	$22.26	$18.01																																																																																																						
76821	"	Middle cerebral artery echo"	S	0265	1.2391	$90.05	$22.26	$18.01																																																																																																						
76825	"	Echo exam of fetal heart"	S	0697	3.4494	$250.67	.	$50.14																																																																																																						
76826	"	Echo exam of fetal heart"	S	0697	3.4494	$250.67	.	$50.14																																																																																																						
76827	"	Echo exam of fetal heart"	S	0265	1.2391	$90.05	$22.26	$18.01																																																																																																						
76828	"	Echo exam of fetal heart"	S	0265	1.2391	$90.05	$22.26	$18.01																																																																																																						
76830	"	Transvaginal us non-ob"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76831	"	Echo exam uterus"	Q3	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
76856	"	Us exam pelvic complete"	Q3	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76857	"	Us exam pelvic limited"	Q3	0265	1.2391	$90.05	$22.26	$18.01																																																																																																						
76870	"	Us exam scrotum"	Q3	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76872	"	Us transrectal"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76873	"	Echograp trans r pros study"	S	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
76881	"	Us xtr non-vasc complete"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
76882	"	Us xtr non-vasc lmtd"	S	0265	1.2391	$90.05	$22.26	$18.01																																																																																																						
76885	"	Us exam infant hips dynamic"	S	0265	1.2391	$90.05	$22.26	$18.01																																																																																																						
76886	"	Us exam infant hips static"	S	0265	1.2391	$90.05	$22.26	$18.01																																																																																																						
76930	"	Echo guide cardiocentesis"	N																																																																																																											
76932	"	Echo guide for heart biopsy"	N																																																																																																											
76936	"	Echo guide for artery repair"	S	0096	1.8035	$131.06	$36.86	$26.22																																																																																																						
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																																																																																																											
76950	"	Echo guidance radiotherapy"	N																																																																																																											
76965	"	Echo guidance radiotherapy"	N																																																																																																											
76970	"	Ultrasound exam follow-up"	S	0265	1.2391	$90.05	$22.26	$18.01																																																																																																						
76975	"	Gi endoscopic ultrasound"	Q2	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
76977	"	Us bone density measure"	X	0340	0.7353	$53.44	$0.00	$0.00																																																																																																						
76998	"	Us guide intraop"	N																																																																																																											
76999	"	Echo examination procedure"	S	0265	1.2391	$90.05	$22.26	$18.01																																																																																																						
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	"	Mr guidance for needle place"	N																																																																																																											
77022	"	Mri for tissue ablation"	N																																																																																																											
77051	"	Computer dx mammogram add-on"	A																																																																																																											
77052	"	Comp screen mammogram add-on"	A																																																																																																											
77053	"	X-ray of mammary duct"	Q2	0263	4.3746	$317.91	.	$63.59																																																																																																						
77054	"	X-ray of mammary ducts"	Q2	0263	4.3746	$317.91	.	$63.59																																																																																																						
77055	"	Mammogram one breast"	A																																																																																																											
77056	"	Mammogram both breasts"	A																																																																																																											
77057	"	Mammogram screening"	A																																																																																																											
77058	"	Mri one breast"	B																																																																																																											
77059	"	Mri both breasts"	B																																																																																																											
77071	"	X-ray stress view"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
77072	"	X-rays for bone age"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
77073	"	X-rays bone length studies"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
77074	"	X-rays bone survey limited"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
77075	"	X-rays bone survey complete"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
77076	"	X-rays bone survey infant"	X	0261	1.2507	$90.89	.	$18.18																																																																																																						
77077	"	Joint survey single view"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
77078	"	Ct bone density axial"	S	0288	1.2407	$90.16	$0.00	$0.00																																																																																																						
77080	"	Dxa bone density axial"	S	0288	1.2407	$90.16	$0.00	$0.00																																																																																																						
77081	"	Dxa bone density/peripheral"	S	0665	0.7047	$51.21	$0.00	$0.00																																																																																																						
77082	"	Dxa bone density vert fx"	X	0260	0.7891	$57.35	.	$11.47																																																																																																						
77084	"	Magnetic image bone marrow"	S	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
77261	"	Radiation therapy planning"	B																																																																																																											
77262	"	Radiation therapy planning"	B																																																																																																											
77263	"	Radiation therapy planning"	B																																																																																																											
77280	"	Set radiation therapy field"	X	0304	1.5776	$114.65	$34.63	$22.93																																																																																																						
77285	"	Set radiation therapy field"	X	0305	4.2846	$311.37	$88.78	$62.28																																																																																																						
77290	"	Set radiation therapy field"	X	0305	4.2846	$311.37	$88.78	$62.28																																																																																																						
77293	"	Respirator motion mgmt simul"	N																																																																																																											
77295	"	3-d radiotherapy plan"	X	0310	14.2612	"$1,036.39"	$325.27	$207.28																																																																																																						
77299	"	Radiation therapy planning"	X	0304	1.5776	$114.65	$34.63	$22.93																																																																																																						
77300	"	Radiation therapy dose plan"	X	0304	1.5776	$114.65	$34.63	$22.93																																																																																																						
77301	"	Radiotherapy dose plan imrt"	X	0310	14.2612	"$1,036.39"	$325.27	$207.28																																																																																																						
77305	"	Teletx isodose plan simple"	X	0304	1.5776	$114.65	$34.63	$22.93																																																																																																						
77310	"	Teletx isodose plan intermed"	X	0304	1.5776	$114.65	$34.63	$22.93																																																																																																						
77315	"	Teletx isodose plan complex"	X	0305	4.2846	$311.37	$88.78	$62.28																																																																																																						
77321	"	Special teletx port plan"	X	0305	4.2846	$311.37	$88.78	$62.28																																																																																																						
77326	"	Brachytx isodose calc simp"	X	0304	1.5776	$114.65	$34.63	$22.93																																																																																																						
77327	"	Brachytx isodose calc interm"	X	0305	4.2846	$311.37	$88.78	$62.28																																																																																																						
77328	"	Brachytx isodose plan compl"	X	0305	4.2846	$311.37	$88.78	$62.28																																																																																																						
77331	"	Special radiation dosimetry"	X	0304	1.5776	$114.65	$34.63	$22.93																																																																																																						
77332	"	Radiation treatment aid(s)"	X	0303	2.9377	$213.49	$66.95	$42.70																																																																																																						
77333	"	Radiation treatment aid(s)"	X	0303	2.9377	$213.49	$66.95	$42.70																																																																																																						
77334	"	Radiation treatment aid(s)"	X	0303	2.9377	$213.49	$66.95	$42.70																																																																																																						
77336	"	Radiation physics consult"	X	0304	1.5776	$114.65	$34.63	$22.93																																																																																																						
77338	"	Design mlc device for imrt"	X	0305	4.2846	$311.37	$88.78	$62.28																																																																																																						
77370	"	Radiation physics consult"	X	0304	1.5776	$114.65	$34.63	$22.93																																																																																																						
77371	"	Srs multisource"	S	0067	49.4227	"$3,591.65"	.	$718.33																																																																																																						
77372	"	Srs linear based"	S	0067	49.4227	"$3,591.65"	.	$718.33																																																																																																						
77373	"	Sbrt delivery"	S	0066	26.4380	"$1,921.30"	.	$384.26																																																																																																						
77399	"	External radiation dosimetry"	X	0304	1.5776	$114.65	$34.63	$22.93																																																																																																						
77401	"	Radiation treatment delivery"	S	0300	1.4346	$104.26	.	$20.86																																																																																																						
77402	"	Radiation treatment delivery"	S	0300	1.4346	$104.26	.	$20.86																																																																																																						
77403	"	Radiation treatment delivery"	S	0300	1.4346	$104.26	.	$20.86																																																																																																						
77404	"	Radiation treatment delivery"	S	0300	1.4346	$104.26	.	$20.86																																																																																																						
77406	"	Radiation treatment delivery"	S	0301	2.6458	$192.28	.	$38.46																																																																																																						
77407	"	Radiation treatment delivery"	S	0300	1.4346	$104.26	.	$20.86																																																																																																						
77408	"	Radiation treatment delivery"	S	0301	2.6458	$192.28	.	$38.46																																																																																																						
77409	"	Radiation treatment delivery"	S	0301	2.6458	$192.28	.	$38.46																																																																																																						
77411	"	Radiation treatment delivery"	S	0301	2.6458	$192.28	.	$38.46																																																																																																						
77412	"	Radiation treatment delivery"	S	0301	2.6458	$192.28	.	$38.46																																																																																																						
77413	"	Radiation treatment delivery"	S	0301	2.6458	$192.28	.	$38.46																																																																																																						
77414	"	Radiation treatment delivery"	S	0301	2.6458	$192.28	.	$38.46																																																																																																						
77416	"	Radiation treatment delivery"	S	0301	2.6458	$192.28	.	$38.46																																																																																																						
77417	"	Radiology port film(s)"	N																																																																																																											
77418	"	Radiation tx delivery imrt"	S	0412	7.0241	$510.46	.	$102.10																																																																																																						
77421	"	Stereoscopic x-ray guidance"	N																																																																																																											
77422	"	Neutron beam tx simple"	S	0301	2.6458	$192.28	.	$38.46																																																																																																						
77423	"	Neutron beam tx complex"	S	0301	2.6458	$192.28	.	$38.46																																																																																																						
77424	"	Io rad tx delivery by x-ray"	S	0065	17.1769	"$1,248.28"	.	$249.66																																																																																																						
77425	"	Io rad tx deliver by elctrns"	S	0065	17.1769	"$1,248.28"	.	$249.66																																																																																																						
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	0299	5.6861	$413.22	.	$82.65																																																																																																						
77499	"	Radiation therapy management"	B																																																																																																											
77520	"	Proton trmt simple w/o comp"	S	0664	12.0042	$872.37	.	$174.48																																																																																																						
77522	"	Proton trmt simple w/comp"	S	0664	12.0042	$872.37	.	$174.48																																																																																																						
77523	"	Proton trmt intermediate"	S	0667	16.5851	"$1,205.27"	.	$241.06																																																																																																						
77525	"	Proton treatment complex"	S	0667	16.5851	"$1,205.27"	.	$241.06																																																																																																						
77600	"	Hyperthermia treatment"	S	0299	5.6861	$413.22	.	$82.65																																																																																																						
77605	"	Hyperthermia treatment"	S	0299	5.6861	$413.22	.	$82.65																																																																																																						
77610	"	Hyperthermia treatment"	S	0299	5.6861	$413.22	.	$82.65																																																																																																						
77615	"	Hyperthermia treatment"	S	0299	5.6861	$413.22	.	$82.65																																																																																																						
77620	"	Hyperthermia treatment"	S	0299	5.6861	$413.22	.	$82.65																																																																																																						
77750	"	Infuse radioactive materials"	S	0301	2.6458	$192.28	.	$38.46																																																																																																						
77761	"	Apply intrcav radiat simple"	S	0312	4.9715	$361.29	.	$72.26																																																																																																						
77762	"	Apply intrcav radiat interm"	S	0312	4.9715	$361.29	.	$72.26																																																																																																						
77763	"	Apply intrcav radiat compl"	S	0312	4.9715	$361.29	.	$72.26																																																																																																						
77776	"	Apply interstit radiat simpl"	S	0312	4.9715	$361.29	.	$72.26																																																																																																						
77777	"	Apply interstit radiat inter"	S	0312	4.9715	$361.29	.	$72.26																																																																																																						
77778	"	Apply interstit radiat compl"	Q3	0651	13.7315	$997.90	.	$199.58																																																																																																						
77785	"	Hdr brachytx 1 channel"	S	0313	10.0974	$733.80	$259.86	$146.76																																																																																																						
77786	"	Hdr brachytx 2-12 channel"	S	0313	10.0974	$733.80	$259.86	$146.76																																																																																																						
77787	"	Hdr brachytx over 12 chan"	S	0313	10.0974	$733.80	$259.86	$146.76																																																																																																						
77789	"	Apply surface radiation"	S	0301	2.6458	$192.28	.	$38.46																																																																																																						
77790	"	Radiation handling"	N																																																																																																											
77799	"	Radium/radioisotope therapy"	S	0312	4.9715	$361.29	.	$72.26																																																																																																						
78012	"	Thyroid uptake measurement"	S	0389	1.9318	$140.39	.	$28.08																																																																																																						
78013	"	Thyroid imaging w/blood flow"	S	0390	2.5236	$183.40	$47.69	$36.68																																																																																																						
78014	"	Thyroid imaging w/blood flow"	S	0391	3.9484	$286.94	$65.46	$57.39																																																																																																						
78015	"	Thyroid met imaging"	S	0406	5.2671	$382.77	$85.06	$76.56																																																																																																						
78016	"	Thyroid met imaging/studies"	S	0406	5.2671	$382.77	$85.06	$76.56																																																																																																						
78018	"	Thyroid met imaging body"	S	0406	5.2671	$382.77	$85.06	$76.56																																																																																																						
78020	"	Thyroid met uptake"	N																																																																																																											
78070	"	Parathyroid planar imaging"	S	0391	3.9484	$286.94	$65.46	$57.39																																																																																																						
78071	"	Parathyrd planar w/wo subtrj"	X	0317	10.1647	$738.69	.	$147.74																																																																																																						
78072	"	Parathyrd planar w/spect&ct"	X	0317	10.1647	$738.69	.	$147.74																																																																																																						
78075	"	Adrenal cortex & medulla img"	S	0408	15.9266	"$1,157.42"	.	$231.49																																																																																																						
78099	"	Endocrine nuclear procedure"	S	0390	2.5236	$183.40	$47.69	$36.68																																																																																																						
78102	"	Bone marrow imaging ltd"	S	0400	4.7658	$346.34	$90.90	$69.27																																																																																																						
78103	"	Bone marrow imaging mult"	S	0400	4.7658	$346.34	$90.90	$69.27																																																																																																						
78104	"	Bone marrow imaging body"	S	0400	4.7658	$346.34	$90.90	$69.27																																																																																																						
78110	"	Plasma volume single"	S	0393	7.7877	$565.95	.	$113.19																																																																																																						
78111	"	Plasma volume multiple"	S	0393	7.7877	$565.95	.	$113.19																																																																																																						
78120	"	Red cell mass single"	S	0393	7.7877	$565.95	.	$113.19																																																																																																						
78121	"	Red cell mass multiple"	S	0393	7.7877	$565.95	.	$113.19																																																																																																						
78122	"	Blood volume"	S	0393	7.7877	$565.95	.	$113.19																																																																																																						
78130	"	Red cell survival study"	S	0393	7.7877	$565.95	.	$113.19																																																																																																						
78135	"	Red cell survival kinetics"	S	0393	7.7877	$565.95	.	$113.19																																																																																																						
78140	"	Red cell sequestration"	S	0393	7.7877	$565.95	.	$113.19																																																																																																						
78185	"	Spleen imaging"	S	0400	4.7658	$346.34	$90.90	$69.27																																																																																																						
78190	"	Platelet survival kinetics"	S	0392	3.5423	$257.43	.	$51.49																																																																																																						
78191	"	Platelet survival"	S	0392	3.5423	$257.43	.	$51.49																																																																																																						
78195	"	Lymph system imaging"	S	0400	4.7658	$346.34	$90.90	$69.27																																																																																																						
78199	"	Blood/lymph nuclear exam"	S	0400	4.7658	$346.34	$90.90	$69.27																																																																																																						
78201	"	Liver imaging"	S	0394	5.1267	$372.57	$90.78	$74.52																																																																																																						
78202	"	Liver imaging with flow"	S	0394	5.1267	$372.57	$90.78	$74.52																																																																																																						
78205	"	Liver imaging (3d)"	S	0394	5.1267	$372.57	$90.78	$74.52																																																																																																						
78206	"	Liver image (3d) with flow"	S	0394	5.1267	$372.57	$90.78	$74.52																																																																																																						
78215	"	Liver and spleen imaging"	S	0394	5.1267	$372.57	$90.78	$74.52																																																																																																						
78216	"	Liver & spleen image/flow"	S	0394	5.1267	$372.57	$90.78	$74.52																																																																																																						
78226	"	Hepatobiliary system imaging"	S	0394	5.1267	$372.57	$90.78	$74.52																																																																																																						
78227	"	Hepatobil syst image w/drug"	S	0394	5.1267	$372.57	$90.78	$74.52																																																																																																						
78230	"	Salivary gland imaging"	S	0395	4.4553	$323.78	$87.01	$64.76																																																																																																						
78231	"	Serial salivary imaging"	S	0395	4.4553	$323.78	$87.01	$64.76																																																																																																						
78232	"	Salivary gland function exam"	S	0395	4.4553	$323.78	$87.01	$64.76																																																																																																						
78258	"	Esophageal motility study"	S	0395	4.4553	$323.78	$87.01	$64.76																																																																																																						
78261	"	Gastric mucosa imaging"	S	0395	4.4553	$323.78	$87.01	$64.76																																																																																																						
78262	"	Gastroesophageal reflux exam"	S	0395	4.4553	$323.78	$87.01	$64.76																																																																																																						
78264	"	Gastric emptying study"	S	0395	4.4553	$323.78	$87.01	$64.76																																																																																																						
78267	"	Breath tst attain/anal c-14"	A																																																																																																											
78268	"	Breath test analysis c-14"	A																																																																																																											
78270	"	Vit b-12 absorption exam"	S	0392	3.5423	$257.43	.	$51.49																																																																																																						
78271	"	Vit b-12 absrp exam int fac"	S	0392	3.5423	$257.43	.	$51.49																																																																																																						
78272	"	Vit b-12 absorp combined"	S	0392	3.5423	$257.43	.	$51.49																																																																																																						
78278	"	Acute gi blood loss imaging"	S	0395	4.4553	$323.78	$87.01	$64.76																																																																																																						
78282	"	Gi protein loss exam"	S	0395	4.4553	$323.78	$87.01	$64.76																																																																																																						
78290	"	Meckels divert exam"	S	0395	4.4553	$323.78	$87.01	$64.76																																																																																																						
78291	"	Leveen/shunt patency exam"	S	0395	4.4553	$323.78	$87.01	$64.76																																																																																																						
78299	"	Gi nuclear procedure"	S	0395	4.4553	$323.78	$87.01	$64.76																																																																																																						
78300	"	Bone imaging limited area"	S	0396	4.4576	$323.94	$94.20	$64.79																																																																																																						
78305	"	Bone imaging multiple areas"	S	0396	4.4576	$323.94	$94.20	$64.79																																																																																																						
78306	"	Bone imaging whole body"	S	0396	4.4576	$323.94	$94.20	$64.79																																																																																																						
78315	"	Bone imaging 3 phase"	S	0396	4.4576	$323.94	$94.20	$64.79																																																																																																						
78320	"	Bone imaging (3d)"	S	0396	4.4576	$323.94	$94.20	$64.79																																																																																																						
78350	"	Bone mineral single photon"	E																																																																																																											
78351	"	Bone mineral dual photon"	E																																																																																																											
78399	"	Musculoskeletal nuclear exam"	S	0396	4.4576	$323.94	$94.20	$64.79																																																																																																						
78414	"	Non-imaging heart function"	S	0398	5.2717	$383.10	$93.33	$76.62																																																																																																						
78428	"	Cardiac shunt imaging"	S	0398	5.2717	$383.10	$93.33	$76.62																																																																																																						
78445	"	Vascular flow imaging"	X	0263	4.3746	$317.91	.	$63.59																																																																																																						
78451	"	Ht muscle image spect sing"	S	0377	15.8743	"$1,153.62"	.	$230.73																																																																																																						
78452	"	Ht muscle image spect mult"	S	0377	15.8743	"$1,153.62"	.	$230.73																																																																																																						
78453	"	Ht muscle image planar sing"	S	0377	15.8743	"$1,153.62"	.	$230.73																																																																																																						
78454	"	Ht musc image planar mult"	S	0377	15.8743	"$1,153.62"	.	$230.73																																																																																																						
78456	"	Acute venous thrombus image"	X	0317	10.1647	$738.69	.	$147.74																																																																																																						
78457	"	Venous thrombosis imaging"	X	0263	4.3746	$317.91	.	$63.59																																																																																																						
78458	"	Ven thrombosis images bilat"	X	0263	4.3746	$317.91	.	$63.59																																																																																																						
78459	"	Heart muscle imaging (pet)"	S	0308	18.0344	"$1,310.60"	.	$262.12																																																																																																						
78466	"	Heart infarct image"	S	0398	5.2717	$383.10	$93.33	$76.62																																																																																																						
78468	"	Heart infarct image (ef)"	S	0398	5.2717	$383.10	$93.33	$76.62																																																																																																						
78469	"	Heart infarct image (3d)"	S	0398	5.2717	$383.10	$93.33	$76.62																																																																																																						
78472	"	Gated heart planar single"	S	0398	5.2717	$383.10	$93.33	$76.62																																																																																																						
78473	"	Gated heart multiple"	S	0398	5.2717	$383.10	$93.33	$76.62																																																																																																						
78481	"	Heart first pass single"	S	0398	5.2717	$383.10	$93.33	$76.62																																																																																																						
78483	"	Heart first pass multiple"	S	0377	15.8743	"$1,153.62"	.	$230.73																																																																																																						
78491	"	Heart image (pet) single"	S	0308	18.0344	"$1,310.60"	.	$262.12																																																																																																						
78492	"	Heart image (pet) multiple"	S	0308	18.0344	"$1,310.60"	.	$262.12																																																																																																						
78494	"	Heart image spect"	S	0398	5.2717	$383.10	$93.33	$76.62																																																																																																						
78496	"	Heart first pass add-on"	N																																																																																																											
78499	"	Cardiovascular nuclear exam"	S	0398	5.2717	$383.10	$93.33	$76.62																																																																																																						
78579	"	Lung ventilation imaging"	S	0401	4.2109	$306.01	$71.16	$61.21																																																																																																						
78580	"	Lung perfusion imaging"	S	0401	4.2109	$306.01	$71.16	$61.21																																																																																																						
78582	"	Lung ventilat&perfus imaging"	S	0378	5.9289	$430.87	$126.64	$86.18																																																																																																						
78597	"	Lung perfusion differential"	S	0401	4.2109	$306.01	$71.16	$61.21																																																																																																						
78598	"	Lung perf&ventilat diferentl"	S	0378	5.9289	$430.87	$126.64	$86.18																																																																																																						
78599	"	Respiratory nuclear exam"	S	0401	4.2109	$306.01	$71.16	$61.21																																																																																																						
78600	"	Brain image < 4 views"	S	0403	2.2385	$162.68	$44.61	$32.54																																																																																																						
78601	"	Brain image w/flow < 4 views"	S	0402	7.3368	$533.18	.	$106.64																																																																																																						
78605	"	Brain image 4+ views"	S	0402	7.3368	$533.18	.	$106.64																																																																																																						
78606	"	Brain image w/flow 4 + views"	S	0402	7.3368	$533.18	.	$106.64																																																																																																						
78607	"	Brain imaging (3d)"	S	0408	15.9266	"$1,157.42"	.	$231.49																																																																																																						
78608	"	Brain imaging (pet)"	S	0308	18.0344	"$1,310.60"	.	$262.12																																																																																																						
78609	"	Brain imaging (pet)"	E																																																																																																											
78610	"	Brain flow imaging only"	S	0402	7.3368	$533.18	.	$106.64																																																																																																						
78630	"	Cerebrospinal fluid scan"	S	0402	7.3368	$533.18	.	$106.64																																																																																																						
78635	"	Csf ventriculography"	S	0402	7.3368	$533.18	.	$106.64																																																																																																						
78645	"	Csf shunt evaluation"	S	0402	7.3368	$533.18	.	$106.64																																																																																																						
78647	"	Cerebrospinal fluid scan"	S	0402	7.3368	$533.18	.	$106.64																																																																																																						
78650	"	Csf leakage imaging"	S	0402	7.3368	$533.18	.	$106.64																																																																																																						
78660	"	Nuclear exam of tear flow"	S	0403	2.2385	$162.68	$44.61	$32.54																																																																																																						
78699	"	Nervous system nuclear exam"	S	0403	2.2385	$162.68	$44.61	$32.54																																																																																																						
78700	"	Kidney imaging morphol"	S	0404	5.7384	$417.02	.	$83.41																																																																																																						
78701	"	Kidney imaging with flow"	S	0404	5.7384	$417.02	.	$83.41																																																																																																						
78707	"	K flow/funct image w/o drug"	S	0404	5.7384	$417.02	.	$83.41																																																																																																						
78708	"	K flow/funct image w/drug"	S	0404	5.7384	$417.02	.	$83.41																																																																																																						
78709	"	K flow/funct image multiple"	S	0404	5.7384	$417.02	.	$83.41																																																																																																						
78710	"	Kidney imaging (3d)"	S	0404	5.7384	$417.02	.	$83.41																																																																																																						
78725	"	Kidney function study"	S	0392	3.5423	$257.43	.	$51.49																																																																																																						
78730	"	Urinary bladder retention"	N																																																																																																											
78740	"	Ureteral reflux study"	S	0404	5.7384	$417.02	.	$83.41																																																																																																						
78761	"	Testicular imaging w/flow"	S	0404	5.7384	$417.02	.	$83.41																																																																																																						
78799	"	Genitourinary nuclear exam"	S	0404	5.7384	$417.02	.	$83.41																																																																																																						
78800	"	Tumor imaging limited area"	S	0406	5.2671	$382.77	$85.06	$76.56																																																																																																						
78801	"	Tumor imaging mult areas"	S	0406	5.2671	$382.77	$85.06	$76.56																																																																																																						
78802	"	Tumor imaging whole body"	S	0414	9.0402	$656.97	.	$131.40																																																																																																						
78803	"	Tumor imaging (3d)"	S	0414	9.0402	$656.97	.	$131.40																																																																																																						
78804	"	Tumor imaging whole body"	S	0408	15.9266	"$1,157.42"	.	$231.49																																																																																																						
78805	"	Abscess imaging ltd area"	S	0414	9.0402	$656.97	.	$131.40																																																																																																						
78806	"	Abscess imaging whole body"	S	0414	9.0402	$656.97	.	$131.40																																																																																																						
78807	"	Nuclear localization/abscess"	S	0414	9.0402	$656.97	.	$131.40																																																																																																						
78808	"	Iv inj ra drug dx study"	Q1	0392	3.5423	$257.43	.	$51.49																																																																																																						
78811	"	Pet image ltd area"	S	0308	18.0344	"$1,310.60"	.	$262.12																																																																																																						
78812	"	Pet image skull-thigh"	S	0308	18.0344	"$1,310.60"	.	$262.12																																																																																																						
78813	"	Pet image full body"	S	0308	18.0344	"$1,310.60"	.	$262.12																																																																																																						
78814	"	Pet image w/ct lmtd"	S	0308	18.0344	"$1,310.60"	.	$262.12																																																																																																						
78815	"	Pet image w/ct skull-thigh"	S	0308	18.0344	"$1,310.60"	.	$262.12																																																																																																						
78816	"	Pet image w/ct full body"	S	0308	18.0344	"$1,310.60"	.	$262.12																																																																																																						
78999	"	Nuclear diagnostic exam"	S	0389	1.9318	$140.39	.	$28.08																																																																																																						
79005	"	Nuclear rx oral admin"	S	0407	3.5200	$255.81	$78.13	$51.17																																																																																																						
79101	"	Nuclear rx iv admin"	S	0407	3.5200	$255.81	$78.13	$51.17																																																																																																						
79200	"	Nuclear rx intracav admin"	S	0413	4.9081	$356.68	.	$71.34																																																																																																						
79300	"	Nuclr rx interstit colloid"	S	0407	3.5200	$255.81	$78.13	$51.17																																																																																																						
79403	"	Hematopoietic nuclear tx"	S	0413	4.9081	$356.68	.	$71.34																																																																																																						
79440	"	Nuclear rx intra-articular"	S	0413	4.9081	$356.68	.	$71.34																																																																																																						
79445	"	Nuclear rx intra-arterial"	S	0407	3.5200	$255.81	$78.13	$51.17																																																																																																						
79999	"	Nuclear medicine therapy"	S	0407	3.5200	$255.81	$78.13	$51.17																																																																																																						
80047	"	Metabolic panel ionized ca"	N																																																																																																											
80048	"	Metabolic panel total ca"	N																																																																																																											
80050	"	General health panel"	E																																																																																																											
80051	"	Electrolyte panel"	N																																																																																																											
80053	"	Comprehen metabolic panel"	N																																																																																																											
80055	"	Obstetric panel"	E																																																																																																											
80061	"	Lipid panel"	N																																																																																																											
80069	"	Renal function panel"	N																																																																																																											
80074	"	Acute hepatitis panel"	N																																																																																																											
80076	"	Hepatic function panel"	N																																																																																																											
80100	"	Drug screen qualitate/multi"	E																																																																																																											
80101	"	Drug screen single"	E																																																																																																											
80102	"	Drug confirmation"	N																																																																																																											
80103	"	Drug analysis tissue prep"	N																																																																																																											
80104	"	Drug scrn 1+ class nonchromo"	E																																																																																																											
80150	"	Assay of amikacin"	N																																																																																																											
80152	"	Assay of amitriptyline"	N																																																																																																											
80154	"	Assay of benzodiazepines"	N																																																																																																											
80155	"	Drug screen quant caffeine"	A																																																																																																											
80156	"	Assay carbamazepine total"	N																																																																																																											
80157	"	Assay carbamazepine free"	N																																																																																																											
80158	"	Assay of cyclosporine"	N																																																																																																											
80159	"	Drug screen quant clozapine"	A																																																																																																											
80160	"	Assay of desipramine"	N																																																																																																											
80162	"	Assay of digoxin"	N																																																																																																											
80164	"	Assay dipropylacetic acid"	N																																																																																																											
80166	"	Assay of doxepin"	N																																																																																																											
80168	"	Assay of ethosuximide"	N																																																																																																											
80169	"	Drug screen quant everolimus"	A																																																																																																											
80170	"	Assay of gentamicin"	N																																																																																																											
80171	"	Drug screen quant gabapentin"	A																																																																																																											
80172	"	Assay of gold"	N																																																																																																											
80173	"	Assay of haloperidol"	N																																																																																																											
80174	"	Assay of imipramine"	N																																																																																																											
80175	"	Drug screen quan lamotrigine"	A																																																																																																											
80176	"	Assay of lidocaine"	N																																																																																																											
80177	"	Drug scrn quan levetiracetam"	A																																																																																																											
80178	"	Assay of lithium"	N																																																																																																											
80180	"	Drug scrn quan mycophenolate"	A																																																																																																											
80182	"	Assay of nortriptyline"	N																																																																																																											
80183	"	Drug scrn quant oxcarbazepin"	A																																																																																																											
80184	"	Assay of phenobarbital"	N																																																																																																											
80185	"	Assay of phenytoin total"	N																																																																																																											
80186	"	Assay of phenytoin free"	N																																																																																																											
80188	"	Assay of primidone"	N																																																																																																											
80190	"	Assay of procainamide"	N																																																																																																											
80192	"	Assay of procainamide"	N																																																																																																											
80194	"	Assay of quinidine"	N																																																																																																											
80195	"	Assay of sirolimus"	N																																																																																																											
80196	"	Assay of salicylate"	N																																																																																																											
80197	"	Assay of tacrolimus"	N																																																																																																											
80198	"	Assay of theophylline"	N																																																																																																											
80199	"	Drug screen quant tiagabine"	A																																																																																																											
80200	"	Assay of tobramycin"	N																																																																																																											
80201	"	Assay of topiramate"	N																																																																																																											
80202	"	Assay of vancomycin"	N																																																																																																											
80203	"	Drug screen quant zonisamide"	A																																																																																																											
80299	"	Quantitative assay drug"	N																																																																																																											
80400	"	Acth stimulation panel"	N																																																																																																											
80402	"	Acth stimulation panel"	N																																																																																																											
80406	"	Acth stimulation panel"	N																																																																																																											
80408	"	Aldosterone suppression eval"	N																																																																																																											
80410	"	Calcitonin stimul panel"	N																																																																																																											
80412	"	Crh stimulation panel"	N																																																																																																											
80414	"	Testosterone response"	N																																																																																																											
80415	"	Estradiol response panel"	N																																																																																																											
80416	"	Renin stimulation panel"	N																																																																																																											
80417	"	Renin stimulation panel"	N																																																																																																											
80418	"	Pituitary evaluation panel"	N																																																																																																											
80420	"	Dexamethasone panel"	N																																																																																																											
80422	"	Glucagon tolerance panel"	N																																																																																																											
80424	"	Glucagon tolerance panel"	N																																																																																																											
80426	"	Gonadotropin hormone panel"	N																																																																																																											
80428	"	Growth hormone panel"	N																																																																																																											
80430	"	Growth hormone panel"	N																																																																																																											
80432	"	Insulin suppression panel"	N																																																																																																											
80434	"	Insulin tolerance panel"	N																																																																																																											
80435	"	Insulin tolerance panel"	N																																																																																																											
80436	"	Metyrapone panel"	N																																																																																																											
80438	"	Trh stimulation panel"	N																																																																																																											
80439	"	Trh stimulation panel"	N																																																																																																											
80440	"	Trh stimulation panel"	N																																																																																																											
80500	"	Lab pathology consultation"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
80502	"	Lab pathology consultation"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
81000	"	Urinalysis nonauto w/scope"	N																																																																																																											
81001	"	Urinalysis auto w/scope"	N																																																																																																											
81002	"	Urinalysis nonauto w/o scope"	N																																																																																																											
81003	"	Urinalysis auto w/o scope"	N																																																																																																											
81005	"	Urinalysis"	N																																																																																																											
81007	"	Urine screen for bacteria"	N																																																																																																											
81015	"	Microscopic exam of urine"	N																																																																																																											
81020	"	Urinalysis glass test"	N																																																																																																											
81025	"	Urine pregnancy test"	N																																																																																																											
81050	"	Urinalysis volume measure"	N																																																																																																											
81099	"	Urinalysis test procedure"	N																																																																																																											
81161	"	Dmd dup/delet analysis"	E																																																																																																											
81200	"	Aspa gene"	A																																																																																																											
81201	"	Apc gene full sequence"	A																																																																																																											
81202	"	Apc gene known fam variants"	A																																																																																																											
81203	"	Apc gene dup/delet variants"	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																																																																																																											
81211	"	Brca1&2 seq & com dup/del"	A																																																																																																											
81212	"	Brca1&2 185&5385&6174 var"	A																																																																																																											
81213	"	Brca1&2 uncom dup/del var"	A																																																																																																											
81214	"	Brca1 full seq & com dup/del"	A																																																																																																											
81215	"	Brca1 gene known fam variant"	A																																																																																																											
81216	"	Brca2 gene full sequence"	A																																																																																																											
81217	"	Brca2 gene known fam variant"	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																																																																																																											
81235	"	Egfr gene com variants"	A																																																																																																											
81240	"	F2 gene"	A																																																																																																											
81241	"	F5 gene"	A																																																																																																											
81242	"	Fancc gene"	A																																																																																																											
81243	"	Fmr1 gene detection"	A																																																																																																											
81244	"	Fmr1 gene characterization"	A																																																																																																											
81245	"	Flt3 gene"	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																																																																																																											
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																																																																																																											
81270	"	Jak2 gene"	A																																																																																																											
81275	"	Kras gene"	A																																																																																																											
81280	"	Long qt synd gene full seq"	A																																																																																																											
81281	"	Long qt synd known fam var"	A																																																																																																											
81282	"	Long qt syn gene dup/dlt var"	A																																																																																																											
81287	"	Mgmt gene methylation anal"	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																																																																																																											
81310	"	Npm1 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																																																																																																											
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																																																																																																											
81330	"	Smpd1 gene common variants"	A																																																																																																											
81331	"	Snrpn/ube3a gene"	A																																																																																																											
81332	"	Serpina1 gene"	A																																																																																																											
81340	"	Trb@ gene rearrange amplify"	A																																																																																																											
81341	"	Trb@ gene rearrange dirprobe"	A																																																																																																											
81342	"	Trg gene rearrangement anal"	A																																																																																																											
81350	"	Ugt1a1 gene"	A																																																																																																											
81355	"	Vkorc1 gene"	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																																																																																																											
81479	"	Unlisted molecular pathology"	A																																																																																																											
81500	"	Onco (ovar) two proteins"	E																																																																																																											
81503	"	Onco (ovar) five proteins"	E																																																																																																											
81504	"	Oncology tissue of origin"	A																																																																																																											
81506	"	Endo assay seven anal"	E																																																																																																											
81507	"	Fetal aneuploidy trisom risk"	A																																																																																																											
81508	"	Ftl cgen abnor two proteins"	E																																																																																																											
81509	"	Ftl cgen abnor 3 proteins"	E																																																																																																											
81510	"	Ftl cgen abnor three anal"	E																																																																																																											
81511	"	Ftl cgen abnor four anal"	E																																																																																																											
81512	"	Ftl cgen abnor five anal"	E																																																																																																											
81599	"	Unlisted maaa"	E																																																																																																											
82000	"	Assay of blood acetaldehyde"	N																																																																																																											
82003	"	Assay of acetaminophen"	N																																																																																																											
82009	"	Test for acetone/ketones"	N																																																																																																											
82010	"	Acetone assay"	N																																																																																																											
82013	"	Acetylcholinesterase assay"	N																																																																																																											
82016	"	Acylcarnitines qual"	N																																																																																																											
82017	"	Acylcarnitines quant"	N																																																																																																											
82024	"	Assay of acth"	N																																																																																																											
82030	"	Assay of adp & amp"	N																																																																																																											
82040	"	Assay of serum albumin"	N																																																																																																											
82042	"	Assay of urine albumin"	N																																																																																																											
82043	"	Microalbumin quantitative"	N																																																																																																											
82044	"	Microalbumin semiquant"	N																																																																																																											
82045	"	Albumin ischemia modified"	N																																																																																																											
82055	"	Assay of ethanol"	N																																																																																																											
82075	"	Assay of breath ethanol"	N																																																																																																											
82085	"	Assay of aldolase"	N																																																																																																											
82088	"	Assay of aldosterone"	N																																																																																																											
82101	"	Assay of urine alkaloids"	N																																																																																																											
82103	"	Alpha-1-antitrypsin total"	N																																																																																																											
82104	"	Alpha-1-antitrypsin pheno"	N																																																																																																											
82105	"	Alpha-fetoprotein serum"	N																																																																																																											
82106	"	Alpha-fetoprotein amniotic"	N																																																																																																											
82107	"	Alpha-fetoprotein l3"	N																																																																																																											
82108	"	Assay of aluminum"	N																																																																																																											
82120	"	Amines vaginal fluid qual"	N																																																																																																											
82127	"	Amino acid single qual"	N																																																																																																											
82128	"	Amino acids mult qual"	N																																																																																																											
82131	"	Amino acids single quant"	N																																																																																																											
82135	"	Assay aminolevulinic acid"	N																																																																																																											
82136	"	Amino acids quant 2-5"	N																																																																																																											
82139	"	Amino acids quan 6 or more"	N																																																																																																											
82140	"	Assay of ammonia"	N																																																																																																											
82143	"	Amniotic fluid scan"	N																																																																																																											
82145	"	Assay of amphetamines"	N																																																																																																											
82150	"	Assay of amylase"	N																																																																																																											
82154	"	Androstanediol glucuronide"	N																																																																																																											
82157	"	Assay of androstenedione"	N																																																																																																											
82160	"	Assay of androsterone"	N																																																																																																											
82163	"	Assay of angiotensin ii"	N																																																																																																											
82164	"	Angiotensin i enzyme test"	N																																																																																																											
82172	"	Assay of apolipoprotein"	N																																																																																																											
82175	"	Assay of arsenic"	N																																																																																																											
82180	"	Assay of ascorbic acid"	N																																																																																																											
82190	"	Atomic absorption"	N																																																																																																											
82205	"	Assay of barbiturates"	N																																																																																																											
82232	"	Assay of beta-2 protein"	N																																																																																																											
82239	"	Bile acids total"	N																																																																																																											
82240	"	Bile acids cholylglycine"	N																																																																																																											
82247	"	Bilirubin total"	N																																																																																																											
82248	"	Bilirubin direct"	N																																																																																																											
82252	"	Fecal bilirubin test"	N																																																																																																											
82261	"	Assay of biotinidase"	N																																																																																																											
82270	"	Occult blood feces"	N																																																																																																											
82271	"	Occult blood other sources"	N																																																																																																											
82272	"	Occult bld feces 1-3 tests"	N																																																																																																											
82274	"	Assay test for blood fecal"	N																																																																																																											
82286	"	Assay of bradykinin"	N																																																																																																											
82300	"	Assay of cadmium"	N																																																																																																											
82306	"	Vitamin d 25 hydroxy"	N																																																																																																											
82308	"	Assay of calcitonin"	N																																																																																																											
82310	"	Assay of calcium"	N																																																																																																											
82330	"	Assay of calcium"	N																																																																																																											
82331	"	Calcium infusion test"	N																																																																																																											
82340	"	Assay of calcium in urine"	N																																																																																																											
82355	"	Calculus analysis qual"	N																																																																																																											
82360	"	Calculus assay quant"	N																																																																																																											
82365	"	Calculus spectroscopy"	N																																																																																																											
82370	"	X-ray assay calculus"	N																																																																																																											
82373	"	Assay c-d transfer measure"	N																																																																																																											
82374	"	Assay blood carbon dioxide"	N																																																																																																											
82375	"	Assay carboxyhb quant"	N																																																																																																											
82376	"	Assay carboxyhb qual"	N																																																																																																											
82378	"	Carcinoembryonic antigen"	N																																																																																																											
82379	"	Assay of carnitine"	N																																																																																																											
82380	"	Assay of carotene"	N																																																																																																											
82382	"	Assay urine catecholamines"	N																																																																																																											
82383	"	Assay blood catecholamines"	N																																																																																																											
82384	"	Assay three catecholamines"	N																																																																																																											
82387	"	Assay of cathepsin-d"	N																																																																																																											
82390	"	Assay of ceruloplasmin"	N																																																																																																											
82397	"	Chemiluminescent assay"	N																																																																																																											
82415	"	Assay of chloramphenicol"	N																																																																																																											
82435	"	Assay of blood chloride"	N																																																																																																											
82436	"	Assay of urine chloride"	N																																																																																																											
82438	"	Assay other fluid chlorides"	N																																																																																																											
82441	"	Test for chlorohydrocarbons"	N																																																																																																											
82465	"	Assay bld/serum cholesterol"	N																																																																																																											
82480	"	Assay serum cholinesterase"	N																																																																																																											
82482	"	Assay rbc cholinesterase"	N																																																																																																											
82485	"	Assay chondroitin sulfate"	N																																																																																																											
82486	"	Gas/liquid chromatography"	N																																																																																																											
82487	"	Paper chromatography"	N																																																																																																											
82488	"	Paper chromatography"	N																																																																																																											
82489	"	Thin layer chromatography"	N																																																																																																											
82491	"	Chromotography quant sing"	N																																																																																																											
82492	"	Chromotography quant mult"	N																																																																																																											
82495	"	Assay of chromium"	N																																																																																																											
82507	"	Assay of citrate"	N																																																																																																											
82520	"	Assay of cocaine"	N																																																																																																											
82523	"	Collagen crosslinks"	N																																																																																																											
82525	"	Assay of copper"	N																																																																																																											
82528	"	Assay of corticosterone"	N																																																																																																											
82530	"	Cortisol free"	N																																																																																																											
82533	"	Total cortisol"	N																																																																																																											
82540	"	Assay of creatine"	N																																																																																																											
82541	"	Column chromotography qual"	N																																																																																																											
82542	"	Column chromotography quant"	N																																																																																																											
82543	"	Column chromotograph/isotope"	N																																																																																																											
82544	"	Column chromotograph/isotope"	N																																																																																																											
82550	"	Assay of ck (cpk)"	N																																																																																																											
82552	"	Assay of cpk in blood"	N																																																																																																											
82553	"	Creatine mb fraction"	N																																																																																																											
82554	"	Creatine isoforms"	N																																																																																																											
82565	"	Assay of creatinine"	N																																																																																																											
82570	"	Assay of urine creatinine"	N																																																																																																											
82575	"	Creatinine clearance test"	N																																																																																																											
82585	"	Assay of cryofibrinogen"	N																																																																																																											
82595	"	Assay of cryoglobulin"	N																																																																																																											
82600	"	Assay of cyanide"	N																																																																																																											
82607	"	Vitamin b-12"	N																																																																																																											
82608	"	B-12 binding capacity"	N																																																																																																											
82610	"	Cystatin c"	N																																																																																																											
82615	"	Test for urine cystines"	N																																																																																																											
82626	"	Dehydroepiandrosterone"	N																																																																																																											
82627	"	Dehydroepiandrosterone"	N																																																																																																											
82633	"	Desoxycorticosterone"	N																																																																																																											
82634	"	Deoxycortisol"	N																																																																																																											
82638	"	Assay of dibucaine number"	N																																																																																																											
82646	"	Assay of dihydrocodeinone"	N																																																																																																											
82649	"	Assay of dihydromorphinone"	N																																																																																																											
82651	"	Assay of dihydrotestosterone"	N																																																																																																											
82652	"	Vit d 1 25-dihydroxy"	N																																																																																																											
82654	"	Assay of dimethadione"	N																																																																																																											
82656	"	Pancreatic elastase fecal"	N																																																																																																											
82657	"	Enzyme cell activity"	N																																																																																																											
82658	"	Enzyme cell activity ra"	N																																																																																																											
82664	"	Electrophoretic test"	N																																																																																																											
82666	"	Assay of epiandrosterone"	N																																																																																																											
82668	"	Assay of erythropoietin"	N																																																																																																											
82670	"	Assay of estradiol"	N																																																																																																											
82671	"	Assay of estrogens"	N																																																																																																											
82672	"	Assay of estrogen"	N																																																																																																											
82677	"	Assay of estriol"	N																																																																																																											
82679	"	Assay of estrone"	N																																																																																																											
82690	"	Assay of ethchlorvynol"	N																																																																																																											
82693	"	Assay of ethylene glycol"	N																																																																																																											
82696	"	Assay of etiocholanolone"	N																																																																																																											
82705	"	Fats/lipids feces qual"	N																																																																																																											
82710	"	Fats/lipids feces quant"	N																																																																																																											
82715	"	Assay of fecal fat"	N																																																																																																											
82725	"	Assay of blood fatty acids"	N																																																																																																											
82726	"	Long chain fatty acids"	N																																																																																																											
82728	"	Assay of ferritin"	N																																																																																																											
82731	"	Assay of fetal fibronectin"	N																																																																																																											
82735	"	Assay of fluoride"	N																																																																																																											
82742	"	Assay of flurazepam"	N																																																																																																											
82746	"	Assay of folic acid serum"	N																																																																																																											
82747	"	Assay of folic acid rbc"	N																																																																																																											
82757	"	Assay of semen fructose"	N																																																																																																											
82759	"	Assay of rbc galactokinase"	N																																																																																																											
82760	"	Assay of galactose"	N																																																																																																											
82775	"	Assay galactose transferase"	N																																																																																																											
82776	"	Galactose transferase test"	N																																																																																																											
82777	"	Galectin-3"	N																																																																																																											
82784	"	Assay iga/igd/igg/igm each"	N																																																																																																											
82785	"	Assay of ige"	N																																																																																																											
82787	"	Igg 1 2 3 or 4 each"	N																																																																																																											
82800	"	Blood ph"	N																																																																																																											
82803	"	Blood gases any combination"	N																																																																																																											
82805	"	Blood gases w/o2 saturation"	N																																																																																																											
82810	"	Blood gases o2 sat only"	N																																																																																																											
82820	"	Hemoglobin-oxygen affinity"	N																																																																																																											
82930	"	Gastric analy w/ph ea spec"	N																																																																																																											
82938	"	Gastrin test"	N																																																																																																											
82941	"	Assay of gastrin"	N																																																																																																											
82943	"	Assay of glucagon"	N																																																																																																											
82945	"	Glucose other fluid"	N																																																																																																											
82946	"	Glucagon tolerance test"	N																																																																																																											
82947	"	Assay glucose blood quant"	N																																																																																																											
82948	"	Reagent strip/blood glucose"	N																																																																																																											
82950	"	Glucose test"	N																																																																																																											
82951	"	Glucose tolerance test (gtt)"	N																																																																																																											
82952	"	Gtt-added samples"	N																																																																																																											
82953	"	Glucose-tolbutamide test"	N																																																																																																											
82955	"	Assay of g6pd enzyme"	N																																																																																																											
82960	"	Test for g6pd enzyme"	N																																																																																																											
82962	"	Glucose blood test"	N																																																																																																											
82963	"	Assay of glucosidase"	N																																																																																																											
82965	"	Assay of gdh enzyme"	N																																																																																																											
82975	"	Assay of glutamine"	N																																																																																																											
82977	"	Assay of ggt"	N																																																																																																											
82978	"	Assay of glutathione"	N																																																																																																											
82979	"	Assay rbc glutathione"	N																																																																																																											
82980	"	Assay of glutethimide"	N																																																																																																											
82985	"	Assay of glycated protein"	N																																																																																																											
83001	"	Assay of gonadotropin (fsh)"	N																																																																																																											
83002	"	Assay of gonadotropin (lh)"	N																																																																																																											
83003	"	Assay growth hormone (hgh)"	N																																																																																																											
83008	"	Assay of guanosine"	N																																																																																																											
83009	"	H pylori (c-13) blood"	N																																																																																																											
83010	"	Assay of haptoglobin quant"	N																																																																																																											
83012	"	Assay of haptoglobins"	N																																																																																																											
83013	"	H pylori (c-13) breath"	N																																																																																																											
83014	"	H pylori drug admin"	N																																																																																																											
83015	"	Heavy metal screen"	N																																																																																																											
83018	"	Quantitative screen metals"	N																																																																																																											
83020	"	Hemoglobin electrophoresis"	N																																																																																																											
83021	"	Hemoglobin chromotography"	N																																																																																																											
83026	"	Hemoglobin copper sulfate"	N																																																																																																											
83030	"	Fetal hemoglobin chemical"	N																																																																																																											
83033	"	Fetal hemoglobin assay qual"	N																																																																																																											
83036	"	Glycosylated hemoglobin test"	N																																																																																																											
83037	"	Glycosylated hb home device"	N																																																																																																											
83045	"	Blood methemoglobin test"	N																																																																																																											
83050	"	Blood methemoglobin assay"	N																																																																																																											
83051	"	Assay of plasma hemoglobin"	N																																																																																																											
83055	"	Blood sulfhemoglobin test"	N																																																																																																											
83060	"	Blood sulfhemoglobin assay"	N																																																																																																											
83065	"	Assay of hemoglobin heat"	N																																																																																																											
83068	"	Hemoglobin stability screen"	N																																																																																																											
83069	"	Assay of urine hemoglobin"	N																																																																																																											
83070	"	Assay of hemosiderin qual"	N																																																																																																											
83071	"	Assay of hemosiderin quant"	N																																																																																																											
83080	"	Assay of b hexosaminidase"	N																																																																																																											
83088	"	Assay of histamine"	N																																																																																																											
83090	"	Assay of homocystine"	N																																																																																																											
83150	"	Assay of homovanillic acid"	N																																																																																																											
83491	"	Assay of corticosteroids 17"	N																																																																																																											
83497	"	Assay of 5-hiaa"	N																																																																																																											
83498	"	Assay of progesterone 17-d"	N																																																																																																											
83499	"	Assay of progesterone 20-"	N																																																																																																											
83500	"	Assay free hydroxyproline"	N																																																																																																											
83505	"	Assay total hydroxyproline"	N																																																																																																											
83516	"	Immunoassay nonantibody"	N																																																																																																											
83518	"	Immunoassay dipstick"	N																																																																																																											
83519	"	Ria nonantibody"	N																																																																																																											
83520	"	Immunoassay quant nos nonab"	N																																																																																																											
83525	"	Assay of insulin"	N																																																																																																											
83527	"	Assay of insulin"	N																																																																																																											
83528	"	Assay of intrinsic factor"	N																																																																																																											
83540	"	Assay of iron"	N																																																																																																											
83550	"	Iron binding test"	N																																																																																																											
83570	"	Assay of idh enzyme"	N																																																																																																											
83582	"	Assay of ketogenic steroids"	N																																																																																																											
83586	"	Assay 17- ketosteroids"	N																																																																																																											
83593	"	Fractionation ketosteroids"	N																																																																																																											
83605	"	Assay of lactic acid"	N																																																																																																											
83615	"	Lactate (ld) (ldh) enzyme"	N																																																																																																											
83625	"	Assay of ldh enzymes"	N																																																																																																											
83630	"	Lactoferrin fecal (qual)"	N																																																																																																											
83631	"	Lactoferrin fecal (quant)"	N																																																																																																											
83632	"	Placental lactogen"	N																																																																																																											
83633	"	Test urine for lactose"	N																																																																																																											
83634	"	Assay of urine for lactose"	N																																																																																																											
83655	"	Assay of lead"	N																																																																																																											
83661	"	L/s ratio fetal lung"	N																																																																																																											
83662	"	Foam stability fetal lung"	N																																																																																																											
83663	"	Fluoro polarize fetal lung"	N																																																																																																											
83664	"	Lamellar bdy fetal lung"	N																																																																																																											
83670	"	Assay of lap enzyme"	N																																																																																																											
83690	"	Assay of lipase"	N																																																																																																											
83695	"	Assay of lipoprotein(a)"	N																																																																																																											
83698	"	Assay lipoprotein pla2"	N																																																																																																											
83700	"	Lipopro bld electrophoretic"	N																																																																																																											
83701	"	Lipoprotein bld hr fraction"	N																																																																																																											
83704	"	Lipoprotein bld by nmr"	N																																																																																																											
83718	"	Assay of lipoprotein"	N																																																																																																											
83719	"	Assay of blood lipoprotein"	N																																																																																																											
83721	"	Assay of blood lipoprotein"	N																																																																																																											
83727	"	Assay of lrh hormone"	N																																																																																																											
83735	"	Assay of magnesium"	N																																																																																																											
83775	"	Assay malate dehydrogenase"	N																																																																																																											
83785	"	Assay of manganese"	N																																																																																																											
83788	"	Mass spectrometry qual"	N																																																																																																											
83789	"	Mass spectrometry quant"	N																																																																																																											
83805	"	Assay of meprobamate"	N																																																																																																											
83825	"	Assay of mercury"	N																																																																																																											
83835	"	Assay of metanephrines"	N																																																																																																											
83840	"	Assay of methadone"	N																																																																																																											
83857	"	Assay of methemalbumin"	N																																																																																																											
83858	"	Assay of methsuximide"	N																																																																																																											
83861	"	Microfluid analy tears"	N																																																																																																											
83864	"	Mucopolysaccharides"	N																																																																																																											
83866	"	Mucopolysaccharides screen"	N																																																																																																											
83872	"	Assay synovial fluid mucin"	N																																																																																																											
83873	"	Assay of csf protein"	N																																																																																																											
83874	"	Assay of myoglobin"	N																																																																																																											
83876	"	Assay myeloperoxidase"	N																																																																																																											
83880	"	Assay of natriuretic peptide"	N																																																																																																											
83883	"	Assay nephelometry not spec"	N																																																																																																											
83885	"	Assay of nickel"	N																																																																																																											
83887	"	Assay of nicotine"	N																																																																																																											
83915	"	Assay of nucleotidase"	N																																																																																																											
83916	"	Oligoclonal bands"	N																																																																																																											
83918	"	Organic acids total quant"	N																																																																																																											
83919	"	Organic acids qual each"	N																																																																																																											
83921	"	Organic acid single quant"	N																																																																																																											
83925	"	Assay of opiates"	N																																																																																																											
83930	"	Assay of blood osmolality"	N																																																																																																											
83935	"	Assay of urine osmolality"	N																																																																																																											
83937	"	Assay of osteocalcin"	N																																																																																																											
83945	"	Assay of oxalate"	N																																																																																																											
83950	"	Oncoprotein her-2/neu"	N																																																																																																											
83951	"	Oncoprotein dcp"	N																																																																																																											
83970	"	Assay of parathormone"	N																																																																																																											
83986	"	Assay ph body fluid nos"	N																																																																																																											
83987	"	Exhaled breath condensate"	N																																																																																																											
83992	"	Assay for phencyclidine"	N																																																																																																											
83993	"	Assay for calprotectin fecal"	N																																																																																																											
84022	"	Assay of phenothiazine"	N																																																																																																											
84030	"	Assay of blood pku"	N																																																																																																											
84035	"	Assay of phenylketones"	N																																																																																																											
84060	"	Assay acid phosphatase"	N																																																																																																											
84061	"	Phosphatase forensic exam"	N																																																																																																											
84066	"	Assay prostate phosphatase"	N																																																																																																											
84075	"	Assay alkaline phosphatase"	N																																																																																																											
84078	"	Assay alkaline phosphatase"	N																																																																																																											
84080	"	Assay alkaline phosphatases"	N																																																																																																											
84081	"	Assay phosphatidylglycerol"	N																																																																																																											
84085	"	Assay of rbc pg6d enzyme"	N																																																																																																											
84087	"	Assay phosphohexose enzymes"	N																																																																																																											
84100	"	Assay of phosphorus"	N																																																																																																											
84105	"	Assay of urine phosphorus"	N																																																																																																											
84106	"	Test for porphobilinogen"	N																																																																																																											
84110	"	Assay of porphobilinogen"	N																																																																																																											
84112	"	Eval amniotic fluid protein"	N																																																																																																											
84119	"	Test urine for porphyrins"	N																																																																																																											
84120	"	Assay of urine porphyrins"	N																																																																																																											
84126	"	Assay of feces porphyrins"	N																																																																																																											
84127	"	Assay of feces porphyrins"	N																																																																																																											
84132	"	Assay of serum potassium"	N																																																																																																											
84133	"	Assay of urine potassium"	N																																																																																																											
84134	"	Assay of prealbumin"	N																																																																																																											
84135	"	Assay of pregnanediol"	N																																																																																																											
84138	"	Assay of pregnanetriol"	N																																																																																																											
84140	"	Assay of pregnenolone"	N																																																																																																											
84143	"	Assay of 17-hydroxypregneno"	N																																																																																																											
84144	"	Assay of progesterone"	N																																																																																																											
84145	"	Procalcitonin (pct)"	N																																																																																																											
84146	"	Assay of prolactin"	N																																																																																																											
84150	"	Assay of prostaglandin"	N																																																																																																											
84152	"	Assay of psa complexed"	N																																																																																																											
84153	"	Assay of psa total"	N																																																																																																											
84154	"	Assay of psa free"	N																																																																																																											
84155	"	Assay of protein serum"	N																																																																																																											
84156	"	Assay of protein urine"	N																																																																																																											
84157	"	Assay of protein other"	N																																																																																																											
84160	"	Assay of protein any source"	N																																																																																																											
84163	"	Pappa serum"	N																																																																																																											
84165	"	Protein e-phoresis serum"	N																																																																																																											
84166	"	Protein e-phoresis/urine/csf"	N																																																																																																											
84181	"	Western blot test"	N																																																																																																											
84182	"	Protein western blot test"	N																																																																																																											
84202	"	Assay rbc protoporphyrin"	N																																																																																																											
84203	"	Test rbc protoporphyrin"	N																																																																																																											
84206	"	Assay of proinsulin"	N																																																																																																											
84207	"	Assay of vitamin b-6"	N																																																																																																											
84210	"	Assay of pyruvate"	N																																																																																																											
84220	"	Assay of pyruvate kinase"	N																																																																																																											
84228	"	Assay of quinine"	N																																																																																																											
84233	"	Assay of estrogen"	N																																																																																																											
84234	"	Assay of progesterone"	N																																																																																																											
84235	"	Assay of endocrine hormone"	N																																																																																																											
84238	"	Assay nonendocrine receptor"	N																																																																																																											
84244	"	Assay of renin"	N																																																																																																											
84252	"	Assay of vitamin b-2"	N																																																																																																											
84255	"	Assay of selenium"	N																																																																																																											
84260	"	Assay of serotonin"	N																																																																																																											
84270	"	Assay of sex hormone globul"	N																																																																																																											
84275	"	Assay of sialic acid"	N																																																																																																											
84285	"	Assay of silica"	N																																																																																																											
84295	"	Assay of serum sodium"	N																																																																																																											
84300	"	Assay of urine sodium"	N																																																																																																											
84302	"	Assay of sweat sodium"	N																																																																																																											
84305	"	Assay of somatomedin"	N																																																																																																											
84307	"	Assay of somatostatin"	N																																																																																																											
84311	"	Spectrophotometry"	N																																																																																																											
84315	"	Body fluid specific gravity"	N																																																																																																											
84375	"	Chromatogram assay sugars"	N																																																																																																											
84376	"	Sugars single qual"	N																																																																																																											
84377	"	Sugars multiple qual"	N																																																																																																											
84378	"	Sugars single quant"	N																																																																																																											
84379	"	Sugars multiple quant"	N																																																																																																											
84392	"	Assay of urine sulfate"	N																																																																																																											
84402	"	Assay of free testosterone"	N																																																																																																											
84403	"	Assay of total testosterone"	N																																																																																																											
84425	"	Assay of vitamin b-1"	N																																																																																																											
84430	"	Assay of thiocyanate"	N																																																																																																											
84431	"	Thromboxane urine"	N																																																																																																											
84432	"	Assay of thyroglobulin"	N																																																																																																											
84436	"	Assay of total thyroxine"	N																																																																																																											
84437	"	Assay of neonatal thyroxine"	N																																																																																																											
84439	"	Assay of free thyroxine"	N																																																																																																											
84442	"	Assay of thyroid activity"	N																																																																																																											
84443	"	Assay thyroid stim hormone"	N																																																																																																											
84445	"	Assay of tsi globulin"	N																																																																																																											
84446	"	Assay of vitamin e"	N																																																																																																											
84449	"	Assay of transcortin"	N																																																																																																											
84450	"	Transferase (ast) (sgot)"	N																																																																																																											
84460	"	Alanine amino (alt) (sgpt)"	N																																																																																																											
84466	"	Assay of transferrin"	N																																																																																																											
84478	"	Assay of triglycerides"	N																																																																																																											
84479	"	Assay of thyroid (t3 or t4)"	N																																																																																																											
84480	"	Assay triiodothyronine (t3)"	N																																																																																																											
84481	"	Free assay (ft-3)"	N																																																																																																											
84482	"	T3 reverse"	N																																																																																																											
84484	"	Assay of troponin quant"	N																																																																																																											
84485	"	Assay duodenal fluid trypsin"	N																																																																																																											
84488	"	Test feces for trypsin"	N																																																																																																											
84490	"	Assay of feces for trypsin"	N																																																																																																											
84510	"	Assay of tyrosine"	N																																																																																																											
84512	"	Assay of troponin qual"	N																																																																																																											
84520	"	Assay of urea nitrogen"	N																																																																																																											
84525	"	Urea nitrogen semi-quant"	N																																																																																																											
84540	"	Assay of urine/urea-n"	N																																																																																																											
84545	"	Urea-n clearance test"	N																																																																																																											
84550	"	Assay of blood/uric acid"	N																																																																																																											
84560	"	Assay of urine/uric acid"	N																																																																																																											
84577	"	Assay of feces/urobilinogen"	N																																																																																																											
84578	"	Test urine urobilinogen"	N																																																																																																											
84580	"	Assay of urine urobilinogen"	N																																																																																																											
84583	"	Assay of urine urobilinogen"	N																																																																																																											
84585	"	Assay of urine vma"	N																																																																																																											
84586	"	Assay of vip"	N																																																																																																											
84588	"	Assay of vasopressin"	N																																																																																																											
84590	"	Assay of vitamin a"	N																																																																																																											
84591	"	Assay of nos vitamin"	N																																																																																																											
84597	"	Assay of vitamin k"	N																																																																																																											
84600	"	Assay of volatiles"	N																																																																																																											
84620	"	Xylose tolerance test"	N																																																																																																											
84630	"	Assay of zinc"	N																																																																																																											
84681	"	Assay of c-peptide"	N																																																																																																											
84702	"	Chorionic gonadotropin test"	N																																																																																																											
84703	"	Chorionic gonadotropin assay"	N																																																																																																											
84704	"	Hcg free betachain test"	N																																																																																																											
84830	"	Ovulation tests"	N																																																																																																											
84999	"	Clinical chemistry test"	N																																																																																																											
85002	"	Bleeding time test"	N																																																																																																											
85004	"	Automated diff wbc count"	N																																																																																																											
85007	"	Bl smear w/diff wbc count"	N																																																																																																											
85008	"	Bl smear w/o diff wbc count"	N																																																																																																											
85009	"	Manual diff wbc count b-coat"	N																																																																																																											
85013	"	Spun microhematocrit"	N																																																																																																											
85014	"	Hematocrit"	N																																																																																																											
85018	"	Hemoglobin"	N																																																																																																											
85025	"	Complete cbc w/auto diff wbc"	N																																																																																																											
85027	"	Complete cbc automated"	N																																																																																																											
85032	"	Manual cell count each"	N																																																																																																											
85041	"	Automated rbc count"	N																																																																																																											
85044	"	Manual reticulocyte count"	N																																																																																																											
85045	"	Automated reticulocyte count"	N																																																																																																											
85046	"	Reticyte/hgb concentrate"	N																																																																																																											
85048	"	Automated leukocyte count"	N																																																																																																											
85049	"	Automated platelet count"	N																																																																																																											
85055	"	Reticulated platelet assay"	N																																																																																																											
85060	"	Blood smear interpretation"	B																																																																																																											
85097	"	Bone marrow interpretation"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
85130	"	Chromogenic substrate assay"	N																																																																																																											
85170	"	Blood clot retraction"	N																																																																																																											
85175	"	Blood clot lysis time"	N																																																																																																											
85210	"	Clot factor ii prothrom spec"	N																																																																																																											
85220	"	Blooc clot factor v test"	N																																																																																																											
85230	"	Clot factor vii proconvertin"	N																																																																																																											
85240	"	Clot factor viii ahg 1 stage"	N																																																																																																											
85244	"	Clot factor viii reltd antgn"	N																																																																																																											
85245	"	Clot factor viii vw ristoctn"	N																																																																																																											
85246	"	Clot factor viii vw antigen"	N																																																																																																											
85247	"	Clot factor viii multimetric"	N																																																																																																											
85250	"	Clot factor ix ptc/chrstmas"	N																																																																																																											
85260	"	Clot factor x stuart-power"	N																																																																																																											
85270	"	Clot factor xi pta"	N																																																																																																											
85280	"	Clot factor xii hageman"	N																																																																																																											
85290	"	Clot factor xiii fibrin stab"	N																																																																																																											
85291	"	Clot factor xiii fibrin scrn"	N																																																																																																											
85292	"	Clot factor fletcher fact"	N																																																																																																											
85293	"	Clot factor wght kininogen"	N																																																																																																											
85300	"	Antithrombin iii activity"	N																																																																																																											
85301	"	Antithrombin iii antigen"	N																																																																																																											
85302	"	Clot inhibit prot c antigen"	N																																																																																																											
85303	"	Clot inhibit prot c activity"	N																																																																																																											
85305	"	Clot inhibit prot s total"	N																																																																																																											
85306	"	Clot inhibit prot s free"	N																																																																																																											
85307	"	Assay activated protein c"	N																																																																																																											
85335	"	Factor inhibitor test"	N																																																																																																											
85337	"	Thrombomodulin"	N																																																																																																											
85345	"	Coagulation time lee & white"	N																																																																																																											
85347	"	Coagulation time activated"	N																																																																																																											
85348	"	Coagulation time otr method"	N																																																																																																											
85360	"	Euglobulin lysis"	N																																																																																																											
85362	"	Fibrin degradation products"	N																																																																																																											
85366	"	Fibrinogen test"	N																																																																																																											
85370	"	Fibrinogen test"	N																																																																																																											
85378	"	Fibrin degrade semiquant"	N																																																																																																											
85379	"	Fibrin degradation quant"	N																																																																																																											
85380	"	Fibrin degradj d-dimer"	N																																																																																																											
85384	"	Fibrinogen activity"	N																																																																																																											
85385	"	Fibrinogen antigen"	N																																																																																																											
85390	"	Fibrinolysins screen i&r"	N																																																																																																											
85396	"	Clotting assay whole blood"	N																																																																																																											
85397	"	Clotting funct activity"	N																																																																																																											
85400	"	Fibrinolytic plasmin"	N																																																																																																											
85410	"	Fibrinolytic antiplasmin"	N																																																																																																											
85415	"	Fibrinolytic plasminogen"	N																																																																																																											
85420	"	Fibrinolytic plasminogen"	N																																																																																																											
85421	"	Fibrinolytic plasminogen"	N																																																																																																											
85441	"	Heinz bodies direct"	N																																																																																																											
85445	"	Heinz bodies induced"	N																																																																																																											
85460	"	Hemoglobin fetal"	N																																																																																																											
85461	"	Hemoglobin fetal"	N																																																																																																											
85475	"	Hemolysin acid"	N																																																																																																											
85520	"	Heparin assay"	N																																																																																																											
85525	"	Heparin neutralization"	N																																																																																																											
85530	"	Heparin-protamine tolerance"	N																																																																																																											
85536	"	Iron stain peripheral blood"	N																																																																																																											
85540	"	Wbc alkaline phosphatase"	N																																																																																																											
85547	"	Rbc mechanical fragility"	N																																																																																																											
85549	"	Muramidase"	N																																																																																																											
85555	"	Rbc osmotic fragility"	N																																																																																																											
85557	"	Rbc osmotic fragility"	N																																																																																																											
85576	"	Blood platelet aggregation"	N																																																																																																											
85597	"	Phospholipid pltlt neutraliz"	N																																																																																																											
85598	"	Hexagnal phosph pltlt neutrl"	N																																																																																																											
85610	"	Prothrombin time"	N																																																																																																											
85611	"	Prothrombin test"	N																																																																																																											
85612	"	Viper venom prothrombin time"	N																																																																																																											
85613	"	Russell viper venom diluted"	N																																																																																																											
85635	"	Reptilase test"	N																																																																																																											
85651	"	Rbc sed rate nonautomated"	N																																																																																																											
85652	"	Rbc sed rate automated"	N																																																																																																											
85660	"	Rbc sickle cell test"	N																																																																																																											
85670	"	Thrombin time plasma"	N																																																																																																											
85675	"	Thrombin time titer"	N																																																																																																											
85705	"	Thromboplastin inhibition"	N																																																																																																											
85730	"	Thromboplastin time partial"	N																																																																																																											
85732	"	Thromboplastin time partial"	N																																																																																																											
85810	"	Blood viscosity examination"	N																																																																																																											
85999	"	Hematology procedure"	N																																																																																																											
86000	"	Agglutinins febrile antigen"	N																																																																																																											
86001	"	Allergen specific igg"	N																																																																																																											
86003	"	Allergen specific ige"	N																																																																																																											
86005	"	Allergen specific ige"	N																																																																																																											
86021	"	Wbc antibody identification"	N																																																																																																											
86022	"	Platelet antibodies"	N																																																																																																											
86023	"	Immunoglobulin assay"	N																																																																																																											
86038	"	Antinuclear antibodies"	N																																																																																																											
86039	"	Antinuclear antibodies (ana)"	N																																																																																																											
86060	"	Antistreptolysin o titer"	N																																																																																																											
86063	"	Antistreptolysin o screen"	N																																																																																																											
86077	"	Phys blood bank serv xmatch"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
86078	"	Phys blood bank serv reactj"	X	0343	0.8458	$61.47	.	$12.30																																																																																																						
86079	"	Phys blood bank serv authrj"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
86140	"	C-reactive protein"	N																																																																																																											
86141	"	C-reactive protein hs"	N																																																																																																											
86146	"	Beta-2 glycoprotein antibody"	N																																																																																																											
86147	"	Cardiolipin antibody ea ig"	N																																																																																																											
86148	"	Anti-phospholipid antibody"	N																																																																																																											
86152	"	Cell enumeration & id"	N																																																																																																											
86153	"	Cell enumeration phys interp"	B																																																																																																											
86155	"	Chemotaxis assay"	N																																																																																																											
86156	"	Cold agglutinin screen"	N																																																																																																											
86157	"	Cold agglutinin titer"	N																																																																																																											
86160	"	Complement antigen"	N																																																																																																											
86161	"	Complement/function activity"	N																																																																																																											
86162	"	Complement total (ch50)"	N																																																																																																											
86171	"	Complement fixation each"	N																																																																																																											
86185	"	Counterimmunoelectrophoresis"	N																																																																																																											
86200	"	Ccp antibody"	N																																																																																																											
86215	"	Deoxyribonuclease antibody"	N																																																																																																											
86225	"	Dna antibody native"	N																																																																																																											
86226	"	Dna antibody single strand"	N																																																																																																											
86235	"	Nuclear antigen antibody"	N																																																																																																											
86243	"	Fc receptor"	N																																																																																																											
86255	"	Fluorescent antibody screen"	N																																																																																																											
86256	"	Fluorescent antibody titer"	N																																																																																																											
86277	"	Growth hormone antibody"	N																																																																																																											
86280	"	Hemagglutination inhibition"	N																																																																																																											
86294	"	Immunoassay tumor qual"	N																																																																																																											
86300	"	Immunoassay tumor ca 15-3"	N																																																																																																											
86301	"	Immunoassay tumor ca 19-9"	N																																																																																																											
86304	"	Immunoassay tumor ca 125"	N																																																																																																											
86305	"	Human epididymis protein 4"	N																																																																																																											
86308	"	Heterophile antibody screen"	N																																																																																																											
86309	"	Heterophile antibody titer"	N																																																																																																											
86310	"	Heterophile antibody absrbj"	N																																																																																																											
86316	"	Immunoassay tumor other"	N																																																																																																											
86317	"	Immunoassay infectious agent"	N																																																																																																											
86318	"	Immunoassay infectious agent"	N																																																																																																											
86320	"	Serum immunoelectrophoresis"	N																																																																																																											
86325	"	Other immunoelectrophoresis"	N																																																																																																											
86327	"	Immunoelectrophoresis assay"	N																																																																																																											
86329	"	Immunodiffusion nes"	N																																																																																																											
86331	"	Immunodiffusion ouchterlony"	N																																																																																																											
86332	"	Immune complex assay"	N																																																																																																											
86334	"	Immunofix e-phoresis serum"	N																																																																																																											
86335	"	Immunfix e-phorsis/urine/csf"	N																																																																																																											
86336	"	Inhibin a"	N																																																																																																											
86337	"	Insulin antibodies"	N																																																																																																											
86340	"	Intrinsic factor antibody"	N																																																																																																											
86341	"	Islet cell antibody"	N																																																																																																											
86343	"	Leukocyte histamine release"	N																																																																																																											
86344	"	Leukocyte phagocytosis"	N																																																																																																											
86352	"	Cell function assay w/stim"	N																																																																																																											
86353	"	Lymphocyte transformation"	N																																																																																																											
86355	"	B cells total count"	N																																																																																																											
86356	"	Mononuclear cell antigen"	N																																																																																																											
86357	"	Nk cells total count"	N																																																																																																											
86359	"	T cells total count"	N																																																																																																											
86360	"	T cell absolute count/ratio"	N																																																																																																											
86361	"	T cell absolute count"	N																																																																																																											
86367	"	Stem cells total count"	N																																																																																																											
86376	"	Microsomal antibody each"	N																																																																																																											
86378	"	Migration inhibitory factor"	N																																																																																																											
86382	"	Neutralization test viral"	N																																																																																																											
86384	"	Nitroblue tetrazolium dye"	N																																																																																																											
86386	"	Nuclear matrix protein 22"	N																																																																																																											
86403	"	Particle agglut antbdy scrn"	N																																																																																																											
86406	"	Particle agglut antbdy titr"	N																																																																																																											
86430	"	Rheumatoid factor test qual"	N																																																																																																											
86431	"	Rheumatoid factor quant"	N																																																																																																											
86480	"	Tb test cell immun measure"	N																																																																																																											
86481	"	Tb ag response t-cell susp"	N																																																																																																											
86485	"	Skin test candida"	X	0341	0.1720	$12.50	.	$2.50																																																																																																						
86486	"	Skin test nos antigen"	X	0341	0.1720	$12.50	.	$2.50																																																																																																						
86490	"	Coccidioidomycosis skin test"	X	0341	0.1720	$12.50	.	$2.50																																																																																																						
86510	"	Histoplasmosis skin test"	X	0341	0.1720	$12.50	.	$2.50																																																																																																						
86580	"	Tb intradermal test"	X	0341	0.1720	$12.50	.	$2.50																																																																																																						
86590	"	Streptokinase antibody"	N																																																																																																											
86592	"	Syphilis test non-trep qual"	N																																																																																																											
86593	"	Syphilis test non-trep quant"	N																																																																																																											
86602	"	Antinomyces antibody"	N																																																																																																											
86603	"	Adenovirus antibody"	N																																																																																																											
86606	"	Aspergillus antibody"	N																																																																																																											
86609	"	Bacterium antibody"	N																																																																																																											
86611	"	Bartonella antibody"	N																																																																																																											
86612	"	Blastomyces antibody"	N																																																																																																											
86615	"	Bordetella antibody"	N																																																																																																											
86617	"	Lyme disease antibody"	N																																																																																																											
86618	"	Lyme disease antibody"	N																																																																																																											
86619	"	Borrelia antibody"	N																																																																																																											
86622	"	Brucella antibody"	N																																																																																																											
86625	"	Campylobacter antibody"	N																																																																																																											
86628	"	Candida antibody"	N																																																																																																											
86631	"	Chlamydia antibody"	N																																																																																																											
86632	"	Chlamydia igm antibody"	N																																																																																																											
86635	"	Coccidioides antibody"	N																																																																																																											
86638	"	Q fever antibody"	N																																																																																																											
86641	"	Cryptococcus antibody"	N																																																																																																											
86644	"	Cmv antibody"	N																																																																																																											
86645	"	Cmv antibody igm"	N																																																																																																											
86648	"	Diphtheria antibody"	N																																																																																																											
86651	"	Encephalitis californ antbdy"	N																																																																																																											
86652	"	Encephaltis east eqne anbdy"	N																																																																																																											
86653	"	Encephaltis st louis antbody"	N																																																																																																											
86654	"	Encephaltis west eqne antbdy"	N																																																																																																											
86658	"	Enterovirus antibody"	N																																																																																																											
86663	"	Epstein-barr antibody"	N																																																																																																											
86664	"	Epstein-barr nuclear antigen"	N																																																																																																											
86665	"	Epstein-barr capsid vca"	N																																																																																																											
86666	"	Ehrlichia antibody"	N																																																																																																											
86668	"	Francisella tularensis"	N																																																																																																											
86671	"	Fungus nes antibody"	N																																																																																																											
86674	"	Giardia lamblia antibody"	N																																																																																																											
86677	"	Helicobacter pylori antibody"	N																																																																																																											
86682	"	Helminth antibody"	N																																																																																																											
86684	"	Hemophilus influenza antibdy"	N																																																																																																											
86687	"	Htlv-i antibody"	N																																																																																																											
86688	"	Htlv-ii antibody"	N																																																																																																											
86689	"	Htlv/hiv confirmj antibody"	N																																																																																																											
86692	"	Hepatitis delta agent antbdy"	N																																																																																																											
86694	"	Herpes simplex nes antbdy"	N																																																																																																											
86695	"	Herpes simplex type 1 test"	N																																																																																																											
86696	"	Herpes simplex type 2 test"	N																																																																																																											
86698	"	Histoplasma antibody"	N																																																																																																											
86701	"	Hiv-1antibody"	N																																																																																																											
86702	"	Hiv-2 antibody"	N																																																																																																											
86703	"	Hiv-1/hiv-2 1 result antbdy"	N																																																																																																											
86704	"	Hep b core antibody total"	N																																																																																																											
86705	"	Hep b core antibody igm"	N																																																																																																											
86706	"	Hep b surface antibody"	N																																																																																																											
86707	"	Hepatitis be antibody"	N																																																																																																											
86708	"	Hepatitis a total antibody"	N																																																																																																											
86709	"	Hepatitis a igm antibody"	N																																																																																																											
86710	"	Influenza virus antibody"	N																																																																																																											
86711	"	John cunningham antibody"	N																																																																																																											
86713	"	Legionella antibody"	N																																																																																																											
86717	"	Leishmania antibody"	N																																																																																																											
86720	"	Leptospira antibody"	N																																																																																																											
86723	"	Listeria monocytogenes"	N																																																																																																											
86727	"	Lymph choriomeningitis ab"	N																																																																																																											
86729	"	Lympho venereum antibody"	N																																																																																																											
86732	"	Mucormycosis antibody"	N																																																																																																											
86735	"	Mumps antibody"	N																																																																																																											
86738	"	Mycoplasma antibody"	N																																																																																																											
86741	"	Neisseria meningitidis"	N																																																																																																											
86744	"	Nocardia antibody"	N																																																																																																											
86747	"	Parvovirus antibody"	N																																																																																																											
86750	"	Malaria antibody"	N																																																																																																											
86753	"	Protozoa antibody nos"	N																																																																																																											
86756	"	Respiratory virus antibody"	N																																																																																																											
86757	"	Rickettsia antibody"	N																																																																																																											
86759	"	Rotavirus antibody"	N																																																																																																											
86762	"	Rubella antibody"	N																																																																																																											
86765	"	Rubeola antibody"	N																																																																																																											
86768	"	Salmonella antibody"	N																																																																																																											
86771	"	Shigella antibody"	N																																																																																																											
86774	"	Tetanus antibody"	N																																																																																																											
86777	"	Toxoplasma antibody"	N																																																																																																											
86778	"	Toxoplasma antibody igm"	N																																																																																																											
86780	"	Treponema pallidum"	N																																																																																																											
86784	"	Trichinella antibody"	N																																																																																																											
86787	"	Varicella-zoster antibody"	N																																																																																																											
86788	"	West nile virus ab igm"	N																																																																																																											
86789	"	West nile virus antibody"	N																																																																																																											
86790	"	Virus antibody nos"	N																																																																																																											
86793	"	Yersinia antibody"	N																																																																																																											
86800	"	Thyroglobulin antibody"	N																																																																																																											
86803	"	Hepatitis c ab test"	N																																																																																																											
86804	"	Hep c ab test confirm"	N																																																																																																											
86805	"	Lymphocytotoxicity assay"	N																																																																																																											
86806	"	Lymphocytotoxicity assay"	N																																																																																																											
86807	"	Cytotoxic antibody screening"	N																																																																																																											
86808	"	Cytotoxic antibody screening"	N																																																																																																											
86812	"	Hla typing a b or c"	N																																																																																																											
86813	"	Hla typing a b or c"	N																																																																																																											
86816	"	Hla typing dr/dq"	N																																																																																																											
86817	"	Hla typing dr/dq"	N																																																																																																											
86821	"	Lymphocyte culture mixed"	N																																																																																																											
86822	"	Lymphocyte culture primed"	N																																																																																																											
86825	"	Hla x-math non-cytotoxic"	N																																																																																																											
86826	"	Hla x-match noncytotoxc addl"	N																																																																																																											
86828	"	Hla class i&ii antibody qual"	N																																																																																																											
86829	"	Hla class i/ii antibody qual"	N																																																																																																											
86830	"	Hla class i phenotype qual"	N																																																																																																											
86831	"	Hla class ii phenotype qual"	N																																																																																																											
86832	"	Hla class i high defin qual"	N																																																																																																											
86833	"	Hla class ii high defin qual"	N																																																																																																											
86834	"	Hla class i semiquant panel"	N																																																																																																											
86835	"	Hla class ii semiquant panel"	N																																																																																																											
86849	"	Immunology procedure"	N																																																																																																											
86850	"	Rbc antibody screen"	X	0345	0.1668	$12.12	.	$2.43																																																																																																						
86860	"	Rbc antibody elution"	X	0347	0.8319	$60.46	.	$12.10																																																																																																						
86870	"	Rbc antibody identification"	X	0346	0.4344	$31.57	.	$6.32																																																																																																						
86880	"	Coombs test direct"	X	0345	0.1668	$12.12	.	$2.43																																																																																																						
86885	"	Coombs test indirect qual"	X	0345	0.1668	$12.12	.	$2.43																																																																																																						
86886	"	Coombs test indirect titer"	X	0346	0.4344	$31.57	.	$6.32																																																																																																						
86890	"	Autologous blood process"	X	0347	0.8319	$60.46	.	$12.10																																																																																																						
86891	"	Autologous blood op salvage"	X	0347	0.8319	$60.46	.	$12.10																																																																																																						
86900	"	Blood typing abo"	X	0345	0.1668	$12.12	.	$2.43																																																																																																						
86901	"	Blood typing rh (d)"	X	0345	0.1668	$12.12	.	$2.43																																																																																																						
86902	"	Blood type antigen donor ea"	X	0346	0.4344	$31.57	.	$6.32																																																																																																						
86904	"	Blood typing patient serum"	X	0345	0.1668	$12.12	.	$2.43																																																																																																						
86905	"	Blood typing rbc antigens"	X	0345	0.1668	$12.12	.	$2.43																																																																																																						
86906	"	Blood typing rh phenotype"	X	0345	0.1668	$12.12	.	$2.43																																																																																																						
86910	"	Blood typing paternity test"	E																																																																																																											
86911	"	Blood typing antigen system"	E																																																																																																											
86920	"	Compatibility test spin"	X	0346	0.4344	$31.57	.	$6.32																																																																																																						
86921	"	Compatibility test incubate"	X	0345	0.1668	$12.12	.	$2.43																																																																																																						
86922	"	Compatibility test antiglob"	X	0346	0.4344	$31.57	.	$6.32																																																																																																						
86923	"	Compatibility test electric"	X	0346	0.4344	$31.57	.	$6.32																																																																																																						
86927	"	Plasma fresh frozen"	S	0438	1.4572	$105.90	.	$21.18																																																																																																						
86930	"	Frozen blood prep"	X	0347	0.8319	$60.46	.	$12.10																																																																																																						
86931	"	Frozen blood thaw"	X	0347	0.8319	$60.46	.	$12.10																																																																																																						
86932	"	Frozen blood freeze/thaw"	X	0345	0.1668	$12.12	.	$2.43																																																																																																						
86940	"	Hemolysins/agglutinins auto"	N																																																																																																											
86941	"	Hemolysins/agglutinins"	N																																																																																																											
86945	"	Blood product/irradiation"	X	0345	0.1668	$12.12	.	$2.43																																																																																																						
86950	"	Leukacyte transfusion"	X	0345	0.1668	$12.12	.	$2.43																																																																																																						
86960	"	Vol reduction of blood/prod"	X	0346	0.4344	$31.57	.	$6.32																																																																																																						
86965	"	Pooling blood platelets"	X	0347	0.8319	$60.46	.	$12.10																																																																																																						
86970	"	Rbc pretx incubatj w/chemicl"	X	0346	0.4344	$31.57	.	$6.32																																																																																																						
86971	"	Rbc pretx incubatj w/enzymes"	X	0346	0.4344	$31.57	.	$6.32																																																																																																						
86972	"	Rbc pretx incubatj w/density"	X	0346	0.4344	$31.57	.	$6.32																																																																																																						
86975	"	Rbc serum pretx incubj drugs"	X	0346	0.4344	$31.57	.	$6.32																																																																																																						
86976	"	Rbc serum pretx id dilution"	X	0347	0.8319	$60.46	.	$12.10																																																																																																						
86977	"	Rbc serum pretx incubj/inhib"	X	0347	0.8319	$60.46	.	$12.10																																																																																																						
86978	"	Rbc pretreatment serum"	X	0346	0.4344	$31.57	.	$6.32																																																																																																						
86985	"	Split blood or products"	X	0347	0.8319	$60.46	.	$12.10																																																																																																						
86999	"	Transfusion procedure"	X	0345	0.1668	$12.12	.	$2.43																																																																																																						
87001	"	Small animal inoculation"	N																																																																																																											
87003	"	Small animal inoculation"	N																																																																																																											
87015	"	Specimen infect agnt concntj"	N																																																																																																											
87040	"	Blood culture for bacteria"	N																																																																																																											
87045	"	Feces culture aerobic bact"	N																																																																																																											
87046	"	Stool cultr aerobic bact ea"	N																																																																																																											
87070	"	Culture othr specimn aerobic"	N																																																																																																											
87071	"	Culture aerobic quant other"	N																																																																																																											
87073	"	Culture bacteria anaerobic"	N																																																																																																											
87075	"	Cultr bacteria except blood"	N																																																																																																											
87076	"	Culture anaerobe ident each"	N																																																																																																											
87077	"	Culture aerobic identify"	N																																																																																																											
87081	"	Culture screen only"	N																																																																																																											
87084	"	Culture of specimen by kit"	N																																																																																																											
87086	"	Urine culture/colony count"	N																																																																																																											
87088	"	Urine bacteria culture"	N																																																																																																											
87101	"	Skin fungi culture"	N																																																																																																											
87102	"	Fungus isolation culture"	N																																																																																																											
87103	"	Blood fungus culture"	N																																																																																																											
87106	"	Fungi identification yeast"	N																																																																																																											
87107	"	Fungi identification mold"	N																																																																																																											
87109	"	Mycoplasma"	N																																																																																																											
87110	"	Chlamydia culture"	N																																																																																																											
87116	"	Mycobacteria culture"	N																																																																																																											
87118	"	Mycobacteric identification"	N																																																																																																											
87140	"	Culture type immunofluoresc"	N																																																																																																											
87143	"	Culture typing glc/hplc"	N																																																																																																											
87147	"	Culture type immunologic"	N																																																																																																											
87149	"	Dna/rna direct probe"	N																																																																																																											
87150	"	Dna/rna amplified probe"	N																																																																																																											
87152	"	Culture type pulse field gel"	N																																																																																																											
87153	"	Dna/rna sequencing"	N																																																																																																											
87158	"	Culture typing added method"	N																																																																																																											
87164	"	Dark field examination"	N																																																																																																											
87166	"	Dark field examination"	N																																																																																																											
87168	"	Macroscopic exam arthropod"	N																																																																																																											
87169	"	Macroscopic exam parasite"	N																																																																																																											
87172	"	Pinworm exam"	N																																																																																																											
87176	"	Tissue homogenization cultr"	N																																																																																																											
87177	"	Ova and parasites smears"	N																																																																																																											
87181	"	Microbe susceptible diffuse"	N																																																																																																											
87184	"	Microbe susceptible disk"	N																																																																																																											
87185	"	Microbe susceptible enzyme"	N																																																																																																											
87186	"	Microbe susceptible mic"	N																																																																																																											
87187	"	Microbe susceptible mlc"	N																																																																																																											
87188	"	Microbe suscept macrobroth"	N																																																																																																											
87190	"	Microbe suscept mycobacteri"	N																																																																																																											
87197	"	Bactericidal level serum"	N																																																																																																											
87205	"	Smear gram stain"	N																																																																																																											
87206	"	Smear fluorescent/acid stai"	N																																																																																																											
87207	"	Smear special stain"	N																																																																																																											
87209	"	Smear complex stain"	N																																																																																																											
87210	"	Smear wet mount saline/ink"	N																																																																																																											
87220	"	Tissue exam for fungi"	N																																																																																																											
87230	"	Assay toxin or antitoxin"	N																																																																																																											
87250	"	Virus inoculate eggs/animal"	N																																																																																																											
87252	"	Virus inoculation tissue"	N																																																																																																											
87253	"	Virus inoculate tissue addl"	N																																																																																																											
87254	"	Virus inoculation shell via"	N																																																																																																											
87255	"	Genet virus isolate hsv"	N																																																																																																											
87260	"	Adenovirus ag if"	N																																																																																																											
87265	"	Pertussis ag if"	N																																																																																																											
87267	"	Enterovirus antibody dfa"	N																																																																																																											
87269	"	Giardia ag if"	N																																																																																																											
87270	"	Chlamydia trachomatis ag if"	N																																																																																																											
87271	"	Cytomegalovirus dfa"	N																																																																																																											
87272	"	Cryptosporidium ag if"	N																																																																																																											
87273	"	Herpes simplex 2 ag if"	N																																																																																																											
87274	"	Herpes simplex 1 ag if"	N																																																																																																											
87275	"	Influenza b ag if"	N																																																																																																											
87276	"	Influenza a ag if"	N																																																																																																											
87277	"	Legionella micdadei ag if"	N																																																																																																											
87278	"	Legion pneumophilia ag if"	N																																																																																																											
87279	"	Parainfluenza ag if"	N																																																																																																											
87280	"	Respiratory syncytial ag if"	N																																																																																																											
87281	"	Pneumocystis carinii ag if"	N																																																																																																											
87283	"	Rubeola ag if"	N																																																																																																											
87285	"	Treponema pallidum ag if"	N																																																																																																											
87290	"	Varicella zoster ag if"	N																																																																																																											
87299	"	Antibody detection nos if"	N																																																																																																											
87300	"	Ag detection polyval if"	N																																																																																																											
87301	"	Adenovirus ag eia"	N																																																																																																											
87305	"	Aspergillus ag eia"	N																																																																																																											
87320	"	Chylmd trach ag eia"	N																																																																																																											
87324	"	Clostridium ag eia"	N																																																																																																											
87327	"	Cryptococcus neoform ag eia"	N																																																																																																											
87328	"	Cryptosporidium ag eia"	N																																																																																																											
87329	"	Giardia ag eia"	N																																																																																																											
87332	"	Cytomegalovirus ag eia"	N																																																																																																											
87335	"	E coli 0157 ag eia"	N																																																																																																											
87336	"	Entamoeb hist dispr ag eia"	N																																																																																																											
87337	"	Entamoeb hist group ag eia"	N																																																																																																											
87338	"	Hpylori stool eia"	N																																																																																																											
87339	"	H pylori ag eia"	N																																																																																																											
87340	"	Hepatitis b surface ag eia"	N																																																																																																											
87341	"	Hepatitis b surface ag eia"	N																																																																																																											
87350	"	Hepatitis be ag eia"	N																																																																																																											
87380	"	Hepatitis delta ag eia"	N																																																																																																											
87385	"	Histoplasma capsul ag eia"	N																																																																																																											
87389	"	Hiv-1 ag w/hiv-1 & hiv-2 ab"	N																																																																																																											
87390	"	Hiv-1 ag eia"	N																																																																																																											
87391	"	Hiv-2 ag eia"	N																																																																																																											
87400	"	Influenza a/b ag eia"	N																																																																																																											
87420	"	Resp syncytial ag eia"	N																																																																																																											
87425	"	Rotavirus ag eia"	N																																																																																																											
87427	"	Shiga-like toxin ag eia"	N																																																																																																											
87430	"	Strep a ag eia"	N																																																																																																											
87449	"	Ag detect nos eia mult"	N																																																																																																											
87450	"	Ag detect nos eia single"	N																																																																																																											
87451	"	Ag detect polyval eia mult"	N																																																																																																											
87470	"	Bartonella dna dir probe"	N																																																																																																											
87471	"	Bartonella dna amp probe"	N																																																																																																											
87472	"	Bartonella dna quant"	N																																																																																																											
87475	"	Lyme dis dna dir probe"	N																																																																																																											
87476	"	Lyme dis dna amp probe"	N																																																																																																											
87477	"	Lyme dis dna quant"	N																																																																																																											
87480	"	Candida dna dir probe"	N																																																																																																											
87481	"	Candida dna amp probe"	N																																																																																																											
87482	"	Candida dna quant"	N																																																																																																											
87485	"	Chylmd pneum dna dir probe"	N																																																																																																											
87486	"	Chylmd pneum dna amp probe"	N																																																																																																											
87487	"	Chylmd pneum dna quant"	N																																																																																																											
87490	"	Chylmd trach dna dir probe"	N																																																																																																											
87491	"	Chylmd trach dna amp probe"	N																																																																																																											
87492	"	Chylmd trach dna quant"	N																																																																																																											
87493	"	C diff amplified probe"	N																																																																																																											
87495	"	Cytomeg dna dir probe"	N																																																																																																											
87496	"	Cytomeg dna amp probe"	N																																																																																																											
87497	"	Cytomeg dna quant"	N																																																																																																											
87498	"	Enterovirus probe&revrs trns"	N																																																																																																											
87500	"	Vanomycin dna amp probe"	N																																																																																																											
87501	"	Influenza dna amp prob 1+"	N																																																																																																											
87502	"	Influenza dna amp probe"	N																																																																																																											
87503	"	Influenza dna amp prob addl"	N																																																																																																											
87510	"	Gardner vag dna dir probe"	N																																																																																																											
87511	"	Gardner vag dna amp probe"	N																																																																																																											
87512	"	Gardner vag dna quant"	N																																																																																																											
87515	"	Hepatitis b dna dir probe"	N																																																																																																											
87516	"	Hepatitis b dna amp probe"	N																																																																																																											
87517	"	Hepatitis b dna quant"	N																																																																																																											
87520	"	Hepatitis c rna dir probe"	N																																																																																																											
87521	"	Hepatitis c probe&rvrs trnsc"	N																																																																																																											
87522	"	Hepatitis c revrs trnscrpj"	N																																																																																																											
87525	"	Hepatitis g dna dir probe"	N																																																																																																											
87526	"	Hepatitis g dna amp probe"	N																																																																																																											
87527	"	Hepatitis g dna quant"	N																																																																																																											
87528	"	Hsv dna dir probe"	N																																																																																																											
87529	"	Hsv dna amp probe"	N																																																																																																											
87530	"	Hsv dna quant"	N																																																																																																											
87531	"	Hhv-6 dna dir probe"	N																																																																																																											
87532	"	Hhv-6 dna amp probe"	N																																																																																																											
87533	"	Hhv-6 dna quant"	N																																																																																																											
87534	"	Hiv-1 dna dir probe"	N																																																																																																											
87535	"	Hiv-1 probe&reverse trnscrpj"	N																																																																																																											
87536	"	Hiv-1 quant&revrse trnscrpj"	N																																																																																																											
87537	"	Hiv-2 dna dir probe"	N																																																																																																											
87538	"	Hiv-2 probe&revrse trnscripj"	N																																																																																																											
87539	"	Hiv-2 quant&revrse trnscripj"	N																																																																																																											
87540	"	Legion pneumo dna dir prob"	N																																																																																																											
87541	"	Legion pneumo dna amp prob"	N																																																																																																											
87542	"	Legion pneumo dna quant"	N																																																																																																											
87550	"	Mycobacteria dna dir probe"	N																																																																																																											
87551	"	Mycobacteria dna amp probe"	N																																																																																																											
87552	"	Mycobacteria dna quant"	N																																																																																																											
87555	"	M.tuberculo dna dir probe"	N																																																																																																											
87556	"	M.tuberculo dna amp probe"	N																																																																																																											
87557	"	M.tuberculo dna quant"	N																																																																																																											
87560	"	M.avium-intra dna dir prob"	N																																																																																																											
87561	"	M.avium-intra dna amp prob"	N																																																																																																											
87562	"	M.avium-intra dna quant"	N																																																																																																											
87580	"	M.pneumon dna dir probe"	N																																																																																																											
87581	"	M.pneumon dna amp probe"	N																																																																																																											
87582	"	M.pneumon dna quant"	N																																																																																																											
87590	"	N.gonorrhoeae dna dir prob"	N																																																																																																											
87591	"	N.gonorrhoeae dna amp prob"	N																																																																																																											
87592	"	N.gonorrhoeae dna quant"	N																																																																																																											
87620	"	Hpv dna dir probe"	N																																																																																																											
87621	"	Hpv dna amp probe"	N																																																																																																											
87622	"	Hpv dna quant"	N																																																																																																											
87631	"	Resp virus 3-5 targets"	N																																																																																																											
87632	"	Resp virus 6-11 targets"	N																																																																																																											
87633	"	Resp virus 12-25 targets"	N																																																																																																											
87640	"	Staph a dna amp probe"	N																																																																																																											
87641	"	Mr-staph dna amp probe"	N																																																																																																											
87650	"	Strep a dna dir probe"	N																																																																																																											
87651	"	Strep a dna amp probe"	N																																																																																																											
87652	"	Strep a dna quant"	N																																																																																																											
87653	"	Strep b dna amp probe"	N																																																																																																											
87660	"	Trichomonas vagin dir probe"	N																																																																																																											
87661	"	Trichomonas vaginalis amplif"	A																																																																																																											
87797	"	Detect agent nos dna dir"	N																																																																																																											
87798	"	Detect agent nos dna amp"	N																																																																																																											
87799	"	Detect agent nos dna quant"	N																																																																																																											
87800	"	Detect agnt mult dna direc"	N																																																																																																											
87801	"	Detect agnt mult dna ampli"	N																																																																																																											
87802	"	Strep b assay w/optic"	N																																																																																																											
87803	"	Clostridium toxin a w/optic"	N																																																																																																											
87804	"	Influenza assay w/optic"	N																																																																																																											
87807	"	Rsv assay w/optic"	N																																																																																																											
87808	"	Trichomonas assay w/optic"	N																																																																																																											
87809	"	Adenovirus assay w/optic"	N																																																																																																											
87810	"	Chylmd trach assay w/optic"	N																																																																																																											
87850	"	N. gonorrhoeae assay w/optic"	N																																																																																																											
87880	"	Strep a assay w/optic"	N																																																																																																											
87899	"	Agent nos assay w/optic"	N																																																																																																											
87900	"	Phenotype infect agent drug"	N																																																																																																											
87901	"	Genotype dna hiv reverse t"	N																																																																																																											
87902	"	Genotype dna/rna hep c"	N																																																																																																											
87903	"	Phenotype dna hiv w/culture"	N																																																																																																											
87904	"	Phenotype dna hiv w/clt add"	N																																																																																																											
87905	"	Sialidase enzyme assay"	N																																																																																																											
87906	"	Genotype dna/rna hiv"	N																																																																																																											
87910	"	Genotype cytomegalovirus"	N																																																																																																											
87912	"	Genotype dna hepatitis b"	N																																																																																																											
87999	"	Microbiology procedure"	N																																																																																																											
88000	"	Autopsy (necropsy) gross"	E																																																																																																											
88005	"	Autopsy (necropsy) gross"	E																																																																																																											
88007	"	Autopsy (necropsy) gross"	E																																																																																																											
88012	"	Autopsy (necropsy) gross"	E																																																																																																											
88014	"	Autopsy (necropsy) gross"	E																																																																																																											
88016	"	Autopsy (necropsy) gross"	E																																																																																																											
88020	"	Autopsy (necropsy) complete"	E																																																																																																											
88025	"	Autopsy (necropsy) complete"	E																																																																																																											
88027	"	Autopsy (necropsy) complete"	E																																																																																																											
88028	"	Autopsy (necropsy) complete"	E																																																																																																											
88029	"	Autopsy (necropsy) complete"	E																																																																																																											
88036	"	Limited autopsy"	E																																																																																																											
88037	"	Limited autopsy"	E																																																																																																											
88040	"	Forensic autopsy (necropsy)"	E																																																																																																											
88045	"	Coroners autopsy (necropsy)"	E																																																																																																											
88099	"	Necropsy (autopsy) procedure"	E																																																																																																											
88104	"	Cytopath fl nongyn smears"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88106	"	Cytopath fl nongyn filter"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88108	"	Cytopath concentrate tech"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88112	"	Cytopath cell enhance tech"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88120	"	Cytp urne 3-5 probes ea spec"	X	0343	0.8458	$61.47	.	$12.30																																																																																																						
88121	"	Cytp urine 3-5 probes cmptr"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
88125	"	Forensic cytopathology"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88130	"	Sex chromatin identification"	N																																																																																																											
88140	"	Sex chromatin identification"	N																																																																																																											
88141	"	Cytopath c/v interpret"	N																																																																																																											
88142	"	Cytopath c/v thin layer"	N																																																																																																											
88143	"	Cytopath c/v thin layer redo"	N																																																																																																											
88147	"	Cytopath c/v automated"	N																																																																																																											
88148	"	Cytopath c/v auto rescreen"	N																																																																																																											
88150	"	Cytopath c/v manual"	N																																																																																																											
88152	"	Cytopath c/v auto redo"	N																																																																																																											
88153	"	Cytopath c/v redo"	N																																																																																																											
88154	"	Cytopath c/v select"	N																																																																																																											
88155	"	Cytopath c/v index add-on"	N																																																																																																											
88160	"	Cytopath smear other source"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88161	"	Cytopath smear other source"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88162	"	Cytopath smear other source"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88164	"	Cytopath tbs c/v manual"	N																																																																																																											
88165	"	Cytopath tbs c/v redo"	N																																																																																																											
88166	"	Cytopath tbs c/v auto redo"	N																																																																																																											
88167	"	Cytopath tbs c/v select"	N																																																																																																											
88172	"	Cytp dx eval fna 1st ea site"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88173	"	Cytopath eval fna report"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88174	"	Cytopath c/v auto in fluid"	N																																																																																																											
88175	"	Cytopath c/v auto fluid redo"	N																																																																																																											
88177	"	Cytp fna eval ea addl"	N																																																																																																											
88182	"	Cell marker study"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88184	"	Flowcytometry/ tc 1 marker"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88185	"	Flowcytometry/tc add-on"	N																																																																																																											
88187	"	Flowcytometry/read 2-8"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
88188	"	Flowcytometry/read 9-15"	X	0661	3.8286	$278.23	.	$55.65																																																																																																						
88189	"	Flowcytometry/read 16 & >"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88199	"	Cytopathology procedure"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88230	"	Tissue culture lymphocyte"	N																																																																																																											
88233	"	Tissue culture skin/biopsy"	N																																																																																																											
88235	"	Tissue culture placenta"	N																																																																																																											
88237	"	Tissue culture bone marrow"	N																																																																																																											
88239	"	Tissue culture tumor"	N																																																																																																											
88240	"	Cell cryopreserve/storage"	N																																																																																																											
88241	"	Frozen cell preparation"	N																																																																																																											
88245	"	Chromosome analysis 20-25"	N																																																																																																											
88248	"	Chromosome analysis 50-100"	N																																																																																																											
88249	"	Chromosome analysis 100"	N																																																																																																											
88261	"	Chromosome analysis 5"	N																																																																																																											
88262	"	Chromosome analysis 15-20"	N																																																																																																											
88263	"	Chromosome analysis 45"	N																																																																																																											
88264	"	Chromosome analysis 20-25"	N																																																																																																											
88267	"	Chromosome analys placenta"	N																																																																																																											
88269	"	Chromosome analys amniotic"	N																																																																																																											
88271	"	Cytogenetics dna probe"	N																																																																																																											
88272	"	Cytogenetics 3-5"	N																																																																																																											
88273	"	Cytogenetics 10-30"	N																																																																																																											
88274	"	Cytogenetics 25-99"	N																																																																																																											
88275	"	Cytogenetics 100-300"	N																																																																																																											
88280	"	Chromosome karyotype study"	N																																																																																																											
88283	"	Chromosome banding study"	N																																																																																																											
88285	"	Chromosome count additional"	N																																																																																																											
88289	"	Chromosome study additional"	N																																																																																																											
88291	"	Cyto/molecular report"	M																																																																																																											
88299	"	Cytogenetic study"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88300	"	Surgical path gross"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88302	"	Tissue exam by pathologist"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88304	"	Tissue exam by pathologist"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88305	"	Tissue exam by pathologist"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88307	"	Tissue exam by pathologist"	X	0343	0.8458	$61.47	.	$12.30																																																																																																						
88309	"	Tissue exam by pathologist"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
88311	"	Decalcify tissue"	N																																																																																																											
88312	"	Special stains group 1"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88313	"	Special stains group 2"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88314	"	Histochemical stains add-on"	N																																																																																																											
88319	"	Enzyme histochemistry"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
88321	"	Microslide consultation"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88323	"	Microslide consultation"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88325	"	Comprehensive review of data"	X	0343	0.8458	$61.47	.	$12.30																																																																																																						
88329	"	Path consult introp"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88331	"	Path consult intraop 1 bloc"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88332	"	Path consult intraop addl"	N																																																																																																											
88333	"	Intraop cyto path consult 1"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88334	"	Intraop cyto path consult 2"	N																																																																																																											
88342	"	Immunohisto antibody slide"	E																																																																																																											
88343	"	Immunohisto antibod add slid"	E																																																																																																											
88346	"	Immunofluorescent study"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88347	"	Immunofluorescent study"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88348	"	Electron microscopy"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
88349	"	Scanning electron microscopy"	X	0343	0.8458	$61.47	.	$12.30																																																																																																						
88355	"	Analysis skeletal muscle"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
88356	"	Analysis nerve"	X	0343	0.8458	$61.47	.	$12.30																																																																																																						
88358	"	Analysis tumor"	X	0343	0.8458	$61.47	.	$12.30																																																																																																						
88360	"	Tumor immunohistochem/manual"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88361	"	Tumor immunohistochem/comput"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88362	"	Nerve teasing preparations"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
88363	"	Xm archive tissue molec anal"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88365	"	Insitu hybridization (fish)"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88367	"	Insitu hybridization auto"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88368	"	Insitu hybridization manual"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
88371	"	Protein western blot tissue"	N																																																																																																											
88372	"	Protein analysis w/probe"	N																																																																																																											
88375	"	Optical endomicroscpy interp"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
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"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
88720	"	Bilirubin total transcut"	N																																																																																																											
88738	"	Hgb quant transcutaneous"	N																																																																																																											
88740	"	Transcutaneous carboxyhb"	N																																																																																																											
88741	"	Transcutaneous methb"	N																																																																																																											
88749	"	In vivo lab service"	N																																																																																																											
89049	"	Chct for mal hyperthermia"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
89050	"	Body fluid cell count"	N																																																																																																											
89051	"	Body fluid cell count"	N																																																																																																											
89055	"	Leukocyte assessment fecal"	N																																																																																																											
89060	"	Exam synovial fluid crystals"	N																																																																																																											
89125	"	Specimen fat stain"	N																																																																																																											
89160	"	Exam feces for meat fibers"	N																																																																																																											
89190	"	Nasal smear for eosinophils"	N																																																																																																											
89220	"	Sputum specimen collection"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
89230	"	Collect sweat for test"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
89240	"	Pathology lab procedure"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
89250	"	Cultr oocyte/embryo <4 days"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
89251	"	Cultr oocyte/embryo <4 days"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
89253	"	Embryo hatching"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
89254	"	Oocyte identification"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
89255	"	Prepare embryo for transfer"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
89257	"	Sperm identification"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
89258	"	Cryopreservation embryo(s)"	X	0661	3.8286	$278.23	.	$55.65																																																																																																						
89259	"	Cryopreservation sperm"	X	0343	0.8458	$61.47	.	$12.30																																																																																																						
89260	"	Sperm isolation simple"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
89261	"	Sperm isolation complex"	X	0343	0.8458	$61.47	.	$12.30																																																																																																						
89264	"	Identify sperm tissue"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
89268	"	Insemination of oocytes"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
89272	"	Extended culture of oocytes"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
89280	"	Assist oocyte fertilization"	X	0661	3.8286	$278.23	.	$55.65																																																																																																						
89281	"	Assist oocyte fertilization"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
89290	"	Biopsy oocyte polar body"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
89291	"	Biopsy oocyte polar body"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
89300	"	Semen analysis w/huhner"	N																																																																																																											
89310	"	Semen analysis w/count"	N																																																																																																											
89320	"	Semen anal vol/count/mot"	N																																																																																																											
89321	"	Semen anal sperm detection"	N																																																																																																											
89322	"	Semen anal strict criteria"	N																																																																																																											
89325	"	Sperm antibody test"	N																																																																																																											
89329	"	Sperm evaluation test"	N																																																																																																											
89330	"	Evaluation cervical mucus"	N																																																																																																											
89331	"	Retrograde ejaculation anal"	N																																																																																																											
89335	"	Cryopreserve testicular tiss"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
89342	"	Storage/year embryo(s)"	X	0343	0.8458	$61.47	.	$12.30																																																																																																						
89343	"	Storage/year sperm/semen"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
89344	"	Storage/year reprod tissue"	X	0343	0.8458	$61.47	.	$12.30																																																																																																						
89346	"	Storage/year oocyte(s)"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
89352	"	Thawing cryopresrved embryo"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
89353	"	Thawing cryopresrved sperm"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
89354	"	Thaw cryoprsvrd reprod tiss"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
89356	"	Thawing cryopresrved oocyte"	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
89398	"	Unlisted reprod med lab proc"	X	0342	0.2730	$19.84	.	$3.97																																																																																																						
9001F	"	Aortic aneurysm<5cm diam ct"	E																																																																																																											
9002F	"	Aortic aneurysm 5-5.4cm diam"	E																																																																																																											
9003F	"	Aortic anrysm5.5-5.9cm diam"	M																																																																																																											
9004F	"	Aortic anrysm 6/> cm diam"	M																																																																																																											
9005F	"	Asympt carot/vrtbrbas sten"	E																																																																																																											
9006F	"	Sympt sten-tia/strk<120days"	M																																																																																																											
9007F	"	Other carot sten 120 days/>"	M																																																																																																											
90281	"	Human ig im"	E																																																																																																											
90283	"	Human ig iv"	E																																																																																																											
90284	"	Human ig sc"	E																																																																																																											
90287	"	Botulinum antitoxin"	E																																																																																																											
90288	"	Botulism ig iv"	E																																																																																																											
90291	"	Cmv ig iv"	E																																																																																																											
90296	"	Diphtheria antitoxin"	N																																																																																																											
90371	"	Hep b ig im"	K	1630		$117.38	.	$23.48	*																																																																																																					
90375	"	Rabies ig im/sc"	K	9133		$247.57	.	$49.52	*																																																																																																					
90376	"	Rabies ig heat treated"	K	9134		$237.82	.	$47.57	*																																																																																																					
90378	"	Rsv mab im 50mg"	K	9003		"$1,308.40"	.	$261.68																																																																																																						
90384	"	Rh ig full-dose im"	E																																																																																																											
90385	"	Rh ig minidose im"	N																																																																																																											
90386	"	Rh ig iv"	E																																																																																																											
90389	"	Tetanus ig im"	E																																																																																																											
90393	"	Vaccina ig im"	E																																																																																																											
90396	"	Varicella-zoster ig im"	K	9135		$675.22	.	$135.04																																																																																																						
90399	"	Immune globulin"	E																																																																																																											
90460	"	Im admin 1st/only component"	B																																																																																																											
90461	"	Im admin each addl component"	B																																																																																																											
90471	"	Immunization admin"	S	0437	0.6024	$43.78	.	$8.76																																																																																																						
90472	"	Immunization admin each add"	N																																																																																																											
90473	"	Immune admin oral/nasal"	S	0437	0.6024	$43.78	.	$8.76																																																																																																						
90474	"	Immune admin oral/nasal addl"	N																																																																																																											
90476	"	Adenovirus vaccine type 4"	N																																																																																																											
90477	"	Adenovirus vaccine type 7"	N																																																																																																											
90581	"	Anthrax vaccine sc or im"	K	1422		$94.05	.	$18.81																																																																																																						
90585	"	Bcg vaccine percut"	K	9137		$121.96	.	$24.40	*																																																																																																					
90586	"	Bcg vaccine intravesical"	B																																																																																																											
90632	"	Hep a vaccine adult im"	N																																																																																																											
90633	"	Hep a vacc ped/adol 2 dose"	N																																																																																																											
90634	"	Hep a vacc ped/adol 3 dose"	N																																																																																																											
90636	"	Hep a/hep b vacc adult im"	N																																																																																																											
90644	"	Meningoccl hib vac 4 dose im"	E																																																																																																											
90645	"	Hib vaccine hboc im"	N																																																																																																											
90646	"	Hib vaccine prp-d im"	N																																																																																																											
90647	"	Hib vaccine prp-omp im"	N																																																																																																											
90648	"	Hib vaccine prp-t im"	N																																																																																																											
90649	"	Hpv vaccine 4 valent im"	M																																																																																																											
90650	"	Hpv vaccine 2 valent im"	M																																																																																																											
90653	"	Flu vaccine adjuvant im"	E																																																																																																											
90654	"	Flu vaccine no preserv id"	L																																																																																																											
90655	"	Flu vac no prsv 3 val 6-35 m"	L																																																																																																											
90656	"	Flu vaccine no preserv 3 & >"	L																																																																																																											
90657	"	Flu vaccine 3 yrs im"	L																																																																																																											
90658	"	Flu vaccine 3 yrs & > im"	E																																																																																																											
90660	"	Flu vaccine nasal"	L																																																																																																											
90661	"	Flu vacc cell cult prsv free"	L																																																																																																											
90662	"	Flu vacc prsv free inc antig"	L																																																																																																											
90664	"	Flu vacc pandemic intranasal"	E																																																																																																											
90666	"	Flu vac pandem prsrv free im"	E																																																																																																											
90667	"	Flu vac pandemic adjuvant im"	E																																																																																																											
90668	"	Flu vac pandemic splt im"	E																																																																																																											
90669	"	Pneumococcal vacc 7 val im"	L																																																																																																											
90670	"	Pneumococcal vacc 13 val im"	L																																																																																																											
90672	"	Flu vaccine 4 valent nasal"	L																																																																																																											
90673	"	Flu vacc riv3 no preserv"	L																																																																																																											
90675	"	Rabies vaccine im"	K	9139		$223.78	.	$44.76	*																																																																																																					
90676	"	Rabies vaccine id"	K	9140		$158.42	.	$31.69																																																																																																						
90680	"	Rotovirus vacc 3 dose oral"	N																																																																																																											
90681	"	Rotavirus vacc 2 dose oral"	E																																																																																																											
90685	"	Flu vac no prsv 4 val 6-35 m"	L																																																																																																											
90686	"	Flu vac no prsv 4 val 3 yrs+"	L																																																																																																											
90687	"	Flu vaccine 4 val 6-35 mo im"	E																																																																																																											
90688	"	Flu vacc 4 val 3 yrs plus im"	L																																																																																																											
90690	"	Typhoid vaccine oral"	N																																																																																																											
90691	"	Typhoid vaccine im"	N																																																																																																											
90692	"	Typhoid vaccine h-p sc/id"	N																																																																																																											
90693	"	Typhoid vaccine akd sc"	B																																																																																																											
90696	"	Dtap-ipv vacc 4-6 yr im"	N																																																																																																											
90698	"	Dtap-hib-ip vaccine im"	N																																																																																																											
90700	"	Dtap vaccine < 7 yrs im"	N																																																																																																											
90702	"	Dt vaccine < 7 yrs im"	N																																																																																																											
90703	"	Tetanus vaccine im"	N																																																																																																											
90704	"	Mumps vaccine sc"	K	1454		$162.34	.	$32.47																																																																																																						
90705	"	Measles vaccine sc"	N																																																																																																											
90706	"	Rubella vaccine sc"	N																																																																																																											
90707	"	Mmr vaccine sc"	N																																																																																																											
90708	"	Measles-rubella vaccine sc"	N																																																																																																											
90710	"	Mmrv vaccine sc"	N																																																																																																											
90712	"	Oral poliovirus vaccine"	N																																																																																																											
90713	"	Poliovirus ipv sc/im"	N																																																																																																											
90714	"	Td vaccine no prsrv 7/> im"	N																																																																																																											
90715	"	Tdap vaccine 7 yrs/> im"	N																																																																																																											
90716	"	Chicken pox vaccine sc"	M																																																																																																											
90717	"	Yellow fever vaccine sc"	N																																																																																																											
90719	"	Diphtheria vaccine im"	N																																																																																																											
90720	"	Dtp/hib vaccine im"	N																																																																																																											
90721	"	Dtap/hib vaccine im"	N																																																																																																											
90723	"	Dtap-hep b-ipv vaccine im"	E																																																																																																											
90725	"	Cholera vaccine injectable"	N																																																																																																											
90727	"	Plague vaccine im"	E																																																																																																											
90732	"	Pneumococcal vacc 23 val im"	L																																																																																																											
90733	"	Meningococcal vaccine sc"	K	9143		$106.49	.	$21.30																																																																																																						
90734	"	Meningococcal vaccine im"	K	9145		$100.46	.	$20.10	*																																																																																																					
90735	"	Encephalitis vaccine sc"	K	9144		$104.13	.	$20.83																																																																																																						
90736	"	Zoster vacc sc"	M																																																																																																											
90738	"	Inactivated je vacc im"	M																																																																																																											
90739	"	Hep b vacc adult 2 dose im"	E																																																																																																											
90740	"	Hepb vacc ill pat 3 dose im"	F																																																																																																											
90743	"	Hep b vacc adol 2 dose im"	F																																																																																																											
90744	"	Hepb vacc ped/adol 3 dose im"	F																																																																																																											
90746	"	Hep b vacc adult 3 dose im"	F																																																																																																											
90747	"	Hepb vacc ill pat 4 dose im"	F																																																																																																											
90748	"	Hep b/hib vaccine im"	E																																																																																																											
90749	"	Vaccine toxoid"	N																																																																																																											
90785	"	Psytx complex interactive"	N																																																																																																											
90791	"	Psych diagnostic evaluation"	Q3	0323	1.5807	$114.87	.	$22.98																																																																																																						
90792	"	Psych diag eval w/med srvcs"	Q3	0323	1.5807	$114.87	.	$22.98																																																																																																						
90832	"	Psytx pt&/family 30 minutes"	Q3	0322	1.1613	$84.39	.	$16.88																																																																																																						
90833	"	Psytx pt&/fam w/e&m 30 min"	N																																																																																																											
90834	"	Psytx pt&/family 45 minutes"	Q3	0323	1.5807	$114.87	.	$22.98																																																																																																						
90836	"	Psytx pt&/fam w/e&m 45 min"	N																																																																																																											
90837	"	Psytx pt&/family 60 minutes"	Q3	0323	1.5807	$114.87	.	$22.98																																																																																																						
90838	"	Psytx pt&/fam w/e&m 60 min"	N																																																																																																											
90839	"	Psytx crisis initial 60 min"	Q3	0323	1.5807	$114.87	.	$22.98																																																																																																						
90840	"	Psytx crisis ea addl 30 min"	N																																																																																																											
90845	"	Psychoanalysis"	Q3	0323	1.5807	$114.87	.	$22.98																																																																																																						
90846	"	Family psytx w/o patient"	Q3	0324	1.7784	$129.24	.	$25.85																																																																																																						
90847	"	Family psytx w/patient"	Q3	0324	1.7784	$129.24	.	$25.85																																																																																																						
90849	"	Multiple family group psytx"	Q3	0325	0.9541	$69.34	.	$13.87																																																																																																						
90853	"	Group psychotherapy"	Q3	0325	0.9541	$69.34	.	$13.87																																																																																																						
90863	"	Pharmacologic mgmt w/psytx"	E																																																																																																											
90865	"	Narcosynthesis"	Q3	0323	1.5807	$114.87	.	$22.98																																																																																																						
90867	"	Tcranial magn stim tx plan"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
90868	"	Tcranial magn stim tx deli"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
90869	"	Tcran magn stim redetemine"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
90870	"	Electroconvulsive therapy"	S	0320	5.9928	$435.51	.	$87.11																																																																																																						
90875	"	Psychophysiological therapy"	E																																																																																																											
90876	"	Psychophysiological therapy"	E																																																																																																											
90880	"	Hypnotherapy"	Q3	0323	1.5807	$114.87	.	$22.98																																																																																																						
90882	"	Environmental manipulation"	E																																																																																																											
90885	"	Psy evaluation of records"	N																																																																																																											
90887	"	Consultation with family"	N																																																																																																											
90889	"	Preparation of report"	N																																																																																																											
90899	"	Psychiatric service/therapy"	Q3	0322	1.1613	$84.39	.	$16.88																																																																																																						
90901	"	Biofeedback train any meth"	A																																																																																																											
90911	"	Biofeedback peri/uro/rectal"	T	0126	1.0909	$79.28	.	$15.86																																																																																																						
90935	"	Hemodialysis one evaluation"	S	0170	8.3974	$610.26	.	$122.06																																																																																																						
90937	"	Hemodialysis repeated eval"	B																																																																																																											
90940	"	Hemodialysis access study"	N																																																																																																											
90945	"	Dialysis one evaluation"	V	0633	4.5113	$327.85	.	$65.57																																																																																																						
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 home pt serv p day <2"	M																																																																																																											
90968	"	Esrd home pt srv p day 2-11"	M																																																																																																											
90969	"	Esrd home pt srv p day 12-19"	M																																																																																																											
90970	"	Esrd home pt serv p day 20+"	M																																																																																																											
90989	"	Dialysis training complete"	B																																																																																																											
90993	"	Dialysis training incompl"	B																																																																																																											
90997	"	Hemoperfusion"	B																																																																																																											
90999	"	Dialysis procedure"	B																																																																																																											
91010	"	Esophagus motility study"	X	0361	4.4489	$323.31	$83.23	$64.67																																																																																																						
91013	"	Esophgl motil w/stim/perfus"	N																																																																																																											
91020	"	Gastric motility studies"	X	0361	4.4489	$323.31	$83.23	$64.67																																																																																																						
91022	"	Duodenal motility study"	X	0361	4.4489	$323.31	$83.23	$64.67																																																																																																						
91030	"	Acid perfusion of esophagus"	X	0361	4.4489	$323.31	$83.23	$64.67																																																																																																						
91034	"	Gastroesophageal reflux test"	X	0361	4.4489	$323.31	$83.23	$64.67																																																																																																						
91035	"	G-esoph reflx tst w/electrod"	X	0361	4.4489	$323.31	$83.23	$64.67																																																																																																						
91037	"	Esoph imped function test"	X	0360	1.9973	$145.15	$33.59	$29.03																																																																																																						
91038	"	Esoph imped funct test > 1hr"	X	0361	4.4489	$323.31	$83.23	$64.67																																																																																																						
91040	"	Esoph balloon distension tst"	X	0360	1.9973	$145.15	$33.59	$29.03																																																																																																						
91065	"	Breath hydrogen/methane test"	X	0360	1.9973	$145.15	$33.59	$29.03																																																																																																						
91110	"	Gi tract capsule endoscopy"	T	0142	11.5200	$837.18	.	$167.44																																																																																																						
91111	"	Esophageal capsule endoscopy"	T	0419	13.9400	"$1,013.05"	$207.70	$202.61																																																																																																						
91112	"	Gi wireless capsule measure"	X	0361	4.4489	$323.31	$83.23	$64.67																																																																																																						
91117	"	Colon motility 6 hr study"	T	0156	5.7679	$419.16	.	$83.84																																																																																																						
91120	"	Rectal sensation test"	T	0126	1.0909	$79.28	.	$15.86																																																																																																						
91122	"	Anal pressure record"	T	0164	2.9049	$211.10	.	$42.22																																																																																																						
91132	"	Electrogastrography"	X	0360	1.9973	$145.15	$33.59	$29.03																																																																																																						
91133	"	Electrogastrography w/test"	X	0360	1.9973	$145.15	$33.59	$29.03																																																																																																						
91299	"	Gastroenterology procedure"	X	0360	1.9973	$145.15	$33.59	$29.03																																																																																																						
92002	"	Eye exam new patient"	V	0632	1.3283	$96.53	.	$19.31																																																																																																						
92004	"	Eye exam new patient"	V	0632	1.3283	$96.53	.	$19.31																																																																																																						
92012	"	Eye exam establish patient"	V	0632	1.3283	$96.53	.	$19.31																																																																																																						
92014	"	Eye exam&tx estab pt 1/>vst"	V	0632	1.3283	$96.53	.	$19.31																																																																																																						
92015	"	Determine refractive state"	E																																																																																																											
92018	"	New eye exam & treatment"	T	0699	16.4654	"$1,196.57"	.	$239.32																																																																																																						
92019	"	Eye exam & treatment"	T	0699	16.4654	"$1,196.57"	.	$239.32																																																																																																						
92020	"	Special eye evaluation"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92025	"	Corneal topography"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92060	"	Special eye evaluation"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92065	"	Orthoptic/pleoptic training"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92071	"	Contact lens fitting for tx"	N																																																																																																											
92072	"	Fit contac lens for managmnt"	N																																																																																																											
92081	"	Visual field examination(s)"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92082	"	Visual field examination(s)"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92083	"	Visual field examination(s)"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92100	"	Serial tonometry exam(s)"	N																																																																																																											
92132	"	Cmptr ophth dx img ant segmt"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92133	"	Cmptr ophth img optic nerve"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92134	"	Cptr ophth dx img post segmt"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92136	"	Ophthalmic biometry"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92140	"	Glaucoma provocative tests"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92225	"	Special eye exam initial"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92226	"	Special eye exam subsequent"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92227	"	Remote dx retinal imaging"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
92228	"	Remote retinal imaging mgmt"	X	0035	0.3042	$22.11	.	$4.43																																																																																																						
92230	"	Eye exam with photos"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92235	"	Eye exam with photos"	S	0231	2.5031	$181.91	.	$36.39																																																																																																						
92240	"	Icg angiography"	S	0231	2.5031	$181.91	.	$36.39																																																																																																						
92250	"	Eye exam with photos"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92260	"	Ophthalmoscopy/dynamometry"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92265	"	Eye muscle evaluation"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92270	"	Electro-oculography"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92275	"	Electroretinography"	S	0231	2.5031	$181.91	.	$36.39																																																																																																						
92283	"	Color vision examination"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92284	"	Dark adaptation eye exam"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92285	"	Eye photography"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92286	"	Internal eye photography"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92287	"	Internal eye photography"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92310	"	Contact lens fitting"	E																																																																																																											
92311	"	Contact lens fitting"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92312	"	Contact lens fitting"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92313	"	Contact lens fitting"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92314	"	Prescription of contact lens"	E																																																																																																											
92315	"	Rx cntact lens aphakia 1 eye"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92316	"	Rx cntact lens aphakia 2 eye"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92317	"	Rx corneoscleral cntact lens"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92325	"	Modification of contact lens"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92326	"	Replacement of contact lens"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92340	"	Fit spectacles monofocal"	E																																																																																																											
92341	"	Fit spectacles bifocal"	E																																																																																																											
92342	"	Fit spectacles multifocal"	E																																																																																																											
92352	"	Fit aphakia spectcl monofocl"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92353	"	Fit aphakia spectcl multifoc"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92354	"	Fit spectacles single system"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92355	"	Fit spectacles compound lens"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92358	"	Aphakia prosth service temp"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92370	"	Repair & adjust spectacles"	E																																																																																																											
92371	"	Repair & adjust spectacles"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
92499	"	Eye service or procedure"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
92502	"	Ear and throat examination"	T	0251	3.5927	$261.09	.	$52.22																																																																																																						
92504	"	Ear microscopy examination"	N																																																																																																											
92507	"	Speech/hearing therapy"	A																																																																																																											
92508	"	Speech/hearing therapy"	A																																																																																																											
92511	"	Nasopharyngoscopy"	T	0071	2.0698	$150.42	.	$30.09																																																																																																						
92512	"	Nasal function studies"	X	0363	1.0239	$74.41	$16.12	$14.89																																																																																																						
92516	"	Facial nerve function test"	X	0363	1.0239	$74.41	$16.12	$14.89																																																																																																						
92520	"	Laryngeal function studies"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
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																																																																																																											
92540	"	Basic vestibular evaluation"	X	0660	1.9041	$138.37	.	$27.68																																																																																																						
92541	"	Spontaneous nystagmus test"	X	0363	1.0239	$74.41	$16.12	$14.89																																																																																																						
92542	"	Positional nystagmus test"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
92543	"	Caloric vestibular test"	X	0660	1.9041	$138.37	.	$27.68																																																																																																						
92544	"	Optokinetic nystagmus test"	X	0363	1.0239	$74.41	$16.12	$14.89																																																																																																						
92545	"	Oscillating tracking test"	X	0363	1.0239	$74.41	$16.12	$14.89																																																																																																						
92546	"	Sinusoidal rotational test"	X	0660	1.9041	$138.37	.	$27.68																																																																																																						
92547	"	Supplemental electrical test"	N																																																																																																											
92548	"	Posturography"	X	0363	1.0239	$74.41	$16.12	$14.89																																																																																																						
92550	"	Tympanometry & reflex thresh"	X	0365	1.0561	$76.75	.	$15.35																																																																																																						
92551	"	Pure tone hearing test air"	E																																																																																																											
92552	"	Pure tone audiometry air"	X	0364	0.4530	$32.92	.	$6.59																																																																																																						
92553	"	Audiometry air & bone"	X	0365	1.0561	$76.75	.	$15.35																																																																																																						
92555	"	Speech threshold audiometry"	X	0364	0.4530	$32.92	.	$6.59																																																																																																						
92556	"	Speech audiometry complete"	X	0364	0.4530	$32.92	.	$6.59																																																																																																						
92557	"	Comprehensive hearing test"	X	0365	1.0561	$76.75	.	$15.35																																																																																																						
92558	"	Evoked auditory test qual"	E																																																																																																											
92559	"	Group audiometric testing"	E																																																																																																											
92560	"	Bekesy audiometry screen"	E																																																																																																											
92561	"	Bekesy audiometry diagnosis"	X	0365	1.0561	$76.75	.	$15.35																																																																																																						
92562	"	Loudness balance test"	X	0365	1.0561	$76.75	.	$15.35																																																																																																						
92563	"	Tone decay hearing test"	X	0364	0.4530	$32.92	.	$6.59																																																																																																						
92564	"	Sisi hearing test"	X	0364	0.4530	$32.92	.	$6.59																																																																																																						
92565	"	Stenger test pure tone"	X	0364	0.4530	$32.92	.	$6.59																																																																																																						
92567	"	Tympanometry"	X	0364	0.4530	$32.92	.	$6.59																																																																																																						
92568	"	Acoustic refl threshold tst"	X	0364	0.4530	$32.92	.	$6.59																																																																																																						
92570	"	Acoustic immitance testing"	X	0365	1.0561	$76.75	.	$15.35																																																																																																						
92571	"	Filtered speech hearing test"	X	0364	0.4530	$32.92	.	$6.59																																																																																																						
92572	"	Staggered spondaic word test"	X	0366	1.6185	$117.62	.	$23.53																																																																																																						
92575	"	Sensorineural acuity test"	X	0364	0.4530	$32.92	.	$6.59																																																																																																						
92576	"	Synthetic sentence test"	X	0364	0.4530	$32.92	.	$6.59																																																																																																						
92577	"	Stenger test speech"	X	0366	1.6185	$117.62	.	$23.53																																																																																																						
92579	"	Visual audiometry (vra)"	X	0365	1.0561	$76.75	.	$15.35																																																																																																						
92582	"	Conditioning play audiometry"	X	0365	1.0561	$76.75	.	$15.35																																																																																																						
92583	"	Select picture audiometry"	X	0364	0.4530	$32.92	.	$6.59																																																																																																						
92584	"	Electrocochleography"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
92585	"	Auditor evoke potent compre"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
92586	"	Auditor evoke potent limit"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
92587	"	Evoked auditory test limited"	X	0363	1.0239	$74.41	$16.12	$14.89																																																																																																						
92588	"	Evoked auditory tst complete"	X	0363	1.0239	$74.41	$16.12	$14.89																																																																																																						
92590	"	Hearing aid exam one ear"	E																																																																																																											
92591	"	Hearing aid exam both ears"	E																																																																																																											
92592	"	Hearing aid check one ear"	E																																																																																																											
92593	"	Hearing aid check both ears"	E																																																																																																											
92594	"	Electro hearng aid test one"	E																																																																																																											
92595	"	Electro hearng aid tst both"	E																																																																																																											
92596	"	Ear protector evaluation"	X	0364	0.4530	$32.92	.	$6.59																																																																																																						
92597	"	Oral speech device eval"	A																																																																																																											
92601	"	Cochlear implt f/up exam <7"	X	0366	1.6185	$117.62	.	$23.53																																																																																																						
92602	"	Reprogram cochlear implt 7/>"	X	0366	1.6185	$117.62	.	$23.53																																																																																																						
92603	"	Cochlear implt f/up exam 7/>"	X	0366	1.6185	$117.62	.	$23.53																																																																																																						
92604	"	Reprogram cochlear implt 7/>"	X	0366	1.6185	$117.62	.	$23.53																																																																																																						
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 tst (fees)"	A																																																																																																											
92613	"	Endoscopy swallow tst (fees)"	B																																																																																																											
92614	"	Laryngoscopic sensory test"	A																																																																																																											
92615	"	Eval laryngoscopy sense tst"	E																																																																																																											
92616	"	Fees w/laryngeal sense test"	A																																																																																																											
92617	"	Interprt fees/laryngeal test"	E																																																																																																											
92618	"	Ex for nonspeech dev rx add"	A																																																																																																											
92620	"	Auditory function 60 min"	X	0365	1.0561	$76.75	.	$15.35																																																																																																						
92621	"	Auditory function + 15 min"	N																																																																																																											
92625	"	Tinnitus assessment"	X	0365	1.0561	$76.75	.	$15.35																																																																																																						
92626	"	Eval aud rehab status"	X	0366	1.6185	$117.62	.	$23.53																																																																																																						
92627	"	Eval aud status rehab add-on"	N																																																																																																											
92630	"	Aud rehab pre-ling hear loss"	E																																																																																																											
92633	"	Aud rehab postling hear loss"	E																																																																																																											
92640	"	Aud brainstem implt programg"	X	0365	1.0561	$76.75	.	$15.35																																																																																																						
92700	"	Ent procedure/service"	X	0364	0.4530	$32.92	.	$6.59																																																																																																						
92920	"	Prq cardiac angioplast 1 art"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
92921	"	Prq cardiac angio addl art"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
92924	"	Prq card angio/athrect 1 art"	T	0082	121.6791	"$8,842.66"	.	"$1,768.54"																																																																																																						
92925	"	Prq card angio/athrect addl"	T	0082	121.6791	"$8,842.66"	.	"$1,768.54"																																																																																																						
92928	"	Prq card stent w/angio 1 vsl"	T	0104	87.5681	"$6,363.75"	.	"$1,272.75"																																																																																																						
92929	"	Prq card stent w/angio addl"	T	0104	87.5681	"$6,363.75"	.	"$1,272.75"																																																																																																						
92933	"	Prq card stent/ath/angio"	T	0104	87.5681	"$6,363.75"	.	"$1,272.75"																																																																																																						
92934	"	Prq card stent/ath/angio"	T	0104	87.5681	"$6,363.75"	.	"$1,272.75"																																																																																																						
92937	"	Prq revasc byp graft 1 vsl"	T	0104	87.5681	"$6,363.75"	.	"$1,272.75"																																																																																																						
92938	"	Prq revasc byp graft addl"	T	0104	87.5681	"$6,363.75"	.	"$1,272.75"																																																																																																						
92941	"	Prq card revasc mi 1 vsl"	T	0104	87.5681	"$6,363.75"	.	"$1,272.75"																																																																																																						
92943	"	Prq card revasc chronic 1vsl"	T	0104	87.5681	"$6,363.75"	.	"$1,272.75"																																																																																																						
92944	"	Prq card revasc chronic addl"	T	0104	87.5681	"$6,363.75"	.	"$1,272.75"																																																																																																						
92950	"	Heart/lung resuscitation cpr"	S	0094	2.1968	$159.65	$43.48	$31.93																																																																																																						
92953	"	Temporary external pacing"	Q3	0094	2.1968	$159.65	$43.48	$31.93																																																																																																						
92960	"	Cardioversion electric ext"	S	0679	6.0743	$441.43	$95.30	$88.29																																																																																																						
92961	"	Cardioversion electric int"	S	0679	6.0743	$441.43	$95.30	$88.29																																																																																																						
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	0676	2.5286	$183.76	.	$36.76																																																																																																						
92978	"	Intravasc us heart add-on"	N																																																																																																											
92979	"	Intravasc us heart add-on"	N																																																																																																											
92986	"	Revision of aortic valve"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
92987	"	Revision of mitral valve"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
92990	"	Revision of pulmonary valve"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
92992	"	Revision of heart chamber"	C																																																																																																											
92993	"	Revision of heart chamber"	C																																																																																																											
92997	"	Pul art balloon repr percut"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
92998	"	Pul art balloon repr percut"	T	0083	60.6892	"$4,410.41"	.	$882.09																																																																																																						
93000	"	Electrocardiogram complete"	M																																																																																																											
93005	"	Electrocardiogram tracing"	S	0099	0.3732	$27.12	.	$5.43																																																																																																						
93010	"	Electrocardiogram report"	B																																																																																																											
93015	"	Cardiovascular stress test"	B																																																																																																											
93016	"	Cardiovascular stress test"	B																																																																																																											
93017	"	Cardiovascular stress test"	Q1	0100	3.3604	$244.21	.	$48.85																																																																																																						
93018	"	Cardiovascular stress test"	B																																																																																																											
93024	"	Cardiac drug stress test"	X	0100	3.3604	$244.21	.	$48.85																																																																																																						
93025	"	Microvolt t-wave assess"	X	0100	3.3604	$244.21	.	$48.85																																																																																																						
93040	"	Rhythm ecg with report"	B																																																																																																											
93041	"	Rhythm ecg tracing"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
93042	"	Rhythm ecg report"	B																																																																																																											
93224	"	Ecg monit/reprt up to 48 hrs"	M																																																																																																											
93225	"	Ecg monit/reprt up to 48 hrs"	S	0097	0.9657	$70.18	.	$14.04																																																																																																						
93226	"	Ecg monit/reprt up to 48 hrs"	S	0097	0.9657	$70.18	.	$14.04																																																																																																						
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	0209	6.0562	$440.12	$136.62	$88.03																																																																																																						
93268	"	Ecg record/review"	M																																																																																																											
93270	"	Remote 30 day ecg rev/report"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93271	"	Ecg/monitoring and analysis"	S	0692	1.5938	$115.82	.	$23.17																																																																																																						
93272	"	Ecg/review interpret only"	M																																																																																																											
93278	"	Ecg/signal-averaged"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
93279	"	Pm device progr eval sngl"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93280	"	Pm device progr eval dual"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93281	"	Pm device progr eval multi"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93282	"	Icd device progr eval 1 sngl"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93283	"	Icd device progr eval dual"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93284	"	Icd device progr eval mult"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93285	"	Ilr device eval progr"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93286	"	Peri-px pacemaker device evl"	N																																																																																																											
93287	"	Peri-px icd device eval&prgr"	N																																																																																																											
93288	"	Pm device eval in person"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93289	"	Icd device interrogate"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93290	"	Icm device eval"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93291	"	Ilr device interrogate"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93292	"	Wcd device interrogate"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93293	"	Pm phone r-strip device eval"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93294	"	Pm device interrogate remote"	M																																																																																																											
93295	"	Icd device interrogat remote"	M																																																																																																											
93296	"	Pm/icd remote tech serv"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93297	"	Icm device interrogat remote"	M																																																																																																											
93298	"	Ilr device interrogat remote"	M																																																																																																											
93299	"	Icm/ilr remote tech serv"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
93303	"	Echo transthoracic"	S	0270	8.1793	$594.41	$128.73	$118.89																																																																																																						
93304	"	Echo transthoracic"	S	0269	5.8794	$427.27	.	$85.46																																																																																																						
93306	"	Tte w/doppler complete"	S	0269	5.8794	$427.27	.	$85.46																																																																																																						
93307	"	Tte w/o doppler complete"	S	0269	5.8794	$427.27	.	$85.46																																																																																																						
93308	"	Tte f-up or lmtd"	S	0697	3.4494	$250.67	.	$50.14																																																																																																						
93312	"	Echo transesophageal"	S	0270	8.1793	$594.41	$128.73	$118.89																																																																																																						
93313	"	Echo transesophageal"	S	0269	5.8794	$427.27	.	$85.46																																																																																																						
93314	"	Echo transesophageal"	N																																																																																																											
93315	"	Echo transesophageal"	S	0269	5.8794	$427.27	.	$85.46																																																																																																						
93316	"	Echo transesophageal"	S	0270	8.1793	$594.41	$128.73	$118.89																																																																																																						
93317	"	Echo transesophageal"	N																																																																																																											
93318	"	Echo transesophageal intraop"	S	0270	8.1793	$594.41	$128.73	$118.89																																																																																																						
93320	"	Doppler echo exam heart"	N																																																																																																											
93321	"	Doppler echo exam heart"	N																																																																																																											
93325	"	Doppler color flow add-on"	N																																																																																																											
93350	"	Stress tte only"	S	0269	5.8794	$427.27	.	$85.46																																																																																																						
93351	"	Stress tte complete"	S	0270	8.1793	$594.41	$128.73	$118.89																																																																																																						
93352	"	Admin ecg contrast agent"	M																																																																																																											
93451	"	Right heart cath"	T	0080	35.5980	"$2,586.98"	$795.89	$517.40																																																																																																						
93452	"	Left hrt cath w/ventrclgrphy"	T	0080	35.5980	"$2,586.98"	$795.89	$517.40																																																																																																						
93453	"	R&l hrt cath w/ventriclgrphy"	T	0080	35.5980	"$2,586.98"	$795.89	$517.40																																																																																																						
93454	"	Coronary artery angio s&i"	T	0080	35.5980	"$2,586.98"	$795.89	$517.40																																																																																																						
93455	"	Coronary art/grft angio s&i"	T	0080	35.5980	"$2,586.98"	$795.89	$517.40																																																																																																						
93456	"	R hrt coronary artery angio"	T	0080	35.5980	"$2,586.98"	$795.89	$517.40																																																																																																						
93457	"	R hrt art/grft angio"	T	0080	35.5980	"$2,586.98"	$795.89	$517.40																																																																																																						
93458	"	L hrt artery/ventricle angio"	T	0080	35.5980	"$2,586.98"	$795.89	$517.40																																																																																																						
93459	"	L hrt art/grft angio"	T	0080	35.5980	"$2,586.98"	$795.89	$517.40																																																																																																						
93460	"	R&l hrt art/ventricle angio"	T	0080	35.5980	"$2,586.98"	$795.89	$517.40																																																																																																						
93461	"	R&l hrt art/ventricle angio"	T	0080	35.5980	"$2,586.98"	$795.89	$517.40																																																																																																						
93462	"	L hrt cath trnsptl puncture"	N																																																																																																											
93463	"	Drug admin & hemodynmic meas"	N																																																																																																											
93464	"	Exercise w/hemodynamic meas"	N																																																																																																											
93503	"	Insert/place heart catheter"	T	0103	20.9727	"$1,524.13"	.	$304.83																																																																																																						
93505	"	Biopsy of heart lining"	T	0103	20.9727	"$1,524.13"	.	$304.83																																																																																																						
93530	"	Rt heart cath congenital"	T	0080	35.5980	"$2,586.98"	$795.89	$517.40																																																																																																						
93531	"	R & l heart cath congenital"	T	0080	35.5980	"$2,586.98"	$795.89	$517.40																																																																																																						
93532	"	R & l heart cath congenital"	T	0080	35.5980	"$2,586.98"	$795.89	$517.40																																																																																																						
93533	"	R & l heart cath congenital"	T	0080	35.5980	"$2,586.98"	$795.89	$517.40																																																																																																						
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"	T	0434	175.9639	"$12,787.65"	.	"$2,557.53"																																																																																																						
93581	"	Transcath closure of vsd"	T	0434	175.9639	"$12,787.65"	.	"$2,557.53"																																																																																																						
93582	"	Perq transcath closure pda"	T	0434	175.9639	"$12,787.65"	.	"$2,557.53"																																																																																																						
93583	"	Perq transcath septal reduxn"	C																																																																																																											
93600	"	Bundle of his recording"	S	0084	10.3795	$754.30	.	$150.86																																																																																																						
93602	"	Intra-atrial recording"	S	0084	10.3795	$754.30	.	$150.86																																																																																																						
93603	"	Right ventricular recording"	S	0084	10.3795	$754.30	.	$150.86																																																																																																						
93609	"	Map tachycardia add-on"	N																																																																																																											
93610	"	Intra-atrial pacing"	S	0084	10.3795	$754.30	.	$150.86																																																																																																						
93612	"	Intraventricular pacing"	S	0084	10.3795	$754.30	.	$150.86																																																																																																						
93613	"	Electrophys map 3d add-on"	N																																																																																																											
93615	"	Esophageal recording"	S	0084	10.3795	$754.30	.	$150.86																																																																																																						
93616	"	Esophageal recording"	S	0084	10.3795	$754.30	.	$150.86																																																																																																						
93618	"	Heart rhythm pacing"	S	0084	10.3795	$754.30	.	$150.86																																																																																																						
93619	"	Electrophysiology evaluation"	Q3	0085	58.2446	"$4,232.75"	.	$846.55																																																																																																						
93620	"	Electrophysiology evaluation"	Q3	0085	58.2446	"$4,232.75"	.	$846.55																																																																																																						
93621	"	Electrophysiology evaluation"	N																																																																																																											
93622	"	Electrophysiology evaluation"	N																																																																																																											
93623	"	Stimulation pacing heart"	N																																																																																																											
93624	"	Electrophysiologic study"	T	0085	58.2446	"$4,232.75"	.	$846.55																																																																																																						
93631	"	Heart pacing mapping"	N																																																																																																											
93640	"	Evaluation heart device"	N																																																																																																											
93641	"	Electrophysiology evaluation"	N																																																																																																											
93642	"	Electrophysiology evaluation"	S	0084	10.3795	$754.30	.	$150.86																																																																																																						
93650	"	Ablate heart dysrhythm focus"	Q3	0085	58.2446	"$4,232.75"	.	$846.55																																																																																																						
93653	"	Ep & ablate supravent arrhyt"	Q3	8000	180.4692	"$13,115.06"	.	"$2,623.02"																																																																																																						
93654	"	Ep & ablate ventric tachy"	Q3	8000	180.4692	"$13,115.06"	.	"$2,623.02"																																																																																																						
93655	"	Ablate arrhythmia add on"	N																																																																																																											
93656	"	Tx atrial fib pulm vein isol"	Q3	8000	180.4692	"$13,115.06"	.	"$2,623.02"																																																																																																						
93657	"	Tx l/r atrial fib addl"	N																																																																																																											
93660	"	Tilt table evaluation"	S	0101	4.4677	$324.68	$100.24	$64.94																																																																																																						
93662	"	Intracardiac ecg (ice)"	N																																																																																																											
93668	"	Peripheral vascular rehab"	E																																																																																																											
93701	"	Bioimpedance cv analysis"	S	0099	0.3732	$27.12	.	$5.43																																																																																																						
93724	"	Analyze pacemaker system"	S	0691	3.7962	$275.88	.	$55.18																																																																																																						
93740	"	Temperature gradient studies"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
93745	"	Set-up cardiovert-defibrill"	S	0691	3.7962	$275.88	.	$55.18																																																																																																						
93750	"	Interrogation vad in person"	S	0692	1.5938	$115.82	.	$23.17																																																																																																						
93770	"	Measure venous pressure"	N																																																																																																											
93784	"	Ambulatory bp monitoring"	B																																																																																																											
93786	"	Ambulatory bp recording"	S	0097	0.9657	$70.18	.	$14.04																																																																																																						
93788	"	Ambulatory bp analysis"	S	0097	0.9657	$70.18	.	$14.04																																																																																																						
93790	"	Review/report bp recording"	M																																																																																																											
93797	"	Cardiac rehab"	S	0095	1.4213	$103.29	.	$20.66																																																																																																						
93798	"	Cardiac rehab/monitor"	S	0095	1.4213	$103.29	.	$20.66																																																																																																						
93799	"	Cardiovascular procedure"	S	0097	0.9657	$70.18	.	$14.04																																																																																																						
93880	"	Extracranial bilat study"	S	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
93882	"	Extracranial uni/ltd study"	S	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
93886	"	Intracranial complete study"	S	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
93888	"	Intracranial limited study"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
93890	"	Tcd vasoreactivity study"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
93892	"	Tcd emboli detect w/o inj"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
93893	"	Tcd emboli detect w/inj"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
93922	"	Upr/l xtremity art 2 levels"	S	0097	0.9657	$70.18	.	$14.04																																																																																																						
93923	"	Upr/lxtr art stdy 3+ lvls"	S	0096	1.8035	$131.06	$36.86	$26.22																																																																																																						
93924	"	Lwr xtr vasc stdy bilat"	S	0096	1.8035	$131.06	$36.86	$26.22																																																																																																						
93925	"	Lower extremity study"	S	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
93926	"	Lower extremity study"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
93930	"	Upper extremity study"	S	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
93931	"	Upper extremity study"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
93965	"	Extremity study"	S	0096	1.8035	$131.06	$36.86	$26.22																																																																																																						
93970	"	Extremity study"	S	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
93971	"	Extremity study"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
93975	"	Vascular study"	S	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
93976	"	Vascular study"	S	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
93978	"	Vascular study"	S	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
93979	"	Vascular study"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
93980	"	Penile vascular study"	S	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
93981	"	Penile vascular study"	S	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
93982	"	Aneurysm pressure sens study"	S	0097	0.9657	$70.18	.	$14.04																																																																																																						
93990	"	Doppler flow testing"	S	0266	1.8517	$134.57	$37.23	$26.92																																																																																																						
93998	"	Noninvas vasc dx study proc"	X	0035	0.3042	$22.11	.	$4.43																																																																																																						
94002	"	Vent mgmt inpat init day"	Q3	0079	4.8053	$349.21	.	$69.85																																																																																																						
94003	"	Vent mgmt inpat subq day"	Q3	0079	4.8053	$349.21	.	$69.85																																																																																																						
94004	"	Vent mgmt nf per day"	B																																																																																																											
94005	"	Home vent mgmt supervision"	M																																																																																																											
94010	"	Breathing capacity test"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
94011	"	Spirometry up to 2 yrs old"	X	0367	0.7895	$57.37	$11.97	$11.48																																																																																																						
94012	"	Spirmtry w/brnchdil inf-2 yr"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
94013	"	Meas lung vol thru 2 yrs"	X	0369	3.3536	$243.71	.	$48.75																																																																																																						
94014	"	Patient recorded spirometry"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
94015	"	Patient recorded spirometry"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
94016	"	Review patient spirometry"	A																																																																																																											
94060	"	Evaluation of wheezing"	S	0078	1.8631	$135.40	.	$27.08																																																																																																						
94070	"	Evaluation of wheezing"	X	0369	3.3536	$243.71	.	$48.75																																																																																																						
94150	"	Vital capacity test"	X	0367	0.7895	$57.37	$11.97	$11.48																																																																																																						
94200	"	Lung function test (mbc/mvv)"	X	0367	0.7895	$57.37	$11.97	$11.48																																																																																																						
94250	"	Expired gas collection"	X	0367	0.7895	$57.37	$11.97	$11.48																																																																																																						
94375	"	Respiratory flow volume loop"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
94400	"	Co2 breathing response curve"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
94450	"	Hypoxia response curve"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
94452	"	Hast w/report"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
94453	"	Hast w/oxygen titrate"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
94610	"	Surfactant admin thru tube"	S	0102	1.0759	$78.19	.	$15.64																																																																																																						
94620	"	Pulmonary stress test/simple"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
94621	"	Pulm stress test/complex"	X	0369	3.3536	$243.71	.	$48.75																																																																																																						
94640	"	Airway inhalation treatment"	S	0102	1.0759	$78.19	.	$15.64																																																																																																						
94642	"	Aerosol inhalation treatment"	S	0078	1.8631	$135.40	.	$27.08																																																																																																						
94644	"	Cbt 1st hour"	X	0420	1.3520	$98.25	.	$19.65																																																																																																						
94645	"	Cbt each addl hour"	N																																																																																																											
94660	"	Pos airway pressure cpap"	Q3	0102	1.0759	$78.19	.	$15.64																																																																																																						
94662	"	Neg press ventilation cnp"	Q3	0079	4.8053	$349.21	.	$69.85																																																																																																						
94664	"	Evaluate pt use of inhaler"	S	0102	1.0759	$78.19	.	$15.64																																																																																																						
94667	"	Chest wall manipulation"	S	0102	1.0759	$78.19	.	$15.64																																																																																																						
94668	"	Chest wall manipulation"	S	0077	0.5415	$39.35	.	$7.87																																																																																																						
94669	"	Mechanical chest wall oscill"	S	0077	0.5415	$39.35	.	$7.87																																																																																																						
94680	"	Exhaled air analysis o2"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
94681	"	Exhaled air analysis o2/co2"	X	0369	3.3536	$243.71	.	$48.75																																																																																																						
94690	"	Exhaled air analysis"	X	0035	0.3042	$22.11	.	$4.43																																																																																																						
94726	"	Pulm funct tst plethysmograp"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
94727	"	Pulm function test by gas"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
94728	"	Pulm funct test oscillometry"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
94729	"	Co/membane diffuse capacity"	N																																																																																																											
94750	"	Pulmonary compliance study"	X	0367	0.7895	$57.37	$11.97	$11.48																																																																																																						
94760	"	Measure blood oxygen level"	N																																																																																																											
94761	"	Measure blood oxygen level"	N																																																																																																											
94762	"	Measure blood oxygen level"	Q3	0096	1.8035	$131.06	$36.86	$26.22																																																																																																						
94770	"	Exhaled carbon dioxide test"	X	0369	3.3536	$243.71	.	$48.75																																																																																																						
94772	"	Breath recording infant"	X	0369	3.3536	$243.71	.	$48.75																																																																																																						
94774	"	Ped home apnea rec compl"	B																																																																																																											
94775	"	Ped home apnea rec hk-up"	S	0097	0.9657	$70.18	.	$14.04																																																																																																						
94776	"	Ped home apnea rec downld"	S	0097	0.9657	$70.18	.	$14.04																																																																																																						
94777	"	Ped home apnea rec report"	B																																																																																																											
94780	"	Car seat/bed test 60 min"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
94781	"	Car seat/bed test + 30 min"	N																																																																																																											
94799	"	Pulmonary service/procedure"	X	0367	0.7895	$57.37	$11.97	$11.48																																																																																																						
95004	"	Percut allergy skin tests"	X	0370	0.5687	$41.33	.	$8.27																																																																																																						
95012	"	Exhaled nitric oxide meas"	X	0367	0.7895	$57.37	$11.97	$11.48																																																																																																						
95017	"	Perq & icut allg test venoms"	X	0381	0.4810	$34.96	.	$7.00																																																																																																						
95018	"	Perq&ic allg test drugs/biol"	X	0381	0.4810	$34.96	.	$7.00																																																																																																						
95024	"	Icut allergy test drug/bug"	X	0381	0.4810	$34.96	.	$7.00																																																																																																						
95027	"	Icut allergy titrate-airborn"	X	0381	0.4810	$34.96	.	$7.00																																																																																																						
95028	"	Icut allergy test-delayed"	X	0381	0.4810	$34.96	.	$7.00																																																																																																						
95044	"	Allergy patch tests"	X	0370	0.5687	$41.33	.	$8.27																																																																																																						
95052	"	Photo patch test"	X	0381	0.4810	$34.96	.	$7.00																																																																																																						
95056	"	Photosensitivity tests"	X	0370	0.5687	$41.33	.	$8.27																																																																																																						
95060	"	Eye allergy tests"	X	0370	0.5687	$41.33	.	$8.27																																																																																																						
95065	"	Nose allergy test"	X	0381	0.4810	$34.96	.	$7.00																																																																																																						
95070	"	Bronchial allergy tests"	X	0369	3.3536	$243.71	.	$48.75																																																																																																						
95071	"	Bronchial allergy tests"	X	0368	1.2211	$88.74	$20.93	$17.75																																																																																																						
95076	"	Ingest challenge ini 120 min"	X	0361	4.4489	$323.31	$83.23	$64.67																																																																																																						
95079	"	Ingest challenge addl 60 min"	N																																																																																																											
95115	"	Immunotherapy one injection"	S	0436	0.4059	$29.50	.	$5.90																																																																																																						
95117	"	Immunotherapy injections"	S	0436	0.4059	$29.50	.	$5.90																																																																																																						
95120	"	Immunotherapy one injection"	E																																																																																																											
95125	"	Immunotherapy 2/> injections"	E																																																																																																											
95130	"	Immntx 1 sting insect"	E																																																																																																											
95131	"	Immntx 2 sting insects"	E																																																																																																											
95132	"	Immntx 3 sting insects"	E																																																																																																											
95133	"	Immntx 4 sting insects"	E																																																																																																											
95134	"	Immntx 5 sting insects"	E																																																																																																											
95144	"	Antigen therapy services"	S	0437	0.6024	$43.78	.	$8.76																																																																																																						
95145	"	Antigen therapy services"	S	0436	0.4059	$29.50	.	$5.90																																																																																																						
95146	"	Antigen therapy services"	S	0438	1.4572	$105.90	.	$21.18																																																																																																						
95147	"	Antigen therapy services"	S	0438	1.4572	$105.90	.	$21.18																																																																																																						
95148	"	Antigen therapy services"	S	0437	0.6024	$43.78	.	$8.76																																																																																																						
95149	"	Antigen therapy services"	S	0437	0.6024	$43.78	.	$8.76																																																																																																						
95165	"	Antigen therapy services"	S	0436	0.4059	$29.50	.	$5.90																																																																																																						
95170	"	Antigen therapy services"	S	0437	0.6024	$43.78	.	$8.76																																																																																																						
95180	"	Rapid desensitization"	X	0370	0.5687	$41.33	.	$8.27																																																																																																						
95199	"	Allergy immunology services"	X	0381	0.4810	$34.96	.	$7.00																																																																																																						
95250	"	Glucose monitoring cont"	V	0632	1.3283	$96.53	.	$19.31																																																																																																						
95251	"	Gluc monitor cont phys i&r"	B																																																																																																											
95782	"	Polysom <6 yrs 4/> paramtrs"	S	0209	6.0562	$440.12	$136.62	$88.03																																																																																																						
95783	"	Polysom <6 yrs cpap/bilvl"	S	0209	6.0562	$440.12	$136.62	$88.03																																																																																																						
95800	"	Slp stdy unattended"	S	0213	2.4989	$181.60	$53.58	$36.32																																																																																																						
95801	"	Slp stdy unatnd w/anal"	S	0213	2.4989	$181.60	$53.58	$36.32																																																																																																						
95803	"	Actigraphy testing"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
95805	"	Multiple sleep latency test"	S	0435	11.8685	$862.51	$267.73	$172.51																																																																																																						
95806	"	Sleep study unatt&resp efft"	S	0213	2.4989	$181.60	$53.58	$36.32																																																																																																						
95807	"	Sleep study attended"	S	0209	6.0562	$440.12	$136.62	$88.03																																																																																																						
95808	"	Polysom any age 1-3> param"	S	0435	11.8685	$862.51	$267.73	$172.51																																																																																																						
95810	"	Polysom 6/> yrs 4/> param"	S	0435	11.8685	$862.51	$267.73	$172.51																																																																																																						
95811	"	Polysom 6/>yrs cpap 4/> parm"	S	0435	11.8685	$862.51	$267.73	$172.51																																																																																																						
95812	"	Eeg 41-60 minutes"	S	0213	2.4989	$181.60	$53.58	$36.32																																																																																																						
95813	"	Eeg over 1 hour"	S	0213	2.4989	$181.60	$53.58	$36.32																																																																																																						
95816	"	Eeg awake and drowsy"	S	0213	2.4989	$181.60	$53.58	$36.32																																																																																																						
95819	"	Eeg awake and asleep"	S	0213	2.4989	$181.60	$53.58	$36.32																																																																																																						
95822	"	Eeg coma or sleep only"	S	0213	2.4989	$181.60	$53.58	$36.32																																																																																																						
95824	"	Eeg cerebral death only"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
95827	"	Eeg all night recording"	S	0209	6.0562	$440.12	$136.62	$88.03																																																																																																						
95829	"	Surgery electrocorticogram"	N																																																																																																											
95830	"	Insert electrodes for eeg"	B																																																																																																											
95831	"	Limb muscle testing manual"	A																																																																																																											
95832	"	Hand muscle testing manual"	A																																																																																																											
95833	"	Body muscle testing manual"	A																																																																																																											
95834	"	Body muscle testing manual"	A																																																																																																											
95851	"	Range of motion measurements"	A																																																																																																											
95852	"	Range of motion measurements"	A																																																																																																											
95857	"	Cholinesterase challenge"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
95860	"	Muscle test one limb"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
95861	"	Muscle test 2 limbs"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
95863	"	Muscle test 3 limbs"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
95864	"	Muscle test 4 limbs"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
95865	"	Muscle test larynx"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
95866	"	Muscle test hemidiaphragm"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
95867	"	Muscle test cran nerv unilat"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
95868	"	Muscle test cran nerve bilat"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
95869	"	Muscle test thor paraspinal"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
95870	"	Muscle test nonparaspinal"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
95872	"	Muscle test one fiber"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
95873	"	Guide nerv destr elec stim"	N																																																																																																											
95874	"	Guide nerv destr needle emg"	N																																																																																																											
95875	"	Limb exercise test"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
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"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
95907	"	Nvr cndj tst 1-2 studies"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
95908	"	Nrv cndj tst 3-4 studies"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
95909	"	Nrv cndj tst 5-6 studies"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
95910	"	Nrv cndj test 7-8 studies"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
95911	"	Nrv cndj test 9-10 studies"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
95912	"	Nrv cndj test 11-12 studies"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
95913	"	Nrv cndj test 13/> studies"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
95921	"	Autonomic nrv parasym inervj"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
95922	"	Autonomic nrv adrenrg inervj"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
95923	"	Autonomic nrv syst funj test"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
95924	"	Ans parasymp & symp w/tilt"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
95925	"	Somatosensory testing"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
95926	"	Somatosensory testing"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
95927	"	Somatosensory testing"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
95928	"	C motor evoked uppr limbs"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
95929	"	C motor evoked lwr limbs"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
95930	"	Visual evoked potential test"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
95933	"	Blink reflex test"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
95937	"	Neuromuscular junction test"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
95938	"	Somatosensory testing"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
95939	"	C motor evoked upr&lwr limbs"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
95940	"	Ionm in operatng room 15 min"	N																																																																																																											
95941	"	Ionm remote/>1 pt or per hr"	N																																																																																																											
95943	"	Parasymp&symp hrt rate test"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
95950	"	Ambulatory eeg monitoring"	S	0209	6.0562	$440.12	$136.62	$88.03																																																																																																						
95951	"	Eeg monitoring/videorecord"	S	0435	11.8685	$862.51	$267.73	$172.51																																																																																																						
95953	"	Eeg monitoring/computer"	S	0209	6.0562	$440.12	$136.62	$88.03																																																																																																						
95954	"	Eeg monitoring/giving drugs"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
95955	"	Eeg during surgery"	N																																																																																																											
95956	"	Eeg monitor technol attended"	S	0209	6.0562	$440.12	$136.62	$88.03																																																																																																						
95957	"	Eeg digital analysis"	N																																																																																																											
95958	"	Eeg monitoring/function test"	S	0435	11.8685	$862.51	$267.73	$172.51																																																																																																						
95961	"	Electrode stimulation brain"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
95962	"	Electrode stim brain add-on"	N																																																																																																											
95965	"	Meg spontaneous"	S	0065	17.1769	"$1,248.28"	.	$249.66																																																																																																						
95966	"	Meg evoked single"	S	0065	17.1769	"$1,248.28"	.	$249.66																																																																																																						
95967	"	Meg evoked each addl"	N																																																																																																											
95970	"	Analyze neurostim no prog"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
95971	"	Analyze neurostim simple"	S	0692	1.5938	$115.82	.	$23.17																																																																																																						
95972	"	Analyze neurostim complex"	S	0692	1.5938	$115.82	.	$23.17																																																																																																						
95973	"	Analyze neurostim complex"	N																																																																																																											
95974	"	Cranial neurostim complex"	S	0692	1.5938	$115.82	.	$23.17																																																																																																						
95975	"	Cranial neurostim complex"	N																																																																																																											
95978	"	Analyze neurostim brain/1h"	S	0692	1.5938	$115.82	.	$23.17																																																																																																						
95979	"	Analyz neurostim brain addon"	N																																																																																																											
95980	"	Io anal gast n-stim init"	N																																																																																																											
95981	"	Io anal gast n-stim subsq"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
95982	"	Io ga n-stim subsq w/reprog"	S	0690	0.4974	$36.15	.	$7.23																																																																																																						
95990	"	Spin/brain pump refil & main"	S	0439	2.3693	$172.18	.	$34.44																																																																																																						
95991	"	Spin/brain pump refil & main"	S	0439	2.3693	$172.18	.	$34.44																																																																																																						
95992	"	Canalith repositioning proc"	A																																																																																																											
95999	"	Neurological procedure"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
96000	"	Motion analysis video/3d"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
96001	"	Motion test w/ft press meas"	S	0216	2.9831	$216.79	.	$43.36																																																																																																						
96002	"	Dynamic surface emg"	S	0218	1.7579	$127.75	.	$25.55																																																																																																						
96003	"	Dynamic fine wire emg"	S	0215	0.6921	$50.30	.	$10.06																																																																																																						
96004	"	Phys review of motion tests"	B																																																																																																											
96020	"	Functional brain mapping"	N																																																																																																											
96040	"	Genetic counseling 30 min"	B																																																																																																											
96101	"	Psycho testing by psych/phys"	Q3	0382	2.8102	$204.22	.	$40.85																																																																																																						
96102	"	Psycho testing by technician"	Q3	0373	1.5077	$109.57	.	$21.92																																																																																																						
96103	"	Psycho testing admin by comp"	Q3	0373	1.5077	$109.57	.	$21.92																																																																																																						
96105	"	Assessment of aphasia"	A																																																																																																											
96110	"	Developmental screen"	E																																																																																																											
96111	"	Developmental test extend"	Q3	0373	1.5077	$109.57	.	$21.92																																																																																																						
96116	"	Neurobehavioral status exam"	Q3	0382	2.8102	$204.22	.	$40.85																																																																																																						
96118	"	Neuropsych tst by psych/phys"	Q3	0382	2.8102	$204.22	.	$40.85																																																																																																						
96119	"	Neuropsych testing by tec"	Q3	0382	2.8102	$204.22	.	$40.85																																																																																																						
96120	"	Neuropsych tst admin w/comp"	Q3	0373	1.5077	$109.57	.	$21.92																																																																																																						
96125	"	Cognitive test by hc pro"	A																																																																																																											
96150	"	Assess hlth/behave init"	Q3	0432	0.6759	$49.12	.	$9.83																																																																																																						
96151	"	Assess hlth/behave subseq"	Q3	0432	0.6759	$49.12	.	$9.83																																																																																																						
96152	"	Intervene hlth/behave indiv"	Q3	0432	0.6759	$49.12	.	$9.83																																																																																																						
96153	"	Intervene hlth/behave group"	Q3	0031	0.3292	$23.92	.	$4.79																																																																																																						
96154	"	Interv hlth/behav fam w/pt"	Q3	0432	0.6759	$49.12	.	$9.83																																																																																																						
96155	"	Interv hlth/behav fam no pt"	E																																																																																																											
96360	"	Hydration iv infusion init"	S	0438	1.4572	$105.90	.	$21.18																																																																																																						
96361	"	Hydrate iv infusion add-on"	S	0436	0.4059	$29.50	.	$5.90																																																																																																						
96365	"	Ther/proph/diag iv inf init"	S	0439	2.3693	$172.18	.	$34.44																																																																																																						
96366	"	Ther/proph/diag iv inf addon"	S	0436	0.4059	$29.50	.	$5.90																																																																																																						
96367	"	Tx/proph/dg addl seq iv inf"	S	0437	0.6024	$43.78	.	$8.76																																																																																																						
96368	"	Ther/diag concurrent inf"	N																																																																																																											
96369	"	Sc ther infusion up to 1 hr"	S	0439	2.3693	$172.18	.	$34.44																																																																																																						
96370	"	Sc ther infusion addl hr"	S	0437	0.6024	$43.78	.	$8.76																																																																																																						
96371	"	Sc ther infusion reset pump"	N																																																																																																											
96372	"	Ther/proph/diag inj sc/im"	S	0437	0.6024	$43.78	.	$8.76																																																																																																						
96373	"	Ther/proph/diag inj ia"	S	0438	1.4572	$105.90	.	$21.18																																																																																																						
96374	"	Ther/proph/diag inj iv push"	S	0438	1.4572	$105.90	.	$21.18																																																																																																						
96375	"	Tx/pro/dx inj new drug addon"	S	0437	0.6024	$43.78	.	$8.76																																																																																																						
96376	"	Tx/pro/dx inj same drug adon"	N																																																																																																											
96379	"	Ther/prop/diag inj/inf proc"	S	0436	0.4059	$29.50	.	$5.90																																																																																																						
96401	"	Chemo anti-neopl sq/im"	S	0438	1.4572	$105.90	.	$21.18																																																																																																						
96402	"	Chemo hormon antineopl sq/im"	S	0437	0.6024	$43.78	.	$8.76																																																																																																						
96405	"	Chemo intralesional up to 7"	S	0437	0.6024	$43.78	.	$8.76																																																																																																						
96406	"	Chemo intralesional over 7"	S	0439	2.3693	$172.18	.	$34.44																																																																																																						
96409	"	Chemo iv push sngl drug"	S	0439	2.3693	$172.18	.	$34.44																																																																																																						
96411	"	Chemo iv push addl drug"	S	0437	0.6024	$43.78	.	$8.76																																																																																																						
96413	"	Chemo iv infusion 1 hr"	S	0440	4.1217	$299.53	.	$59.91																																																																																																						
96415	"	Chemo iv infusion addl hr"	S	0437	0.6024	$43.78	.	$8.76																																																																																																						
96416	"	Chemo prolong infuse w/pump"	S	0440	4.1217	$299.53	.	$59.91																																																																																																						
96417	"	Chemo iv infus each addl seq"	S	0437	0.6024	$43.78	.	$8.76																																																																																																						
96420	"	Chemo ia push tecnique"	S	0438	1.4572	$105.90	.	$21.18																																																																																																						
96422	"	Chemo ia infusion up to 1 hr"	S	0440	4.1217	$299.53	.	$59.91																																																																																																						
96423	"	Chemo ia infuse each addl hr"	S	0438	1.4572	$105.90	.	$21.18																																																																																																						
96425	"	Chemotherapy infusion method"	S	0440	4.1217	$299.53	.	$59.91																																																																																																						
96440	"	Chemotherapy intracavitary"	S	0439	2.3693	$172.18	.	$34.44																																																																																																						
96446	"	Chemotx admn prtl cavity"	S	0439	2.3693	$172.18	.	$34.44																																																																																																						
96450	"	Chemotherapy into cns"	S	0440	4.1217	$299.53	.	$59.91																																																																																																						
96521	"	Refill/maint portable pump"	S	0439	2.3693	$172.18	.	$34.44																																																																																																						
96522	"	Refill/maint pump/resvr syst"	S	0439	2.3693	$172.18	.	$34.44																																																																																																						
96523	"	Irrig drug delivery device"	Q1	0624	1.1143	$80.98	.	$16.20																																																																																																						
96542	"	Chemotherapy injection"	S	0438	1.4572	$105.90	.	$21.18																																																																																																						
96549	"	Chemotherapy unspecified"	S	0436	0.4059	$29.50	.	$5.90																																																																																																						
96567	"	Photodynamic tx skin"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
96570	"	Photodynmc tx 30 min add-on"	N																																																																																																											
96571	"	Photodynamic tx addl 15 min"	N																																																																																																											
96900	"	Ultraviolet light therapy"	S	0001	0.5238	$38.07	.	$7.62																																																																																																						
96902	"	Trichogram"	N																																																																																																											
96904	"	Whole body photography"	N																																																																																																											
96910	"	Photochemotherapy with uv-b"	S	0001	0.5238	$38.07	.	$7.62																																																																																																						
96912	"	Photochemotherapy with uv-a"	S	0001	0.5238	$38.07	.	$7.62																																																																																																						
96913	"	Photochemotherapy uv-a or b"	S	0683	2.9575	$214.93	.	$42.99																																																																																																						
96920	"	Laser tx skin < 250 sq cm"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
96921	"	Laser tx skin 250-500 sq cm"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
96922	"	Laser tx skin >500 sq cm"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
96999	"	Dermatological procedure"	T	0012	0.8370	$60.83	.	$12.17																																																																																																						
97001	"	Pt evaluation"	A																																																																																																											
97002	"	Pt re-evaluation"	A																																																																																																											
97003	"	Ot evaluation"	A																																																																																																											
97004	"	Ot re-evaluation"	A																																																																																																											
97005	"	Athletic train eval"	E																																																																																																											
97006	"	Athletic train reeval"	E																																																																																																											
97010	"	Hot or cold packs therapy"	A																																																																																																											
97012	"	Mechanical traction therapy"	A																																																																																																											
97014	"	Electric stimulation therapy"	E																																																																																																											
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																																																																																																											
97139	"	Physical medicine procedure"	A																																																																																																											
97140	"	Manual therapy 1/> regions"	A																																																																																																											
97150	"	Group therapeutic procedures"	A																																																																																																											
97530	"	Therapeutic activities"	A																																																																																																											
97532	"	Cognitive skills development"	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	0015	2.0281	$147.39	.	$29.48																																																																																																						
97598	"	Rmvl devital tis addl 20cm/<"	N																																																																																																											
97602	"	Wound(s) care non-selective"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
97605	"	Neg press wound tx </=50 cm"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
97606	"	Neg press wound tx >50 cm"	T	0015	2.0281	$147.39	.	$29.48																																																																																																						
97610	"	Low frequency non-thermal us"	T	0013	1.1522	$83.73	.	$16.75																																																																																																						
97750	"	Physical performance test"	A																																																																																																											
97755	"	Assistive technology assess"	A																																																																																																											
97760	"	Orthotic mgmt and training"	A																																																																																																											
97761	"	Prosthetic training"	A																																																																																																											
97762	"	C/o for orthotic/prosth use"	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"	E																																																																																																											
97811	"	Acupunct w/o stimul addl 15m"	E																																																																																																											
97813	"	Acupunct w/stimul 15 min"	E																																																																																																											
97814	"	Acupunct w/stimul addl 15m"	E																																																																																																											
98925	"	Osteopath manj 1-2 regions"	S	0060	0.2422	$17.60	.	$3.52																																																																																																						
98926	"	Osteopath manj 3-4 regions"	S	0060	0.2422	$17.60	.	$3.52																																																																																																						
98927	"	Osteopath manj 5-6 regions"	S	0060	0.2422	$17.60	.	$3.52																																																																																																						
98928	"	Osteopath manj 7-8 regions"	S	0060	0.2422	$17.60	.	$3.52																																																																																																						
98929	"	Osteopath manj 9-10 regions"	S	0060	0.2422	$17.60	.	$3.52																																																																																																						
98940	"	Chiropract manj 1-2 regions"	S	0060	0.2422	$17.60	.	$3.52																																																																																																						
98941	"	Chiropract manj 3-4 regions"	S	0060	0.2422	$17.60	.	$3.52																																																																																																						
98942	"	Chiropractic manj 5 regions"	S	0060	0.2422	$17.60	.	$3.52																																																																																																						
98943	"	Chiropract manj xtrspinl 1/>"	E																																																																																																											
98960	"	Self-mgmt educ & train 1 pt"	E																																																																																																											
98961	"	Self-mgmt educ/train 2-4 pt"	E																																																																																																											
98962	"	Self-mgmt educ/train 5-8 pt"	E																																																																																																											
98966	"	Hc pro phone call 5-10 min"	E																																																																																																											
98967	"	Hc pro phone call 11-20 min"	E																																																																																																											
98968	"	Hc pro phone call 21-30 min"	E																																																																																																											
98969	"	Online service by hc pro"	E																																																																																																											
99000	"	Specimen handling office-lab"	E																																																																																																											
99001	"	Specimen handling pt-lab"	E																																																																																																											
99002	"	Device handling phys/qhp"	B																																																																																																											
99024	"	Postop follow-up visit"	B																																																																																																											
99026	"	In-hospital on call service"	E																																																																																																											
99027	"	Out-of-hosp on call service"	E																																																																																																											
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																																																																																																											
99075	"	Medical testimony"	E																																																																																																											
99078	"	Group health education"	N																																																																																																											
99080	"	Special reports or forms"	B																																																																																																											
99082	"	Unusual physician travel"	B																																																																																																											
99090	"	Computer data analysis"	B																																																																																																											
99091	"	Collect/review data from pt"	N																																																																																																											
99100	"	Special anesthesia service"	B																																																																																																											
99116	"	Anesthesia with hypothermia"	B																																																																																																											
99135	"	Special anesthesia procedure"	B																																																																																																											
99140	"	Emergency anesthesia"	B																																																																																																											
99143	"	Mod sedat phys/qhp <5 yrs"	N																																																																																																											
99144	"	Mod sedat phys/qhp 5yrs/>"	N																																																																																																											
99145	"	Mod sedat phys/qhp ea 15 min"	N																																																																																																											
99148	"	Mod sed diff phys/qhp<5 yrs"	N																																																																																																											
99149	"	Mod sed diff phys/qhp 5/>yrs"	N																																																																																																											
99150	"	Mod sed diff phys/qhp add on"	N																																																																																																											
99170	"	Anogenital exam child w imag"	T	0191	0.1421	$10.33	.	$2.07																																																																																																						
99172	"	Ocular function screen"	E																																																																																																											
99173	"	Visual acuity screen"	E																																																																																																											
99174	"	Ocular instrumnt screen bil"	E																																																																																																											
99175	"	Induction of vomiting"	N																																																																																																											
99183	"	Hyperbaric oxygen therapy"	B																																																																																																											
99190	"	Special pump services"	C																																																																																																											
99191	"	Special pump services"	C																																																																																																											
99192	"	Special pump services"	C																																																																																																											
99195	"	Phlebotomy"	X	0624	1.1143	$80.98	.	$16.20																																																																																																						
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"	E																																																																																																											
99242	"	Office consultation"	E																																																																																																											
99243	"	Office consultation"	E																																																																																																											
99244	"	Office consultation"	E																																																																																																											
99245	"	Office consultation"	E																																																																																																											
99251	"	Inpatient consultation"	E																																																																																																											
99252	"	Inpatient consultation"	E																																																																																																											
99253	"	Inpatient consultation"	E																																																																																																											
99254	"	Inpatient consultation"	E																																																																																																											
99255	"	Inpatient consultation"	E																																																																																																											
99281	"	Emergency dept visit"	V	0609	0.7658	$55.65	$12.04	$11.13																																																																																																						
99282	"	Emergency dept visit"	V	0613	1.3886	$100.91	$20.80	$20.19																																																																																																						
99283	"	Emergency dept visit"	V	0614	2.2904	$166.45	$33.60	$33.29																																																																																																						
99284	"	Emergency dept visit"	Q3	0615	4.0416	$293.71	.	$58.75																																																																																																						
99285	"	Emergency dept visit"	Q3	0616	6.2738	$455.93	.	$91.19																																																																																																						
99288	"	Direct advanced life support"	B																																																																																																											
99291	"	Critical care first hour"	Q3	0617	8.7371	$634.94	.	$126.99																																																																																																						
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	"	Prolonged service office"	N																																																																																																											
99355	"	Prolonged service office"	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																																																																																																											
99363	"	Anticoagulant mgmt initial"	B																																																																																																											
99364	"	Anticoagulant mgmt subseq"	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"	E																																																																																																											
99377	"	Hospice care supervision"	B																																																																																																											
99378	"	Hospice care supervision"	E																																																																																																											
99379	"	Nursing fac care supervision"	B																																																																																																											
99380	"	Nursing fac care supervision"	B																																																																																																											
99381	"	Init pm e/m new pat infant"	E																																																																																																											
99382	"	Init pm e/m new pat 1-4 yrs"	E																																																																																																											
99383	"	Prev visit new age 5-11"	E																																																																																																											
99384	"	Prev visit new age 12-17"	E																																																																																																											
99385	"	Prev visit new age 18-39"	E																																																																																																											
99386	"	Prev visit new age 40-64"	E																																																																																																											
99387	"	Init pm e/m new pat 65+ yrs"	E																																																																																																											
99391	"	Per pm reeval est pat infant"	E																																																																																																											
99392	"	Prev visit est age 1-4"	E																																																																																																											
99393	"	Prev visit est age 5-11"	E																																																																																																											
99394	"	Prev visit est age 12-17"	E																																																																																																											
99395	"	Prev visit est age 18-39"	E																																																																																																											
99396	"	Prev visit est age 40-64"	E																																																																																																											
99397	"	Per pm reeval est pat 65+ yr"	E																																																																																																											
99401	"	Preventive counseling indiv"	E																																																																																																											
99402	"	Preventive counseling indiv"	E																																																																																																											
99403	"	Preventive counseling indiv"	E																																																																																																											
99404	"	Preventive counseling indiv"	E																																																																																																											
99406	"	Behav chng smoking 3-10 min"	S	0031	0.3292	$23.92	.	$4.79																																																																																																						
99407	"	Behav chng smoking > 10 min"	S	0031	0.3292	$23.92	.	$4.79																																																																																																						
99408	"	Audit/dast 15-30 min"	E																																																																																																											
99409	"	Audit/dast over 30 min"	E																																																																																																											
99411	"	Preventive counseling group"	E																																																																																																											
99412	"	Preventive counseling group"	E																																																																																																											
99420	"	Health risk assessment test"	E																																																																																																											
99429	"	Unlisted preventive service"	E																																																																																																											
99441	"	Phone e/m phys/qhp 5-10 min"	E																																																																																																											
99442	"	Phone e/m phys/qhp 11-20 min"	E																																																																																																											
99443	"	Phone e/m phys/qhp 21-30 min"	E																																																																																																											
99444	"	Online e/m by phys/qhp"	E																																																																																																											
99446	"	Interprof phone/online 5-10"	E																																																																																																											
99447	"	Interprof phone/online 11-20"	E																																																																																																											
99448	"	Interprof phone/online 21-30"	E																																																																																																											
99449	"	Interprof phone/online 31/>"	E																																																																																																											
99450	"	Basic life disability exam"	E																																																																																																											
99455	"	Work related disability exam"	B																																																																																																											
99456	"	Disability examination"	B																																																																																																											
99460	"	Init nb em per day hosp"	V	0632	1.3283	$96.53	.	$19.31																																																																																																						
99461	"	Init nb em per day non-fac"	M																																																																																																											
99462	"	Sbsq nb em per day hosp"	C																																																																																																											
99463	"	Same day nb discharge"	V	0632	1.3283	$96.53	.	$19.31																																																																																																						
99464	"	Attendance at delivery"	N																																																																																																											
99465	"	Nb resuscitation"	S	0094	2.1968	$159.65	$43.48	$31.93																																																																																																						
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																																																																																																											
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																																																																																																											
99481	"	Tot body syst hypothermia"	N																																																																																																											
99482	"	Selective head hypothermia"	N																																																																																																											
99485	"	Suprv interfacilty transport"	B																																																																																																											
99486	"	Suprv interfac trnsport addl"	B																																																																																																											
99487	"	Cmplx chron care w/o pt vsit"	N																																																																																																											
99488	"	Cmplx chron care w/ pt vsit"	N																																																																																																											
99489	"	Complx chron care addl30 min"	N																																																																																																											
99495	"	Trans care mgmt 14 day disch"	V	0632	1.3283	$96.53	.	$19.31																																																																																																						
99496	"	Trans care mgmt 7 day disch"	V	0632	1.3283	$96.53	.	$19.31																																																																																																						
99499	"	Unlisted e&m service"	B																																																																																																											
99500	"	Home visit prenatal"	E																																																																																																											
99501	"	Home visit postnatal"	E																																																																																																											
99502	"	Home visit nb care"	E																																																																																																											
99503	"	Home visit resp therapy"	E																																																																																																											
99504	"	Home visit mech ventilator"	E																																																																																																											
99505	"	Home visit stoma care"	E																																																																																																											
99506	"	Home visit im injection"	E																																																																																																											
99507	"	Home visit cath maintain"	E																																																																																																											
99509	"	Home visit day life activity"	E																																																																																																											
99510	"	Home visit sing/m/fam couns"	E																																																																																																											
99511	"	Home visit fecal/enema mgmt"	E																																																																																																											
99512	"	Home visit for hemodialysis"	E																																																																																																											
99600	"	Home visit nos"	E																																																																																																											
99601	"	Home infusion/visit 2 hrs"	E																																																																																																											
99602	"	Home infusion each addtl hr"	E																																																																																																											
99605	"	Mtms by pharm np 15 min"	E																																																																																																											
99606	"	Mtms by pharm est 15 min"	E																																																																																																											
99607	"	Mtms by pharm addl 15 min"	E																																																																																																											
A0021	"	Outside state ambulance serv"	E																																																																																																											
A0080	"	Noninterest escort in non er"	E																																																																																																											
A0090	"	Interest escort in non er"	E																																																																																																											
A0100	"	Nonemergency transport taxi"	E																																																																																																											
A0110	"	Nonemergency transport bus"	E																																																																																																											
A0120	"	Noner transport mini-bus"	E																																																																																																											
A0130	"	Noner transport wheelch van"	E																																																																																																											
A0140	"	Nonemergency transport air"	E																																																																																																											
A0160	"	Noner transport case worker"	E																																																																																																											
A0170	"	Transport parking fees/tolls"	E																																																																																																											
A0180	"	Noner transport lodgng recip"	E																																																																																																											
A0190	"	Noner transport meals recip"	E																																																																																																											
A0200	"	Noner transport lodgng escrt"	E																																																																																																											
A0210	"	Noner transport meals escort"	E																																																																																																											
A0225	"	Neonatal emergency transport"	E																																																																																																											
A0380	"	Basic life support mileage"	E																																																																																																											
A0382	"	Basic support routine suppls"	E																																																																																																											
A0384	"	Bls defibrillation supplies"	E																																																																																																											
A0390	"	Advanced life support mileag"	E																																																																																																											
A0392	"	Als defibrillation supplies"	E																																																																																																											
A0394	Als iv drug therapy supplies	E																																																																																																											
A0396	"	Als esophageal intub suppls"	E																																																																																																											
A0398	"	Als routine disposble suppls"	E																																																																																																											
A0420	"	Ambulance waiting 1/2 hr"	E																																																																																																											
A0422	"	Ambulance 02 life sustaining"	E																																																																																																											
A0424	"	Extra ambulance attendant"	E																																																																																																											
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"	E																																																																																																											
A0998	"	Ambulance response/treatment"	E																																																																																																											
A0999	"	Unlisted ambulance service"	A																																																																																																											
A4206	1 cc sterile syringe&needle	E																																																																																																											
A4207	2 cc sterile syringe&needle	E																																																																																																											
A4208	3 cc sterile syringe&needle	E																																																																																																											
A4209	5+ cc sterile syringe&needle	E																																																																																																											
A4210	"	Nonneedle injection device"	E																																																																																																											
A4211	"	Supp for self-adm injections"	E																																																																																																											
A4212	"	Non coring needle or stylet"	B																																																																																																											
A4213	20+ cc syringe only	E																																																																																																											
A4215	"	Sterile needle"	E																																																																																																											
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	"	Maint drug infus cath per wk"	Y																																																																																																											
A4222	"	Infusion supplies with pump"	Y																																																																																																											
A4223	"	Infusion supplies w/o pump"	E																																																																																																											
A4230	"	Infus insulin pump non needl"	N																																																																																																											
A4231	"	Infusion insulin pump needle"	N																																																																																																											
A4232	"	Syringe w/needle insulin 3cc"	E																																																																																																											
A4233	"	Alkalin batt for glucose mon"	Y																																																																																																											
A4234	"	J-cell batt for glucose mon"	Y																																																																																																											
A4235	"	Lithium batt for glucose mon"	Y																																																																																																											
A4236	"	Silvr oxide batt glucose mon"	Y																																																																																																											
A4244	"	Alcohol or peroxide per pint"	E																																																																																																											
A4245	"	Alcohol wipes per box"	E																																																																																																											
A4246	"	Betadine/phisohex solution"	E																																																																																																											
A4247	"	Betadine/iodine swabs/wipes"	E																																																																																																											
A4248	"	Chlorhexidine antisept"	N																																																																																																											
A4250	"	Urine reagent strips/tablets"	E																																																																																																											
A4252	"	Blood ketone test or strip"	E																																																																																																											
A4253	"	Blood glucose/reagent strips"	Y																																																																																																											
A4255	"	Glucose monitor platforms"	Y																																																																																																											
A4256	"	Calibrator solution/chips"	Y																																																																																																											
A4257	Replace lensshield cartridge	Y																																																																																																											
A4258	"	Lancet device each"	Y																																																																																																											
A4259	"	Lancets per box"	Y																																																																																																											
A4261	"	Cervical cap contraceptive"	E																																																																																																											
A4262	"	Temporary tear duct plug"	N																																																																																																											
A4263	"	Permanent tear duct plug"	N																																																																																																											
A4264	"	Intratubal occlusion device"	E																																																																																																											
A4265	"	Paraffin"	Y																																																																																																											
A4266	"	Diaphragm"	E																																																																																																											
A4267	"	Male condom"	E																																																																																																											
A4268	"	Female condom"	E																																																																																																											
A4269	"	Spermicide"	E																																																																																																											
A4270	"	Disposable endoscope sheath"	N																																																																																																											
A4280	"	Brst prsths adhsv attchmnt"	N																																																																																																											
A4281	"	Replacement breastpump tube"	E																																																																																																											
A4282	"	Replacement breastpump adpt"	E																																																																																																											
A4283	"	Replacement breastpump cap"	E																																																																																																											
A4284	"	Replcmnt breast pump shield"	E																																																																																																											
A4285	"	Replcmnt breast pump bottle"	E																																																																																																											
A4286	"	Replcmnt breastpump lok ring"	E																																																																																																											
A4290	"	Sacral nerve stim test lead"	B																																																																																																											
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"	A																																																																																																											
A4311	"	Catheter w/o bag 2-way latex"	A																																																																																																											
A4312	"	Cath w/o bag 2-way silicone"	A																																																																																																											
A4313	"	Catheter w/bag 3-way"	A																																																																																																											
A4314	"	Cath w/drainage 2-way latex"	A																																																																																																											
A4315	"	Cath w/drainage 2-way silcne"	A																																																																																																											
A4316	"	Cath w/drainage 3-way"	A																																																																																																											
A4320	"	Irrigation tray"	A																																																																																																											
A4321	"	Cath therapeutic irrig agent"	A																																																																																																											
A4322	"	Irrigation syringe"	A																																																																																																											
A4326	"	Male external catheter"	A																																																																																																											
A4327	"	Fem urinary collect dev cup"	A																																																																																																											
A4328	"	Fem urinary collect pouch"	A																																																																																																											
A4330	"	Stool collection pouch"	A																																																																																																											
A4331	"	Extension drainage tubing"	A																																																																																																											
A4332	"	Lube sterile packet"	A																																																																																																											
A4333	"	Urinary cath anchor device"	A																																																																																																											
A4334	"	Urinary cath leg strap"	A																																																																																																											
A4335	"	Incontinence supply"	A																																																																																																											
A4336	"	Urethral insert"	A																																																																																																											
A4338	"	Indwelling catheter latex"	A																																																																																																											
A4340	"	Indwelling catheter special"	A																																																																																																											
A4344	"	Cath indw foley 2 way silicn"	A																																																																																																											
A4346	"	Cath indw foley 3 way"	A																																																																																																											
A4349	"	Disposable male external cat"	A																																																																																																											
A4351	"	Straight tip urine catheter"	A																																																																																																											
A4352	"	Coude tip urinary catheter"	A																																																																																																											
A4353	"	Intermittent urinary cath"	A																																																																																																											
A4354	"	Cath insertion tray w/bag"	A																																																																																																											
A4355	"	Bladder irrigation tubing"	A																																																																																																											
A4356	"	Ext ureth clmp or compr dvc"	A																																																																																																											
A4357	"	Bedside drainage bag"	A																																																																																																											
A4358	"	Urinary leg or abdomen bag"	A																																																																																																											
A4360	"	Disposable ext urethral dev"	A																																																																																																											
A4361	"	Ostomy face plate"	A																																																																																																											
A4362	"	Solid skin barrier"	A																																																																																																											
A4363	"	Ostomy clamp, replacement"	A																																																																																																											
A4364	"	Adhesive, liquid or equal"	A																																																																																																											
A4366	"	Ostomy vent"	A																																																																																																											
A4367	"	Ostomy belt"	A																																																																																																											
A4368	"	Ostomy filter"	A																																																																																																											
A4369	"	Skin barrier liquid per oz"	A																																																																																																											
A4371	"	Skin barrier powder per oz"	A																																																																																																											
A4372	"	Skin barrier solid 4x4 equiv"	A																																																																																																											
A4373	"	Skin barrier with flange"	A																																																																																																											
A4375	"	Drainable plastic pch w fcpl"	A																																																																																																											
A4376	"	Drainable rubber pch w fcplt"	A																																																																																																											
A4377	"	Drainable plstic pch w/o fp"	A																																																																																																											
A4378	"	Drainable rubber pch w/o fp"	A																																																																																																											
A4379	"	Urinary plastic pouch w fcpl"	A																																																																																																											
A4380	"	Urinary rubber pouch w fcplt"	A																																																																																																											
A4381	"	Urinary plastic pouch w/o fp"	A																																																																																																											
A4382	"	Urinary hvy plstc pch w/o fp"	A																																																																																																											
A4383	"	Urinary rubber pouch w/o fp"	A																																																																																																											
A4384	"	Ostomy faceplt/silicone ring"	A																																																																																																											
A4385	"	Ost skn barrier sld ext wear"	A																																																																																																											
A4387	"	Ost clsd pouch w att st barr"	A																																																																																																											
A4388	"	Drainable pch w ex wear barr"	A																																																																																																											
A4389	"	Drainable pch w st wear barr"	A																																																																																																											
A4390	"	Drainable pch ex wear convex"	A																																																																																																											
A4391	"	Urinary pouch w ex wear barr"	A																																																																																																											
A4392	"	Urinary pouch w st wear barr"	A																																																																																																											
A4393	"	Urine pch w ex wear bar conv"	A																																																																																																											
A4394	"	Ostomy pouch liq deodorant"	A																																																																																																											
A4395	"	Ostomy pouch solid deodorant"	A																																																																																																											
A4396	"	Peristomal hernia supprt blt"	A																																																																																																											
A4397	"	Irrigation supply sleeve"	A																																																																																																											
A4398	"	Ostomy irrigation bag"	A																																																																																																											
A4399	"	Ostomy irrig cone/cath w brs"	A																																																																																																											
A4400	"	Ostomy irrigation set"	A																																																																																																											
A4402	"	Lubricant per ounce"	A																																																																																																											
A4404	"	Ostomy ring each"	A																																																																																																											
A4405	"	Nonpectin based ostomy paste"	A																																																																																																											
A4406	"	Pectin based ostomy paste"	A																																																																																																											
A4407	"	Ext wear ost skn barr <=4sq"""	A																																																																																																											
A4408	"	Ext wear ost skn barr >4sq"""	A																																																																																																											
A4409	"	Ost skn barr convex <=4 sq i"	A																																																																																																											
A4410	"	Ost skn barr extnd >4 sq"	A																																																																																																											
A4411	"	Ost skn barr extnd =4sq"	A																																																																																																											
A4412	"	Ost pouch drain high output"	A																																																																																																											
A4413	"	2 pc drainable ost pouch"	A																																																																																																											
A4414	"	Ost sknbar w/o conv<=4 sq in"	A																																																																																																											
A4415	"	Ost skn barr w/o conv >4 sqi"	A																																																																																																											
A4416	"	Ost pch clsd w barrier/filtr"	A																																																																																																											
A4417	"	Ost pch w bar/bltinconv/fltr"	A																																																																																																											
A4418	"	Ost pch clsd w/o bar w filtr"	A																																																																																																											
A4419	"	Ost pch for bar w flange/flt"	A																																																																																																											
A4420	"	Ost pch clsd for bar w lk fl"	A																																																																																																											
A4421	"	Ostomy supply misc"	E																																																																																																											
A4422	"	Ost pouch absorbent material"	A																																																																																																											
A4423	"	Ost pch for bar w lk fl/fltr"	A																																																																																																											
A4424	"	Ost pch drain w bar & filter"	A																																																																																																											
A4425	"	Ost pch drain for barrier fl"	A																																																																																																											
A4426	"	Ost pch drain 2 piece system"	A																																																																																																											
A4427	"	Ost pch drain/barr lk flng/f"	A																																																																																																											
A4428	"	Urine ost pouch w faucet/tap"	A																																																																																																											
A4429	"	Urine ost pouch w bltinconv"	A																																																																																																											
A4430	"	Ost urine pch w b/bltin conv"	A																																																																																																											
A4431	"	Ost pch urine w barrier/tapv"	A																																																																																																											
A4432	"	Os pch urine w bar/fange/tap"	A																																																																																																											
A4433	"	Urine ost pch bar w lock fln"	A																																																																																																											
A4434	"	Ost pch urine w lock flng/ft"	A																																																																																																											
A4435	"	1pc ost pch drain hgh output"	A																																																																																																											
A4450	"	Non-waterproof tape"	N																																																																																																											
A4452	"	Waterproof tape"	N																																																																																																											
A4455	"	Adhesive remover per ounce"	N																																																																																																											
A4456	"	Adhesive remover, wipes"	N																																																																																																											
A4458	"	Reusable enema bag"	E																																																																																																											
A4461	"	Surgicl dress hold non-reuse"	N																																																																																																											
A4463	"	Surgical dress holder reuse"	N																																																																																																											
A4465	"	Non-elastic extremity binder"	N																																																																																																											
A4466	"	Elastic garment/covering"	E																																																																																																											
A4470	"	Gravlee jet washer"	N																																																																																																											
A4480	"	Vabra aspirator"	N																																																																																																											
A4481	"	Tracheostoma filter"	N																																																																																																											
A4483	"	Moisture exchanger"	N																																																																																																											
A4490	"	Above knee surgical stocking"	E																																																																																																											
A4495	"	Thigh length surg stocking"	E																																																																																																											
A4500	"	Below knee surgical stocking"	E																																																																																																											
A4510	"	Full length surg stocking"	E																																																																																																											
A4520	"	Incontinence garment anytype"	E																																																																																																											
A4550	"	Surgical trays"	B																																																																																																											
A4554	"	Disposable underpads"	E																																																																																																											
A4555	Ca tx e-stim electr/transduc	E																																																																																																											
A4556	"	Electrodes, pair"	Y																																																																																																											
A4557	"	Lead wires, pair"	Y																																																																																																											
A4558	"	Conductive gel or paste"	Y																																																																																																											
A4559	"	Coupling gel or paste"	Y																																																																																																											
A4561	"	Pessary rubber, any type"	N																																																																																																											
A4562	"	Pessary, non rubber,any type"	N																																																																																																											
A4565	"	Slings"	N																																																																																																											
A4566	"	Should sling/vest/abrestrain"	E																																																																																																											
A4570	"	Splint"	E																																																																																																											
A4575	"	Hyperbaric o2 chamber disps"	E																																																																																																											
A4580	"	Cast supplies (plaster)"	E																																																																																																											
A4590	"	Special casting material"	E																																																																																																											
A4595	Tens suppl 2 lead per month	Y																																																																																																											
A4600	"	Sleeve, inter limb comp dev"	Y																																																																																																											
A4601	"	Lith ion batt, non-pros use"	Y																																																																																																											
A4604	"	Tubing with heating element"	Y																																																																																																											
A4605	"	Trach suction cath close sys"	Y																																																																																																											
A4606	"	Oxygen probe used w oximeter"	N																																																																																																											
A4608	"	Transtracheal oxygen cath"	N																																																																																																											
A4611	"	Heavy duty battery"	E																																																																																																											
A4612	"	Battery cables"	E																																																																																																											
A4613	"	Battery charger"	E																																																																																																											
A4614	Hand-held pefr meter	Y																																																																																																											
A4615	"	Cannula nasal"	Y																																																																																																											
A4616	"	Tubing (oxygen) per foot"	Y																																																																																																											
A4617	"	Mouth piece"	Y																																																																																																											
A4618	"	Breathing circuits"	Y																																																																																																											
A4619	"	Face tent"	Y																																																																																																											
A4620	"	Variable concentration mask"	Y																																																																																																											
A4623	"	Tracheostomy inner cannula"	N																																																																																																											
A4624	"	Tracheal suction tube"	Y																																																																																																											
A4625	"	Trach care kit for new trach"	N																																																																																																											
A4626	"	Tracheostomy cleaning brush"	N																																																																																																											
A4627	"	Spacer bag/reservoir"	E																																																																																																											
A4628	"	Oropharyngeal suction cath"	Y																																																																																																											
A4629	"	Tracheostomy care kit"	N																																																																																																											
A4630	"	Repl bat t.e.n.s. own by pt"	Y																																																																																																											
A4633	"	Uvl replacement bulb"	Y																																																																																																											
A4634	"	Replacement bulb th lightbox"	N																																																																																																											
A4635	"	Underarm crutch pad"	Y																																																																																																											
A4636	"	Handgrip for cane etc"	Y																																																																																																											
A4637	"	Repl tip cane/crutch/walker"	Y																																																																																																											
A4638	"	Repl batt pulse gen sys"	Y																																																																																																											
A4639	"	Infrared ht sys replcmnt pad"	Y																																																																																																											
A4640	"	Alternating pressure pad"	Y																																																																																																											
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"	E																																																																																																											
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"	E																																																																																																											
A5051	"	Pouch clsd w barr attached"	A																																																																																																											
A5052	"	Clsd ostomy pouch w/o barr"	A																																																																																																											
A5053	"	Clsd ostomy pouch faceplate"	A																																																																																																											
A5054	"	Clsd ostomy pouch w/flange"	A																																																																																																											
A5055	"	Stoma cap"	A																																																																																																											
A5056	"	1 pc ost pouch w filter"	A																																																																																																											
A5057	"	1 pc ost pou w built-in conv"	A																																																																																																											
A5061	"	Pouch drainable w barrier at"	A																																																																																																											
A5062	"	Drnble ostomy pouch w/o barr"	A																																																																																																											
A5063	"	Drain ostomy pouch w/flange"	A																																																																																																											
A5071	"	Urinary pouch w/barrier"	A																																																																																																											
A5072	"	Urinary pouch w/o barrier"	A																																																																																																											
A5073	"	Urinary pouch on barr w/flng"	A																																																																																																											
A5081	"Stoma plug or seal, any type"	A																																																																																																											
A5082	"	Continent stoma catheter"	A																																																																																																											
A5083	"	Stoma absorptive cover"	A																																																																																																											
A5093	"	Ostomy accessory convex inse"	A																																																																																																											
A5102	"	Bedside drain btl w/wo tube"	A																																																																																																											
A5105	"	Urinary suspensory"	A																																																																																																											
A5112	"	Urinary leg bag"	A																																																																																																											
A5113	"	Latex leg strap"	A																																																																																																											
A5114	"	Foam/fabric leg strap"	A																																																																																																											
A5120	"	Skin barrier, wipe or swab"	A																																																																																																											
A5121	"	Solid skin barrier 6x6"	A																																																																																																											
A5122	"	Solid skin barrier 8x8"	A																																																																																																											
A5126	"	Disk/foam pad +or- adhesive"	A																																																																																																											
A5131	"	Appliance cleaner"	A																																																																																																											
A5200	"	Percutaneous catheter anchor"	A																																																																																																											
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"	E																																																																																																											
A5512	"	Multi den insert direct form"	Y																																																																																																											
A5513	"	Multi den insert custom mold"	Y																																																																																																											
A6000	"	Wound warming wound cover"	E																																																																																																											
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"	E																																																																																																											
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"	E																																																																																																											
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																																																																																																											
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	E																																																																																																											
A6531	Compression stocking bk30-40	N																																																																																																											
A6532	Compression stocking bk40-50	N																																																																																																											
A6533	"	Gc stocking thighlngth 18-30"	E																																																																																																											
A6534	"	Gc stocking thighlngth 30-40"	E																																																																																																											
A6535	"	Gc stocking thighlngth 40-50"	E																																																																																																											
A6536	"	Gc stocking full lngth 18-30"	E																																																																																																											
A6537	"	Gc stocking full lngth 30-40"	E																																																																																																											
A6538	"	Gc stocking full lngth 40-50"	E																																																																																																											
A6539	"	Gc stocking waistlngth 18-30"	E																																																																																																											
A6540	"	Gc stocking waistlngth 30-40"	E																																																																																																											
A6541	"	Gc stocking waistlngth 40-50"	E																																																																																																											
A6544	"	Gc stocking garter belt"	E																																																																																																											
A6545	Grad comp non-elastic bk	N																																																																																																											
A6549	"	G compression stocking"	E																																																																																																											
A6550	"	Neg pres wound ther drsg set"	Y																																																																																																											
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																																																																																																											
A7011	"	Nondispos 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"	Y																																																																																																											
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																																																																																																											
A7042	"	Implanted pleural catheter"	N																																																																																																											
A7043	"	Vacuum drainagebottle/tubing"	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																																																																																																											
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"	E																																																																																																											
A9153	"	Multi-vitamin nos"	E																																																																																																											
A9155	"	Artificial saliva"	B																																																																																																											
A9180	"	Lice treatment, topical"	E																																																																																																											
A9270	"	Non-covered item or service"	E																																																																																																											
A9272	"	Disp wound suct, drsg/access"	E																																																																																																											
A9273	"	Hot/cold h2obot/cap/col/wrap"	E																																																																																																											
A9274	"	Ext amb insulin delivery sys"	E																																																																																																											
A9275	"	Disp home glucose monitor"	E																																																																																																											
A9276	"Disposable sensor, cgm sys"	E																																																																																																											
A9277	"External transmitter, cgm"	E																																																																																																											
A9278	"External receiver, cgm sys"	E																																																																																																											
A9279	Monitoring feature/devicenoc	E																																																																																																											
A9280	"	Alert device, noc"	E																																																																																																											
A9281	"	Reaching/grabbing device"	E																																																																																																											
A9282	"	Wig any type"	E																																																																																																											
A9283	"	Foot press off load supp dev"	E																																																																																																											
A9284	"	Non-electronic spirometer"	N																																																																																																											
A9300	"	Exercise equipment"	E																																																																																																											
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																																																																																																											
A9516	Iodine i-123 sod iodide mic	N																																																																																																											
A9517	"	I131 iodide cap, rx"	K	1064		$18.52	.	$3.71																																																																																																						
A9520	Tc99 tilmanocept diag 0.5mci	G	1463		$240.00		$0.00																																																																																																						
A9521	"	Tc99m exametazime"	N																																																																																																											
A9524	"	I131 serum albumin, dx"	N																																																																																																											
A9526	Nitrogen n-13 ammonia	N																																																																																																											
A9527	Iodine i-125 sodium iodide	U	2632	0.2610	$18.97	.	$3.80																																																																																																						
A9528	"Iodine i-131 iodide cap, dx"	N																																																																																																											
A9529	"	I131 iodide sol, dx"	N																																																																																																											
A9530	"	I131 iodide sol, rx"	K	1150		$10.80	.	$2.16																																																																																																						
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		"$44,161.14"	.	"$8,832.23"	*																																																																																																					
A9544	"	I131 tositumomab, dx"	N																																																																																																											
A9545	"	I131 tositumomab, rx"	E																																																																																																											
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		$223.07	.	$44.62																																																																																																						
A9564	"	P32 chromic phosphate"	K	1676		$316.07	.	$63.22																																																																																																						
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																																																																																																											
A9599	Radiopha dx beta amyloid pet	N																																																																																																											
A9600	"	Sr89 strontium"	K	0701		"$1,130.06"	.	$226.02	*																																																																																																					
A9604	"	Sm 153 lexidronam"	K	1295		"$8,442.67"	.	"$1,688.54"	*																																																																																																					
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"	A																																																																																																											
B4088	"	Gastro/jejuno tube, low-pro"	A																																																																																																											
B4100	"	Food thickener oral"	E																																																																																																											
B4102	Ef adult fluids and electro	Y																																																																																																											
B4103	Ef ped fluid and electrolyte	Y																																																																																																											
B4104	"	Additive for enteral formula"	E																																																																																																											
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	"	Parenteral sol 10 gm 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 sol hepatic-fream"	Y																																																																																																											
B5200	"	Parenteral sol stres-brnch c"	Y																																																																																																											
B9000	"	Enter infusion pump w/o alrm"	Y																																																																																																											
B9002	"	Enteral infusion pump w/ ala"	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																																																																																																											
C1300	Hyperbaric oxygen	S	0659	1.5264	$110.93	.	$22.19																																																																																																						
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	1716	0.6372	$46.31	.	$9.27																																																																																																						
C1717	"Brachytx, non-str,hdr ir-192"	U	1717	3.8288	$278.25	.	$55.65																																																																																																						
C1719	"Brachytx, ns, non-hdrir-192"	U	1719	0.4615	$33.54	.	$6.71																																																																																																						
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																																																																																																											
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																																																																																																											
C1830	"	Power bone marrow bx needle"	N																																																																																																											
C1840	"	Telescopic intraocular lens"	N																																																																																																											
C1841	Retinal prosth int/ext comp	H	1841																																																																																																										
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																																																																																																											
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																																																																																																											
C2614	"	Probe, perc lumb disc"	N																																																																																																											
C2615	"	Sealant, pulmonary, liquid"	N																																																																																																											
C2616	"Brachytx, non-str,yttrium-90"	U	2616	231.5765	"$16,829.13"	.	"$3,365.83"																																																																																																						
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																																																																																																											
C2625	"	Stent, non-cor, tem w/del sy"	N																																																																																																											
C2626	"	Infusion pump, non-prog,temp"	N																																																																																																											
C2627	"	Cath, suprapubic/cystoscopic"	N																																																																																																											
C2628	"	Catheter, occlusion"	N																																																																																																											
C2629	"	Intro/sheath, laser"	N																																																																																																											
C2630	"Cath, ep, cool-tip"	N																																																																																																											
C2631	"	Rep dev, urinary, w/o sling"	N																																																																																																											
C2634	"Brachytx, non-str, ha, i-125"	U	2634	1.0200	$74.13	.	$14.83																																																																																																						
C2635	"Brachytx, non-str, ha, p-103"	U	2635	0.3669	$26.66	.	$5.34																																																																																																						
C2636	"Brachy linear, non-str,p-103"	U	2636	0.5551	$40.34	.	$8.07																																																																																																						
C2637	"Brachy,non-str,ytterbium-169"	B																																																																																																											
C2638	"Brachytx, stranded, i-125"	U	2638	0.6663	$48.42	.	$9.69																																																																																																						
C2639	"Brachytx, non-stranded,i-125"	U	2639	0.5575	$40.51	.	$8.11																																																																																																						
C2640	"Brachytx, stranded, p-103"	U	2640	0.9885	$71.84	.	$14.37																																																																																																						
C2641	"Brachytx, non-stranded,p-103"	U	2641	0.9461	$68.75	.	$13.75																																																																																																						
C2642	"Brachytx, stranded, c-131"	U	2642	1.9129	$139.01	.	$27.81																																																																																																						
C2643	"Brachytx, non-stranded,c-131"	U	2643	0.8672	$63.02	.	$12.61																																																																																																						
C2644	Brachytx cesium-131 chloride	U	2644	0.2610	$18.97		$3.80																																																																																																						
C2698	"Brachytx, stranded, nos"	U	2698	0.6663	$48.42	.	$9.69																																																																																																						
C2699	"Brachytx, non-stranded, nos"	U	2699	0.3669	$26.66	.	$5.34																																																																																																						
C5271	"	Low cost skin substitute app"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
C5272	"	Low cost skin substitute app"	N																																																																																																											
C5273	"	Low cost skin substitute app"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
C5274	"	Low cost skin substitute app"	N																																																																																																											
C5275	"	Low cost skin substitute app"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
C5276	"	Low cost skin substitute app"	N																																																																																																											
C5277	"	Low cost skin substitute app"	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
C5278	"	Low cost skin substitute app"	N																																																																																																											
C8900	"Mra w/cont, abd"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
C8901	"Mra w/o cont, abd"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
C8902	"Mra w/o fol w/cont, abd"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
C8903	"Mri w/cont, breast,  uni"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
C8904	"Mri w/o cont, breast, uni"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
C8905	"Mri w/o fol w/cont, brst, un"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
C8906	"Mri w/cont, breast,  bi"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
C8907	"Mri w/o cont, breast, bi"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
C8908	"Mri w/o fol w/cont, breast,"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
C8909	"Mra w/cont, chest"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
C8910	"Mra w/o cont, chest"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
C8911	"Mra w/o fol w/cont, chest"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
C8912	"Mra w/cont, lwr ext"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
C8913	"Mra w/o cont, lwr ext"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
C8914	"Mra w/o fol w/cont, lwr ext"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
C8918	"Mra w/cont, pelvis"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
C8919	"Mra w/o cont, pelvis"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
C8920	"Mra w/o fol w/cont, pelvis"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
C8921	"Tte w or w/o fol w/cont, com"	S	0178	9.0028	$654.25	$172.48	$130.85																																																																																																						
C8922	"Tte w or w/o fol w/cont, f/u"	S	0177	6.8881	$500.57	$129.40	$100.12																																																																																																						
C8923	"2d tte w or w/o fol w/con,co"	S	0177	6.8881	$500.57	$129.40	$100.12																																																																																																						
C8924	"2d tte w or w/o fol w/con,fu"	S	0177	6.8881	$500.57	$129.40	$100.12																																																																																																						
C8925	"2d tee w or w/o fol w/con,in"	S	0178	9.0028	$654.25	$172.48	$130.85																																																																																																						
C8926	"Tee w or w/o fol w/cont,cong"	S	0178	9.0028	$654.25	$172.48	$130.85																																																																																																						
C8927	"Tee w or w/o fol w/cont, mon"	S	0177	6.8881	$500.57	$129.40	$100.12																																																																																																						
C8928	"Tte w or w/o fol w/con,stres"	S	0178	9.0028	$654.25	$172.48	$130.85																																																																																																						
C8929	"Tte w or wo fol wcon,doppler"	S	0178	9.0028	$654.25	$172.48	$130.85																																																																																																						
C8930	"Tte w or w/o contr, cont ecg"	S	0178	9.0028	$654.25	$172.48	$130.85																																																																																																						
C8931	"Mra, w/dye, spinal canal"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
C8932	"Mra, w/o dye, spinal canal"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
C8933	"Mra, w/o&w/dye, spinal canal"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
C8934	"Mra, w/dye, upper extremity"	Q3	0284	5.8687	$426.49	$137.54	$85.30																																																																																																						
C8935	"Mra, w/o dye, upper extr"	Q3	0336	4.0563	$294.78	$116.16	$58.96																																																																																																						
C8936	"Mra, w/o&w/dye, upper extr"	Q3	0337	6.7828	$492.92	$177.30	$98.59																																																																																																						
C8957	"Prolonged iv inf, req pump"	S	0440	4.1217	$299.53	.	$59.91																																																																																																						
C9021	"Injection, obinutuzumab"	G	1476		$54.27		$10.86	*																																																																																																					
C9022	"Injection, elosulfase alfa"	G	1480		$222.13		$44.43	*																																																																																																					
C9023	Inj testosterone undecanoate	G	1487		$1.15		$0.23	*																																																																																																					
C9025	"Injection, ramucirumab"	G	1488		$54.06		$10.82	*																																																																																																					
C9026	"Injection, vedolizumab"	G	1489		$17.03		$3.41	*																																																																																																					
C9113	"	Inj pantoprazole sodium, via"	N																																																																																																											
C9121	"	Injection, argatroban"	K	9121		$15.70	.	$3.14	*																																																																																																					
C9132	"	Kcentra, per i.u."	G	9132		$1.54	.	$0.31																																																																																																						
C9133	Factor ix recombinant	G	1467		$1.22		$0.24																																																																																																						
C9134	Factor XIII A-subunit recomb	G	1481		$134.95		$26.99	*																																																																																																					
C9135	Factor ix (Alprolix)	G	1486		$3.02		$0.61	*																																																																																																					
C9248	"	Inj, clevidipine butyrate"	N																																																																																																											
C9250	"	Artiss fibrin sealant"	K	9250		$132.98	.	$26.60	*																																																																																																					
C9254	"	Injection, lacosamide"	N																																																																																																											
C9257	"	Bevacizumab injection"	K	1281		$1.67	.	$0.34	*																																																																																																					
C9275	Hexaminolevulinate hcl	N																																																																																																											
C9285	"	Patch, lidocaine/tetracaine"	N																																																																																																											
C9290	"	Inj, bupivacaine liposome"	G	9290		$1.15		$0.00	*																																																																																																					
C9293	"	Injection, glucarpidase"	G	9293		$257.94	.	$51.59	*																																																																																																					
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																																																																																																											
C9497	"Loxapine, inhalation powder"	G	9497		$153.70		$30.74																																																																																																						
C9600	"	Perc drug-el cor stent sing"	T	0656	106.1485	"$7,714.02"	.	"$1,542.81"																																																																																																						
C9601	"	Perc drug-el cor stent bran"	T	0656	106.1485	"$7,714.02"	.	"$1,542.81"																																																																																																						
C9602	"	Perc d-e cor stent ather s"	T	0656	106.1485	"$7,714.02"	.	"$1,542.81"																																																																																																						
C9603	"	Perc d-e cor stent ather br"	T	0656	106.1485	"$7,714.02"	.	"$1,542.81"																																																																																																						
C9604	"	Perc d-e cor revasc t cabg s"	T	0656	106.1485	"$7,714.02"	.	"$1,542.81"																																																																																																						
C9605	Perc d-e cor revasc t cabg b	T	0656	106.1485	"$7,714.02"	.	"$1,542.81"																																																																																																						
C9606	Perc d-e cor revasc w ami s	T	0656	106.1485	"$7,714.02"	.	"$1,542.81"																																																																																																						
C9607	"	Perc d-e cor revasc chro sin"	T	0656	106.1485	"$7,714.02"	.	"$1,542.81"																																																																																																						
C9608	"	Perc d-e cor revasc chro add"	T	0656	106.1485	"$7,714.02"	.	"$1,542.81"																																																																																																						
C9724	Eps stomach plic	T	0422	27.0909	"$1,968.75"	.	$393.75																																																																																																						
C9725	"	Place endorectal app"	T	0148	6.5068	$472.86	.	$94.58																																																																																																						
C9726	"	Rxt breast appl place/remov"	N																																																																																																											
C9727	"	Insert palate implants"	T	0252	7.5014	$545.14	.	$109.03																																																																																																						
C9728	"	Place device/marker, non pro"	X	0310	14.2612	"$1,036.39"	$325.27	$207.28																																																																																																						
C9733	Non-ophthalmic fva	Q2	0263	4.3746	$317.91	.	$63.59																																																																																																						
C9734	"U/s trtmt, not leiomyomata"	S	0065	17.1769	"$1,248.28"	.	$249.66																																																																																																						
C9735	"	Anoscopy, submucosal inj"	T	0150	34.4192	"$2,501.31"	.	$500.27																																																																																																						
C9737	"	Lap esoph augmentation"	T	0174	118.2491	"$8,593.40"	"$1,911.61"	"$1,718.68"																																																																																																						
C9739	Cystoscopy prostatic imp 1-3	T	0162	27.6217	"$2,007.32"	.	$401.47																																																																																																						
C9740	Cysto impl 4 or more	T	1564		"$4,750.00"	.	$950.00																																																																																																						
C9741	Impl pressure sensor w/angio 	T	0319	213.4246	"$15,509.99"	"$5,559.48"	"$3,102.00"	*																																																																																																					
C9800	"	Dermal filler inj px/suppl"	T	0328	18.8682	"$1,371.19"	.	$274.24																																																																																																						
C9898	"	Inpnt stay radiolabeled item"	N																																																																																																											
C9899	"	Inpt implant pros dev,no cov"	A																																																																																																											
D0120	"	Periodic oral evaluation"	E																																																																																																											
D0140	"	Limit oral eval problm focus"	E																																																																																																											
D0145	"	Oral evaluation, pt < 3yrs"	E																																																																																																											
D0150	"	Comprehensve oral evaluation"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D0160	"	Extensv oral eval prob focus"	E																																																																																																											
D0170	"	Re-eval,est pt,problem focus"	E																																																																																																											
D0180	"	Comp periodontal evaluation"	E																																																																																																											
D0190	"	Screening of a patient"	E																																																																																																											
D0191	"	Assessment of a patient"	E																																																																																																											
D0210	"	Intraor complete film series"	E																																																																																																											
D0220	"	Intraoral periapical first"	E																																																																																																											
D0230	"	Intraoral periapical ea add"	E																																																																																																											
D0240	"	Intraoral occlusal film"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D0250	"	Extraoral first film"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D0260	"	Extraoral ea additional film"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D0270	"	Dental bitewing single image"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D0272	"	Dental bitewings two images"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D0273	"	Bitewings - three images"	E																																																																																																											
D0274	"	Bitewings four images"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D0277	"	Vert bitewings 7 to 8 images"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D0290	"	Skull/facial bone image"	E																																																																																																											
D0310	"	Dental saliography"	E																																																																																																											
D0320	"	Dental tmj arthrogram incl i"	E																																																																																																											
D0321	Other tmj images by report	E																																																																																																											
D0322	"	Dental tomographic survey"	E																																																																																																											
D0330	"	Panoramic image"	E																																																																																																											
D0340	"	Cephalometric image"	E																																																																																																											
D0350	"	Oral/facial photo images"	E																																																																																																											
D0364	"	Cone beam ct capt & interp"	E																																																																																																											
D0365	"	Cone beam ct interprete man"	E																																																																																																											
D0366	"	Cone beam ct interprete max"	E																																																																																																											
D0367	"	Cone beam ct interp both jaw"	E																																																																																																											
D0368	Cone beam ct interprete tmj	E																																																																																																											
D0369	Max mri capture & interprete	E																																																																																																											
D0370	"	Max ultrasound capt & interp"	E																																																																																																											
D0371	"	Sialoendoscopy capt & interp"	E																																																																																																											
D0380	"	Cone beam ct capture limited"	E																																																																																																											
D0381	"	Cone beam ct capt mandible"	E																																																																																																											
D0382	"	Cone beam ct capt maxilla"	E																																																																																																											
D0383	"	Cone beam ct both jaws"	E																																																																																																											
D0384	Cone beam ct capture tmj	E																																																																																																											
D0385	Max mri image capture	E																																																																																																											
D0386	"	Max ultrasound image capture"	E																																																																																																											
D0391	"	Imterprete diagnostic image"	E																																																																																																											
D0393	Trtmnt simulation 3d image	E																																																																																																											
D0394	Digital sub 2 or more images	E																																																																																																											
D0395	Fusion 2 or more 3d images	E																																																																																																											
D0415	"	Collection of microorganisms"	E																																																																																																											
D0416	"	Viral culture"	B																																																																																																											
D0417	"	Collect & prep saliva sample"	E																																																																																																											
D0418	"	Analysis of saliva sample"	E																																																																																																											
D0421	"	Gen tst suscept oral disease"	B																																																																																																											
D0425	"	Caries susceptibility test"	E																																																																																																											
D0431	"	Diag tst detect mucos abnorm"	B																																																																																																											
D0460	"	Pulp vitality test"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D0470	"	Diagnostic casts"	E																																																																																																											
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 diagnost"	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"	E																																																																																																											
D0502	"	Other oral pathology procedu"	B																																																																																																											
D0601	Caries risk assess low risk	E																																																																																																											
D0602	Caries risk assess mod risk	E																																																																																																											
D0603	Caries risk assess high risk	E																																																																																																											
D0999	"	Unspecified diagnostic proce"	B																																																																																																											
D1110	"	Dental prophylaxis adult"	E																																																																																																											
D1120	"	Dental prophylaxis child"	E																																																																																																											
D1206	"	Topical fluoride varnish"	E																																																																																																											
D1208	"	Topical app of fluoride"	E																																																																																																											
D1310	"	Nutri counsel-control caries"	E																																																																																																											
D1320	"	Tobacco counseling"	E																																																																																																											
D1330	"	Oral hygiene instruction"	E																																																																																																											
D1351	"	Dental sealant per tooth"	E																																																																																																											
D1352	"	Prev resin rest, perm tooth"	E																																																																																																											
D1510	"	Space maintainer fxd unilat"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D1515	"	Fixed bilat space maintainer"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D1520	"	Remove unilat space maintain"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D1525	"	Remove bilat space maintain"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D1550	"	Recement space maintainer"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D1555	"	Remove fix space maintainer"	E																																																																																																											
D1999	Unspecified preventive proc	E																																																																																																											
D2140	"	Amalgam one surface permanen"	E																																																																																																											
D2150	"	Amalgam two surfaces permane"	E																																																																																																											
D2160	"	Amalgam three surfaces perma"	E																																																																																																											
D2161	"	Amalgam 4 or > surfaces perm"	E																																																																																																											
D2330	"	Resin one surface-anterior"	E																																																																																																											
D2331	"	Resin two surfaces-anterior"	E																																																																																																											
D2332	"	Resin three surfaces-anterio"	E																																																																																																											
D2335	"	Resin 4/> surf or w incis an"	E																																																																																																											
D2390	"	Ant resin-based cmpst crown"	E																																																																																																											
D2391	"	Post 1 srfc resinbased cmpst"	E																																																																																																											
D2392	"	Post 2 srfc resinbased cmpst"	E																																																																																																											
D2393	"	Post 3 srfc resinbased cmpst"	E																																																																																																											
D2394	"	Post >=4srfc resinbase cmpst"	E																																																																																																											
D2410	"	Dental gold foil one surface"	E																																																																																																											
D2420	"	Dental gold foil two surface"	E																																																																																																											
D2430	"	Dental gold foil three surfa"	E																																																																																																											
D2510	"	Dental inlay metalic 1 surf"	E																																																																																																											
D2520	"	Dental inlay metallic 2 surf"	E																																																																																																											
D2530	"	Dental inlay metl 3/more sur"	E																																																																																																											
D2542	"	Dental onlay metallic 2 surf"	E																																																																																																											
D2543	"	Dental onlay metallic 3 surf"	E																																																																																																											
D2544	"	Dental onlay metl 4/more sur"	E																																																																																																											
D2610	"	Inlay porcelain/ceramic 1 su"	E																																																																																																											
D2620	"	Inlay porcelain/ceramic 2 su"	E																																																																																																											
D2630	"	Dental onlay porc 3/more sur"	E																																																																																																											
D2642	"	Dental onlay porcelin 2 surf"	E																																																																																																											
D2643	"	Dental onlay porcelin 3 surf"	E																																																																																																											
D2644	"	Dental onlay porc 4/more sur"	E																																																																																																											
D2650	"	Inlay composite/resin one su"	E																																																																																																											
D2651	"	Inlay composite/resin two su"	E																																																																																																											
D2652	"	Dental inlay resin 3/mre sur"	E																																																																																																											
D2662	"	Dental onlay resin 2 surface"	E																																																																																																											
D2663	"	Dental onlay resin 3 surface"	E																																																																																																											
D2664	"	Dental onlay resin 4/mre sur"	E																																																																																																											
D2710	"	Crown resin-based indirect"	E																																																																																																											
D2712	"	Crown 3/4 resin-based compos"	E																																																																																																											
D2720	"	Crown resin w/ high noble me"	E																																																																																																											
D2721	"	Crown resin w/ base metal"	E																																																																																																											
D2722	"	Crown resin w/ noble metal"	E																																																																																																											
D2740	"	Crown porcelain/ceramic subs"	E																																																																																																											
D2750	"	Crown porcelain w/ h noble m"	E																																																																																																											
D2751	"	Crown porcelain fused base m"	E																																																																																																											
D2752	"	Crown porcelain w/ noble met"	E																																																																																																											
D2780	"	Crown 3/4 cast hi noble met"	E																																																																																																											
D2781	"	Crown 3/4 cast base metal"	E																																																																																																											
D2782	"	Crown 3/4 cast noble metal"	E																																																																																																											
D2783	"	Crown 3/4 porcelain/ceramic"	E																																																																																																											
D2790	"	Crown full cast high noble m"	E																																																																																																											
D2791	"	Crown full cast base metal"	E																																																																																																											
D2792	"	Crown full cast noble metal"	E																																																																																																											
D2794	"	Crown-titanium"	E																																																																																																											
D2799	"	Provisional crown"	E																																																																																																											
D2910	"	Recement inlay onlay or part"	E																																																																																																											
D2915	"	Recement cast or prefab post"	E																																																																																																											
D2920	"	Dental recement crown"	E																																																																																																											
D2921	Reattach tooth fragment	E																																																																																																											
D2929	"	Prefab porc/ceram crown pri"	E																																																																																																											
D2930	"	Prefab stnlss steel crwn pri"	E																																																																																																											
D2931	"	Prefab stnlss steel crown pe"	E																																																																																																											
D2932	"	Prefabricated resin crown"	E																																																																																																											
D2933	"	Prefab stainless steel crown"	E																																																																																																											
D2934	"	Prefab steel crown primary"	E																																																																																																											
D2940	"	Protective restoration"	E																																																																																																											
D2941	Int therapeutic restoration	E																																																																																																											
D2949	Restorative foundation	E																																																																																																											
D2950	"	Core build-up incl any pins"	E																																																																																																											
D2951	"	Tooth pin retention"	E																																																																																																											
D2952	"	Post and core cast + crown"	E																																																																																																											
D2953	"	Each addtnl cast post"	E																																																																																																											
D2954	"	Prefab post/core + crown"	E																																																																																																											
D2955	"	Post removal"	E																																																																																																											
D2957	"	Each addtnl prefab post"	E																																																																																																											
D2960	"	Laminate labial veneer"	E																																																																																																											
D2961	"	Lab labial veneer resin"	E																																																																																																											
D2962	"	Lab labial veneer porcelain"	E																																																																																																											
D2970	"	Temp crown (fractured tooth)"	E																																																																																																											
D2971	"	Add proc construct new crown"	E																																																																																																											
D2975	"	Coping"	E																																																																																																											
D2980	"	Crown repair"	E																																																																																																											
D2981	"	Inlay repair"	E																																																																																																											
D2982	"	Onlay repair"	E																																																																																																											
D2983	"	Veneer repair"	E																																																																																																											
D2990	"	Resin infiltration of lesion"	E																																																																																																											
D2999	"	Dental unspec restorative pr"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D3110	"	Pulp cap direct"	E																																																																																																											
D3120	"	Pulp cap indirect"	E																																																																																																											
D3220	"	Therapeutic pulpotomy"	E																																																																																																											
D3221	"	Gross pulpal debridement"	E																																																																																																											
D3222	"	Part pulp for apexogenesis"	E																																																																																																											
D3230	"	Pulpal therapy anterior prim"	E																																																																																																											
D3240	"	Pulpal therapy posterior pri"	E																																																																																																											
D3310	"	End thxpy, anterior tooth"	E																																																																																																											
D3320	"	End thxpy, bicuspid tooth"	E																																																																																																											
D3330	"	End thxpy, molar"	E																																																																																																											
D3331	"	Non-surg tx root canal obs"	E																																																																																																											
D3332	"	Incomplete endodontic tx"	E																																																																																																											
D3333	"	Internal root repair"	E																																																																																																											
D3346	"	Retreat root canal anterior"	E																																																																																																											
D3347	"	Retreat root canal bicuspid"	E																																																																																																											
D3348	"	Retreat root canal molar"	E																																																																																																											
D3351	"	Apexification/recalc initial"	E																																																																																																											
D3352	"	Apexification/recalc interim"	E																																																																																																											
D3353	"	Apexification/recalc final"	E																																																																																																											
D3355	Pulpal regeneration initial	E																																																																																																											
D3356	Pulpal regeneration interim	E																																																																																																											
D3357	Pulpal regeneration complete	E																																																																																																											
D3410	Apicoectomy - anterior	E																																																																																																											
D3421	"	Root surgery bicuspid"	E																																																																																																											
D3425	"	Root surgery molar"	E																																																																																																											
D3426	"	Root surgery ea add root"	E																																																																																																											
D3427	Periradicular surgery	E																																																																																																											
D3428	Bone graft peri per tooth	E																																																																																																											
D3429	Bone graft peri each addl	E																																																																																																											
D3430	"	Retrograde filling"	E																																																																																																											
D3431	Biological materials	E																																																																																																											
D3432	Guided tissue regeneration	E																																																																																																											
D3450	"	Root amputation"	E																																																																																																											
D3460	"	Endodontic endosseous implan"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D3470	"	Intentional replantation"	E																																																																																																											
D3910	"	Isolation- tooth w rubb dam"	E																																																																																																											
D3920	"	Tooth splitting"	E																																																																																																											
D3950	"	Canal prep/fitting of dowel"	E																																																																																																											
D3999	"	Endodontic procedure"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D4210	"	Gingivectomy/plasty 4 or mor"	E																																																																																																											
D4211	"	Gingivectomy/plasty 1 to 3"	E																																																																																																											
D4212	"	Gingivectomy/plasty rest"	E																																																																																																											
D4230	"	Ana crown exp 4 or> per quad"	E																																																																																																											
D4231	"	Ana crown exp 1-3 per quad"	E																																																																																																											
D4240	"	Gingival flap proc w/ planin"	E																																																																																																											
D4241	"	Gngvl flap w rootplan 1-3 th"	E																																																																																																											
D4245	"	Apically positioned flap"	E																																																																																																											
D4249	"	Crown lengthen hard tissue"	E																																																																																																											
D4260	"	Osseous surgery 4 or more"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D4261	"	Osseous surg 1 to 3 teeth"	E																																																																																																											
D4263	"	Bone replce graft first site"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D4264	"	Bone replce graft each add"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D4265	"	Bio mtrls to aid soft/os reg"	E																																																																																																											
D4266	"	Guided tiss regen resorble"	E																																																																																																											
D4267	"	Guided tiss regen nonresorb"	E																																																																																																											
D4268	"	Surgical revision procedure"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D4270	"	Pedicle soft tissue graft pr"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D4273	"	Subepithelial tissue graft"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D4274	"	Distal/proximal wedge proc"	E																																																																																																											
D4275	"	Soft tissue allograft"	E																																																																																																											
D4276	"	Con tissue w dble ped graft"	E																																																																																																											
D4277	"	Soft tissue graft firsttooth"	E																																																																																																											
D4278	"	Soft tissue graft addl tooth"	E																																																																																																											
D4320	"	Provision splnt intracoronal"	E																																																																																																											
D4321	"	Provisional splint extracoro"	E																																																																																																											
D4341	"	Periodontal scaling & root"	E																																																																																																											
D4342	"	Periodontal scaling 1-3teeth"	E																																																																																																											
D4355	"	Full mouth debridement"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D4381	"	Localized delivery antimicro"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D4910	"	Periodontal maint procedures"	E																																																																																																											
D4920	"	Unscheduled dressing change"	E																																																																																																											
D4921	Gingival irrigation per quad	E																																																																																																											
D4999	"	Unspecified periodontal proc"	E																																																																																																											
D5110	"	Dentures complete maxillary"	E																																																																																																											
D5120	"	Dentures complete mandible"	E																																																																																																											
D5130	"	Dentures immediat maxillary"	E																																																																																																											
D5140	"	Dentures immediat mandible"	E																																																																																																											
D5211	"	Dentures maxill part resin"	E																																																																																																											
D5212	"	Dentures mand part resin"	E																																																																																																											
D5213	"	Dentures maxill part metal"	E																																																																																																											
D5214	"	Dentures mandibl part metal"	E																																																																																																											
D5225	"	Maxillary part denture flex"	E																																																																																																											
D5226	"	Mandibular part denture flex"	E																																																																																																											
D5281	"	Removable partial denture"	E																																																																																																											
D5410	"	Dentures adjust cmplt maxil"	E																																																																																																											
D5411	"	Dentures adjust cmplt mand"	E																																																																																																											
D5421	"	Dentures adjust part maxill"	E																																																																																																											
D5422	"	Dentures adjust part mandbl"	E																																																																																																											
D5510	"	Dentur repr broken compl bas"	E																																																																																																											
D5520	"	Replace denture teeth complt"	E																																																																																																											
D5610	"	Dentures repair resin base"	E																																																																																																											
D5620	"	Rep part denture cast frame"	E																																																																																																											
D5630	"	Rep partial denture clasp"	E																																																																																																											
D5640	"	Replace part denture teeth"	E																																																																																																											
D5650	"	Add tooth to partial denture"	E																																																																																																											
D5660	"	Add clasp to partial denture"	E																																																																																																											
D5670	"	Replc tth&acrlc on mtl frmwk"	E																																																																																																											
D5671	"	Replc tth&acrlc mandibular"	E																																																																																																											
D5710	"	Dentures rebase cmplt maxil"	E																																																																																																											
D5711	"	Dentures rebase cmplt mand"	E																																																																																																											
D5720	"	Dentures rebase part maxill"	E																																																																																																											
D5721	"	Dentures rebase part mandbl"	E																																																																																																											
D5730	"	Denture reln cmplt maxil ch"	E																																																																																																											
D5731	"	Denture reln cmplt mand chr"	E																																																																																																											
D5740	"	Denture reln part maxil chr"	E																																																																																																											
D5741	"	Denture reln part mand chr"	E																																																																																																											
D5750	"	Denture reln cmplt max lab"	E																																																																																																											
D5751	"	Denture reln cmplt mand lab"	E																																																																																																											
D5760	"	Denture reln part maxil lab"	E																																																																																																											
D5761	"	Denture reln part mand lab"	E																																																																																																											
D5810	"	Denture interm cmplt maxill"	E																																																																																																											
D5811	"	Denture interm cmplt mandbl"	E																																																																																																											
D5820	"	Denture interm part maxill"	E																																																																																																											
D5821	"	Denture interm part mandbl"	E																																																																																																											
D5850	"	Denture tiss conditn maxill"	E																																																																																																											
D5851	"	Denture tiss condtin mandbl"	E																																																																																																											
D5862	"	Precision attachment"	E																																																																																																											
D5863	Overdenture complete max	E																																																																																																											
D5864	Overdenture partial max	E																																																																																																											
D5865	Overdenture complete mandib	E																																																																																																											
D5866	Overdenture partial mandib	E																																																																																																											
D5867	"	Replacement of precision att"	E																																																																																																											
D5875	"	Prosthesis modification"	E																																																																																																											
D5899	"	Removable prosthodontic proc"	E																																																																																																											
D5911	"	Facial moulage sectional"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D5912	"	Facial moulage complete"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D5913	"	Nasal prosthesis"	E																																																																																																											
D5914	"	Auricular prosthesis"	E																																																																																																											
D5915	"	Orbital prosthesis"	E																																																																																																											
D5916	"	Ocular prosthesis"	E																																																																																																											
D5919	"	Facial prosthesis"	E																																																																																																											
D5922	"	Nasal septal prosthesis"	E																																																																																																											
D5923	"	Ocular prosthesis interim"	E																																																																																																											
D5924	"	Cranial prosthesis"	E																																																																																																											
D5925	"	Facial augmentation implant"	E																																																																																																											
D5926	"	Replacement nasal prosthesis"	E																																																																																																											
D5927	"	Auricular replacement"	E																																																																																																											
D5928	"	Orbital replacement"	E																																																																																																											
D5929	"	Facial replacement"	E																																																																																																											
D5931	"	Surgical obturator"	E																																																																																																											
D5932	"	Postsurgical obturator"	E																																																																																																											
D5933	"	Refitting of obturator"	E																																																																																																											
D5934	"	Mandibular flange prosthesis"	E																																																																																																											
D5935	"	Mandibular denture prosth"	E																																																																																																											
D5936	"	Temp obturator prosthesis"	E																																																																																																											
D5937	"	Trismus appliance"	E																																																																																																											
D5951	"	Feeding aid"	E																																																																																																											
D5952	"	Pediatric speech aid"	E																																																																																																											
D5953	"	Adult speech aid"	E																																																																																																											
D5954	"	Superimposed prosthesis"	E																																																																																																											
D5955	"	Palatal lift prosthesis"	E																																																																																																											
D5958	"	Intraoral con def inter plt"	E																																																																																																											
D5959	"	Intraoral con def mod palat"	E																																																																																																											
D5960	"	Modify speech aid prosthesis"	E																																																																																																											
D5982	"	Surgical stent"	E																																																																																																											
D5983	"	Radiation applicator"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D5984	"	Radiation shield"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D5985	"	Radiation cone locator"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D5986	"	Fluoride applicator"	E																																																																																																											
D5987	"	Commissure splint"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D5988	"	Surgical splint"	E																																																																																																											
D5991	Vesiculobullous disease carr	E																																																																																																											
D5992	"	Adjust max prost appliance"	E																																																																																																											
D5993	"	Main/clean max prosthesis"	E																																																																																																											
D5994	Peridontal medicament	E																																																																																																											
D5999	"	Maxillofacial prosthesis"	E																																																																																																											
D6010	"	Odontics endosteal implant"	E																																																																																																											
D6011	Second stage implant surgery	E																																																																																																											
D6012	"	Endosteal implant"	E																																																																																																											
D6013	Surgical place mini implant	E																																																																																																											
D6040	"	Odontics eposteal implant"	E																																																																																																											
D6050	"	Odontics transosteal implnt"	E																																																																																																											
D6051	"	Interim abutment"	E																																																																																																											
D6052	Semi precision attach abut	E																																																																																																											
D6053	"	Implnt/abtmnt spprt remv dnt"	E																																																																																																											
D6054	"	Implnt/abtmnt spprt remvprtl"	E																																																																																																											
D6055	"	Implant connecting bar"	E																																																																																																											
D6056	"	Prefabricated abutment"	E																																																																																																											
D6057	"	Custom abutment"	E																																																																																																											
D6058	"	Abutment supported crown"	E																																																																																																											
D6059	"	Abutment supported mtl crown"	E																																																																																																											
D6060	"	Abutment supported mtl crown"	E																																																																																																											
D6061	"	Abutment supported mtl crown"	E																																																																																																											
D6062	"	Abutment supported mtl crown"	E																																																																																																											
D6063	"	Abutment supported mtl crown"	E																																																																																																											
D6064	"	Abutment supported mtl crown"	E																																																																																																											
D6065	"	Implant supported crown"	E																																																																																																											
D6066	"	Implant supported mtl crown"	E																																																																																																											
D6067	"	Implant supported mtl crown"	E																																																																																																											
D6068	"	Abutment supported retainer"	E																																																																																																											
D6069	"	Abutment supported retainer"	E																																																																																																											
D6070	"	Abutment supported retainer"	E																																																																																																											
D6071	"	Abutment supported retainer"	E																																																																																																											
D6072	"	Abutment supported retainer"	E																																																																																																											
D6073	"	Abutment supported retainer"	E																																																																																																											
D6074	"	Abutment supported retainer"	E																																																																																																											
D6075	"	Implant supported retainer"	E																																																																																																											
D6076	"	Implant supported retainer"	E																																																																																																											
D6077	"	Implant supported retainer"	E																																																																																																											
D6078	"	Implnt/abut suprtd fixd dent"	E																																																																																																											
D6079	"	Implnt/abut suprtd fixd dent"	E																																																																																																											
D6080	"	Implant maintenance"	E																																																																																																											
D6090	"	Repair implant"	E																																																																																																											
D6091	"	Repl semi/precision attach"	E																																																																																																											
D6092	"	Recement supp crown"	E																																																																																																											
D6093	"	Recement supp part denture"	E																																																																																																											
D6094	"	Abut support crown titanium"	E																																																																																																											
D6095	"	Odontics repr abutment"	E																																																																																																											
D6100	"	Removal of implant"	E																																																																																																											
D6101	"	Debridement of a periimplant"	E																																																																																																											
D6102	"	Debridement & contouring"	E																																																																																																											
D6103	"	Bone graft repair perimplant"	E																																																																																																											
D6104	"	Bone graft time of implant"	E																																																																																																											
D6190	"	Radio/surgical implant index"	E																																																																																																											
D6194	"	Abut support retainer titani"	E																																																																																																											
D6199	"	Implant procedure"	E																																																																																																											
D6205	"	Pontic-indirect resin based"	E																																																																																																											
D6210	"	Prosthodont high noble metal"	E																																																																																																											
D6211	"	Bridge base metal cast"	E																																																																																																											
D6212	"	Bridge noble metal cast"	E																																																																																																											
D6214	"	Pontic titanium"	E																																																																																																											
D6240	"	Bridge porcelain high noble"	E																																																																																																											
D6241	"	Bridge porcelain base metal"	E																																																																																																											
D6242	"	Bridge porcelain nobel metal"	E																																																																																																											
D6245	"	Bridge porcelain/ceramic"	E																																																																																																											
D6250	"	Bridge resin w/high noble"	E																																																																																																											
D6251	"	Bridge resin base metal"	E																																																																																																											
D6252	"	Bridge resin w/noble metal"	E																																																																																																											
D6253	"	Provisional pontic"	E																																																																																																											
D6545	"	Dental retainr cast metl"	E																																																																																																											
D6548	"	Porcelain/ceramic retainer"	E																																																																																																											
D6600	"	Porcelain/ceramic inlay 2srf"	E																																																																																																											
D6601	"	Porc/ceram inlay >= 3 surfac"	E																																																																																																											
D6602	"	Cst hgh nble mtl inlay 2 srf"	E																																																																																																											
D6603	"	Cst hgh nble mtl inlay >=3sr"	E																																																																																																											
D6604	"	Cst bse mtl inlay 2 surfaces"	E																																																																																																											
D6605	"	Cst bse mtl inlay >= 3 surfa"	E																																																																																																											
D6606	"	Cast noble metal inlay 2 sur"	E																																																																																																											
D6607	"	Cst noble mtl inlay >=3 surf"	E																																																																																																											
D6608	"	Onlay porc/crmc 2 surfaces"	E																																																																																																											
D6609	"	Onlay porc/crmc >=3 surfaces"	E																																																																																																											
D6610	"	Onlay cst hgh nbl mtl 2 srfc"	E																																																																																																											
D6611	"	Onlay cst hgh nbl mtl >=3srf"	E																																																																																																											
D6612	"	Onlay cst base mtl 2 surface"	E																																																																																																											
D6613	"	Onlay cst base mtl >=3 surfa"	E																																																																																																											
D6614	"	Onlay cst nbl mtl 2 surfaces"	E																																																																																																											
D6615	"	Onlay cst nbl mtl >=3 surfac"	E																																																																																																											
D6624	"	Inlay titanium"	E																																																																																																											
D6634	"	Onlay titanium"	E																																																																																																											
D6710	"	Crown-indirect resin based"	E																																																																																																											
D6720	"	Retain crown resin w hi nble"	E																																																																																																											
D6721	"	Crown resin w/base metal"	E																																																																																																											
D6722	"	Crown resin w/noble metal"	E																																																																																																											
D6740	"	Crown porcelain/ceramic"	E																																																																																																											
D6750	"	Crown porcelain high noble"	E																																																																																																											
D6751	"	Crown porcelain base metal"	E																																																																																																											
D6752	"	Crown porcelain noble metal"	E																																																																																																											
D6780	"	Crown 3/4 high noble metal"	E																																																																																																											
D6781	"	Crown 3/4 cast based metal"	E																																																																																																											
D6782	"	Crown 3/4 cast noble metal"	E																																																																																																											
D6783	"	Crown 3/4 porcelain/ceramic"	E																																																																																																											
D6790	"	Crown full high noble metal"	E																																																																																																											
D6791	"	Crown full base metal cast"	E																																																																																																											
D6792	"	Crown full noble metal cast"	E																																																																																																											
D6793	"	Provisional retainer crown"	E																																																																																																											
D6794	"	Crown titanium"	E																																																																																																											
D6920	"	Dental connector bar"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D6930	"	Dental recement bridge"	E																																																																																																											
D6940	"	Stress breaker"	E																																																																																																											
D6950	"	Precision attachment"	E																																																																																																											
D6975	"	Coping"	E																																																																																																											
D6980	"	Fixed partial repair"	E																																																																																																											
D6985	"	Pediatric partial denture fx"	E																																																																																																											
D6999	"	Fixed prosthodontic proc"	E																																																																																																											
D7111	"	Extraction coronal remnants"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D7140	"	Extraction erupted tooth/exr"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D7210	"	Rem imp tooth w mucoper flp"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D7220	"	Impact tooth remov soft tiss"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D7230	"	Impact tooth remov part bony"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D7240	"	Impact tooth remov comp bony"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D7241	"	Impact tooth rem bony w/comp"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D7250	"	Tooth root removal"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D7251	"	Coronectomy"	E																																																																																																											
D7260	"	Oral antral fistula closure"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D7261	"	Primary closure sinus perf"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D7270	"	Tooth reimplantation"	E																																																																																																											
D7272	"	Tooth transplantation"	E																																																																																																											
D7280	"	Exposure impact tooth orthod"	E																																																																																																											
D7282	"	Mobilize erupted/malpos toot"	E																																																																																																											
D7283	"	Place device impacted tooth"	B																																																																																																											
D7285	"	Biopsy of oral tissue hard"	E																																																																																																											
D7286	"	Biopsy of oral tissue soft"	E																																																																																																											
D7287	"	Exfoliative cytolog collect"	E																																																																																																											
D7288	"	Brush biopsy"	B																																																																																																											
D7290	"	Repositioning of teeth"	E																																																																																																											
D7291	"	Transseptal fiberotomy"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D7292	"	Screw retained plate"	E																																																																																																											
D7293	"	Temp anchorage dev w flap"	E																																																																																																											
D7294	"	Temp anchorage dev w/o flap"	E																																																																																																											
D7295	"	Bone harvest,auto graft proc"	E																																																																																																											
D7310	"	Alveoplasty w/ extraction"	E																																																																																																											
D7311	"	Alveoloplasty w/extract 1-3"	E																																																																																																											
D7320	"	Alveoplasty w/o extraction"	E																																																																																																											
D7321	"	Alveoloplasty not w/extracts"	B																																																																																																											
D7340	"	Vestibuloplasty ridge extens"	E																																																																																																											
D7350	"	Vestibuloplasty exten graft"	E																																																																																																											
D7410	"	Rad exc lesion up to 1.25 cm"	E																																																																																																											
D7411	"	Excision benign lesion>1.25c"	E																																																																																																											
D7412	"	Excision benign lesion compl"	E																																																																																																											
D7413	"	Excision malig lesion<=1.25c"	E																																																																																																											
D7414	"	Excision malig lesion>1.25cm"	E																																																																																																											
D7415	"	Excision malig les complicat"	E																																																																																																											
D7440	"	Malig tumor exc to 1.25 cm"	E																																																																																																											
D7441	"	Malig tumor > 1.25 cm"	E																																																																																																											
D7450	"	Rem odontogen cyst to 1.25cm"	E																																																																																																											
D7451	"	Rem odontogen cyst > 1.25 cm"	E																																																																																																											
D7460	"	Rem nonodonto cyst to 1.25cm"	E																																																																																																											
D7461	"	Rem nonodonto cyst > 1.25 cm"	E																																																																																																											
D7465	"	Lesion destruction"	E																																																																																																											
D7471	"	Rem exostosis any site"	E																																																																																																											
D7472	"	Removal of torus palatinus"	E																																																																																																											
D7473	"	Remove torus mandibularis"	E																																																																																																											
D7485	"	Surg reduct osseoustuberosit"	E																																																																																																											
D7490	"	Maxilla or mandible resectio"	E																																																																																																											
D7510	"	I&d absc intraoral soft tiss"	E																																																																																																											
D7511	"	Incision/drain abscess intra"	B																																																																																																											
D7520	"	I&d abscess extraoral"	E																																																																																																											
D7521	"	Incision/drain abscess extra"	B																																																																																																											
D7530	"	Removal fb skin/areolar tiss"	E																																																																																																											
D7540	"	Removal of fb reaction"	E																																																																																																											
D7550	"	Removal of sloughed off bone"	E																																																																																																											
D7560	"	Maxillary sinusotomy"	E																																																																																																											
D7610	"	Maxilla open reduct simple"	E																																																																																																											
D7620	"	Clsd reduct simpl maxilla fx"	E																																																																																																											
D7630	"	Open red simpl mandible fx"	E																																																																																																											
D7640	"	Clsd red simpl mandible fx"	E																																																																																																											
D7650	"	Open red simp malar/zygom fx"	E																																																																																																											
D7660	"	Clsd red simp malar/zygom fx"	E																																																																																																											
D7670	"	Closd rductn splint alveolus"	E																																																																																																											
D7671	"	Alveolus open reduction"	E																																																																																																											
D7680	"	Reduct simple facial bone fx"	E																																																																																																											
D7710	"	Maxilla open reduct compound"	E																																																																																																											
D7720	"	Clsd reduct compd maxilla fx"	E																																																																																																											
D7730	"	Open reduct compd mandble fx"	E																																																																																																											
D7740	"	Clsd reduct compd mandble fx"	E																																																																																																											
D7750	"	Open red comp malar/zygma fx"	E																																																																																																											
D7760	"	Clsd red comp malar/zygma fx"	E																																																																																																											
D7770	"	Open reduc compd alveolus fx"	E																																																																																																											
D7771	"	Alveolus clsd reduc stblz te"	E																																																																																																											
D7780	"	Reduct compnd facial bone fx"	E																																																																																																											
D7810	"	Tmj open reduct-dislocation"	E																																																																																																											
D7820	"	Closed tmp manipulation"	E																																																																																																											
D7830	"	Tmj manipulation under anest"	E																																																																																																											
D7840	"	Removal of tmj condyle"	E																																																																																																											
D7850	"	Tmj meniscectomy"	E																																																																																																											
D7852	"	Tmj repair of joint disc"	E																																																																																																											
D7854	"	Tmj excisn of joint membrane"	E																																																																																																											
D7856	"	Tmj cutting of a muscle"	E																																																																																																											
D7858	"	Tmj reconstruction"	E																																																																																																											
D7860	"	Tmj cutting into joint"	E																																																																																																											
D7865	"	Tmj reshaping components"	E																																																																																																											
D7870	"	Tmj aspiration joint fluid"	E																																																																																																											
D7871	"	Lysis + lavage w catheters"	E																																																																																																											
D7872	"	Tmj diagnostic arthroscopy"	E																																																																																																											
D7873	"	Tmj arthroscopy lysis adhesn"	E																																																																																																											
D7874	"	Tmj arthroscopy disc reposit"	E																																																																																																											
D7875	"	Tmj arthroscopy synovectomy"	E																																																																																																											
D7876	"	Tmj arthroscopy discectomy"	E																																																																																																											
D7877	"	Tmj arthroscopy debridement"	E																																																																																																											
D7880	"	Occlusal orthotic appliance"	E																																																																																																											
D7899	"	Tmj unspecified therapy"	E																																																																																																											
D7910	"	Dent sutur recent wnd to 5cm"	E																																																																																																											
D7911	"	Dental suture wound to 5 cm"	E																																																																																																											
D7912	"	Suture complicate wnd > 5 cm"	E																																																																																																											
D7920	"	Dental skin graft"	E																																																																																																											
D7921	"	Collect & appl blood product"	E																																																																																																											
D7940	"	Reshaping bone orthognathic"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D7941	"	Bone cutting ramus closed"	E																																																																																																											
D7943	"	Cutting ramus open w/graft"	E																																																																																																											
D7944	"	Bone cutting segmented"	E																																																																																																											
D7945	"	Bone cutting body mandible"	E																																																																																																											
D7946	"	Reconstruction maxilla total"	E																																																																																																											
D7947	"	Reconstruct maxilla segment"	E																																																																																																											
D7948	"	Reconstruct midface no graft"	E																																																																																																											
D7949	"	Reconstruct midface w/graft"	E																																																																																																											
D7950	"	Mandible graft"	E																																																																																																											
D7951	"	Sinus aug w bone or bone sub"	E																																																																																																											
D7952	"	Sinus augmentation vertical"	E																																																																																																											
D7953	"	Bone replacement graft"	E																																																																																																											
D7955	"	Repair maxillofacial defects"	E																																																																																																											
D7960	"	Frenulectomy/frenectomy"	E																																																																																																											
D7963	"	Frenuloplasty"	E																																																																																																											
D7970	"	Excision hyperplastic tissue"	E																																																																																																											
D7971	"	Excision pericoronal gingiva"	E																																																																																																											
D7972	"	Surg redct fibrous tuberosit"	E																																																																																																											
D7980	"	Sialolithotomy"	E																																																																																																											
D7981	"	Excision of salivary gland"	E																																																																																																											
D7982	"	Sialodochoplasty"	E																																																																																																											
D7983	"	Closure of salivary fistula"	E																																																																																																											
D7990	"	Emergency tracheotomy"	E																																																																																																											
D7991	"	Dental coronoidectomy"	E																																																																																																											
D7995	"	Synthetic graft facial bones"	E																																																																																																											
D7996	"	Implant mandible for augment"	E																																																																																																											
D7997	"	Appliance removal"	E																																																																																																											
D7998	"	Intraoral place of fix dev"	E																																																																																																											
D7999	"	Oral surgery procedure"	E																																																																																																											
D8010	"	Limited dental tx primary"	E																																																																																																											
D8020	"	Limited dental tx transition"	E																																																																																																											
D8030	"	Limited dental tx adolescent"	E																																																																																																											
D8040	"	Limited dental tx adult"	E																																																																																																											
D8050	"	Intercep dental tx primary"	E																																																																																																											
D8060	"	Intercep dental tx transitn"	E																																																																																																											
D8070	"	Compre dental tx transition"	E																																																																																																											
D8080	"	Compre dental tx adolescent"	E																																																																																																											
D8090	"	Compre dental tx adult"	E																																																																																																											
D8210	"	Orthodontic rem appliance tx"	E																																																																																																											
D8220	"	Fixed appliance therapy habt"	E																																																																																																											
D8660	"	Preorthodontic tx visit"	E																																																																																																											
D8670	"	Periodic orthodontc tx visit"	E																																																																																																											
D8680	"	Orthodontic retention"	E																																																																																																											
D8690	"	Orthodontic treatment"	E																																																																																																											
D8691	"	Repair ortho appliance"	E																																																																																																											
D8692	"	Replacement retainer"	E																																																																																																											
D8693	Rebond/recement retainers	E																																																																																																											
D8694	Repair fixed retainers	E																																																																																																											
D8999	"	Orthodontic procedure"	E																																																																																																											
D9110	"	Tx dental pain minor proc"	N																																																																																																											
D9120	"	Fix partial denture section"	E																																																																																																											
D9210	"	Dent anesthesia w/o surgery"	E																																																																																																											
D9211	"	Regional block anesthesia"	E																																																																																																											
D9212	"	Trigeminal block anesthesia"	E																																																																																																											
D9215	"	Local anesthesia"	E																																																																																																											
D9220	"	General anesthesia"	E																																																																																																											
D9221	"	General anesthesia ea ad 15m"	E																																																																																																											
D9230	"	Analgesia"	N																																																																																																											
D9241	"	Intravenous sedation"	E																																																																																																											
D9242	IV sedation ea ad 15 m	E																																																																																																											
D9248	"	Sedation (non-iv)"	N																																																																																																											
D9310	"	Dental consultation"	E																																																																																																											
D9410	"	Dental house call"	E																																																																																																											
D9420	Hospital/asc call	E																																																																																																											
D9430	"	Office visit during hours"	E																																																																																																											
D9440	"	Office visit after hours"	E																																																																																																											
D9450	"	Case presentation tx plan"	E																																																																																																											
D9610	"	Dent therapeutic drug inject"	E																																																																																																											
D9612	"	Thera par drugs 2 or > admin"	E																																																																																																											
D9630	"	Other drugs/medicaments"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D9910	"	Dent appl desensitizing med"	E																																																																																																											
D9911	"	Appl desensitizing resin"	E																																																																																																											
D9920	"	Behavior management"	E																																																																																																											
D9930	"	Treatment of complications"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D9940	"	Dental occlusal guard"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D9941	"	Fabrication athletic guard"	E																																																																																																											
D9942	"	Repair/reline occlusal guard"	E																																																																																																											
D9950	"	Occlusion analysis"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D9951	"	Limited occlusal adjustment"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D9952	"	Complete occlusal adjustment"	S	0330	6.2552	$454.58	.	$90.92																																																																																																						
D9970	"	Enamel microabrasion"	E																																																																																																											
D9971	"	Odontoplasty 1-2 teeth"	E																																																																																																											
D9972	"	Extrnl bleaching per arch"	E																																																																																																											
D9973	"	Extrnl bleaching per tooth"	E																																																																																																											
D9974	"	Intrnl bleaching per tooth"	E																																																																																																											
D9975	"	External bleaching home app"	E																																																																																																											
D9985	Sales tax	E																																																																																																											
D9999	"	Adjunctive procedure"	E																																																																																																											
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"	E																																																																																																											
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"	E																																																																																																											
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"	E																																																																																																											
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"	E																																																																																																											
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	"	Water circ cold pad w pump"	Y																																																																																																											
E0221	"	Infrared heating pad system"	Y																																																																																																											
E0225	"	Hydrocollator unit"	Y																																																																																																											
E0231	"	Wound warming device"	E																																																																																																											
E0232	Warming card for nwt	E																																																																																																											
E0235	"	Paraffin bath unit portable"	Y																																																																																																											
E0236	"	Pump for water circulating p"	Y																																																																																																											
E0239	"	Hydrocollator unit portable"	Y																																																																																																											
E0240	"	Bath/shower chair"	E																																																																																																											
E0241	"	Bath tub wall rail"	E																																																																																																											
E0242	"	Bath tub rail floor"	E																																																																																																											
E0243	"	Toilet rail"	E																																																																																																											
E0244	"	Toilet seat raised"	E																																																																																																											
E0245	"	Tub stool or bench"	E																																																																																																											
E0246	"	Transfer tub rail attachment"	E																																																																																																											
E0247	"	Trans bench w/wo comm open"	E																																																																																																											
E0248	Hdtrans bench w/wo comm open	E																																																																																																											
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"	E																																																																																																											
E0271	"	Mattress innerspring"	Y																																																																																																											
E0272	"	Mattress foam rubber"	Y																																																																																																											
E0273	"	Bed board"	E																																																																																																											
E0274	"	Over-bed table"	E																																																																																																											
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 w/o rail w/o"	Y																																																																																																											
E0293	"	Hosp bed var ht w/o rail w/"	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"	E																																																																																																											
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"	E																																																																																																											
E0352	"	Disposable pack w/bowel syst"	E																																																																																																											
E0370	"	Air elevator for heel"	E																																																																																																											
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"	E																																																																																																											
E0430	"	Oxygen system gas portable"	E																																																																																																											
E0431	"	Portable gaseous 02"	Y																																																																																																											
E0433	"	Portable liquid oxygen sys"	Y																																																																																																											
E0434	"	Portable liquid 02"	Y																																																																																																											
E0435	"	Oxygen system liquid portabl"	E																																																																																																											
E0439	"	Stationary liquid 02"	Y																																																																																																											
E0440	"	Oxygen system liquid station"	E																																																																																																											
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"	E																																																																																																											
E0450	"	Vol control vent invasiv int"	Y																																																																																																											
E0455	"	Oxygen tent excl croup/ped t"	Y																																																																																																											
E0457	"	Chest shell"	E																																																																																																											
E0459	"	Chest wrap"	E																																																																																																											
E0460	"	Neg press vent portabl/statn"	Y																																																																																																											
E0461	"	Vol control vent noninv int"	Y																																																																																																											
E0462	"	Rocking bed w/ or w/o side r"	Y																																																																																																											
E0463	"	Press supp vent invasive int"	Y																																																																																																											
E0464	"	Press supp vent noninv int"	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"	E																																																																																																											
E0482	"	Cough stimulating device"	Y																																																																																																											
E0483	"	Chest compression gen system"	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"	E																																																																																																											
E0627	"	Seat lift incorp lift-chair"	Y																																																																																																											
E0628	"	Seat lift for pt furn-electr"	Y																																																																																																											
E0629	"	Seat lift for pt furn-non-el"	Y																																																																																																											
E0630	"	Patient lift hydraulic"	Y																																																																																																											
E0635	"	Patient lift electric"	Y																																																																																																											
E0636	Pt support & positioning sys	Y																																																																																																											
E0637	"	Combination sit to stand sys"	E																																																																																																											
E0638	"	Standing frame sys"	E																																																																																																											
E0639	"	Moveable patient lift system"	E																																																																																																											
E0640	"	Fixed patient lift system"	E																																																																																																											
E0641	"	Multi-position stnd fram sys"	E																																																																																																											
E0642	"	Dynamic standing frame"	E																																																																																																											
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"	E																																																																																																											
E0705	"	Transfer device"	B																																																																																																											
E0710	"	Restraints any type"	E																																																																																																											
E0720	"	Tens two lead"	Y																																																																																																											
E0730	"	Tens four lead"	Y																																																																																																											
E0731	"	Conductive garment for tens/"	Y																																																																																																											
E0740	"	Incontinence treatment systm"	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"	E																																																																																																											
E0760	"	Osteogen ultrasound stimltor"	Y																																																																																																											
E0761	"	Nontherm electromgntc device"	E																																																																																																											
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																																																																																																											
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 bladder"	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"	E																																																																																																											
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																																																																																																											
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	"	Manual wc hand rim w project"	Y																																																																																																											
E0968	"	Wheelchair commode seat"	Y																																																																																																											
E0969	"	Wheelchair narrowing device"	Y																																																																																																											
E0970	"	Wheelchair no. 2 footplates"	E																																																																																																											
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 pow assist"	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	"	Wheelchair calf rest"	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																																																																																																											
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"	E																																																																																																											
E1086	"	Hemi-wheelchair detachable a"	E																																																																																																											
E1087	"	Wheelchair lightwt fixed arm"	Y																																																																																																											
E1088	"	Wheelchair lightweight det a"	Y																																																																																																											
E1089	"	Wheelchair lightwt fixed arm"	E																																																																																																											
E1090	"	Wheelchair lightweight det a"	E																																																																																																											
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"	E																																																																																																											
E1140	"	Wheelchair standard detach a"	E																																																																																																											
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"	E																																																																																																											
E1260	"	Wheelchair lightwt foot rest"	E																																																																																																											
E1270	"	Wheelchair lightweight leg r"	Y																																																																																																											
E1280	"	Whchr h-duty det arm leg res"	Y																																																																																																											
E1285	"	Wheelchair heavy duty fixed"	E																																																																																																											
E1290	"	Wheelchair hvy duty detach a"	E																																																																																																											
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"	E																																																																																																											
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	"	Dialysis scale"	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	"	Complete wheel lock assembly"	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 propulsion tire each"	Y																																																																																																											
E2221	"	Solid caster tire each"	Y																																																																																																											
E2222	"	Solid caster integrated whl"	Y																																																																																																											
E2224	"	Propulsion whl excludes tire"	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"	E																																																																																																											
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																																																																																																											
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"	E																																																																																																											
E8001	"	Upright gait trainer"	E																																																																																																											
E8002	"	Anterior gait trainer"	E																																																																																																											
G0008	"	Admin influenza virus vac"	S	0436	0.4059	$29.50	$0.00	$0.00																																																																																																						
G0009	"	Admin pneumococcal vaccine"	S	0437	0.6024	$43.78	$0.00	$0.00																																																																																																						
G0010	"	Admin hepatitis b vaccine"	S	0437	0.6024	$43.78	$0.00	$0.00																																																																																																						
G0027	"	Semen analysis"	A																																																																																																											
G0101	Ca screen;pelvic/breast exam	V	0631	1.0401	$75.59	$0.00	$0.00																																																																																																						
G0102	"	Prostate ca screening; dre"	N																																																																																																											
G0103	Psa screening	A																																																																																																											
G0104	Ca screen;flexi sigmoidscope	S	0159	6.3454	$461.13	$0.00	$0.00																																																																																																						
G0105	"	Colorectal scrn; hi risk ind"	T	0158	8.8993	$646.73	$0.00	$0.00																																																																																																						
G0106	Colon ca screen;barium enema	S	0157	3.9900	$289.96	.	$58.00																																																																																																						
G0108	Diab manage trn  per indiv	A																																																																																																											
G0109	"	Diab manage trn ind/group"	A																																																																																																											
G0117	"	Glaucoma scrn hgh risk direc"	S	0698	1.0663	$77.49	.	$15.50																																																																																																						
G0118	"	Glaucoma scrn hgh risk direc"	S	0230	0.7093	$51.55	.	$10.31																																																																																																						
G0120	"	Colon ca scrn; barium enema"	S	0157	3.9900	$289.96	.	$58.00																																																																																																						
G0121	"	Colon ca scrn not hi rsk ind"	T	0158	8.8993	$646.73	$0.00	$0.00																																																																																																						
G0122	"	Colon ca scrn; barium enema"	E																																																																																																											
G0123	"	Screen cerv/vag thin layer"	A																																																																																																											
G0124	Screen c/v thin layer by md	B																																																																																																											
G0127	"	Trim nail(s)"	T	0012	0.8370	$60.83	.	$12.17																																																																																																						
G0128	Corf skilled nursing service	B																																																																																																											
G0129	"	Partial hosp prog service"	P																																																																																																											
G0130	"	Single energy x-ray study"	X	0260	0.7891	$57.35	$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																																																																																																											
G0154	"Hhcp-svs of rn,ea 15 min"	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																																																																																																											
G0163	Hhc lpn/rn obs/asses ea 15	B																																																																																																											
G0164	Hhc lis nurse train ea 15	B																																																																																																											
G0166	"	Extrnl counterpulse, per tx"	T	0678	1.4936	$108.54	.	$21.71																																																																																																						
G0168	"	Wound closure by adhesive"	B																																																																																																											
G0173	"	Linear acc stereo radsur com"	B																																																																																																											
G0175	"Opps service,sched team conf"	V	0633	4.5113	$327.85	.	$65.57																																																																																																						
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	0235	5.9113	$429.59	.	$85.92																																																																																																						
G0202	"	Screeningmammographydigital"	A																																																																																																											
G0204	"	Diagnosticmammographydigital"	A																																																																																																											
G0206	"	Diagnosticmammographydigital"	A																																																																																																											
G0219	Pet img wholbod melano nonco	E																																																																																																											
G0235	Pet not otherwise specified	E																																																																																																											
G0237	"	Therapeutic procd strg endur"	S	0077	0.5415	$39.35	.	$7.87																																																																																																						
G0238	"	Oth resp proc, indiv"	S	0077	0.5415	$39.35	.	$7.87																																																																																																						
G0239	"	Oth resp proc, group"	S	0077	0.5415	$39.35	.	$7.87																																																																																																						
G0245	"	Initial foot exam pt lops"	V	0631	1.0401	$75.59	.	$15.12																																																																																																						
G0246	"	Followup eval of foot pt lop"	V	0631	1.0401	$75.59	.	$15.12																																																																																																						
G0247	"	Routine footcare pt w lops"	T	0012	0.8370	$60.83	.	$12.17																																																																																																						
G0248	"	Demonstrate use home inr mon"	V	0632	1.3283	$96.53	.	$19.31																																																																																																						
G0249	Provide inr test mater/equip	V	0632	1.3283	$96.53	.	$19.31																																																																																																						
G0250	Md inr test revie inter mgmt	M																																																																																																											
G0251	"	Linear acc based stero radio"	B																																																																																																											
G0252	Pet imaging initial dx	E																																																																																																											
G0255	"	Current percep threshold tst"	E																																																																																																											
G0257	Unsched dialysis esrd pt hos	S	0170	8.3974	$610.26	.	$122.06																																																																																																						
G0259	"	Inject for sacroiliac joint"	N																																																																																																											
G0260	"	Inj for sacroiliac jt anesth"	T	0207	9.2183	$669.91	.	$133.99																																																																																																						
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																																																																																																											
G0278	"	Iliac art angio,cardiac cath"	N																																																																																																											
G0281	"	Elec stim unattend for press"	A																																																																																																											
G0282	"	Elect stim wound care not pd"	E																																																																																																											
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"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
G0294	"	Non-cov proc, clinical trial"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
G0295	"	Electromagnetic therapy onc"	E																																																																																																											
G0302	Pre-op service lvrs complete	S	0209	6.0562	$440.12	$136.62	$88.03																																																																																																						
G0303	Pre-op service lvrs 10-15dos	S	0209	6.0562	$440.12	$136.62	$88.03																																																																																																						
G0304	Pre-op service lvrs 1-9 dos	S	0213	2.4989	$181.60	$53.58	$36.32																																																																																																						
G0305	Post op service lvrs min 6	S	0213	2.4989	$181.60	$53.58	$36.32																																																																																																						
G0306	Cbc/diffwbc w/o platelet	A																																																																																																											
G0307	Cbc without platelet	A																																																																																																											
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																																																																																																											
G0364	"	Bone marrow aspirate &biopsy"	T	0019	4.3867	$318.79	.	$63.76																																																																																																						
G0365	"	Vessel mapping hemo access"	S	0267	2.6261	$190.84	$59.55	$38.17																																																																																																						
G0372	Md service required for pmd	M																																																																																																											
G0378	"	Hospital observation per hr"	N																																																																																																											
G0379	"	Direct refer hospital observ"	Q3	0633	4.5113	$327.85	.	$65.57																																																																																																						
G0380	Lev 1 hosp type b ed visit	V	0626	0.7145	$51.92	.	$10.39																																																																																																						
G0381	Lev 2 hosp type b ed visit	V	0627	0.8486	$61.67	.	$12.34																																																																																																						
G0382	Lev 3 hosp type b ed visit	V	0628	1.2620	$91.71	.	$18.35																																																																																																						
G0383	Lev 4 hosp type b ed visit	V	0629	2.2467	$163.27	.	$32.66																																																																																																						
G0384	Lev 5 hosp type b ed visit	Q3	0630	4.2992	$312.43	.	$62.49																																																																																																						
G0389	Ultrasound exam aaa screen	S	0265	1.2391	$90.05	$0.00	$0.00																																																																																																						
G0390	Trauma respons w/hosp criti	S	0618	13.2308	$961.51	.	$192.31																																																																																																						
G0396	"	Alcohol/subs interv 15-30mn"	S	0432	0.6759	$49.12	.	$9.83																																																																																																						
G0397	"	Alcohol/subs interv >30 min"	S	0432	0.6759	$49.12	.	$9.83																																																																																																						
G0398	Home sleep test/type 2 porta	S	0213	2.4989	$181.60	$53.58	$36.32																																																																																																						
G0399	Home sleep test/type 3 porta	S	0213	2.4989	$181.60	$53.58	$36.32																																																																																																						
G0400	Home sleep test/type 4 porta	S	0213	2.4989	$181.60	$53.58	$36.32																																																																																																						
G0402	"	Initial preventive exam"	V	0632	1.3283	$96.53	$0.00	$0.00																																																																																																						
G0403	Ekg for initial prevent exam	M																																																																																																											
G0404	Ekg tracing for initial prev	X	0035	0.3042	$22.11	.	$4.43																																																																																																						
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"	T	0050	35.4456	"$2,575.90"	.	$515.18																																																																																																						
G0414	"	Pelvic ring fx treat int fix"	C																																																																																																											
G0415	"	Open tx post pelvic fxcture"	C																																																																																																											
G0416	Biopsy prostate 10-20 	X	0344	2.4724	$179.67	.	$35.94																																																																																																						
G0417	Biopsy prostate 21-40 	X	0661	3.8286	$278.23	.	$55.65																																																																																																						
G0418	Biopsy prostate 41-60 	X	0661	3.8286	$278.23	.	$55.65																																																																																																						
G0419	Biopsy prostate: >60 	X	0661	3.8286	$278.23	.	$55.65																																																																																																						
G0420	Ed svc ckd ind per session	A																																																																																																											
G0421	Ed svc ckd grp per session	A																																																																																																											
G0422	"	Intens cardiac rehab w/exerc"	S	0095	1.4213	$103.29	.	$20.66																																																																																																						
G0423	"	Intens cardiac rehab no exer"	S	0095	1.4213	$103.29	.	$20.66																																																																																																						
G0424	"	Pulmonary rehab w exer"	S	0077	0.5415	$39.35	.	$7.87																																																																																																						
G0425	Inpt/ed teleconsult30	B																																																																																																											
G0426	Inpt/ed teleconsult50	B																																																																																																											
G0427	Inpt/ed teleconsult70	B																																																																																																											
G0428	Collagen meniscus implant	E																																																																																																											
G0429	"	Dermal filler injection(s)"	B																																																																																																											
G0431	"	Drug screen multiple class"	A																																																																																																											
G0432	Eia hiv-1/hiv-2 screen	A																																																																																																											
G0433	Elisa hiv-1/hiv-2 screen	A																																																																																																											
G0434	"	Drug screen multi drug class"	A																																																																																																											
G0435	Oral hiv-1/hiv-2 screen	A																																																																																																											
G0436	"	Tobacco-use counsel 3-10 min"	S	0031	0.3292	$23.92	$0.00	$0.00																																																																																																						
G0437	"	Tobacco-use counsel>10min"	S	0432	0.6759	$49.12	$0.00	$0.00																																																																																																						
G0438	"Ppps, initial visit"	A																																																																																																											
G0439	"Ppps, subseq visit"	A																																																																																																											
G0442	"	Annual alcohol screen 15 min"	S	0432	0.6759	$49.12	$0.00	$0.00																																																																																																						
G0443	"	Brief alcohol misuse counsel"	S	0432	0.6759	$49.12	$0.00	$0.00																																																																																																						
G0444	"	Depression screen annual"	S	0031	0.3292	$23.92	$0.00	$0.00																																																																																																						
G0445	High inten beh couns std 30m	S	0031	0.3292	$23.92	$0.00	$0.00																																																																																																						
G0446	"	Intens behave ther cardio dx"	S	0031	0.3292	$23.92	$0.00	$0.00																																																																																																						
G0447	"	Behavior counsel obesity 15m"	S	0432	0.6759	$49.12	$0.00	$0.00																																																																																																						
G0448	"	Place perm pacing cardiovert"	B																																																																																																											
G0451	"	Devlopment test interpt&rep"	Q3	0432	0.6759	$49.12	.	$9.83																																																																																																						
G0452	"	Molecular pathology interpr"	B																																																																																																											
G0453	"	Cont intraop neuro monitor"	N																																																																																																											
G0454	Md document visit by npp	B																																																																																																											
G0455	"	Fecal microbiota prep instil"	X	0340	0.7353	$53.44	.	$10.69																																																																																																						
G0456	"	Neg pre wound <=50 sq cm"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
G0457	"	Neg pres wound >50 sq cm"	T	0016	3.7815	$274.81	.	$54.97																																																																																																						
G0458	Ldr prostate brachy comp rat	B																																																																																																											
G0459	"	Telehealth inpt pharm mgmt"	B																																																																																																											
G0460	Autologous prp for ulcers	T	0327	5.6337	$409.41	.	$81.89																																																																																																						
G0461	"	Immunohisto/cyto chem 1st st"	X	0433	0.5027	$36.53	.	$7.31																																																																																																						
G0462	"	Immunohisto/cyto chem add"	N																																																																																																											
G0463	"	Hospital outpt clinic visit"	Q3	0634	1.2732	$92.53	.	$18.51																																																																																																						
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						*																																																																																																					
G0908	Hgb > 12 g/dl	M																																																																																																											
G0909	Hbg not doc	M																																																																																																											
G0910	Hgb <= 12 g/dl	M																																																																																																											
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																																																																																																											
G0919	"	Flu immunize not avail"	M																																																																																																											
G0920	"	Type loc act doc"	M																																																																																																											
G0921	"	Doc pt reas no assess"	M																																																																																																											
G0922	"	Type loc act not doc"	M																																																																																																											
G3001	"	Admin + supply, tositumomab"	S	0442	25.0763	"$1,822.34"	.	$364.47																																																																																																						
G8126	"	Pt treat w/antidepress12wks"	M																																																																																																											
G8127	"	Pt not treat w/antidepres12w"	M																																																																																																											
G8128	"	Pt inelig for antidepres med"	M																																																																																																											
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 document or order	M																																																																																																											
G8400	Pt w/dxa no document or orde	M																																																																																																											
G8401	"	Pt inelig osteo screen measu"	M																																																																																																											
G8404	"	Low extemity neur exam docum"	M																																																																																																											
G8405	"	Low extemity neur not perfor"	M																																																																																																											
G8406	"	Pt inelig lower extrem neuro"	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	"	Doc cur meds by prov"	M																																																																																																											
G8428	"	Cur meds not document"	M																																																																																																											
G8430	"	Pt inelig med check"	M																																																																																																											
G8431	"	Pos clin depres scrn f/u doc"	M																																																																																																											
G8432	"	Clin depression screen not d"	M																																																																																																											
G8433	"	Pt inelig; scrn clin dep"	M																																																																																																											
G8442	"	Pt inelig pain assessment"	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																																																																																																											
G8458	"	Pt inelig geno no antvir tx"	M																																																																																																											
G8460	Pt inelig rna no antvir tx	M																																																																																																											
G8461	"	Pt rec antivir treat hep c"	M																																																																																																											
G8464	"	Pt inelig; lo to no dter rsk"	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 <130 and dias <80	M																																																																																																											
G8477	Bp sys>=130 and/or dias >=80	M																																																																																																											
G8478	Bp not performed/doc	M																																																																																																											
G8482	"	Flu immunize order/admin"	M																																																																																																											
G8483	"	Flu imm no ord/admin doc rea"	M																																																																																																											
G8484	"	Flu immunize no order/admin"	M																																																																																																											
G8485	"Report, diabetes measures"	M																																																																																																											
G8486	"Report, prev care measures"	M																																																																																																											
G8487	Report ckd measures	M																																																																																																											
G8489	Cad measures grp	M																																																																																																											
G8490	Ra measures grp	M																																																																																																											
G8491	Hiv/aids measures grp	M																																																																																																											
G8492	Periop care measures grp	M																																																																																																											
G8493	"	Back pain measures grp"	M																																																																																																											
G8494	Dm meas qual act perform	M																																																																																																											
G8495	Ckd meas qual act perform	M																																																																																																											
G8496	Prev care mg qual act perfrm	M																																																																																																											
G8497	Cabg meas qual act perform	M																																																																																																											
G8498	Cad meas qual act perform	M																																																																																																											
G8499	Ra meas qual act perform	M																																																																																																											
G8500	Hiv meas qual act perform	M																																																																																																											
G8501	"	Perio meas qual act perform"	M																																																																																																											
G8502	Back pain mg qual act perfrm	M																																																																																																											
G8506	Pt rec ace/arb	M																																																																																																											
G8509	"	Pos pain assess no f/u doc"	M																																																																																																											
G8510	"	Pt inelig neg scrn depres"	M																																																																																																											
G8511	"	Clin depres scrn no f/u doc"	M																																																																																																											
G8530	Auto av fistula recd	M																																																																																																											
G8531	Pt inelig; auto av fistula	M																																																																																																											
G8532	No auto av fistula; no reas	M																																																																																																											
G8535	"	Pt inelig no eld mal scrn"	M																																																																																																											
G8536	"	No doc elder mal scrn"	M																																																																																																											
G8539	"	Doc funct and care plan"	M																																																																																																											
G8540	"	Pt inelig funct assess"	M																																																																																																											
G8541	"	No doc cur funct assess"	M																																																																																																											
G8542	"	Doc funct no deficiencies"	M																																																																																																											
G8543	"	Cur funct asses; no care pln"	M																																																																																																											
G8544	Cabg measures grp	M																																																																																																											
G8545	Hepc measures grp	M																																																																																																											
G8547	Ivd measures grp	M																																																																																																											
G8548	Hf measures grp	M																																																																																																											
G8549	Hepc mg qual act perform	M																																																																																																											
G8551	Hf mg qual act perform	M																																																																																																											
G8552	Ivd mg qual act perform	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																																																																																																											
G8579	"	Antplt med disch"	M																																																																																																											
G8580	"	Antplt med contraind"	M																																																																																																											
G8581	No antplt med disch	M																																																																																																											
G8582	"	Bblock disch"	M																																																																																																											
G8583	"	Bblock contraind"	M																																																																																																											
G8584	"	No bblock disch"	M																																																																																																											
G8585	"	Antilipid treat disch"	M																																																																																																											
G8586	"	Antlip disch contra"	M																																																																																																											
G8587	"	No antlipid treat disch"	M																																																																																																											
G8593	"	Lipid pn results"	M																																																																																																											
G8594	"	No lipid prof perf"	M																																																																																																											
G8595	"	Ldl < 100"	M																																																																																																											
G8597	"	Ldl >= 100"	M																																																																																																											
G8598	"	Asp therp used"	M																																																																																																											
G8599	"	No asp therp used"	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																																																																																																											
G8629	"	Doc antibio order b/4 surg"	M																																																																																																											
G8630	"	Doc antibio given b/4 surg"	M																																																																																																											
G8631	"	Pt no elg 4 order antbi give"	M																																																																																																											
G8632	"	Doc no antibi order b/4 surg"	M																																																																																																											
G8633	"	Pharm ther osteo rx"	M																																																																																																											
G8634	"	Pt no elg phar ther osteo"	M																																																																																																											
G8635	"	No pharm ther osteo rx"	M																																																																																																											
G8645	"	Asthma measures grp"	M																																																																																																											
G8646	Asthma mg qual act perform	M																																																																																																											
G8647	"	Fun stat score knee >= 0"	M																																																																																																											
G8648	"	Fun stat score knee < 0"	M																																																																																																											
G8649	"	Fun stat score knee pt noelg"	M																																																																																																											
G8650	"	Fun stat score knee not done"	M																																																																																																											
G8651	"	Fun stat score hip >= 0"	M																																																																																																											
G8652	"	Fun stat score hip < 0"	M																																																																																																											
G8653	"	Fun stat score hip pt no elg"	M																																																																																																											
G8654	"	Fun stat score hip not done"	M																																																																																																											
G8655	Fun stat score le >= 0	M																																																																																																											
G8656	Fun stat score le < 0	M																																																																																																											
G8657	Fun stat score le pt no elg	M																																																																																																											
G8658	Fun stat score le not done	M																																																																																																											
G8659	Fun stat score ls >= 0	M																																																																																																											
G8660	Fun stat score ls < 0	M																																																																																																											
G8661	Fun stat score ls pt no elg	M																																																																																																											
G8662	Fun stat score ls not done	M																																																																																																											
G8663	"	Fun stat score shdl >=0"	M																																																																																																											
G8664	"	Fun stat score shdl < 0"	M																																																																																																											
G8665	"	Fun stat score shdl pt no el"	M																																																																																																											
G8666	"	Fun stat score shdl not done"	M																																																																																																											
G8667	Fun stat score ue >=0	M																																																																																																											
G8668	Fun stat score ue < 0	M																																																																																																											
G8669	Fun stat score ue pt no elg	M																																																																																																											
G8670	Fun stat score ue not done	M																																																																																																											
G8671	Fun stat score neck/ts >=0	M																																																																																																											
G8672	Fun stat score neck/ts < 0	M																																																																																																											
G8673	Fun stat scor nek/ts pt no e	M																																																																																																											
G8674	Fun stat scor nek/ts not don	M																																																																																																											
G8682	Lvg test perf	M																																																																																																											
G8683	Pt not elig for lvf test	M																																																																																																											
G8685	Lvf test not perf	M																																																																																																											
G8694	"	Lvef <40%"	M																																																																																																											
G8696	"	Antithromb thx presc"	M																																																																																																											
G8697	"	Antithromb no presc doc reas"	M																																																																																																											
G8698	"	Antithromb no presc no reas"	M																																																																																																											
G8699	"	Rehab ordered disch"	M																																																																																																											
G8700	"	Rehab not indicated disch"	M																																																																																																											
G8701	"	Rehab not ordered"	M																																																																																																											
G8702	"	Antiobiotics 4 hr prior surg"	M																																																																																																											
G8703	"	Antibiotics not prior surg"	M																																																																																																											
G8704	Ecg performed	M																																																																																																											
G8705	Med reas no ecg	M																																																																																																											
G8706	Pt reas no ecg	M																																																																																																											
G8707	Ecg not performed	M																																																																																																											
G8708	"	Antibiotic not pres"	M																																																																																																											
G8709	"	Med reas antibiotic pres"	M																																																																																																											
G8710	"	Pt pres antibiotic"	M																																																																																																											
G8711	"	Pres antibiotic"	M																																																																																																											
G8712	"	Not pres antibiotic"	M																																																																																																											
G8713	Spkt/v great 1.2 kt/v	M																																																																																																											
G8714	"	Hemodialysis 3 times week"	M																																																																																																											
G8717	Less 1.2 kt/v	M																																																																																																											
G8718	Great 1.7 kt/v per week	M																																																																																																											
G8720	Less 1.7 kt/v per week	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																																																																																																											
G8725	"	Lipid profile perf doc"	M																																																																																																											
G8726	"	Doc reas no lipid profile"	M																																																																																																											
G8728	"	Lipid profile not perf"	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																																																																																																											
G8736	Ldl-c <100mg/dl	M																																																																																																											
G8737	Ldl-c >=100mg/dl	M																																																																																																											
G8738	"	Lvef < 40%"	M																																																																																																											
G8739	"	Lvef >= 40%"	M																																																																																																											
G8740	Lvef not perfrmd	M																																																																																																											
G8749	"	Signs of melanoma absent"	M																																																																																																											
G8751	"	Smkg status not assess"	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																																																																																																											
G8757	Copd mg qual act perform	M																																																																																																											
G8758	Ibd mg qual act perform	M																																																																																																											
G8759	Osa mg qual act perform	M																																																																																																											
G8761	Dementia mg qual act perform	M																																																																																																											
G8762	Pd mg qual act perform	M																																																																																																											
G8763	Hyperten mg qual act perform	M																																																																																																											
G8764	Car prev mg qual act perform	M																																																																																																											
G8765	Cataract mg qual act perform	M																																																																																																											
G8767	"	Lipid panel res doc rev"	M																																																																																																											
G8768	"	Doc med reas no lipid profle"	M																																																																																																											
G8769	"	Lipid profile not perform"	M																																																																																																											
G8770	"	Urine protein test doc rev"	M																																																																																																											
G8771	Doc dx ckd	M																																																																																																											
G8772	"	Doc med reas no urine protn"	M																																																																																																											
G8773	"	No urine protein test"	M																																																																																																											
G8774	"	Serum creatinine doc rev"	M																																																																																																											
G8775	"	Doc med reas no serum crtn"	M																																																																																																											
G8776	"	No serum creatinine test"	M																																																																																																											
G8777	"	Diabetes screen"	M																																																																																																											
G8778	"	Doc med reas no diabete scrn"	M																																																																																																											
G8779	"	No diabetes screen"	M																																																																																																											
G8780	"	Counsel diet phys activity"	M																																																																																																											
G8781	"	Doc med reas no counsel diet"	M																																																																																																											
G8782	"	No counsel diet phys act"	M																																																																																																											
G8783	Bp scrn perf rec interval	M																																																																																																											
G8784	Pt no elig for bp assess	M																																																																																																											
G8785	Bp scrn no perf at interval	M																																																																																																											
G8797	"	Specimen site not esophagus"	M																																																																																																											
G8798	"	Specimen site not prostate"	M																																																																																																											
G8806	Transab or transvag us	M																																																																																																											
G8807	Doc reas no us	M																																																																																																											
G8808	No transab or transvag us	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																																																																																																											
G8848	Mild 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																																																																																																											
G8853	Pos air press not 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																																																																																																											
G8859	"	Corticosteroids 10mg 60 days"	M																																																																																																											
G8860	"	Corticosteroid 10 mg 60 days"	M																																																																																																											
G8861	Dxa ordered for osteo	M																																																																																																											
G8862	"	No corticostrd 10mg 60 days"	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																																																																																																											
G8868	1st course antitnf	M																																																																																																											
G8869	Doc immun hep b 1st antitnf	M																																																																																																											
G8870	Hepb admin 1st antitnf	M																																																																																																											
G8871	No 1st 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																																																																																																											
G8879	"	Node neg inv brst cncr"	M																																																																																																											
G8880	"	Doc reas no lymph node biop"	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																																																																																																											
G8886	Bp under control	M																																																																																																											
G8887	Doc med reas bp not control	M																																																																																																											
G8888	Bp not under control	M																																																																																																											
G8889	No doc bp	M																																																																																																											
G8890	Ldl-c under control	M																																																																																																											
G8891	Doc med reas no ldl-c contrl	M																																																																																																											
G8892	Doc med reas no ldl-c test	M																																																																																																											
G8893	Ldl-c not under control	M																																																																																																											
G8894	Ldl-c not performed	M																																																																																																											
G8895	"	Antrom prescribe"	M																																																																																																											
G8896	"	Doc med reas no antihtrom"	M																																																																																																											
G8897	"	Antithrom not prescribe"	M																																																																																																											
G8898	Copd measures group	M																																																																																																											
G8899	Inflammatory bowel dis mg	M																																																																																																											
G8900	Obstructive sleep apnea mg	M																																																																																																											
G8902	Dementia measures group	M																																																																																																											
G8903	Parkinson's disease mg	M																																																																																																											
G8904	Hypertension mg	M																																																																																																											
G8905	Cardiovascular prevention mg	M																																																																																																											
G8906	Cataract measures group	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	Spiro ev1/fvc <60% copd sym	M																																																																																																											
G8925	Spiro>=60% or pt no copd sym	M																																																																																																											
G8926	"	Spiro no perf or doc"	M																																																																																																											
G8927	Adj chem pres ajcc iii	M																																																																																																											
G8928	"	Adj chem not pres rsn spec"	M																																																																																																											
G8929	"	Adj cmo not pres rsn not gvn"	M																																																																																																											
G8930	"	Assess of dep @ initial eval"	M																																																																																																											
G8931	"	Asses of dep not documented"	M																																																																																																											
G8932	"	Suicd rsk assessed init eval"	M																																																																																																											
G8933	"	Suicide risk not assessed"	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 calc, pt no f/u plan elg"	M																																																																																																											
G8939	"	Pain assess doc, f/u no doc"	M																																																																																																											
G8940	"	Srn clin dep doc no f/u pln"	M																																																																																																											
G8941	"	No doc elder scrn, pt no el"	M																																																																																																											
G8942	"	Doc fcn/care plan w/30 days"	M																																																																																																											
G8943	Ldlc not pres w/i 12 mo prir	M																																																																																																											
G8944	Ajcc mel cnr stg 0 - iic	M																																																																																																											
G8946	Mibm but no dx of breast ca	M																																																																																																											
G8947	"	1 or more neuropsych"	M																																																																																																											
G8948	"	No neuropsych symptoms"	M																																																																																																											
G8949	"	Doc pt reas on counsel diet"	M																																																																																																											
G8950	"	Pre-htn or htn doc, f/u indc"	M																																																																																																											
G8951	"	Pre-htn/htn doc, no pt f/u"	M																																																																																																											
G8952	"	Pre-htn/htn, no f/u, not gvn"	M																																																																																																											
G8953	Oncology mg qual act perform	M																																																																																																											
G8955	"	Most recent assess vol mgmt"	M																																																																																																											
G8956	Pt rcv hedia outpt dyls fac	M																																																																																																											
G8957	Pt no hedia in outpt 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	"	Wrfrn or oral antigoag pres"	M																																																																																																											
G8968	Md rsn no pres wrfrn or othr	M																																																																																																											
G8969	Pt rsn no pres wrfrn or othr	M																																																																																																											
G8970	No rsk fac or 1 mod risk te	M																																																																																																											
G8971	"	Warfrn or othr antcog no rx"	M																																																																																																											
G8972	1>=risk or>= mod risk for 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																																																																																																											
G8977	"	Oncology measures grp"	M																																																																																																											
G8978	"	Mobility current status"	E																																																																																																											
G8979	"	Mobility goal status"	E																																																																																																											
G8980	Mobility d/c status	E																																																																																																											
G8981	"	Body pos current status"	E																																																																																																											
G8982	"	Body pos goal status"	E																																																																																																											
G8983	Body pos d/c status	E																																																																																																											
G8984	"	Carry current status"	E																																																																																																											
G8985	"	Carry goal status"	E																																																																																																											
G8986	Carry d/c status	E																																																																																																											
G8987	"	Self care current status"	E																																																																																																											
G8988	"	Self care goal status"	E																																																																																																											
G8989	Self care d/c status	E																																																																																																											
G8990	Other pt/ot current status	E																																																																																																											
G8991	Other pt/ot goal status	E																																																																																																											
G8992	Other pt/ot  d/c status	E																																																																																																											
G8993	Sub pt/ot current status	E																																																																																																											
G8994	Sub pt/ot goal status	E																																																																																																											
G8995	Sub pt/ot d/c status	E																																																																																																											
G8996	"	Swallow current status"	E																																																																																																											
G8997	"	Swallow goal status"	E																																																																																																											
G8998	Swallow d/c status	E																																																																																																											
G8999	"	Motor speech current status"	E																																																																																																											
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	E																																																																																																											
G9014	Esrd demo bundle-level ii	E																																																																																																											
G9016	"	Demo-smoking cessation coun"	E																																																																																																											
G9017	Amantadine hcl 100mg oral	A																																																																																																											
G9018	"	Zanamivir,inhalation pwd 10m"	A																																																																																																											
G9019	"	Oseltamivir phosphate 75mg"	A																																																																																																											
G9020	Rimantadine hcl 100mg oral	A																																																																																																											
G9033	Amantadine hcl oral brand	A																																																																																																											
G9034	"	Zanamivir, inh pwdr, brand"	A																																																																																																											
G9035	"	Oseltamivir phosp, brand"	A																																																																																																											
G9036	"Rimantadine hcl, brand"	A																																																																																																											
G9050	"	Oncology work-up evaluation"	E																																																																																																											
G9051	"	Oncology tx decision-mgmt"	E																																																																																																											
G9052	"	Onc surveillance for disease"	E																																																																																																											
G9053	"	Onc expectant management pt"	E																																																																																																											
G9054	"	Onc supervision palliative"	E																																																																																																											
G9055	Onc visit unspecified nos	E																																																																																																											
G9056	"	Onc prac mgmt adheres guide"	E																																																																																																											
G9057	"	Onc pract mgmt differs trial"	E																																																																																																											
G9058	"	Onc prac mgmt disagree w/gui"	E																																																																																																											
G9059	"	Onc prac mgmt pt opt alterna"	E																																																																																																											
G9060	"	Onc prac mgmt dif pt comorb"	E																																																																																																											
G9061	"	Onc prac cond noadd by guide"	E																																																																																																											
G9062	"	Onc prac guide differs nos"	E																																																																																																											
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"	A																																																																																																											
G9147	Outpt iv insulin tx any mea	E																																																																																																											
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																																																																																																											
G9158	Motor speech d/c status	E																																																																																																											
G9159	"	Lang comp current status"	E																																																																																																											
G9160	"	Lang comp goal status"	E																																																																																																											
G9161	Lang comp d/c status	E																																																																																																											
G9162	"	Lang express current status"	E																																																																																																											
G9163	"	Lang express goal status"	E																																																																																																											
G9164	Lang express d/c status	E																																																																																																											
G9165	"	Atten current status"	E																																																																																																											
G9166	"	Atten goal status"	E																																																																																																											
G9167	Atten d/c status	E																																																																																																											
G9168	"	Memory current status"	E																																																																																																											
G9169	"	Memory goal status"	E																																																																																																											
G9170	Memory d/c status	E																																																																																																											
G9171	"	Voice current status"	E																																																																																																											
G9172	"	Voice goal status"	E																																																																																																											
G9173	Voice d/c status	E																																																																																																											
G9174	"	Speech lang current status"	E																																																																																																											
G9175	"	Speech lang goal status"	E																																																																																																											
G9176	Speech lang d/c status	E																																																																																																											
G9186	"	Motor speech goal status"	E																																																																																																											
G9187	Bpci home visit	E																																																																																																											
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																																																																																																											
G9193	"	Doc not eligible for dep med"	M																																																																																																											
G9194	"	Mdd pt treated for 180d"	M																																																																																																											
G9195	Mdd pt not treated for 180d	M																																																																																																											
G9196	"	Med reason for no ceph"	M																																																																																																											
G9197	"	Order for ceph"	M																																																																																																											
G9198	"	No order for ceph no reason"	M																																																																																																											
G9199	"	Doc reason for no vte"	M																																																																																																											
G9200	"	No reason for no vte"	M																																																																																																											
G9201	"	Vte given upon admission"	M																																																																																																											
G9202	"	Hep c aby pos"	M																																																																																																											
G9203	"	Hep c rna done prior to med"	M																																																																																																											
G9204	"	No reason for no hep c rna"	M																																																																																																											
G9205	"	Hep c antiviral started"	M																																																																																																											
G9206	"	Hep c therapy started"	M																																																																																																											
G9207	"	Hep c genotype prior to med"	M																																																																																																											
G9208	"	No reason for no hep c geno"	M																																																																																																											
G9209	"	Hep c rna 4to12 wk after med"	M																																																																																																											
G9210	"	No hepc rna after med docrsn"	M																																																																																																											
G9211	"	No hepc rna after med no rsn"	M																																																																																																											
G9212	"	Doc of dsm-iv init eval"	M																																																																																																											
G9213	No doc of dsm-iv	M																																																																																																											
G9214	"	Cd4 count documented"	M																																																																																																											
G9215	"	No cd4 count no reason"	M																																																																																																											
G9216	"	No pcp proph at dx no reason"	M																																																																																																											
G9217	"	No pcp proph low cd4 norsn"	M																																																																																																											
G9218	"	No pcp prop low at cd4 norsn"	M																																																																																																											
G9219	"	No oder pjp for med reason"	M																																																																																																											
G9220	"	No order for pjp for medrsn"	M																																																																																																											
G9221	"	Pjp proph prescribed"	M																																																																																																											
G9222	"	Pjp proph ordered low cd4"	M																																																																																																											
G9223	"	Pjp proph ordered cd4 low"	M																																																																																																											
G9224	"	Medrsn no foot exam"	M																																																																																																											
G9225	"	Norsn no foot exam"	M																																																																																																											
G9226	"	3 comp foot exam completed"	M																																																																																																											
G9227	"	Docrsn no care plan"	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	"	Docrsn no comm comorb"	M																																																																																																											
G9233	"	Tkr composite"	M																																																																																																											
G9234	"	Tkr intent"	M																																																																																																											
G9235	"	Gs mg composite"	M																																																																																																											
G9236	"	Op rad mg composite"	M																																																																																																											
G9237	"	Gs mg intent"	M																																																																																																											
G9238	"	Op rad mg intent"	M																																																																																																											
G9239	"	Docrsn for catheter"	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																																																																																																											
G9244	"	Antiviral not ordered"	M																																																																																																											
G9245	"	Antiviral ordered"	M																																																																																																											
G9246	"	No med visit in 24mo"	M																																																																																																											
G9247	"	1 med visit in 24mo"	M																																																																																																											
G9248	"	No med visit 6mo"	M																																																																																																											
G9249	"	Med visit w in 6mo"	M																																																																																																											
G9250	"	Doc of pain comfort 48hr"	M																																																																																																											
G9251	"	Doc no pain comfort 48hr"	M																																																																																																											
G9252	"	Neo detect scrn colo"	M																																																																																																											
G9253	"	No neo detect scrn colo"	M																																																																																																											
G9254	"	Doc pt dischg >2d"	M																																																																																																											
G9255	Doc pt dischg <=2d	M																																																																																																											
G9256	"	Doc death after cas"	M																																																																																																											
G9257	"	Doc stroke after cas"	M																																																																																																											
G9258	"	Doc stroke after cea"	M																																																																																																											
G9259	"	Doc surv no stroke after cas"	M																																																																																																											
G9260	"	Doc death after cea"	M																																																																																																											
G9261	"	Doc surv no stroke after cea"	M																																																																																																											
G9262	"	Doc death in hosp aaa repair"	M																																																																																																											
G9263	Doc surv in hosp aaa repair	M																																																																																																											
G9264	"	Docrsn for cath maint dia"	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																																																																																																											
G9271	Ldl under 100	M																																																																																																											
G9272	Ldl 100 and over	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	"	Doc antibio order w in 7d"	M																																																																																																											
G9287	"	No doc antibio order w in 7d"	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	"	Unplnd ret to surg 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	"	Docrsn not first line amox"	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																																																																																																											
G9320	"	Medrsn no std nomenclature"	M																																																																																																											
G9321	"	Doc count of ct in 12mo"	M																																																																																																											
G9322	"	No doc count of ct in 12mo"	M																																																																																																											
G9323	"	Mdrsn no doc cnt of ct"	M																																																																																																											
G9324	"	Not all data norsn"	M																																																																																																											
G9325	"	Medrsn no ct rpt to reg"	M																																																																																																											
G9326	"	Norsn no ct rpt to reg"	M																																																																																																											
G9327	"	Ct rpt to reg"	M																																																																																																											
G9328	"	Medrsn no dicom format doc"	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																																																																																																											
G9343	"	Medrsn no dicom srch"	M																																																																																																											
G9344	"	Sysrsn no dicom srch"	M																																																																																																											
G9345	"	Follow up pulm nod"	M																																																																																																											
G9346	"	No follow up pulm nod"	M																																																																																																											
G9347	"	No follow up pulm nod norsn"	M																																																																																																											
G9348	"	Docrsn no sinus ct dx"	M																																																																																																											
G9349	"	Doc sinus ct 28d"	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	"	Norsn >1 sinus ct w 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	"	Doc of neg or man pos tb scn"	M																																																																																																											
G9360	"	No doc of neg or man pos tb"	M																																																																																																											
G9361	Med Ind for induction	M																																																																																																											
J0120	"	Tetracyclin injection"	N																																																																																																											
J0129	"	Abatacept injection"	K	9230		$32.25	.	$6.45	*																																																																																																					
J0130	"	Abciximab injection"	K	1605		$739.17	.	$147.84	*																																																																																																					
J0131	"	Acetaminophen injection"	N																																																																																																											
J0132	"	Acetylcysteine injection"	K	1272		$2.19	.	$0.44	*																																																																																																					
J0133	"	Acyclovir injection"	N																																																																																																											
J0135	"	Adalimumab injection"	K	1083		$570.94	.	$114.19	*																																																																																																					
J0150	Injection adenosine 6 mg	N																																																																																																											
J0151	Inj adenosine diag 1mg	N																																																																																																											
J0171	"	Adrenalin epinephrine inject"	N																																																																																																											
J0178	"	Aflibercept injection"	G	1420		$980.50	.	$196.10																																																																																																						
J0180	"	Agalsidase beta injection"	K	9208		$152.35	.	$30.47	*																																																																																																					
J0190	"	Inj biperiden lactate/5 mg"	E																																																																																																											
J0200	"	Alatrofloxacin mesylate"	N																																																																																																											
J0205	"	Alglucerase injection"	E																																																																																																											
J0207	"	Amifostine"	K	7000		$310.72	.	$62.15	*																																																																																																					
J0210	"	Methyldopate hcl injection"	N																																																																																																											
J0215	"	Alefacept"	K	1633		$41.64	.	$8.33																																																																																																						
J0220	"	Alglucosidase alfa injection"	K	9234		$206.63	.	$41.33																																																																																																						
J0221	"	Lumizyme injection"	K	1413		$153.64	.	$30.73																																																																																																						
J0256	"	Alpha 1 proteinase inhibitor"	K	0901		$4.11	.	$0.83	*																																																																																																					
J0257	"	Glassia injection"	K	1415		$3.98	.	$0.80	*																																																																																																					
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		$10.41	.	$2.09	*																																																																																																					
J0288	"	Ampho b cholesteryl sulfate"	N																																																																																																											
J0289	"	Amphotericin b liposome inj"	K	0736		$16.83	.	$3.37	*																																																																																																					
J0290	Ampicillin 500 mg inj	N																																																																																																											
J0295	"	Ampicillin sodium per 1.5 gm"	N																																																																																																											
J0300	Amobarbital 125 mg inj	K	1341		$194.26	.	$38.85																																																																																																						
J0330	"	Succinycholine chloride inj"	N																																																																																																											
J0348	"	Anidulafungin injection"	N																																																																																																											
J0350	"	Injection anistreplase 30 u"	E 																																																																																																											
J0360	"	Hydralazine hcl injection"	N																																																																																																											
J0364	"	Apomorphine hydrochloride"	N																																																																																																											
J0365	"	Aprotonin, 10,000 kiu"	K	1439		$3.42	.	$0.68																																																																																																						
J0380	"	Inj metaraminol bitartrate"	N																																																																																																											
J0390	"	Chloroquine injection"	N																																																																																																											
J0395	"	Arbutamine hcl injection"	E 																																																																																																											
J0400	"	Aripiprazole injection"	N																																																																																																											
J0401	Inj aripiprazole ext rel 1mg	K	1468		$3.87		$0.77																																																																																																						
J0456	"	Azithromycin"	N																																																																																																											
J0461	"	Atropine sulfate injection"	N																																																																																																											
J0470	"	Dimecaprol injection"	N																																																																																																											
J0475	Baclofen 10 mg injection	K	9032		$162.80	.	$32.56	*																																																																																																					
J0476	"	Baclofen intrathecal trial"	K	1631		$76.29	.	$15.26	*																																																																																																					
J0480	"	Basiliximab"	K	1683		"$2,716.18"	.	$543.24	*																																																																																																					
J0485	"	Belatacept injection"	K	9286		$3.81	.	$0.77	*																																																																																																					
J0490	"	Belimumab injection"	K	1353		$39.48	.	$7.90	*																																																																																																					
J0500	"	Dicyclomine injection"	N																																																																																																											
J0515	"	Inj benztropine mesylate"	N																																																																																																											
J0520	"	Bethanechol chloride inject"	N																																																																																																											
J0558	Peng benzathine/procaine inj	N																																																																																																											
J0561	"	Penicillin g benzathine inj"	N																																																																																																											
J0583	"	Bivalirudin"	K	3041		$3.42	.	$0.69	*																																																																																																					
J0585	"Injection,onabotulinumtoxina"	K	0902		$5.56	.	$1.12	*																																																																																																					
J0586	Abobotulinumtoxina	K	1289		$7.43	.	$1.49	*																																																																																																					
J0587	"Inj, rimabotulinumtoxinb"	K	9018		$11.30	.	$2.26																																																																																																						
J0588	"	Incobotulinumtoxin a"	K	9278		$4.48	.	$0.90																																																																																																						
J0592	"	Buprenorphine hydrochloride"	N																																																																																																											
J0594	"	Busulfan injection"	K	1178		$28.94	.	$5.79																																																																																																						
J0595	"	Butorphanol tartrate 1 mg"	N																																																																																																											
J0597	"	C-1 esterase, berinert"	K	9269		$37.64	.	$7.53	*																																																																																																					
J0598	"	C-1 esterase, cinryze"	K	9251		$51.86	.	$10.38	*																																																																																																					
J0600	"	Edetate calcium disodium inj"	K	1274		"$3,477.51"	.	$695.51	*																																																																																																					
J0610	"	Calcium gluconate injection"	N																																																																																																											
J0620	Calcium glycer & lact/10 ml	N																																																																																																											
J0630	"	Calcitonin salmon injection"	K	1433		$69.29	.	$13.86	*																																																																																																					
J0636	"	Inj calcitriol per 0.1 mcg"	N																																																																																																											
J0637	"	Caspofungin acetate"	K	9019		$11.84	.	$2.37	*																																																																																																					
J0638	"	Canakinumab injection"	K	1311		$90.96	.	$18.20	*																																																																																																					
J0640	"	Leucovorin calcium injection"	N																																																																																																											
J0641	"	Levoleucovorin injection"	K	1236		$1.77	.	$0.36	*																																																																																																					
J0670	Inj mepivacaine hcl/10 ml	N																																																																																																											
J0690	"	Cefazolin sodium injection"	N																																																																																																											
J0692	Cefepime hcl for injection	N																																																																																																											
J0694	"	Cefoxitin sodium injection"	N																																																																																																											
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"	N																																																																																																											
J0712	"	Ceftaroline fosamil inj"	N																																																																																																											
J0713	"	Inj ceftazidime per 500 mg"	N																																																																																																											
J0715	Ceftizoxime sodium / 500 mg	N																																																																																																											
J0716	"	Centruroides immune f(ab)"	G	1431		"$3,635.80"	.	$727.16																																																																																																						
J0717	Certolizumab pegol inj 1mg	K	1474		$6.56	.	$1.32	*																																																																																																					
J0720	"	Chloramphenicol sodium injec"	N																																																																																																											
J0725	"	Chorionic gonadotropin/1000u"	N																																																																																																											
J0735	"	Clonidine hydrochloride"	N																																																																																																											
J0740	"	Cidofovir injection"	K	9033		$588.10	.	$117.62	*																																																																																																					
J0743	"	Cilastatin sodium injection"	N																																																																																																											
J0744	"	Ciprofloxacin iv"	N																																																																																																											
J0745	Inj codeine phosphate /30 mg	N																																																																																																											
J0760	"	Colchicine injection"	N																																																																																																											
J0770	"	Colistimethate sodium inj"	N																																																																																																											
J0775	"	Collagenase, clost hist inj"	K	1340		$38.26	.	$7.66	*																																																																																																					
J0780	"	Prochlorperazine injection"	N																																																																																																											
J0795	"	Corticorelin ovine triflutal"	K	1684		$7.72	.	$1.55	*																																																																																																					
J0800	"	Corticotropin injection"	K	1280		"$3,324.92"	.	$664.99	*																																																																																																					
J0833	Cosyntropin injection nos	K	0835		$101.68	.	$20.34																																																																																																						
J0834	"	Cosyntropin cortrosyn inj"	N																																																																																																											
J0840	"	Crotalidae poly immune fab"	K	9274		"$2,493.12"	.	$498.63	*																																																																																																					
J0850	Cytomegalovirus imm iv /vial	K	0903		"$1,013.87"	.	$202.78																																																																																																						
J0878	"	Daptomycin injection"	K	9124		$0.67	.	$0.13																																																																																																						
J0881	"	Darbepoetin alfa, non-esrd"	K	1685		$3.77	.	$0.76	*																																																																																																					
J0882	"	Darbepoetin alfa, esrd use"	A																																																																																																											
J0885	"	Epoetin alfa, non-esrd"	K	1686		$11.65	.	$2.33	*																																																																																																					
J0886	Epoetin alfa 1000 units esrd	A																																																																																																											
J0890	"	Peginesatide injection"	A																																																																																																											
J0894	"	Decitabine injection"	K	9231		$28.25	.	$5.65	*																																																																																																					
J0895	"	Deferoxamine mesylate inj"	N																																																																																																											
J0897	"	Denosumab injection"	K	9272		$14.45	.	$2.89	*																																																																																																					
J0900	"	Testosterone enanthate inj"	N																																																																																																											
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																																																																																																											
J1060	Testosterone cypionate 1 ml	N																																																																																																											
J1070	Testosterone cypionat 100 mg	N																																																																																																											
J1080	Testosterone cypionat 200 mg	N																																																																																																											
J1094	"	Inj dexamethasone acetate"	N																																																																																																											
J1100	"	Dexamethasone sodium phos"	N																																																																																																											
J1110	"	Inj dihydroergotamine mesylt"	N																																																																																																											
J1120	"	Acetazolamid sodium injectio"	N																																																																																																											
J1160	"	Digoxin injection"	N																																																																																																											
J1162	"	Digoxin immune fab (ovine)"	K	1687		"$2,051.63"	.	$410.33	*																																																																																																					
J1165	"	Phenytoin sodium injection"	N																																																																																																											
J1170	"	Hydromorphone injection"	N																																																																																																											
J1180	"	Dyphylline injection"	E																																																																																																											
J1190	Dexrazoxane hcl injection	K	0726		$144.86	.	$28.98	*																																																																																																					
J1200	"	Diphenhydramine hcl injectio"	N																																																																																																											
J1205	"	Chlorothiazide sodium inj"	K	0747		$122.65	.	$24.53	*																																																																																																					
J1212	Dimethyl sulfoxide 50% 50 ml	N																																																																																																											
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"	N																																																																																																											
J1270	"	Injection, doxercalciferol"	N																																																																																																											
J1290	"	Ecallantide injection"	K	9263		$375.64	.	$75.13	*																																																																																																					
J1300	"	Eculizumab injection"	K	9236		$206.14	.	$41.23																																																																																																						
J1320	"	Amitriptyline injection"	N																																																																																																											
J1324	"	Enfuvirtide injection"	K	1361		$0.55	.	$0.11																																																																																																						
J1325	"	Epoprostenol injection"	N																																																																																																											
J1327	"	Eptifibatide injection"	K	1607		$27.29	.	$5.46	*																																																																																																					
J1330	"	Ergonovine maleate injection"	N																																																																																																											
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		$180.14	.	$36.03	*																																																																																																					
J1430	"	Ethanolamine oleate 100 mg"	K	1688		$311.06	.	$62.22	*																																																																																																					
J1435	Injection estrone per 1 mg	E																																																																																																											
J1436	"	Etidronate disodium inj"	N																																																																																																											
J1438	"	Etanercept injection"	K	1608		$285.27	.	$57.06	*																																																																																																					
J1442	"Inj, filgrastim g-csf 1mcg"	K	1469		$0.99	.	$0.20	*																																																																																																					
J1446	"	Inj, tbo-filgrastim, 5 mcg"	G	1477		$3.99		$0.80	*																																																																																																					
J1450	"	Fluconazole"	N																																																																																																											
J1451	"	Fomepizole, 15 mg"	K	1689		$6.44	.	$1.29	*																																																																																																					
J1452	Intraocular fomivirsen na	N																																																																																																											
J1453	"	Fosaprepitant injection"	K	9242		$1.73	.	$0.35	*																																																																																																					
J1455	"	Foscarnet sodium injection"	K	1455		$13.32	.	$2.66																																																																																																						
J1457	"	Gallium nitrate injection"	N																																																																																																											
J1458	"	Galsulfase injection"	K	9224		$359.12	.	$71.83	*																																																																																																					
J1459	Inj ivig privigen 500 mg	K	1214		$37.03	.	$7.41	*																																																																																																					
J1460	Gamma globulin 1 cc inj	K	3043		$28.77	.	$5.76	*																																																																																																					
J1556	"Inj, imm glob bivigam, 500mg"	G	9130		$36.21	.	$7.25	*																																																																																																					
J1557	"	Gammaplex injection"	K	9270		$35.84	.	$7.17	*																																																																																																					
J1559	"	Hizentra injection"	K	1312		$7.94	.	$1.59	*																																																																																																					
J1560	Gamma globulin > 10 cc inj	K	0933		$287.67	.	$57.54	*																																																																																																					
J1561	Gamunex-c/gammaked	K	0948		$40.02	.	$8.01	*																																																																																																					
J1562	"	Vivaglobin, inj"	E																																																																																																											
J1566	"	Immune globulin, powder"	K	2731		$26.75	.	$5.35	*																																																																																																					
J1568	"	Octagam injection"	K	0943		$36.92	.	$7.39	*																																																																																																					
J1569	"	Gammagard liquid injection"	K	0944		$39.36	.	$7.88	*																																																																																																					
J1570	"	Ganciclovir sodium injection"	K	1343		$72.11	.	$14.43	*																																																																																																					
J1571	"	Hepagam b im injection"	K	0946		$53.70	.	$10.74	*																																																																																																					
J1572	"	Flebogamma injection"	K	0947		$37.76	.	$7.56	*																																																																																																					
J1573	"	Hepagam b intravenous, inj"	K	1138		$53.70	.	$10.74	*																																																																																																					
J1580	"	Garamycin gentamicin inj"	N																																																																																																											
J1590	"	Gatifloxacin injection"	N																																																																																																											
J1595	"	Injection glatiramer acetate"	K	1015		$176.31	.	$35.27	*																																																																																																					
J1599	"Ivig non-lyophilized, nos"	N																																																																																																											
J1600	"	Gold sodium thiomaleate inj"	N																																																																																																											
J1602	Golimumab for iv use 1mg	K	1475		$24.16		$4.84	*																																																																																																					
J1610	Glucagon hydrochloride/1 mg	K	9042		$146.07	.	$29.22	*																																																																																																					
J1620	"	Gonadorelin hydroch/ 100 mcg"	E																																																																																																											
J1626	"	Granisetron hcl injection"	N																																																																																																											
J1630	"	Haloperidol injection"	N																																																																																																											
J1631	"	Haloperidol decanoate inj"	N																																																																																																											
J1640	"	Hemin, 1 mg"	K	1690		$20.73	.	$4.15	*																																																																																																					
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		$326.32	.	$65.27	*																																																																																																					
J1675	"	Histrelin acetate"	B																																																																																																											
J1700	"	Hydrocortisone acetate inj"	N																																																																																																											
J1710	"	Hydrocortisone sodium ph inj"	N																																																																																																											
J1720	"	Hydrocortisone sodium succ i"	N																																																																																																											
J1725	"	Hydroxyprogesterone caproate"	K	1354		$2.66	.	$0.54	*																																																																																																					
J1730	"	Diazoxide injection"	E																																																																																																											
J1740	"	Ibandronate sodium injection"	K	9229		$151.80	.	$30.36	*																																																																																																					
J1741	"	Ibuprofen injection"	N																																																																																																											
J1742	"	Ibutilide fumarate injection"	K	9044		$112.30	.	$22.46	*																																																																																																					
J1743	"	Idursulfase injection"	K	9232		$483.05	.	$96.61	*																																																																																																					
J1744	"	Icatibant injection"	K	1443		$276.90	.	$55.38	*																																																																																																					
J1745	"	Infliximab injection"	K	7043		$74.34	.	$14.87	*																																																																																																					
J1750	"	Inj iron dextran"	K	1237		$12.16	.	$2.44	*																																																																																																					
J1756	"	Iron sucrose injection"	N																																																																																																											
J1786	"	Imuglucerase injection"	K	1327		$42.01	.	$8.40																																																																																																						
J1790	"	Droperidol injection"	N																																																																																																											
J1800	"	Propranolol injection"	N																																																																																																											
J1810	"	Droperidol/fentanyl inj"	E																																																																																																											
J1815	"	Insulin injection"	N																																																																																																											
J1817	"	Insulin for insulin pump use"	N																																																																																																											
J1826	Interferon beta-1a inj	E																																																																																																											
J1830	Interferon beta-1b / .25 mg	K	0910		$353.28	.	$70.66	*																																																																																																					
J1835	"	Itraconazole injection"	E																																																																																																											
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		$41.40	.	$8.28	*																																																																																																					
J1931	"	Laronidase injection"	K	9209		$29.45	.	$5.89	*																																																																																																					
J1940	"	Furosemide injection"	N																																																																																																											
J1945	"	Lepirudin"	K	1693		$256.73	.	$51.35																																																																																																						
J1950	Leuprolide acetate /3.75 mg	K	0800		$829.72	.	$165.95	*																																																																																																					
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"	K	9001		$45.66	.	$9.14	*																																																																																																					
J2060	"	Lorazepam injection"	N																																																																																																											
J2150	"	Mannitol injection"	N																																																																																																											
J2170	"	Mecasermin injection"	N																																																																																																											
J2175	Meperidine hydrochl /100 mg	N																																																																																																											
J2180	"	Meperidine/promethazine inj"	N																																																																																																											
J2185	"	Meropenem"	N																																																																																																											
J2210	"	Methylergonovin maleate inj"	N																																																																																																											
J2212	"	Methylnaltrexone injection"	K	1445		$0.48	.	$0.10	*																																																																																																					
J2248	"	Micafungin sodium injection"	K	9227		$0.98	.	$0.20	*																																																																																																					
J2250	"	Inj midazolam hydrochloride"	N																																																																																																											
J2260	Inj milrinone lactate / 5 mg	N																																																																																																											
J2265	"	Minocycline hydrochloride"	N																																																																																																											
J2270	"	Morphine sulfate injection"	N																																																																																																											
J2271	"	Morphine so4 injection 100mg"	E																																																																																																											
J2275	"	Morphine sulfate injection"	E																																																																																																											
J2278	"	Ziconotide injection"	K	1694		$6.87	.	$1.37																																																																																																						
J2280	"	Inj, moxifloxacin 100 mg"	N																																																																																																											
J2300	"	Inj nalbuphine hydrochloride"	N																																																																																																											
J2310	"	Inj naloxone hydrochloride"	N																																																																																																											
J2315	"	Naltrexone, depot form"	K	0759		$2.88	.	$0.58	*																																																																																																					
J2320	Nandrolone decanoate 50 mg	N																																																																																																											
J2323	"	Natalizumab injection"	K	9126		$14.91	.	$2.99	*																																																																																																					
J2325	"	Nesiritide injection"	K	1695		$66.66	.	$13.34	*																																																																																																					
J2353	"	Octreotide injection, depot"	K	1207		$141.87	.	$28.38	*																																																																																																					
J2354	"	Octreotide inj, non-depot"	N																																																																																																											
J2355	"	Oprelvekin injection"	K	7011		$321.88	.	$64.38	*																																																																																																					
J2357	"	Omalizumab injection"	K	9300		$27.85	.	$5.57	*																																																																																																					
J2358	"	Olanzapine long-acting inj"	K	1331		$2.75	.	$0.55																																																																																																						
J2360	"	Orphenadrine injection"	N																																																																																																											
J2370	"	Phenylephrine hcl injection"	N																																																																																																											
J2400	"	Chloroprocaine hcl injection"	N																																																																																																											
J2405	"	Ondansetron hcl injection"	N																																																																																																											
J2410	"	Oxymorphone hcl injection"	N																																																																																																											
J2425	"	Palifermin injection"	K	1696		$14.85	.	$2.97	*																																																																																																					
J2426	"	Paliperidone palmitate inj"	K	9255		$7.91	.	$1.59	*																																																																																																					
J2430	Pamidronate disodium /30 mg	N																																																																																																											
J2440	"	Papaverin hcl injection"	N																																																																																																											
J2460	"	Oxytetracycline injection"	E																																																																																																											
J2469	"	Palonosetron hcl"	K	9210		$20.01	.	$4.01	*																																																																																																					
J2501	"	Paricalcitol"	N																																																																																																											
J2503	"	Pegaptanib sodium injection"	K	1697		"$1,034.02"	.	$206.81	*																																																																																																					
J2504	"	Pegademase bovine, 25 iu"	K	1739		$281.40	.	$56.28	*																																																																																																					
J2505	"	Injection, pegfilgrastim 6mg"	K	9119		"$3,403.54"	.	$680.71	*																																																																																																					
J2507	"	Pegloticase injection"	K	9281		$856.64	.	$171.33	*																																																																																																					
J2510	"	Penicillin g procaine inj"	N																																																																																																											
J2513	"	Pentastarch 10% solution"	N																																																																																																											
J2515	"	Pentobarbital sodium inj"	K	1456		$35.82	.	$7.17	*																																																																																																					
J2540	"	Penicillin g potassium inj"	N																																																																																																											
J2543	"	Piperacillin/tazobactam"	N																																																																																																											
J2545	"	Pentamidine non-comp unit"	B																																																																																																											
J2550	"	Promethazine hcl injection"	N																																																																																																											
J2560	"	Phenobarbital sodium inj"	N																																																																																																											
J2562	"	Plerixafor injection"	K	9252		$301.20	.	$60.24	*																																																																																																					
J2590	"	Oxytocin injection"	N																																																																																																											
J2597	"	Inj desmopressin acetate"	K	1440		$5.08	.	$1.02	*																																																																																																					
J2650	"	Prednisolone acetate inj"	N																																																																																																											
J2670	"	Totazoline hcl injection"	K	1457		$40.01	.	$8.01																																																																																																						
J2675	Inj progesterone per 50 mg	N																																																																																																											
J2680	Fluphenazine decanoate 25 mg	N																																																																																																											
J2690	"	Procainamide hcl injection"	N																																																																																																											
J2700	"	Oxacillin sodium injeciton"	N																																																																																																											
J2710	"	Neostigmine methylslfte inj"	N																																																																																																											
J2720	Inj protamine sulfate/10 mg	N																																																																																																											
J2724	"	Protein c concentrate"	K	1139		$14.52	.	$2.91	*																																																																																																					
J2725	"	Inj protirelin per 250 mcg"	E																																																																																																											
J2730	"	Pralidoxime chloride inj"	K	1023		$89.16	.	$17.84	*																																																																																																					
J2760	"	Phentolaine mesylate inj"	K	1458		$113.40	.	$22.68	*																																																																																																					
J2765	"	Metoclopramide hcl injection"	N																																																																																																											
J2770	"	Quinupristin/dalfopristin"	K	2770		$245.22	.	$49.05	*																																																																																																					
J2778	"	Ranibizumab injection"	K	9233		$396.43	.	$79.29	*																																																																																																					
J2780	"	Ranitidine hydrochloride inj"	N																																																																																																											
J2783	"	Rasburicase"	K	0738		$218.75	.	$43.75	*																																																																																																					
J2785	"	Regadenoson injection"	N																																																																																																											
J2788	"	Rho d immune globulin 50 mcg"	N																																																																																																											
J2790	"	Rho d immune globulin inj"	N																																																																																																											
J2791	"	Rhophylac injection"	K	0945		$4.80	.	$0.96	*																																																																																																					
J2792	"Rho(d) immune globulin h, sd"	K	1609		$18.85	.	$3.77	*																																																																																																					
J2793	"	Rilonacept injection"	K	1291		$24.09	.	$4.82																																																																																																						
J2794	"	Risperidone, long acting"	K	9125		$6.16	.	$1.24	*																																																																																																					
J2795	Ropivacaine hcl injection	N																																																																																																											
J2796	"	Romiplostim injection"	K	9245		$53.63	.	$10.73	*																																																																																																					
J2800	"	Methocarbamol injection"	N																																																																																																											
J2805	"	Sincalide injection"	N																																																																																																											
J2810	Inj theophylline per 40 mg	N																																																																																																											
J2820	"	Sargramostim injection"	K	0731		$30.13	.	$6.03	*																																																																																																					
J2850	"	Inj secretin synthetic human"	K	1700		$34.78	.	$6.96	*																																																																																																					
J2910	"	Aurothioglucose injeciton"	N																																																																																																											
J2916	"	Na ferric gluconate complex"	N																																																																																																											
J2920	"	Methylprednisolone injection"	N																																																																																																											
J2930	"	Methylprednisolone injection"	N																																																																																																											
J2940	"	Somatrem injection"	E																																																																																																											
J2941	"	Somatropin injection"	N																																																																																																											
J2950	"	Promazine hcl injection"	N																																																																																																											
J2993	"	Reteplase injection"	K	9005		"$2,301.91"	.	$460.39																																																																																																						
J2995	Inj streptokinase /250000 iu	N																																																																																																											
J2997	"	Alteplase recombinant"	K	7048		$64.30	.	$12.86	*																																																																																																					
J3000	"	Streptomycin injection"	N																																																																																																											
J3010	"	Fentanyl citrate injeciton"	N																																																																																																											
J3030	Sumatriptan succinate / 6 mg	N																																																																																																											
J3060	"Inj, taliglucerace alfa 10 u"	G	9294		$31.94	.	$6.39	*																																																																																																					
J3070	"	Pentazocine injection"	N																																																																																																											
J3095	"	Telavancin injection"	K	9258		$4.52	.	$0.91	*																																																																																																					
J3101	"	Tenecteplase injection"	K	9002		$86.21	.	$17.25	*																																																																																																					
J3105	"	Terbutaline sulfate inj"	N																																																																																																											
J3110	"	Teriparatide injection"	B																																																																																																											
J3120	"	Testosterone enanthate inj"	N																																																																																																											
J3130	"	Testosterone enanthate inj"	N																																																																																																											
J3140	"	Testosterone suspension inj"	N																																																																																																											
J3150	"	Testosteron propionate inj"	N																																																																																																											
J3230	"	Chlorpromazine hcl injection"	N																																																																																																											
J3240	"	Thyrotropin injection"	K	9108		"$1,430.43"	.	$286.09	*																																																																																																					
J3243	"	Tigecycline injection"	K	9228		$2.00	.	$0.40	*																																																																																																					
J3246	Tirofiban hcl	K	7041		$9.17	.	$1.84	*																																																																																																					
J3250	"	Trimethobenzamide hcl inj"	N																																																																																																											
J3260	"	Tobramycin sulfate injection"	N																																																																																																											
J3262	"	Tocilizumab injection"	K	9264		$3.68	.	$0.74	*																																																																																																					
J3265	"	Injection torsemide 10 mg/ml"	N																																																																																																											
J3280	"	Thiethylperazine maleate inj"	N																																																																																																											
J3285	"	Treprostinil injection"	K	1701		$61.24	.	$12.25																																																																																																						
J3300	Triamcinolone a inj prs-free	K	1253		$3.73	.	$0.75	*																																																																																																					
J3301	Triamcinolone acet inj nos	N																																																																																																											
J3302	"	Triamcinolone diacetate inj"	N																																																																																																											
J3303	"	Triamcinolone hexacetonl inj"	N																																																																																																											
J3305	"	Inj trimetrexate glucoronate"	N																																																																																																											
J3310	"	Perphenazine injeciton"	N																																																																																																											
J3315	"	Triptorelin pamoate"	K	9122		$170.77	.	$34.16	*																																																																																																					
J3320	"	Spectinomycn di-hcl inj"	N																																																																																																											
J3350	"	Urea injection"	K	1459		$122.40	.	$24.48																																																																																																						
J3355	"	Urofollitropin, 75 iu"	K	1741		$63.11	.	$12.63	*																																																																																																					
J3357	"	Ustekinumab injection"	K	9261		$162.29	.	$32.46	*																																																																																																					
J3360	"	Diazepam injection"	N																																																																																																											
J3364	Urokinase 5000 iu injection	N																																																																																																											
J3365	"Urokinase 250,000 iu inj"	E																																																																																																											
J3370	"	Vancomycin hcl injection"	N																																																																																																											
J3385	"	Velaglucerase alfa"	K	9271		$353.35	.	$70.67	*																																																																																																					
J3396	"	Verteporfin injection"	K	1203		$10.79	.	$2.16	*																																																																																																					
J3400	"	Triflupromazine hcl inj"	N																																																																																																											
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"	K	1052		$3.97	.	$0.80	*																																																																																																					
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	K	1356		$47.48	.	$9.50	*																																																																																																					
J3490	"	Drugs unclassified injection"	N																																																																																																											
J3520	"	Edetate disodium per 150 mg"	E																																																																																																											
J3530	"	Nasal vaccine inhalation"	N																																																																																																											
J3535	"	Metered dose inhaler drug"	E																																																																																																											
J3570	Laetrile amygdalin vit b17	E																																																																																																											
J3590	"	Unclassified biologics"	N																																																																																																											
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																																																																																																											
J7131	"	Hypertonic saline sol"	N																																																																																																											
J7178	"	Human fibrinogen conc inj"	K	1478		$0.97		$0.20	*																																																																																																					
J7180	Factor xiii anti-hem factor	K	1416		$6.74	.	$1.35																																																																																																						
J7183	"	Wilate injection"	K	1352		$0.95	.	$0.19	*																																																																																																					
J7185	"	Xyntha inj"	K	1268		$1.17	.	$0.24	*																																																																																																					
J7186	"	Antihemophilic viii/vwf comp"	K	1213		$0.94	.	$0.19	*																																																																																																					
J7187	"Humate-p, inj"	K	1704		$0.95	.	$0.19																																																																																																						
J7189	"	Factor viia"	K	1705		$1.73	.	$0.35	*																																																																																																					
J7190	"	Factor viii"	K	0925		$0.93	.	$0.19																																																																																																						
J7191	Factor viii (porcine)	K	1464		$0.20	.	$0.04																																																																																																						
J7192	Factor viii recombinant nos	K	0927		$1.14	.	$0.23																																																																																																						
J7193	Factor ix non-recombinant	K	0931		$1.01	.	$0.20																																																																																																						
J7194	"	Factor ix complex"	K	0928		$1.12	.	$0.22																																																																																																						
J7195	Factor ix recombinant	K	0932		$1.35	.	$0.27	*																																																																																																					
J7196	"	Antithrombin recombinant"	K	1332		$103.35	.	$20.67																																																																																																						
J7197	"	Antithrombin iii injection"	K	1263		$3.27	.	$0.66	*																																																																																																					
J7198	"	Anti-inhibitor"	K	0929		$1.70	.	$0.34																																																																																																						
J7199	"	Hemophilia clot factor noc"	B																																																																																																											
J7300	"	Intraut copper contraceptive"	E																																																																																																											
J7301	"	Skyla 13.5mg"	E																																																																																																											
J7302	"	Levonorgestrel iu contracept"	E																																																																																																											
J7303	"	Contraceptive vaginal ring"	E																																																																																																											
J7304	"	Contraceptive hormone patch"	E																																																																																																											
J7306	"	Levonorgestrel implant sys"	E																																																																																																											
J7307	"	Etonogestrel implant system"	E																																																																																																											
J7308	"	Aminolevulinic acid hcl top"	K	7308		$242.30	.	$48.46	*																																																																																																					
J7309	"	Methyl aminolevulinate, top"	K	1338		$83.69	.	$16.74																																																																																																						
J7310	"	Ganciclovir long act implant"	K	0913		"$16,960.00"	.	"$3,392.00"																																																																																																						
J7311	"	Fluocinolone acetonide implt"	K	9225		"$19,641.05"	.	"$3,928.21"	*																																																																																																					
J7312	"	Dexamethasone intra implant"	K	9256		$201.31	.	$40.27	*																																																																																																					
J7315	Ophthalmic mitomycin	G	1448		$368.88	.	$73.78	*																																																																																																					
J7316	"Inj, ocriplasmin, 0.125 mg"	G	9298		"$1,046.75"	.	$209.35																																																																																																						
J7321	"	Hyalgan/supartz inj per dose"	K	0873		$90.81	.	$18.17	*																																																																																																					
J7323	"	Euflexxa inj per dose"	K	0875		$160.42	.	$32.09	*																																																																																																					
J7324	"	Orthovisc inj per dose"	K	0877		$186.89	.	$37.38	*																																																																																																					
J7325	Synvisc or synvisc-one	K	0874		$12.50	.	$2.50	*																																																																																																					
J7326	"	Gel-one"	K	1417		$562.08	.	$112.42	*																																																																																																					
J7330	"	Cultured chondrocytes implnt"	B																																																																																																											
J7335	"	Capsaicin 8% patch"	K	9268		$26.50	.	$5.30	*																																																																																																					
J7500	"	Azathioprine oral 50mg"	N																																																																																																											
J7501	"	Azathioprine parenteral"	K	0887		$217.30	.	$43.46																																																																																																						
J7502	"	Cyclosporine oral 100 mg"	N																																																																																																											
J7504	"	Lymphocyte immune globulin"	K	0890		$852.69	.	$170.54	*																																																																																																					
J7505	"	Monoclonal antibodies"	K	7038		$6.62	.	$1.32																																																																																																						
J7506	"	Prednisone oral"	N																																																																																																											
J7507	Tacrolimus imme rel oral 1mg	N																																																																																																											
J7508	"	Tacrolimus ex rel oral 0.1mg"	G	1465		$0.40		$0.08																																																																																																						
J7509	"	Methylprednisolone oral"	N																																																																																																											
J7510	"	Prednisolone oral per 5 mg"	N																																																																																																											
J7511	"	Antithymocyte globuln rabbit"	K	9104		$594.74	.	$118.95	*																																																																																																					
J7513	"	Daclizumab, parenteral"	K	1612		$526.34	.	$105.27																																																																																																						
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		$141.10	.	$28.22	*																																																																																																					
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"	E																																																																																																											
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																																																																																																											
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																																																																																																											
J8498	Antiemetic rectal/supp nos	B																																																																																																											
J8499	"	Oral prescrip drug non chemo"	E																																																																																																											
J8501	"	Oral aprepitant"	K	0868		$7.68	.	$1.54	*																																																																																																					
J8510	"	Oral busulfan"	N																																																																																																											
J8515	"	Cabergoline, oral 0.25mg"	E																																																																																																											
J8520	"	Capecitabine, oral, 150 mg"	K	7042		$8.67	.	$1.74	*																																																																																																					
J8521	"	Capecitabine, oral, 500 mg"	K	0934		$28.63	.	$5.73	*																																																																																																					
J8530	Cyclophosphamide oral 25 mg	N																																																																																																											
J8540	"	Oral dexamethasone"	N																																																																																																											
J8560	Etoposide oral 50 mg	K	0802		$57.09	.	$11.42	*																																																																																																					
J8562	"	Oral fludarabine phosphate"	N																																																																																																											
J8565	"	Gefitinib oral"	E																																																																																																											
J8597	Antiemetic drug oral nos	N																																																																																																											
J8600	Melphalan oral 2 mg	N																																																																																																											
J8610	Methotrexate oral 2.5 mg	N																																																																																																											
J8650	"	Nabilone oral"	K	1424		$28.42	.	$5.68																																																																																																						
J8700	"	Temozolomide"	K	1086		$5.39	.	$1.08	*																																																																																																					
J8705	"	Topotecan oral"	K	1238		$94.74	.	$18.95	*																																																																																																					
J8999	"	Oral prescription drug chemo"	B																																																																																																											
J9000	"	Doxorubicin hcl injection"	N																																																																																																											
J9010	"	Alemtuzumab injection"	K	9110		$582.30	.	$116.46																																																																																																						
J9015	"	Aldesleukin injection"	K	0807		"$2,110.63"	.	$422.13	*																																																																																																					
J9017	"	Arsenic trioxide injection"	K	9012		$53.58	.	$10.72	*																																																																																																					
J9019	"	Erwinaze injection"	G	9289		$354.76	.	$70.95																																																																																																						
J9020	"Asparaginase, nos"	K	0814		$64.56	.	$12.91																																																																																																						
J9025	"	Azacitidine injection"	K	1709		$4.08	.	$0.82	*																																																																																																					
J9027	"	Clofarabine injection"	K	1710		$134.10	.	$26.82	*																																																																																																					
J9031	"	Bcg live intravesical vac"	K	0809		$121.96	.	$24.40	*																																																																																																					
J9033	"	Bendamustine injection"	K	9243		$22.21	.	$4.45	*																																																																																																					
J9035	"	Bevacizumab injection"	K	9214		$66.65	.	$13.33	*																																																																																																					
J9040	"	Bleomycin sulfate injection"	N																																																																																																											
J9041	"	Bortezomib injection"	K	9207		$46.08	.	$9.22																																																																																																						
J9042	"	Brentuximab vedotin inj"	K	9287		$110.82	.	$22.17	*																																																																																																					
J9043	"	Cabazitaxel injection"	K	9276		$142.42	.	$28.49	*																																																																																																					
J9045	"	Carboplatin injection"	N																																																																																																											
J9047	"Injection, carfilzomib, 1 mg"	G	9295		$29.81	.	$5.97	*																																																																																																					
J9050	"	Carmustine injection"	K	0812		"$1,861.12"	.	$372.23	*																																																																																																					
J9055	"	Cetuximab injection"	K	9215		$53.29	.	$10.66	*																																																																																																					
J9060	Cisplatin 10 mg injection	N																																																																																																											
J9065	Inj cladribine per 1 mg	K	0858		$21.21	.	$4.25	*																																																																																																					
J9070	Cyclophosphamide 100 mg inj	K	1408		$63.16	.	$12.64	*																																																																																																					
J9098	"	Cytarabine liposome inj"	K	1166		$561.39	.	$112.28	*																																																																																																					
J9100	Cytarabine hcl 100 mg inj	N																																																																																																											
J9120	"	Dactinomycin injection"	K	0752		$807.19	.	$161.44	*																																																																																																					
J9130	"	Dacarbazine 100 mg inj"	N																																																																																																											
J9150	"	Daunorubicin injection"	K	0820		$22.56	.	$4.52	*																																																																																																					
J9151	"	Daunorubicin citrate inj"	K	0821		$239.10	.	$47.82	*																																																																																																					
J9155	"	Degarelix injection"	K	1296		$3.55	.	$0.71	*																																																																																																					
J9160	"	Denileukin diftitox inj"	E						*																																																																																																					
J9165	"	Diethylstilbestrol injection"	E																																																																																																											
J9171	"	Docetaxel injection"	K	0823		$4.66	.	$0.94	*																																																																																																					
J9175	"	Elliotts b solution per ml"	N																																																																																																											
J9178	"	Inj, epirubicin hcl, 2 mg"	N																																																																																																											
J9179	"	Eribulin mesylate injection"	K	1426		$99.01	.	$19.81	*																																																																																																					
J9181	"	Etoposide injection"	N																																																																																																											
J9185	"	Fludarabine phosphate inj"	K	0842		$70.98	.	$14.20	*																																																																																																					
J9190	"	Fluorouracil injection"	N																																																																																																											
J9200	"	Floxuridine injection"	K	0827		$55.65	.	$11.13	*																																																																																																					
J9201	"	Gemcitabine hcl injection"	N																																																																																																											
J9202	"	Goserelin acetate implant"	K	0810		$225.02	.	$45.01	*																																																																																																					
J9206	"	Irinotecan injection"	N																																																																																																											
J9207	"	Ixabepilone injection"	K	9240		$70.21	.	$14.05	*																																																																																																					
J9208	"	Ifosfamide injection"	K	0831		$33.41	.	$6.69	*																																																																																																					
J9209	"	Mesna injection"	N																																																																																																											
J9211	"	Idarubicin hcl injection"	K	0832		$49.11	.	$9.83	*																																																																																																					
J9212	"	Interferon alfacon-1 inj"	N																																																																																																											
J9213	"	Interferon alfa-2a inj"	K	1460		$53.66	.	$10.74																																																																																																						
J9214	"	Interferon alfa-2b inj"	K	0836		$21.17	.	$4.24	*																																																																																																					
J9215	"	Interferon alfa-n3 inj"	K	1473		$31.80		$6.36																																																																																																						
J9216	"	Interferon gamma 1-b inj"	K	0838		"$3,168.87"	.	$633.78	*																																																																																																					
J9217	"	Leuprolide acetate suspnsion"	K	9217		$229.26	.	$45.86	*																																																																																																					
J9218	"	Leuprolide acetate injeciton"	K	0861		$7.18	.	$1.44	*																																																																																																					
J9219	"	Leuprolide acetate implant"	E																																																																																																											
J9225	"	Vantas implant"	K	1711		"$3,001.59"	.	$600.32	*																																																																																																					
J9226	Supprelin la implant	K	1142		"$18,317.24"	.	"$3,663.45"	*																																																																																																					
J9228	"	Ipilimumab injection"	K	9284		$133.61	.	$26.73	*																																																																																																					
J9230	"	Mechlorethamine hcl inj"	K	0751		$189.63	.	$37.93	*																																																																																																					
J9245	Inj melphalan hydrochl 50 mg	K	0840		"$1,226.63"	.	$245.33	*																																																																																																					
J9250	"	Methotrexate sodium inj"	N																																																																																																											
J9260	"	Methotrexate sodium inj"	N																																																																																																											
J9261	"	Nelarabine injection"	K	0825		$138.87	.	$27.78	*																																																																																																					
J9262	"Inj, omacetaxine mep, 0.01mg"	G	9297		$2.48	.	$0.50																																																																																																						
J9263	"	Oxaliplatin"	K	1738		$0.57	.	$0.12	*																																																																																																					
J9264	"	Paclitaxel protein bound"	K	1712		$9.70	.	$1.94	*																																																																																																					
J9265	"	Paclitaxel injection"	N																																																																																																											
J9266	"	Pegaspargase injection"	K	0843		"$6,220.80"	.	"$1,244.16"	*																																																																																																					
J9268	"	Pentostatin injection"	K	0844		"$1,483.27"	.	$296.66	*																																																																																																					
J9270	"	Plicamycin (mithramycin) inj"	N																																																																																																											
J9280	"	Mitomycin injection"	K	1232		$20.88	.	$4.18	*																																																																																																					
J9293	Mitoxantrone hydrochl / 5 mg	K	0864		$32.34	.	$6.47	*																																																																																																					
J9300	"	Gemtuzumab ozogamicin inj"	E						*																																																																																																					
J9302	"	Ofatumumab injection"	K	9260		$47.76	.	$9.56	*																																																																																																					
J9303	"	Panitumumab injection"	K	9235		$94.79	.	$18.96	*																																																																																																					
J9305	"	Pemetrexed injection"	K	9213		$60.27	.	$12.06	*																																																																																																					
J9306	"Injection, pertuzumab, 1 mg"	G	1471		$10.22	.	$2.04																																																																																																						
J9307	"	Pralatrexate injection"	K	9259		$197.12	.	$39.43	*																																																																																																					
J9310	"	Rituximab injection"	K	0849		$708.68	.	$141.74	*																																																																																																					
J9315	"	Romidepsin injection"	K	9265		$270.64	.	$54.13	*																																																																																																					
J9320	"	Streptozocin injection"	K	0850		$335.28	.	$67.06	*																																																																																																					
J9328	"	Temozolomide injection"	K	9253		$5.68	.	$1.14	*																																																																																																					
J9330	"	Temsirolimus injection"	K	1168		$58.83	.	$11.77	*																																																																																																					
J9340	"	Thiotepa injection"	K	0851		$630.70	.	$126.14																																																																																																						
J9351	"	Topotecan injection"	K	1350		$1.83	.	$0.37	*																																																																																																					
J9354	"Inj, ado-trastuzumab emt 1mg"	G	9131		$29.14	.	$5.83																																																																																																						
J9355	"	Trastuzumab injection"	K	1613		$82.49	.	$16.50	*																																																																																																					
J9357	"	Valrubicin injection"	K	1235		"$1,085.29"	.	$217.06	*																																																																																																					
J9360	"	Vinblastine sulfate inj"	N																																																																																																											
J9370	Vincristine sulfate 1 mg inj	N																																																																																																											
J9371	"	Inj, vincristine sul lip 1mg"	G	1466		"$2,148.20"		$429.64	*																																																																																																					
J9390	"	Vinorelbine tartrate inj"	N																																																																																																											
J9395	"Injection, fulvestrant"	K	9120		$91.27	.	$18.26	*																																																																																																					
J9400	"	Inj, ziv-aflibercept, 1mg"	G	9296		$8.12	.	$1.63	*																																																																																																					
J9600	"	Porfimer sodium injection"	K	0856		"$20,002.20"	.	"$4,000.44"	*																																																																																																					
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-adjus hght armrst"	Y																																																																																																											
K0017	"	Detach adjust armrest base"	Y																																																																																																											
K0018	"	Detach adjust armrst upper"	Y																																																																																																											
K0019	"	Arm pad each"	Y																																																																																																											
K0020	"	Fixed adjust armrest pair"	Y																																																																																																											
K0037	"	High mount flip-up footrest"	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 footplate each"	Y																																																																																																											
K0043	"	Ftrst lower extension tube"	Y																																																																																																											
K0044	"	Ftrst upper hanger bracket"	Y																																																																																																											
K0045	"	Footrest complete assembly"	Y																																																																																																											
K0046	"	Elevat legrst low extension"	Y																																																																																																											
K0047	"	Elevat legrst up hangr brack"	Y																																																																																																											
K0050	"	Ratchet assembly"	Y																																																																																																											
K0051	"	Cam relese assem ftrst/lgrst"	Y																																																																																																											
K0052	"	Swingaway detach footrest"	Y																																																																																																											
K0053	"	Elevate footrest articulate"	Y																																																																																																											
K0056	"	Seat ht <17 or >=21 ltwt wc"	Y																																																																																																											
K0065	"	Spoke protectors"	Y																																																																																																											
K0069	"	Rear whl complete solid tire"	Y																																																																																																											
K0070	"	Rear whl compl pneum tire"	Y																																																																																																											
K0071	"	Front castr compl pneum tire"	Y																																																																																																											
K0072	"	Frnt cstr cmpl sem-pneum tir"	Y																																																																																																											
K0073	"	Caster pin lock each"	Y																																																																																																											
K0077	"	Front caster assem complete"	Y																																																																																																											
K0098	"	Drive belt power wheelchair"	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	"	Supply/ext inf pump syr type"	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"	E																																																																																																											
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																																																																																																											
K0901	Ko single upright pre ots	A						*																																																																																																					
K0902	Ko double upright pre ots	A						*																																																																																																					
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																																																																																																											
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																																																																																																											
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"	E																																																																																																											
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"	E																																																																																																											
L3216	"	Orthoped ladies shoes dpth i"	E																																																																																																											
L3217	"	Ladies shoes hightop depth i"	E																																																																																																											
L3219	"	Orthopedic mens shoes oxford"	E																																																																																																											
L3221	"	Orthopedic mens shoes dpth i"	E																																																																																																											
L3222	"	Mens shoes hightop depth inl"	E																																																																																																											
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"	E																																																																																																											
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 withjoint, prefabricated"	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"	E																																																																																																											
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	"	Upp ext fx orthosis humeral"	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																																																																																																											
L6025	"	Part hand disart myoelectric"	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																																																																																																											
L7260	"	Electron wrist rotator otto"	A																																																																																																											
L7261	"	Electron wrist rotator utah"	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"	E																																																																																																											
L7900	"	Male vacuum erection system"	A																																																																																																											
L7902	"	Tension ring, vac erect dev"	A																																																																																																											
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																																																																																																											
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																																																																																																											
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																																																																																																											
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"	E																																																																																																											
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"	E																																																																																																											
L8686	"	Implt nrostm pls gen sng non"	E																																																																																																											
L8687	"	Implt nrostm pls gen dua rec"	E																																																																																																											
L8688	"	Implt nrostm pls gen dua non"	E																																																																																																											
L8689	"	External recharg sys intern"	A																																																																																																											
L8690	"	Aud osseo dev, int/ext comp"	N																																																																																																											
L8691	"	Osseointegrated snd proc rpl"	A																																																																																																											
L8692	"	Non-osseointegrated snd proc"	E																																																																																																											
L8693	"	Aud osseo dev, abutment"	A																																																																																																											
L8695	"	External recharg sys extern"	A																																																																																																											
L8699	Prosthetic implant nos	N																																																																																																											
L9900	O&p supply/accessory/service	N																																																																																																											
M0064	"	Visit for drug monitoring"	Q3	0632	1.3283	$96.53	.	$19.31																																																																																																						
M0075	"	Cellular therapy"	E																																																																																																											
M0076	"	Prolotherapy"	E																																																																																																											
M0100	"	Intragastric hypothermia"	E																																																																																																											
M0300	Iv chelationtherapy	E																																																																																																											
M0301	"	Fabric wrapping of aneurysm"	E																																																																																																											
P2028	"	Cephalin floculation test"	A																																																																																																											
P2029	"	Congo red blood test"	A																																																																																																											
P2031	"	Hair analysis"	E																																																																																																											
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"	E																																																																																																											
P9010	"	Whole blood for transfusion"	R	0950	2.6922	$195.65	.	$39.13																																																																																																						
P9011	"	Blood split unit"	R	0967	1.3989	$101.66	.	$20.34																																																																																																						
P9012	"	Cryoprecipitate each unit"	R	0952	0.9017	$65.53	.	$13.11																																																																																																						
P9016	Rbc leukocytes reduced	R	0954	2.6243	$190.71	.	$38.15																																																																																																						
P9017	"	Plasma 1 donor frz w/in 8 hr"	R	9508	1.0893	$79.16	.	$15.84																																																																																																						
P9019	"	Platelets, each unit"	R	0957	1.6189	$117.65	.	$23.53																																																																																																						
P9020	"	Plaelet rich plasma unit"	R	0958	2.2834	$165.94	.	$33.19																																																																																																						
P9021	"	Red blood cells unit"	R	0959	2.0846	$151.49	.	$30.30																																																																																																						
P9022	"	Washed red blood cells unit"	R	0960	3.9824	$289.41	.	$57.89																																																																																																						
P9023	"	Frozen plasma, pooled, sd"	R	0949	0.9852	$71.60	.	$14.32																																																																																																						
P9031	"	Platelets leukocytes reduced"	R	1013	1.6274	$118.27	.	$23.66																																																																																																						
P9032	"	Platelets, irradiated"	R	9500	2.3175	$168.42	.	$33.69																																																																																																						
P9033	"	Platelets leukoreduced irrad"	R	0968	2.2131	$160.83	.	$32.17																																																																																																						
P9034	"	Platelets, pheresis"	R	9507	5.5347	$402.22	.	$80.45																																																																																																						
P9035	"	Platelet pheres leukoreduced"	R	9501	6.8758	$499.68	.	$99.94																																																																																																						
P9036	"	Platelet pheresis irradiated"	R	9502	8.0385	$584.17	.	$116.84																																																																																																						
P9037	"	Plate pheres leukoredu irrad"	R	1019	9.2150	$669.67	.	$133.94																																																																																																						
P9038	Rbc irradiated	R	9505	3.0182	$219.34	.	$43.87																																																																																																						
P9039	Rbc deglycerolized	R	9504	5.2269	$379.85	.	$75.97																																																																																																						
P9040	Rbc leukoreduced irradiated	R	0969	3.8311	$278.41	.	$55.69																																																																																																						
P9041	"	Albumin (human),5%, 50ml"	K	0961		$20.94	.	$4.19																																																																																																						
P9043	"	Plasma protein fract,5%,50ml"	R	0956	0.2308	$16.77	.	$3.36																																																																																																						
P9044	"	Cryoprecipitatereducedplasma"	R	1009	1.1834	$86.00	.	$17.20																																																																																																						
P9045	"	Albumin (human), 5%, 250 ml"	K	0963		$68.22	.	$13.64																																																																																																						
P9046	"	Albumin (human), 25%, 20 ml"	K	0964		$34.13	.	$6.83																																																																																																						
P9047	"	Albumin (human), 25%, 50ml"	K	0965		$69.57	.	$13.91																																																																																																						
P9048	"	Plasmaprotein fract,5%,250ml"	R	0966	0.5095	$37.03	.	$7.41																																																																																																						
P9050	"	Granulocytes, pheresis unit"	R	9506	25.9683	"$1,887.17"	.	$377.44																																																																																																						
P9051	"	Blood, l/r, cmv-neg"	R	1010	2.3364	$169.79	.	$33.96																																																																																																						
P9052	"	Platelets, hla-m, l/r, unit"	R	1011	10.7576	$781.78	.	$156.36																																																																																																						
P9053	"	Plt, pher, l/r cmv-neg, irr"	R	1020	9.6381	$700.42	.	$140.09																																																																																																						
P9054	"	Blood, l/r, froz/degly/wash"	R	1016	3.1210	$226.81	.	$45.37																																																																																																						
P9055	"	Plt, aph/pher, l/r, cmv-neg"	R	1017	5.9522	$432.56	.	$86.52																																																																																																						
P9056	"	Blood, l/r, irradiated"	R	1018	2.2752	$165.34	.	$33.07																																																																																																						
P9057	"Rbc, frz/deg/wsh, l/r, irrad"	R	1021	5.9800	$434.58	.	$86.92																																																																																																						
P9058	"Rbc, l/r, cmv-neg, irrad"	R	1022	3.9952	$290.34	.	$58.07																																																																																																						
P9059	"	Plasma, frz between 8-24hour"	R	0955	0.9578	$69.61	.	$13.93																																																																																																						
P9060	"	Fr frz plasma donor retested"	R	9503	0.8398	$61.03	.	$12.21																																																																																																						
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"	X	0100	3.3604	$244.21	.	$48.85																																																																																																						
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"	T	0191	0.1421	$10.33	$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		$0.74	.	$0.15	*																																																																																																					
Q0139	"	Ferumoxytol, esrd use"	A																																																																																																											
Q0144	"	Azithromycin dihydrate, oral"	E																																																																																																											
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"	N																																																																																																											
Q0175	"	Perphenazine 4mg oral"	N																																																																																																											
Q0177	"	Hydroxyzine pamoate 25mg"	N																																																																																																											
Q0180	"	Dolasetron mesylate oral"	N																																																																																																											
Q0181	"	Unspecified oral anti-emetic"	N																																																																																																											
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"	N																																																																																																											
Q0508	Mis sup/acc imp vad	N																																																																																																											
Q0509	"	Mis sup/ac imp vad nopay med"	N																																																																																																											
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"	E																																																																																																											
Q1004	"	Ntiol category 4"	E																																																																																																											
Q1005	"	Ntiol category 5"	E																																																																																																											
Q2004	"	Bladder calculi irrig sol"	N																																																																																																											
Q2009	Fosphenytoin inj pe	N																																																																																																											
Q2017	"	Teniposide, 50 mg"	K	7035		$830.00	.	$166.00																																																																																																						
Q2026	"	Radiesse injection"	B																																																																																																											
Q2028	"Inj, sculptra, 0.5mg"	B																																																																																																											
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	"Nos flu vacc, 3 yrs & >, im"	L																																																																																																											
Q2043	Sipuleucel-t auto cd54+	K	9273		"$34,916.42"	.	"$6,983.29"	*																																																																																																					
Q2049	"	Imported lipodox inj"	K	1421		$508.43	.	$101.69	*																																																																																																					
Q2050	"	Doxorubicin inj 10mg"	K	7046		$490.49	.	$98.10	*																																																																																																					
Q2052	"Ivig demo, services/supplies"	E																																																																																																											
Q3001	Brachytherapy radioelements	B																																																																																																											
Q3014	"	Telehealth facility fee"	A																																																																																																											
Q3027	"	Inj beta interferon im 1 mcg"	K	1472		$36.37	.	$7.28	*																																																																																																					
Q3028	"	Inj beta interferon sq 1 mcg"	E																																																																																																											
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"	A																																																																																																											
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	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																																																																																																											
Q4119	"	Matristem wound matrix"	N																																																																																																											
Q4120	"	Matristem burn matrix"	N																																																																																																											
Q4121	"	Theraskin"	G	1479		$32.42		$0.00	*																																																																																																					
Q4122	"	Dermacell"	G	1419		$80.58		$0.00	*																																																																																																					
Q4123	"	Alloskin"	N																																																																																																											
Q4124	"	Oasis tri-layer wound matrix"	N																																																																																																											
Q4125	"	Arthroflex"	N																																																																																																											
Q4126	"	Memoderm/derma/tranz/integup"	N																																																																																																											
Q4127	"	Talymed"	G	1449		$13.78		$0.00																																																																																																						
Q4128	Flexhd/allopatchhd/matrixhd	N																																																																																																											
Q4129	"	Unite biomatrix"	N																																																																																																											
Q4130	Strattice tm	N																																																																																																											
Q4131	"	Epifix"	G	9366		$219.52		$0.00	*																																																																																																					
Q4132	"	Grafix core"	G	9368		$118.03		$0.00	*																																																																																																					
Q4133	"	Grafix prime"	G	9369		$115.18		$0.00	*																																																																																																					
Q4134	Hmatrix	N																																																																																																											
Q4135	"	Mediskin"	N																																																																																																											
Q4136	Ezderm	N																																																																																																											
Q4137	"	Amnioexcel or biodexcel, 1cm"	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, 1cm"	N																																																																																																											
Q4148	"	Neox 1k, 1cm"	N																																																																																																											
Q4149	"	Excellagen, 0.1 cc"	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																																																																																																											
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"	N																																																																																																											
Q9969	Non-heu tc-99m add-on/dose	K	1442		$10.00	.	$2.00																																																																																																						
Q9970	Inj Ferric Carboxymaltos 1mg	G	9441		$1.05		$0.21	*																																																																																																					
Q9972	"Epoetin Beta, ESRD Use"	E						*																																																																																																					
Q9973	"Epoetin Beta, non-esrd"	E						*																																																																																																					
Q9974	Morphine epidural/intratheca	N																																																																																																											
R0070	"	Transport portable x-ray"	B																																																																																																											
R0075	"	Transport port x-ray multipl"	B																																																																																																											
R0076	Transport portable ekg	B																																																																																																											
V2020	"	Vision svcs frames purchases"	A																																																																																																											
V2025	"	Eyeglasses delux frames"	E																																																																																																											
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																																																																																																											
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"	E																																																																																																											
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"	E																																																																																																											
V2760	"	Scratch resistant coating"	A																																																																																																											
V2761	"	Mirror coating"	B																																																																																																											
V2762	"	Polarization, any lens"	A																																																																																																											
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"	A																																																																																																											
V2787	"	Astigmatism-correct function"	E																																																																																																											
V2788	"	Presbyopia-correct function"	E																																																																																																											
V2790	"	Amniotic membrane"	N																																																																																																											
V2797	"	Vis item/svc in other code"	A																																																																																																											
V2799	"	Miscellaneous vision service"	A																																																																																																											
V5008	"	Hearing screening"	E																																																																																																											
V5010	"	Assessment for hearing aid"	E																																																																																																											
V5011	"	Hearing aid fitting/checking"	E																																																																																																											
V5014	"	Hearing aid repair/modifying"	E																																																																																																											
V5020	"	Conformity evaluation"	E																																																																																																											
V5030	"	Body-worn hearing aid air"	E																																																																																																											
V5040	"	Body-worn hearing aid bone"	E																																																																																																											
V5050	"	Hearing aid monaural in ear"	E																																																																																																											
V5060	"	Behind ear hearing aid"	E																																																																																																											
V5070	"	Glasses air conduction"	E																																																																																																											
V5080	"	Glasses bone conduction"	E																																																																																																											
V5090	"	Hearing aid dispensing fee"	E																																																																																																											
V5095	"	Implant mid ear hearing pros"	E																																																																																																											
V5100	"	Body-worn bilat hearing aid"	E																																																																																																											
V5110	"	Hearing aid dispensing fee"	E																																																																																																											
V5120	"	Body-worn binaur hearing aid"	E																																																																																																											
V5130	"	In ear binaural hearing aid"	E																																																																																																											
V5140	"	Behind ear binaur hearing ai"	E																																																																																																											
V5150	"	Glasses binaural hearing aid"	E																																																																																																											
V5160	"	Dispensing fee binaural"	E																																																																																																											
V5170	"	Within ear cros hearing aid"	E																																																																																																											
V5180	"	Behind ear cros hearing aid"	E																																																																																																											
V5190	"	Glasses cros hearing aid"	E																																																																																																											
V5200	"	Cros hearing aid dispens fee"	E																																																																																																											
V5210	"	In ear bicros hearing aid"	E																																																																																																											
V5220	"	Behind ear bicros hearing ai"	E																																																																																																											
V5230	"	Glasses bicros hearing aid"	E																																																																																																											
V5240	"	Dispensing fee bicros"	E																																																																																																											
V5241	"	Dispensing fee, monaural"	E																																																																																																											
V5242	"	Hearing aid, monaural, cic"	E																																																																																																											
V5243	"	Hearing aid, monaural, itc"	E																																																																																																											
V5244	"	Hearing aid, prog, mon, cic"	E																																																																																																											
V5245	"	Hearing aid, prog, mon, itc"	E																																																																																																											
V5246	"	Hearing aid, prog, mon, ite"	E																																																																																																											
V5247	"	Hearing aid, prog, mon, bte"	E																																																																																																											
V5248	"	Hearing aid, binaural, cic"	E																																																																																																											
V5249	"	Hearing aid, binaural, itc"	E																																																																																																											
V5250	"	Hearing aid, prog, bin, cic"	E																																																																																																											
V5251	"	Hearing aid, prog, bin, itc"	E																																																																																																											
V5252	"	Hearing aid, prog, bin, ite"	E																																																																																																											
V5253	"	Hearing aid, prog, bin, bte"	E																																																																																																											
V5254	"	Hearing id, digit, mon, cic"	E																																																																																																											
V5255	"	Hearing aid, digit, mon, itc"	E																																																																																																											
V5256	"	Hearing aid, digit, mon, ite"	E																																																																																																											
V5257	"	Hearing aid, digit, mon, bte"	E																																																																																																											
V5258	"	Hearing aid, digit, bin, cic"	E																																																																																																											
V5259	"	Hearing aid, digit, bin, itc"	E																																																																																																											
V5260	"	Hearing aid, digit, bin, ite"	E																																																																																																											
V5261	"	Hearing aid, digit, bin, bte"	E																																																																																																											
V5262	"	Hearing aid, disp, monaural"	E																																																																																																											
V5263	"	Hearing aid, disp, binaural"	E																																																																																																											
V5264	"	Ear mold/insert"	E																																																																																																											
V5265	"	Ear mold/insert, disp"	E																																																																																																											
V5266	"	Battery for hearing device"	E																																																																																																											
V5267	"	Hearing aid sup/access/dev"	E																																																																																																											
V5268	Ald telephone amplifier	E																																																																																																											
V5269	"	Alerting device, any type"	E																																																																																																											
V5270	"Ald, tv amplifier, any type"	E																																																																																																											
V5271	"Ald, tv caption decoder"	E																																																																																																											
V5272	"	Tdd"	E																																																																																																											
V5273	Ald for cochlear implant	E																																																																																																											
V5274	Ald unspecified	E																																																																																																											
V5275	"	Ear impression"	E																																																																																																											
V5281	"	Ald fm/dm system, monaural"	E																																																																																																											
V5282	"	Ald fm/dm system binaural"	E																																																																																																											
V5283	"	Ald neck, loop ind receiver"	E																																																																																																											
V5284	Ald fm/dm ear level receiver	E																																																																																																											
V5285	"	Ald fm/dm aud input receiver"	E																																																																																																											
V5286	"	Ald blu tooth fm/dm receiver"	E																																																																																																											
V5287	"Ald fm/dm receiver, nos"	E																																																																																																											
V5288	"	Ald fm/dm transmitter ald"	E																																																																																																											
V5289	"	Ald fm/dm adapt/boot couplin"	E																																																																																																											
V5290	"	Ald transmitter microphone"	E																																																																																																											
V5298	"	Hearing aid noc"	E																																																																																																											
V5299	"	Hearing service"	B																																																																																																											
V5336	"	Repair communication device"	E																																																																																																											
V5362	"	Speech screening"	E																																																																																																											
V5363	"	Language screening"	E																																																																																																											
V5364	"	Dysphagia screening"	E																																																																																																											
