HCPCS code	HCPCS code description	Period	Labor code	Labor code description	Labor cost per minute	Labor activity	Non-facility minutes	Facility minutes	Modifier
00100	Anesthesia for procedure on salivary gland with biopsy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00102	Anesthesia for procedure to repair lip defect present at birth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00103	Anesthesia for procedure on eyelid	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00104	Anesthesia for electric shock treatment	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00120	Anesthesia for biopsy of external middle and inner ear	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00124	Anesthesia for examination and biopsy of external middle and inner ear using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00126	Anesthesia for incision of ear drum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00140	Anesthesia for procedure on eye	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00142	Anesthesia for lens surgery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00144	Anesthesia for procedure on eye for corneal transplant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00145	Anesthesia for retinal surgery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00147	Anesthesia for procedure on eye for removal of iris	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00148	Anesthesia for eye examination using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00160	Anesthesia for procedure on nose and sinus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00162	Anesthesia for surgery of nose and sinus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00164	Anesthesia for soft tissue biopsy on nose and sinus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00170	Anesthesia for procedure on mouth including biopsy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00172	Anesthesia for procedure on mouth to repair palate deformity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00174	Anesthesia for procedure on throat for removal of tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00176	Anesthesia for surgery on mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00190	Anesthesia for procedure on facial bones or skull	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00192	Anesthesia for surgery of facial bones or skull	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00210	Anesthesia for procedure on brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00211	Anesthesia for procedure to remove blood collection in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00212	Anesthesia for procedure to remove fluid in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00214	Anesthesia for procedure to create holes in skull including X-ray imaging	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00215	Anesthesia for procedure to repair skull or skull fracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00216	Anesthesia for procedure on blood vessel in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00218	Anesthesia for procedure on brain patient in sitting position	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00220		Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00222	Anesthesia for procedure on nerve in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00300	Anesthesia for procedure on esophagus and neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00320	"Anesthesia for procedure on esophagus and neck, age 1 year or older"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00322	Anesthesia for needle biopsy of thyroid	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00326		Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00350	Anesthesia for procedure on major blood vessels of neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00352	Anesthesia for tying procedure on major blood vessels of neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00400	"Anesthesia for procedure on skin of arms, legs, or trunk"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00402	Anesthesia for breast reconstruction	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00404	Anesthesia for removal of breast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00406	Anesthesia for removal of breast and lymph nodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00410	Anesthesia for procedure to correct abnormal heart rhythm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00450	Anesthesia for procedure on collar bone and shoulder blade	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00454	Anesthesia for biopsy of collar bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00470	Anesthesia for partial removal of rib	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00472	Anesthesia for partial removal of rib and chest wall repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00474	Anesthesia for partial removal of rib and chest wall reconstruction	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00500	Anesthesia for procedure on esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00520	Anesthesia for closed procedure in chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00522	Anesthesia for closed needle biopsy of lung	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00524	Anesthesia for closed drainage of lung fluid	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00528	Anesthesia for closed diagnostic examination of chest using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00529	Anesthesia for closed diagnostic examination of chest using an endoscope with 1 lung ventilation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00530	Anesthesia for insertion of permanent heart pacemaker	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00532	Anesthesia for central vein access	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00534	Anesthesia for insertion or replace of pacing heart defibrillator	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00537	Anesthesia for procedure on heart to correct abnormal rhythm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00539	Anesthesia for reconstruction of windpipe and lung airway	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00540	Anesthesia for procedure in chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00541	Anesthesia for procedure in chest with 1 lung ventilation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00542	Anesthesia for removal of lung lining	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00546	Anesthesia for lung removal and chest wall repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00548	Anesthesia for procedure on windpipe and lung airway	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00550	Anesthesia for removal of breast bone tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00560	Anesthesia for procedure on heart and great blood vessels	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00561	"Anesthesia for procedure on heart and great blood vessels on heart-lung machine, younger than 1 year of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00562	"Anesthesia for procedure on heart and great blood vessels on heart-lung machine, age 1 year or older, or re-operation more than 1 month after original procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00563	Anesthesia for procedure on heart and great blood vessels on heart-lung machine	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00566	Anesthesia for heart artery bypass grafting	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00567	Anesthesia for heart artery bypass grafting on heart-lung machine	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00580	Anesthesia for heart or heart-lung transplant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00600	Anesthesia for procedure on upper spine and spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00604	"Anesthesia for procedure on spine and spinal cord, patient in sitting position"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00620	Anesthesia for procedure on middle spine and spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00625	Anesthesia for procedure on middle spine and spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00626	Anesthesia for procedure on middle spine and spinal cord with 1 lung ventilation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00630	Anesthesia for procedure on lower spine	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00632	Anesthesia for removal of nerves in lower spine	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00635	Anesthesia for spinal tap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00640	Anesthesia for closed manipulation of spine	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00670	Anesthesia for procedure on spine and spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00700	Anesthesia for procedure on upper front abdominal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00702	Anesthesia for liver biopsy (accessed through the skin)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00730	Anesthesia for procedure on upper rear abdominal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00740	Anesthesia for procedure on gastrointestinal tract using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00750	Anesthesia for procedure to repair upper abdominal hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00752	Anesthesia for procedure to repair upper abdominal incisional hernia and/or wound opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00754	Anesthesia for procedure to repair upper abdominal hernia present at birth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00756	Anesthesia for procedure to repair abdominal hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00770	Anesthesia for procedure on major abdominal blood vessels	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00790	Anesthesia for procedure in upper abdomen including use of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00792	Anesthesia for partial removal of liver or management of bleeding including use of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00794	Anesthesia for removal of pancreas including use of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00796	Anesthesia for liver transplant recipient including use of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00797	Anesthesia for procedure on stomach for obesity including use of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00800	Anesthesia for procedure on lower front abdominal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00802	Anesthesia for removal of excess tissue on lower abdominal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00810	Anesthesia for procedure on lower intestine using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00820	Anesthesia for procedure on lower rear abdominal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00830	Anesthesia for lower abdominal hernia repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00832	Anesthesia for middle or incisional abdominal hernia repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00834	"Anesthesia for lower abdominal hernia repair, child younger than 1 year of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00836	"Anesthesia for lower abdominal hernia repair, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgery"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00840	Anesthesia for procedure in lower abdominal cavity including use of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00842	Anesthesia for removal of amniotic fluid in uterus including use of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00844	Anesthesia for procedure in lower abdominal cavity and rectum including use of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00846	Anesthesia for removal of uterus including use of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00848	Anesthesia for removal of pelvic organs including use of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00851	Anesthesia for tying or incision of fallopian tubes using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00860	Anesthesia for procedure in lower abdomen including urinary tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00862	Anesthesia for procedure on upper urinary duct (ureter) or removal of kidney for transplant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00864	Anesthesia for removal of urinary bladder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00865	Anesthesia for removal of prostate	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00866	Anesthesia for removal of adrenal gland	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00868	Anesthesia for kidney transplant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00870	Anesthesia for removal of urinary bladder stone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00872	Anesthesia for shock wave therapy for urinary system stones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00873	Anesthesia for shock wave therapy for urinary system stones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00880	Anesthesia for procedure on major lower abdominal wall blood vessels	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00882	Anesthesia for tying of major vein in lower abdomen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00902	Anesthesia for procedure on anus and rectum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00904	Anesthesia for procedure on perineum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00906	Anesthesia for removal of external female genitalia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00908	Anesthesia for removal of prostate	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00910	Anesthesia for procedure on urinary system including use of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00912	Anesthesia for removal of urinary bladder tumors including use of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00914	Anesthesia for removal of prostate including use of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00916	Anesthesia for procedure to control urinary system bleeding including use of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00918	"Anesthesia for fragmenting, manipulation and/or removal of kidney stone including use of an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00920	Anesthesia for procedure on male genitalia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00921	Anesthesia for vasectomy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00922	Anesthesia for procedure on male genitalia glands	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00924	Anesthesia for repair of undescended testicle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00926	Anesthesia for removal of testicle through groin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00928	Anesthesia for removal of testicle through abdomen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00930	Anesthesia for relocation of undescended testicle into scrotum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00932	Anesthesia for removal of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00934	Anesthesia for removal of penis and lymph nodes on both sides of groin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00936	Anesthesia for removal of penis and lymph nodes on both sides of groin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00938	Anesthesia for insertion of penile prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00940	"Anesthesia for vaginal biopsy of cervix, uterine lining, or external genitalia"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00942	Anesthesia for repair or removal of vagina and urinary procedure	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00944	Anesthesia for vaginal removal of uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00948	Anesthesia for suture closure of cervix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00950	Anesthesia for examination of cervix using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
00952	Anesthesia for examination of uterus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01112	Anesthesia for bone marrow aspiration and/or biopsy at pelvic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01120	Anesthesia for procedure on pelvic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01130	Anesthesia for application or revision of body cast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01140	Anesthesia for amputation of leg including pelvic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01150	Anesthesia for removal of pelvic bone tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01160	Anesthesia for procedure on pubic bone or sacroiliac joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01170	Anesthesia for open procedure on pubic bone or sacroiliac joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01173	Anesthesia for open repair of pelvic fracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01180	Anesthesia for removal of external pelvic nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01190	Anesthesia for removal of internal pelvic nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01200	Anesthesia for closed procedure on hip joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01202	Anesthesia for procedure on hip joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01210	Anesthesia for open surgical procedure on hip joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01212	Anesthesia for open hip joint dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01214	Anesthesia for open total hip joint replacement	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01215	Anesthesia for open revision of total hip joint replacement	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01220	Anesthesia for closed procedure on upper two-thirds of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01230	Anesthesia for open procedure on upper two-thirds of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01232	Anesthesia for open amputation at upper two-thirds of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01234	Anesthesia for open removal of muscle or tissue at upper two-thirds of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01250	"Anesthesia for procedure on nerves, muscles, tendons, fascia, and bursae of upper leg"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01260	Anesthesia for procedure on veins of upper leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01270	Anesthesia for procedure on arteries of upper leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01272	Anesthesia for groin artery bypass graft and tying of upper leg artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01274	Anesthesia for removal of groin artery blood clot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01320	"Anesthesia for procedure on nerves, muscles, tendons, fascia, and/or bursae of knee"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01340	Anesthesia for closed procedure on lower one-third of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01360	Anesthesia for open procedure on lower one-third of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01380	Anesthesia for closed procedure on knee joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01382	Anesthesia for diagnostic examination of knee joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01390	Anesthesia for closed procedure at kneecap and/or upper foreleg bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01392	Anesthesia for open procedure at kneecap and upper foreleg bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01400	Anesthesia for open or endoscopic procedure on knee including	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01402	Anesthesia for open or endoscopic total knee joint replacement	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01404	Anesthesia for open or endoscopic procedure of dislocated knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01420	"Anesthesia for knee joint cast application, removal, or repair"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01430	Anesthesia for procedure on knee veins	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01432	Anesthesia for repair of abnormal artery-vein formation of knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01440	Anesthesia for procedure on knee arteries	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01442	Anesthesia for removal of blood clot in artery behind knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01444	Anesthesia for repair of bulging (aneurysm) defect in knee artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01462	"Anesthesia for closed procedure on lower leg, ankle, and foot"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01464	Anesthesia for procedure on ankle and/or foot using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01470	"Anesthesia for procedure on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01472	Anesthesia for procedure to repair calf muscle tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01474	Anesthesia for procedure to repair calf muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01480	"Anesthesia for open procedure on bones of lower leg, ankle and foot"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01482	Anesthesia for open amputation below the knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01484	"Anesthesia for open reconstruction of lower leg, ankle, and/or foot bone"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01486	Anesthesia for open total ankle joint replacement	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01490	"Anesthesia for lower leg cast application, removal, or repair"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01500	Anesthesia for procedure on arteries of lower leg including bypass graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01502	Anesthesia for lower leg artery bypass graft or blood clot removal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01520	Anesthesia for procedure on veins of lower leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01522	Anesthesia for removal of lower leg vein obstruction	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01610	"Anesthesia for procedure on nerves, muscles, tendons, fascia, and bursae of shoulder and underarm"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01620	Anesthesia for closed procedure on upper arm bone and shoulder joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01622	Anesthesia for diagnostic examination of shoulder joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01630	Anesthesia for open or endoscopic procedure at upper arm and shoulder joint including	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01634	Anesthesia for open or endoscopic procedure of dislocated shoulder joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01636	"Anesthesia for open or endoscopic amputation of arm, shoulder blade, and collar bone"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01638	Anesthesia for open or endoscopic total shoulder joint replacement	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01650	Anesthesia for procedure on arteries of shoulder and underarm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01652	Anesthesia for repair of bulging (aneurysm) defect in upper arm artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01654	Anesthesia for bypass graft in shoulder or underarm artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01656	Anesthesia for bypass graft from groin artery to shoulder or underarm artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01670	Anesthesia for procedure on veins of shoulder and underarm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01680	"Anesthesia for cast application, removal or repair"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01682	"Anesthesia for shoulder spica cast application, removal or repair"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01710	"Anesthesia for procedure on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01712	Anesthesia for open incision of elbow to shoulder tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01714	Anesthesia for repair of elbow to shoulder tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01716	Anesthesia for suture of upper arm and elbow tendon to bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01730	Anesthesia for closed procedure on upper arm and elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01732	Anesthesia for diagnostic examination of elbow joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01740	Anesthesia for open or endoscopic procedure on elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01742	Anesthesia for open or endoscopic procedure at upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01744	Anesthesia for open or endoscopic repair of non-healed fracture of upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01756	Anesthesia for open or endoscopic surgical procedure on elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01758	Anesthesia for open or endoscopic removal cyst or tumor of upper arm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01760	Anesthesia for open or endoscopic total elbow joint replacement	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01770	Anesthesia for procedure on arteries of upper arm and elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01772	Anesthesia for removal of blood clot from upper arm or elbow artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01780	Anesthesia for procedure on veins of upper arm and elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01782	Anesthesia for suture of upper arm or elbow vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01810	"Anesthesia for procedure on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01820	"Anesthesia for closed procedure on bones of forearm, wrist, or hand"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01829	Anesthesia for diagnostic examination of the wrist using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01830	"Anesthesia for open or endoscopic procedure on bones of forearm, wrist, or hand"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01832	Anesthesia for open or endoscopic total wrist joint replacement	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01840	"Anesthesia for procedure on arteries of forearm, wrist, and hand"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01842	"Anesthesia for removal of blood clot from forearm, wrist, or hand artery"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01844	Anesthesia for placement or revision of blood flow shunt	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01850	"Anesthesia for procedure on veins of forearm, wrist, and hand"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01852	"Anesthesia for suture of forearm, wrist, or hand vein"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01860	"Anesthesia for forearm, wrist, or hand cast application, removal or repair"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01916	Anesthesia for diagnostic X-ray procedure on arteries or veins	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01920	Anesthesia for procedure on heart vessels and chambers	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01922	Anesthesia for X-ray or radiation therapy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01924	Anesthesia for X-ray procedure on arteries	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01925	Anesthesia for X-ray procedure on neck or heart artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01926	"Anesthesia for X-ray procedure on artery in brain, heart, or major vessel of chest (aorta)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01930	Anesthesia for X-ray procedure on vein or lymph system	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01931	Anesthesia for X-ray procedure on liver vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01932	Anesthesia for X-ray procedure on chest or neck vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01933	Anesthesia for X-ray procedure on brain vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01935	Anesthesia for diagnostic X-ray procedure (accessed through the skin) on spine and spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01936	Anesthesia for X-ray procedure (accessed through the skin) on spine and spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01951	"Anesthesia for treatment of second and third-degree burn, less than 4% total body surface"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01952	"Anesthesia for treatment of second and third-degree burn, between 4% and 9% total body surface area"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01953	test code 1	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01958	test code 2	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01960	test code 4	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01961	Anesthesia for cesarean delivery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01962	Anesthesia for procedure to remove uterus following delivery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01963	Anesthesia for cesarean removal of uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01967	Anesthesia for labor during planned vaginal delivery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01968	Anesthesia for cesarean delivery following labor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01969	Anesthesia for cesarean removal of uterus following labor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01990	Physiological support for harvesting of organs	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01991	Anesthesia for nerve block and injection procedure	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01992	"Anesthesia for nerve block and injection procedure, prone position"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
01996	Daily hospital management of continuous spinal drug administration	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
10021	Fine needle aspiration; without imaging guidance	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	0		
10021	Fine needle aspiration; without imaging guidance	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
10021	Fine needle aspiration; without imaging guidance	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
10021	Fine needle aspiration; without imaging guidance	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
10021	Fine needle aspiration; without imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	17		
10021	Fine needle aspiration; without imaging guidance	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	2		
10021	Fine needle aspiration; without imaging guidance	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
10021	Fine needle aspiration; without imaging guidance	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
10022	Fine needle aspiration using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	0	
10030	"Fluid collection drainage by catheter using imaging guidance, accessed through the skin"	Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Preservice total costs	5	0	
10030	"Fluid collection drainage by catheter using imaging guidance, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	6	
10030	"Fluid collection drainage by catheter using imaging guidance, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	62	0	
10030	"Fluid collection drainage by catheter using imaging guidance, accessed through the skin"	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	62	0	
10030	"Fluid collection drainage by catheter using imaging guidance, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	22	0	
10035	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion"	Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Availability of prior images confirmed	2		
10035	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion"	Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
10035	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion"	Service  pre	L051B	RN/Diagnostic Medical Sonographer	0.51	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
10035	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion"	Service  pre	L051B	RN/Diagnostic Medical Sonographer	0.51	Obtain vital signs	3		
10035	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion"	Service  pre	L051B	RN/Diagnostic Medical Sonographer	0.51	Prepare and position pt/ monitor pt/ set up IV	3		
10035	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion"	Service  pre	L051B	RN/Diagnostic Medical Sonographer	0.51	"Prepare room, equipment, supplies"	3		
10035	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion"	Service  pre	L051B	RN/Diagnostic Medical Sonographer	0.51	Provide pre-service education/obtain consent	5		
10035	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion"	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Acquire images	15		
10035	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion"	Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	1		
10035	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion"	Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	Clean room/equipment by physician staff	3		
10035	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion"	Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
10035	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion"	Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	5		
10035	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion"	Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	Review examination with interpreting MD	2		
10035	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion"	Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	"Review/read X-ray, lab, and pathology reports"	0		
10035	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion"	Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
10036	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (List separately in addition to code for primary procedure)"	Service  pre	L051B	RN/Diagnostic Medical Sonographer	0.51	Prepare and position pt/ monitor pt/ set up IV	3		
10036	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (List separately in addition to code for primary procedure)"	Service  pre	L051B	RN/Diagnostic Medical Sonographer	0.51	"Prepare room, equipment, supplies"	1		
10036	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (List separately in addition to code for primary procedure)"	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Acquire images	14		
10036	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (List separately in addition to code for primary procedure)"	Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	1		
10036	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (List separately in addition to code for primary procedure)"	Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	Clean room/equipment by physician staff	1		
10036	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (List separately in addition to code for primary procedure)"	Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
10036	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (List separately in addition to code for primary procedure)"	Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	Review examination with interpreting MD	2		
10036	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (List separately in addition to code for primary procedure)"	Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	"Review/read X-ray, lab, and pathology reports"	0		
10036	"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (List separately in addition to code for primary procedure)"	Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
10040	Acne surgery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	6	
10040	Acne surgery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	14	14	
10060	Drainage of abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
10060	Drainage of abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	6	
10060	Drainage of abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
10061	Drainage of multiple abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	13	
10061	Drainage of multiple abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	12	
10061	Drainage of multiple abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
10080	Drainage of tailbone cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	16	
10080	Drainage of tailbone cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	33	6	
10080	Drainage of tailbone cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
10081	Drainage of tailbone cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	16	
10081	Drainage of tailbone cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	6	
10081	Drainage of tailbone cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
10120	"Removal of foreign body from tissue, accessed beneath the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	10	30	
10120	"Removal of foreign body from tissue, accessed beneath the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	6	
10120	"Removal of foreign body from tissue, accessed beneath the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
10121	"Removal of foreign body from tissue, accessed beneath the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	30	
10121	"Removal of foreign body from tissue, accessed beneath the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	6	
10121	"Removal of foreign body from tissue, accessed beneath the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
10140	Drainage of blood or fluid accumulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	10	30	
10140	Drainage of blood or fluid accumulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	6	
10140	Drainage of blood or fluid accumulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
10160	"Aspiration of abscess, blood accumulation, blister, or cyst"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	10	30	
10160	"Aspiration of abscess, blood accumulation, blister, or cyst"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	6	
10160	"Aspiration of abscess, blood accumulation, blister, or cyst"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
10180	Drainage of wound infection after surgery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	30	
10180	Drainage of wound infection after surgery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	12	
10180	Drainage of wound infection after surgery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11000	"Removal of inflamed or infected skin, up to 10% of body surface"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	32	0	
11000	"Removal of inflamed or infected skin, up to 10% of body surface"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
11001	Removal of inflamed or infected skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	7	0	
11010	Removal of foreign material from skin and tissue at open fracture and/or dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
11010	Removal of foreign material from skin and tissue at open fracture and/or dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	89	12	
11010	Removal of foreign material from skin and tissue at open fracture and/or dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	27	
11011	"Removal of foreign material from skin, tissue, and muscle at open fracture and/or dislocation"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
11011	"Removal of foreign material from skin, tissue, and muscle at open fracture and/or dislocation"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	99	0	
11011	"Removal of foreign material from skin, tissue, and muscle at open fracture and/or dislocation"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
11012	"Removal of foreign material from skin, tissue, muscle, and bone at open fracture and/or dislocation"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
11012	"Removal of foreign material from skin, tissue, muscle, and bone at open fracture and/or dislocation"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	129	0	
11012	"Removal of foreign material from skin, tissue, muscle, and bone at open fracture and/or dislocation"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
11042	Removal of skin and tissue first 20 sq cm or less	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	22	
11042	Removal of skin and tissue first 20 sq cm or less	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	52	0	
11042	Removal of skin and tissue first 20 sq cm or less	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
11043	Removal of skin and/or muscle first 20 sq cm or less	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	22	
11043	Removal of skin and/or muscle first 20 sq cm or less	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	76	0	
11043	Removal of skin and/or muscle first 20 sq cm or less	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	6	
11044	Removal of skin and bone first 20 sq cm or less	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	22	
11044	Removal of skin and bone first 20 sq cm or less	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	91	0	
11044	Removal of skin and bone first 20 sq cm or less	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	6	
11045	Removal of skin and tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
11046	Removal of skin and/or muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
11047	Removal of skin and bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	0	
11055	Removal of single thickened skin growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	0	
11056	Removal of 2 to 4 thickened skin growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	0	
11057	Removal of more than 4 thickened skin growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	0	
11100	Biopsy of single growth of skin and/or tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	24	0	
11101	Biopsy of each additional growth of skin and/or tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	12	0	
11200	Removal of up to and including 15 skin tags	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	15	
11200	Removal of up to and including 15 skin tags	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	22	6	
11200	Removal of up to and including 15 skin tags	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11201	Removal of skin tags	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	4	0	
11300	"Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	24	0	
11301	"Shaving of 0.6 centimeters to 1.0 centimeters skin growth of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	0	
11302	"Shaving of 1.1 to 2.0 centimeters skin growth of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	0	
11303	"Shaving of over 2.0 centimeters skin growth of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	32	0	
11305	"Shaving of 0.5 centimeters or less skin growth of scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	0	
11306	"Shaving of 0.6 centimeters to 1.0 centimeters skin growth of scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	0	
11307	"Shaving of 1.1 to 2.0 centimeters skin growth of scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	31	0	
11308	"Shaving of over 2.0 centimeters skin growth of scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	34	0	
11310	"Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	0	
11311	"Shaving of 0.6 centimeters to 1.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	34	0	
11312	"Shaving of 1.1 to 2.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	37	0	
11313	"Shaving of over 2.0 centimeters skin growth of face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
11400	"Removal of growth (0.5 centimeters or less) of the trunk, arms or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	13	
11400	"Removal of growth (0.5 centimeters or less) of the trunk, arms or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	6	
11400	"Removal of growth (0.5 centimeters or less) of the trunk, arms or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11401	"Removal of growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	13	
11401	"Removal of growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	31	6	
11401	"Removal of growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11402	"Removal of growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	13	
11402	"Removal of growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	6	
11402	"Removal of growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11403	"Removal of growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	35	
11403	"Removal of growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	6	
11403	"Removal of growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11404	"Removal of growth (3.1 to 4.0 centimeters) of the trunk, arms, or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	35	
11404	"Removal of growth (3.1 to 4.0 centimeters) of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	6	
11404	"Removal of growth (3.1 to 4.0 centimeters) of the trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11406	"Removal of growth (4.0 centimeters) of the trunk, arms, or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	35	
11406	"Removal of growth (4.0 centimeters) of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	6	
11406	"Removal of growth (4.0 centimeters) of the trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11420	"Removal of growth (0.5 centimeters or less) of the scalp, neck, hands, feet, or genitals"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	13	
11420	"Removal of growth (0.5 centimeters or less) of the scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
11420	"Removal of growth (0.5 centimeters or less) of the scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11421	"Removal of growth (0.6 to 1.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	13	
11421	"Removal of growth (0.6 to 1.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	6	
11421	"Removal of growth (0.6 to 1.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11422	"Removal of growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	35	
11422	"Removal of growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	6	
11422	"Removal of growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11423	"Removal of growth (2.1 to 3.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	35	
11423	"Removal of growth (2.1 to 3.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	6	
11423	"Removal of growth (2.1 to 3.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11424	"Removal of growth (3.1 to 4.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	35	
11424	"Removal of growth (3.1 to 4.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	6	
11424	"Removal of growth (3.1 to 4.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11426	"Removal of growth (over 4.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	36	
11426	"Removal of growth (over 4.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	6	
11426	"Removal of growth (over 4.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	36	
11440	"Removal of growth (0.5 centimeters or less) of the face, ears, eyelids, nose, lips, or mouth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	35	
11440	"Removal of growth (0.5 centimeters or less) of the face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	6	
11440	"Removal of growth (0.5 centimeters or less) of the face, ears, eyelids, nose, lips, or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11441	"Removal of growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	35	
11441	"Removal of growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	6	
11441	"Removal of growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11442	"Removal of growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	35	
11442	"Removal of growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	6	
11442	"Removal of growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, lips, or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11443	"Removal of growth (2.1 to 3.0 centimeters) of face, ears, eyelids, nose, lips, or mouth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	35	
11443	"Removal of growth (2.1 to 3.0 centimeters) of face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	6	
11443	"Removal of growth (2.1 to 3.0 centimeters) of face, ears, eyelids, nose, lips, or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11444	"Removal (3.1 to 4.0 centimeters) growth of face, ears, eyelids, nose, lips, or mouth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	35	
11444	"Removal (3.1 to 4.0 centimeters) growth of face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	6	
11444	"Removal (3.1 to 4.0 centimeters) growth of face, ears, eyelids, nose, lips, or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11446	"Removal (over 4.0 centimeters) growth of the face, ears, eyelids, nose, lips, or mouth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	35	
11446	"Removal (over 4.0 centimeters) growth of the face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	73	6	
11446	"Removal (over 4.0 centimeters) growth of the face, ears, eyelids, nose, lips, or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11450	Removal of skin and tissue beneath the skin of underarms for excessive sweating	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
11450	Removal of skin and tissue beneath the skin of underarms for excessive sweating	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	73	6	
11450	Removal of skin and tissue beneath the skin of underarms for excessive sweating	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
11451	Removal of skin and tissue beneath the skin of underarms for excessive sweating	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
11451	Removal of skin and tissue beneath the skin of underarms for excessive sweating	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	81	6	
11451	Removal of skin and tissue beneath the skin of underarms for excessive sweating	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
11462	Removal of skin and tissue beneath the skin of groin for excessive sweating	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
11462	Removal of skin and tissue beneath the skin of groin for excessive sweating	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	6	
11462	Removal of skin and tissue beneath the skin of groin for excessive sweating	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
11463	Removal of skin and tissue beneath the skin of groin for excessive sweating	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
11463	Removal of skin and tissue beneath the skin of groin for excessive sweating	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	91	6	
11463	Removal of skin and tissue beneath the skin of groin for excessive sweating	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
11470	Removal of skin and tissue beneath the skin of anus or navel for excessive sweating	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
11470	Removal of skin and tissue beneath the skin of anus or navel for excessive sweating	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	80	6	
11470	Removal of skin and tissue beneath the skin of anus or navel for excessive sweating	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
11471	Removal of skin and tissue beneath the skin of anus or navel for excessive sweating	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
11471	Removal of skin and tissue beneath the skin of anus or navel for excessive sweating	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	87	6	
11471	Removal of skin and tissue beneath the skin of anus or navel for excessive sweating	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
11600	"Removal of malignant growth (0.5 centimeters or less) of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	34	6	
11600	"Removal of malignant growth (0.5 centimeters or less) of the trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11601	"Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	6	
11601	"Removal of malignant growth (0.6 to 1.0 centimeters) of the trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11602	"Removal of malignant growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	6	
11602	"Removal of malignant growth (1.1 to 2.0 centimeters) of the trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11603	"Removal of malignant growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	54	6	
11603	"Removal of malignant growth (2.1 to 3.0 centimeters) of the trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11604	"Removal of malignant growth (3.1 to 4 centimeters) of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	6	
11604	"Removal of malignant growth (3.1 to 4 centimeters) of the trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11606	"Removal of malignant growth (over 4.0 centimeters) of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	112	6	
11606	"Removal of malignant growth (over 4.0 centimeters) of the trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11620	"Removal of malignant growth (0.5 centimeters or less) of the scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	34	6	
11620	"Removal of malignant growth (0.5 centimeters or less) of the scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11621	"Removal of malignant growth (0.6 to 1.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	6	
11621	"Removal of malignant growth (0.6 to 1.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11622	"Removal of malignant growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	6	
11622	"Removal of malignant growth (1.1 to 2.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11623	"Removal of malignant growth (2.1 to 3.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	6	
11623	"Removal of malignant growth (2.1 to 3.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11624	"Removal of malignant growth (3.1 to 4 centimeters) of the scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	6	
11624	"Removal of malignant growth (3.1 to 4 centimeters) of the scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11626	"Removal of malignant growth (over 4.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	86	6	
11626	"Removal of malignant growth (over 4.0 centimeters) of the scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11640	"Removal of malignant growth (0.5 centimeters or less) of the face, ears, eyelids, nose, or lips"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	6	
11640	"Removal of malignant growth (0.5 centimeters or less) of the face, ears, eyelids, nose, or lips"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11641	"Removal of malignant growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, or lips"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	6	
11641	"Removal of malignant growth (0.6 to 1.0 centimeters) of the face, ears, eyelids, nose, or lips"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11642	"Removal of malignant growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, or lips"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	6	
11642	"Removal of malignant growth (1.1 to 2.0 centimeters) of the face, ears, eyelids, nose, or lips"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11643	"Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	6	
11643	"Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11644	"Removal of malignant growth (3.1 to 4.0 centimeters) of the face, ears, eyelids, nose, or lips"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	79	6	
11644	"Removal of malignant growth (3.1 to 4.0 centimeters) of the face, ears, eyelids, nose, or lips"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11646	"Removal of malignant growth (over 4.0 centimeters) of the face, ears, eyelids, nose, or lips"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	91	6	
11646	"Removal of malignant growth (over 4.0 centimeters) of the face, ears, eyelids, nose, or lips"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
11719	Trimming of fingernails or toenails	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	10	0	
11720	Removal of tissue from 1 to 5 finger or toe nails	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	0	
11721	Removal of tissue from 6 or more finger or toe nails	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
11730	Separation of nail plate from nail bed	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	0	
11730	Separation of nail plate from nail bed	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
11732	Separation of nail plate from nail bed	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	7	0	
11740	Removal of blood accumulation between nail and nail bed	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	10	30	
11740	Removal of blood accumulation between nail and nail bed	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	32	0	
11740	Removal of blood accumulation between nail and nail bed	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
11750	Removal of nail	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
11750	Removal of nail	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		3	
11750	Removal of nail	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
11750	Removal of nail	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
11750	Removal of nail	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
11750	Removal of nail	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
11750	Removal of nail	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
11750	Removal of nail	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
11750	Removal of nail	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
11750	Removal of nail	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2		
11750	Removal of nail	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	15		
11750	Removal of nail	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
11750	Removal of nail	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
11750	Removal of nail	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	10		
11750	Removal of nail	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management  same day 99238 --6 minutes		6	
11750	Removal of nail	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes	27	27	
11752	Removal of nail with amputation of fingertip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	10	30	
11752	Removal of nail with amputation of fingertip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	6	
11752	Removal of nail with amputation of fingertip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
11755	Biopsy of finger or toe nail	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	30	
11755	Biopsy of finger or toe nail	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
11755	Biopsy of finger or toe nail	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
11760	Repair of nail bed	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0		
11760	Repair of nail bed	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	0	10	
11760	Repair of nail bed	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	0		
11760	Repair of nail bed	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
11760	Repair of nail bed	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
11760	Repair of nail bed	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
11760	Repair of nail bed	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
11760	Repair of nail bed	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
11760	Repair of nail bed	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
11760	Repair of nail bed	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (67%)	22		
11760	Repair of nail bed	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
11760	Repair of nail bed	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
11760	Repair of nail bed	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	10		
11760	Repair of nail bed	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management		0	
11760	Repair of nail bed	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	2		
11760	Repair of nail bed	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes	27	27	
11762	Repair of finger or toe nail bed with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	30	
11762	Repair of finger or toe nail bed with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	6	
11762	Repair of finger or toe nail bed with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11765	Removal of skin of finger or toe nail	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	30	
11765	Removal of skin of finger or toe nail	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	6	
11765	Removal of skin of finger or toe nail	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11770	Removal of tailbone cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	16	
11770	Removal of tailbone cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	6	
11770	Removal of tailbone cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
11771	Removal of tailbone cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
11771	Removal of tailbone cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	6	
11771	Removal of tailbone cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
11772	Removal of tailbone cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
11772	Removal of tailbone cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	79	12	
11772	Removal of tailbone cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
11900	Injection of up to 7 skin growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	24	0	
11901	Injection of more than 7 skin growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
11920	Introduction of pigment into skin (6.0 sq cm or less) to correct color defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
11920	Introduction of pigment into skin (6.0 sq cm or less) to correct color defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	0	
11920	Introduction of pigment into skin (6.0 sq cm or less) to correct color defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
11921	Introduction of pigment into skin (6.1 to 20.0 sq cm) to correct color defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
11921	Introduction of pigment into skin (6.1 to 20.0 sq cm) to correct color defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	0	
11921	Introduction of pigment into skin (6.1 to 20.0 sq cm) to correct color defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
11922	Introduction of pigment into skin to correct color defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
11950	Injection of 1 cc or less filling material into tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	0	
11950	Injection of 1 cc or less filling material into tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
11950	Injection of 1 cc or less filling material into tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
11951	"Injection of 1.1 to 5.0 cc filling material, beneath the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	0	
11951	"Injection of 1.1 to 5.0 cc filling material, beneath the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	0	
11951	"Injection of 1.1 to 5.0 cc filling material, beneath the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
11952	Injection of 5.1 to 10.0 cc filling material into tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	0	
11952	Injection of 5.1 to 10.0 cc filling material into tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
11952	Injection of 5.1 to 10.0 cc filling material into tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
11954	"Injection of over 10.0 cc filling material, beneath the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	0	
11954	"Injection of over 10.0 cc filling material, beneath the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
11954	"Injection of over 10.0 cc filling material, beneath the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
11960	Insertion of tissue expanders	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
11960	Insertion of tissue expanders	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
11960	Insertion of tissue expanders	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		338	
11970	Replacement of tissue expander with permanent prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
11970	Replacement of tissue expander with permanent prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
11970	Replacement of tissue expander with permanent prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
11971	Removal of tissue expanders	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
11971	Removal of tissue expanders	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	127	6	
11971	Removal of tissue expanders	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
11976	Removal of implantable contraceptive capsules	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	67	0	
11980	Subcutaneous hormone pellet implantation	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
11980	Subcutaneous hormone pellet implantation	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
11980	Subcutaneous hormone pellet implantation	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
11980	Subcutaneous hormone pellet implantation	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
11980	Subcutaneous hormone pellet implantation	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2		
11980	Subcutaneous hormone pellet implantation	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
11980	Subcutaneous hormone pellet implantation	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	12		
11980	Subcutaneous hormone pellet implantation	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	2		
11980	Subcutaneous hormone pellet implantation	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
11980	Subcutaneous hormone pellet implantation	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	10		
11980	Subcutaneous hormone pellet implantation	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
11981	Insertion of drug delivery implant into tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	67	0	
11982	Removal of drug delivery implant from tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	67	0	
11983	Removal with reinsertion of drug delivery implant into tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	67	0	
12001	"Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
12002	"Repair of wound (2.6 to 7.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	33	6	
12004	"Repair of wound (7.6 to 12.5 centimeters) of the scalp, neck, underarms, genitals, trunk, arms and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	6	
12005	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
12005	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
12005	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	3		
12005	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
12005	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
12005	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (67%)	17		
12005	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
12005	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
12005	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management		0	
12006	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
12006	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
12006	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	3		
12006	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
12006	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
12006	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (67%)	20		
12006	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
12006	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
12006	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management		0	
12007	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
12007	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
12007	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	3		
12007	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
12007	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
12007	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (67%)	24		
12007	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
12007	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
12007	"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management		0	
12011	"Repair of wound (2.5 centimeters or less) of the face, ears, eyelids, nose, lips, and/or mucous membranes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	31	6	
12013	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
12013	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
12013	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
12013	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
12013	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
12013	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (67%)	10		
12013	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
12013	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
12013	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management		0	
12014	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
12014	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
12014	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
12014	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
12014	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
12014	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (67%)	13		
12014	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
12014	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
12014	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management		0	
12015	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
12015	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
12015	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
12015	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
12015	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
12015	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (67%)	16		
12015	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
12015	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
12015	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management		0	
12016	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
12016	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
12016	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
12016	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
12016	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
12016	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (67%)	20		
12016	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
12016	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
12016	"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management		0	
12017	"Repair of wound (20.1 to 30.0 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
12018	"Repair of wound (over 30.0 centimeters) of the face, ears, eyelids, nose, lips, and/or mucous membranes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
12020	Repair of separation of wound closure	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
12020	Repair of separation of wound closure	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	6	
12020	Repair of separation of wound closure	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
12021	Repair of separation of wound closure with insertion of packing	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
12021	Repair of separation of wound closure with insertion of packing	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	12	
12021	Repair of separation of wound closure with insertion of packing	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
12031	"Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	15	
12031	"Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	6	
12031	"Repair of wound (2.5 centimeters or less) of the scalp, underarms, trunk, arms, and/or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
12032	"Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
12032	"Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	62	6	
12032	"Repair of wound (2.6 to 7.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
12034	"Repair of wound (7.6 to 12.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	15	
12034	"Repair of wound (7.6 to 12.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	66	6	
12034	"Repair of wound (7.6 to 12.5 centimeters) of the scalp, underarms, trunk, arms, and/or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
12035	"Repair of wound (12.6 to 20.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
12035	"Repair of wound (12.6 to 20.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	95	6	
12035	"Repair of wound (12.6 to 20.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
12036	"Repair of wound (20.1 to 30.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
12036	"Repair of wound (20.1 to 30.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	106	6	
12036	"Repair of wound (20.1 to 30.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
12037	"Repair of wound (over 30.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
12037	"Repair of wound (over 30.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	126	6	
12037	"Repair of wound (over 30.0 centimeters) of the scalp, underarms, trunk, arms, and/or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0		
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	0	10	
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	0		
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2	0	
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (67%)	14		
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	10		
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management		0	
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	3		
12041	"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less"	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes	27	27	
12042	"Repair of wound (2.6 to 7.5 centimeters) of neck, hands, feet, and/or genitals"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	15	
12042	"Repair of wound (2.6 to 7.5 centimeters) of neck, hands, feet, and/or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	6	
12042	"Repair of wound (2.6 to 7.5 centimeters) of neck, hands, feet, and/or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
12044	"Repair of wound (7.6 to 12.5 centimeters) of neck, hands, feet, and/or genitals"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	15	
12044	"Repair of wound (7.6 to 12.5 centimeters) of neck, hands, feet, and/or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	93	6	
12044	"Repair of wound (7.6 to 12.5 centimeters) of neck, hands, feet, and/or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
12045	"Repair of wound (12.6 to 20.0 centimeters) of neck, hands, feet, and/or genitals"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
12045	"Repair of wound (12.6 to 20.0 centimeters) of neck, hands, feet, and/or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	96	6	
12045	"Repair of wound (12.6 to 20.0 centimeters) of neck, hands, feet, and/or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
12046	"Repair of wound (20.1 to 30.0 centimeters) of neck, hands, feet, and/or genitals"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
12046	"Repair of wound (20.1 to 30.0 centimeters) of neck, hands, feet, and/or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	116	6	
12046	"Repair of wound (20.1 to 30.0 centimeters) of neck, hands, feet, and/or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
12047	"Repair of wound (over 30.0 centimeters) of neck, hands, feet, and/or genitals"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
12047	"Repair of wound (over 30.0 centimeters) of neck, hands, feet, and/or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	136	6	
12047	"Repair of wound (over 30.0 centimeters) of neck, hands, feet, and/or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
12051	"Repair of wound (2.5 centimeters or less) of face, ears, eyelids, nose, lips, and/or mouth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	15	
12051	"Repair of wound (2.5 centimeters or less) of face, ears, eyelids, nose, lips, and/or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	6	
12051	"Repair of wound (2.5 centimeters or less) of face, ears, eyelids, nose, lips, and/or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
12052	"Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	15	
12052	"Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	6	
12052	"Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
12053	"Repair of wound (5.1 to 7.5 centimeters) of face, ears, eyelids, nose, lips, and/or mouth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	15	
12053	"Repair of wound (5.1 to 7.5 centimeters) of face, ears, eyelids, nose, lips, and/or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	6	
12053	"Repair of wound (5.1 to 7.5 centimeters) of face, ears, eyelids, nose, lips, and/or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0		
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	0	10	
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	0		
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2	0	
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (67%)	33		
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	15		
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management		0	
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	3		
12054	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm"	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes	27	27	
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0		
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	0	10	
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	0		
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (67%)	40		
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	15		
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management		6	
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	3		
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes	27	27	
12055	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes	36	36	
12056	"Repair of wound (20.1 to 30.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	15	
12056	"Repair of wound (20.1 to 30.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	83	6	
12056	"Repair of wound (20.1 to 30.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0		
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	0	10	
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	0		
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	15		
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management		6	
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	3		
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes	27	27	
12057	"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes	36	36	
13100	Repair of wound (1.1 to 2.5 centimeters) of trunk	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	0	
13100	Repair of wound (1.1 to 2.5 centimeters) of trunk	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	33	
13101	Repair of wound (2.6 to 7.5 centimeters) of trunk	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	0	
13101	Repair of wound (2.6 to 7.5 centimeters) of trunk	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	33	
13102	Repair of wound of trunk	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
13120	"Repair of wound (1.1 to 2.5 centimeters) of scalp, arms, and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
13120	"Repair of wound (1.1 to 2.5 centimeters) of scalp, arms, and/or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	33	
13121	"Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	0	
13121	"Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	33	
13122	"Repair of wound of scalp, arms, and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
13131	"Repair of wound (1.1 to 2.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	0	
13131	"Repair of wound (1.1 to 2.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	33	
13132	"Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	0	
13132	"Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	33	
13133	"Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	0	
13151	"Repair of wound (1.1 to 2.5 centimeters) of eyelids, nose, ears, and/or lips"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	0	
13151	"Repair of wound (1.1 to 2.5 centimeters) of eyelids, nose, ears, and/or lips"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	33	
13152	"Repair of wound (2.6 to 7.5 centimeters) of eyelids, nose, ears, and/or lips"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	0	
13152	"Repair of wound (2.6 to 7.5 centimeters) of eyelids, nose, ears, and/or lips"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	33	
13153	"Repair of wound of eyelids, nose, ears, and/or lips"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	0	
13160	Second repair of surgical wound	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
13160	Second repair of surgical wound	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
13160	Second repair of surgical wound	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
14000	Tissue transfer repair of wound (10 sq centimeters or less) of the trunk	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
14000	Tissue transfer repair of wound (10 sq centimeters or less) of the trunk	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	98	6	
14000	Tissue transfer repair of wound (10 sq centimeters or less) of the trunk	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
14001	Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the trunk	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
14001	Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the trunk	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	139	6	
14001	Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the trunk	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
14020	"Tissue transfer repair of wound (10 sq centimeters or less) of the scalp, arms, and/or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
14020	"Tissue transfer repair of wound (10 sq centimeters or less) of the scalp, arms, and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	112	6	
14020	"Tissue transfer repair of wound (10 sq centimeters or less) of the scalp, arms, and/or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
14021	"Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
14021	"Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	150	6	
14021	"Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
14040	"Tissue transfer repair of wound (10 sq centimeters or less) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
14040	"Tissue transfer repair of wound (10 sq centimeters or less) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	124	6	
14040	"Tissue transfer repair of wound (10 sq centimeters or less) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
14041	"Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
14041	"Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	161	6	
14041	"Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
14060	"Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
14060	"Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	94	6	
14060	"Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
14061	"Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of eyelids, nose, ears, and/or lips"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
14061	"Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of eyelids, nose, ears, and/or lips"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	187	6	
14061	"Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of eyelids, nose, ears, and/or lips"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	162	162	
14301	Tissue transfer repair of wound (30.1 to 60.0 sq centimeters)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
14301	Tissue transfer repair of wound (30.1 to 60.0 sq centimeters)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	130	6	
14301	Tissue transfer repair of wound (30.1 to 60.0 sq centimeters)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	135	135	
14350	Repair of tissue loss of finger or toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
14350	Repair of tissue loss of finger or toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
14350	Repair of tissue loss of finger or toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
15002	"Preparation of graft site at trunk, arms, or legs (first 100 sq cm or 1% body area infants and children)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
15002	"Preparation of graft site at trunk, arms, or legs (first 100 sq cm or 1% body area infants and children)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	0	
15002	"Preparation of graft site at trunk, arms, or legs (first 100 sq cm or 1% body area infants and children)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
15003	"Preparation of graft site at trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
15004	"Preparation of graft site of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or 1% body area of infants and children)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
15004	"Preparation of graft site of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or 1% body area of infants and children)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	73	0	
15004	"Preparation of graft site of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or 1% body area of infants and children)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
15005	"Preparation of graft site of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
15040	Relocation of skin (100 sq cm or less) for tissue cultured graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
15040	Relocation of skin (100 sq cm or less) for tissue cultured graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	0	
15050	Skin graft (2 centimeters) to tip of finger or toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15050	Skin graft (2 centimeters) to tip of finger or toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	80	6	
15050	Skin graft (2 centimeters) to tip of finger or toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
15100	"Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body are of infants and children)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15100	"Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body are of infants and children)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	12	
15100	"Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body are of infants and children)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
15101	"Skin graft at trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	29	0	
15110	"Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body area of infants and children)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15110	"Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body area of infants and children)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	12	
15110	"Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body area of infants and children)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
15111	"Skin graft at trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	17	0	
15115	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15115	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	12	
15115	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
15116	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	0	
15120	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15120	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	100	6	
15120	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	99	99	
15121	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	0	
15130	"Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body area of infants and children)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15130	"Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body area of infants and children)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	12	
15130	"Skin graft at trunk, arms, or legs (first 100 sq cm or less, or 1% body area of infants and children)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
15131	"Skin graft at trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	12	0	
15135	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15135	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	12	
15135	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or less, or 1% body area of infants and children)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
15136	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	10	0	
15150	"Skin graft at trunk, arms, or legs (first 25 sq centimeters or less)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15150	"Skin graft at trunk, arms, or legs (first 25 sq centimeters or less)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	12	
15150	"Skin graft at trunk, arms, or legs (first 25 sq centimeters or less)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
15151	"Skin graft at trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	13	0	
15152	"Skin graft at trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	13	0	
15155	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 25 sq centimeters or less)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15155	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 25 sq centimeters or less)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	12	
15155	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 25 sq centimeters or less)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
15156	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	13	0	
15157	"Skin graft of face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
15200	Relocation of patient skin (20 sq centimeters or less) to trunk	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15200	Relocation of patient skin (20 sq centimeters or less) to trunk	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	125	6	
15200	Relocation of patient skin (20 sq centimeters or less) to trunk	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
15201	Relocation of patient skin to trunk	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
15220	"Relocation of patient skin (20 sq centimeters or less) to scalp, arms, and/or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15220	"Relocation of patient skin (20 sq centimeters or less) to scalp, arms, and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	125	6	
15220	"Relocation of patient skin (20 sq centimeters or less) to scalp, arms, and/or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
15221	"Relocation of patient skin to scalp, arms, and/or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	16	0	
15240	"Relocation of patient skin to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet (20 sq centimeters or less)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15240	"Relocation of patient skin to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet (20 sq centimeters or less)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	95	6	
15240	"Relocation of patient skin to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet (20 sq centimeters or less)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	198	198	
15241	"Relocation of patient skin to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	0	
15260	"Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15260	"Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	135	6	
15260	"Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	180	180	
15261	"Relocation of patient skin to nose, ears, eyelids, and/or lips"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
15271	"Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs (first 25 sq cm or less)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
15271	"Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs (first 25 sq cm or less)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	0	
15271	"Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs (first 25 sq cm or less)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
15272	"Application of skin substitute (wound surface up to 100 sq cm) to trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	10	0	
15273	"Application of skin substitute (wound surface greater or equal to 100 sq cm) to trunk, arms, or legs (first 100 sq cm or 1% body area of infants and children)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
15273	"Application of skin substitute (wound surface greater or equal to 100 sq cm) to trunk, arms, or legs (first 100 sq cm or 1% body area of infants and children)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	0	
15273	"Application of skin substitute (wound surface greater or equal to 100 sq cm) to trunk, arms, or legs (first 100 sq cm or 1% body area of infants and children)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
15274	"Application of skin substitute (wound surface greater or equal to 100 sq cm) to trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	10	0	
15275	"Application of skin substitute (wound surface up to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 25 sq cm or less)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
15275	"Application of skin substitute (wound surface up to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 25 sq cm or less)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	0	
15275	"Application of skin substitute (wound surface up to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 25 sq cm or less)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
15276	"Application of skin substitute (wound surface up to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	10	0	
15277	"Application of skin substitute (wound surface great than or equal to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or 1% body area of infants and children)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
15277	"Application of skin substitute (wound surface great than or equal to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or 1% body area of infants and children)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
15277	"Application of skin substitute (wound surface great than or equal to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes (first 100 sq cm or 1% body area of infants and children)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
15278	"Application of skin substitute (wound surface great than or equal to 100 sq cm) to face, scalp, eyelids, mouth, neck, ears, eye region, genitals, hands, feet, and/or multiple fingers or toes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	14	0	
15570	Creation of flap graft to trunk	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15570	Creation of flap graft to trunk	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	138	6	
15570	Creation of flap graft to trunk	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	116	116	
15572	"Creation of flap graft to scalp, arms, or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15572	"Creation of flap graft to scalp, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	128	6	
15572	"Creation of flap graft to scalp, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	134	134	
15574	"Creation of flap graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15574	"Creation of flap graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	148	6	
15574	"Creation of flap graft to forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	134	134	
15576	"Creation of flap graft to eyelids, nose, ears, lips, or mouth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15576	"Creation of flap graft to eyelids, nose, ears, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	128	6	
15576	"Creation of flap graft to eyelids, nose, ears, lips, or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	99	99	
15600	Transfer of skin flap to trunk	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15600	Transfer of skin flap to trunk	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	90	6	
15600	Transfer of skin flap to trunk	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
15610	"Transfer of skin flap to scalp, arms, or legs"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15610	"Transfer of skin flap to scalp, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	90	12	
15610	"Transfer of skin flap to scalp, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
15620	"Transfer of skin flap to forehead, cheeks, chin, neck, underarms, genitals, hands, or feet"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15620	"Transfer of skin flap to forehead, cheeks, chin, neck, underarms, genitals, hands, or feet"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	90	6	
15620	"Transfer of skin flap to forehead, cheeks, chin, neck, underarms, genitals, hands, or feet"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
15630	"Transfer of skin flap to eyelids, nose, ears, or lips"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15630	"Transfer of skin flap to eyelids, nose, ears, or lips"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	94	6	
15630	"Transfer of skin flap to eyelids, nose, ears, or lips"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
15650	Transfer of skin flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15650	Transfer of skin flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	108	6	
15650	Transfer of skin flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
15731	"Creation of flap graft to nose, forehead, temple, or scalp"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15731	"Creation of flap graft to nose, forehead, temple, or scalp"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	103	6	
15731	"Creation of flap graft to nose, forehead, temple, or scalp"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	188	188	
15732	Muscle flap wound repair at head and neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	65	
15732	Muscle flap wound repair at head and neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	183	6	
15732	Muscle flap wound repair at head and neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	152	152	
15734	Muscle flap wound repair at trunk	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15734	Muscle flap wound repair at trunk	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	196	12	
15734	Muscle flap wound repair at trunk	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	179	179	
15736	Muscle flap wound repair of arm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15736	Muscle flap wound repair of arm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	183	6	
15736	Muscle flap wound repair of arm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	106	106	
15738	Muscle flap wound repair of leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15738	Muscle flap wound repair of leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	183	12	
15738	Muscle flap wound repair of leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	106	106	
15740	Creation of skin and tissue graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15740	Creation of skin and tissue graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	161	6	
15740	Creation of skin and tissue graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	162	162	
15750	Creation of nerve and blood vessel skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15750	Creation of nerve and blood vessel skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
15750	Creation of nerve and blood vessel skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
15756	Creation of muscle and blood vessel skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
15756	Creation of muscle and blood vessel skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15756	Creation of muscle and blood vessel skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		169	
15757	Creation of muscle and blood vessel skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
15757	Creation of muscle and blood vessel skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15757	Creation of muscle and blood vessel skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		169	
15758	Creation of muscle and blood vessel skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15758	Creation of muscle and blood vessel skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15758	Creation of muscle and blood vessel skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		169	
15760	Creation of multiple tissue skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15760	Creation of multiple tissue skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	143	6	
15760	Creation of multiple tissue skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
15770	"Creation of skin, fat and muscle graft"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15770	"Creation of skin, fat and muscle graft"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
15770	"Creation of skin, fat and muscle graft"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
15775	Hair transplant (1 to 15 punch grafts)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
15775	Hair transplant (1 to 15 punch grafts)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	68	0	
15775	Hair transplant (1 to 15 punch grafts)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
15776	Hair transplant (more than 15 punch grafts)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
15776	Hair transplant (more than 15 punch grafts)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	0	
15776	Hair transplant (more than 15 punch grafts)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
15780	Scraping of skin of face	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15780	Scraping of skin of face	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	101	6	
15780	Scraping of skin of face	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	162	162	
15781	Scraping of skin of face	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15781	Scraping of skin of face	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	73	6	
15781	Scraping of skin of face	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
15782	Scraping of skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15782	Scraping of skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	6	
15782	Scraping of skin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
15783	Scraping of skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15783	Scraping of skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	6	
15783	Scraping of skin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
15786	Scraping of skin growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	8	
15786	Scraping of skin growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	37	6	
15786	Scraping of skin growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
15787	Scraping of multiple skin growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8	0	
15788	Chemical peel of skin of face	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15788	Chemical peel of skin of face	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	72	6	
15788	Chemical peel of skin of face	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
15789	Chemical peel of skin of face	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15789	Chemical peel of skin of face	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	92	6	
15789	Chemical peel of skin of face	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
15792	Chemical peel of skin of face	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15792	Chemical peel of skin of face	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	68	6	
15792	Chemical peel of skin of face	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
15793	Chemical peel of skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15793	Chemical peel of skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	82	6	
15793	Chemical peel of skin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
15819	Removal of excessive skin of neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15819	Removal of excessive skin of neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
15819	Removal of excessive skin of neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
15820	Removal of excessive skin of lower eyelid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
15820	Removal of excessive skin of lower eyelid	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	76	6	
15820	Removal of excessive skin of lower eyelid	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	126	126	
15821	Removal of excessive skin of lower eyelid and fat around eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
15821	Removal of excessive skin of lower eyelid and fat around eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	86	6	
15821	Removal of excessive skin of lower eyelid and fat around eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	126	126	
15822	Removal of excessive skin of upper eyelid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
15822	Removal of excessive skin of upper eyelid	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	73	6	
15822	Removal of excessive skin of upper eyelid	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	95	95	
15823	Removal of excessive skin and fat of upper eyelid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
15823	Removal of excessive skin and fat of upper eyelid	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	88	6	
15823	Removal of excessive skin and fat of upper eyelid	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	127	127	
15830	Removal of excessive skin and tissue beneath the skin of abdomen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15830	Removal of excessive skin and tissue beneath the skin of abdomen	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15830	Removal of excessive skin and tissue beneath the skin of abdomen	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
15832	Removal of excessive skin and tissue beneath the skin of thigh	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15832	Removal of excessive skin and tissue beneath the skin of thigh	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15832	Removal of excessive skin and tissue beneath the skin of thigh	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
15833	Removal of excessive skin and tissue beneath the skin of leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15833	Removal of excessive skin and tissue beneath the skin of leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15833	Removal of excessive skin and tissue beneath the skin of leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
15834	Removal of excessive skin and tissue beneath the skin of hip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15834	Removal of excessive skin and tissue beneath the skin of hip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15834	Removal of excessive skin and tissue beneath the skin of hip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
15835	Removal of excessive skin and tissue beneath the skin of buttock	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15835	Removal of excessive skin and tissue beneath the skin of buttock	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15835	Removal of excessive skin and tissue beneath the skin of buttock	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
15836	Removal of excessive skin and tissue beneath the skin of arm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15836	Removal of excessive skin and tissue beneath the skin of arm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
15836	Removal of excessive skin and tissue beneath the skin of arm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
15837	Removal of excessive skin and tissue beneath the skin of lower arm or hand	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15837	Removal of excessive skin and tissue beneath the skin of lower arm or hand	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	127	6	
15837	Removal of excessive skin and tissue beneath the skin of lower arm or hand	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
15838	Removal of excessive skin and tissue beneath the skin under chin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15838	Removal of excessive skin and tissue beneath the skin under chin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15838	Removal of excessive skin and tissue beneath the skin under chin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
15839	Removal of excessive skin and tissue beneath the skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
15839	Removal of excessive skin and tissue beneath the skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	143	6	
15839	Removal of excessive skin and tissue beneath the skin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
15840	Graft to relieve or reactivate facial paralysis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15840	Graft to relieve or reactivate facial paralysis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
15840	Graft to relieve or reactivate facial paralysis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
15841	Graft to relieve or reactivate facial paralysis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15841	Graft to relieve or reactivate facial paralysis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
15841	Graft to relieve or reactivate facial paralysis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		216	
15842	Graft to relieve or reactivate facial paralysis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15842	Graft to relieve or reactivate facial paralysis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
15842	Graft to relieve or reactivate facial paralysis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		234	
15845	Graft to relieve or reactivate facial paralysis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15845	Graft to relieve or reactivate facial paralysis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
15845	Graft to relieve or reactivate facial paralysis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		198	
15850	Removal of sutures under anesthesia by same surgeon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	0	
15851	Removal of sutures under anesthesia by other surgeon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	0	
15920	Removal of pressure sore and bone at tailbone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15920	Removal of pressure sore and bone at tailbone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15920	Removal of pressure sore and bone at tailbone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
15922	Removal of pressure sore and bone at tailbone with skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15922	Removal of pressure sore and bone at tailbone with skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15922	Removal of pressure sore and bone at tailbone with skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
15931	Removal of pressure sore of sacrum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15931	Removal of pressure sore of sacrum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15931	Removal of pressure sore of sacrum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
15933	Removal of pressure sore and bone at sacrum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15933	Removal of pressure sore and bone at sacrum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15933	Removal of pressure sore and bone at sacrum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		149	
15934	Removal of pressure sore at sacrum with skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15934	Removal of pressure sore at sacrum with skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15934	Removal of pressure sore at sacrum with skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
15935	Removal of pressure sore and bone at sacrum with skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15935	Removal of pressure sore and bone at sacrum with skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15935	Removal of pressure sore and bone at sacrum with skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		176	
15936	Removal of pressure sore at sacrum in preparation of muscle flap or skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15936	Removal of pressure sore at sacrum in preparation of muscle flap or skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15936	Removal of pressure sore at sacrum in preparation of muscle flap or skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
15937	Removal of pressure sore and bone at sacrum in preparation of muscle flap or skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15937	Removal of pressure sore and bone at sacrum in preparation of muscle flap or skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15937	Removal of pressure sore and bone at sacrum in preparation of muscle flap or skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
15940	Removal of pressure sore at lower pelvic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15940	Removal of pressure sore at lower pelvic bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15940	Removal of pressure sore at lower pelvic bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
15941	Removal of pressure sore and lower pelvic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15941	Removal of pressure sore and lower pelvic bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15941	Removal of pressure sore and lower pelvic bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		149	
15944	Removal of pressure sore with skin graft at lower pelvic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15944	Removal of pressure sore with skin graft at lower pelvic bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15944	Removal of pressure sore with skin graft at lower pelvic bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		149	
15945	Removal of pressure sore and lower pelvic bone with skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15945	Removal of pressure sore and lower pelvic bone with skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15945	Removal of pressure sore and lower pelvic bone with skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
15946	Removal of pressure sore and lower pelvic bone in preparation of muscle flap or skin graft closure	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15946	Removal of pressure sore and lower pelvic bone in preparation of muscle flap or skin graft closure	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15946	Removal of pressure sore and lower pelvic bone in preparation of muscle flap or skin graft closure	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		212	
15950	Removal of pressure sore at hip bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15950	Removal of pressure sore at hip bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15950	Removal of pressure sore at hip bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
15951	Removal of pressure sore and bone at hip bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15951	Removal of pressure sore and bone at hip bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15951	Removal of pressure sore and bone at hip bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		149	
15952	Removal of pressure sore at hip bone with skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15952	Removal of pressure sore at hip bone with skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15952	Removal of pressure sore at hip bone with skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		149	
15953	Removal of pressure sore and bone at hip bone with skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15953	Removal of pressure sore and bone at hip bone with skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15953	Removal of pressure sore and bone at hip bone with skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
15956	Removal of pressure sore at hip bone in preparation of muscle flap or skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15956	Removal of pressure sore at hip bone in preparation of muscle flap or skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15956	Removal of pressure sore at hip bone in preparation of muscle flap or skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		176	
15958	Removal of pressure sore and bone at hip bone in preparation of muscle flap or skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
15958	Removal of pressure sore and bone at hip bone in preparation of muscle flap or skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
15958	Removal of pressure sore and bone at hip bone in preparation of muscle flap or skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		176	
16000	First degree burn treatment	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	24	0	
16000	First degree burn treatment	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
16020	Dressing change and/or removal of burn tissue (less than 5% total body surface)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
16020	Dressing change and/or removal of burn tissue (less than 5% total body surface)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	0	
16020	Dressing change and/or removal of burn tissue (less than 5% total body surface)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
16025	Dressing change and/or removal of burn tissue (5% to 10% total body surface)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
16025	Dressing change and/or removal of burn tissue (5% to 10% total body surface)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	0	
16025	Dressing change and/or removal of burn tissue (5% to 10% total body surface)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
16030	Dressing change and/or removal of burn tissue (greater than 10% total body surface)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
16030	Dressing change and/or removal of burn tissue (greater than 10% total body surface)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
16030	Dressing change and/or removal of burn tissue (greater than 10% total body surface)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
16035	Incision of burn tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
17000	Destruction of skin growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	12	0	
17000	Destruction of skin growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17003	Destruction of 2-14 skin growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	1	0	
17004	Destruction of 15 or more skin growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	19	0	
17004	Destruction of 15 or more skin growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17106	Destruction of skin growth (less than 10 sq centimeters)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	35	
17106	Destruction of skin growth (less than 10 sq centimeters)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	6	
17106	Destruction of skin growth (less than 10 sq centimeters)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
17107	Destruction of skin growth (10.0 to 50.0 sq centimeters)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	35	
17107	Destruction of skin growth (10.0 to 50.0 sq centimeters)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	6	
17107	Destruction of skin growth (10.0 to 50.0 sq centimeters)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
17108	Destruction of skin growth (over 50.0 sq centimeters)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	35	
17108	Destruction of skin growth (over 50.0 sq centimeters)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	83	6	
17108	Destruction of skin growth (over 50.0 sq centimeters)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	117	117	
17110	Destruction of up to 14 skin growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	21	
17110	Destruction of up to 14 skin growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	6	
17110	Destruction of up to 14 skin growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17111	Destruction of 15 or more skin growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	21	
17111	Destruction of 15 or more skin growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	32	6	
17111	Destruction of 15 or more skin growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17250	Application of chemical agent to excessive wound tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	21	
17250	Application of chemical agent to excessive wound tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25	0	
17260	"Destruction of malignant growth (0.5 centimeters or less) of trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	17	6	
17260	"Destruction of malignant growth (0.5 centimeters or less) of trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	13.5	13.5	
17261	"Destruction of malignant growth (0.6 to 1.0 centimeters) of trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	34	6	
17261	"Destruction of malignant growth (0.6 to 1.0 centimeters) of trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17262	"Destruction of malignant growth (1.1 to 2.0 centimeters) of trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	6	
17262	"Destruction of malignant growth (1.1 to 2.0 centimeters) of trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17263	"Destruction of malignant growth (2.1 to 3.0 centimeters) of trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	6	
17263	"Destruction of malignant growth (2.1 to 3.0 centimeters) of trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17264	"Destruction of malignant growth (3.1 to 4.0 centimeters) of trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	6	
17264	"Destruction of malignant growth (3.1 to 4.0 centimeters) of trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17266	"Destruction of malignant growth (over 4.0 centimeters) of trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	6	
17266	"Destruction of malignant growth (over 4.0 centimeters) of trunk, arms, or legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17270	"Destruction of malignant growth (0.5 centimeters) of scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	33	6	
17270	"Destruction of malignant growth (0.5 centimeters) of scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17271	"Destruction of malignant growth (0.6 to 1.0 centimeters) of scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	34	6	
17271	"Destruction of malignant growth (0.6 to 1.0 centimeters) of scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17272	"Destruction of malignant growth (1.1 to 2.0 centimeters) of scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	6	
17272	"Destruction of malignant growth (1.1 to 2.0 centimeters) of scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17273	"Destruction of malignant growth (2.1 to 3.0 centimeters) of scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	6	
17273	"Destruction of malignant growth (2.1 to 3.0 centimeters) of scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17274	"Destruction of malignant growth (3.1 to 4.0 centimeters) of scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	6	
17274	"Destruction of malignant growth (3.1 to 4.0 centimeters) of scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17276	"Destruction of malignant growth (over 4.0 centimeters) of scalp, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	6	
17276	"Destruction of malignant growth (over 4.0 centimeters) of scalp, neck, hands, feet, or genitals"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17280	"Destruction of malignant growth (0.5 centimeters or less) of face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	32	6	
17280	"Destruction of malignant growth (0.5 centimeters or less) of face, ears, eyelids, nose, lips, or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17281	"Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	6	
17281	"Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17282	"Destruction of malignant growth (1.1 to 2.0 centimeters) of face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	6	
17282	"Destruction of malignant growth (1.1 to 2.0 centimeters) of face, ears, eyelids, nose, lips, or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17283	"Destruction of malignant growth (2.1 to 3.0 centimeters) of face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	6	
17283	"Destruction of malignant growth (2.1 to 3.0 centimeters) of face, ears, eyelids, nose, lips, or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17284	"Destruction of malignant growth (3.1 to 4.0 centimeters) of face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	6	
17284	"Destruction of malignant growth (3.1 to 4.0 centimeters) of face, ears, eyelids, nose, lips, or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17286	"Destruction of malignant growth (over 4.0 centimeters) of face, ears, eyelids, nose, lips, or mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	6	
17286	"Destruction of malignant growth (over 4.0 centimeters) of face, ears, eyelids, nose, lips, or mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
17311	"Removal and microscopic examination of growth of the head, neck, hands, feet, or genitals (first stage, up to 5 tissue blocks)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15	0	
17311	"Removal and microscopic examination of growth of the head, neck, hands, feet, or genitals (first stage, up to 5 tissue blocks)"	Service  intra	L037B	Histotechnologist	0.37	Service total costs	109	0	
17311	"Removal and microscopic examination of growth of the head, neck, hands, feet, or genitals (first stage, up to 5 tissue blocks)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	99	0	
17312	"Removal and microscopic examination of growth of the head, neck, hands, feet, or genitals"	Service  intra	L037B	Histotechnologist	0.37	Service total costs	70	0	
17312	"Removal and microscopic examination of growth of the head, neck, hands, feet, or genitals"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	0	
17313	"Removal and microscopic examination of growth of the trunk, arms, or legs (first stage, up to 5 tissue blocks)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15	0	
17313	"Removal and microscopic examination of growth of the trunk, arms, or legs (first stage, up to 5 tissue blocks)"	Service  intra	L037B	Histotechnologist	0.37	Service total costs	109	0	
17313	"Removal and microscopic examination of growth of the trunk, arms, or legs (first stage, up to 5 tissue blocks)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	95	0	
17314	"Removal and microscopic examination of growth of the trunk, arms, or legs"	Service  intra	L037B	Histotechnologist	0.37	Service total costs	70	0	
17314	"Removal and microscopic examination of growth of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	0	
17315	"Removal and microscopic examination of growth of the trunk, arms, or legs"	Service  intra	L037B	Histotechnologist	0.37	Service total costs	21	0	
17315	"Removal and microscopic examination of growth of the trunk, arms, or legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
17340	Chemical treatment of acne	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	10	6	
17340	Chemical treatment of acne	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	8	
17360	Chemical treatment of acne	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	6	
17360	Chemical treatment of acne	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	14	14	
19000	Aspiration of breast cyst	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	30	0	
19001	Puncture aspiration of breast cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	7	0	
19020	Drainage of breast abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
19020	Drainage of breast abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	83	6	
19020	Drainage of breast abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
19030	Injection for X-ray imaging of breast duct	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	50	0	
19081	Biopsy of breast accessed through the skin with stereotactic guidance	Pre-service	L043A	Mammography Technologist	0.43	Preservice total costs	3	0	
19081	Biopsy of breast accessed through the skin with stereotactic guidance	Service  intra	L043A	Mammography Technologist	0.43	Service total costs	71	0	
19081	Biopsy of breast accessed through the skin with stereotactic guidance	Post-service	L043A	Mammography Technologist	0.43	Post service total costs	3	0	
19082	Biopsy of breast accessed through the skin with stereotactic guidance	Service  intra	L043A	Mammography Technologist	0.43	Service total costs	46	0	
19083	Biopsy of breast accessed through the skin with ultrasound guidance	Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Preservice total costs	3	0	
19083	Biopsy of breast accessed through the skin with ultrasound guidance	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	66	0	
19083	Biopsy of breast accessed through the skin with ultrasound guidance	Post-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Post service total costs	3	0	
19084	Biopsy of breast accessed through the skin with ultrasound guidance	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	41	0	
19085	Biopsy of breast accessed through the skin with MRI guidance	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	3	0	
19085	Biopsy of breast accessed through the skin with MRI guidance	Service  intra	L047A	MRI Technologist	0.47	Service total costs	86	0	
19085	Biopsy of breast accessed through the skin with MRI guidance	Post-service	L047A	MRI Technologist	0.47	Post service total costs	3	0	
19086	Biopsy of breast accessed through the skin with MRI guidance	Service  intra	L047A	MRI Technologist	0.47	Service total costs	59	0	
19100	Needle biopsy of breast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
19101	"Biopsy of breast, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15	0	
19101	"Biopsy of breast, open procedure"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	30	6	
19101	"Biopsy of breast, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	6	
19101	"Biopsy of breast, open procedure"	Post-service	L026A	Medical/Technical Assistant	0.26	Post service total costs	0	27	
19101	"Biopsy of breast, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
19105	Freezing of breast growth using ultrasound guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	12	
19105	Freezing of breast growth using ultrasound guidance	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	45	0	
19105	Freezing of breast growth using ultrasound guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	0	
19105	Freezing of breast growth using ultrasound guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
19110	Exploration of breast nipple	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
19110	Exploration of breast nipple	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	77	6	
19110	Exploration of breast nipple	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
19112	Removal of abnormal drainage of breast duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
19112	Removal of abnormal drainage of breast duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	72	6	
19112	Removal of abnormal drainage of breast duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
19120	"Removal of 1 or more breast growth, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
19120	"Removal of 1 or more breast growth, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	97	6	
19120	"Removal of 1 or more breast growth, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
19125	"Removal of breast growth, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
19125	"Removal of breast growth, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	112	6	
19125	"Removal of breast growth, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	72	72	
19260	Removal of growth of chest wall and ribs	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19260	Removal of growth of chest wall and ribs	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
19260	Removal of growth of chest wall and ribs	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
19271	Removal of growth of chest wall and ribs	Pre-service	L051A	RN	0.51	Preservice total costs		60	
19271	Removal of growth of chest wall and ribs	Service  intra	L051A	RN	0.51	Service total costs		12	
19271	Removal of growth of chest wall and ribs	Post-service	L051A	RN	0.51	Post service total costs		234	
19272	Removal of growth and lymph nodes of chest wall and ribs	Pre-service	L051A	RN	0.51	Preservice total costs		60	
19272	Removal of growth and lymph nodes of chest wall and ribs	Service  intra	L051A	RN	0.51	Service total costs		12	
19272	Removal of growth and lymph nodes of chest wall and ribs	Post-service	L051A	RN	0.51	Post service total costs		252	
19281	Placement of breast localization devices accessed through the skin with mammographic guidance	Pre-service	L043A	Mammography Technologist	0.43	Preservice total costs	3	0	
19281	Placement of breast localization devices accessed through the skin with mammographic guidance	Service  intra	L043A	Mammography Technologist	0.43	Service total costs	64	0	
19282	Placement of breast localization devices accessed through the skin with mammographic guidance	Service  intra	L043A	Mammography Technologist	0.43	Service total costs	47	0	
19283	Placement of breast localization devices accessed through the skin with stereotactic guidance	Pre-service	L043A	Mammography Technologist	0.43	Preservice total costs	3	0	
19283	Placement of breast localization devices accessed through the skin with stereotactic guidance	Service  intra	L043A	Mammography Technologist	0.43	Service total costs	55	0	
19284	Placement of breast localization devices accessed through the skin with stereotactic guidance	Service  intra	L043A	Mammography Technologist	0.43	Service total costs	36	0	
19285	Placement of breast localization devices accessed through the skin with ultrasound guidance	Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Preservice total costs	3	0	
19285	Placement of breast localization devices accessed through the skin with ultrasound guidance	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	49	0	
19286	Placement of breast localization devices accessed through the skin with ultrasound guidance	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	30	0	
19287	Placement of breast localization devices accessed through the skin with MRI guidance	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	3	0	
19287	Placement of breast localization devices accessed through the skin with MRI guidance	Service  intra	L047A	MRI Technologist	0.47	Service total costs	71	0	
19287	Placement of breast localization devices accessed through the skin with MRI guidance	Post-service	L047A	MRI Technologist	0.47	Post service total costs	3	0	
19288	Placement of breast localization devices accessed through the skin with MRI guidance	Service  intra	L047A	MRI Technologist	0.47	Service total costs	46	0	
19296	Insertion of catheter into breast for radiation therapy using imaging guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	18	
19296	Insertion of catheter into breast for radiation therapy using imaging guidance	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	47	0	
19296	Insertion of catheter into breast for radiation therapy using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	19	0	
19296	Insertion of catheter into breast for radiation therapy using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
19298	Insertion of catheters into breast for radiation therapy with or after breast removal using imaging guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	18	
19298	Insertion of catheters into breast for radiation therapy with or after breast removal using imaging guidance	Service  intra	L051A	RN	0.51	Service total costs	77	0	
19298	Insertion of catheters into breast for radiation therapy with or after breast removal using imaging guidance	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	81	0	
19298	Insertion of catheters into breast for radiation therapy with or after breast removal using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
19298	Insertion of catheters into breast for radiation therapy with or after breast removal using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
19300	Removal of extra breast tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
19300	Removal of extra breast tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	68	6	
19300	Removal of extra breast tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
19301	Partial removal of breast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19301	Partial removal of breast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
19301	Partial removal of breast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
19302	Partial removal of breast and underarm lymph nodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19302	Partial removal of breast and underarm lymph nodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
19302	Partial removal of breast and underarm lymph nodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116.5	
19303	Total removal of breast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19303	Total removal of breast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
19303	Total removal of breast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
19304	"Removal of tumor and breast tissue, accessed beneath the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19304	"Removal of tumor and breast tissue, accessed beneath the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
19304	"Removal of tumor and breast tissue, accessed beneath the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
19305	"Removal of breast, lymph nodes, and muscle"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19305	"Removal of breast, lymph nodes, and muscle"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
19305	"Removal of breast, lymph nodes, and muscle"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
19306	"Removal of breast, skin, lymph nodes, and chest muscles"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19306	"Removal of breast, skin, lymph nodes, and chest muscles"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
19306	"Removal of breast, skin, lymph nodes, and chest muscles"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		198	
19307	Removal of breast and underarm lymph nodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19307	Removal of breast and underarm lymph nodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
19307	Removal of breast and underarm lymph nodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		198	
19316	Enlargement of breast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19316	Enlargement of breast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
19316	Enlargement of breast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
19318	Repositioning of breast on chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19318	Repositioning of breast on chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
19318	Repositioning of breast on chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
19324	Enlargement of breast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19324	Enlargement of breast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
19324	Enlargement of breast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
19325	Enlargement of breast with insertion of prosthetic implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19325	Enlargement of breast with insertion of prosthetic implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
19325	Enlargement of breast with insertion of prosthetic implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
19328	Removal of intact breast implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19328	Removal of intact breast implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
19328	Removal of intact breast implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
19330	Removal of mammary implant material	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19330	Removal of mammary implant material	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
19330	Removal of mammary implant material	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
19340	"Insertion of breast prosthesis at time of breast repositioning, removal or reconstruction"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19340	"Insertion of breast prosthesis at time of breast repositioning, removal or reconstruction"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
19340	"Insertion of breast prosthesis at time of breast repositioning, removal or reconstruction"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
19342	"Insertion of breast prosthesis following breast repositioning, removal or reconstruction"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19342	"Insertion of breast prosthesis following breast repositioning, removal or reconstruction"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
19342	"Insertion of breast prosthesis following breast repositioning, removal or reconstruction"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
19350	Reconstruction of nipple or area around nipple	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
19350	Reconstruction of nipple or area around nipple	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	125	6	
19350	Reconstruction of nipple or area around nipple	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
19355	Correction of inverted nipples of breast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
19355	Correction of inverted nipples of breast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	105	6	
19355	Correction of inverted nipples of breast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
19357	Insertion of tissue expander in breast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19357	Insertion of tissue expander in breast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
19357	Insertion of tissue expander in breast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		341	
19361	Plastic surgery to reconstruct breast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19361	Plastic surgery to reconstruct breast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
19361	Plastic surgery to reconstruct breast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		153	
19364	Plastic surgery to reconstruct breast with muscle flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19364	Plastic surgery to reconstruct breast with muscle flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
19364	Plastic surgery to reconstruct breast with muscle flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		158	
19366	Plastic surgery to reconstruct breast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19366	Plastic surgery to reconstruct breast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
19366	Plastic surgery to reconstruct breast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
19367	Plastic surgery to reconstruct breast with abdominal muscle flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19367	Plastic surgery to reconstruct breast with abdominal muscle flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
19367	Plastic surgery to reconstruct breast with abdominal muscle flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
19368	Plastic surgery to reconstruct breast with muscle and blood vessel flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19368	Plastic surgery to reconstruct breast with muscle and blood vessel flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
19368	Plastic surgery to reconstruct breast with muscle and blood vessel flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
19369	Plastic surgery to reconstruct breast with double abdominal muscle flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19369	Plastic surgery to reconstruct breast with double abdominal muscle flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
19369	Plastic surgery to reconstruct breast with double abdominal muscle flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
19370	"Incision of capsule surrounding breast with freeing of scar tissue, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19370	"Incision of capsule surrounding breast with freeing of scar tissue, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
19370	"Incision of capsule surrounding breast with freeing of scar tissue, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
19371	Removal of capsule surrounding breast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19371	Removal of capsule surrounding breast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
19371	Removal of capsule surrounding breast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
19380	Revision of reconstructed breast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
19380	Revision of reconstructed breast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
19380	Revision of reconstructed breast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
19396	Preparation of mold for custom breast implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	23	
19396	Preparation of mold for custom breast implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	37	0	
20005	Incision and drainage of soft tissue abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
20005	Incision and drainage of soft tissue abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	79	12	
20005	Incision and drainage of soft tissue abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
20100	Exploration of penetrating wound of neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20100	Exploration of penetrating wound of neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
20101	Exploration of penetrating wound of chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	8	
20101	Exploration of penetrating wound of chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	12	
20101	Exploration of penetrating wound of chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	16	16	
20102	"Exploration of penetrating wound of abdomen, flank, or back"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	8	
20102	"Exploration of penetrating wound of abdomen, flank, or back"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	12	
20102	"Exploration of penetrating wound of abdomen, flank, or back"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
20103	Exploration of penetrating wound of arm or leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
20103	Exploration of penetrating wound of arm or leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	96	6	
20103	Exploration of penetrating wound of arm or leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
20150	Removal of growth plate	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20150	Removal of growth plate	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20150	Removal of growth plate	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
20200	Biopsy of muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	19	
20200	Biopsy of muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
20200	Biopsy of muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
20205	Deep biopsy of muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
20205	Deep biopsy of muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	0	
20205	Deep biopsy of muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
20206	"Needle biopsy of muscle, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
20206	"Needle biopsy of muscle, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	0	
20206	"Needle biopsy of muscle, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
20220	Biopsy of bone using needle or trocar	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
20220	Biopsy of bone using needle or trocar	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
20220	Biopsy of bone using needle or trocar	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
20225	Deep biopsy of bone using needle or trocar	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
20225	Deep biopsy of bone using needle or trocar	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	66	0	
20225	Deep biopsy of bone using needle or trocar	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
20240	"Biopsy of bone, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
20240	"Biopsy of bone, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
20240	"Biopsy of bone, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		0	
20240	"Biopsy of bone, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
20240	"Biopsy of bone, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
20240	"Biopsy of bone, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
20245	"Biopsy of bone, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
20245	"Biopsy of bone, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
20245	"Biopsy of bone, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
20245	"Biopsy of bone, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
20245	"Biopsy of bone, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
20250	"Biopsy of spine bone at middle spinal column, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20250	"Biopsy of spine bone at middle spinal column, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20250	"Biopsy of spine bone at middle spinal column, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
20251	"Biopsy of spine bone at upper or lower spinal column, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20251	"Biopsy of spine bone at upper or lower spinal column, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20251	"Biopsy of spine bone at upper or lower spinal column, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
20500		Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	14	
20500		Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25	0	
20500		Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
20501	Injection of abnormal muscle drainage tract for X-ray study	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	36	0	
20520	Removal of foreign body in muscle or tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
20520	Removal of foreign body in muscle or tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	6	
20520	Removal of foreign body in muscle or tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
20525	Removal of deep foreign body in muscle or tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
20525	Removal of deep foreign body in muscle or tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	89	6	
20525	Removal of deep foreign body in muscle or tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
20526	Injection of carpal tunnel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
20526	Injection of carpal tunnel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	5	
20527	Injection of enzyme in palm tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	11	
20527	Injection of enzyme in palm tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
20550	"Injections of tendon sheath, ligament, or muscle membrane"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
20550	"Injections of tendon sheath, ligament, or muscle membrane"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	5	
20551	Injections of tendon attachment to bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
20551	Injections of tendon attachment to bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	5	
20552	Injections of trigger points in 1 or 2 muscles	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
20552	Injections of trigger points in 1 or 2 muscles	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	5	
20553	Injections of trigger points in 3 or more muscles	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	31	0	
20553	Injections of trigger points in 3 or more muscles	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	5	
20555	Insertion of needles or catheters into muscle and/or tissue for radiation therapy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
20555	Insertion of needles or catheters into muscle and/or tissue for radiation therapy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
20600	Aspiration and/or injection of small joint or joint capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	16	0	
20600	Aspiration and/or injection of small joint or joint capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
20604	"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting"	Pre-service	L037D	RN/LPN/MTA	0.37	Retrieve prior images for comparison	3		
20604	"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	3		
20604	"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
20604	"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
20604	"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	10		
20604	"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
20604	"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
20604	"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting"	Service  post	L037D	RN/LPN/MTA	0.37	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
20604	"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting"	Service  post	L037D	RN/LPN/MTA	0.37	Review examination with interpreting MD	2		
20604	"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting"	Service  post	L037D	RN/LPN/MTA	0.37	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	1		
20604	"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	0	0	
20605	Aspiration and/or injection of medium joint or joint capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	16	0	
20605	Aspiration and/or injection of medium joint or joint capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
20606	"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting"	Pre-service	L037D	RN/LPN/MTA	0.37	Retrieve prior images for comparison	3		
20606	"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	3		
20606	"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
20606	"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
20606	"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	10		
20606	"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
20606	"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
20606	"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting"	Service  post	L037D	RN/LPN/MTA	0.37	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
20606	"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting"	Service  post	L037D	RN/LPN/MTA	0.37	Review examination with interpreting MD	2		
20606	"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting"	Service  post	L037D	RN/LPN/MTA	0.37	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	1		
20606	"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	0	0	
20610	Aspiration and/or injection of large joint or joint capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	16	0	
20610	Aspiration and/or injection of large joint or joint capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
20611	"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, joint subacromial bursa); with ultrasound guidance, with permanent recording and reporting"	Pre-service	L037D	RN/LPN/MTA	0.37	Retrieve prior images for comparison	3		
20611	"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, joint subacromial bursa); with ultrasound guidance, with permanent recording and reporting"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	3		
20611	"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, joint subacromial bursa); with ultrasound guidance, with permanent recording and reporting"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
20611	"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, joint subacromial bursa); with ultrasound guidance, with permanent recording and reporting"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
20611	"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, joint subacromial bursa); with ultrasound guidance, with permanent recording and reporting"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	10		
20611	"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, joint subacromial bursa); with ultrasound guidance, with permanent recording and reporting"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
20611	"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, joint subacromial bursa); with ultrasound guidance, with permanent recording and reporting"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
20611	"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, joint subacromial bursa); with ultrasound guidance, with permanent recording and reporting"	Service  post	L037D	RN/LPN/MTA	0.37	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
20611	"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, joint subacromial bursa); with ultrasound guidance, with permanent recording and reporting"	Service  post	L037D	RN/LPN/MTA	0.37	Review examination with interpreting MD	2		
20611	"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, joint subacromial bursa); with ultrasound guidance, with permanent recording and reporting"	Service  post	L037D	RN/LPN/MTA	0.37	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	1		
20611	"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, joint subacromial bursa); with ultrasound guidance, with permanent recording and reporting"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	0	0	
20612	Aspiration and/or injection of cysts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
20612	Aspiration and/or injection of cysts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	8	
20615	Aspiration and injection treatment of bone cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
20615	Aspiration and injection treatment of bone cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	6	
20615	Aspiration and injection treatment of bone cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
20650	Insertion and removal of wire or pin with bone traction	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
20650	Insertion and removal of wire or pin with bone traction	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	6	
20650	Insertion and removal of wire or pin with bone traction	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
20661	Application of cranial halo device (stabilization device for skull)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20661	Application of cranial halo device (stabilization device for skull)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20661	Application of cranial halo device (stabilization device for skull)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
20662	Application of pelvic halo device (stabilization device for pelvis)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20662	Application of pelvic halo device (stabilization device for pelvis)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20662	Application of pelvic halo device (stabilization device for pelvis)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
20663	Application of groin halo device (stabilization device for groin)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20663	Application of groin halo device (stabilization device for groin)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
20663	Application of groin halo device (stabilization device for groin)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
20664	Application of cranial halo (stabilization device for skull)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20664	Application of cranial halo (stabilization device for skull)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20664	Application of cranial halo (stabilization device for skull)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
20665	Removal of cranial tongs or halo (stabilization device for skull)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	10	15	
20665	Removal of cranial tongs or halo (stabilization device for skull)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	34	12	
20665	Removal of cranial tongs or halo (stabilization device for skull)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
20670	Removal of bone implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
20670	Removal of bone implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	69	6	
20670	Removal of bone implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
20680	Removal of deep bone implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
20680	Removal of deep bone implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	72	6	
20680	Removal of deep bone implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
20690	Application of uniplane external bone fixation on one arm or leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20690	Application of uniplane external bone fixation on one arm or leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
20692	Application of multiplane external bone fixation system on one arm or leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20692	Application of multiplane external bone fixation system on one arm or leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20692	Application of multiplane external bone fixation system on one arm or leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		216	
20693	Adjustment or revision of external bone fixation system under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20693	Adjustment or revision of external bone fixation system under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20693	Adjustment or revision of external bone fixation system under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
20694	Removal of external bone fixation under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
20694	Removal of external bone fixation under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	6	
20694	Removal of external bone fixation under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
20696	Application of multiplane external bone fixation system on one arm or leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20696	Application of multiplane external bone fixation system on one arm or leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20696	Application of multiplane external bone fixation system on one arm or leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		189	
20697	"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0		
20697	"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	0		
20697	"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	0		
20697	"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	0		
20697	"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0		
20697	"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
20697	"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
20697	"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
20697	"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	10		
20697	"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	2		
20697	"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	3		
20697	"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	0	0	
20802	Replantation of amputated arm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20802	Replantation of amputated arm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
20802	Replantation of amputated arm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		242	
20805	Replantation of amputated lower arm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20805	Replantation of amputated lower arm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20805	Replantation of amputated lower arm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		242	
20808	Replantation of amputated hand	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20808	Replantation of amputated hand	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20808	Replantation of amputated hand	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		242	
20816	Replantation of amputated finger at junction of hand bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20816	Replantation of amputated finger at junction of hand bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
20816	Replantation of amputated finger at junction of hand bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
20822	Replantation of amputated finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20822	Replantation of amputated finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
20822	Replantation of amputated finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		189	
20824	Replantation of amputated thumb	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20824	Replantation of amputated thumb	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20824	Replantation of amputated thumb	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
20827	Replantation of amputated thumb	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20827	Replantation of amputated thumb	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
20827	Replantation of amputated thumb	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		189	
20838	Replantation of amputated foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20838	Replantation of amputated foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
20838	Replantation of amputated foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		242	
20900	Small bone graft harvest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	30	
20900	Small bone graft harvest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	72	0	
20902	Bone graft harvest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
20910	Rib cartilage graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20910	Rib cartilage graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
20910	Rib cartilage graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
20912	Nasal cartilage graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20912	Nasal cartilage graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
20912	Nasal cartilage graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
20920	Obtaining deep thigh tissue for graft using stripper	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20920	Obtaining deep thigh tissue for graft using stripper	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20920	Obtaining deep thigh tissue for graft using stripper	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
20922	Incision of deep thigh tissue for graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
20922	Incision of deep thigh tissue for graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	85	12	
20922	Incision of deep thigh tissue for graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
20924	Tendon graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20924	Tendon graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
20924	Tendon graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
20926	Tissue graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20926	Tissue graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20926	Tissue graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
20950	Insertion of device to monitor muscle compartment fluid pressure	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
20950	Insertion of device to monitor muscle compartment fluid pressure	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
20950	Insertion of device to monitor muscle compartment fluid pressure	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
20955	Bone graft at lower leg with microvascular connection	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20955	Bone graft at lower leg with microvascular connection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20955	Bone graft at lower leg with microvascular connection	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		189	
20956	Bone graft of pelvic bone with microvascular connection	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20956	Bone graft of pelvic bone with microvascular connection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20956	Bone graft of pelvic bone with microvascular connection	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		207	
20957	Bone graft of foot bone with microvascular connection	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20957	Bone graft of foot bone with microvascular connection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20957	Bone graft of foot bone with microvascular connection	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		234	
20962	Bone graft with microvascular connection	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20962	Bone graft with microvascular connection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20962	Bone graft with microvascular connection	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		394	
20969	Placement of skin and bone flap with microvascular connection	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20969	Placement of skin and bone flap with microvascular connection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20969	Placement of skin and bone flap with microvascular connection	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		232	
20970	Placement of skin and bone flap to pelvic bone with microvascular connection	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20970	Placement of skin and bone flap to pelvic bone with microvascular connection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
20970	Placement of skin and bone flap to pelvic bone with microvascular connection	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		232	
20972	Placement of skin and bone flap to foot with microvascular connection	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20972	Placement of skin and bone flap to foot with microvascular connection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
20972	Placement of skin and bone flap to foot with microvascular connection	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		232	
20973	Placement of skin and bone flap to toe bone and web space with microvascular connection	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
20973	Placement of skin and bone flap to toe bone and web space with microvascular connection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
20973	Placement of skin and bone flap to toe bone and web space with microvascular connection	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		232	
20974	Placement of electrical bone healing device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	18	
20974	Placement of electrical bone healing device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	33	0	
20974	Placement of electrical bone healing device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
20975	Invasive electrical stimulation to aid bone healing	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
20975	Invasive electrical stimulation to aid bone healing	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
20979	"Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative)"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	45	0	
20982	Ablation therapy for reduction or eradication of 1 or more bone tumors	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	6	0	
20982	Ablation therapy for reduction or eradication of 1 or more bone tumors	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	23	
20982	Ablation therapy for reduction or eradication of 1 or more bone tumors	Service  intra	L046A	CT Technologist	0.46	Service total costs	152	0	
20982	Ablation therapy for reduction or eradication of 1 or more bone tumors	Service  intra	L051A	RN	0.51	Service total costs	97	0	
20982	Ablation therapy for reduction or eradication of 1 or more bone tumors	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	5	5	
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	10	
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Pre-service	L046A	CT Technologist	0.46	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	6		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	7	7	
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  pre	L046A	CT Technologist	0.46	Prepare and position pt/ monitor pt/ set up IV	2		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  pre	L046A	CT Technologist	0.46	"Prepare room, equipment, supplies"	6		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  intra	L046A	CT Technologist	0.46	Acquire images (75%)	86		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  intra	L046A	CT Technologist	0.46	Assist physician	115		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  intra	L051A	RN	0.51	Assist physician in performing procedure	115		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	29		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  post	L037D	RN/LPN/MTA	0.37	Clean RFA equipment	3		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  post	L046A	CT Technologist	0.46	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Service  post	L046A	CT Technologist	0.46	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
20983	Ablation  therapy for reduction or eradication of 1 or more bone tumors; cryoablation	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
21010	Incision of jaw temporomandibular joint (TMJ)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21010	Incision of jaw temporomandibular joint (TMJ)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21010	Incision of jaw temporomandibular joint (TMJ)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
21011	Removal of (less than 2 centimeter) tissue growth beneath the skin of face and scalp	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21011	Removal of (less than 2 centimeter) tissue growth beneath the skin of face and scalp	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
21011	Removal of (less than 2 centimeter) tissue growth beneath the skin of face and scalp	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
21012	Removal of (2 centimeters or greater) tissue growth beneath the skin of face and scalp	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21012	Removal of (2 centimeters or greater) tissue growth beneath the skin of face and scalp	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21012	Removal of (2 centimeters or greater) tissue growth beneath the skin of face and scalp	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
21013	Removal of (less than 2 centimeters) muscle growth of face and scalp	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21013	Removal of (less than 2 centimeters) muscle growth of face and scalp	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	6	
21013	Removal of (less than 2 centimeters) muscle growth of face and scalp	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
21014	Removal of (2 centimeters or greater) muscle growth of face and scalp	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21014	Removal of (2 centimeters or greater) muscle growth of face and scalp	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21014	Removal of (2 centimeters or greater) muscle growth of face and scalp	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
21015	Removal of (less than 2 centimeters) soft tissue growth of face or scalp	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21015	Removal of (less than 2 centimeters) soft tissue growth of face or scalp	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21015	Removal of (less than 2 centimeters) soft tissue growth of face or scalp	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
21016	Removal of (2 centimeters or greater) soft tissue growth of face or scalp	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21016	Removal of (2 centimeters or greater) soft tissue growth of face or scalp	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21016	Removal of (2 centimeters or greater) soft tissue growth of face or scalp	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
21025	Removal of lower jaw bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21025	Removal of lower jaw bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	132	6	
21025	Removal of lower jaw bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
21026	Removal of facial bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21026	Removal of facial bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	102	12	
21026	Removal of facial bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
21029	Removal of facial bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21029	Removal of facial bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	102	6	
21029	Removal of facial bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	99	99	
21030	Removal or scraping of upper jaw or cheek bone growth or cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21030	Removal or scraping of upper jaw or cheek bone growth or cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	6	
21030	Removal or scraping of upper jaw or cheek bone growth or cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
21031	Removal of bony growth of jaw bone inside mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21031	Removal of bony growth of jaw bone inside mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	72	6	
21031	Removal of bony growth of jaw bone inside mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
21032	Removal of bony growth of upper jaw bone inside mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21032	Removal of bony growth of upper jaw bone inside mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	87	6	
21032	Removal of bony growth of upper jaw bone inside mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
21034	Removal of malignant growth of upper jaw or cheek bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21034	Removal of malignant growth of upper jaw or cheek bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	162	12	
21034	Removal of malignant growth of upper jaw or cheek bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	152	152	
21040	Removal and/or scraping of lower jaw bone growth or cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21040	Removal and/or scraping of lower jaw bone growth or cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	79	6	
21040	Removal and/or scraping of lower jaw bone growth or cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
21044	Removal of malignant growth of lower jaw bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21044	Removal of malignant growth of lower jaw bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21044	Removal of malignant growth of lower jaw bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		143	
21045	Removal of malignant growth of jaw bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21045	Removal of malignant growth of jaw bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21045	Removal of malignant growth of jaw bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		179	
21046	Oral removal of lower jaw bone growth or cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21046	Oral removal of lower jaw bone growth or cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21046	Oral removal of lower jaw bone growth or cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		189	
21047	External removal of lower jaw bone growth or cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21047	External removal of lower jaw bone growth or cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21047	External removal of lower jaw bone growth or cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		189	
21048	Oral removal of upper jaw bone growth or cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21048	Oral removal of upper jaw bone growth or cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21048	Oral removal of upper jaw bone growth or cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		189	
21049	External removal of upper jaw bone growth or cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21049	External removal of upper jaw bone growth or cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21049	External removal of upper jaw bone growth or cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		189	
21050	Removal of hinged joint of upper and lower jaw bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21050	Removal of hinged joint of upper and lower jaw bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21050	Removal of hinged joint of upper and lower jaw bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		170	
21060	Removal of cartilage of hinged joint of upper and lower jaw bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21060	Removal of cartilage of hinged joint of upper and lower jaw bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21060	Removal of cartilage of hinged joint of upper and lower jaw bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
21070	Removal of diseased or fractured portion of lower jaw bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21070	Removal of diseased or fractured portion of lower jaw bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21070	Removal of diseased or fractured portion of lower jaw bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
21073	Manipulation of hinged joints of upper and lower jaw bones under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	0	
21073	Manipulation of hinged joints of upper and lower jaw bones under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	0	
21073	Manipulation of hinged joints of upper and lower jaw bones under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	117	0	
21076	Impression and custom preparation of oral prosthesis for use during surgery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	35	
21076	Impression and custom preparation of oral prosthesis for use during surgery	Service  intra	L033A	Lab Technician	0.33	Service total costs	150	0	
21076	Impression and custom preparation of oral prosthesis for use during surgery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	81	0	
21076	Impression and custom preparation of oral prosthesis for use during surgery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	16	
21077	Impression and preparation of eye socket prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21077	Impression and preparation of eye socket prosthesis	Service  intra	L033A	Lab Technician	0.33	Service total costs	380	0	
21077	Impression and preparation of eye socket prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	173	0	
21077	Impression and preparation of eye socket prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	32	48	
21079	Impression and custom preparation of temporary oral prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21079	Impression and custom preparation of temporary oral prosthesis	Service  intra	L033A	Lab Technician	0.33	Service total costs	260	0	
21079	Impression and custom preparation of temporary oral prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	187	0	
21079	Impression and custom preparation of temporary oral prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	48	48	
21080	Impression and custom preparation of permanent oral prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21080	Impression and custom preparation of permanent oral prosthesis	Service  intra	L033A	Lab Technician	0.33	Service total costs	285	0	
21080	Impression and custom preparation of permanent oral prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	257	0	
21080	Impression and custom preparation of permanent oral prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	48	48	
21081	Impression and custom preparation of lower jaw bone prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21081	Impression and custom preparation of lower jaw bone prosthesis	Service  intra	L033A	Lab Technician	0.33	Service total costs	225	0	
21081	Impression and custom preparation of lower jaw bone prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	272	0	
21081	Impression and custom preparation of lower jaw bone prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	48	48	
21082	Impression and custom preparation of prosthesis for roof of mouth enlargement	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21082	Impression and custom preparation of prosthesis for roof of mouth enlargement	Service  intra	L033A	Lab Technician	0.33	Service total costs	245	0	
21082	Impression and custom preparation of prosthesis for roof of mouth enlargement	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	263	0	
21082	Impression and custom preparation of prosthesis for roof of mouth enlargement	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	87	97	
21083	Impression and custom preparation of roof of mouth prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21083	Impression and custom preparation of roof of mouth prosthesis	Service  intra	L033A	Lab Technician	0.33	Service total costs	220	0	
21083	Impression and custom preparation of roof of mouth prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	313	0	
21083	Impression and custom preparation of roof of mouth prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	97	97	
21084	Impression and custom preparation of speech aid prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21084	Impression and custom preparation of speech aid prosthesis	Service  intra	L033A	Lab Technician	0.33	Service total costs	245	0	
21084	Impression and custom preparation of speech aid prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	343	0	
21084	Impression and custom preparation of speech aid prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	97	97	
21085	Impression and custom preparation of outer ear prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	35	
21085	Impression and custom preparation of outer ear prosthesis	Service  intra	L033A	Lab Technician	0.33	Service total costs	75	0	
21085	Impression and custom preparation of outer ear prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	170	0	
21085	Impression and custom preparation of outer ear prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
21086	Impression and custom preparation of outer ear prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21086	Impression and custom preparation of outer ear prosthesis	Service  intra	L033A	Lab Technician	0.33	Service total costs	275	0	
21086	Impression and custom preparation of outer ear prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	89	0	
21086	Impression and custom preparation of outer ear prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	16	16	
21087	Impression and custom preparation of nasal prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21087	Impression and custom preparation of nasal prosthesis	Service  intra	L033A	Lab Technician	0.33	Service total costs	275	0	
21087	Impression and custom preparation of nasal prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	89	0	
21087	Impression and custom preparation of nasal prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	16	16	
21100	Application and removal of facial and cheek bone halo device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21100	Application and removal of facial and cheek bone halo device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	116	6	
21100	Application and removal of facial and cheek bone halo device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
21110	Application and removal of dental fixation device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21110	Application and removal of dental fixation device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	140	6	
21110	Application and removal of dental fixation device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	153	153	
21116	Injection for X-ray imaging of hinged joint of upper and lower jaw bones	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	31	0	
21116	Injection for X-ray imaging of hinged joint of upper and lower jaw bones	Post-service	L041B	Radiologic Technologist	0.41	Post service total costs	3	0	
21120	Implantation of graft to enlarge chin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21120	Implantation of graft to enlarge chin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	102	6	
21120	Implantation of graft to enlarge chin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
21121	Insertion of sliding bone graft to enlarge chin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21121	Insertion of sliding bone graft to enlarge chin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	111	12	
21121	Insertion of sliding bone graft to enlarge chin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
21122	Insertion of sliding bone grafts to enlarge chin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21122	Insertion of sliding bone grafts to enlarge chin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21122	Insertion of sliding bone grafts to enlarge chin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
21123	Insertion of sliding bone graft to enlarge chin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21123	Insertion of sliding bone graft to enlarge chin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21123	Insertion of sliding bone graft to enlarge chin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
21125	Insertion of prosthetic material to enlarge lower jaw bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21125	Insertion of prosthetic material to enlarge lower jaw bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	126	12	
21125	Insertion of prosthetic material to enlarge lower jaw bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
21127	Insertion of bone grafts between portions of bone to enlarge lower jaw bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21127	Insertion of bone grafts between portions of bone to enlarge lower jaw bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	206	12	
21127	Insertion of bone grafts between portions of bone to enlarge lower jaw bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
21137	Repair of bony defect of forehead	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21137	Repair of bony defect of forehead	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21137	Repair of bony defect of forehead	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
21138	Repair of bony defect of forehead with insertion of prosthetic material	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21138	Repair of bony defect of forehead with insertion of prosthetic material	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21138	Repair of bony defect of forehead with insertion of prosthetic material	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		115	
21139	Repair of frontal sinus through forehead	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21139	Repair of frontal sinus through forehead	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21139	Repair of frontal sinus through forehead	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
21141	Reconstruction of midface bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21141	Reconstruction of midface bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21141	Reconstruction of midface bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		233	
21142	Reconstruction of midface bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21142	Reconstruction of midface bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21142	Reconstruction of midface bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		233	
21143	Reconstruction of midface bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21143	Reconstruction of midface bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21143	Reconstruction of midface bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		233	
21145	Reconstruction of midface bones with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21145	Reconstruction of midface bones with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21145	Reconstruction of midface bones with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		216	
21146	Reconstruction of midface bones with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21146	Reconstruction of midface bones with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21146	Reconstruction of midface bones with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		234	
21147	Reconstruction of midface bones with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21147	Reconstruction of midface bones with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21147	Reconstruction of midface bones with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		234	
21150	Reconstruction of midface bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21150	Reconstruction of midface bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21150	Reconstruction of midface bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		158	
21151	Reconstruction of midface bones with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21151	Reconstruction of midface bones with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21151	Reconstruction of midface bones with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		158	
21154	Reconstruction of midface bones with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21154	Reconstruction of midface bones with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21154	Reconstruction of midface bones with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		185	
21155	Reconstruction of midface bones with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21155	Reconstruction of midface bones with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21155	Reconstruction of midface bones with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		185	
21159	Reconstruction of midface bones with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21159	Reconstruction of midface bones with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21159	Reconstruction of midface bones with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		185	
21160	Reconstruction of midface bones with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21160	Reconstruction of midface bones with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21160	Reconstruction of midface bones with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		185	
21172	Repair of bony defect of forehead and eye bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21172	Repair of bony defect of forehead and eye bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21172	Repair of bony defect of forehead and eye bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
21175	Repair of bony defect of lower forehead and both outer portions of eye bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21175	Repair of bony defect of lower forehead and both outer portions of eye bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21175	Repair of bony defect of lower forehead and both outer portions of eye bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
21179	Repair of bony defect of lower forehead and/or both upper portions of eye bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21179	Repair of bony defect of lower forehead and/or both upper portions of eye bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21179	Repair of bony defect of lower forehead and/or both upper portions of eye bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
21180	Reconstruction of forehead and/or eye bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21180	Reconstruction of forehead and/or eye bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21180	Reconstruction of forehead and/or eye bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
21181	Reconstruction of midface with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21181	Reconstruction of midface with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21181	Reconstruction of midface with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
21182	"Reconstruction of bony defect of skull, forehead, and both upper portions of eye bones with bone graft, total area of bone grafting less than 40 sq cm"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21182	"Reconstruction of bony defect of skull, forehead, and both upper portions of eye bones with bone graft, total area of bone grafting less than 40 sq cm"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21182	"Reconstruction of bony defect of skull, forehead, and both upper portions of eye bones with bone graft, total area of bone grafting less than 40 sq cm"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
21183	"Reconstruction of bony defect of skull, forehead, and both upper portions of eye bones with bone graft, total area of bone grafting greater than 40 sq cm but less than 80 sq cm"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21183	"Reconstruction of bony defect of skull, forehead, and both upper portions of eye bones with bone graft, total area of bone grafting greater than 40 sq cm but less than 80 sq cm"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21183	"Reconstruction of bony defect of skull, forehead, and both upper portions of eye bones with bone graft, total area of bone grafting greater than 40 sq cm but less than 80 sq cm"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
21184	"Reconstruction of bony defect of skull, forehead, and both upper portions of eye bones with bone graft, total area of bone grafting greater than 80 sq cm"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21184	"Reconstruction of bony defect of skull, forehead, and both upper portions of eye bones with bone graft, total area of bone grafting greater than 80 sq cm"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21184	"Reconstruction of bony defect of skull, forehead, and both upper portions of eye bones with bone graft, total area of bone grafting greater than 80 sq cm"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
21188	"Repair of bony defect of midface through scalp, eyelid, and oral incisions with bone graft"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21188	"Repair of bony defect of midface through scalp, eyelid, and oral incisions with bone graft"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21188	"Repair of bony defect of midface through scalp, eyelid, and oral incisions with bone graft"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		230	
21193	Reconstruction of jaw bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21193	Reconstruction of jaw bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21193	Reconstruction of jaw bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
21194	Reconstruction of jaw bones with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21194	Reconstruction of jaw bones with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21194	Reconstruction of jaw bones with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		198	
21195	Reconstruction of lower jaw bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21195	Reconstruction of lower jaw bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21195	Reconstruction of lower jaw bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		198	
21196	Reconstruction of jaw bones with insertion of hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21196	Reconstruction of jaw bones with insertion of hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21196	Reconstruction of jaw bones with insertion of hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		198	
21198	Incision of lower jaw bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21198	Incision of lower jaw bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21198	Incision of lower jaw bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
21199	Incision of lower jaw bone with advancement of tongue muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21199	Incision of lower jaw bone with advancement of tongue muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21199	Incision of lower jaw bone with advancement of tongue muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
21206	Incision and repositioning of cheek bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21206	Incision and repositioning of cheek bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21206	Incision and repositioning of cheek bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
21208	Incision and repair of bony defect of cheek bone with repositioning of bony segment	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21208	Incision and repair of bony defect of cheek bone with repositioning of bony segment	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	148	6	
21208	Incision and repair of bony defect of cheek bone with repositioning of bony segment	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	153	153	
21209	Incision and repair of bony defect of cheek bone including bony segment reduction	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21209	Incision and repair of bony defect of cheek bone including bony segment reduction	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	115	6	
21209	Incision and repair of bony defect of cheek bone including bony segment reduction	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	189	189	
21210	Repair of nasal or cheek bone with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21210	Repair of nasal or cheek bone with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	196	6	
21210	Repair of nasal or cheek bone with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	162	162	
21215	Repair of lower jaw bone with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21215	Repair of lower jaw bone with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	212	12	
21215	Repair of lower jaw bone with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	162	162	
21230	Harvest of rib cartilage for grafting	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21230	Harvest of rib cartilage for grafting	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21230	Harvest of rib cartilage for grafting	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
21235	Obtaining ear cartilage for grafting	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21235	Obtaining ear cartilage for grafting	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	143	6	
21235	Obtaining ear cartilage for grafting	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	153	153	
21240	Repair of hinged joint of upper and lower jaw bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21240	Repair of hinged joint of upper and lower jaw bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21240	Repair of hinged joint of upper and lower jaw bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		216	
21242	Repair of hinged joint of upper and lower jaw bones with donor graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21242	Repair of hinged joint of upper and lower jaw bones with donor graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21242	Repair of hinged joint of upper and lower jaw bones with donor graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		206	
21243	Repair of hinged joint of upper and lower jaw bones with prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21243	Repair of hinged joint of upper and lower jaw bones with prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21243	Repair of hinged joint of upper and lower jaw bones with prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		360	
21244	Reconstruction of lower jaw bone with insertion of bone plate	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21244	Reconstruction of lower jaw bone with insertion of bone plate	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21244	Reconstruction of lower jaw bone with insertion of bone plate	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		206	
21245	Partial repair of lower jaw or cheek bone with implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21245	Partial repair of lower jaw or cheek bone with implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	133	12	
21245	Partial repair of lower jaw or cheek bone with implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	153	153	
21246	Reconstruction of lower jaw or cheek bone with implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21246	Reconstruction of lower jaw or cheek bone with implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21246	Reconstruction of lower jaw or cheek bone with implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
21247	Reconstruction of hinged joint of jaw bones with insertion of rib cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21247	Reconstruction of hinged joint of jaw bones with insertion of rib cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21247	Reconstruction of hinged joint of jaw bones with insertion of rib cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		242	
21248	Partial reconstruction of lower jaw or cheek bone with insertion of implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21248	Partial reconstruction of lower jaw or cheek bone with insertion of implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	109	6	
21248	Partial reconstruction of lower jaw or cheek bone with insertion of implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
21249	Reconstruction of lower jaw or cheek bone with insertion of implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21249	Reconstruction of lower jaw or cheek bone with insertion of implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	178	12	
21249	Reconstruction of lower jaw or cheek bone with insertion of implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
21255	Reconstruction of cheek bone with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21255	Reconstruction of cheek bone with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21255	Reconstruction of cheek bone with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		242	
21256	Plastic reconstruction of eye socket bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21256	Plastic reconstruction of eye socket bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21256	Plastic reconstruction of eye socket bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		179	
21260	Plastic repositioning of eye socket bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21260	Plastic repositioning of eye socket bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21260	Plastic repositioning of eye socket bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		146	
21261	Repositioning of cheek bone prominence using prosthetic material	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21261	Repositioning of cheek bone prominence using prosthetic material	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21261	Repositioning of cheek bone prominence using prosthetic material	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		235	
21263	Repositioning of cheek bone prominence with forehead advancement	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21263	Repositioning of cheek bone prominence with forehead advancement	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21263	Repositioning of cheek bone prominence with forehead advancement	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		235	
21267	"Plastic repositioning of eye socket bones on one side of the face with bone grafts, extracranial approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21267	"Plastic repositioning of eye socket bones on one side of the face with bone grafts, extracranial approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21267	"Plastic repositioning of eye socket bones on one side of the face with bone grafts, extracranial approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		199	
21268	"Plastic repositioning of eye socket bones on one side of the face with bone grafts, extracranial approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21268	"Plastic repositioning of eye socket bones on one side of the face with bone grafts, extracranial approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21268	"Plastic repositioning of eye socket bones on one side of the face with bone grafts, extracranial approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		235	
21270	Insertion of prosthetic material to enlarge cheek bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21270	Insertion of prosthetic material to enlarge cheek bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	278	6	
21270	Insertion of prosthetic material to enlarge cheek bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
21275	Plastic revision of prior eye socket and facial bone repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21275	Plastic revision of prior eye socket and facial bone repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21275	Plastic revision of prior eye socket and facial bone repair	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
21280	Reattachment of nasal and eye socket ligament	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21280	Reattachment of nasal and eye socket ligament	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21280	Reattachment of nasal and eye socket ligament	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
21282	Reattachment of nasal and eye socket ligament	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21282	Reattachment of nasal and eye socket ligament	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21282	Reattachment of nasal and eye socket ligament	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
21295	Reduction of major chewing muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21295	Reduction of major chewing muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21295	Reduction of major chewing muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
21296	Reduction through mouth of major chewing muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21296	Reduction through mouth of major chewing muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21296	Reduction through mouth of major chewing muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
21310	Closed treatment of broken nasal bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	0	
21310	Closed treatment of broken nasal bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
21315	Closed treatment of broken nasal bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	19	
21315	Closed treatment of broken nasal bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	6	
21315	Closed treatment of broken nasal bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
21320	Closed treatment of broken nasal bone with stabilization	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	19	
21320	Closed treatment of broken nasal bone with stabilization	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	52	6	
21320	Closed treatment of broken nasal bone with stabilization	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	14	14	
21325	Open treatment of broken nasal bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21325	Open treatment of broken nasal bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21325	Open treatment of broken nasal bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		110	
21330	Open treatment of broken nasal bone and/or insertion of hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21330	Open treatment of broken nasal bone and/or insertion of hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21330	Open treatment of broken nasal bone and/or insertion of hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		110	
21335	Open treatment of broken nasal bone and nasal cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21335	Open treatment of broken nasal bone and nasal cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21335	Open treatment of broken nasal bone and nasal cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		110	
21336	Open treatment of tissue dividing nasal passages	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21336	Open treatment of tissue dividing nasal passages	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21336	Open treatment of tissue dividing nasal passages	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		182	
21337	Closed treatment of nasal cartilage dividing nasal passages	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21337	Closed treatment of nasal cartilage dividing nasal passages	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	6	
21337	Closed treatment of nasal cartilage dividing nasal passages	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	99	99	
21338	Open treatment of broken nasal and eye bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21338	Open treatment of broken nasal and eye bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21338	Open treatment of broken nasal and eye bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		130	
21339	Open treatment of broken eye socket and nasal bones with external hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21339	Open treatment of broken eye socket and nasal bones with external hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21339	Open treatment of broken eye socket and nasal bones with external hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		130	
21340	"Treatment of broken eye socket and nasal bones, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21340	"Treatment of broken eye socket and nasal bones, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21340	"Treatment of broken eye socket and nasal bones, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
21343	Open treatment of frontal sinus fracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21343	Open treatment of frontal sinus fracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21343	Open treatment of frontal sinus fracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		192	
21344	Open treatment of depressed frontal sinus fracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21344	Open treatment of depressed frontal sinus fracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		156	
21345	Closed treatment of broken nasal and cheek bones with wiring or splinting of teeth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21345	Closed treatment of broken nasal and cheek bones with wiring or splinting of teeth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	151	12	
21345	Closed treatment of broken nasal and cheek bones with wiring or splinting of teeth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	153	153	
21346	Open treatment of broken nasal and cheek bones with wiring of teeth and/or insertion of hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21346	Open treatment of broken nasal and cheek bones with wiring of teeth and/or insertion of hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21346	Open treatment of broken nasal and cheek bones with wiring of teeth and/or insertion of hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
21347	Open treatment of broken nasal and cheek bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21347	Open treatment of broken nasal and cheek bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		176	
21348	Open treatment of broken nasal and cheek bones with bone grafting	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21348	Open treatment of broken nasal and cheek bones with bone grafting	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21348	Open treatment of broken nasal and cheek bones with bone grafting	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
21355	"Treatment of broken lower and upper cheek bones with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	19	
21355	"Treatment of broken lower and upper cheek bones with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	102	6	
21355	"Treatment of broken lower and upper cheek bones with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	99	99	
21356	Open treatment of broken cheek bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	19	
21356	Open treatment of broken cheek bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	112	6	
21356	Open treatment of broken cheek bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	99	99	
21360	Open treatment of broken cheek bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21360	Open treatment of broken cheek bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21360	Open treatment of broken cheek bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
21365	Open treatment of broken cheek bones with insertion of internal hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21365	Open treatment of broken cheek bones with insertion of internal hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
21366	Open treatment of broken cheek bones with bone grafting and insertion of internal hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21366	Open treatment of broken cheek bones with bone grafting and insertion of internal hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21366	Open treatment of broken cheek bones with bone grafting and insertion of internal hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
21385	Open treatment of broken eye socket bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21385	Open treatment of broken eye socket bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21385	Open treatment of broken eye socket bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
21386	Open treatment of broken eye socket bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21386	Open treatment of broken eye socket bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21386	Open treatment of broken eye socket bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
21387	Open treatment of broken eye socket bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21387	Open treatment of broken eye socket bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21387	Open treatment of broken eye socket bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
21390	Open treatment of broken eye socket bone with implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21390	Open treatment of broken eye socket bone with implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21390	Open treatment of broken eye socket bone with implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
21395	Open treatment of broken eye socket bone with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21395	Open treatment of broken eye socket bone with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21395	Open treatment of broken eye socket bone with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
21400	Closed treatment of broken eye socket bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21400	Closed treatment of broken eye socket bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	68	6	
21400	Closed treatment of broken eye socket bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
21401	Closed treatment of broken eye socket bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21401	Closed treatment of broken eye socket bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	94	6	
21401	Closed treatment of broken eye socket bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
21406	Open treatment of broken eye socket bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21406	Open treatment of broken eye socket bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21406	Open treatment of broken eye socket bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
21407	Open treatment of broken eye socket bone with implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21407	Open treatment of broken eye socket bone with implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21407	Open treatment of broken eye socket bone with implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
21408	Open treatment of broken eye socket bone with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21408	Open treatment of broken eye socket bone with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21408	Open treatment of broken eye socket bone with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
21421	Closed treatment of fracture at roof of mouth or cheek bone with insertion of hardware or oral splint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21421	Closed treatment of fracture at roof of mouth or cheek bone with insertion of hardware or oral splint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	104	6	
21421	Closed treatment of fracture at roof of mouth or cheek bone with insertion of hardware or oral splint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	170	170	
21422	Open treatment of fracture at roof of mouth or cheek bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21422	Open treatment of fracture at roof of mouth or cheek bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21422	Open treatment of fracture at roof of mouth or cheek bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
21423	Open treatment of fracture of roof of mouth or cheek bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21423	Open treatment of fracture of roof of mouth or cheek bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
21431	"Closed treatment of broken bones of cheek, nose or face with insertion of hardware or oral splint"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21431	"Closed treatment of broken bones of cheek, nose or face with insertion of hardware or oral splint"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21431	"Closed treatment of broken bones of cheek, nose or face with insertion of hardware or oral splint"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
21432	Open treatment of broken bones of face and head and/or insertion of hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21432	Open treatment of broken bones of face and head and/or insertion of hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		84	
21433	Open treatment of broken bones of face and head	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21433	Open treatment of broken bones of face and head	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21433	Open treatment of broken bones of face and head	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
21435	Open treatment of broken bones of face and head and/or insertion of hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21435	Open treatment of broken bones of face and head and/or insertion of hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21435	Open treatment of broken bones of face and head and/or insertion of hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		179	
21436	Open treatment of broken bones of face and head with insertion of hardware and bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21436	Open treatment of broken bones of face and head with insertion of hardware and bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21436	Open treatment of broken bones of face and head with insertion of hardware and bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		215	
21440	Closed treatment of broken jaw or cheek bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21440	Closed treatment of broken jaw or cheek bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	92	6	
21440	Closed treatment of broken jaw or cheek bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
21445	Open treatment of broken jaw or cheek bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21445	Open treatment of broken jaw or cheek bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	118	6	
21445	Open treatment of broken jaw or cheek bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	117	117	
21450	Closed treatment of broken jaw bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21450	Closed treatment of broken jaw bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	87	6	
21450	Closed treatment of broken jaw bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
21451	Closed treatment of broken jaw bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21451	Closed treatment of broken jaw bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	127	6	
21451	Closed treatment of broken jaw bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	153	153	
21452	"Treatment of broken jaw bone with placement of external hardware, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21452	"Treatment of broken jaw bone with placement of external hardware, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	82	6	
21452	"Treatment of broken jaw bone with placement of external hardware, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
21453	Closed treatment of broken jaw bone with insertion of hardware or oral splint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21453	Closed treatment of broken jaw bone with insertion of hardware or oral splint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	115	6	
21453	Closed treatment of broken jaw bone with insertion of hardware or oral splint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	189	189	
21454	Open treatment of broken jaw bone with placement of external hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21454	Open treatment of broken jaw bone with placement of external hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21454	Open treatment of broken jaw bone with placement of external hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		153	
21461	Open treatment of broken jaw bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21461	Open treatment of broken jaw bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	144	12	
21461	Open treatment of broken jaw bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	189	189	
21462	Open treatment of broken jaw bone with insertion of hardware or oral splint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21462	Open treatment of broken jaw bone with insertion of hardware or oral splint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	170	12	
21462	Open treatment of broken jaw bone with insertion of hardware or oral splint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	189	189	
21465	Open treatment of hinge of jaw bone fracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21465	Open treatment of hinge of jaw bone fracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21465	Open treatment of hinge of jaw bone fracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		189	
21470	Open treatment for broken jaw bone with insertion of hardware and/or oral splint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21470	Open treatment for broken jaw bone with insertion of hardware and/or oral splint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21470	Open treatment for broken jaw bone with insertion of hardware and/or oral splint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		216	
21480	Closed treatment of jaw temporomandibular joint (TMJ) dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	0	
21480	Closed treatment of jaw temporomandibular joint (TMJ) dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
21485	Closed treatment of jaw temporomandibular joint (TMJ) dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21485	Closed treatment of jaw temporomandibular joint (TMJ) dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	111	6	
21485	Closed treatment of jaw temporomandibular joint (TMJ) dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	153	153	
21490	Open treatment of jaw temporomandibular joint (TMJ) dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21490	Open treatment of jaw temporomandibular joint (TMJ) dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21490	Open treatment of jaw temporomandibular joint (TMJ) dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		189	
21495	Open treatment of bone between chin and thyroid	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21495	Open treatment of bone between chin and thyroid	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		189	
21497	Wiring of jaw or oral splint to teeth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21497	Wiring of jaw or oral splint to teeth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	117	6	
21497	Wiring of jaw or oral splint to teeth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	153	153	
21501	Incision and drainage of abscess or blood accumulation in soft tissues of neck or chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21501	Incision and drainage of abscess or blood accumulation in soft tissues of neck or chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	12	
21501	Incision and drainage of abscess or blood accumulation in soft tissues of neck or chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
21502	Incision and drainage of abscess or blood accumulation in soft tissues of neck or chest with removal of rib	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21502	Incision and drainage of abscess or blood accumulation in soft tissues of neck or chest with removal of rib	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21502	Incision and drainage of abscess or blood accumulation in soft tissues of neck or chest with removal of rib	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
21510	Incision of chest bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21510	Incision of chest bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21510	Incision of chest bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
21550	Biopsy of soft tissue of neck or chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
21550	Biopsy of soft tissue of neck or chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	70	6	
21550	Biopsy of soft tissue of neck or chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
21552	Removal of (3 centimeters or greater) tissue growth beneath the skin of neck or front of chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21552	Removal of (3 centimeters or greater) tissue growth beneath the skin of neck or front of chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21552	Removal of (3 centimeters or greater) tissue growth beneath the skin of neck or front of chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
21554	Removal of (5 centimeters or greater) muscle growth of neck or front of chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21554	Removal of (5 centimeters or greater) muscle growth of neck or front of chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21554	Removal of (5 centimeters or greater) muscle growth of neck or front of chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
21555	Removal of (less than 3 centimeters) tissue growth beneath the skin of neck or front of chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21555	Removal of (less than 3 centimeters) tissue growth beneath the skin of neck or front of chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	6	
21555	Removal of (less than 3 centimeters) tissue growth beneath the skin of neck or front of chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
21556	Removal of (less than 5 centimeters) muscle growth of neck or front of chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21556	Removal of (less than 5 centimeters) muscle growth of neck or front of chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21556	Removal of (less than 5 centimeters) muscle growth of neck or front of chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
21557	Removal of (less than 5 centimeters) growth of neck or front of chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21557	Removal of (less than 5 centimeters) growth of neck or front of chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21557	Removal of (less than 5 centimeters) growth of neck or front of chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
21558	Removal of (5 centimeters or greater) growth of neck or front of chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21558	Removal of (5 centimeters or greater) growth of neck or front of chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21558	Removal of (5 centimeters or greater) growth of neck or front of chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
21600	Removal of rib	Pre-service	L051A	RN	0.51	Preservice total costs		60	
21600	Removal of rib	Service  intra	L051A	RN	0.51	Service total costs		12	
21600	Removal of rib	Post-service	L051A	RN	0.51	Post service total costs		108	
21610	Removal of joint joining rib and spine bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21610	Removal of joint joining rib and spine bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21610	Removal of joint joining rib and spine bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
21615	Removal of first and/or extra rib at neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21615	Removal of first and/or extra rib at neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21615	Removal of first and/or extra rib at neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
21616	Removal of first and/or extra rib at neck with removal of sympathetic nerves	Pre-service	L051A	RN	0.51	Preservice total costs		60	
21616	Removal of first and/or extra rib at neck with removal of sympathetic nerves	Service  intra	L051A	RN	0.51	Service total costs		12	
21616	Removal of first and/or extra rib at neck with removal of sympathetic nerves	Post-service	L051A	RN	0.51	Post service total costs		135	
21620	Partial removal of chest bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21620	Partial removal of chest bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21620	Partial removal of chest bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
21627	Debridement of chest bone	Pre-service	L051A	RN	0.51	Preservice total costs		60	
21627	Debridement of chest bone	Service  intra	L051A	RN	0.51	Service total costs		12	
21627	Debridement of chest bone	Post-service	L051A	RN	0.51	Post service total costs		108	
21630	Removal of chest bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21630	Removal of chest bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21630	Removal of chest bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		149	
21632	Removal of chest bone with removal of lymph nodes	Pre-service	L051A	RN	0.51	Preservice total costs		60	
21632	Removal of chest bone with removal of lymph nodes	Service  intra	L051A	RN	0.51	Service total costs		12	
21632	Removal of chest bone with removal of lymph nodes	Post-service	L051A	RN	0.51	Post service total costs		149	
21685	Repositioning of bone between chin and thyroid	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21685	Repositioning of bone between chin and thyroid	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21685	Repositioning of bone between chin and thyroid	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
21700	Removal of neck muscle with release of nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21700	Removal of neck muscle with release of nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21700	Removal of neck muscle with release of nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
21705	Removal of neck muscle and extra rib at neck with release of nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21705	Removal of neck muscle and extra rib at neck with release of nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21705	Removal of neck muscle and extra rib at neck with release of nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
21720	"Release of tendons of neck muscle, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21720	"Release of tendons of neck muscle, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21720	"Release of tendons of neck muscle, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
21725	"Release of tendons of neck muscle with cast application, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21725	"Release of tendons of neck muscle with cast application, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21725	"Release of tendons of neck muscle with cast application, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
21740	"Repair of depression of breast bone, open procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
21740	"Repair of depression of breast bone, open procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
21740	"Repair of depression of breast bone, open procedure"	Post-service	L051A	RN	0.51	Post service total costs		72	
21750	Repair of separation of chest bone	Pre-service	L051A	RN	0.51	Preservice total costs		60	
21750	Repair of separation of chest bone	Service  intra	L051A	RN	0.51	Service total costs		12	
21750	Repair of separation of chest bone	Post-service	L051A	RN	0.51	Post service total costs		36	
21811	Open treatment of rib fracture(s) with internal fixation; 1-3 ribs	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
21811	Open treatment of rib fracture(s) with internal fixation; 1-3 ribs	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
21811	Open treatment of rib fracture(s) with internal fixation; 1-3 ribs	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
21811	Open treatment of rib fracture(s) with internal fixation; 1-3 ribs	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		0	
21812	Open treatment of rib fracture(s) with internal fixation; 4-6 ribs	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
21812	Open treatment of rib fracture(s) with internal fixation; 4-6 ribs	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
21812	Open treatment of rib fracture(s) with internal fixation; 4-6 ribs	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
21812	Open treatment of rib fracture(s) with internal fixation; 4-6 ribs	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		0	
21813	Open treatment of rib fracture(s) with internal fixation; 7 or more ribs	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
21813	Open treatment of rib fracture(s) with internal fixation; 7 or more ribs	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
21813	Open treatment of rib fracture(s) with internal fixation; 7 or more ribs	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
21813	Open treatment of rib fracture(s) with internal fixation; 7 or more ribs	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		0	
21820	Closed treatment of sternum fracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21820	Closed treatment of sternum fracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	6	
21820	Closed treatment of sternum fracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	41	41	
21825	Open treatment of sternum fracture with or without skeletal fixation	Pre-service	L051A	RN	0.51	Preservice total costs		60	
21825	Open treatment of sternum fracture with or without skeletal fixation	Service  intra	L051A	RN	0.51	Service total costs		12	
21825	Open treatment of sternum fracture with or without skeletal fixation	Post-service	L051A	RN	0.51	Post service total costs		95	
21920	Biopsy of tissue of back or flank	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	19	
21920	Biopsy of tissue of back or flank	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	52	6	
21920	Biopsy of tissue of back or flank	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
21925	Biopsy of tissue of back or flank	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21925	Biopsy of tissue of back or flank	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	66	6	
21925	Biopsy of tissue of back or flank	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
21930	Removal (less than 3 centimeters) tissue growth beneath the skin of back or flank	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
21930	Removal (less than 3 centimeters) tissue growth beneath the skin of back or flank	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	6	
21930	Removal (less than 3 centimeters) tissue growth beneath the skin of back or flank	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
21931	Removal (3 centimeters or greater) tissue growth beneath the skin of back or flank	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21931	Removal (3 centimeters or greater) tissue growth beneath the skin of back or flank	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
21931	Removal (3 centimeters or greater) tissue growth beneath the skin of back or flank	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
21932	Removal (less than 5 centimeters) muscle growth of back or flank	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21932	Removal (less than 5 centimeters) muscle growth of back or flank	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21932	Removal (less than 5 centimeters) muscle growth of back or flank	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
21933	Removal (5 centimeters or greater) muscle growth of back or flank	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21933	Removal (5 centimeters or greater) muscle growth of back or flank	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21933	Removal (5 centimeters or greater) muscle growth of back or flank	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
21935	Removal (less than 5 centimeters) tissue growth of back or flank	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21935	Removal (less than 5 centimeters) tissue growth of back or flank	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21935	Removal (less than 5 centimeters) tissue growth of back or flank	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
21936	Removal (5 centimeters or greater) tissue growth of back or flank	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
21936	Removal (5 centimeters or greater) tissue growth of back or flank	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
21936	Removal (5 centimeters or greater) tissue growth of back or flank	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
22010	"Drainage of abscess of upper or middle spine, open chest procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22010	"Drainage of abscess of upper or middle spine, open chest procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22010	"Drainage of abscess of upper or middle spine, open chest procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
22015	"Drainage of abscess of lower spine or sacrum, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22015	"Drainage of abscess of lower spine or sacrum, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22015	"Drainage of abscess of lower spine or sacrum, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
22100	Partial removal of spine bone and growth at upper spinal column	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22100	Partial removal of spine bone and growth at upper spinal column	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22100	Partial removal of spine bone and growth at upper spinal column	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22101	Partial removal of spine bone and growth at middle spinal column	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22101	Partial removal of spine bone and growth at middle spinal column	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22101	Partial removal of spine bone and growth at middle spinal column	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22102	Partial removal of spine bone and growth at lower spinal column	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22102	Partial removal of spine bone and growth at lower spinal column	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
22102	Partial removal of spine bone and growth at lower spinal column	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22110	Partial removal of spine bone and growth at upper spinal column	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22110	Partial removal of spine bone and growth at upper spinal column	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22110	Partial removal of spine bone and growth at upper spinal column	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22112	Partial removal of spine bone and growth at middle spinal column	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22112	Partial removal of spine bone and growth at middle spinal column	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22112	Partial removal of spine bone and growth at middle spinal column	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22114	Partial removal of spine bone and growth at lower spinal column	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22114	Partial removal of spine bone and growth at lower spinal column	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22114	Partial removal of spine bone and growth at lower spinal column	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22206	Incision of spine to correct deformity at middle spinal column	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22206	Incision of spine to correct deformity at middle spinal column	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22206	Incision of spine to correct deformity at middle spinal column	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
22207	Incision of spine to correct deformity at lower spinal column	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22207	Incision of spine to correct deformity at lower spinal column	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22207	Incision of spine to correct deformity at lower spinal column	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
22210	Incision of spine to correct deformity at upper spinal column	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22210	Incision of spine to correct deformity at upper spinal column	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22210	Incision of spine to correct deformity at upper spinal column	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
22212	Incision of spine to correct deformity at middle spinal column	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22212	Incision of spine to correct deformity at middle spinal column	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22212	Incision of spine to correct deformity at middle spinal column	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
22214	Incision of spine to correct deformity at lower spinal column	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22214	Incision of spine to correct deformity at lower spinal column	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22214	Incision of spine to correct deformity at lower spinal column	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
22220	Incision of spine bone with removal of disc at upper spinal column	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22220	Incision of spine bone with removal of disc at upper spinal column	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22220	Incision of spine bone with removal of disc at upper spinal column	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
22222	Incision of spine bone with removal of disc at middle spinal column	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22222	Incision of spine bone with removal of disc at middle spinal column	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22222	Incision of spine bone with removal of disc at middle spinal column	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
22224	Incision of spine bone with removal of disc material at lower spinal column	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22224	Incision of spine bone with removal of disc material at lower spinal column	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22224	Incision of spine bone with removal of disc material at lower spinal column	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
22305	Closed treatment of broken spine bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	20	20	
22305	Closed treatment of broken spine bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	12	
22305	Closed treatment of broken spine bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	41	41	
22310	Closed treatment of broken spine bones with casting or bracing	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	20	20	
22310	Closed treatment of broken spine bones with casting or bracing	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	12	
22310	Closed treatment of broken spine bones with casting or bracing	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	41	41	
22315	Closed treatment of broken and/or dislocated spine bones with casting and/or bracing with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
22315	Closed treatment of broken and/or dislocated spine bones with casting and/or bracing with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	154	12	
22315	Closed treatment of broken and/or dislocated spine bones with casting and/or bracing with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
22318	Open treatment of broken and/or dislocated upper spine bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22318	Open treatment of broken and/or dislocated upper spine bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22318	Open treatment of broken and/or dislocated upper spine bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
22319	Open treatment of broken and/or dislocated upper spine bones with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22319	Open treatment of broken and/or dislocated upper spine bones with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22319	Open treatment of broken and/or dislocated upper spine bones with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
22325	Open treatment of broken and/or dislocated lower spine bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22325	Open treatment of broken and/or dislocated lower spine bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22325	Open treatment of broken and/or dislocated lower spine bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
22326	Open treatment of broken and/or dislocated upper spine bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22326	Open treatment of broken and/or dislocated upper spine bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22326	Open treatment of broken and/or dislocated upper spine bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22327	Open treatment of broken and/or dislocated middle spine bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22327	Open treatment of broken and/or dislocated middle spine bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22327	Open treatment of broken and/or dislocated middle spine bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
22505	Manipulation of spine under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		27	
22505	Manipulation of spine under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	5	5	
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	10	
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	7	7	
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	3		
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	5		
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician	45		
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician - acquire images	34		
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician - circulator	11		
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Service  intra	L051A	RN	0.51	Assist physician in performing procedure	45		
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	5		
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Service  post	L037D	RN/LPN/MTA	0.37	"Review/read X-ray, lab, and pathology reports"	2		
22510	Percutaneous vertebroplasty 1 vertebral body; cervicothoracic	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes	36	36	
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	5	5	
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	10	
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	7	7	
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	3		
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	5		
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician	45		
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician - acquire images	34		
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician - circulator	11		
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  intra	L051A	RN	0.51	Assist physician in performing procedure	45		
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  intra	L041C	Second Radiologic Technologist for Vertebroplasty	0.41	Assist physician in performing procedure	0		
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	5		
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Service  post	L037D	RN/LPN/MTA	0.37	"Review/read X-ray, lab, and pathology reports"	2		
22511	Percutaneous vertebroplasty 1 vertebral body; lumbosacral	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes	36	36	
22512	Percutaneous vertebroplasty; each additional cervicothoracic or lumbosacral vertebral body	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician - acquire images	23		
22512	Percutaneous vertebroplasty; each additional cervicothoracic or lumbosacral vertebral body	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician - circulator	7		
22512	Percutaneous vertebroplasty; each additional cervicothoracic or lumbosacral vertebral body	Service  intra	L051A	RN	0.51	Assist physician in performing procedure	30		
22512	Percutaneous vertebroplasty; each additional cervicothoracic or lumbosacral vertebral body	Service  intra	L041C	Second Radiologic Technologist for Vertebroplasty	0.41	Assist physician in performing procedure	30		
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	5	5	
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	10	
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	7	7	
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	3		
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	5		
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician - acquire images	38		
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician - circulator	12		
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure	50		
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Service  intra	L041C	Second Radiologic Technologist for Vertebroplasty	0.41	Assist physician in performing procedure	50		
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Service  post	L037D	RN/LPN/MTA	0.37	"Review/read X-ray, lab, and pathology reports"	2		
22513	"Percutaneous vertebral augmentation, including cavity creation;thoracic"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes	36	36	
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	5	5	
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	10	
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	7	7	
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	3		
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	5		
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician	45		
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician - acquire images	38		
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician - circulator	12		
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	50		
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure	50		
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	5		
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Service  post	L037D	RN/LPN/MTA	0.37	"Review/read X-ray, lab, and pathology reports"	2		
22514	"Percutaneous vertebral augmentation, including cavity creation;lumbar"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes	36	36	
22515	"Percutaneous vertebral augmentation, including cavity creation;each additional thoracic or lumbar"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician - acquire images	23		
22515	"Percutaneous vertebral augmentation, including cavity creation;each additional thoracic or lumbar"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician - circulator	7		
22515	"Percutaneous vertebral augmentation, including cavity creation;each additional thoracic or lumbar"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure	30		
22515	"Percutaneous vertebral augmentation, including cavity creation;each additional thoracic or lumbar"	Service  intra	L041C	Second Radiologic Technologist for Vertebroplasty	0.41	Assist physician in performing procedure	30		
22526	"Removal of cartilage ring at spinal disc using fluoroscopic guidance, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
22526	"Removal of cartilage ring at spinal disc using fluoroscopic guidance, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	45	0	
22526	"Removal of cartilage ring at spinal disc using fluoroscopic guidance, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	62	0	
22526	"Removal of cartilage ring at spinal disc using fluoroscopic guidance, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	13	6	
22526	"Removal of cartilage ring at spinal disc using fluoroscopic guidance, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
22527	"Removal cartilage ring at spinal disc using fluoroscopic guidance, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	45	0	
22527	"Removal cartilage ring at spinal disc using fluoroscopic guidance, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	45	0	
22532	"Fusion of middle spine bones with removal of disc, lateral approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22532	"Fusion of middle spine bones with removal of disc, lateral approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22532	"Fusion of middle spine bones with removal of disc, lateral approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
22533	"Fusion of lower spine bones with removal of disc, lateral approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22533	"Fusion of lower spine bones with removal of disc, lateral approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22533	"Fusion of lower spine bones with removal of disc, lateral approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
22548	"Fusion of spine bones at base of neck, oral approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22548	"Fusion of spine bones at base of neck, oral approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22548	"Fusion of spine bones at base of neck, oral approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22551	"Fusion of spine bones with removal of disc at upper spinal column, anterior approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22551	"Fusion of spine bones with removal of disc at upper spinal column, anterior approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22551	"Fusion of spine bones with removal of disc at upper spinal column, anterior approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
22554	"Fusion of spine bones with removal of disc at upper spinal column, anterior approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22554	"Fusion of spine bones with removal of disc at upper spinal column, anterior approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22554	"Fusion of spine bones with removal of disc at upper spinal column, anterior approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
22556	"Fusion of middle spine bones with removal of disc, anterior approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22556	"Fusion of middle spine bones with removal of disc, anterior approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22556	"Fusion of middle spine bones with removal of disc, anterior approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22558	"Fusion of spine bones with removal of disc at lower spinal column, anterior approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22558	"Fusion of spine bones with removal of disc at lower spinal column, anterior approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22558	"Fusion of spine bones with removal of disc at lower spinal column, anterior approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22586	Fusion of spine bones with removal of disc at lower spinal column with posterior instrumentation and image guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22586	Fusion of spine bones with removal of disc at lower spinal column with posterior instrumentation and image guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22586	Fusion of spine bones with removal of disc at lower spinal column with posterior instrumentation and image guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22590	"Fusion of first two upper spine bones of spinal column, posterior approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22590	"Fusion of first two upper spine bones of spinal column, posterior approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22590	"Fusion of first two upper spine bones of spinal column, posterior approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22595	"Fusion of spine bones at skull base, posterior approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22595	"Fusion of spine bones at skull base, posterior approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22595	"Fusion of spine bones at skull base, posterior approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22600	"Fusion of upper spine bones, posterior or posterolateral approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22600	"Fusion of upper spine bones, posterior or posterolateral approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22600	"Fusion of upper spine bones, posterior or posterolateral approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22610	"Fusion of middle spine bones, posterior or posterolateral approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22610	"Fusion of middle spine bones, posterior or posterolateral approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22610	"Fusion of middle spine bones, posterior or posterolateral approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22612	"Fusion of lower spine bones, posterior or posterolateral approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22612	"Fusion of lower spine bones, posterior or posterolateral approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22612	"Fusion of lower spine bones, posterior or posterolateral approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
22630	"Fusion of lower spine bones with removal of disc, posterior approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22630	"Fusion of lower spine bones with removal of disc, posterior approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22630	"Fusion of lower spine bones with removal of disc, posterior approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22633	"Fusion of lower spine bones with removal of disc, posterior or posterolateral approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22633	"Fusion of lower spine bones with removal of disc, posterior or posterolateral approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22633	"Fusion of lower spine bones with removal of disc, posterior or posterolateral approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
22800	"Fusion of spine bones for correction of deformity, posterior approach, up to 6 vertebral segments"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22800	"Fusion of spine bones for correction of deformity, posterior approach, up to 6 vertebral segments"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22800	"Fusion of spine bones for correction of deformity, posterior approach, up to 6 vertebral segments"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22802	"Fusion of spine bones for correction of deformity, posterior approach, 7 to 12 vertebral segments"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22802	"Fusion of spine bones for correction of deformity, posterior approach, 7 to 12 vertebral segments"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22802	"Fusion of spine bones for correction of deformity, posterior approach, 7 to 12 vertebral segments"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22804	"Fusion of spine bones for correction of deformity, posterior approach, 13 or more vertebral segments"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22804	"Fusion of spine bones for correction of deformity, posterior approach, 13 or more vertebral segments"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22804	"Fusion of spine bones for correction of deformity, posterior approach, 13 or more vertebral segments"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22808	"Fusion of spine bones for correction of deformity, anterior approach, 2 to 3 vertebral segments"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22808	"Fusion of spine bones for correction of deformity, anterior approach, 2 to 3 vertebral segments"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22808	"Fusion of spine bones for correction of deformity, anterior approach, 2 to 3 vertebral segments"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22810	"Fusion of spine bones for correction of deformity, anterior approach, 4 to 7 vertebral segments"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22810	"Fusion of spine bones for correction of deformity, anterior approach, 4 to 7 vertebral segments"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22810	"Fusion of spine bones for correction of deformity, anterior approach, 4 to 7 vertebral segments"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22812	"Fusion of spine bones for correction of deformity, anterior approach, 8 or more vertebral segments"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22812	"Fusion of spine bones for correction of deformity, anterior approach, 8 or more vertebral segments"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22812	"Fusion of spine bones for correction of deformity, anterior approach, 8 or more vertebral segments"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
22818	"Fusion of spine bones for correction of hunchback deformity, single or 2 segments"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22818	"Fusion of spine bones for correction of hunchback deformity, single or 2 segments"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22818	"Fusion of spine bones for correction of hunchback deformity, single or 2 segments"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
22819	"Fusion of spine bones for correction of hunchback deformity, 3 or more segments"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22819	"Fusion of spine bones for correction of hunchback deformity, 3 or more segments"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22819	"Fusion of spine bones for correction of hunchback deformity, 3 or more segments"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22830	Exploration of spinal fusion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22830	Exploration of spinal fusion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22830	Exploration of spinal fusion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
22849	Reinsertion of spinal fixation device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22849	Reinsertion of spinal fixation device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22849	Reinsertion of spinal fixation device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
22850	Removal of posterior spinal instrumentation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22850	Removal of posterior spinal instrumentation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22850	Removal of posterior spinal instrumentation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
22852	Removal of posterior spinal instrumentation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22852	Removal of posterior spinal instrumentation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22852	Removal of posterior spinal instrumentation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
22855	Removal of anterior spinal instrumentation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22855	Removal of anterior spinal instrumentation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22855	Removal of anterior spinal instrumentation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
22856	"Total disc arthroplasty; single interspace, cervical"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
22856	"Total disc arthroplasty; single interspace, cervical"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
22856	"Total disc arthroplasty; single interspace, cervical"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
22856	"Total disc arthroplasty; single interspace, cervical"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
22856	"Total disc arthroplasty; single interspace, cervical"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
22856	"Total disc arthroplasty; single interspace, cervical"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
22856	"Total disc arthroplasty; single interspace, cervical"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		108	
22857	"Insertion of artificial lower spine disc, anterior approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22857	"Insertion of artificial lower spine disc, anterior approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22857	"Insertion of artificial lower spine disc, anterior approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22861	Revision of artificial upper spine disc	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22861	Revision of artificial upper spine disc	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22861	Revision of artificial upper spine disc	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
22862	Revision of artificial lower spine disc	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22862	Revision of artificial lower spine disc	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22862	Revision of artificial lower spine disc	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22864	Revision of artificial upper spine disc	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22864	Revision of artificial upper spine disc	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22864	Revision of artificial upper spine disc	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
22865	Revision of artificial lower spine disc	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
22865	Revision of artificial lower spine disc	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22865	Revision of artificial lower spine disc	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
22900	Removal (less than 5 centimeters) muscle growth in abdominal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22900	Removal (less than 5 centimeters) muscle growth in abdominal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22900	Removal (less than 5 centimeters) muscle growth in abdominal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
22901	Removal (5 centimeters or greater) muscle growth in abdominal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22901	Removal (5 centimeters or greater) muscle growth in abdominal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22901	Removal (5 centimeters or greater) muscle growth in abdominal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
22902	Removal (less than 3 centimeters) tissue growth beneath the skin in abdominal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
22902	Removal (less than 3 centimeters) tissue growth beneath the skin in abdominal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	6	
22902	Removal (less than 3 centimeters) tissue growth beneath the skin in abdominal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
22903	Removal (3 centimeters or greater) tissue growth beneath the skin in abdominal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22903	Removal (3 centimeters or greater) tissue growth beneath the skin in abdominal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
22903	Removal (3 centimeters or greater) tissue growth beneath the skin in abdominal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
22904	Removal (less than 5 centimeters) tissue growth in abdominal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22904	Removal (less than 5 centimeters) tissue growth in abdominal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22904	Removal (less than 5 centimeters) tissue growth in abdominal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
22905	Removal (5 centimeters or greater) tissue growth in abdominal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
22905	Removal (5 centimeters or greater) tissue growth in abdominal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
22905	Removal (5 centimeters or greater) tissue growth in abdominal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
23000	"Removal of calcium deposits at rotator cuff tendons, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23000	"Removal of calcium deposits at rotator cuff tendons, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	91	6	
23000	"Removal of calcium deposits at rotator cuff tendons, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
23020	Severing of shoulder tendon to repair contracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23020	Severing of shoulder tendon to repair contracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23020	Severing of shoulder tendon to repair contracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23030	Drainage of abscess or blood accumulation in shoulder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
23030	Drainage of abscess or blood accumulation in shoulder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	72	12	
23030	Drainage of abscess or blood accumulation in shoulder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
23031	Drainage of infected fluid-filled sac (bursa) of shoulder joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
23031	Drainage of infected fluid-filled sac (bursa) of shoulder joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	12	
23031	Drainage of infected fluid-filled sac (bursa) of shoulder joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
23035	Incision of bone of shoulder area	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23035	Incision of bone of shoulder area	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23035	Incision of bone of shoulder area	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23040	Incision to repair shoulder joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23040	Incision to repair shoulder joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23040	Incision to repair shoulder joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23044	Incision of to repair shoulder joint area	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23044	Incision of to repair shoulder joint area	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23044	Incision of to repair shoulder joint area	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
23065	Biopsy of tissue of shoulder area	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
23065	Biopsy of tissue of shoulder area	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	6	
23065	Biopsy of tissue of shoulder area	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	14	14	
23066	Biopsy of tissue of shoulder area	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23066	Biopsy of tissue of shoulder area	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	93	6	
23066	Biopsy of tissue of shoulder area	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
23071	Removal (3 centimeters or greater) tissue growth beneath the skin of shoulder area	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23071	Removal (3 centimeters or greater) tissue growth beneath the skin of shoulder area	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23071	Removal (3 centimeters or greater) tissue growth beneath the skin of shoulder area	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
23073	Removal (5 centimeters or greater) muscle growth of shoulder area	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23073	Removal (5 centimeters or greater) muscle growth of shoulder area	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23073	Removal (5 centimeters or greater) muscle growth of shoulder area	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
23075	Removal (less than 3 centimeters) tissue growth beneath the skin of shoulder area	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23075	Removal (less than 3 centimeters) tissue growth beneath the skin of shoulder area	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
23075	Removal (less than 3 centimeters) tissue growth beneath the skin of shoulder area	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
23076	Removal (less than 5 centimeters) muscle growth of shoulder area	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23076	Removal (less than 5 centimeters) muscle growth of shoulder area	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23076	Removal (less than 5 centimeters) muscle growth of shoulder area	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
23077	Removal (less than 5 centimeters) tissue growth of shoulder area	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23077	Removal (less than 5 centimeters) tissue growth of shoulder area	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23077	Removal (less than 5 centimeters) tissue growth of shoulder area	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
23078	Removal (5 centimeters or greater) tissue growth of shoulder area	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23078	Removal (5 centimeters or greater) tissue growth of shoulder area	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23078	Removal (5 centimeters or greater) tissue growth of shoulder area	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
23100	Incision and biopsy of shoulder joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23100	Incision and biopsy of shoulder joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23100	Incision and biopsy of shoulder joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
23101	"Incision to repair joints between shoulder, chest and collar bones"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23101	"Incision to repair joints between shoulder, chest and collar bones"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23101	"Incision to repair joints between shoulder, chest and collar bones"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
23105	Removal of shoulder joint lining	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23105	Removal of shoulder joint lining	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23105	Removal of shoulder joint lining	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23106	Removal of lining of joint between collar and chest bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23106	Removal of lining of joint between collar and chest bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23106	Removal of lining of joint between collar and chest bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
23107	Exploration of shoulder joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23107	Exploration of shoulder joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23107	Exploration of shoulder joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23120	Partial removal of collar bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23120	Partial removal of collar bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23120	Partial removal of collar bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
23125	Removal of collar bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23125	Removal of collar bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23125	Removal of collar bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23130	Removal or repair of collar bone and shoulder blade joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23130	Removal or repair of collar bone and shoulder blade joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23130	Removal or repair of collar bone and shoulder blade joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
23140	Removal of cyst or growth of collar bone or shoulder blade	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23140	Removal of cyst or growth of collar bone or shoulder blade	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23140	Removal of cyst or growth of collar bone or shoulder blade	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
23145	Removal of cyst or growth of collar bone or shoulder blade with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23145	Removal of cyst or growth of collar bone or shoulder blade with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23145	Removal of cyst or growth of collar bone or shoulder blade with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23146	Removal of cyst or growth of collar bone or shoulder blade with donor bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23146	Removal of cyst or growth of collar bone or shoulder blade with donor bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23146	Removal of cyst or growth of collar bone or shoulder blade with donor bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23150	Removal of cyst or growth of upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23150	Removal of cyst or growth of upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23150	Removal of cyst or growth of upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23155	Removal of cyst or growth of upper arm bone with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23155	Removal of cyst or growth of upper arm bone with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23155	Removal of cyst or growth of upper arm bone with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
23156	Removal of cyst or growth of upper arm bone with donor bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23156	Removal of cyst or growth of upper arm bone with donor bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23156	Removal of cyst or growth of upper arm bone with donor bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23170	Removal of dead collar bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23170	Removal of dead collar bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23170	Removal of dead collar bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
23172	Removal of dead shoulder blade	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23172	Removal of dead shoulder blade	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23172	Removal of dead shoulder blade	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
23174	Removal of dead upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23174	Removal of dead upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23174	Removal of dead upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
23180	Partial removal of collar bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23180	Partial removal of collar bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23180	Partial removal of collar bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
23182	Partial removal of shoulder blade	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23182	Partial removal of shoulder blade	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23182	Partial removal of shoulder blade	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
23184	Partial removal of upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23184	Partial removal of upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23184	Partial removal of upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
23190	Removal of portion of shoulder blade	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23190	Removal of portion of shoulder blade	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23190	Removal of portion of shoulder blade	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
23195	Removal of shoulder blade	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23195	Removal of shoulder blade	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23195	Removal of shoulder blade	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23200	Removal of growth of collar bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23200	Removal of growth of collar bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23200	Removal of growth of collar bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
23210	Removal of growth of shoulder blade	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23210	Removal of growth of shoulder blade	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23210	Removal of growth of shoulder blade	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
23220	Removal of growth of upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23220	Removal of growth of upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23220	Removal of growth of upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
23330	"Removal of foreign body of shoulder joint, accessed beneath the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	30	
23330	"Removal of foreign body of shoulder joint, accessed beneath the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	54	6	
23330	"Removal of foreign body of shoulder joint, accessed beneath the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
23333	"Removal of foreign body of shoulder joint, accessed beneath the tissue or muscle"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23333	"Removal of foreign body of shoulder joint, accessed beneath the tissue or muscle"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23333	"Removal of foreign body of shoulder joint, accessed beneath the tissue or muscle"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
23334	Removal of prosthesis of shoulder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23334	Removal of prosthesis of shoulder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23334	Removal of prosthesis of shoulder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
23335	Removal of prosthesis of shoulder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23335	Removal of prosthesis of shoulder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23335	Removal of prosthesis of shoulder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
23350	Injection of dye for X-ray imaging of shoulder joint	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	26	0	
23350	Injection of dye for X-ray imaging of shoulder joint	Post-service	L041B	Radiologic Technologist	0.41	Post service total costs	3	0	
23395	Relocation of muscle of shoulder or upper arm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23395	Relocation of muscle of shoulder or upper arm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23395	Relocation of muscle of shoulder or upper arm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
23397	Relocation of muscles of shoulder or upper arm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23397	Relocation of muscles of shoulder or upper arm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23397	Relocation of muscles of shoulder or upper arm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
23400	Reshaping and relocation of shoulder blade bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23400	Reshaping and relocation of shoulder blade bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23400	Reshaping and relocation of shoulder blade bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
23405	Incision of shoulder tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23405	Incision of shoulder tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23405	Incision of shoulder tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
23406	Incision of shoulder tendons	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23406	Incision of shoulder tendons	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23406	Incision of shoulder tendons	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
23410	"Repair of torn tendons of shoulder, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23410	"Repair of torn tendons of shoulder, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23410	"Repair of torn tendons of shoulder, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
23412	"Repair of torn tendons of shoulder, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23412	"Repair of torn tendons of shoulder, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23412	"Repair of torn tendons of shoulder, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
23415	Release of collar bone and shoulder ligament	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23415	Release of collar bone and shoulder ligament	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23415	Release of collar bone and shoulder ligament	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
23420	Repair of torn shoulder tendons	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23420	Repair of torn shoulder tendons	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23420	Repair of torn shoulder tendons	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		153	
23430	Anchoring of biceps tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23430	Anchoring of biceps tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23430	Anchoring of biceps tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
23440	Transplantation of biceps tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23440	Transplantation of biceps tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23440	Transplantation of biceps tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
23450	Reattachment of shoulder joint capsule	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23450	Reattachment of shoulder joint capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23450	Reattachment of shoulder joint capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23455	Reattachment of shoulder joint capsule and cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23455	Reattachment of shoulder joint capsule and cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23455	Reattachment of shoulder joint capsule and cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23460	Reattachment of shoulder joint capsule and cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23460	Reattachment of shoulder joint capsule and cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23460	Reattachment of shoulder joint capsule and cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
23462	Reattachment of shoulder joint capsule	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23462	Reattachment of shoulder joint capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23462	Reattachment of shoulder joint capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23465	Repair of shoulder joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23465	Repair of shoulder joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23465	Repair of shoulder joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
23466	Repair of shoulder joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23466	Repair of shoulder joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23466	Repair of shoulder joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
23470	Prosthetic repair of shoulder joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23470	Prosthetic repair of shoulder joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23470	Prosthetic repair of shoulder joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
23472	Prosthetic repair of shoulder joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23472	Prosthetic repair of shoulder joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23472	Prosthetic repair of shoulder joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
23473	Revision of total shoulder repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23473	Revision of total shoulder repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23473	Revision of total shoulder repair	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
23474	Revision of total shoulder repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23474	Revision of total shoulder repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23474	Revision of total shoulder repair	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
23480	Incision to repair collar bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23480	Incision to repair collar bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23480	Incision to repair collar bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23485	Incision to repair collar bone for nonunion of fracture with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23485	Incision to repair collar bone for nonunion of fracture with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23485	Incision to repair collar bone for nonunion of fracture with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23490	Stabilization of collar bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23490	Stabilization of collar bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23490	Stabilization of collar bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23491	Stabilization of upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23491	Stabilization of upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23491	Stabilization of upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
23500	Closed treatment of collar bone fracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23500	Closed treatment of collar bone fracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	6	
23500	Closed treatment of collar bone fracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
23505	Closed treatment of collar bone broken with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23505	Closed treatment of collar bone broken with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	12	
23505	Closed treatment of collar bone broken with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
23515	Open treatment of collar bone broken	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23515	Open treatment of collar bone broken	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23515	Open treatment of collar bone broken	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
23520	Closed treatment of dislocation joint between collar and chest bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23520	Closed treatment of dislocation joint between collar and chest bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	6	
23520	Closed treatment of dislocation joint between collar and chest bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
23525	Closed treatment of dislocation of joint between collar and chest bones with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23525	Closed treatment of dislocation of joint between collar and chest bones with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	64	6	
23525	Closed treatment of dislocation of joint between collar and chest bones with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
23530	Open treatment of dislocation of joint between collar and chest bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23530	Open treatment of dislocation of joint between collar and chest bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23530	Open treatment of dislocation of joint between collar and chest bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
23532	Open treatment of dislocation of joint between collar and chest bones with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23532	Open treatment of dislocation of joint between collar and chest bones with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23532	Open treatment of dislocation of joint between collar and chest bones with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23540	Closed treatment of collar bone and shoulder joint dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23540	Closed treatment of collar bone and shoulder joint dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	6	
23540	Closed treatment of collar bone and shoulder joint dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
23545	Closed treatment of collar bone and shoulder joint dislocation with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23545	Closed treatment of collar bone and shoulder joint dislocation with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	6	
23545	Closed treatment of collar bone and shoulder joint dislocation with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
23550	Open treatment of collar bone and shoulder joint dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23550	Open treatment of collar bone and shoulder joint dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23550	Open treatment of collar bone and shoulder joint dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
23552	Open treatment of collar bone and shoulder joint dislocation with tissue graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23552	Open treatment of collar bone and shoulder joint dislocation with tissue graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23552	Open treatment of collar bone and shoulder joint dislocation with tissue graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23570	Closed treatment of shoulder blade fracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23570	Closed treatment of shoulder blade fracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	12	
23570	Closed treatment of shoulder blade fracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
23575	Closed treatment of broken shoulder blade with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23575	Closed treatment of broken shoulder blade with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	64	12	
23575	Closed treatment of broken shoulder blade with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
23585	Open treatment of broken shoulder blade	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23585	Open treatment of broken shoulder blade	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23585	Open treatment of broken shoulder blade	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
23600	Closed treatment of upper arm fracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23600	Closed treatment of upper arm fracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	3	
23600	Closed treatment of upper arm fracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	117	117	
23605	Closed treatment of broken upper arm bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23605	Closed treatment of broken upper arm bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	69	12	
23605	Closed treatment of broken upper arm bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
23615	Open treatment of broken upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23615	Open treatment of broken upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23615	Open treatment of broken upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
23616	Open treatment of broken upper arm bone with prosthetic replacement	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23616	Open treatment of broken upper arm bone with prosthetic replacement	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23616	Open treatment of broken upper arm bone with prosthetic replacement	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
23620	Closed treatment of fracture of upper arm bone at shoulder joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23620	Closed treatment of fracture of upper arm bone at shoulder joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	6	
23620	Closed treatment of fracture of upper arm bone at shoulder joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
23625	Closed treatment of broken upper arm bone at shoulder joint with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23625	Closed treatment of broken upper arm bone at shoulder joint with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
23625	Closed treatment of broken upper arm bone at shoulder joint with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
23630	Open treatment of broken upper arm bone at shoulder joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23630	Open treatment of broken upper arm bone at shoulder joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23630	Open treatment of broken upper arm bone at shoulder joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
23650	Closed treatment of shoulder dislocation with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23650	Closed treatment of shoulder dislocation with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	6	
23650	Closed treatment of shoulder dislocation with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
23655	Closed treatment of shoulder dislocation with manipulation under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23655	Closed treatment of shoulder dislocation with manipulation under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23655	Closed treatment of shoulder dislocation with manipulation under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
23660	Open treatment of shoulder dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23660	Open treatment of shoulder dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23660	Open treatment of shoulder dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
23665	Closed treatment of shoulder dislocation and broken of upper arm bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23665	Closed treatment of shoulder dislocation and broken of upper arm bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	64	6	
23665	Closed treatment of shoulder dislocation and broken of upper arm bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
23670	Open treatment of shoulder dislocation and broken upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23670	Open treatment of shoulder dislocation and broken upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23670	Open treatment of shoulder dislocation and broken upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
23675	Closed treatment of shoulder dislocation and broken upper arm bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
23675	Closed treatment of shoulder dislocation and broken upper arm bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	6	
23675	Closed treatment of shoulder dislocation and broken upper arm bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
23680	Open treatment of shoulder dislocation and broken upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23680	Open treatment of shoulder dislocation and broken upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23680	Open treatment of shoulder dislocation and broken upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
23700	Manipulation of shoulder joint under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
23700	Manipulation of shoulder joint under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23700	Manipulation of shoulder joint under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
23800	Fusion of bones of shoulder joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23800	Fusion of bones of shoulder joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23800	Fusion of bones of shoulder joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
23802	Fusion of bones of shoulder joint with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23802	Fusion of bones of shoulder joint with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23802	Fusion of bones of shoulder joint with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
23900	Amputation of entire arm with removal shoulder blade and a portion of collar bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23900	Amputation of entire arm with removal shoulder blade and a portion of collar bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23900	Amputation of entire arm with removal shoulder blade and a portion of collar bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
23920	"Removal of tendons, ligaments, and muscles of shoulder"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23920	"Removal of tendons, ligaments, and muscles of shoulder"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23920	"Removal of tendons, ligaments, and muscles of shoulder"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
23921	"Removal of tendons, ligaments, and muscles of shoulder"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23921	"Removal of tendons, ligaments, and muscles of shoulder"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
23921	"Removal of tendons, ligaments, and muscles of shoulder"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
23930	Drainage of abscess or blood accumulation at upper arm or elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
23930	Drainage of abscess or blood accumulation at upper arm or elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	67	12	
23930	Drainage of abscess or blood accumulation at upper arm or elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
23931	Drainage of fluid-filled sac (bursa) of upper arm or elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
23931	Drainage of fluid-filled sac (bursa) of upper arm or elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	12	
23931	Drainage of fluid-filled sac (bursa) of upper arm or elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
23935	Incision of bone of upper arm or elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
23935	Incision of bone of upper arm or elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
23935	Incision of bone of upper arm or elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24000	"Incision of elbow with exploration, drainage, or removal of foreign body"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24000	"Incision of elbow with exploration, drainage, or removal of foreign body"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24000	"Incision of elbow with exploration, drainage, or removal of foreign body"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
24006	Incision of elbow with removal of joint capsule	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24006	Incision of elbow with removal of joint capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24006	Incision of elbow with removal of joint capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24065	Biopsy of soft tissue of upper arm or elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
24065	Biopsy of soft tissue of upper arm or elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	6	
24065	Biopsy of soft tissue of upper arm or elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
24066	Biopsy of soft tissue of upper arm or elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24066	Biopsy of soft tissue of upper arm or elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	96	6	
24066	Biopsy of soft tissue of upper arm or elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
24071	Removal (3 centimeters or greater) tissue growth beneath the skin of upper arm or elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24071	Removal (3 centimeters or greater) tissue growth beneath the skin of upper arm or elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
24073	Removal (5 centimeters or greater) muscle growth of upper arm or elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24073	Removal (5 centimeters or greater) muscle growth of upper arm or elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24073	Removal (5 centimeters or greater) muscle growth of upper arm or elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
24075	Removal (less than 3 centimeters) tissue growth beneath the skin of upper arm or elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24075	Removal (less than 3 centimeters) tissue growth beneath the skin of upper arm or elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
24075	Removal (less than 3 centimeters) tissue growth beneath the skin of upper arm or elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
24076	Removal (less than 5 centimeters) muscle growth of upper arm or elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24076	Removal (less than 5 centimeters) muscle growth of upper arm or elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24076	Removal (less than 5 centimeters) muscle growth of upper arm or elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
24077	Removal (less than 5 centimeters) tissue growth of upper arm or elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24077	Removal (less than 5 centimeters) tissue growth of upper arm or elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24077	Removal (less than 5 centimeters) tissue growth of upper arm or elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
24079	Removal (5 centimeters or greater) tissue growth of upper arm or elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24079	Removal (5 centimeters or greater) tissue growth of upper arm or elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24079	Removal (5 centimeters or greater) tissue growth of upper arm or elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
24100	Incision of elbow with biopsy of joint lining	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24100	Incision of elbow with biopsy of joint lining	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24100	Incision of elbow with biopsy of joint lining	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
24101	Incision and exploration of elbow joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24101	Incision and exploration of elbow joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24101	Incision and exploration of elbow joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24102	Removal of elbow joint lining	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24102	Removal of elbow joint lining	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24102	Removal of elbow joint lining	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24105	Removal of fluid-filled sac of elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24105	Removal of fluid-filled sac of elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24105	Removal of fluid-filled sac of elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24110	Removal of upper arm bone cyst or growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24110	Removal of upper arm bone cyst or growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24110	Removal of upper arm bone cyst or growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24115	Removal of upper arm bone cyst or growth with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24115	Removal of upper arm bone cyst or growth with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24115	Removal of upper arm bone cyst or growth with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24116	Removal of upper arm bone cyst or growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24116	Removal of upper arm bone cyst or growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24116	Removal of upper arm bone cyst or growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24120	Removal of elbow or upper forearm bone cyst or growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24120	Removal of elbow or upper forearm bone cyst or growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24120	Removal of elbow or upper forearm bone cyst or growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24125	Removal of elbow or upper forearm bone cyst or growth with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24125	Removal of elbow or upper forearm bone cyst or growth with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24125	Removal of elbow or upper forearm bone cyst or growth with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24126	Removal of elbow or upper forearm bone cyst or growth with donor graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24126	Removal of elbow or upper forearm bone cyst or growth with donor graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24126	Removal of elbow or upper forearm bone cyst or growth with donor graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24130	Removal of forearm bone at elbow joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24130	Removal of forearm bone at elbow joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24130	Removal of forearm bone at elbow joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24134	Removal of dead upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24134	Removal of dead upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24134	Removal of dead upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24136	Removal of dead forearm bone at elbow joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24136	Removal of dead forearm bone at elbow joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24136	Removal of dead forearm bone at elbow joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24138	Removal of dead elbow bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24138	Removal of dead elbow bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24138	Removal of dead elbow bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		149	
24140	Partial removal of upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24140	Partial removal of upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24140	Partial removal of upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24145	Partial removal of forearm bone at elbow joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24145	Partial removal of forearm bone at elbow joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24145	Partial removal of forearm bone at elbow joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24147	Partial removal of elbow bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24147	Partial removal of elbow bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24147	Partial removal of elbow bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
24149	Removal of elbow joint capsule and bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24149	Removal of elbow joint capsule and bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24149	Removal of elbow joint capsule and bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		216	
24150	Removal of upper arm bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24150	Removal of upper arm bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24150	Removal of upper arm bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
24152	Removal of growth of forearm bone at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24152	Removal of growth of forearm bone at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24152	Removal of growth of forearm bone at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
24155	Removal of elbow joint bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24155	Removal of elbow joint bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24155	Removal of elbow joint bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24160	Removal of elbow joint hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24160	Removal of elbow joint hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24160	Removal of elbow joint hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
24164	Removal of hardware of forearm bone at elbow joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24164	Removal of hardware of forearm bone at elbow joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24164	Removal of hardware of forearm bone at elbow joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24200	"Removal of foreign body of upper arm or elbow area, accessed beneath the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	30	
24200	"Removal of foreign body of upper arm or elbow area, accessed beneath the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	6	
24200	"Removal of foreign body of upper arm or elbow area, accessed beneath the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
24201	"Removal of foreign body, upper arm or elbow area"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24201	"Removal of foreign body, upper arm or elbow area"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	90	6	
24201	"Removal of foreign body, upper arm or elbow area"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
24220	Injection of dye for X-ray imaging of elbow joint	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	28	0	
24220	Injection of dye for X-ray imaging of elbow joint	Post-service	L041B	Radiologic Technologist	0.41	Post service total costs	3	0	
24300	Manipulation of elbow under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24300	Manipulation of elbow under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24300	Manipulation of elbow under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
24301	Relocation of muscle or tendon of upper arm or elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24301	Relocation of muscle or tendon of upper arm or elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24301	Relocation of muscle or tendon of upper arm or elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24305	Lengthening of tendon of upper arm or elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24305	Lengthening of tendon of upper arm or elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24305	Lengthening of tendon of upper arm or elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24310	"Incision of tendon located from elbow to shoulder, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24310	"Incision of tendon located from elbow to shoulder, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24310	"Incision of tendon located from elbow to shoulder, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
24320	Relocation of forearm tendon and muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24320	Relocation of forearm tendon and muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24320	Relocation of forearm tendon and muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24330	Relocation of forearm tendons	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24330	Relocation of forearm tendons	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24330	Relocation of forearm tendons	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24331	Relocation of forearm tendons	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24331	Relocation of forearm tendons	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24331	Relocation of forearm tendons	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24332	Release of scarring of upper arm tendon at shoulder joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24332	Release of scarring of upper arm tendon at shoulder joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24332	Release of scarring of upper arm tendon at shoulder joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
24340	Anchoring of biceps tendon at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24340	Anchoring of biceps tendon at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24340	Anchoring of biceps tendon at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24341	Repair of tendon or muscle of upper arm or elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24341	Repair of tendon or muscle of upper arm or elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24341	Repair of tendon or muscle of upper arm or elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
24342	Reinsertion of torn biceps or triceps tendon at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24342	Reinsertion of torn biceps or triceps tendon at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24342	Reinsertion of torn biceps or triceps tendon at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24343	Repair of ligament at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24343	Repair of ligament at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24343	Repair of ligament at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
24344	Repair of ligament at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24344	Repair of ligament at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24344	Repair of ligament at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		189	
24345	Repair of ligament at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24345	Repair of ligament at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24345	Repair of ligament at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
24346	Repair of ligament at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24346	Repair of ligament at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24346	Repair of ligament at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		189	
24357	"Incision of tendon to repair elbow joint, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24357	"Incision of tendon to repair elbow joint, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24357	"Incision of tendon to repair elbow joint, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24358	"Removal of tissue and/or bone at elbow, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24358	"Removal of tissue and/or bone at elbow, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24358	"Removal of tissue and/or bone at elbow, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24359	"Removal of tissue and/or bone at elbow with tendon repair, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24359	"Removal of tissue and/or bone at elbow with tendon repair, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24359	"Removal of tissue and/or bone at elbow with tendon repair, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24360	Repair of elbow joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24360	Repair of elbow joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24360	Repair of elbow joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
24361	Repair of elbow joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24361	Repair of elbow joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24361	Repair of elbow joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
24362	Repair of elbow joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24362	Repair of elbow joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24362	Repair of elbow joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
24363	Prosthetic repair of elbow joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24363	Prosthetic repair of elbow joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24363	Prosthetic repair of elbow joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
24365	Repair of forearm bone at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24365	Repair of forearm bone at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24365	Repair of forearm bone at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24366	Repair of forearm bone at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24366	Repair of forearm bone at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24366	Repair of forearm bone at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24370	Revision of total elbow repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24370	Revision of total elbow repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24370	Revision of total elbow repair	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
24371	Revision of total elbow repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24371	Revision of total elbow repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24371	Revision of total elbow repair	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
24400	Incision to repair upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24400	Incision to repair upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24400	Incision to repair upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
24410	Repair of upper arm bone with rod insertion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24410	Repair of upper arm bone with rod insertion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24410	Repair of upper arm bone with rod insertion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
24420	Reconstruction of upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24420	Reconstruction of upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24420	Reconstruction of upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
24430	Repair of non-healed upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24430	Repair of non-healed upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24430	Repair of non-healed upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
24435	Repair of non-healed upper arm bone with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24435	Repair of non-healed upper arm bone with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24435	Repair of non-healed upper arm bone with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
24470	Repair of growth plates of upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24470	Repair of growth plates of upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24470	Repair of growth plates of upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24495	Incision of tissue of forearm muscle compartment with exploration of artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24495	Incision of tissue of forearm muscle compartment with exploration of artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24495	Incision of tissue of forearm muscle compartment with exploration of artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24498	Stabilization of upper arm bone with hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24498	Stabilization of upper arm bone with hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24498	Stabilization of upper arm bone with hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24500	Closed treatment of upper arm fracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24500	Closed treatment of upper arm fracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	6	
24500	Closed treatment of upper arm fracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
24505	Closed treatment of broken upper arm bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24505	Closed treatment of broken upper arm bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	6	
24505	Closed treatment of broken upper arm bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
24515	Open treatment of broken upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24515	Open treatment of broken upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24515	Open treatment of broken upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
24516	Treatment of broken upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24516	Treatment of broken upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24516	Treatment of broken upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24530	Closed treatment of growth plate or broken upper arm bone at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24530	Closed treatment of growth plate or broken upper arm bone at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	62	6	
24530	Closed treatment of growth plate or broken upper arm bone at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
24535	Closed treatment of growth plate or broken upper arm bone at elbow with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24535	Closed treatment of growth plate or broken upper arm bone at elbow with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	80	12	
24535	Closed treatment of growth plate or broken upper arm bone at elbow with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	135	135	
24538	"Insertion of hardware to growth plate or broken upper arm bone at elbow, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24538	"Insertion of hardware to growth plate or broken upper arm bone at elbow, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24538	"Insertion of hardware to growth plate or broken upper arm bone at elbow, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
24545	Open treatment of growth plate or broken upper arm bone at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24545	Open treatment of growth plate or broken upper arm bone at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24545	Open treatment of growth plate or broken upper arm bone at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
24546	Open treatment of growth plate or broken upper arm at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24546	Open treatment of growth plate or broken upper arm at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24546	Open treatment of growth plate or broken upper arm at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
24560	Closed treatment of broken upper arm bone at shoulder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24560	Closed treatment of broken upper arm bone at shoulder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	6	
24560	Closed treatment of broken upper arm bone at shoulder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
24565	Closed treatment of broken upper arm bone at shoulder with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24565	Closed treatment of broken upper arm bone at shoulder with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	76	12	
24565	Closed treatment of broken upper arm bone at shoulder with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
24566	"Insertion of hardware to broken upper arm bone at elbow with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24566	"Insertion of hardware to broken upper arm bone at elbow with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24566	"Insertion of hardware to broken upper arm bone at elbow with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
24575	Open treatment of broken upper arm bone at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24575	Open treatment of broken upper arm bone at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24575	Open treatment of broken upper arm bone at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
24576	Closed treatment of broken upper arm bone at shoulder joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24576	Closed treatment of broken upper arm bone at shoulder joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
24576	Closed treatment of broken upper arm bone at shoulder joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
24577	Closed treatment of broken of upper arm bone at shoulder with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24577	Closed treatment of broken of upper arm bone at shoulder with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	79	12	
24577	Closed treatment of broken of upper arm bone at shoulder with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
24579	Open treatment of broken upper arm bone at shoulder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24579	Open treatment of broken upper arm bone at shoulder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24579	Open treatment of broken upper arm bone at shoulder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
24582	"Insertion of hardware to broken upper arm bone at shoulder with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24582	"Insertion of hardware to broken upper arm bone at shoulder with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24582	"Insertion of hardware to broken upper arm bone at shoulder with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
24586	Open treatment of broken and/or dislocated upper or lower arm bones at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24586	Open treatment of broken and/or dislocated upper or lower arm bones at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24586	Open treatment of broken and/or dislocated upper or lower arm bones at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
24587	Open treatment of broken and/or dislocated upper or lower arm bones at elbow with implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24587	Open treatment of broken and/or dislocated upper or lower arm bones at elbow with implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24587	Open treatment of broken and/or dislocated upper or lower arm bones at elbow with implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
24600	Treatment of elbow dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24600	Treatment of elbow dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	52	6	
24600	Treatment of elbow dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
24605	Treatment of dislocated elbow under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24605	Treatment of dislocated elbow under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24605	Treatment of dislocated elbow under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
24615	Open treatment of dislocated elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24615	Open treatment of dislocated elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24615	Open treatment of dislocated elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24620	Closed treatment of broken and dislocated forearm bones at elbow with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24620	Closed treatment of broken and dislocated forearm bones at elbow with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24620	Closed treatment of broken and dislocated forearm bones at elbow with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
24635	Open treatment of broken and dislocated forearm bones at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24635	Open treatment of broken and dislocated forearm bones at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24635	Open treatment of broken and dislocated forearm bones at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
24640	"Closed treatment of dislocated forearm bone of elbow, child"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	5	
24640	"Closed treatment of dislocated forearm bone of elbow, child"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	32	6	
24640	"Closed treatment of dislocated forearm bone of elbow, child"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
24650	Closed treatment of broken forearm bone at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24650	Closed treatment of broken forearm bone at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	6	
24650	Closed treatment of broken forearm bone at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
24655	Closed treatment of broken forearm bone at elbow with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24655	Closed treatment of broken forearm bone at elbow with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	64	6	
24655	Closed treatment of broken forearm bone at elbow with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
24665	Open treatment of broken forearm bone at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24665	Open treatment of broken forearm bone at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24665	Open treatment of broken forearm bone at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
24666	Open treatment of broken forearm bone at elbow with prosthetic replacement	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24666	Open treatment of broken forearm bone at elbow with prosthetic replacement	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24666	Open treatment of broken forearm bone at elbow with prosthetic replacement	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24670	Closed treatment of broke forearm bone at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24670	Closed treatment of broke forearm bone at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	52	6	
24670	Closed treatment of broke forearm bone at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
24675	Closed treatment of broken forearm bone at elbow with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
24675	Closed treatment of broken forearm bone at elbow with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	70	12	
24675	Closed treatment of broken forearm bone at elbow with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
24685	Open treatment of broken forearm bone at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24685	Open treatment of broken forearm bone at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24685	Open treatment of broken forearm bone at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
24800	Fusion of elbow joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24800	Fusion of elbow joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24800	Fusion of elbow joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
24802	Fusion of elbow joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24802	Fusion of elbow joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24802	Fusion of elbow joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
24900	Amputation at upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24900	Amputation at upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24900	Amputation at upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
24920	"Amputation at upper arm bone, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24920	"Amputation at upper arm bone, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24920	"Amputation at upper arm bone, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24925	Revision of scar or wound closure of previous amputation at upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24925	Revision of scar or wound closure of previous amputation at upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24925	Revision of scar or wound closure of previous amputation at upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24930	Re-amputation of remaining arm at upper arm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24930	Re-amputation of remaining arm at upper arm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24930	Re-amputation of remaining arm at upper arm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
24931	Amputation of arm at upper arm bone with implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24931	Amputation of arm at upper arm bone with implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
24931	Amputation of arm at upper arm bone with implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
24935	Lengthening of amputation stump of arm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
24935	Lengthening of amputation stump of arm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
24935	Lengthening of amputation stump of arm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
25000	Incision to repair tendon covering at wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25000	Incision to repair tendon covering at wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25000	Incision to repair tendon covering at wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25001	Incision to repair tendon covering at wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25001	Incision to repair tendon covering at wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25001	Incision to repair tendon covering at wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
25020	Incision of tissue of forearm and/or wrist muscle compartment	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25020	Incision of tissue of forearm and/or wrist muscle compartment	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25020	Incision of tissue of forearm and/or wrist muscle compartment	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
25023	Incision of tissue of forearm and/or wrist muscle compartment with removal of muscle and/or nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25023	Incision of tissue of forearm and/or wrist muscle compartment with removal of muscle and/or nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25023	Incision of tissue of forearm and/or wrist muscle compartment with removal of muscle and/or nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25024	Incision of tissue of forearm and/or wrist muscle compartment	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25024	Incision of tissue of forearm and/or wrist muscle compartment	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25024	Incision of tissue of forearm and/or wrist muscle compartment	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
25025	Incision of tissue of forearm and/or wrist muscle compartment with removal of muscle and/or nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25025	Incision of tissue of forearm and/or wrist muscle compartment with removal of muscle and/or nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25025	Incision of tissue of forearm and/or wrist muscle compartment with removal of muscle and/or nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
25028	Drainage of abscess or blood accumulation at forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25028	Drainage of abscess or blood accumulation at forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25028	Drainage of abscess or blood accumulation at forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
25031	Drainage of infected fluid-filled sac (bursa) of forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25031	Drainage of infected fluid-filled sac (bursa) of forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25031	Drainage of infected fluid-filled sac (bursa) of forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
25035	Incision of forearm and/or wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25035	Incision of forearm and/or wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25035	Incision of forearm and/or wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25040	Drainage or removal of foreign body of wrist joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25040	Drainage or removal of foreign body of wrist joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25040	Drainage or removal of foreign body of wrist joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
25065	Biopsy of tissue of forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
25065	Biopsy of tissue of forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	6	
25065	Biopsy of tissue of forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
25066	Biopsy of tissue of forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25066	Biopsy of tissue of forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25066	Biopsy of tissue of forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
25071	Removal (3 centimeters or greater) tissue growth beneath the skin at forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25071	Removal (3 centimeters or greater) tissue growth beneath the skin at forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25071	Removal (3 centimeters or greater) tissue growth beneath the skin at forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
25073	Removal (3 centimeters or greater) muscle growth at forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25073	Removal (3 centimeters or greater) muscle growth at forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25073	Removal (3 centimeters or greater) muscle growth at forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
25075	Removal (less than 3 centimeters) tissue growth beneath the skin at forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25075	Removal (less than 3 centimeters) tissue growth beneath the skin at forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
25075	Removal (less than 3 centimeters) tissue growth beneath the skin at forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
25076	Removal (less than 3 centimeters) muscle growth at forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25076	Removal (less than 3 centimeters) muscle growth at forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25076	Removal (less than 3 centimeters) muscle growth at forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
25077	Removal (less than 3 centimeters) tissue growth at forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25077	Removal (less than 3 centimeters) tissue growth at forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25077	Removal (less than 3 centimeters) tissue growth at forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
25078	Removal (3 centimeters or greater) tissue growth at forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25078	Removal (3 centimeters or greater) tissue growth at forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25078	Removal (3 centimeters or greater) tissue growth at forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
25085	Incision to repair wrist joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25085	Incision to repair wrist joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25085	Incision to repair wrist joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
25100	Incision of joint capsule of wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25100	Incision of joint capsule of wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25100	Incision of joint capsule of wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
25101	Incision and exploration of wrist joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25101	Incision and exploration of wrist joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25101	Incision and exploration of wrist joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
25105	Incision to repair wrist joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25105	Incision to repair wrist joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25105	Incision to repair wrist joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25107	Incision to repair wrist joint with repair of cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25107	Incision to repair wrist joint with repair of cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25107	Incision to repair wrist joint with repair of cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
25109	Removal of tendon of forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25109	Removal of tendon of forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25109	Removal of tendon of forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
25110	Removal of growth of tendon covering at forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25110	Removal of growth of tendon covering at forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25110	Removal of growth of tendon covering at forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
25111	Removal of cyst at wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25111	Removal of cyst at wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25111	Removal of cyst at wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
25112	Removal of cyst at wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25112	Removal of cyst at wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25112	Removal of cyst at wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
25115	Removal of fluid-filled sac (bursa) of wrist joint lining or forearm tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25115	Removal of fluid-filled sac (bursa) of wrist joint lining or forearm tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25115	Removal of fluid-filled sac (bursa) of wrist joint lining or forearm tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
25116	Removal of fluid-filled sac (bursa) of wrist joint lining or forearm tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25116	Removal of fluid-filled sac (bursa) of wrist joint lining or forearm tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25116	Removal of fluid-filled sac (bursa) of wrist joint lining or forearm tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
25118	Removal of lining of tendon covering of wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25118	Removal of lining of tendon covering of wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25118	Removal of lining of tendon covering of wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
25119	Removal of lining of tendon covering of wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25119	Removal of lining of tendon covering of wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25119	Removal of lining of tendon covering of wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25120	Removal of forearm bone cyst or growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25120	Removal of forearm bone cyst or growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25120	Removal of forearm bone cyst or growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25125	Removal of forearm bone cyst or growth with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25125	Removal of forearm bone cyst or growth with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25125	Removal of forearm bone cyst or growth with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25126	Removal of forearm bone cyst or growth with donor bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25126	Removal of forearm bone cyst or growth with donor bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25126	Removal of forearm bone cyst or growth with donor bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25130	Removal of wrist bone cyst or growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25130	Removal of wrist bone cyst or growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25130	Removal of wrist bone cyst or growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25135	Removal of wrist bone cyst or growth with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25135	Removal of wrist bone cyst or growth with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25135	Removal of wrist bone cyst or growth with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25136	Removal of wrist bone cyst or growth with donor bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25136	Removal of wrist bone cyst or growth with donor bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25136	Removal of wrist bone cyst or growth with donor bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25145	Removal of dead forearm and/or wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25145	Removal of dead forearm and/or wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25145	Removal of dead forearm and/or wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25150	Partial removal of forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25150	Partial removal of forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25150	Partial removal of forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25151	Partial removal of forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25151	Partial removal of forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25151	Partial removal of forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25170	Removal of forearm bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25170	Removal of forearm bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
25210	Removal of wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25210	Removal of wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25210	Removal of wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25215	Removal of multiple wrist bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25215	Removal of multiple wrist bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25215	Removal of multiple wrist bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25230	Partial removal of wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25230	Partial removal of wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25230	Partial removal of wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
25240	Partial removal of forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25240	Partial removal of forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25240	Partial removal of forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
25246	Injection of dye for X-ray imaging of wrist joint	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	28	0	
25246	Injection of dye for X-ray imaging of wrist joint	Post-service	L041B	Radiologic Technologist	0.41	Post service total costs	3	0	
25248	Removal of foreign body of forearm or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25248	Removal of foreign body of forearm or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25248	Removal of foreign body of forearm or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25250	Removal of wrist prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25250	Removal of wrist prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25250	Removal of wrist prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25251	Removal of wrist prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25251	Removal of wrist prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25251	Removal of wrist prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25259	Manipulation of wrist under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25259	Manipulation of wrist under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25259	Manipulation of wrist under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
25260	Repair of tendon or muscle of forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25260	Repair of tendon or muscle of forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25260	Repair of tendon or muscle of forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
25263	Repair of tendon or muscle of forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25263	Repair of tendon or muscle of forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25263	Repair of tendon or muscle of forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25265	Repair of forearm and/or wrist tendon or muscle with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25265	Repair of forearm and/or wrist tendon or muscle with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25265	Repair of forearm and/or wrist tendon or muscle with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25270	Repair of forearm and/or wrist tendon or muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25270	Repair of forearm and/or wrist tendon or muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25270	Repair of forearm and/or wrist tendon or muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25272	Repair of forearm and/or wrist tendon or muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25272	Repair of forearm and/or wrist tendon or muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25272	Repair of forearm and/or wrist tendon or muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25274	Repair of forearm and/or wrist tendon or muscle with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25274	Repair of forearm and/or wrist tendon or muscle with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25274	Repair of forearm and/or wrist tendon or muscle with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25275	Repair of forearm and/or wrist tendon covering with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25275	Repair of forearm and/or wrist tendon covering with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25275	Repair of forearm and/or wrist tendon covering with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
25280	Lengthening or shortening of tendon of forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25280	Lengthening or shortening of tendon of forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25280	Lengthening or shortening of tendon of forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25290	"Incision of tendon of forearm and/or wrist, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25290	"Incision of tendon of forearm and/or wrist, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25290	"Incision of tendon of forearm and/or wrist, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
25295	Removal of scar tissue of tendon of forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25295	Removal of scar tissue of tendon of forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25295	Removal of scar tissue of tendon of forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25300	Anchoring of tendon of fingers to wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25300	Anchoring of tendon of fingers to wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25300	Anchoring of tendon of fingers to wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25301	Anchoring of tendon of fingers to wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25301	Anchoring of tendon of fingers to wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25301	Anchoring of tendon of fingers to wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25310	Relocation of tendon of forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25310	Relocation of tendon of forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25310	Relocation of tendon of forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
25312	Relocation of tendon of forearm and/or wrist with grafts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25312	Relocation of tendon of forearm and/or wrist with grafts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25312	Relocation of tendon of forearm and/or wrist with grafts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25315	Repair of tendon of forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25315	Repair of tendon of forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25315	Repair of tendon of forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25316	Repair and relocation of tendons of forearm and/or wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25316	Repair and relocation of tendons of forearm and/or wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25316	Repair and relocation of tendons of forearm and/or wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25320	"Repair of wrist joint, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25320	"Repair of wrist joint, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25320	"Repair of wrist joint, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		248	
25332	Repair of wrist joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25332	Repair of wrist joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25332	Repair of wrist joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25335	Advancement of tendons of outer forearm at wrist joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25335	Advancement of tendons of outer forearm at wrist joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25335	Advancement of tendons of outer forearm at wrist joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25337	Repair of tendons of outer forearm at wrist joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25337	Repair of tendons of outer forearm at wrist joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25337	Repair of tendons of outer forearm at wrist joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		195	
25350	Incision to repair forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25350	Incision to repair forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25350	Incision to repair forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25355	Incision to repair forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25355	Incision to repair forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25355	Incision to repair forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25360	Incision to repair forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25360	Incision to repair forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25360	Incision to repair forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25365	Incision to repair forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25365	Incision to repair forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25365	Incision to repair forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25370	Incision to repair forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25370	Incision to repair forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25370	Incision to repair forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		149	
25375	Incision to repair both forearm bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25375	Incision to repair both forearm bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25375	Incision to repair both forearm bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25390	Shortening of one of the forearm bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25390	Shortening of one of the forearm bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25390	Shortening of one of the forearm bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25391	Lengthening of one of the forearm bones with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25391	Lengthening of one of the forearm bones with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25391	Lengthening of one of the forearm bones with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25392	Shortening of both bones of forearm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25392	Shortening of both bones of forearm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25392	Shortening of both bones of forearm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25393	Lengthening of both bones of forearm with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25393	Lengthening of both bones of forearm with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25393	Lengthening of both bones of forearm with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25394	Shortening of bone of wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25394	Shortening of bone of wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25394	Shortening of bone of wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
25400	Repair non-healed fracture of forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25400	Repair non-healed fracture of forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25400	Repair non-healed fracture of forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25405	Repair non-healed fracture of forearm bone with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25405	Repair non-healed fracture of forearm bone with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25405	Repair non-healed fracture of forearm bone with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25415	Repair non-healed fracture of forearm bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25415	Repair non-healed fracture of forearm bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25415	Repair non-healed fracture of forearm bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25420	Repair non-healed fracture of forearm bones with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25420	Repair non-healed fracture of forearm bones with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25420	Repair non-healed fracture of forearm bones with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
25425	Repair of forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25425	Repair of forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25425	Repair of forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25426	Repair of forearm bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25426	Repair of forearm bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25426	Repair of forearm bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25430	Insertion of vascular bone graft into wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25430	Insertion of vascular bone graft into wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25430	Insertion of vascular bone graft into wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
25431	Repair of non-healed wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25431	Repair of non-healed wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25431	Repair of non-healed wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
25440	Repair of non-healed wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25440	Repair of non-healed wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25440	Repair of non-healed wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25441	Removal of forearm bone at wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25441	Removal of forearm bone at wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25441	Removal of forearm bone at wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25442	Removal of forearm bone at wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25442	Removal of forearm bone at wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25442	Removal of forearm bone at wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25443	Removal of wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25443	Removal of wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25443	Removal of wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25444	Removal of wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25444	Removal of wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25444	Removal of wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25445	Removal of wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25445	Removal of wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25445	Removal of wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25446	Removal of forearm bone at wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25446	Removal of forearm bone at wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25446	Removal of forearm bone at wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25447	Removal of bone joints between wrist and fingers	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25447	Removal of bone joints between wrist and fingers	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25447	Removal of bone joints between wrist and fingers	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		153	
25449	Removal and reinsertion of implant at wrist joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25449	Removal and reinsertion of implant at wrist joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25449	Removal and reinsertion of implant at wrist joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25450	Stapling of growth plate of forearm bone at wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25450	Stapling of growth plate of forearm bone at wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25450	Stapling of growth plate of forearm bone at wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25455	Stapling of growth plate of forearm bone at wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25455	Stapling of growth plate of forearm bone at wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25455	Stapling of growth plate of forearm bone at wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25490	Stabilization of forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25490	Stabilization of forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25490	Stabilization of forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25491	Stabilization of forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25491	Stabilization of forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25491	Stabilization of forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25492	Stabilization of both forearm bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25492	Stabilization of both forearm bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25492	Stabilization of both forearm bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25500	Closed treatment of broken forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25500	Closed treatment of broken forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	6	
25500	Closed treatment of broken forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
25505	Closed treatment of broken forearm bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25505	Closed treatment of broken forearm bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	69	6	
25505	Closed treatment of broken forearm bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	135	135	
25515	Open treatment of broken forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25515	Open treatment of broken forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25515	Open treatment of broken forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
25520	Closed treatment of broken forearm and dislocated wrist bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25520	Closed treatment of broken forearm and dislocated wrist bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	6	
25520	Closed treatment of broken forearm and dislocated wrist bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	135	135	
25525	Open treatment of broken forearm bone and closed treatment of joint dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25525	Open treatment of broken forearm bone and closed treatment of joint dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25525	Open treatment of broken forearm bone and closed treatment of joint dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
25526	Open treatment of broken forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25526	Open treatment of broken forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25526	Open treatment of broken forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		153	
25530	Closed treatment of broken forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25530	Closed treatment of broken forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	6	
25530	Closed treatment of broken forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
25535	Closed treatment of broken forearm bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25535	Closed treatment of broken forearm bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	6	
25535	Closed treatment of broken forearm bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
25545	Open treatment of broken forearm bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25545	Open treatment of broken forearm bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25545	Open treatment of broken forearm bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
25560	Closed treatment of broken forearm bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25560	Closed treatment of broken forearm bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	6	
25560	Closed treatment of broken forearm bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
25565	Closed treatment of broken forearm bones with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25565	Closed treatment of broken forearm bones with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	77	6	
25565	Closed treatment of broken forearm bones with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
25574	Open treatment of broken forearm bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25574	Open treatment of broken forearm bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25574	Open treatment of broken forearm bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
25575	Open treatment of broken forearm bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25575	Open treatment of broken forearm bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25575	Open treatment of broken forearm bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		153	
25600	Closed treatment of broken forearm bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25600	Closed treatment of broken forearm bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	6	
25600	Closed treatment of broken forearm bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	135	135	
25605	Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25605	Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	6	
25605	Closed treatment of broken or growth plate separate of forearm bone at wrist with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
25606	"Insertion of hardware to lower forearm bone broken or growth plate separation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25606	"Insertion of hardware to lower forearm bone broken or growth plate separation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25606	"Insertion of hardware to lower forearm bone broken or growth plate separation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
25607	Open treatment of broken of lower forearm bone or growth plate separation with insertion of hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25607	Open treatment of broken of lower forearm bone or growth plate separation with insertion of hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25607	Open treatment of broken of lower forearm bone or growth plate separation with insertion of hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
25608	Open treatment of broken of lower forearm or growth plate separation with insertion of hardware of 2 fragments	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25608	Open treatment of broken of lower forearm or growth plate separation with insertion of hardware of 2 fragments	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25608	Open treatment of broken of lower forearm or growth plate separation with insertion of hardware of 2 fragments	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
25609	Open treatment of broken of lower forearm or growth plate separation with insertion of hardware 3 or more fragments	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25609	Open treatment of broken of lower forearm or growth plate separation with insertion of hardware 3 or more fragments	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25609	Open treatment of broken of lower forearm or growth plate separation with insertion of hardware 3 or more fragments	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		198	
25622	Closed treatment of broken wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25622	Closed treatment of broken wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	6	
25622	Closed treatment of broken wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
25624	Closed treatment of broken wrist bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25624	Closed treatment of broken wrist bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	69	6	
25624	Closed treatment of broken wrist bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	135	135	
25628	Open treatment of broken wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25628	Open treatment of broken wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25628	Open treatment of broken wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
25630	Closed treatment of broken wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25630	Closed treatment of broken wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	6	
25630	Closed treatment of broken wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
25635	Closed treatment of broken wrist bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25635	Closed treatment of broken wrist bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	6	
25635	Closed treatment of broken wrist bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
25645	Open treatment of broken wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25645	Open treatment of broken wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25645	Open treatment of broken wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25650	Closed treatment of broken forearm at wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25650	Closed treatment of broken forearm at wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	6	
25650	Closed treatment of broken forearm at wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
25651	"Insertion of hardware broken bone of forearm at wrist, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25651	"Insertion of hardware broken bone of forearm at wrist, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25651	"Insertion of hardware broken bone of forearm at wrist, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
25652	Open treatment of broken wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25652	Open treatment of broken wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25652	Open treatment of broken wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
25660	Closed treatment of dislocated wrist with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25660	Closed treatment of dislocated wrist with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25660	Closed treatment of dislocated wrist with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25670	Open treatment of dislocated 1 or more wrist joint bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25670	Open treatment of dislocated 1 or more wrist joint bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25670	Open treatment of dislocated 1 or more wrist joint bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25671	"Insertion of hardware to dislocated wrist, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25671	"Insertion of hardware to dislocated wrist, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25671	"Insertion of hardware to dislocated wrist, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
25675	Closed treatment of dislocated wrist with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
25675	Closed treatment of dislocated wrist with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	6	
25675	Closed treatment of dislocated wrist with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
25676	Open treatment of dislocated wrist joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25676	Open treatment of dislocated wrist joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25676	Open treatment of dislocated wrist joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25680	Closed treatment of dislocated wrist with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25680	Closed treatment of dislocated wrist with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25680	Closed treatment of dislocated wrist with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
25685	Open treatment of broken and dislocated wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25685	Open treatment of broken and dislocated wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25685	Open treatment of broken and dislocated wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25690	Closed treatment of dislocated wrist bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25690	Closed treatment of dislocated wrist bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25690	Closed treatment of dislocated wrist bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25695	Open treatment of dislocated wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25695	Open treatment of dislocated wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25695	Open treatment of dislocated wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25800	Fusion of entire wrist joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25800	Fusion of entire wrist joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25800	Fusion of entire wrist joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25805	Fusion of wrist joint with bone graft from wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25805	Fusion of wrist joint with bone graft from wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25805	Fusion of wrist joint with bone graft from wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
25810	Fusion of wrist joint with graft from hip or other bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25810	Fusion of wrist joint with graft from hip or other bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25810	Fusion of wrist joint with graft from hip or other bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
25820	Fusion of part of wrist joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25820	Fusion of part of wrist joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25820	Fusion of part of wrist joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
25825	Fusion of part of wrist joint with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25825	Fusion of part of wrist joint with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25825	Fusion of part of wrist joint with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
25830	Fusion of both forearm bones at wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25830	Fusion of both forearm bones at wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25830	Fusion of both forearm bones at wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		143	
25900	Amputation through both bones of forearm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25900	Amputation through both bones of forearm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25900	Amputation through both bones of forearm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
25905	"Amputation through both bones of forearm, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25905	"Amputation through both bones of forearm, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25905	"Amputation through both bones of forearm, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25907	Revision of scar or wound closure of previous amputation through both bones of forearm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25907	Revision of scar or wound closure of previous amputation through both bones of forearm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25907	Revision of scar or wound closure of previous amputation through both bones of forearm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25909	Re-amputation of remaining upper arm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25909	Re-amputation of remaining upper arm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25909	Re-amputation of remaining upper arm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25915	Conversion of wrist amputation stump to grasping function	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25915	Conversion of wrist amputation stump to grasping function	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25915	Conversion of wrist amputation stump to grasping function	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
25920	"Removal of tendons, ligaments, and muscles of wrist"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25920	"Removal of tendons, ligaments, and muscles of wrist"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25920	"Removal of tendons, ligaments, and muscles of wrist"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25922	"Removal of tendons, ligaments, and muscles of wrist"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25922	"Removal of tendons, ligaments, and muscles of wrist"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25922	"Removal of tendons, ligaments, and muscles of wrist"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25924	"Removal of tendons, ligaments, and muscles of wrist with re-amputation of remaining arm"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25924	"Removal of tendons, ligaments, and muscles of wrist with re-amputation of remaining arm"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25924	"Removal of tendons, ligaments, and muscles of wrist with re-amputation of remaining arm"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25927	Amputation of hand bone at wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25927	Amputation of hand bone at wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25927	Amputation of hand bone at wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25929	Revision of scar or wound closure of previous hand bone amputation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25929	Revision of scar or wound closure of previous hand bone amputation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
25929	Revision of scar or wound closure of previous hand bone amputation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
25931	Re-amputation of remaining hand bone at wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
25931	Re-amputation of remaining hand bone at wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
25931	Re-amputation of remaining hand bone at wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26010	Drainage of finger abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
26010	Drainage of finger abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	6	
26010	Drainage of finger abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
26011	Drainage of finger abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
26011	Drainage of finger abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	6	
26011	Drainage of finger abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
26020	Drainage of tendon of finger and/or palm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26020	Drainage of tendon of finger and/or palm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
26020	Drainage of tendon of finger and/or palm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26025	Drainage of fluid-filled sac (bursa) of palm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26025	Drainage of fluid-filled sac (bursa) of palm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
26025	Drainage of fluid-filled sac (bursa) of palm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
26030	Drainage of multiple fluid-filled sacs (bursa) of palm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26030	Drainage of multiple fluid-filled sacs (bursa) of palm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
26030	Drainage of multiple fluid-filled sacs (bursa) of palm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
26034	Incision of bone of hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26034	Incision of bone of hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26034	Incision of bone of hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
26035	Release of tissues of fingers and/or hand	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26035	Release of tissues of fingers and/or hand	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26035	Release of tissues of fingers and/or hand	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
26037	Incision of tissues of hand	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26037	Incision of tissues of hand	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
26037	Incision of tissues of hand	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
26040	"Release of tissues of palm, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26040	"Release of tissues of palm, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26040	"Release of tissues of palm, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
26045	"Partial release of tissues of palm, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26045	"Partial release of tissues of palm, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26045	"Partial release of tissues of palm, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26055	Incision of tendon covering	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26055	Incision of tendon covering	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	6	
26055	Incision of tendon covering	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
26060	"Incision of finger tendon, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26060	"Incision of finger tendon, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26060	"Incision of finger tendon, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
26070	"Exploration, drainage, or removal of foreign body of wrist bone"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26070	"Exploration, drainage, or removal of foreign body of wrist bone"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26070	"Exploration, drainage, or removal of foreign body of wrist bone"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
26075	"Exploration, drainage, or removal of foreign body of hand joint"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26075	"Exploration, drainage, or removal of foreign body of hand joint"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26075	"Exploration, drainage, or removal of foreign body of hand joint"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
26080	"Exploration, drainage, or removal of foreign body of hand joint"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26080	"Exploration, drainage, or removal of foreign body of hand joint"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26080	"Exploration, drainage, or removal of foreign body of hand joint"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26100	Biopsy of wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26100	Biopsy of wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26100	Biopsy of wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
26105	Biopsy of hand joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26105	Biopsy of hand joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26105	Biopsy of hand joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
26110	Biopsy of finger joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26110	Biopsy of finger joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26110	Biopsy of finger joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
26111	Removal (1.5 centimeters or greater) tissue beneath the skin growth of hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26111	Removal (1.5 centimeters or greater) tissue beneath the skin growth of hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26111	Removal (1.5 centimeters or greater) tissue beneath the skin growth of hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
26113	Removal (1.5 centimeters or greater) muscle growth of hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26113	Removal (1.5 centimeters or greater) muscle growth of hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26113	Removal (1.5 centimeters or greater) muscle growth of hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
26115	Removal (less than 1.5 centimeters) tissue beneath the skin growth of hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26115	Removal (less than 1.5 centimeters) tissue beneath the skin growth of hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
26115	Removal (less than 1.5 centimeters) tissue beneath the skin growth of hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
26116	Removal (less than 1.5 centimeters) muscle growth of hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26116	Removal (less than 1.5 centimeters) muscle growth of hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26116	Removal (less than 1.5 centimeters) muscle growth of hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
26117	Removal (less than 3 centimeters) tissue growth of hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26117	Removal (less than 3 centimeters) tissue growth of hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26117	Removal (less than 3 centimeters) tissue growth of hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
26118	Removal (3 centimeters or greater) tissue growth of hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26118	Removal (3 centimeters or greater) tissue growth of hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
26118	Removal (3 centimeters or greater) tissue growth of hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		179	
26121	Removal of tissue of palm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26121	Removal of tissue of palm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26121	Removal of tissue of palm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26123	Removal of tissue of palm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26123	Removal of tissue of palm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26123	Removal of tissue of palm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
26130	Repair of wrist joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26130	Repair of wrist joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26130	Repair of wrist joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26135	Repair of hand joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26135	Repair of hand joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26135	Repair of hand joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26140	Repair of finger joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26140	Repair of finger joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26140	Repair of finger joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26145	"Repair of tendon, finger and/or hand"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26145	"Repair of tendon, finger and/or hand"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26145	"Repair of tendon, finger and/or hand"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26160	Removal of growth of tendon finger or hand	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26160	Removal of growth of tendon finger or hand	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	86	6	
26160	Removal of growth of tendon finger or hand	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
26170	Removal of tendon of palm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26170	Removal of tendon of palm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26170	Removal of tendon of palm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
26180	Removal of tendon of finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26180	Removal of tendon of finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26180	Removal of tendon of finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26185	Removal of bone at base of thumb	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26185	Removal of bone at base of thumb	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26185	Removal of bone at base of thumb	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
26200	Removal or scraping of hand bone cyst or growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26200	Removal or scraping of hand bone cyst or growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26200	Removal or scraping of hand bone cyst or growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
26205	Removal or scraping of hand bone cyst or growth with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26205	Removal or scraping of hand bone cyst or growth with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26205	Removal or scraping of hand bone cyst or growth with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26210	Removal or scraping of finger bone cyst or growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26210	Removal or scraping of finger bone cyst or growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26210	Removal or scraping of finger bone cyst or growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26215	Removal or scraping of finger bone cyst or growth with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26215	Removal or scraping of finger bone cyst or growth with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26215	Removal or scraping of finger bone cyst or growth with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26230	Partial removal of hand bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26230	Partial removal of hand bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26230	Partial removal of hand bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
26235	Partial removal of finger bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26235	Partial removal of finger bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26235	Partial removal of finger bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
26236	Partial removal of finger bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26236	Partial removal of finger bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26236	Partial removal of finger bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
26250	Removal of growth of hand	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26250	Removal of growth of hand	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26250	Removal of growth of hand	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
26260	Removal of growth of finger joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26260	Removal of growth of finger joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26260	Removal of growth of finger joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
26262	Removal of growth of finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26262	Removal of growth of finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26262	Removal of growth of finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
26320	Removal of implant from finger or hand	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26320	Removal of implant from finger or hand	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26320	Removal of implant from finger or hand	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
26340	Manipulation of finger joint under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26340	Manipulation of finger joint under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26340	Manipulation of finger joint under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
26341	Manipulation of palm pretendinous cord following enzyme injection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	0	
26341	Manipulation of palm pretendinous cord following enzyme injection	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
26350	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26350	Repair of finger tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26350	Repair of finger tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
26352	Repair of finger tendon with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26352	Repair of finger tendon with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26352	Repair of finger tendon with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26356	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
26356	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
26356	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
26356	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
26356	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
26356	Repair of finger tendon	Service  post	L037D	RN/LPN/MTA	0.37	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		6	
26356	Repair of finger tendon	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		108	
26356	Repair of finger tendon	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
26357	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
26357	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
26357	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
26357	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
26357	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
26357	Repair of finger tendon	Service  post	L037D	RN/LPN/MTA	0.37	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		6	
26357	Repair of finger tendon	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		108	
26357	Repair of finger tendon	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
26358	Repair of finger tendon with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
26358	Repair of finger tendon with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
26358	Repair of finger tendon with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
26358	Repair of finger tendon with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
26358	Repair of finger tendon with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
26358	Repair of finger tendon with graft	Service  post	L037D	RN/LPN/MTA	0.37	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		6	
26358	Repair of finger tendon with graft	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		108	
26358	Repair of finger tendon with graft	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
26370	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26370	Repair of finger tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26370	Repair of finger tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26372	Repair of finger tendon with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26372	Repair of finger tendon with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26372	Repair of finger tendon with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26373	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26373	Repair of finger tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26373	Repair of finger tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26390	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26390	Repair of finger tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26390	Repair of finger tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26392	Removal of synthetic rod and insertion of tendon graft at hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26392	Removal of synthetic rod and insertion of tendon graft at hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26392	Removal of synthetic rod and insertion of tendon graft at hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26410	Repair of hand tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26410	Repair of hand tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26410	Repair of hand tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
26412	Repair of hand tendon with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26412	Repair of hand tendon with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26412	Repair of hand tendon with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26415	Removal of tendon in hand or finger with rod insertion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26415	Removal of tendon in hand or finger with rod insertion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26415	Removal of tendon in hand or finger with rod insertion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26416	Removal of rod with tendon graft at hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26416	Removal of rod with tendon graft at hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26416	Removal of rod with tendon graft at hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26418	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26418	Repair of finger tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26418	Repair of finger tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
26420	Repair of finger tendon with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26420	Repair of finger tendon with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26420	Repair of finger tendon with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26426	Repair of finger tendon using tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26426	Repair of finger tendon using tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26426	Repair of finger tendon using tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26428	Repair of finger tendon with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26428	Repair of finger tendon with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26428	Repair of finger tendon with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26432	Closed treatment of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26432	Closed treatment of finger tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26432	Closed treatment of finger tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
26433	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26433	Repair of finger tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26433	Repair of finger tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
26434	Repair of finger tendon with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26434	Repair of finger tendon with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26434	Repair of finger tendon with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26437	Repair of finger tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26437	Repair of finger tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26437	Repair of finger tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26440	Removal of scar tissue to release tendon of palm or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26440	Removal of scar tissue to release tendon of palm or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26440	Removal of scar tissue to release tendon of palm or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
26442	Removal of scar tissue to release tendon of palm and finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26442	Removal of scar tissue to release tendon of palm and finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26442	Removal of scar tissue to release tendon of palm and finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
26445	Removal of scar tissue to release tendon of palm or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26445	Removal of scar tissue to release tendon of palm or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26445	Removal of scar tissue to release tendon of palm or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
26449	Removal of scar tissue from tendon of finger and forearm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26449	Removal of scar tissue from tendon of finger and forearm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26449	Removal of scar tissue from tendon of finger and forearm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
26450	"Incision of tendon of palm, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26450	"Incision of tendon of palm, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26450	"Incision of tendon of palm, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
26455	"Incision of tendon of finger, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26455	"Incision of tendon of finger, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26455	"Incision of tendon of finger, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
26460	"Incision of tendon of hand or finger, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26460	"Incision of tendon of hand or finger, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26460	"Incision of tendon of hand or finger, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
26471	Anchoring of tendon to first joint of finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26471	Anchoring of tendon to first joint of finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26471	Anchoring of tendon to first joint of finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26474	Anchoring of tendon to third joint of finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26474	Anchoring of tendon to third joint of finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26474	Anchoring of tendon to third joint of finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26476	Lengthening of tendon of hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26476	Lengthening of tendon of hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26476	Lengthening of tendon of hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26477	Shortening of tendon of hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26477	Shortening of tendon of hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26477	Shortening of tendon of hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26478	Lengthening of tendon of hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26478	Lengthening of tendon of hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26478	Lengthening of tendon of hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26479	Lengthening of tendon of hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26479	Lengthening of tendon of hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26479	Lengthening of tendon of hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26480	Transplant of tendon of hand	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26480	Transplant of tendon of hand	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26480	Transplant of tendon of hand	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
26483	Transplant of tendon of hand	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26483	Transplant of tendon of hand	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26483	Transplant of tendon of hand	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26485	Transplant of tendon to palm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26485	Transplant of tendon to palm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26485	Transplant of tendon to palm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26489	Transplant of tendon to palm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26489	Transplant of tendon to palm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26489	Transplant of tendon to palm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26490	Transplant of tendon to palm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26490	Transplant of tendon to palm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26490	Transplant of tendon to palm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26492	Transplant of tendon to palm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26492	Transplant of tendon to palm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26492	Transplant of tendon to palm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
26494	Transplant of muscle to palm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26494	Transplant of muscle to palm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26494	Transplant of muscle to palm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26496	"Transplant of tendon thumb, palm, or wrist"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26496	"Transplant of tendon thumb, palm, or wrist"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26496	"Transplant of tendon thumb, palm, or wrist"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26497	Transplant of tendon to ring and small fingers	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26497	Transplant of tendon to ring and small fingers	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26497	Transplant of tendon to ring and small fingers	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26498	"Transfer of tendon of hand, all four fingers"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26498	"Transfer of tendon of hand, all four fingers"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26498	"Transfer of tendon of hand, all four fingers"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
26499	Correction of claw finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26499	Correction of claw finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26499	Correction of claw finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26500	Repair of tendon ligament	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26500	Repair of tendon ligament	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26500	Repair of tendon ligament	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26502	Repair of tendon ligament with tendon or tissue graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26502	Repair of tendon ligament with tendon or tissue graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26502	Repair of tendon ligament with tendon or tissue graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26508	Release of muscles of palm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26508	Release of muscles of palm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26508	Release of muscles of palm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26510	Transfer of tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26510	Transfer of tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26510	Transfer of tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26516	Repair of joint capsule of hand and finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26516	Repair of joint capsule of hand and finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26516	Repair of joint capsule of hand and finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26517	Repair of joint capsule of hand and finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26517	Repair of joint capsule of hand and finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26517	Repair of joint capsule of hand and finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26518	Repair of joint capsule of hand and finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26518	Repair of joint capsule of hand and finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26518	Repair of joint capsule of hand and finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26520	Removal of hand or finger joint capsule	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26520	Removal of hand or finger joint capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26520	Removal of hand or finger joint capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26525	"Repair of joint capsule, hand and finger"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26525	"Repair of joint capsule, hand and finger"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26525	"Repair of joint capsule, hand and finger"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26530	Repair of joint of hand bone and finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26530	Repair of joint of hand bone and finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26530	Repair of joint of hand bone and finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26531	Repair of joint of hand bone and finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26531	Repair of joint of hand bone and finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26531	Repair of joint of hand bone and finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
26535	Repair of finger joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26535	Repair of finger joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26535	Repair of finger joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26536	Repair of finger joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26536	Repair of finger joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26536	Repair of finger joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26540	Repair of ligament of hand or finger joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26540	Repair of ligament of hand or finger joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26540	Repair of ligament of hand or finger joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26541	Repair of ligament of hand or finger joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26541	Repair of ligament of hand or finger joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26541	Repair of ligament of hand or finger joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26542	Repair of ligament of hand or finger joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26542	Repair of ligament of hand or finger joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26542	Repair of ligament of hand or finger joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26545	Repair of ligament of hand or finger joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26545	Repair of ligament of hand or finger joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26545	Repair of ligament of hand or finger joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26546	Repair of non-healed hand or finger bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26546	Repair of non-healed hand or finger bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26546	Repair of non-healed hand or finger bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		216	
26548	Repair of floor of finger joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26548	Repair of floor of finger joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26548	Repair of floor of finger joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26550	Reconstruction of thumb	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26550	Reconstruction of thumb	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26550	Reconstruction of thumb	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
26551	Transfer of great toe to hand	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26551	Transfer of great toe to hand	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
26551	Transfer of great toe to hand	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		207	
26553	Transfer of toe to hand	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26553	Transfer of toe to hand	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26553	Transfer of toe to hand	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		207	
26554	Transfer of toe to hand	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26554	Transfer of toe to hand	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26554	Transfer of toe to hand	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		234	
26555	Transfer of finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26555	Transfer of finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26555	Transfer of finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
26556	Transfer of toe joint to finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26556	Transfer of toe joint to finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26556	Transfer of toe joint to finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		252	
26560	Repair of webbed finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26560	Repair of webbed finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26560	Repair of webbed finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
26561	Repair of webbed finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26561	Repair of webbed finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26561	Repair of webbed finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26562	Repair of webbed finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26562	Repair of webbed finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26562	Repair of webbed finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		197	
26565	Incision of bone of hand	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26565	Incision of bone of hand	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26565	Incision of bone of hand	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26567	Incision of finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26567	Incision of finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26567	Incision of finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26568	Lengthening of hand or finger bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26568	Lengthening of hand or finger bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26568	Lengthening of hand or finger bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26580	Repair of deformed hand	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26580	Repair of deformed hand	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26580	Repair of deformed hand	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
26587	Removal of extra finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26587	Removal of extra finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26587	Removal of extra finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
26590	Repair of abnormal finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26590	Repair of abnormal finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26590	Repair of abnormal finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
26591	Repair of hand muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26591	Repair of hand muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26591	Repair of hand muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
26593	Release of hand muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26593	Release of hand muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26593	Release of hand muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26596	Removal of constricting skin of finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26596	Removal of constricting skin of finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26596	Removal of constricting skin of finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26600	Closed treatment of fracture hand bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26600	Closed treatment of fracture hand bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	6	
26600	Closed treatment of fracture hand bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
26605	Closed treatment of fracture of bone of hand with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26605	Closed treatment of fracture of bone of hand with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	52	6	
26605	Closed treatment of fracture of bone of hand with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
26607	Closed treatment of fracture of bone of hand with manipulation and external hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26607	Closed treatment of fracture of bone of hand with manipulation and external hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26607	Closed treatment of fracture of bone of hand with manipulation and external hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
26608	"Insertion of hardware to broken finger, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26608	"Insertion of hardware to broken finger, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26608	"Insertion of hardware to broken finger, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26615	Open treatment of broken finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26615	Open treatment of broken finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26615	Open treatment of broken finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
26641	Closed treatment of thumb dislocation with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26641	Closed treatment of thumb dislocation with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	6	
26641	Closed treatment of thumb dislocation with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
26645	Closed treatment of broken thumb with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26645	Closed treatment of broken thumb with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
26645	Closed treatment of broken thumb with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
26650	"Insertion of hardware to broken thumb with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26650	"Insertion of hardware to broken thumb with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26650	"Insertion of hardware to broken thumb with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
26665	Open treatment of broken thumb at wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26665	Open treatment of broken thumb at wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26665	Open treatment of broken thumb at wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
26670	Closed treatment of dislocated hand bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26670	Closed treatment of dislocated hand bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	6	
26670	Closed treatment of dislocated hand bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
26675	Closed treatment of dislocated hand bone under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26675	Closed treatment of dislocated hand bone under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	62	6	
26675	Closed treatment of dislocated hand bone under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
26676	"Insertion of hardware to dislocated hand bone at wrist joint with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26676	"Insertion of hardware to dislocated hand bone at wrist joint with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26676	"Insertion of hardware to dislocated hand bone at wrist joint with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
26685	Open treatment of dislocated wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26685	Open treatment of dislocated wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26685	Open treatment of dislocated wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
26686	Open treatment of dislocated wrist bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26686	Open treatment of dislocated wrist bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26686	Open treatment of dislocated wrist bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26700	Closed treatment of dislocated hand joint with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26700	Closed treatment of dislocated hand joint with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	6	
26700	Closed treatment of dislocated hand joint with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
26705	Closed treatment of dislocated hand joint with manipulation under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26705	Closed treatment of dislocated hand joint with manipulation under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
26705	Closed treatment of dislocated hand joint with manipulation under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
26706	"Insertion of hardware to dislocated hand joint with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26706	"Insertion of hardware to dislocated hand joint with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26706	"Insertion of hardware to dislocated hand joint with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26715	Open treatment of dislocated hand joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26715	Open treatment of dislocated hand joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26715	Open treatment of dislocated hand joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
26720	Closed treatment of broken finger or thumb	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26720	Closed treatment of broken finger or thumb	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	6	
26720	Closed treatment of broken finger or thumb	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
26725	Closed treatment of broken finger or thumb with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26725	Closed treatment of broken finger or thumb with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	6	
26725	Closed treatment of broken finger or thumb with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
26727	"Insertion of hardware to broken finger or thumb with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26727	"Insertion of hardware to broken finger or thumb with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26727	"Insertion of hardware to broken finger or thumb with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26735	Open treatment of broken finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26735	Open treatment of broken finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26735	Open treatment of broken finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
26740	Closed treatment of broken hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26740	Closed treatment of broken hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	6	
26740	Closed treatment of broken hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
26742	Closed treatment of broken hand or finger with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26742	Closed treatment of broken hand or finger with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	6	
26742	Closed treatment of broken hand or finger with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
26746	Open treatment of broken hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26746	Open treatment of broken hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26746	Open treatment of broken hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
26750	Closed treatment of broken finger or thumb	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26750	Closed treatment of broken finger or thumb	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	6	
26750	Closed treatment of broken finger or thumb	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
26755	Closed treatment of broken finger or thumb with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26755	Closed treatment of broken finger or thumb with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	66	6	
26755	Closed treatment of broken finger or thumb with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
26756	"Insertion of hardware to broken finger or thumb, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26756	"Insertion of hardware to broken finger or thumb, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26756	"Insertion of hardware to broken finger or thumb, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26765	Open treatment of broken finger or thumb	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26765	Open treatment of broken finger or thumb	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26765	Open treatment of broken finger or thumb	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
26770	Closed treatment of dislocated finger joint with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26770	Closed treatment of dislocated finger joint with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	6	
26770	Closed treatment of dislocated finger joint with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
26775	Closed treatment of dislocated finger joint with manipulation under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26775	Closed treatment of dislocated finger joint with manipulation under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	62	6	
26775	Closed treatment of dislocated finger joint with manipulation under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
26776	"Insertion of hardware to dislocated finger joint with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26776	"Insertion of hardware to dislocated finger joint with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26776	"Insertion of hardware to dislocated finger joint with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26785	Open treatment of dislocated finger joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26785	Open treatment of dislocated finger joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26785	Open treatment of dislocated finger joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
26820	Fusion of thumb	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26820	Fusion of thumb	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26820	Fusion of thumb	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26841	Fusion of thumb at wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26841	Fusion of thumb at wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26841	Fusion of thumb at wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
26842	Fusion of thumb at wrist with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26842	Fusion of thumb at wrist with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26842	Fusion of thumb at wrist with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26843	Fusion of hand joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26843	Fusion of hand joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26843	Fusion of hand joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26844	Fusion of hand joint with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26844	Fusion of hand joint with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26844	Fusion of hand joint with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26850	Fusion of finger joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26850	Fusion of finger joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26850	Fusion of finger joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26852	Fusion of finger joint with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26852	Fusion of finger joint with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26852	Fusion of finger joint with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26860	Fusion of finger joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26860	Fusion of finger joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26860	Fusion of finger joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26862	Fusion of finger joint with bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26862	Fusion of finger joint with bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26862	Fusion of finger joint with bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26910	"Amputation of hand bone, finger, or thumb"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26910	"Amputation of hand bone, finger, or thumb"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26910	"Amputation of hand bone, finger, or thumb"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
26951	Amputation of finger or thumb	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26951	Amputation of finger or thumb	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26951	Amputation of finger or thumb	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		153	
26952	Amputation of finger or thumb	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26952	Amputation of finger or thumb	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
26952	Amputation of finger or thumb	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26990	Drainage of abscess or blood accumulation in pelvis or hip joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26990	Drainage of abscess or blood accumulation in pelvis or hip joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
26990	Drainage of abscess or blood accumulation in pelvis or hip joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
26991	Incision of infected fluid-filled sac (bursa) of pelvis or hip joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
26991	Incision of infected fluid-filled sac (bursa) of pelvis or hip joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	80	12	
26991	Incision of infected fluid-filled sac (bursa) of pelvis or hip joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
26992	Incision of pelvis and/or hip joint bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
26992	Incision of pelvis and/or hip joint bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
26992	Incision of pelvis and/or hip joint bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27000	"Incision of hip tendon, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27000	"Incision of hip tendon, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27000	"Incision of hip tendon, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
27001	"Incision of hip tendon, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27001	"Incision of hip tendon, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27001	"Incision of hip tendon, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27003	"Incision of hip tendon with removal of nerve, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27003	"Incision of hip tendon with removal of nerve, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27003	"Incision of hip tendon with removal of nerve, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27005	"Incision of hip tendons, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27005	"Incision of hip tendons, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27005	"Incision of hip tendons, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27006	"Incision of hip tendons, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27006	"Incision of hip tendons, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27006	"Incision of hip tendons, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27025	Incision of tissues of hip or thigh	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27025	Incision of tissues of hip or thigh	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27025	Incision of tissues of hip or thigh	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
27027	Incision of tissue of muscle compartments of one side of pelvis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		25	
27027	Incision of tissue of muscle compartments of one side of pelvis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27027	Incision of tissue of muscle compartments of one side of pelvis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27030	Incision of hip joint with drainage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27030	Incision of hip joint with drainage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27030	Incision of hip joint with drainage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27033	Incision of hip joint with exploration or removal of loose or foreign body	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27033	Incision of hip joint with exploration or removal of loose or foreign body	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27033	Incision of hip joint with exploration or removal of loose or foreign body	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27035	Removal of hip or pelvic nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27035	Removal of hip or pelvic nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27035	Removal of hip or pelvic nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27036	Repair of hip joint capsule	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27036	Repair of hip joint capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27036	Repair of hip joint capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27040	Biopsy of tissue of pelvis and hip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
27040	Biopsy of tissue of pelvis and hip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	6	
27040	Biopsy of tissue of pelvis and hip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
27041	Biopsy of tissue of pelvis and hip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27041	Biopsy of tissue of pelvis and hip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27041	Biopsy of tissue of pelvis and hip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27043	Removal (3 centimeters or greater) tissue growth beneath the skin of pelvis or hip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27043	Removal (3 centimeters or greater) tissue growth beneath the skin of pelvis or hip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27043	Removal (3 centimeters or greater) tissue growth beneath the skin of pelvis or hip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
27045	Removal (5 centimeters or greater) muscle growth of pelvis or hip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27045	Removal (5 centimeters or greater) muscle growth of pelvis or hip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27045	Removal (5 centimeters or greater) muscle growth of pelvis or hip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
27047	Removal (less than 3 centimeters) tissue growth of pelvis or hip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27047	Removal (less than 3 centimeters) tissue growth of pelvis or hip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	70	6	
27047	Removal (less than 3 centimeters) tissue growth of pelvis or hip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
27048	Removal (less than 5 centimeters) muscle growth of pelvis or hip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27048	Removal (less than 5 centimeters) muscle growth of pelvis or hip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27048	Removal (less than 5 centimeters) muscle growth of pelvis or hip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
27049	Removal of (less than 5 centimeters) tissue growth of pelvis or hip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27049	Removal of (less than 5 centimeters) tissue growth of pelvis or hip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27049	Removal of (less than 5 centimeters) tissue growth of pelvis or hip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27050	Biopsy of sacroiliac joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27050	Biopsy of sacroiliac joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27050	Biopsy of sacroiliac joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27052	Biopsy of hip joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27052	Biopsy of hip joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27052	Biopsy of hip joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27054	Removal of membrane covering hip joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27054	Removal of membrane covering hip joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27054	Removal of membrane covering hip joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27057	Incision of tissue on one side of pelvic muscle compartment with removal of muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		25	
27057	Incision of tissue on one side of pelvic muscle compartment with removal of muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27057	Incision of tissue on one side of pelvic muscle compartment with removal of muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27059	Removal (5 centimeters or greater) tissue growth of pelvis or hip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27059	Removal (5 centimeters or greater) tissue growth of pelvis or hip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27059	Removal (5 centimeters or greater) tissue growth of pelvis or hip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
27060	Removal of fluid-filled sac (bursa) of pelvis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27060	Removal of fluid-filled sac (bursa) of pelvis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27060	Removal of fluid-filled sac (bursa) of pelvis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27062	Removal of fluid-filled sac (bursa) or calcium deposit of pelvis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27062	Removal of fluid-filled sac (bursa) or calcium deposit of pelvis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27062	Removal of fluid-filled sac (bursa) or calcium deposit of pelvis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27065	Removal of bone cyst or growth of hip or pelvic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27065	Removal of bone cyst or growth of hip or pelvic bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27065	Removal of bone cyst or growth of hip or pelvic bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27066	Removal of bone cyst or growth of hip or pelvic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27066	Removal of bone cyst or growth of hip or pelvic bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27066	Removal of bone cyst or growth of hip or pelvic bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27067	Removal of bone cyst or growth of hip or pelvic bone with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27067	Removal of bone cyst or growth of hip or pelvic bone with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27067	Removal of bone cyst or growth of hip or pelvic bone with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27070	Partial removal of hip or pelvic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27070	Partial removal of hip or pelvic bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27070	Partial removal of hip or pelvic bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27071	Partial removal of hip or pelvic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27071	Partial removal of hip or pelvic bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27071	Partial removal of hip or pelvic bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27075	Removal of growth or infected tissue of pelvic or pubic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27075	Removal of growth or infected tissue of pelvic or pubic bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27075	Removal of growth or infected tissue of pelvic or pubic bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
27076	Removal of growth or infected tissue of pelvic or pubic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27076	Removal of growth or infected tissue of pelvic or pubic bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27076	Removal of growth or infected tissue of pelvic or pubic bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
27077	Removal of infected tissue of pelvic or pubic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27077	Removal of infected tissue of pelvic or pubic bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27077	Removal of infected tissue of pelvic or pubic bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
27078	Removal of growth or infected tissue of pelvic or pubic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27078	Removal of growth or infected tissue of pelvic or pubic bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27078	Removal of growth or infected tissue of pelvic or pubic bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
27080	Removal of tailbone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27080	Removal of tailbone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27080	Removal of tailbone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27086	"Removal of foreign body in tissue of pelvis or hip, accessed beneath the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	30	
27086	"Removal of foreign body in tissue of pelvis or hip, accessed beneath the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
27086	"Removal of foreign body in tissue of pelvis or hip, accessed beneath the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
27087	Removal of foreign body in tissue or muscle of pelvis or hip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27087	Removal of foreign body in tissue or muscle of pelvis or hip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27087	Removal of foreign body in tissue or muscle of pelvis or hip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27090	Removal of hip prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27090	Removal of hip prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27090	Removal of hip prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27091	Removal of hip prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27091	Removal of hip prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27091	Removal of hip prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27093	Injection of dye for X-ray imaging of hip joint	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	33	0	
27093	Injection of dye for X-ray imaging of hip joint	Post-service	L041B	Radiologic Technologist	0.41	Post service total costs	3	0	
27095	Injection procedure for X-ray imaging of hip under anesthesia	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	42	0	
27095	Injection procedure for X-ray imaging of hip under anesthesia	Post-service	L041B	Radiologic Technologist	0.41	Post service total costs	3	0	
27096	Injection procedure into sacroiliac joint for anesthetic or steroid	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3	0	
27096	Injection procedure into sacroiliac joint for anesthetic or steroid	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	12	
27096	Injection procedure into sacroiliac joint for anesthetic or steroid	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20	0	
27096	Injection procedure into sacroiliac joint for anesthetic or steroid	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	39	0	
27096	Injection procedure into sacroiliac joint for anesthetic or steroid	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
27097	Release of upper hamstring muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27097	Release of upper hamstring muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27097	Release of upper hamstring muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27098	Transfer of tendon to pelvic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27098	Transfer of tendon to pelvic bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27098	Transfer of tendon to pelvic bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27100	Transfer of muscle to thigh bone at hip joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27100	Transfer of muscle to thigh bone at hip joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27100	Transfer of muscle to thigh bone at hip joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27105	Transfer of muscle to hip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27105	Transfer of muscle to hip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27105	Transfer of muscle to hip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27110	Transfer of muscle to thigh bone at hip joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27110	Transfer of muscle to thigh bone at hip joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27110	Transfer of muscle to thigh bone at hip joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27111	Transfer of muscle to upper thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27111	Transfer of muscle to upper thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27111	Transfer of muscle to upper thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27120	Repair of hip socket	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27120	Repair of hip socket	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27120	Repair of hip socket	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27122	Repair of hip socket with removal of head of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27122	Repair of hip socket with removal of head of thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27122	Repair of hip socket with removal of head of thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27125	Partial replacement of thigh bone at hip joint with prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27125	Partial replacement of thigh bone at hip joint with prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27125	Partial replacement of thigh bone at hip joint with prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
27130	Replacement of thigh bone and hip joint prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27130	Replacement of thigh bone and hip joint prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27130	Replacement of thigh bone and hip joint prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27132	Replacement of thigh bone and hip joint prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27132	Replacement of thigh bone and hip joint prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27132	Replacement of thigh bone and hip joint prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27134	Revision of thigh bone and hip joint prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27134	Revision of thigh bone and hip joint prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27134	Revision of thigh bone and hip joint prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27137	Revision of hip joint prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27137	Revision of hip joint prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27137	Revision of hip joint prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27138	Revision of thigh bone prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27138	Revision of thigh bone prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27138	Revision of thigh bone prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27140	Transfer of head of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27140	Transfer of head of thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27140	Transfer of head of thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27146	Incision of pelvic bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27146	Incision of pelvic bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27146	Incision of pelvic bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27147	"Incision of pelvic bone with repair of hip joint dislocation, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27147	"Incision of pelvic bone with repair of hip joint dislocation, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27147	"Incision of pelvic bone with repair of hip joint dislocation, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27151	Incision of pelvic and thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27151	Incision of pelvic and thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27151	Incision of pelvic and thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27156	"Incision of pelvic and thigh bone with repair of hip joint dislocation, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27156	"Incision of pelvic and thigh bone with repair of hip joint dislocation, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27156	"Incision of pelvic and thigh bone with repair of hip joint dislocation, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27158	Repair of pelvic bones on both sides	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27158	Repair of pelvic bones on both sides	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27158	Repair of pelvic bones on both sides	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27161	Incision of upper thigh bone at hip joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27161	Incision of upper thigh bone at hip joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27161	Incision of upper thigh bone at hip joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27165	Incision of upper thigh bone at hip joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27165	Incision of upper thigh bone at hip joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27165	Incision of upper thigh bone at hip joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
27170	Bone graft of upper thigh bone and hip joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27170	Bone graft of upper thigh bone and hip joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27170	Bone graft of upper thigh bone and hip joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27175	Treatment of slipped growth plate at upper thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27175	Treatment of slipped growth plate at upper thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27175	Treatment of slipped growth plate at upper thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27176	Surgical treatment of growth plate at upper thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27176	Surgical treatment of growth plate at upper thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27176	Surgical treatment of growth plate at upper thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27177	Open treatment of growth plate at upper thigh bone with pinning or bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27177	Open treatment of growth plate at upper thigh bone with pinning or bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27177	Open treatment of growth plate at upper thigh bone with pinning or bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27178	Open surgical treatment of growth plate at upper thigh bone with manipulation and pinning	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27178	Open surgical treatment of growth plate at upper thigh bone with manipulation and pinning	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27178	Open surgical treatment of growth plate at upper thigh bone with manipulation and pinning	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27179	Open treatment of growth plate at upper thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27179	Open treatment of growth plate at upper thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27179	Open treatment of growth plate at upper thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27181	Open treatment of growth plate at upper thigh bone with insertion of hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27181	Open treatment of growth plate at upper thigh bone with insertion of hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27181	Open treatment of growth plate at upper thigh bone with insertion of hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27185	Removal of growth plate of upper thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27185	Removal of growth plate of upper thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27185	Removal of growth plate of upper thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27187	Preventive fixation of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27187	Preventive fixation of thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27187	Preventive fixation of thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27193	Closed treatment of pelvic ring fracture or dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27193	Closed treatment of pelvic ring fracture or dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	12	
27193	Closed treatment of pelvic ring fracture or dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
27194	Closed treatment of pelvic ring fracture or dislocation with manipulation under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27194	Closed treatment of pelvic ring fracture or dislocation with manipulation under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27194	Closed treatment of pelvic ring fracture or dislocation with manipulation under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27200	Closed treatment of broken tailbone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27200	Closed treatment of broken tailbone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	12	
27200	Closed treatment of broken tailbone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	41	41	
27202	Open treatment of broken tailbone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27202	Open treatment of broken tailbone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27202	Open treatment of broken tailbone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
27215	Open treatment of broken bones on one side of pelvis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		33	
27215	Open treatment of broken bones on one side of pelvis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27215	Open treatment of broken bones on one side of pelvis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
27216	"Insertion of hardware to broken and/or dislocated bone on one side of pelvis, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		33	
27216	"Insertion of hardware to broken and/or dislocated bone on one side of pelvis, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27216	"Insertion of hardware to broken and/or dislocated bone on one side of pelvis, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27217	Open treatment of fracture and/or dislocation on one side of pelvis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		33	
27217	Open treatment of fracture and/or dislocation on one side of pelvis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27217	Open treatment of fracture and/or dislocation on one side of pelvis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27218	Open treatment of fracture and/or dislocation on one side of pelvis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		33	
27218	Open treatment of fracture and/or dislocation on one side of pelvis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27218	Open treatment of fracture and/or dislocation on one side of pelvis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27220	Closed treatment of hip socket fractures	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27220	Closed treatment of hip socket fractures	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	12	
27220	Closed treatment of hip socket fractures	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
27222	Closed treatment of hip socket fractures with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27222	Closed treatment of hip socket fractures with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27222	Closed treatment of hip socket fractures with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27226	Open treatment of hip socket fracture with insertion of hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27226	Open treatment of hip socket fracture with insertion of hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27226	Open treatment of hip socket fracture with insertion of hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27227	Open treatment of hip socket fractures with insertion of hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27227	Open treatment of hip socket fractures with insertion of hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27227	Open treatment of hip socket fractures with insertion of hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27228	Open treatment of hip socket fractures with insertion of hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27228	Open treatment of hip socket fractures with insertion of hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27228	Open treatment of hip socket fractures with insertion of hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27230	Closed treatment of upper thigh bone fracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27230	Closed treatment of upper thigh bone fracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	12	
27230	Closed treatment of upper thigh bone fracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
27232	Closed treatment of thigh bone fracture with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27232	Closed treatment of thigh bone fracture with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27232	Closed treatment of thigh bone fracture with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
27235	"Insertion of hardware to broken thigh bone, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27235	"Insertion of hardware to broken thigh bone, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27235	"Insertion of hardware to broken thigh bone, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27236	Open treatment of broken thigh bone with insertion of hardware or prosthetic replacement	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27236	Open treatment of broken thigh bone with insertion of hardware or prosthetic replacement	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27236	Open treatment of broken thigh bone with insertion of hardware or prosthetic replacement	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27238	Closed treatment of fracture below neck of upper thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27238	Closed treatment of fracture below neck of upper thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27238	Closed treatment of fracture below neck of upper thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27240	Closed treatment of broken thigh bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27240	Closed treatment of broken thigh bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27240	Closed treatment of broken thigh bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27244	Surgical treatment of broken thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27244	Surgical treatment of broken thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27244	Surgical treatment of broken thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27245	Surgical treatment of broken thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27245	Surgical treatment of broken thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27245	Surgical treatment of broken thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27246	Closed treatment of broken thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27246	Closed treatment of broken thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	29	12	
27246	Closed treatment of broken thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
27248	Open treatment of broken thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27248	Open treatment of broken thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27252	Closed treatment of hip dislocation under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27252	Closed treatment of hip dislocation under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27252	Closed treatment of hip dislocation under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27253	Open treatment of traumatic hip dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27253	Open treatment of traumatic hip dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27253	Open treatment of traumatic hip dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27254	Open treatment of fracture and traumatic dislocation of hip socket and thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27254	Open treatment of fracture and traumatic dislocation of hip socket and thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27254	Open treatment of fracture and traumatic dislocation of hip socket and thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27256	Treatment of spontaneous hip dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	5	
27256	Treatment of spontaneous hip dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	66	6	
27256	Treatment of spontaneous hip dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
27257	Treatment of spontaneous hip dislocation under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
27257	Treatment of spontaneous hip dislocation under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27257	Treatment of spontaneous hip dislocation under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
27258	Open treatment of spontaneous hip dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27258	Open treatment of spontaneous hip dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27258	Open treatment of spontaneous hip dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27259	Open treatment of spontaneous hip dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27259	Open treatment of spontaneous hip dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27259	Open treatment of spontaneous hip dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		161	
27265	Closed treatment of dislocated hip prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27265	Closed treatment of dislocated hip prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27265	Closed treatment of dislocated hip prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27266	Closed treatment of dislocated hip prosthesis under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27266	Closed treatment of dislocated hip prosthesis under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27266	Closed treatment of dislocated hip prosthesis under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27267	Closed treatment of broken thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		35	
27267	Closed treatment of broken thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27267	Closed treatment of broken thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27268	Closed treatment of fracture of upper portion and head of thigh bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		35	
27268	Closed treatment of fracture of upper portion and head of thigh bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27268	Closed treatment of fracture of upper portion and head of thigh bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27269	Open treatment of fracture of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		35	
27269	Open treatment of fracture of thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27269	Open treatment of fracture of thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27275	Manipulation of hip joint under general anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
27275	Manipulation of hip joint under general anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27275	Manipulation of hip joint under general anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
27279	"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
27279	"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
27279	"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
27279	"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
27279	"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
27279	"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
27279	"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive"	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		27	
27279	"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
27280	"Arthrodesis, open, sacroiliac joint including obtaining bone graft"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
27280	"Arthrodesis, open, sacroiliac joint including obtaining bone graft"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
27280	"Arthrodesis, open, sacroiliac joint including obtaining bone graft"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
27280	"Arthrodesis, open, sacroiliac joint including obtaining bone graft"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
27280	"Arthrodesis, open, sacroiliac joint including obtaining bone graft"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
27280	"Arthrodesis, open, sacroiliac joint including obtaining bone graft"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
27280	"Arthrodesis, open, sacroiliac joint including obtaining bone graft"	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		27	
27280	"Arthrodesis, open, sacroiliac joint including obtaining bone graft"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
27282	Fusion of hip joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27282	Fusion of hip joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27282	Fusion of hip joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27284	Fusion of hip joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27284	Fusion of hip joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27284	Fusion of hip joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27286	Fusion of hip joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27286	Fusion of hip joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27286	Fusion of hip joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27290	Amputation of pelvic structures	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27290	Amputation of pelvic structures	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27290	Amputation of pelvic structures	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		149	
27295	Detachment of hip joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27295	Detachment of hip joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27295	Detachment of hip joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27301	Drainage of abscess or blood collection at thigh or knee region	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27301	Drainage of abscess or blood collection at thigh or knee region	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	84	12	
27301	Drainage of abscess or blood collection at thigh or knee region	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
27303	Incision of bone of thigh or knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27303	Incision of bone of thigh or knee	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27303	Incision of bone of thigh or knee	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27305	"Removal of tissue at thigh or knee region, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27305	"Removal of tissue at thigh or knee region, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27305	"Removal of tissue at thigh or knee region, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27306	"Incision of tendon of thigh or hamstring muscles, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27306	"Incision of tendon of thigh or hamstring muscles, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27306	"Incision of tendon of thigh or hamstring muscles, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
27307	"Incision of multiple tendons of thigh or hamstring muscles, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27307	"Incision of multiple tendons of thigh or hamstring muscles, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27307	"Incision of multiple tendons of thigh or hamstring muscles, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27310	"Exploration, drainage, or removal of foreign body in knee joint"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27310	"Exploration, drainage, or removal of foreign body in knee joint"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27310	"Exploration, drainage, or removal of foreign body in knee joint"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27323	Biopsy of thigh or knee region tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	30	
27323	Biopsy of thigh or knee region tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	6	
27323	Biopsy of thigh or knee region tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
27324	Biopsy of thigh or knee region tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27324	Biopsy of thigh or knee region tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27324	Biopsy of thigh or knee region tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27325	Removal of nerve of hamstring muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27325	Removal of nerve of hamstring muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27325	Removal of nerve of hamstring muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27326	Removal of nerve of calf muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27326	Removal of nerve of calf muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27326	Removal of nerve of calf muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27327	Removal (less than 3 centimeters) tissue growth beneath the skin of thigh or knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27327	Removal (less than 3 centimeters) tissue growth beneath the skin of thigh or knee	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
27327	Removal (less than 3 centimeters) tissue growth beneath the skin of thigh or knee	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
27328	Removal (less than 5 centimeters) muscle growth of thigh or knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27328	Removal (less than 5 centimeters) muscle growth of thigh or knee	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27328	Removal (less than 5 centimeters) muscle growth of thigh or knee	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
27329	Removal (less than 5 centimeters) tissue growth of thigh or knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27329	Removal (less than 5 centimeters) tissue growth of thigh or knee	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27329	Removal (less than 5 centimeters) tissue growth of thigh or knee	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27330	Biopsy of membrane covering knee joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27330	Biopsy of membrane covering knee joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27330	Biopsy of membrane covering knee joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27331	"Exploration, biopsy, or removal of loose or foreign body of knee"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27331	"Exploration, biopsy, or removal of loose or foreign body of knee"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27331	"Exploration, biopsy, or removal of loose or foreign body of knee"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27332	Removal of knee cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27332	Removal of knee cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27332	Removal of knee cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27333	Removal of knee cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27333	Removal of knee cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27333	Removal of knee cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27334	Removal of knee joint covering	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27334	Removal of knee joint covering	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27334	Removal of knee joint covering	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27335	Removal of knee joint covering	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27335	Removal of knee joint covering	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27335	Removal of knee joint covering	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27337	Removal (3 centimeters or greater) tissue growth beneath the skin of thigh or knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27337	Removal (3 centimeters or greater) tissue growth beneath the skin of thigh or knee	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27337	Removal (3 centimeters or greater) tissue growth beneath the skin of thigh or knee	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
27339	Removal (5 centimeters or greater) muscle growth of thigh or knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27339	Removal (5 centimeters or greater) muscle growth of thigh or knee	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27339	Removal (5 centimeters or greater) muscle growth of thigh or knee	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
27340	Removal of fluid-filled sac (bursa) below knee joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27340	Removal of fluid-filled sac (bursa) below knee joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27340	Removal of fluid-filled sac (bursa) below knee joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27345	Removal of cyst of membrane covering behind knee joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27345	Removal of cyst of membrane covering behind knee joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27345	Removal of cyst of membrane covering behind knee joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27347	Removal of growth of knee cartilage or capsule	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27347	Removal of growth of knee cartilage or capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27347	Removal of growth of knee cartilage or capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27350	Removal of knee cap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27350	Removal of knee cap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27350	Removal of knee cap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27355	Removal or scraping of cyst or growth of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27355	Removal or scraping of cyst or growth of thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27355	Removal or scraping of cyst or growth of thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27356	Removal or scraping of cyst or growth of thigh bone with donor bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27356	Removal or scraping of cyst or growth of thigh bone with donor bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27356	Removal or scraping of cyst or growth of thigh bone with donor bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27357	Removal or scraping of cyst or growth of thigh bone with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27357	Removal or scraping of cyst or growth of thigh bone with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27357	Removal or scraping of cyst or growth of thigh bone with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27360	Partial removal of bone of thigh and/or lower leg bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27360	Partial removal of bone of thigh and/or lower leg bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27360	Partial removal of bone of thigh and/or lower leg bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27364	Removal (5 centimeters or greater) tissue growth of thigh or knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27364	Removal (5 centimeters or greater) tissue growth of thigh or knee	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27364	Removal (5 centimeters or greater) tissue growth of thigh or knee	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
27365	Removal of growth of thigh or knee bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27365	Removal of growth of thigh or knee bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27365	Removal of growth of thigh or knee bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
27370	Injection procedure for knee arthrography	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	30	0	
27370	Injection procedure for knee arthrography	Post-service	L041B	Radiologic Technologist	0.41	Post service total costs	3	0	
27372	Removal of foreign body of thigh or knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27372	Removal of foreign body of thigh or knee	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	92	6	
27372	Removal of foreign body of thigh or knee	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
27380	Suture of tendon below knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27380	Suture of tendon below knee	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27380	Suture of tendon below knee	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27381	Suture of tendon below knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27381	Suture of tendon below knee	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27381	Suture of tendon below knee	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27385	Suture of ruptured muscle of thigh	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27385	Suture of ruptured muscle of thigh	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27385	Suture of ruptured muscle of thigh	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117.5	
27386	Suture of ruptured muscle of thigh	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27386	Suture of ruptured muscle of thigh	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27386	Suture of ruptured muscle of thigh	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27390	"Repair of hamstring tendon, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27390	"Repair of hamstring tendon, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27390	"Repair of hamstring tendon, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27391	"Repair of multiple hamstring tendons, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27391	"Repair of multiple hamstring tendons, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27391	"Repair of multiple hamstring tendons, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27392	"Repair of multiple hamstring tendons of both legs, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27392	"Repair of multiple hamstring tendons of both legs, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27392	"Repair of multiple hamstring tendons of both legs, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27393	Lengthening of hamstring tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27393	Lengthening of hamstring tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27393	Lengthening of hamstring tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27394	Lengthening of multiple hamstring tendons in one leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27394	Lengthening of multiple hamstring tendons in one leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27394	Lengthening of multiple hamstring tendons in one leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27395	Lengthening of multiple hamstring tendons in both legs	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27395	Lengthening of multiple hamstring tendons in both legs	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27395	Lengthening of multiple hamstring tendons in both legs	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27396	Transplant or transfer of thigh tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27396	Transplant or transfer of thigh tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27396	Transplant or transfer of thigh tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27397	Transplant or transfer of multiple thigh tendons	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27397	Transplant or transfer of multiple thigh tendons	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27397	Transplant or transfer of multiple thigh tendons	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27400	Transfer of tendon or muscle in hamstring	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27400	Transfer of tendon or muscle in hamstring	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27400	Transfer of tendon or muscle in hamstring	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27403	Incision and repair of knee cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27403	Incision and repair of knee cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27403	Incision and repair of knee cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27405	Repair of torn collateral ligament and/or knee joint capsule	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27405	Repair of torn collateral ligament and/or knee joint capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27405	Repair of torn collateral ligament and/or knee joint capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27407	Repair of torn cruciate ligament and/or knee joint capsule	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27407	Repair of torn cruciate ligament and/or knee joint capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27407	Repair of torn cruciate ligament and/or knee joint capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27409	Repair of torn collateral and cruciate ligaments or knee joint capsule	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27409	Repair of torn collateral and cruciate ligaments or knee joint capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27409	Repair of torn collateral and cruciate ligaments or knee joint capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27412	Implantation of patient's knee cartilage into knee joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
27412	Implantation of patient's knee cartilage into knee joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27412	Implantation of patient's knee cartilage into knee joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
27415	"Implantation of donor cartilage cells into knee bone, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
27415	"Implantation of donor cartilage cells into knee bone, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27415	"Implantation of donor cartilage cells into knee bone, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
27416	"Implantation of patient's knee cartilage cells into knee bone, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27416	"Implantation of patient's knee cartilage cells into knee bone, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27416	"Implantation of patient's knee cartilage cells into knee bone, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
27418	Repair of upper end of shin bone at knee joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27418	Repair of upper end of shin bone at knee joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27418	Repair of upper end of shin bone at knee joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27420	Repair of dislocating knee cap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27420	Repair of dislocating knee cap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27420	Repair of dislocating knee cap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27422	Repair of dislocating knee cap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27422	Repair of dislocating knee cap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27422	Repair of dislocating knee cap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27424	Reconstruction of dislocating knee cap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27424	Reconstruction of dislocating knee cap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27424	Reconstruction of dislocating knee cap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27425	"Release of ligaments of knee joint, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27425	"Release of ligaments of knee joint, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27425	"Release of ligaments of knee joint, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27427	Reconstruction of knee joint ligaments	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27427	Reconstruction of knee joint ligaments	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27427	Reconstruction of knee joint ligaments	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27428	"Reconstruction of knee joint ligaments, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27428	"Reconstruction of knee joint ligaments, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27428	"Reconstruction of knee joint ligaments, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
27429	"Reconstruction of knee joint ligaments, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27429	"Reconstruction of knee joint ligaments, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27429	"Reconstruction of knee joint ligaments, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		216	
27430	Repair of muscle group above knee joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27430	Repair of muscle group above knee joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27430	Repair of muscle group above knee joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27435	Incision of back portion of knee joint capsule	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27435	Incision of back portion of knee joint capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27435	Incision of back portion of knee joint capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27437	Repair of knee cap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27437	Repair of knee cap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27437	Repair of knee cap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27438	Repair of knee cap with insertion of prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27438	Repair of knee cap with insertion of prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27438	Repair of knee cap with insertion of prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27440	Repair of knee joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27440	Repair of knee joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27440	Repair of knee joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27441	Repair of knee joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27441	Repair of knee joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27441	Repair of knee joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27442	Repair of knee joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27442	Repair of knee joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27442	Repair of knee joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27443	Repair of knee joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27443	Repair of knee joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27443	Repair of knee joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27445	Repair of knee joint with hinged prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27445	Repair of knee joint with hinged prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27445	Repair of knee joint with hinged prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27446	Repair of knee joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27446	Repair of knee joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27446	Repair of knee joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
27447	Repair of knee joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27447	Repair of knee joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27447	Repair of knee joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27448	Repair of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27448	Repair of thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27448	Repair of thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27450	Repair of thigh bone with insertion of stabilizing fixation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27450	Repair of thigh bone with insertion of stabilizing fixation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27450	Repair of thigh bone with insertion of stabilizing fixation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27454	Repair of thigh bone with insertion of rod	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27454	Repair of thigh bone with insertion of rod	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27454	Repair of thigh bone with insertion of rod	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27455	Incision or correction of deformity of upper shin bone (prior to growth plate closure)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27455	Incision or correction of deformity of upper shin bone (prior to growth plate closure)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27455	Incision or correction of deformity of upper shin bone (prior to growth plate closure)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27457	Incision or correction of deformity of upper shin bone (after growth plate closure)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27457	Incision or correction of deformity of upper shin bone (after growth plate closure)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27457	Incision or correction of deformity of upper shin bone (after growth plate closure)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27465	Shortening of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27465	Shortening of thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27465	Shortening of thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
27466	Lengthening of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27466	Lengthening of thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27466	Lengthening of thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27468	Shortening and lengthening of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27468	Shortening and lengthening of thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27468	Shortening and lengthening of thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27470	Repair of non-healed fracture of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27470	Repair of non-healed fracture of thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27470	Repair of non-healed fracture of thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27472	Repair of non-healed fracture of thigh bone with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27472	Repair of non-healed fracture of thigh bone with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27472	Repair of non-healed fracture of thigh bone with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27475	Removal of growth plate of lower end of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27475	Removal of growth plate of lower end of thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27475	Removal of growth plate of lower end of thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27477	Removal of growth plate of both leg bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27477	Removal of growth plate of both leg bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27477	Removal of growth plate of both leg bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27479	Removal of growth plate of leg and thigh bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27479	Removal of growth plate of leg and thigh bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27479	Removal of growth plate of leg and thigh bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27485	Removal of growth plate of leg or thigh bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27485	Removal of growth plate of leg or thigh bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27485	Removal of growth plate of leg or thigh bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27486	Revision of one component of total knee joint prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27486	Revision of one component of total knee joint prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27486	Revision of one component of total knee joint prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27487	Revision of lower thigh bone and both shin bone components of total knee joint prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27487	Revision of lower thigh bone and both shin bone components of total knee joint prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27487	Revision of lower thigh bone and both shin bone components of total knee joint prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27488	Removal of total knee joint prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27488	Removal of total knee joint prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27488	Removal of total knee joint prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27495	Strengthening of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27495	Strengthening of thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27495	Strengthening of thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27496	Incision of tissue of thigh and/or knee muscle compartment	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27496	Incision of tissue of thigh and/or knee muscle compartment	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27496	Incision of tissue of thigh and/or knee muscle compartment	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27497	Incision of tissue of thigh and/or knee muscle compartment with removal of muscle and/or nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27497	Incision of tissue of thigh and/or knee muscle compartment with removal of muscle and/or nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27497	Incision of tissue of thigh and/or knee muscle compartment with removal of muscle and/or nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27498	Incision of tissue of multiple thigh and/or knee muscle compartments	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27498	Incision of tissue of multiple thigh and/or knee muscle compartments	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27498	Incision of tissue of multiple thigh and/or knee muscle compartments	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27499	Incision of tissue of multiple thigh and/or knee muscle compartments with removal of muscle and/or nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27499	Incision of tissue of multiple thigh and/or knee muscle compartments with removal of muscle and/or nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27499	Incision of tissue of multiple thigh and/or knee muscle compartments with removal of muscle and/or nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27500	Closed treatment of thigh bone fracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27500	Closed treatment of thigh bone fracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	12	
27500	Closed treatment of thigh bone fracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
27501	Closed treatment of broken thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27501	Closed treatment of broken thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	12	
27501	Closed treatment of broken thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
27502	Closed treatment of broken thigh bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27502	Closed treatment of broken thigh bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27502	Closed treatment of broken thigh bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27503	Closed treatment of broken thigh bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27503	Closed treatment of broken thigh bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27503	Closed treatment of broken thigh bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27506	Open treatment of broken thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27506	Open treatment of broken thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27506	Open treatment of broken thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
27507	Open treatment of broken thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27507	Open treatment of broken thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27507	Open treatment of broken thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27508	Closed treatment of broken thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27508	Closed treatment of broken thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	12	
27508	Closed treatment of broken thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
27509	"Insertion of hardware to stabilize broken thigh bone or separated growth plate, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27509	"Insertion of hardware to stabilize broken thigh bone or separated growth plate, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27509	"Insertion of hardware to stabilize broken thigh bone or separated growth plate, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27510	Closed treatment of broken thigh bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27510	Closed treatment of broken thigh bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27510	Closed treatment of broken thigh bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27511	Open treatment of broken thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27511	Open treatment of broken thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27513	Open treatment of broken thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27513	Open treatment of broken thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27514	Open treatment of broken thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27514	Open treatment of broken thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27516	Closed treatment of growth plate separation at end of thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27516	Closed treatment of growth plate separation at end of thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	12	
27516	Closed treatment of growth plate separation at end of thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
27517	Closed treatment of growth plate separation at end of thigh bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27517	Closed treatment of growth plate separation at end of thigh bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27517	Closed treatment of growth plate separation at end of thigh bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27519	Open treatment of growth plate separation at end of thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27519	Open treatment of growth plate separation at end of thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27520	Closed treatment of knee cap fracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27520	Closed treatment of knee cap fracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	52	6	
27520	Closed treatment of knee cap fracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
27524	Open treatment of knee cap fracture with insertion of hardware and/or removal of knee cap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27524	Open treatment of knee cap fracture with insertion of hardware and/or removal of knee cap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27524	Open treatment of knee cap fracture with insertion of hardware and/or removal of knee cap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27530	Closed treatment of fracture of shin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27530	Closed treatment of fracture of shin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	0	
27530	Closed treatment of fracture of shin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
27532	Closed treatment of fracture of shin bone with traction	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27532	Closed treatment of fracture of shin bone with traction	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	70	12	
27532	Closed treatment of fracture of shin bone with traction	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
27535	Open treatment of broken shin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27535	Open treatment of broken shin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27536	Open treatment of broken shin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27536	Open treatment of broken shin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27536	Open treatment of broken shin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27538	Closed treatment of broken shin bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27538	Closed treatment of broken shin bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	12	
27538	Closed treatment of broken shin bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
27540	Open treatment of broken shin bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27540	Open treatment of broken shin bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27540	Open treatment of broken shin bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27550	Closed treatment of knee dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27550	Closed treatment of knee dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	6	
27550	Closed treatment of knee dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
27552	Closed treatment of knee dislocation under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27552	Closed treatment of knee dislocation under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27552	Closed treatment of knee dislocation under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27556	Open treatment of knee dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27556	Open treatment of knee dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27557	Open treatment of knee dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27557	Open treatment of knee dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27558	Open treatment of knee dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27558	Open treatment of knee dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27560	Closed treatment of dislocation of knee cap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27560	Closed treatment of dislocation of knee cap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	6	
27560	Closed treatment of dislocation of knee cap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
27562	Closed treatment of knee cap dislocation under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27562	Closed treatment of knee cap dislocation under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27562	Closed treatment of knee cap dislocation under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27566	Open treatment of knee cap dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27566	Open treatment of knee cap dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27566	Open treatment of knee cap dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27570	Alignment of knee joint under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
27570	Alignment of knee joint under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27570	Alignment of knee joint under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
27580	Fusion of knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27580	Fusion of knee	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27580	Fusion of knee	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27590	Amputation of thigh through thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27590	Amputation of thigh through thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27590	Amputation of thigh through thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27591	Amputation of thigh through thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27591	Amputation of thigh through thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27591	Amputation of thigh through thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27592	"Amputation of thigh through thigh bone, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27592	"Amputation of thigh through thigh bone, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27592	"Amputation of thigh through thigh bone, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27594	Amputation of thigh through thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27594	Amputation of thigh through thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27594	Amputation of thigh through thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27596	Re-amputation of thigh through thigh bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27596	Re-amputation of thigh through thigh bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27596	Re-amputation of thigh through thigh bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27598	Detachment of knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27598	Detachment of knee	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27598	Detachment of knee	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27600	Incision of tissue of front and/or lateral muscle compartments of lower leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27600	Incision of tissue of front and/or lateral muscle compartments of lower leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27600	Incision of tissue of front and/or lateral muscle compartments of lower leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27601	Incision of tissue of rear muscle compartments of lower leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27601	Incision of tissue of rear muscle compartments of lower leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27601	Incision of tissue of rear muscle compartments of lower leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27602	Incision of tissue of front and/or lateral and rear muscle compartments of lower leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27602	Incision of tissue of front and/or lateral and rear muscle compartments of lower leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27602	Incision of tissue of front and/or lateral and rear muscle compartments of lower leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27603	Drainage of abscess or blood collection at lower leg or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27603	Drainage of abscess or blood collection at lower leg or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	12	
27603	Drainage of abscess or blood collection at lower leg or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
27604	Drainage of infected fluid-filled sac (bursa) of leg or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27604	Drainage of infected fluid-filled sac (bursa) of leg or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	12	
27604	Drainage of infected fluid-filled sac (bursa) of leg or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
27605	"Incision of Achilles tendon, accessed through the skin using local anesthetic"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
27605	"Incision of Achilles tendon, accessed through the skin using local anesthetic"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	69	6	
27605	"Incision of Achilles tendon, accessed through the skin using local anesthetic"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
27606	"Incision of Achilles tendon, accessed through the skin requiring general anesthesia"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
27606	"Incision of Achilles tendon, accessed through the skin requiring general anesthesia"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27606	"Incision of Achilles tendon, accessed through the skin requiring general anesthesia"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
27607	Incision of bone of leg or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27607	Incision of bone of leg or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27607	Incision of bone of leg or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27610	"Exploration, drainage, or removal of foreign body of ankle"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27610	"Exploration, drainage, or removal of foreign body of ankle"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27610	"Exploration, drainage, or removal of foreign body of ankle"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27612	Release of ankle joint capsule	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27612	Release of ankle joint capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27612	Release of ankle joint capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27613	Biopsy of soft tissue of leg or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	30	
27613	Biopsy of soft tissue of leg or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	6	
27613	Biopsy of soft tissue of leg or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
27614	Biopsy of tissue or muscle of lower leg or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27614	Biopsy of tissue or muscle of lower leg or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	98	6	
27614	Biopsy of tissue or muscle of lower leg or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
27615	Removal (less than 5 centimeters) tissue growth of leg or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27615	Removal (less than 5 centimeters) tissue growth of leg or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27615	Removal (less than 5 centimeters) tissue growth of leg or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27616	Removal (5 centimeters or greater) tissue growth of leg or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27616	Removal (5 centimeters or greater) tissue growth of leg or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27616	Removal (5 centimeters or greater) tissue growth of leg or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
27618	Removal (less than 3 centimeters) tissue growth beneath the skin of leg or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27618	Removal (less than 3 centimeters) tissue growth beneath the skin of leg or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
27618	Removal (less than 3 centimeters) tissue growth beneath the skin of leg or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
27619	Removal of (less than 5 centimeters) muscle growth of leg or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27619	Removal of (less than 5 centimeters) muscle growth of leg or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27619	Removal of (less than 5 centimeters) muscle growth of leg or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
27620	Exploration of ankle joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27620	Exploration of ankle joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27620	Exploration of ankle joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27625	Removal of membrane covering of ankle joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27625	Removal of membrane covering of ankle joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27625	Removal of membrane covering of ankle joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27626	Removal of membrane covering ankle joint and tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27626	Removal of membrane covering ankle joint and tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27626	Removal of membrane covering ankle joint and tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27630	Removal of growth of leg and/or ankle tendon lining or capsule	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27630	Removal of growth of leg and/or ankle tendon lining or capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	96	6	
27630	Removal of growth of leg and/or ankle tendon lining or capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
27632	Removal (3 centimeters or greater) tissue growth beneath the skin of leg or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27632	Removal (3 centimeters or greater) tissue growth beneath the skin of leg or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27632	Removal (3 centimeters or greater) tissue growth beneath the skin of leg or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
27634	Removal (5 centimeters or greater) muscle growth of leg or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27634	Removal (5 centimeters or greater) muscle growth of leg or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27634	Removal (5 centimeters or greater) muscle growth of leg or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
27635	Removal or scraping of cyst or growth of either bone of lower leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27635	Removal or scraping of cyst or growth of either bone of lower leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27635	Removal or scraping of cyst or growth of either bone of lower leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27637	Removal or scraping of cyst or growth of either bone of lower leg with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27637	Removal or scraping of cyst or growth of either bone of lower leg with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27637	Removal or scraping of cyst or growth of either bone of lower leg with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27638	Removal or scraping of cyst or growth of either bone of lower leg with donor bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27638	Removal or scraping of cyst or growth of either bone of lower leg with donor bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27638	Removal or scraping of cyst or growth of either bone of lower leg with donor bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27640	Partial removal of shin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27640	Partial removal of shin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27640	Partial removal of shin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27641	Partial removal of leg bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27641	Partial removal of leg bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27641	Partial removal of leg bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27645	Removal of growth of shin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27645	Removal of growth of shin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27645	Removal of growth of shin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
27646	Removal of leg bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27646	Removal of leg bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27646	Removal of leg bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
27647	Removal of heel bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27647	Removal of heel bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27647	Removal of heel bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
27648	Injection for X-ray imaging of ankle	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	30	0	
27648	Injection for X-ray imaging of ankle	Post-service	L041B	Radiologic Technologist	0.41	Post service total costs	3	0	
27650	"Repair of ruptured Achilles tendon, open or through skin procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27650	"Repair of ruptured Achilles tendon, open or through skin procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27650	"Repair of ruptured Achilles tendon, open or through skin procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
27652	"Repair of ruptured Achilles tendon with graft, open or through skin procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27652	"Repair of ruptured Achilles tendon with graft, open or through skin procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27652	"Repair of ruptured Achilles tendon with graft, open or through skin procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27654	Repair of ruptured Achilles tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27654	Repair of ruptured Achilles tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27654	Repair of ruptured Achilles tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
27656	Repair of leg tissue defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27656	Repair of leg tissue defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	94	6	
27656	Repair of leg tissue defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
27658	Repair of leg tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27658	Repair of leg tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27658	Repair of leg tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27659	Repair of leg tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27659	Repair of leg tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27659	Repair of leg tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27664	Repair of leg tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27664	Repair of leg tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27664	Repair of leg tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27665	Repair of leg tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27665	Repair of leg tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27665	Repair of leg tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27675	Repair of dislocating lower leg tendons	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27675	Repair of dislocating lower leg tendons	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27675	Repair of dislocating lower leg tendons	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27676	Repair of dislocating lower leg tendons	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27676	Repair of dislocating lower leg tendons	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27676	Repair of dislocating lower leg tendons	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27680	Release of leg and/or ankle tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27680	Release of leg and/or ankle tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27680	Release of leg and/or ankle tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27681	Release of multiple tendons of leg and/or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27681	Release of multiple tendons of leg and/or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27681	Release of multiple tendons of leg and/or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27685	Lengthening or shortening of tendon of leg or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27685	Lengthening or shortening of tendon of leg or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	94	6	
27685	Lengthening or shortening of tendon of leg or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
27686	Lengthening or shortening of multiple tendons of leg or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27686	Lengthening or shortening of multiple tendons of leg or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27686	Lengthening or shortening of multiple tendons of leg or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27687	Lengthening of calf muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27687	Lengthening of calf muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27687	Lengthening of calf muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27690	Transplant of tendon and muscle rerouting at lower leg or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27690	Transplant of tendon and muscle rerouting at lower leg or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27690	Transplant of tendon and muscle rerouting at lower leg or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
27691	Transplant of deep tendon with muscle rerouting at lower leg or ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27691	Transplant of deep tendon with muscle rerouting at lower leg or ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27691	Transplant of deep tendon with muscle rerouting at lower leg or ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
27695	Repair of disrupted collateral ligament of ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27695	Repair of disrupted collateral ligament of ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27695	Repair of disrupted collateral ligament of ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27696	Repair of disruption of both collateral ligaments of ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27696	Repair of disruption of both collateral ligaments of ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27696	Repair of disruption of both collateral ligaments of ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27698	Repair of disrupted collateral ligament of ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27698	Repair of disrupted collateral ligament of ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27698	Repair of disrupted collateral ligament of ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27700	Repair of ankle joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27700	Repair of ankle joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27700	Repair of ankle joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27702	Repair of ankle joint with prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27702	Repair of ankle joint with prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27702	Repair of ankle joint with prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27703	Repair of ankle joint with revision of prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27703	Repair of ankle joint with revision of prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27703	Repair of ankle joint with revision of prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27704	Removal of ankle implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27704	Removal of ankle implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27704	Removal of ankle implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27705	Incision of shin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27705	Incision of shin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27705	Incision of shin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27707	Incision of leg bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27707	Incision of leg bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27707	Incision of leg bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27709	Incision of shin and outer lower leg bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27709	Incision of shin and outer lower leg bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27709	Incision of shin and outer lower leg bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
27712	Insertion of rod in shin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27712	Insertion of rod in shin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27712	Insertion of rod in shin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27715	Lengthening or shortening of lower leg bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27715	Lengthening or shortening of lower leg bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27715	Lengthening or shortening of lower leg bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27720	Repair of non-healed fracture of shin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27720	Repair of non-healed fracture of shin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27720	Repair of non-healed fracture of shin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27722	Repair of non-healed shin bone with shin bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27722	Repair of non-healed shin bone with shin bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27722	Repair of non-healed shin bone with shin bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27724	Repair of non-healed shin bone with graft from hip or other bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27724	Repair of non-healed shin bone with graft from hip or other bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27724	Repair of non-healed shin bone with graft from hip or other bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
27725	Union of lower leg bones to repair non-healed bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27725	Union of lower leg bones to repair non-healed bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27725	Union of lower leg bones to repair non-healed bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		178	
27726	Repair of non-healed shin bone with insertion of hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27726	Repair of non-healed shin bone with insertion of hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27726	Repair of non-healed shin bone with insertion of hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27727	Repair of congenital nonunion of shin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27727	Repair of congenital nonunion of shin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27727	Repair of congenital nonunion of shin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27730	"Scraping or stapling of shin bone growth plate, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27730	"Scraping or stapling of shin bone growth plate, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27730	"Scraping or stapling of shin bone growth plate, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27732	"Scraping or stapling of leg bone growth plate, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27732	"Scraping or stapling of leg bone growth plate, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27732	"Scraping or stapling of leg bone growth plate, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
27734	"Scraping or stapling of growth plates of leg bones, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27734	"Scraping or stapling of growth plates of leg bones, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27734	"Scraping or stapling of growth plates of leg bones, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27740	Scraping or stapling of growth plates at upper and lower leg bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27740	Scraping or stapling of growth plates at upper and lower leg bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27740	Scraping or stapling of growth plates at upper and lower leg bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27742	Scraping or stapling of growth plates at lower thigh bone and upper and lower leg bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27742	Scraping or stapling of growth plates at lower thigh bone and upper and lower leg bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27742	Scraping or stapling of growth plates at lower thigh bone and upper and lower leg bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27745	Insertion of hardware to shin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27745	Insertion of hardware to shin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27745	Insertion of hardware to shin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27750	Closed treatment of broken shin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27750	Closed treatment of broken shin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	12	
27750	Closed treatment of broken shin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
27752	Closed treatment of broken shin bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27752	Closed treatment of broken shin bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	74	12	
27752	Closed treatment of broken shin bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
27756	"Insertion of fixation to broken shin bone, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27756	"Insertion of fixation to broken shin bone, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27756	"Insertion of fixation to broken shin bone, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27758	Open treatment of broken shin bone with plate or screws	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27758	Open treatment of broken shin bone with plate or screws	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27758	Open treatment of broken shin bone with plate or screws	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27759	Treatment of broken shin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27759	Treatment of broken shin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27759	Treatment of broken shin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27760	Closed treatment of broken ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27760	Closed treatment of broken ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	6	
27760	Closed treatment of broken ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
27762	Closed treatment of broken ankle with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27762	Closed treatment of broken ankle with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	69	6	
27762	Closed treatment of broken ankle with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
27766	Open treatment of broken ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27766	Open treatment of broken ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27766	Open treatment of broken ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
27767	Closed treatment of broken ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	60	
27767	Closed treatment of broken ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	24	6	
27767	Closed treatment of broken ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	141	117	
27768	Closed treatment of broken ankle with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27768	Closed treatment of broken ankle with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27768	Closed treatment of broken ankle with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27769	Open treatment of broken ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27769	Open treatment of broken ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27769	Open treatment of broken ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
27780	Closed treatment of broken ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27780	Closed treatment of broken ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	52	6	
27780	Closed treatment of broken ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
27781	Closed treatment of broken ankle with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27781	Closed treatment of broken ankle with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	62	12	
27781	Closed treatment of broken ankle with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
27784	Open treatment of broken ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27784	Open treatment of broken ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27784	Open treatment of broken ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
27786	Closed treatment of broken ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27786	Closed treatment of broken ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	6	
27786	Closed treatment of broken ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
27788	Closed treatment of broken ankle with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27788	Closed treatment of broken ankle with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	6	
27788	Closed treatment of broken ankle with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
27792	Open treatment of broken ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27792	Open treatment of broken ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27792	Open treatment of broken ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
27808	Closed treatment of broken ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27808	Closed treatment of broken ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
27808	Closed treatment of broken ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
27810	Closed treatment of broken ankle with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27810	Closed treatment of broken ankle with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	12	
27810	Closed treatment of broken ankle with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
27814	Open treatment of broken ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27814	Open treatment of broken ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27814	Open treatment of broken ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
27816	Closed treatment of broken ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27816	Closed treatment of broken ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	6	
27816	Closed treatment of broken ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
27818	Closed treatment of broken ankle with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27818	Closed treatment of broken ankle with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	77	6	
27818	Closed treatment of broken ankle with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
27822	Open treatment of broken ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27822	Open treatment of broken ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27822	Open treatment of broken ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27823	Open treatment of broken ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27823	Open treatment of broken ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27823	Open treatment of broken ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27824	Closed treatment of fracture of lower weight bearing joint of shin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27824	Closed treatment of fracture of lower weight bearing joint of shin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25	12	
27824	Closed treatment of fracture of lower weight bearing joint of shin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
27825	Closed treatment of fracture of lower weight bearing joint of shin bone with traction and/or manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27825	Closed treatment of fracture of lower weight bearing joint of shin bone with traction and/or manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	85	12	
27825	Closed treatment of fracture of lower weight bearing joint of shin bone with traction and/or manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
27826	Open treatment of fracture of lower weight bearing joint of fibula (smaller lower leg bone)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27826	Open treatment of fracture of lower weight bearing joint of fibula (smaller lower leg bone)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27826	Open treatment of fracture of lower weight bearing joint of fibula (smaller lower leg bone)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27827	Open treatment of fracture of lower weight bearing joint of shin bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27827	Open treatment of fracture of lower weight bearing joint of shin bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27827	Open treatment of fracture of lower weight bearing joint of shin bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		171	
27828	Open treatment of fracture of lower weight bearing joint of both lower leg bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27828	Open treatment of fracture of lower weight bearing joint of both lower leg bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27828	Open treatment of fracture of lower weight bearing joint of both lower leg bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		171	
27829	Open treatment of ligament tear at ankle joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27829	Open treatment of ligament tear at ankle joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27829	Open treatment of ligament tear at ankle joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
27830	Closed treatment of knee joint dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
27830	Closed treatment of knee joint dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	6	
27830	Closed treatment of knee joint dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
27831	Closed treatment of knee joint dislocation under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27831	Closed treatment of knee joint dislocation under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27831	Closed treatment of knee joint dislocation under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
27832	Open treatment of knee joint dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27832	Open treatment of knee joint dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27832	Open treatment of knee joint dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
27840	Closed treatment of ankle dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27840	Closed treatment of ankle dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27840	Closed treatment of ankle dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27842	Closed treatment of ankle dislocation under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27842	Closed treatment of ankle dislocation under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27842	Closed treatment of ankle dislocation under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27846	Open treatment of ankle dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27846	Open treatment of ankle dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27846	Open treatment of ankle dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27848	Open treatment of ankle dislocation with repair or internal or external hardware	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27848	Open treatment of ankle dislocation with repair or internal or external hardware	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27848	Open treatment of ankle dislocation with repair or internal or external hardware	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27860	Manipulation of ankle under general anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
27860	Manipulation of ankle under general anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
27860	Manipulation of ankle under general anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
27870	"Fusion of ankle joint, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27870	"Fusion of ankle joint, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27870	"Fusion of ankle joint, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
27871	Fusion of foreleg bones at knee or ankle joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27871	Fusion of foreleg bones at knee or ankle joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27871	Fusion of foreleg bones at knee or ankle joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27880	Amputation of both lower leg bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27880	Amputation of both lower leg bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27880	Amputation of both lower leg bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
27881	Amputation of leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27881	Amputation of leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27881	Amputation of leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
27882	"Amputation of leg, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27882	"Amputation of leg, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27882	"Amputation of leg, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27884	Amputation of leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27884	Amputation of leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27884	Amputation of leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27886	Re-amputation of leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27886	Re-amputation of leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27886	Re-amputation of leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27888	Amputation of foot at ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27888	Amputation of foot at ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27888	Amputation of foot at ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27889	Amputation of foot at ankle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27889	Amputation of foot at ankle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27889	Amputation of foot at ankle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
27892	Incision of tissue of front and/or lateral muscle compartments of lower leg with removal of muscle and/or nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27892	Incision of tissue of front and/or lateral muscle compartments of lower leg with removal of muscle and/or nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27892	Incision of tissue of front and/or lateral muscle compartments of lower leg with removal of muscle and/or nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27893	Incision of tissue of rear muscle compartments of lower leg with removal of muscle and/or nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27893	Incision of tissue of rear muscle compartments of lower leg with removal of muscle and/or nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27893	Incision of tissue of rear muscle compartments of lower leg with removal of muscle and/or nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
27894	Incision of tissue of front and/or lateral and rear muscle compartments of lower leg with removal of muscle and/or nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
27894	Incision of tissue of front and/or lateral and rear muscle compartments of lower leg with removal of muscle and/or nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
27894	Incision of tissue of front and/or lateral and rear muscle compartments of lower leg with removal of muscle and/or nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
28001	Drainage of fluid-filled sac (bursa) of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	30	
28001	Drainage of fluid-filled sac (bursa) of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	12	
28001	Drainage of fluid-filled sac (bursa) of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
28002	Drainage of fluid-filled sac (bursa) of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15	30	
28002	Drainage of fluid-filled sac (bursa) of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	67	6	
28002	Drainage of fluid-filled sac (bursa) of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	72	72	
28003	Drainage of multiple fluid-filled sacs (bursa) of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28003	Drainage of multiple fluid-filled sacs (bursa) of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	98	12	
28003	Drainage of multiple fluid-filled sacs (bursa) of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	162.5	162.5	
28005	Incision of foot bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28005	Incision of foot bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28005	Incision of foot bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
28008	Incision of tissues of muscle compartment of foot and/or toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28008	Incision of tissues of muscle compartment of foot and/or toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	87	6	
28008	Incision of tissues of muscle compartment of foot and/or toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28010	"Repair of toe tendon, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28010	"Repair of toe tendon, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	6	
28010	"Repair of toe tendon, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
28011	"Repair of multiple toe tendons, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28011	"Repair of multiple toe tendons, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	66	6	
28011	"Repair of multiple toe tendons, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28020	"Incision of foot bone at ankle joint with exploration, drainage, or removal of foreign body"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28020	"Incision of foot bone at ankle joint with exploration, drainage, or removal of foreign body"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	89	6	
28020	"Incision of foot bone at ankle joint with exploration, drainage, or removal of foreign body"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28022	"Exploration, drainage, or removal of foreign body of foot"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28022	"Exploration, drainage, or removal of foreign body of foot"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	85	6	
28022	"Exploration, drainage, or removal of foreign body of foot"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28024	"Exploration, drainage, or removal of foreign body of toe joint"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28024	"Exploration, drainage, or removal of foreign body of toe joint"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	81	6	
28024	"Exploration, drainage, or removal of foreign body of toe joint"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28035	Release of nerve between tissue and bone of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28035	Release of nerve between tissue and bone of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	90	6	
28035	Release of nerve between tissue and bone of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28039	Removal (1.5 centimeters or greater) tissue growth beneath the skin of foot or toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28039	Removal (1.5 centimeters or greater) tissue growth beneath the skin of foot or toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	6	
28039	Removal (1.5 centimeters or greater) tissue growth beneath the skin of foot or toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
28041	Removal (1.5 centimeters or greater) muscle growth of foot or toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28041	Removal (1.5 centimeters or greater) muscle growth of foot or toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28041	Removal (1.5 centimeters or greater) muscle growth of foot or toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
28043	Removal (less than 1.5 centimeters) tissue growth beneath the skin of foot or toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28043	Removal (less than 1.5 centimeters) tissue growth beneath the skin of foot or toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
28043	Removal (less than 1.5 centimeters) tissue growth beneath the skin of foot or toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
28045	Removal (less than 1.5 centimeters) muscle growth of foot or toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28045	Removal (less than 1.5 centimeters) muscle growth of foot or toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	6	
28045	Removal (less than 1.5 centimeters) muscle growth of foot or toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
28046	Removal (less than 3 centimeters) tissue growth of foot or toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28046	Removal (less than 3 centimeters) tissue growth of foot or toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28046	Removal (less than 3 centimeters) tissue growth of foot or toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
28047	Removal (3 centimeters or greater) tissue growth of foot or toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28047	Removal (3 centimeters or greater) tissue growth of foot or toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28047	Removal (3 centimeters or greater) tissue growth of foot or toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
28050	Biopsy of foot bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28050	Biopsy of foot bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	83	6	
28050	Biopsy of foot bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28052	Biopsy of foot bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28052	Biopsy of foot bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	77	6	
28052	Biopsy of foot bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
28054	Biopsy of toe joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28054	Biopsy of toe joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	74	6	
28054	Biopsy of toe joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
28055	Removal of nerve of foot muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28055	Removal of nerve of foot muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28055	Removal of nerve of foot muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
28060	Partial removal of tissue at sole of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28060	Partial removal of tissue at sole of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	6	
28060	Partial removal of tissue at sole of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28062	Removal of tissue at sole of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28062	Removal of tissue at sole of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	130	6	
28062	Removal of tissue at sole of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28070	Removal of joint lining of foot bone at ankle joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28070	Removal of joint lining of foot bone at ankle joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	97	6	
28070	Removal of joint lining of foot bone at ankle joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28072	Removal of joint lining at first joint of toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28072	Removal of joint lining at first joint of toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	92	6	
28072	Removal of joint lining at first joint of toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28080	Removal of fibrous nerve growth from between toes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28080	Removal of fibrous nerve growth from between toes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	82	6	
28080	Removal of fibrous nerve growth from between toes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	160	160	
28086	Removal of foot tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28086	Removal of foot tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	89	6	
28086	Removal of foot tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28088	Removal of foot tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28088	Removal of foot tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	80	6	
28088	Removal of foot tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
28090	Removal of growth of tendon covering or joint capsule of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28090	Removal of growth of tendon covering or joint capsule of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	89	6	
28090	Removal of growth of tendon covering or joint capsule of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28092	Removal of growth of tendon covering or joint capsule of toes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28092	Removal of growth of tendon covering or joint capsule of toes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	6	
28092	Removal of growth of tendon covering or joint capsule of toes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28100	Removal or scraping of bone cyst or growth of heel bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28100	Removal or scraping of bone cyst or growth of heel bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	109	6	
28100	Removal or scraping of bone cyst or growth of heel bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28102	Removal or scraping of bone cyst or growth of heel bone with graft from hip or other bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28102	Removal or scraping of bone cyst or growth of heel bone with graft from hip or other bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28102	Removal or scraping of bone cyst or growth of heel bone with graft from hip or other bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
28103	Removal or scraping of bone cyst or growth of heel bone with donor bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28103	Removal or scraping of bone cyst or growth of heel bone with donor bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28103	Removal or scraping of bone cyst or growth of heel bone with donor bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
28104	Removal or scraping of bone cyst or growth of ankle bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28104	Removal or scraping of bone cyst or growth of ankle bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	97	6	
28104	Removal or scraping of bone cyst or growth of ankle bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28106	Removal or scraping of bone cyst or growth of ankle bone with graft from hip or other bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28106	Removal or scraping of bone cyst or growth of ankle bone with graft from hip or other bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28106	Removal or scraping of bone cyst or growth of ankle bone with graft from hip or other bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
28107	Removal or scraping of bone cyst or growth of foot bone with donor bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28107	Removal or scraping of bone cyst or growth of foot bone with donor bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	126	6	
28107	Removal or scraping of bone cyst or growth of foot bone with donor bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28108	Removal or scraping of bone cyst or growth of toes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28108	Removal or scraping of bone cyst or growth of toes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	80	6	
28108	Removal or scraping of bone cyst or growth of toes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28110	Removal of bunion at fifth toe joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28110	Removal of bunion at fifth toe joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	80	6	
28110	Removal of bunion at fifth toe joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28111	Removal of bone at fifth toe joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28111	Removal of bone at fifth toe joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	89	6	
28111	Removal of bone at fifth toe joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28112	"Removal of bones at second, third, or fourth toe joints"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28112	"Removal of bones at second, third, or fourth toe joints"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	81	6	
28112	"Removal of bones at second, third, or fourth toe joints"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28113	Removal of foot bone at fifth toe joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28113	Removal of foot bone at fifth toe joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	6	
28113	Removal of foot bone at fifth toe joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	171	171	
28114	Removal of multiple foot bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28114	Removal of multiple foot bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	135	6	
28114	Removal of multiple foot bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	267	267	
28116	Removal of abnormal bones at ankle joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28116	Removal of abnormal bones at ankle joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	125	6	
28116	Removal of abnormal bones at ankle joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
28118	Removal of heel bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28118	Removal of heel bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	101	6	
28118	Removal of heel bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28119	Removal of heel bone spur	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28119	Removal of heel bone spur	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	97	6	
28119	Removal of heel bone spur	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28120	Partial removal of foot or heel bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28120	Partial removal of foot or heel bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	95	6	
28120	Partial removal of foot or heel bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
28122	Partial removal of foot or heel bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28122	Partial removal of foot or heel bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	85	6	
28122	Partial removal of foot or heel bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
28124	Partial removal of toe bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28124	Partial removal of toe bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	79	6	
28124	Partial removal of toe bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
28126	Removal of bone at base of toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28126	Removal of bone at base of toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	74	6	
28126	Removal of bone at base of toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
28130	Removal of ankle joint bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28130	Removal of ankle joint bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28130	Removal of ankle joint bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
28140	Removal of foot bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28140	Removal of foot bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	103	12	
28140	Removal of foot bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28150	Removal of toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28150	Removal of toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	80	6	
28150	Removal of toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28153	Partial removal of toe bone joints	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28153	Partial removal of toe bone joints	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	74	6	
28153	Partial removal of toe bone joints	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28160	Partial removal of toe joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28160	Partial removal of toe joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	6	
28160	Partial removal of toe joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28171	"Extensive removal of bone growth, middle portion of foot"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28171	"Extensive removal of bone growth, middle portion of foot"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28171	"Extensive removal of bone growth, middle portion of foot"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
28173	Removal of bone growth of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28173	Removal of bone growth of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28173	Removal of bone growth of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
28175	Removal of bone growth of toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28175	Removal of bone growth of toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28175	Removal of bone growth of toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
28190	"Removal of foreign body of foot tissue, accessed beneath the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	30	
28190	"Removal of foreign body of foot tissue, accessed beneath the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	6	
28190	"Removal of foreign body of foot tissue, accessed beneath the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
28192	Removal of foreign body of foot tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28192	Removal of foreign body of foot tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	86	6	
28192	Removal of foreign body of foot tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28193	Removal of foreign body of foot tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28193	Removal of foreign body of foot tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	103	6	
28193	Removal of foreign body of foot tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28200	Repair of foot tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28200	Repair of foot tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	94	6	
28200	Repair of foot tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28202	Repair of foot tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28202	Repair of foot tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	115	6	
28202	Repair of foot tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28208	Repair of foot tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28208	Repair of foot tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	82	6	
28208	Repair of foot tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28210	Repair of foot tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28210	Repair of foot tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	96	6	
28210	Repair of foot tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28220	Release of foot tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28220	Release of foot tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	79	6	
28220	Release of foot tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28222	Release of multiple foot tendons	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28222	Release of multiple foot tendons	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	100	6	
28222	Release of multiple foot tendons	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28225	Release of foot tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28225	Release of foot tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	73	6	
28225	Release of foot tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
28226	Release of multiple tendons in foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28226	Release of multiple tendons in foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	90	6	
28226	Release of multiple tendons in foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28230	"Incision to lengthen foot tendons, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28230	"Incision to lengthen foot tendons, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	80	6	
28230	"Incision to lengthen foot tendons, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
28232	"Incision to lengthen toe tendon, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28232	"Incision to lengthen toe tendon, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	67	6	
28232	"Incision to lengthen toe tendon, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
28234	"Incision to release foot tendon, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28234	"Incision to release foot tendon, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	6	
28234	"Incision to release foot tendon, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28238	Advancement of ankle tendon with removal of ankle joint bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28238	Advancement of ankle tendon with removal of ankle joint bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	120	6	
28238	Advancement of ankle tendon with removal of ankle joint bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28240	Incision to release foot muscle tendon	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28240	Incision to release foot muscle tendon	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	6	
28240	Incision to release foot muscle tendon	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
28250	Incision to release tissue and muscle of sole of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28250	Incision to release tissue and muscle of sole of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	6	
28250	Incision to release tissue and muscle of sole of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28260	Incision of ankle joint capsule to correct foot deformity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28260	Incision of ankle joint capsule to correct foot deformity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	98	6	
28260	Incision of ankle joint capsule to correct foot deformity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28261	Correction of foot deformity with incision of ankle joint capsule and tendon lengthening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28261	Correction of foot deformity with incision of ankle joint capsule and tendon lengthening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	148	6	
28261	Correction of foot deformity with incision of ankle joint capsule and tendon lengthening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
28262	Correction of foot deformity with incision of ankle joint capsule and lengthening of tendons	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28262	Correction of foot deformity with incision of ankle joint capsule and lengthening of tendons	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	185	12	
28262	Correction of foot deformity with incision of ankle joint capsule and lengthening of tendons	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
28264	Release of capsule of ankle joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28264	Release of capsule of ankle joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	119	6	
28264	Release of capsule of ankle joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
28270	Incision of joint capsule of foot and toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28270	Incision of joint capsule of foot and toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	82	6	
28270	Incision of joint capsule of foot and toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28272	Incision of toe joint capsule	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28272	Incision of toe joint capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	6	
28272	Incision of toe joint capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
28280	Creation of web space between toes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28280	Creation of web space between toes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	93	6	
28280	Creation of web space between toes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28285	Correction of toe joint deformity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28285	Correction of toe joint deformity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	6	
28285	Correction of toe joint deformity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126.5	126.5	
28286	Correction of fifth toe joint deformity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28286	Correction of fifth toe joint deformity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	91	6	
28286	Correction of fifth toe joint deformity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28288	Removal of foot bone spur	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28288	Removal of foot bone spur	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	6	
28288	Removal of foot bone spur	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	160	160	
28289	Correction of deformity of first long bone at toe joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28289	Correction of deformity of first long bone at toe joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	90	6	
28289	Correction of deformity of first long bone at toe joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
28290	Correction of bunion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28290	Correction of bunion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	89	6	
28290	Correction of bunion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28292	Correction of bunion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28292	Correction of bunion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	105	6	
28292	Correction of bunion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	233	233	
28293	Correction of bunion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28293	Correction of bunion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	133	6	
28293	Correction of bunion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	269	269	
28294	Correction of bunion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28294	Correction of bunion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	132	6	
28294	Correction of bunion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
28296	Correction of bunion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28296	Correction of bunion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	105	6	
28296	Correction of bunion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	153	153	
28297	Correction of bunion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28297	Correction of bunion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	132	6	
28297	Correction of bunion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
28298	Correction of bunion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28298	Correction of bunion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	122	6	
28298	Correction of bunion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
28299	Correction of bunion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28299	Correction of bunion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	135	6	
28299	Correction of bunion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	135	135	
28300	Incision to repair heel bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28300	Incision to repair heel bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28300	Incision to repair heel bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
28302	Incision to repair ankle joint bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28302	Incision to repair ankle joint bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28302	Incision to repair ankle joint bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
28304	Incision to correct foot or ankle bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28304	Incision to correct foot or ankle bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	102	6	
28304	Incision to correct foot or ankle bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
28305	Incision to correct foot or ankle bones with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28305	Incision to correct foot or ankle bones with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28305	Incision to correct foot or ankle bones with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
28306	Incision to straighten big toe bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28306	Incision to straighten big toe bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	96	6	
28306	Incision to straighten big toe bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28307	Incision to straighten big toe bone with patient-derived bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28307	Incision to straighten big toe bone with patient-derived bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	115	6	
28307	Incision to straighten big toe bone with patient-derived bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28308	Incision to straighten toe bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28308	Incision to straighten toe bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	84	6	
28308	Incision to straighten toe bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
28309	Incision to straighten toe bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28309	Incision to straighten toe bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28309	Incision to straighten toe bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
28310	Incision to straighten big toe bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28310	Incision to straighten big toe bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	91	6	
28310	Incision to straighten big toe bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28312	Incision to straighten toe bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28312	Incision to straighten toe bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	6	
28312	Incision to straighten toe bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28313	Reconstruction of soft tissue angular deformity of toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28313	Reconstruction of soft tissue angular deformity of toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	79	6	
28313	Reconstruction of soft tissue angular deformity of toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28315	Removal of small bone underlying long bone of foot at toe joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28315	Removal of small bone underlying long bone of foot at toe joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	84	6	
28315	Removal of small bone underlying long bone of foot at toe joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28320	Repair of non-healed foot bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28320	Repair of non-healed foot bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28320	Repair of non-healed foot bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
28322	Repair of non-healed foot bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28322	Repair of non-healed foot bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	120	6	
28322	Repair of non-healed foot bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
28340	Reconstruction of abnormal toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28340	Reconstruction of abnormal toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	123	6	
28340	Reconstruction of abnormal toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28341	Reconstruction of abnormal toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28341	Reconstruction of abnormal toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	149	6	
28341	Reconstruction of abnormal toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
28344	Reconstruction of extra toes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28344	Reconstruction of extra toes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	6	
28344	Reconstruction of extra toes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28345	Removal of congenital web space deformity of toes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28345	Removal of congenital web space deformity of toes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	108	6	
28345	Removal of congenital web space deformity of toes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28360	Reconstruction of congenitally deformed foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28360	Reconstruction of congenitally deformed foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28360	Reconstruction of congenitally deformed foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
28400	Closed treatment of broken heel bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28400	Closed treatment of broken heel bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	12	
28400	Closed treatment of broken heel bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28405	Closed treatment of broken heel bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28405	Closed treatment of broken heel bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	70	6	
28405	Closed treatment of broken heel bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28406	"Insertion of hardware to broken heel bone with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28406	"Insertion of hardware to broken heel bone with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28406	"Insertion of hardware to broken heel bone with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
28415	Open treatment of broken heel bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28415	Open treatment of broken heel bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28415	Open treatment of broken heel bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		171	
28420	Open treatment of broken heel bone with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28420	Open treatment of broken heel bone with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28420	Open treatment of broken heel bone with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		171	
28430	Closed treatment of broken ankle joint bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28430	Closed treatment of broken ankle joint bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	6	
28430	Closed treatment of broken ankle joint bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
28435	Closed treatment of broken ankle joint bone with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28435	Closed treatment of broken ankle joint bone with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	69	12	
28435	Closed treatment of broken ankle joint bone with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28436	"Insertion of hardware to broken ankle joint with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28436	"Insertion of hardware to broken ankle joint with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28436	"Insertion of hardware to broken ankle joint with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
28445	Open treatment of broken heel bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28445	Open treatment of broken heel bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28445	Open treatment of broken heel bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		171	
28446	"Implantation of donor cartilage cells into foot joint with grafts, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28446	"Implantation of donor cartilage cells into foot joint with grafts, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28446	"Implantation of donor cartilage cells into foot joint with grafts, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
28450	Treatment of broken foot bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28450	Treatment of broken foot bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	6	
28450	Treatment of broken foot bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
28455	Treatment of broken foot bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28455	Treatment of broken foot bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	67	12	
28455	Treatment of broken foot bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28456	"Insertion of hardware to broken foot joint with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28456	"Insertion of hardware to broken foot joint with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28456	"Insertion of hardware to broken foot joint with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
28465	Open treatment of broken foot bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28465	Open treatment of broken foot bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28465	Open treatment of broken foot bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
28470	Closed treatment of broken foot bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28470	Closed treatment of broken foot bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	6	
28470	Closed treatment of broken foot bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28475	Closed treatment of fracture of foot with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28475	Closed treatment of fracture of foot with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
28475	Closed treatment of fracture of foot with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	56	56	
28476	"Insertion of hardware to broken foot bone with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28476	"Insertion of hardware to broken foot bone with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28476	"Insertion of hardware to broken foot bone with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
28485	Open treatment of broken foot bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28485	Open treatment of broken foot bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28485	Open treatment of broken foot bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
28490	Closed treatment of broken great toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28490	Closed treatment of broken great toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	6	
28490	Closed treatment of broken great toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	41	41	
28495	Closed treatment of broken great toe with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28495	Closed treatment of broken great toe with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	6	
28495	Closed treatment of broken great toe with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
28496	"Insertion of hardware to broken great toe with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28496	"Insertion of hardware to broken great toe with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	92	6	
28496	"Insertion of hardware to broken great toe with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28505	Open treatment of broken great toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28505	Open treatment of broken great toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	104	6	
28505	Open treatment of broken great toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	126	
28510	Closed treatment of broken toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28510	Closed treatment of broken toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	6	
28510	Closed treatment of broken toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	41	41	
28515	Closed treatment of broken toe with manipulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28515	Closed treatment of broken toe with manipulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	6	
28515	Closed treatment of broken toe with manipulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
28525	Open treatment of broken toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28525	Open treatment of broken toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	72	6	
28525	Open treatment of broken toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
28530	Closed treatment of broken foot bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28530	Closed treatment of broken foot bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	6	
28530	Closed treatment of broken foot bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
28531	Open treatment of broken foot bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28531	Open treatment of broken foot bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	102	6	
28531	Open treatment of broken foot bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
28540	Closed treatment of ankle joint bone dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28540	Closed treatment of ankle joint bone dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	6	
28540	Closed treatment of ankle joint bone dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28545	Closed treatment of ankle joint bone dislocation under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28545	Closed treatment of ankle joint bone dislocation under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	6	
28545	Closed treatment of ankle joint bone dislocation under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28546	"Insertion of hardware to foot joint dislocation with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28546	"Insertion of hardware to foot joint dislocation with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	95	6	
28546	"Insertion of hardware to foot joint dislocation with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
28555	Open treatment of dislocated foot joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28555	Open treatment of dislocated foot joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	102	12	
28555	Open treatment of dislocated foot joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
28570	Closed treatment of dislocated foot joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28570	Closed treatment of dislocated foot joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
28570	Closed treatment of dislocated foot joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
28575	Closed treatment of dislocated foot joint under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28575	Closed treatment of dislocated foot joint under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	12	
28575	Closed treatment of dislocated foot joint under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28576	"Insertion of hardware to foot joint dislocation with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28576	"Insertion of hardware to foot joint dislocation with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28576	"Insertion of hardware to foot joint dislocation with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
28585	Open treatment of dislocated foot joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28585	Open treatment of dislocated foot joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	116	6	
28585	Open treatment of dislocated foot joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	162	162	
28600	Closed treatment of dislocated foot joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28600	Closed treatment of dislocated foot joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	6	
28600	Closed treatment of dislocated foot joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
28605	Closed treatment of dislocated foot joint under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28605	Closed treatment of dislocated foot joint under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	62	12	
28605	Closed treatment of dislocated foot joint under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
28606	"Insertion of hardware to foot joint dislocation with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28606	"Insertion of hardware to foot joint dislocation with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28606	"Insertion of hardware to foot joint dislocation with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
28615	Open treatment of dislocated foot joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28615	Open treatment of dislocated foot joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28615	Open treatment of dislocated foot joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		189	
28630	Closed treatment of dislocated foot bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	5	
28630	Closed treatment of dislocated foot bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	6	
28630	Closed treatment of dislocated foot bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
28635	Closed treatment of dislocated foot bone under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
28635	Closed treatment of dislocated foot bone under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	6	
28635	Closed treatment of dislocated foot bone under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
28636	"Insertion of hardware to foot bone dislocation with manipulation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
28636	"Insertion of hardware to foot bone dislocation with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	74	6	
28636	"Insertion of hardware to foot bone dislocation with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
28645	Open treatment of dislocated foot bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28645	Open treatment of dislocated foot bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	86	6	
28645	Open treatment of dislocated foot bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
28660	Closed treatment of dislocation of toe joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	5	
28660	Closed treatment of dislocation of toe joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	6	
28660	Closed treatment of dislocation of toe joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
28665	Closed treatment of dislocation of toe joint under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
28665	Closed treatment of dislocation of toe joint under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	6	
28665	Closed treatment of dislocation of toe joint under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
28666	"Insertion of hardware to toe joint dislocation with manipulation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28666	"Insertion of hardware to toe joint dislocation with manipulation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
28675	Open treatment of toe joint dislocation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28675	Open treatment of toe joint dislocation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	6	
28675	Open treatment of toe joint dislocation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
28705	Fusion of ankle joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28705	Fusion of ankle joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28705	Fusion of ankle joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
28715	Fusion of ankle joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28715	Fusion of ankle joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28715	Fusion of ankle joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		198	
28725	Fusion of foot joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28725	Fusion of foot joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28725	Fusion of foot joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
28730	Fusion of multiple foot joints	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28730	Fusion of multiple foot joints	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28730	Fusion of multiple foot joints	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
28735	Fusion of multiple foot joints	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28735	Fusion of multiple foot joints	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28735	Fusion of multiple foot joints	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
28737	Fusion of foot joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28737	Fusion of foot joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
28737	Fusion of foot joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
28740	Fusion of foot joint	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28740	Fusion of foot joint	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	124	6	
28740	Fusion of foot joint	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
28750	Fusion of great toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28750	Fusion of great toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	119	6	
28750	Fusion of great toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
28755	Fusion of great toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28755	Fusion of great toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	6	
28755	Fusion of great toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
28760	Fusion of great toe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28760	Fusion of great toe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	134	6	
28760	Fusion of great toe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	144	144	
28800	Amputation of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28800	Amputation of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28800	Amputation of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
28805	Amputation of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28805	Amputation of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28805	Amputation of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
28810	Amputation of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
28810	Amputation of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
28810	Amputation of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
28820	Amputation of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28820	Amputation of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	74	6	
28820	Amputation of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126.5	126.5	
28825	Amputation of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
28825	Amputation of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	74	6	
28825	Amputation of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	126	126	
28890	Shock wave therapy under anesthesia to sole of the foot using ultrasound guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	24	
28890	Shock wave therapy under anesthesia to sole of the foot using ultrasound guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	6	
28890	Shock wave therapy under anesthesia to sole of the foot using ultrasound guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
29000	Application of halo type body cast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	160	0	
29000	Application of halo type body cast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	57	57	
29010	Application of jacket type body cast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	160	0	
29010	Application of jacket type body cast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	57	57	
29015	Application of jacket type body cast including head	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	160	0	
29015	Application of jacket type body cast including head	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	57	57	
29035	Application of body cast shoulder to hips	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	160	0	
29035	Application of body cast shoulder to hips	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	57	57	
29040	Application of body cast shoulder to hips including head	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	170	0	
29040	Application of body cast shoulder to hips including head	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	62	62	
29044	Application of body cast shoulder to hips including one thigh	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	170	0	
29044	Application of body cast shoulder to hips including one thigh	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	62	62	
29046	Application of body cast shoulder to hips including both thighs	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	180	0	
29046	Application of body cast shoulder to hips including both thighs	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	67	67	
29049	Application of figure-of-eight cast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
29049	Application of figure-of-eight cast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	25	25	
29055	Application of shoulder spica cast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	122	0	
29055	Application of shoulder spica cast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	48	48	
29058	Application of plaster Velpeau cast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
29058	Application of plaster Velpeau cast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	25	25	
29065	"Application of cast, shoulder to hand (long arm)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
29065	"Application of cast, shoulder to hand (long arm)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	25	25	
29075	"Application of cast, elbow to finger (short arm)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	0	
29075	"Application of cast, elbow to finger (short arm)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	25	25	
29085	Application of cast to hand and lower forearm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
29085	Application of cast to hand and lower forearm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	25	25	
29086	Application of cast to finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
29086	Application of cast to finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	25	25	
29105	Application of long arm splint (shoulder to hand)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
29105	Application of long arm splint (shoulder to hand)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	19	19	
29125	"Application of non-moveable, short arm splint (forearm to hand)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	0	
29125	"Application of non-moveable, short arm splint (forearm to hand)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	19	19	
29126	"Application of moveable, hinged short arm splint (forearm to hand)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	0	
29126	"Application of moveable, hinged short arm splint (forearm to hand)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	19	19	
29130	"Application of non-moveable, hinged finger splint"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
29130	"Application of non-moveable, hinged finger splint"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
29131	"Application of moveable, hinged finger splint"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	0	
29131	"Application of moveable, hinged finger splint"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	6	
29200	Strapping; thorax	Service  pre	L023A	Physical Therapy Aide	0.23	Greet patient and provide gowning	0		
29200	Strapping; thorax	Service  pre	L023A	Physical Therapy Aide	0.23	Prepare and position pt/ monitor pt/ set up IV	2		
29200	Strapping; thorax	Service  pre	L023A	Physical Therapy Aide	0.23	"Prepare room, equipment, supplies"	2		
29200	Strapping; thorax	Service  pre	L023A	Physical Therapy Aide	0.23	SVC Provide pre-service education/obtain consent	3		
29200	Strapping; thorax	Service  intra	L023A	Physical Therapy Aide	0.23	Assist physician in performing procedure	8		
29200	Strapping; thorax	Service  post	L023A	Physical Therapy Aide	0.23	Clean room/equipment by physician staff	3		
29200	Strapping; thorax	Post-service	L023A	Physical Therapy Aide	0.23	Conduct phone calls/call in prescriptions	3		
29240	Strapping; shoulder	Service  pre	L023A	Physical Therapy Aide	0.23	Greet patient and provide gowning	0		
29240	Strapping; shoulder	Service  pre	L023A	Physical Therapy Aide	0.23	Prepare and position pt/ monitor pt/ set up IV	2		
29240	Strapping; shoulder	Service  pre	L023A	Physical Therapy Aide	0.23	"Prepare room, equipment, supplies"	2		
29240	Strapping; shoulder	Service  pre	L023A	Physical Therapy Aide	0.23	SVC Provide pre-service education/obtain consent	3		
29240	Strapping; shoulder	Service  intra	L023A	Physical Therapy Aide	0.23	Assist physician in performing procedure	8		
29240	Strapping; shoulder	Service  post	L023A	Physical Therapy Aide	0.23	Clean room/equipment by physician staff	3		
29240	Strapping; shoulder	Post-service	L023A	Physical Therapy Aide	0.23	Conduct phone calls/call in prescriptions	3		
29260	Strapping; elbow/wrist	Service  pre	L023A	Physical Therapy Aide	0.23	Greet patient and provide gowning	0		
29260	Strapping; elbow/wrist	Service  pre	L023A	Physical Therapy Aide	0.23	Prepare and position pt/ monitor pt/ set up IV	2		
29260	Strapping; elbow/wrist	Service  pre	L023A	Physical Therapy Aide	0.23	"Prepare room, equipment, supplies"	2		
29260	Strapping; elbow/wrist	Service  pre	L023A	Physical Therapy Aide	0.23	SVC Provide pre-service education/obtain consent	3		
29260	Strapping; elbow/wrist	Service  intra	L023A	Physical Therapy Aide	0.23	Assist physician in performing procedure	8		
29260	Strapping; elbow/wrist	Service  post	L023A	Physical Therapy Aide	0.23	Clean room/equipment by physician staff	3		
29260	Strapping; elbow/wrist	Post-service	L023A	Physical Therapy Aide	0.23	Conduct phone calls/call in prescriptions	3		
29280	Strapping; hand/finger	Service  pre	L023A	Physical Therapy Aide	0.23	Greet patient and provide gowning	0		
29280	Strapping; hand/finger	Service  pre	L023A	Physical Therapy Aide	0.23	Prepare and position pt/ monitor pt/ set up IV	2		
29280	Strapping; hand/finger	Service  pre	L023A	Physical Therapy Aide	0.23	"Prepare room, equipment, supplies"	2		
29280	Strapping; hand/finger	Service  pre	L023A	Physical Therapy Aide	0.23	SVC Provide pre-service education/obtain consent	3		
29280	Strapping; hand/finger	Service  intra	L023A	Physical Therapy Aide	0.23	Assist physician in performing procedure	8		
29280	Strapping; hand/finger	Service  post	L023A	Physical Therapy Aide	0.23	Clean room/equipment by physician staff	3		
29280	Strapping; hand/finger	Post-service	L023A	Physical Therapy Aide	0.23	Conduct phone calls/call in prescriptions	3		
29305	Application of hip spica cast on one leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	123	0	
29305	Application of hip spica cast on one leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	57	57	
29325	"Application of hip spica cast, one and one-half hip spica or both legs"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	133	0	
29325	"Application of hip spica cast, one and one-half hip spica or both legs"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	60	60	
29345	Application of long leg cast (thigh to toes)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	0	
29345	Application of long leg cast (thigh to toes)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	28	28	
29355	"Application of long leg cast (thigh to toes), walker or ambulatory type"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	0	
29355	"Application of long leg cast (thigh to toes), walker or ambulatory type"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	28	28	
29358	Application of long leg cast brace	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	80	0	
29358	Application of long leg cast brace	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	28	28	
29365	Application of cylinder cast (thigh to ankle)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	0	
29365	Application of cylinder cast (thigh to ankle)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	28	28	
29405	Application of short leg cast (below knee to toes)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	33	0	
29405	Application of short leg cast (below knee to toes)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	25	25	
29425	"Application of short leg cast (below knee to toes), walking or ambulatory type"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	0	
29425	"Application of short leg cast (below knee to toes), walking or ambulatory type"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	25	25	
29435	Application of knee cap tendon bearing cast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	0	
29435	Application of knee cap tendon bearing cast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	25	25	
29440	Adding walker to previously applied cast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	0	
29440	Adding walker to previously applied cast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	6	
29445	Application of rigid total contact leg cast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	0	
29445	Application of rigid total contact leg cast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	28	28	
29450	Application of long or short leg clubfoot cast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	0	
29450	Application of long or short leg clubfoot cast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	25	25	
29505	Application of long leg splint (thigh to ankle or toes)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
29505	Application of long leg splint (thigh to ankle or toes)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	22	22	
29515	Application of short leg splint (calf to foot)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	0	
29515	Application of short leg splint (calf to foot)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	22	22	
29520	Strapping; hip	Service  pre	L023A	Physical Therapy Aide	0.23	Greet patient and provide gowning	0		
29520	Strapping; hip	Service  pre	L023A	Physical Therapy Aide	0.23	Prepare and position pt/ monitor pt/ set up IV	2		
29520	Strapping; hip	Service  pre	L023A	Physical Therapy Aide	0.23	"Prepare room, equipment, supplies"	2		
29520	Strapping; hip	Service  pre	L023A	Physical Therapy Aide	0.23	SVC Provide pre-service education/obtain consent	3		
29520	Strapping; hip	Service  intra	L023A	Physical Therapy Aide	0.23	Assist physician in performing procedure	8		
29520	Strapping; hip	Service  post	L023A	Physical Therapy Aide	0.23	Clean room/equipment by physician staff	3		
29520	Strapping; hip	Post-service	L023A	Physical Therapy Aide	0.23	Conduct phone calls/call in prescriptions	3		
29530	Strapping; knee	Service  pre	L023A	Physical Therapy Aide	0.23	Greet patient and provide gowning	0		
29530	Strapping; knee	Service  pre	L023A	Physical Therapy Aide	0.23	Prepare and position pt/ monitor pt/ set up IV	2		
29530	Strapping; knee	Service  pre	L023A	Physical Therapy Aide	0.23	"Prepare room, equipment, supplies"	2		
29530	Strapping; knee	Service  pre	L023A	Physical Therapy Aide	0.23	SVC Provide pre-service education/obtain consent	3		
29530	Strapping; knee	Service  intra	L023A	Physical Therapy Aide	0.23	Assist physician in performing procedure	8		
29530	Strapping; knee	Service  post	L023A	Physical Therapy Aide	0.23	Clean room/equipment by physician staff	3		
29530	Strapping; knee	Post-service	L023A	Physical Therapy Aide	0.23	Conduct phone calls/call in prescriptions	3		
29540	Strapping of ankle and/or foot	Service  pre	L023A	Physical Therapy Aide	0.23	Greet patient and provide gowning	0		
29540	Strapping of ankle and/or foot	Service  pre	L023A	Physical Therapy Aide	0.23	Prepare and position pt/ monitor pt/ set up IV	2		
29540	Strapping of ankle and/or foot	Service  pre	L023A	Physical Therapy Aide	0.23	"Prepare room, equipment, supplies"	2		
29540	Strapping of ankle and/or foot	Service  pre	L023A	Physical Therapy Aide	0.23	SVC Provide pre-service education/obtain consent	3		
29540	Strapping of ankle and/or foot	Service  intra	L023A	Physical Therapy Aide	0.23	Assist physician in performing procedure	8		
29540	Strapping of ankle and/or foot	Service  post	L023A	Physical Therapy Aide	0.23	Clean room/equipment by physician staff	3		
29540	Strapping of ankle and/or foot	Post-service	L023A	Physical Therapy Aide	0.23	Conduct phone calls/call in prescriptions	3		
29550	Strapping of toes	Service  pre	L023A	Physical Therapy Aide	0.23	Greet patient and provide gowning	0		
29550	Strapping of toes	Service  pre	L023A	Physical Therapy Aide	0.23	Prepare and position pt/ monitor pt/ set up IV	2		
29550	Strapping of toes	Service  pre	L023A	Physical Therapy Aide	0.23	"Prepare room, equipment, supplies"	2		
29550	Strapping of toes	Service  pre	L023A	Physical Therapy Aide	0.23	SVC Provide pre-service education/obtain consent	3		
29550	Strapping of toes	Service  intra	L023A	Physical Therapy Aide	0.23	Assist physician in performing procedure	8		
29550	Strapping of toes	Service  post	L023A	Physical Therapy Aide	0.23	Clean room/equipment by physician staff	3		
29550	Strapping of toes	Post-service	L023A	Physical Therapy Aide	0.23	Conduct phone calls/call in prescriptions	3		
29580	"Strapping, Unna boot"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	0	
29580	"Strapping, Unna boot"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	17	17	
29581	Application of vein wound compression system lower leg below knee including ankle and foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	34	0	
29581	Application of vein wound compression system lower leg below knee including ankle and foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
29582	Application of vein wound compression system thigh and lower leg	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	8	0	
29582	Application of vein wound compression system thigh and lower leg	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	12	0	
29582	Application of vein wound compression system thigh and lower leg	Post-service	L039B	Physical Therapy Assistant	0.39	Post service total costs	1	0	
29583	Application of vein wound compression system upper arm and forearm	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	8	0	
29583	Application of vein wound compression system upper arm and forearm	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	11	0	
29583	Application of vein wound compression system upper arm and forearm	Post-service	L039B	Physical Therapy Assistant	0.39	Post service total costs	1	0	
29584	"Application of vein wound compression system upper arm, forearm, hand, and fingers"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	8	0	
29584	"Application of vein wound compression system upper arm, forearm, hand, and fingers"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	12	0	
29584	"Application of vein wound compression system upper arm, forearm, hand, and fingers"	Post-service	L039B	Physical Therapy Assistant	0.39	Post service total costs	1	0	
29700	"Removal or bivalving of gauntlet, boot, or body cast"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	0	
29700	"Removal or bivalving of gauntlet, boot, or body cast"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	6	
29705	Removal or bivalving of full arm or leg cast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	0	
29705	Removal or bivalving of full arm or leg cast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	6	
29710	"Removal or bivalving of shoulder, hip spica, or jacket cast"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	0	
29710	"Removal or bivalving of shoulder, hip spica, or jacket cast"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	6	
29720	"Repair of spica, body cast, or jacket"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	0	
29720	"Repair of spica, body cast, or jacket"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	6	
29730	Exposure of skin surface by creation of an opening in cast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	0	
29730	Exposure of skin surface by creation of an opening in cast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	6	
29740	Wedging of cast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
29740	Wedging of cast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	6	
29750	Wedging of clubfoot cast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
29750	Wedging of clubfoot cast	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	6	
29800	Diagnostic examination of jaw joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29800	Diagnostic examination of jaw joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29800	Diagnostic examination of jaw joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
29804	Examination of jaw joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29804	Examination of jaw joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29804	Examination of jaw joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
29805	Diagnostic examination of shoulder using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29805	Diagnostic examination of shoulder using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29805	Diagnostic examination of shoulder using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29806	Incision of should joint capsule using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29806	Incision of should joint capsule using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29806	Incision of should joint capsule using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		153	
29807	Repair of shoulder socket cartilage using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29807	Repair of shoulder socket cartilage using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29807	Repair of shoulder socket cartilage using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		153	
29819	Removal of loose or foreign body of shoulder using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29819	Removal of loose or foreign body of shoulder using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29819	Removal of loose or foreign body of shoulder using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
29820	Partial removal of shoulder joint lining using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29820	Partial removal of shoulder joint lining using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29820	Partial removal of shoulder joint lining using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29821	Removal of entire shoulder joint lining using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29821	Removal of entire shoulder joint lining using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29821	Removal of entire shoulder joint lining using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
29822	Removal of shoulder joint tissue using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29822	Removal of shoulder joint tissue using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29822	Removal of shoulder joint tissue using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
29823	Extensive removal of shoulder joint tissue using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29823	Extensive removal of shoulder joint tissue using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29823	Extensive removal of shoulder joint tissue using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
29824	Partial removal of collar bone at shoulder using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29824	Partial removal of collar bone at shoulder using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29824	Partial removal of collar bone at shoulder using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
29825	Release or removal of shoulder scar tissue using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29825	Release or removal of shoulder scar tissue using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29825	Release or removal of shoulder scar tissue using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
29827	Repair of shoulder rotator cuff using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29827	Repair of shoulder rotator cuff using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29827	Repair of shoulder rotator cuff using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
29828	Release of shoulder biceps tendon using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29828	Release of shoulder biceps tendon using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29828	Release of shoulder biceps tendon using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
29830	Diagnostic examination of elbow joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29830	Diagnostic examination of elbow joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29830	Diagnostic examination of elbow joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
29834	Removal of loose or foreign body of elbow using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29834	Removal of loose or foreign body of elbow using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29834	Removal of loose or foreign body of elbow using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29835	Partial removal of elbow joint lining using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29835	Partial removal of elbow joint lining using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29835	Partial removal of elbow joint lining using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29836	Removal of entire elbow joint lining using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29836	Removal of entire elbow joint lining using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29836	Removal of entire elbow joint lining using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
29837	Removal of elbow tissue or frayed cartilage using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29837	Removal of elbow tissue or frayed cartilage using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29837	Removal of elbow tissue or frayed cartilage using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29838	Removal of elbow tissue or frayed cartilage from all joint compartments using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29838	Removal of elbow tissue or frayed cartilage from all joint compartments using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29838	Removal of elbow tissue or frayed cartilage from all joint compartments using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
29840	Diagnostic examination of the wrist using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29840	Diagnostic examination of the wrist using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29840	Diagnostic examination of the wrist using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29843	"Diagnostic examination of the wrist using an endoscope for infection, irrigation, and drainage"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29843	"Diagnostic examination of the wrist using an endoscope for infection, irrigation, and drainage"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
29843	"Diagnostic examination of the wrist using an endoscope for infection, irrigation, and drainage"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29844	Partial removal of wrist joint lining using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29844	Partial removal of wrist joint lining using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29844	Partial removal of wrist joint lining using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29845	Removal of wrist joint lining using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29845	Removal of wrist joint lining using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29845	Removal of wrist joint lining using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
29846	Removal or repair of wrist joint lining using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29846	Removal or repair of wrist joint lining using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29846	Removal or repair of wrist joint lining using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29847	Insertion of internal hardware using an endoscope to treat a broken wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29847	Insertion of internal hardware using an endoscope to treat a broken wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29847	Insertion of internal hardware using an endoscope to treat a broken wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29848	Release of wrist ligament using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29848	Release of wrist ligament using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29848	Release of wrist ligament using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
29850	Treatment of knee joint fractures with assistance of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29850	Treatment of knee joint fractures with assistance of an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29850	Treatment of knee joint fractures with assistance of an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
29851	Treatment of knee joint fractures with assistance of an endoscope with fixation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29851	Treatment of knee joint fractures with assistance of an endoscope with fixation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29851	Treatment of knee joint fractures with assistance of an endoscope with fixation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
29855	Treatment of broken leg bone with assistance of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29855	Treatment of broken leg bone with assistance of an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
29855	Treatment of broken leg bone with assistance of an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
29856	Treatment of broken leg bone with assistance of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29856	Treatment of broken leg bone with assistance of an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
29856	Treatment of broken leg bone with assistance of an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
29860	Diagnostic examination of hip using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29860	Diagnostic examination of hip using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29860	Diagnostic examination of hip using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
29861	Removal of loose or foreign body of hip joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29861	Removal of loose or foreign body of hip joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29861	Removal of loose or foreign body of hip joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
29862	Removal or shaving of hip joint socket cartilage using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29862	Removal or shaving of hip joint socket cartilage using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29862	Removal or shaving of hip joint socket cartilage using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
29863	Removal of hip joint lining using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29863	Removal of hip joint lining using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29863	Removal of hip joint lining using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
29866	Patient-derived cartilage grafts at knee joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
29866	Patient-derived cartilage grafts at knee joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29866	Patient-derived cartilage grafts at knee joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		153	
29867	Donor cartilage graft at knee joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
29867	Donor cartilage graft at knee joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
29867	Donor cartilage graft at knee joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
29868	Cartilage graft at knee joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
29868	Cartilage graft at knee joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
29868	Cartilage graft at knee joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
29870	Diagnostic examination of knee using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
29870	Diagnostic examination of knee using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	6	
29870	Diagnostic examination of knee using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	67.5	68	
29871	Irrigation and drainage of knee joint for infection using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29871	Irrigation and drainage of knee joint for infection using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
29871	Irrigation and drainage of knee joint for infection using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29873	Release of ligaments at outer aspect of knee joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29873	Release of ligaments at outer aspect of knee joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29873	Release of ligaments at outer aspect of knee joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
29874	Removal of loose or foreign body of knee joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29874	Removal of loose or foreign body of knee joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29874	Removal of loose or foreign body of knee joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29875	Partial removal of knee joint lining using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29875	Partial removal of knee joint lining using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29875	Partial removal of knee joint lining using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29876	Removal of joint lining from two or more knee joint compartments using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29876	Removal of joint lining from two or more knee joint compartments using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29876	Removal of joint lining from two or more knee joint compartments using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
29877	Removal or shaving of knee joint cartilage using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29877	Removal or shaving of knee joint cartilage using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29877	Removal or shaving of knee joint cartilage using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
29879	Repair of knee joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29879	Repair of knee joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29879	Repair of knee joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
29880	Removal of both knee cartilages using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29880	Removal of both knee cartilages using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29880	Removal of both knee cartilages using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
29881	Removal of one knee cartilage using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29881	Removal of one knee cartilage using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29881	Removal of one knee cartilage using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
29882	Repair of knee joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29882	Repair of knee joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29882	Repair of knee joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
29883	Repair of knee joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29883	Repair of knee joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29883	Repair of knee joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
29884	Repair of knee joint and removal of scar tissue using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29884	Repair of knee joint and removal of scar tissue using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29884	Repair of knee joint and removal of scar tissue using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
29885	Repair of knee joint with bone graft using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29885	Repair of knee joint with bone graft using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29885	Repair of knee joint with bone graft using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
29886	Repair of knee joint with bone graft using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29886	Repair of knee joint with bone graft using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29886	Repair of knee joint with bone graft using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
29887	Repair of knee joint with bone graft and hardware using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29887	Repair of knee joint with bone graft and hardware using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29887	Repair of knee joint with bone graft and hardware using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
29888	Repair of anterior cruciate ligament of knee with assistance of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29888	Repair of anterior cruciate ligament of knee with assistance of an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29888	Repair of anterior cruciate ligament of knee with assistance of an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
29889	Repair of posterior cruciate ligament of knee with assistance of an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29889	Repair of posterior cruciate ligament of knee with assistance of an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29889	Repair of posterior cruciate ligament of knee with assistance of an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		188	
29891	Removal of bone defect of shin and/or ankle using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29891	Removal of bone defect of shin and/or ankle using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29891	Removal of bone defect of shin and/or ankle using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
29892	Removal and repair of large bone defect of shin or ankle using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29892	Removal and repair of large bone defect of shin or ankle using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29892	Removal and repair of large bone defect of shin or ankle using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
29893	Repair of fibrous tissue of foot using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
29893	Repair of fibrous tissue of foot using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	52	6	
29893	Repair of fibrous tissue of foot using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	189	189	
29894	Removal of loose or foreign body of ankle using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29894	Removal of loose or foreign body of ankle using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29894	Removal of loose or foreign body of ankle using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29895	Partial removal of ankle joint lining using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29895	Partial removal of ankle joint lining using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29895	Partial removal of ankle joint lining using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29897	Partial removal of ankle joint lining using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29897	Partial removal of ankle joint lining using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29897	Partial removal of ankle joint lining using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
29898	Removal of dead or infected ankle joint tissue using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29898	Removal of dead or infected ankle joint tissue using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29898	Removal of dead or infected ankle joint tissue using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
29899	Fusion of ankle joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29899	Fusion of ankle joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29899	Fusion of ankle joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
29900	Biopsy of lining of joint of finger using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29900	Biopsy of lining of joint of finger using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
29900	Biopsy of lining of joint of finger using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
29901	Removal of dead or infected finger joint tissue using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29901	Removal of dead or infected finger joint tissue using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29901	Removal of dead or infected finger joint tissue using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
29902	Treatment of displaced ligament of finger joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29902	Treatment of displaced ligament of finger joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29902	Treatment of displaced ligament of finger joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
29904	Removal of loose or foreign body of ankle joint at heel bones using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29904	Removal of loose or foreign body of ankle joint at heel bones using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29904	Removal of loose or foreign body of ankle joint at heel bones using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
29905	Removal of lining of foot joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29905	Removal of lining of foot joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29905	Removal of lining of foot joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
29906	Removal of dead or infected foot joint tissue using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29906	Removal of dead or infected foot joint tissue using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29906	Removal of dead or infected foot joint tissue using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
29907	Fusion of foot joint using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29907	Fusion of foot joint using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29907	Fusion of foot joint using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
29914	Reconstruction of hip socket and repair of thigh bone using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29914	Reconstruction of hip socket and repair of thigh bone using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29914	Reconstruction of hip socket and repair of thigh bone using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
29915	Reconstruction of hip socket using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29915	Reconstruction of hip socket using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29915	Reconstruction of hip socket using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
29916	Removal and shaving of hip joint socket cartilage using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
29916	Removal and shaving of hip joint socket cartilage using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
29916	Removal and shaving of hip joint socket cartilage using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
30000	Drainage of abscess or blood accumulation in nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
30000	Drainage of abscess or blood accumulation in nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	6	
30000	Drainage of abscess or blood accumulation in nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
30020	Drainage of abscess or blood accumulation in nasal cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
30020	Drainage of abscess or blood accumulation in nasal cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
30020	Drainage of abscess or blood accumulation in nasal cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
30100	Biopsy of lining of nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
30100	Biopsy of lining of nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
30100	Biopsy of lining of nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
30110	Removal of polyps in nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
30110	Removal of polyps in nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	6	
30110	Removal of polyps in nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
30115	Removal of polyps in nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30115	Removal of polyps in nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30115	Removal of polyps in nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		64	
30117	Removal or destruction of growth in nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
30117	Removal or destruction of growth in nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	104	6	
30117	Removal or destruction of growth in nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	87	87	
30118	Removal or destruction of growth in nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30118	Removal or destruction of growth in nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
30118	Removal or destruction of growth in nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		105	
30120	Removal or scraping of skin on nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
30120	Removal or scraping of skin on nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	6	
30120	Removal or scraping of skin on nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
30124	Removal of growth of skin and tissue on nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30124	Removal of growth of skin and tissue on nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30124	Removal of growth of skin and tissue on nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
30125	Removal of growth under nasal bone or cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30125	Removal of growth under nasal bone or cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
30125	Removal of growth under nasal bone or cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
30130	Removal of nasal air passage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30130	Removal of nasal air passage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30130	Removal of nasal air passage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		64	
30140	Removal of nasal air passage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30140	Removal of nasal air passage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30140	Removal of nasal air passage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		91	
30150	Partial removal of the nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30150	Partial removal of the nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
30150	Partial removal of the nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
30160	Removal of the nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30160	Removal of the nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
30160	Removal of the nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
30200	Injection of drug into nasal air passages	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
30200	Injection of drug into nasal air passages	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	0	
30200	Injection of drug into nasal air passages	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
30210	Irrigation and drainage of sinus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
30210	Irrigation and drainage of sinus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	6	
30210	Irrigation and drainage of sinus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
30220	Insertion of implant to close nasal passage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
30220	Insertion of implant to close nasal passage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	6	
30220	Insertion of implant to close nasal passage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
30300	"Removal foreign body, intranasal; office type procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
30300	"Removal foreign body, intranasal; office type procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
30300	"Removal foreign body, intranasal; office type procedure"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
30300	"Removal foreign body, intranasal; office type procedure"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
30300	"Removal foreign body, intranasal; office type procedure"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
30300	"Removal foreign body, intranasal; office type procedure"	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2		
30300	"Removal foreign body, intranasal; office type procedure"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
30300	"Removal foreign body, intranasal; office type procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	13		
30300	"Removal foreign body, intranasal; office type procedure"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
30300	"Removal foreign body, intranasal; office type procedure"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	10		
30300	"Removal foreign body, intranasal; office type procedure"	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	10		
30300	"Removal foreign body, intranasal; office type procedure"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management		0	
30300	"Removal foreign body, intranasal; office type procedure"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains"	10		
30300	"Removal foreign body, intranasal; office type procedure"	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes	27	27	
30310	Removal of foreign body in nose under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
30310	Removal of foreign body in nose under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30310	Removal of foreign body in nose under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
30320	Incisional removal of foreign body in nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30320	Incisional removal of foreign body in nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30320	Incisional removal of foreign body in nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		78	
30400	Reshaping of tip of nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30400	Reshaping of tip of nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30400	Reshaping of tip of nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		214	
30410	"Reshaping of bone, cartilage, or tip of nose"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30410	"Reshaping of bone, cartilage, or tip of nose"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30410	"Reshaping of bone, cartilage, or tip of nose"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		214	
30420	Reshaping of bony cartilage dividing nasal passages	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30420	Reshaping of bony cartilage dividing nasal passages	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30420	Reshaping of bony cartilage dividing nasal passages	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		214	
30430	Revision to reshape nose or tip of nose after previous repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30430	Revision to reshape nose or tip of nose after previous repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30430	Revision to reshape nose or tip of nose after previous repair	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		214	
30435	Revision to reshape nasal bones after previous repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30435	Revision to reshape nasal bones after previous repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30435	Revision to reshape nasal bones after previous repair	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		214	
30450	Revision to reshape nasal bones and tip of nose after previous repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30450	Revision to reshape nasal bones and tip of nose after previous repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30450	Revision to reshape nasal bones and tip of nose after previous repair	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		214	
30460	Repair of congenital nasal defect to lengthen tip of nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30460	Repair of congenital nasal defect to lengthen tip of nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30460	Repair of congenital nasal defect to lengthen tip of nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
30462	Repair of congenital nasal defect with lengthening of tip of nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30462	Repair of congenital nasal defect with lengthening of tip of nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30462	Repair of congenital nasal defect with lengthening of tip of nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
30465	Widening of nasal passage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30465	Widening of nasal passage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
30465	Widening of nasal passage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
30520	Reshaping of nasal cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30520	Reshaping of nasal cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30520	Reshaping of nasal cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
30540	Reconstruction to create nasal passages	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30540	Reconstruction to create nasal passages	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
30540	Reconstruction to create nasal passages	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		105	
30545	Reconstruction to create nasal passages	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30545	Reconstruction to create nasal passages	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
30545	Reconstruction to create nasal passages	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		118	
30560	Release of nasal scar tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	27	
30560	Release of nasal scar tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	6	
30560	Release of nasal scar tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	34	34	
30580	Repair of abnormal drainage tract between two nasal sinuses	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
30580	Repair of abnormal drainage tract between two nasal sinuses	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	101	6	
30580	Repair of abnormal drainage tract between two nasal sinuses	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
30600	Repair of abnormal drainage tract between mouth and nasal cavity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
30600	Repair of abnormal drainage tract between mouth and nasal cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	105	6	
30600	Repair of abnormal drainage tract between mouth and nasal cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
30620	Repair of mucous lining of nasal passage with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30620	Repair of mucous lining of nasal passage with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
30620	Repair of mucous lining of nasal passage with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
30630	Repair of openings in nasal cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30630	Repair of openings in nasal cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30630	Repair of openings in nasal cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
30801	Destruction of soft tissue of nasal passages	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	19	
30801	Destruction of soft tissue of nasal passages	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	6	
30801	Destruction of soft tissue of nasal passages	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
30802	Destruction of soft tissue in nasal passages	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	19	
30802	Destruction of soft tissue in nasal passages	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	6	
30802	Destruction of soft tissue in nasal passages	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
30901	Simple control of nose bleed	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	0	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	0	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	0	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	0	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	30	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	0	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	10	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	0	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  post	L037D	RN/LPN/MTA	0.37	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)	0	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains"	15	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Service  post	L037D	RN/LPN/MTA	0.37	"Review/read X-ray, lab, and pathology reports"	0	0	
30903	"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	0	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	0	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	0	7	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0	5	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  pre	L037D	RN/LPN/MTA	0.37	Review charts	0	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	0	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	48	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	0	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	10	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	0	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  post	L037D	RN/LPN/MTA	0.37	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains"	15	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Service  post	L037D	RN/LPN/MTA	0.37	"Review/read X-ray, lab, and pathology reports"	0	0	
30905	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	0	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	0	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	0	7	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0	5	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  pre	L037D	RN/LPN/MTA	0.37	Review charts	0	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	0	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	60	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	0	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	10	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	0	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  post	L037D	RN/LPN/MTA	0.37	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)	0	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains"	15	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Service  post	L037D	RN/LPN/MTA	0.37	"Review/read X-ray, lab, and pathology reports"	0	0	
30906	"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	0	
30915	Tying of artery for control of nose bleed	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30915	Tying of artery for control of nose bleed	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
30915	Tying of artery for control of nose bleed	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
30920	Tying of artery for control of nose bleed	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
30920	Tying of artery for control of nose bleed	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
30920	Tying of artery for control of nose bleed	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
30930	Therapeutic fracture of nasal passages	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
30930	Therapeutic fracture of nasal passages	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
30930	Therapeutic fracture of nasal passages	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
31000	Irrigation of nasal sinus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
31000	Irrigation of nasal sinus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	12	
31000	Irrigation of nasal sinus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
31002	Irrigation of nasal sinus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31002	Irrigation of nasal sinus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31002	Irrigation of nasal sinus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
31020	Incision of nasal sinus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
31020	Incision of nasal sinus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	80	6	
31020	Incision of nasal sinus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	78	78	
31030	Incision of nasal sinus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
31030	Incision of nasal sinus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	109	6	
31030	Incision of nasal sinus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	64	64	
31032	Removal of nasal sinus growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31032	Removal of nasal sinus growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31032	Removal of nasal sinus growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		78	
31040	Incision through sinus at cheek bone to reach nerves and blood vessels	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31040	Incision through sinus at cheek bone to reach nerves and blood vessels	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31040	Incision through sinus at cheek bone to reach nerves and blood vessels	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
31050	Incision of nasal sinus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31050	Incision of nasal sinus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31050	Incision of nasal sinus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		64	
31051	Removal of nasal polyps	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31051	Removal of nasal polyps	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31051	Removal of nasal polyps	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		91	
31070	Incision of nasal sinus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31070	Incision of nasal sinus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31070	Incision of nasal sinus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		78	
31075	Incision of nasal sinus of one side of face	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31075	Incision of nasal sinus of one side of face	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31075	Incision of nasal sinus of one side of face	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		105	
31080	Insertion of material to stop growth of nasal sinus lining	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31080	Insertion of material to stop growth of nasal sinus lining	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31080	Insertion of material to stop growth of nasal sinus lining	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		154	
31081	Insertion of material to stop growth of nasal sinus lining	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31081	Insertion of material to stop growth of nasal sinus lining	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31081	Insertion of material to stop growth of nasal sinus lining	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		154	
31084	Insertion of material to stop growth of nasal sinus lining	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31084	Insertion of material to stop growth of nasal sinus lining	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31084	Insertion of material to stop growth of nasal sinus lining	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		154	
31085	Insertion of material to stop growth of nasal sinus lining	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31085	Insertion of material to stop growth of nasal sinus lining	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31085	Insertion of material to stop growth of nasal sinus lining	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		154	
31086	Incision of nasal sinus with placement of bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31086	Incision of nasal sinus with placement of bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31086	Incision of nasal sinus with placement of bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		154	
31087	Incision of nasal sinus with placement of bone graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31087	Incision of nasal sinus with placement of bone graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31087	Incision of nasal sinus with placement of bone graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		136	
31090	Removal of diseased tissue or growths in multiple nasal sinuses on one side of face	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31090	Removal of diseased tissue or growths in multiple nasal sinuses on one side of face	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31090	Removal of diseased tissue or growths in multiple nasal sinuses on one side of face	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		215	
31200	Partial removal of nasal sinus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31200	Partial removal of nasal sinus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31200	Partial removal of nasal sinus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		105	
31201	Removal of nasal sinus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31201	Removal of nasal sinus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31201	Removal of nasal sinus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		105	
31205	Removal of nasal sinus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31205	Removal of nasal sinus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31205	Removal of nasal sinus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		105	
31225	Removal of nasal sinus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31225	Removal of nasal sinus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31225	Removal of nasal sinus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		188	
31230	Removal of nasal sinus and eye bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31230	Removal of nasal sinus and eye bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31230	Removal of nasal sinus and eye bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		188	
31231	Diagnostic examination of nasal passages using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
31231	Diagnostic examination of nasal passages using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
31233	Examination of nasal passage and sinus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
31233	Examination of nasal passage and sinus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	76	0	
31233	Examination of nasal passage and sinus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
31235	Examination of nasal passages and sinus using an endoscope via sinus puncture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
31235	Examination of nasal passages and sinus using an endoscope via sinus puncture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	91	0	
31235	Examination of nasal passages and sinus using an endoscope via sinus puncture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
31237	Biopsy or removal of nasal polyp or tissue using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
31237	Biopsy or removal of nasal polyp or tissue using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	0	
31237	Biopsy or removal of nasal polyp or tissue using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	6	
31238	Control of nasal bleeding using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
31238	Control of nasal bleeding using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	77	0	
31238	Control of nasal bleeding using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	6	
31239	Incision of tear duct using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31239	Incision of tear duct using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31239	Incision of tear duct using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		46	
31240	Removal of nasal breathing passages using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31240	Removal of nasal breathing passages using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31254	Partial removal of nasal sinus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31254	Partial removal of nasal sinus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31255	Removal of nasal sinus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31255	Removal of nasal sinus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31256	Incision of nasal sinus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31256	Incision of nasal sinus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31267	Removal of nasal sinus tissue using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31267	Removal of nasal sinus tissue using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31276	Exploration of nasal sinus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31276	Exploration of nasal sinus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31287	Incision of nasal sinus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31287	Incision of nasal sinus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31288	Removal of nasal sinus tissue using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31288	Removal of nasal sinus tissue using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31290	Repair of spinal fluid leak into nasal sinus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31290	Repair of spinal fluid leak into nasal sinus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31290	Repair of spinal fluid leak into nasal sinus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
31291	Repair of spinal fluid leak into nasal sinus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31291	Repair of spinal fluid leak into nasal sinus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31291	Repair of spinal fluid leak into nasal sinus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
31292	Decompression of eye bone using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31292	Decompression of eye bone using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31292	Decompression of eye bone using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
31293	Decompression of eye bone using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31293	Decompression of eye bone using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31293	Decompression of eye bone using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
31294	Decompression of eye bone and release of optic nerve using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31294	Decompression of eye bone and release of optic nerve using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31294	Decompression of eye bone and release of optic nerve using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0	5	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	10	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3	7	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0	5	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3	0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3	0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2	0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2	0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	0	0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2	0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5	0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	20	0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3	0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3	0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	10	0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	10	0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3	0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  post	L037D	RN/LPN/MTA	0.37	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains"	15	0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Service  post	L037D	RN/LPN/MTA	0.37	"Review/read X-ray, lab, and pathology reports"	0	0	
31295	"Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0	5	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	10	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3	7	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0	5	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	0	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	30	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	10	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	10	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains"	15	0	
31296	"Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	"Review/read X-ray, lab, and pathology reports"	0	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0	5	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	10	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3	7	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0	5	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	0	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	28	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	10	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	10	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains"	15	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Service  post	L037D	RN/LPN/MTA	0.37	"Review/read X-ray, lab, and pathology reports"	0	0	
31297	"Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	0	
31300	Removal of vocal cord growth or cartilage attachment	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31300	Removal of vocal cord growth or cartilage attachment	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31300	Removal of vocal cord growth or cartilage attachment	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		191	
31320	Incision of voice box for diagnosis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31320	Incision of voice box for diagnosis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31320	Incision of voice box for diagnosis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		141	
31360	Removal of voice box	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
31360	Removal of voice box	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31360	Removal of voice box	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		241	
31365	"Removal of voice box, muscle, lymph nodes, and glands"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
31365	"Removal of voice box, muscle, lymph nodes, and glands"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31365	"Removal of voice box, muscle, lymph nodes, and glands"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		241	
31367	Removal of voice box	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
31367	Removal of voice box	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31367	Removal of voice box	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		241	
31368	"Removal of voice box, muscle, lymph nodes, and glands"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
31368	"Removal of voice box, muscle, lymph nodes, and glands"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31368	"Removal of voice box, muscle, lymph nodes, and glands"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		241	
31370	Partial removal of voice box	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
31370	Partial removal of voice box	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31370	Partial removal of voice box	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		241	
31375	Partial removal of voice box	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
31375	Partial removal of voice box	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31375	Partial removal of voice box	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		241	
31380	Partial removal of voice box	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
31380	Partial removal of voice box	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31380	Partial removal of voice box	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		241	
31382	Partial removal of voice box	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
31382	Partial removal of voice box	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31382	Partial removal of voice box	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		241	
31390	"Removal of voice box, throat, muscle, lymph nodes, and glands"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31390	"Removal of voice box, throat, muscle, lymph nodes, and glands"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31390	"Removal of voice box, throat, muscle, lymph nodes, and glands"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		241	
31395	"Removal of voice box and throat, muscle, lymph nodes, and glands with reconstruction of defect"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31395	"Removal of voice box and throat, muscle, lymph nodes, and glands with reconstruction of defect"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31395	"Removal of voice box and throat, muscle, lymph nodes, and glands with reconstruction of defect"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		241	
31400	Removal or repair of the voice box cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31400	Removal or repair of the voice box cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31400	Removal or repair of the voice box cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		200	
31420	Removal of cartilage attaching the tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31420	Removal of cartilage attaching the tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31420	Removal of cartilage attaching the tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		118	
31502	Change of breathing tube of windpipe in neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31505	Diagnostic examination of voice box using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
31505	Diagnostic examination of voice box using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	37	0	
31505	Diagnostic examination of voice box using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
31510	Biopsy of voice box using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
31510	Biopsy of voice box using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	0	
31510	Biopsy of voice box using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
31511	Removal of foreign body from voice box using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
31511	Removal of foreign body from voice box using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	0	
31511	Removal of foreign body from voice box using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
31512	Removal of growth of voice box using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
31512	Removal of growth of voice box using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	0	
31512	Removal of growth of voice box using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
31513	Vocal cord injection using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31513	Vocal cord injection using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31515	Aspiration of voice box using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
31515	Aspiration of voice box using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	0	
31515	Aspiration of voice box using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
31520	"Diagnostic examination of voice box using an endoscope, newborn"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31520	"Diagnostic examination of voice box using an endoscope, newborn"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31525	Diagnostic examination of voice box using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
31525	Diagnostic examination of voice box using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	0	
31525	Diagnostic examination of voice box using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
31526	Diagnostic examination of voice box using an endoscope with operating microscope or telescope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31526	Diagnostic examination of voice box using an endoscope with operating microscope or telescope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31527	Insertion of device to close opening to voice box using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31527	Insertion of device to close opening to voice box using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31528	Dilation of the voice box using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31529	Dilation of the voice box using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31530	Removal of foreign body from voice box using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31530	Removal of foreign body from voice box using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31531	Removal of foreign body from voice box using an endoscope with operating microscope or telescope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31531	Removal of foreign body from voice box using an endoscope with operating microscope or telescope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31535	Biopsy of voice box using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31535	Biopsy of voice box using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31536	Biopsy of voice box using an endoscope with operating microscope or telescope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31536	Biopsy of voice box using an endoscope with operating microscope or telescope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31540	Removal of growth of tongue and/or vocal cord stripping using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31540	Removal of growth of tongue and/or vocal cord stripping using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31541	Removal of growth of tongue and/or vocal cord stripping using an endoscope with operating microscope or telescope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31541	Removal of growth of tongue and/or vocal cord stripping using an endoscope with operating microscope or telescope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31545	Removal of vocal cord growths with tissue flap repair using an endoscope with operating microscope or telescope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31545	Removal of vocal cord growths with tissue flap repair using an endoscope with operating microscope or telescope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31546	Removal of vocal cord growths with tissue flap repair using an endoscope with operating microscope or telescope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31546	Removal of vocal cord growths with tissue flap repair using an endoscope with operating microscope or telescope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31560	Removal of cartilage attaching voice box using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31561	Removal of cartilage attaching voice box using an endoscope with operating microscope or telescope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31570	Injection of vocal cords using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
31570	Injection of vocal cords using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	81	0	
31570	Injection of vocal cords using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
31571	Injection of vocal cords using an endoscope with operating microscope or telescope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31571	Injection of vocal cords using an endoscope with operating microscope or telescope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
31575	Diagnostic examination of voice box using flexible endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
31575	Diagnostic examination of voice box using flexible endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	0	
31575	Diagnostic examination of voice box using flexible endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
31576	Biopsy of voice box using a flexible endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
31576	Biopsy of voice box using a flexible endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	77	0	
31576	Biopsy of voice box using a flexible endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
31577	Removal of foreign body from voice box using a flexible endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
31577	Removal of foreign body from voice box using a flexible endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	0	
31577	Removal of foreign body from voice box using a flexible endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
31578	Removal of growth from voice box using a flexible endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
31578	Removal of growth from voice box using a flexible endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	84	0	
31578	Removal of growth from voice box using a flexible endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
31579	Examination to assess movement of vocal cord flaps using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
31579	Examination to assess movement of vocal cord flaps using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	0	
31579	Examination to assess movement of vocal cord flaps using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
31580	Repair of congenital vocal cord defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
31580	Repair of congenital vocal cord defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31580	Repair of congenital vocal cord defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		236	
31582	Release of voice box cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
31582	Release of voice box cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31582	Release of voice box cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		351	
31584	Incision of voice box to repair thyroid cartilage fracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
31584	Incision of voice box to repair thyroid cartilage fracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31584	Incision of voice box to repair thyroid cartilage fracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		200	
31587	Repair of split in the voice box cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31587	Repair of split in the voice box cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31587	Repair of split in the voice box cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
31588	General repair of voice box	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
31588	General repair of voice box	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31588	General repair of voice box	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		291	
31590	Relocation of nerve and muscle to restore voice box function	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31590	Relocation of nerve and muscle to restore voice box function	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31590	Relocation of nerve and muscle to restore voice box function	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		285	
31595	Severing of nerve of one side of voice box	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31595	Severing of nerve of one side of voice box	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31595	Severing of nerve of one side of voice box	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		150	
31600	Opening of windpipe through neck for insertion of breathing tube	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		20	
31601	"Opening of windpipe through neck for insertion of breathing tube, patient younger than 2 years"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
31610	Creation of permanent opening of windpipe for breathing	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
31610	Creation of permanent opening of windpipe for breathing	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31610	Creation of permanent opening of windpipe for breathing	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		104	
31611	Creation of opening of windpipe and with insertion of speech prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
31611	Creation of opening of windpipe and with insertion of speech prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
31611	Creation of opening of windpipe and with insertion of speech prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		91	
31612	"Puncture of neck and windpipe cartilage for aspiration and/or injection, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	0	
31613	Revision of permanent opening of windpipe for breathing	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31613	Revision of permanent opening of windpipe for breathing	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31613	Revision of permanent opening of windpipe for breathing	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
31614	Revision of permanent opening of windpipe for breathing	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31614	Revision of permanent opening of windpipe for breathing	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31614	Revision of permanent opening of windpipe for breathing	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
31615	Examination of windpipe and lung airways through permanent skin opening to windpipe using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
31615	Examination of windpipe and lung airways through permanent skin opening to windpipe using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	0	
31615	Examination of windpipe and lung airways through permanent skin opening to windpipe using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
31622	Diagnostic examination of lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	5	5	
31622	Diagnostic examination of lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
31622	Diagnostic examination of lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
31622	Diagnostic examination of lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
31622	Diagnostic examination of lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
31622	Diagnostic examination of lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
31622	Diagnostic examination of lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	Obtain vital signs	5		
31622	Diagnostic examination of lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	Prepare and position pt/ monitor pt/ set up IV	2		
31622	Diagnostic examination of lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Prepare room, equipment, supplies"	2		
31622	Diagnostic examination of lung airways using an endoscope	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
31622	Diagnostic examination of lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	Setup scope (non facility setting only)	5		
31622	Diagnostic examination of lung airways using an endoscope	Service  intra	L047C	RN/Respiratory Therapist	0.47	Assist physician in performing procedure (100%)	30		
31622	Diagnostic examination of lung airways using an endoscope	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (100% of physician time)	30		
31622	Diagnostic examination of lung airways using an endoscope	Service  post	L047C	RN/Respiratory Therapist	0.47	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
31622	Diagnostic examination of lung airways using an endoscope	Service  post	L047C	RN/Respiratory Therapist	0.47	Clean room/equipment by physician staff	3		
31622	Diagnostic examination of lung airways using an endoscope	Service  post	L047C	RN/Respiratory Therapist	0.47	Clean scope	30		
31622	Diagnostic examination of lung airways using an endoscope	Service  post	L047C	RN/Respiratory Therapist	0.47	"Complete diagnostic forms, lab, X-ray requisitions"	4		
31622	Diagnostic examination of lung airways using an endoscope	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
31622	Diagnostic examination of lung airways using an endoscope	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	0		
31623	Examination of lung airways using an endoscope	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs	15	15	
31623	Examination of lung airways using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	47	0	
31623	Examination of lung airways using an endoscope	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	79	0	
31624	Irrigation and suction of lung airways to obtain cells using an endoscope	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs	15	15	
31624	Irrigation and suction of lung airways to obtain cells using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	47	0	
31624	Irrigation and suction of lung airways to obtain cells using an endoscope	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	79	0	
31625	Biopsy of lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	5	5	
31625	Biopsy of lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
31625	Biopsy of lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
31625	Biopsy of lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
31625	Biopsy of lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
31625	Biopsy of lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
31625	Biopsy of lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	Obtain vital signs	5		
31625	Biopsy of lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	Prepare and position pt/ monitor pt/ set up IV	2		
31625	Biopsy of lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Prepare room, equipment, supplies"	2		
31625	Biopsy of lung airways using an endoscope	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
31625	Biopsy of lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	Setup scope (non facility setting only)	5		
31625	Biopsy of lung airways using an endoscope	Service  intra	L047C	RN/Respiratory Therapist	0.47	Assist physician in performing procedure (100%)	35		
31625	Biopsy of lung airways using an endoscope	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (100% of physician time)	35		
31625	Biopsy of lung airways using an endoscope	Post-service	L047C	RN/Respiratory Therapist	0.47	Check dressings & wound/home care instructions / coordinate office visits / prescriptions	3		
31625	Biopsy of lung airways using an endoscope	Post-service	L047C	RN/Respiratory Therapist	0.47	Clean room/equipment by physician staff	3		
31625	Biopsy of lung airways using an endoscope	Post-service	L047C	RN/Respiratory Therapist	0.47	Clean scope	30		
31625	Biopsy of lung airways using an endoscope	Post-service	L047C	RN/Respiratory Therapist	0.47	"Complete diagnostic forms, lab & X-ray requisitions"	4		
31625	Biopsy of lung airways using an endoscope	Post-service	L051A	RN	0.51	Monitor pt. following moderate sedation	15		
31625	Biopsy of lung airways using an endoscope	Post-service	L051A	RN	0.51	"Monitor pt. following service/check tubes, monitors, drains (not related to moderate sedation)"	0		
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	5	5	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5	0	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0	3	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Greet patient, provide gowning, ensure appropriate medical records are available"	3	0	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	Obtain vital signs	5	0	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	Prepare and position pt/ monitor pt/ set up IV	2	0	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Prepare room, equipment, supplies"	2	0	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	Sedate/Apply anesthesia	2	0	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	Setup scope (non facility setting only)	5	0	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Service  intra	L047C	RN/Respiratory Therapist	0.47	Assist physician in performing procedure (100%)	45	0	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Service  intra	L047C	RN/Respiratory Therapist	0.47	Assist physician/moderate sedation (100% of physician time)	45	0	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Service  post	L047C	RN/Respiratory Therapist	0.47	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3	0	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Service  post	L047C	RN/Respiratory Therapist	0.47	Clean room/equipment by physician staff	3	0	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Service  post	L047C	RN/Respiratory Therapist	0.47	Clean scope	30	0	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Service  post	L047C	RN/Respiratory Therapist	0.47	"Complete diagnostic forms, lab, X-ray requisitions"	4	0	
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
31626	Insertion of radiation therapy markers into lung airways using an endoscope	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	0		
31627	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed"	Service  pre	L042B	Respiratory Therapist	0.42	"Power, System Preparation & Attaching to Bronchoscope"	11		
31627	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed"	Service  pre	L047C	RN/Respiratory Therapist	0.47	Prepare and position pt/ monitor pt/ set up IV	0		
31627	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed"	Service  intra	L047C	RN/Respiratory Therapist	0.47	Assist physician in performing procedure	30		
31627	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed"	Service  intra	L051A	RN	0.51	Moderate sedation	30		
31628	Biopsy of one lobe of lung using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	5	5	
31628	Biopsy of one lobe of lung using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
31628	Biopsy of one lobe of lung using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
31628	Biopsy of one lobe of lung using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
31628	Biopsy of one lobe of lung using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
31628	Biopsy of one lobe of lung using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
31628	Biopsy of one lobe of lung using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	Obtain vital signs	5		
31628	Biopsy of one lobe of lung using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	Prepare and position pt/ monitor pt/ set up IV	2		
31628	Biopsy of one lobe of lung using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Prepare room, equipment, supplies"	2		
31628	Biopsy of one lobe of lung using an endoscope	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
31628	Biopsy of one lobe of lung using an endoscope	Service  pre	L047C	RN/Respiratory Therapist	0.47	Setup scope (non facility setting only)	5		
31628	Biopsy of one lobe of lung using an endoscope	Service  intra	L047C	RN/Respiratory Therapist	0.47	Assist physician in performing procedure (100%)	40		
31628	Biopsy of one lobe of lung using an endoscope	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (100% of physician time)	40		
31628	Biopsy of one lobe of lung using an endoscope	Service  post	L047C	RN/Respiratory Therapist	0.47	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
31628	Biopsy of one lobe of lung using an endoscope	Service  post	L047C	RN/Respiratory Therapist	0.47	Clean room/equipment by physician staff	3		
31628	Biopsy of one lobe of lung using an endoscope	Service  post	L047C	RN/Respiratory Therapist	0.47	Clean scope	30		
31628	Biopsy of one lobe of lung using an endoscope	Service  post	L047C	RN/Respiratory Therapist	0.47	"Complete diagnostic forms, lab, X-ray requisitions"	4		
31628	Biopsy of one lobe of lung using an endoscope	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
31628	Biopsy of one lobe of lung using an endoscope	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	0		
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	5	5	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5	0	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0	3	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Greet patient, provide gowning, ensure appropriate medical records are available"	3	0	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Service  pre	L047C	RN/Respiratory Therapist	0.47	Obtain vital signs	5	0	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Service  pre	L047C	RN/Respiratory Therapist	0.47	Prepare and position pt/ monitor pt/ set up IV	2	0	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Prepare room, equipment, supplies"	2	0	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2	0	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Service  pre	L047C	RN/Respiratory Therapist	0.47	Setup scope (non facility setting only)	5	0	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Service  intra	L047C	RN/Respiratory Therapist	0.47	Assist physician in performing procedure (100%)	35	0	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (100% of physician time)	35	0	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Service  post	L047C	RN/Respiratory Therapist	0.47	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3	0	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Service  post	L047C	RN/Respiratory Therapist	0.47	Clean room/equipment by physician staff	3	0	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Service  post	L047C	RN/Respiratory Therapist	0.47	Clean scope	30	0	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Service  post	L047C	RN/Respiratory Therapist	0.47	"Complete diagnostic forms, lab, X-ray requisitions"	4	0	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15	0	
31629	"Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	0		
31630	Treatment of windpipe cartilage fracture or dilation of windpipe cartilage using an endoscope	Pre-service	L042B	Respiratory Therapist	0.42	Preservice total costs		18	
31631	Insertion of stents into windpipe using an endoscope	Pre-service	L042B	Respiratory Therapist	0.42	Preservice total costs		18	
31632	Biopsy of lung using an endoscope	Service  intra	L047C	RN/Respiratory Therapist	0.47	Assist physician in performing procedure (100%)	18		
31632	Biopsy of lung using an endoscope	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (100% of physician time)	18		
31633	Needle biopsy of lung using an endoscope	Service  intra	L047C	RN/Respiratory Therapist	0.47	Assist physician in performing procedure (100%)	20		
31633	Needle biopsy of lung using an endoscope	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (100% of physician time)	20		
31634	Examination of lung airways with repair of air leak using an endoscope	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs	16	15	
31634	Examination of lung airways with repair of air leak using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	62	0	
31634	Examination of lung airways with repair of air leak using an endoscope	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	87	0	
31635	Removal of foreign body in lung airways using an endoscope	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs	15	15	
31635	Removal of foreign body in lung airways using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	56	0	
31635	Removal of foreign body in lung airways using an endoscope	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	79	0	
31636	Insertion of stents in lung airways using an endoscope	Pre-service	L042B	Respiratory Therapist	0.42	Preservice total costs		18	
31638	Revision of previously inserted stent in lung airways using an endoscope	Pre-service	L042B	Respiratory Therapist	0.42	Preservice total costs		18	
31640	Removal of growth in lung airways using an endoscope	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs		15	
31641	Destruction of growth or narrowing of lung airway using an endoscope	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs		15	
31643	Insertion of catheters for radiation delivery in lung airway using an endoscope	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs		15	
31645	Aspiration of lung secretions from lung airways using an endoscope	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs	15	15	
31645	Aspiration of lung secretions from lung airways using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	65	0	
31645	Aspiration of lung secretions from lung airways using an endoscope	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	70	0	
31646	Aspiration of lung secretions from lung airways using an endoscope	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs	15	15	
31646	Aspiration of lung secretions from lung airways using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	53	0	
31646	Aspiration of lung secretions from lung airways using an endoscope	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	67	0	
31647	"Assessment of air leak, airway sizing, and insertion of bronchial valves in lung airways using an endoscope"	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs		13	
31648	Removal of bronchial valves in lung airways using an endoscope	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs		13	
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	5	5	
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Service  pre	L047C	RN/Respiratory Therapist	0.47	Obtain vital signs	5		
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Service  pre	L047C	RN/Respiratory Therapist	0.47	Prepare and position pt/ monitor pt/ set up IV	2		
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Prepare room, equipment, supplies"	2		
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Service  pre	L047C	RN/Respiratory Therapist	0.47	Setup scope (non facility setting only)	10		
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Service  intra	L047C	RN/Respiratory Therapist	0.47	Assist physician in performing procedure (100%)	60		
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (100% of physician time)	60		
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Service  post	L047C	RN/Respiratory Therapist	0.47	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Service  post	L047C	RN/Respiratory Therapist	0.47	Clean room/equipment by physician staff	3		
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Service  post	L047C	RN/Respiratory Therapist	0.47	Clean scope	60		
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Service  post	L047C	RN/Respiratory Therapist	0.47	"Complete diagnostic forms, lab, X-ray requisitions"	4		
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Service  post	L051A	RN	0.51	Moderate pt. following moderate sedation	15		
31652	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	0		
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	5	5	
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Service  pre	L047C	RN/Respiratory Therapist	0.47	Obtain vital signs	5		
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Service  pre	L047C	RN/Respiratory Therapist	0.47	Prepare and position pt/ monitor pt/ set up IV	2		
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Prepare room, equipment, supplies"	2		
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Service  pre	L047C	RN/Respiratory Therapist	0.47	Sedate/Apply anesthesia	2		
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Service  pre	L047C	RN/Respiratory Therapist	0.47	Setup scope (non facility setting only)	10		
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Service  intra	L047C	RN/Respiratory Therapist	0.47	Assist physician in performing procedure (100%)	75		
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (100% of physician time)	75		
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Service  post	L047C	RN/Respiratory Therapist	0.47	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Service  post	L047C	RN/Respiratory Therapist	0.47	Clean room/equipment by physician staff	3		
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Service  post	L047C	RN/Respiratory Therapist	0.47	Clean scope	60		
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Service  post	L047C	RN/Respiratory Therapist	0.47	"Complete diagnostic forms, lab, X-ray requisitions"	4		
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
31653	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	0		
31654	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transendoscopic endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s) (List separately in addition to code for primary procedure[s])"	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Prepare room, equipment, supplies"	2	0	
31654	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transendoscopic endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s) (List separately in addition to code for primary procedure[s])"	Service  intra	L047C	RN/Respiratory Therapist	0.47	Assist physician in performing procedure (100%)	30	0	
31654	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transendoscopic endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s) (List separately in addition to code for primary procedure[s])"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (100% of physician time)	30	0	
31654	"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transendoscopic endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s) (List separately in addition to code for primary procedure[s])"	Service  post	L047C	RN/Respiratory Therapist	0.47	Clean room/equipment by physician staff	3	0	
31660	Thermal repair of lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		10	
31661	Thermal repair of lung airways using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		8	
31717	Insertion of catheter into airway of lung for brush biopsy	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs	18	15	
31717	Insertion of catheter into airway of lung for brush biopsy	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	69	0	
31730	"Insertion into windpipe of needle wire, dilator, stent, or tube for oxygen delivery"	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs	18	0	
31730	"Insertion into windpipe of needle wire, dilator, stent, or tube for oxygen delivery"	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	63	0	
31750	Repair of windpipe cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31750	Repair of windpipe cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31750	Repair of windpipe cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		237	
31755	Creation of drainage tract from throat to windpipe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31755	Creation of drainage tract from throat to windpipe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31755	Creation of drainage tract from throat to windpipe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		376	
31760	Repair of windpipe cartilage by insertion of splint or graft	Pre-service	L051A	RN	0.51	Preservice total costs		60	
31760	Repair of windpipe cartilage by insertion of splint or graft	Service  intra	L051A	RN	0.51	Service total costs		12	
31760	Repair of windpipe cartilage by insertion of splint or graft	Post-service	L051A	RN	0.51	Post service total costs		108	
31766	Repair through chest of upper breast bone	Pre-service	L051A	RN	0.51	Preservice total costs		60	
31766	Repair through chest of upper breast bone	Service  intra	L051A	RN	0.51	Service total costs		12	
31766	Repair through chest of upper breast bone	Post-service	L051A	RN	0.51	Post service total costs		81	
31770	Repair of lung airway	Pre-service	L051A	RN	0.51	Preservice total costs		60	
31770	Repair of lung airway	Service  intra	L051A	RN	0.51	Service total costs		12	
31770	Repair of lung airway	Post-service	L051A	RN	0.51	Post service total costs		54	
31775	Repair of narrowed area in lung airway	Pre-service	L051A	RN	0.51	Preservice total costs		60	
31775	Repair of narrowed area in lung airway	Service  intra	L051A	RN	0.51	Service total costs		12	
31775	Repair of narrowed area in lung airway	Post-service	L051A	RN	0.51	Post service total costs		68	
31780	Repair of narrowed area of windpipe cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31780	Repair of narrowed area of windpipe cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31780	Repair of narrowed area of windpipe cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
31781	Repair of narrowed area of windpipe cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31781	Repair of narrowed area of windpipe cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31781	Repair of narrowed area of windpipe cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
31785	Removal of windpipe cartilage growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
31785	Removal of windpipe cartilage growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31785	Removal of windpipe cartilage growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
31786	"Removal of windpipe cartilage growth, open chest procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
31786	"Removal of windpipe cartilage growth, open chest procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
31786	"Removal of windpipe cartilage growth, open chest procedure"	Post-service	L051A	RN	0.51	Post service total costs		68	
31800	Suture of wound or injury to windpipe cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
31800	Suture of wound or injury to windpipe cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		114	
31805	Suture of wound or injury to windpipe cartilage	Pre-service	L051A	RN	0.51	Preservice total costs		60	
31805	Suture of wound or injury to windpipe cartilage	Service  intra	L051A	RN	0.51	Service total costs		12	
31805	Suture of wound or injury to windpipe cartilage	Post-service	L051A	RN	0.51	Post service total costs		68	
31820	Closure of permanent windpipe opening or abnormal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
31820	Closure of permanent windpipe opening or abnormal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	80	6	
31820	Closure of permanent windpipe opening or abnormal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
31825	Plastic repair and closure of permanent windpipe opening or abnormal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
31825	Plastic repair and closure of permanent windpipe opening or abnormal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	107	6	
31825	Plastic repair and closure of permanent windpipe opening or abnormal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
31830	Revision of permanent windpipe opening scar	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
31830	Revision of permanent windpipe opening scar	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	6	
31830	Revision of permanent windpipe opening scar	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
32035	Removal of rib with creation of tract for drainage of infected material	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32035	Removal of rib with creation of tract for drainage of infected material	Service  intra	L051A	RN	0.51	Service total costs		12	
32035	Removal of rib with creation of tract for drainage of infected material	Post-service	L051A	RN	0.51	Post service total costs		81	
32036	Removal of rib with creation of open flap tract for drainage of infected material from lung	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32036	Removal of rib with creation of open flap tract for drainage of infected material from lung	Service  intra	L051A	RN	0.51	Service total costs		12	
32036	Removal of rib with creation of open flap tract for drainage of infected material from lung	Post-service	L051A	RN	0.51	Post service total costs		81	
32096	Opening in chest with biopsy of fluid collection in one lung	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32096	Opening in chest with biopsy of fluid collection in one lung	Service  intra	L051A	RN	0.51	Service total costs		12	
32096	Opening in chest with biopsy of fluid collection in one lung	Post-service	L051A	RN	0.51	Post service total costs		36	
32097	Opening in chest with biopsy of growths in one lung	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32097	Opening in chest with biopsy of growths in one lung	Service  intra	L051A	RN	0.51	Service total costs		12	
32097	Opening in chest with biopsy of growths in one lung	Post-service	L051A	RN	0.51	Post service total costs		36	
32098	Opening in chest with biopsy of lung lining	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32098	Opening in chest with biopsy of lung lining	Service  intra	L051A	RN	0.51	Service total costs		12	
32098	Opening in chest with biopsy of lung lining	Post-service	L051A	RN	0.51	Post service total costs		36	
32100	Incision and exploration of chest cavity	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32100	Incision and exploration of chest cavity	Service  intra	L051A	RN	0.51	Service total costs		12	
32100	Incision and exploration of chest cavity	Post-service	L051A	RN	0.51	Post service total costs		36	
32110	Repair of traumatic tear in lung and/or control of bleeding	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32110	Repair of traumatic tear in lung and/or control of bleeding	Service  intra	L051A	RN	0.51	Service total costs		12	
32110	Repair of traumatic tear in lung and/or control of bleeding	Post-service	L051A	RN	0.51	Post service total costs		89	
32120	Incision of chest cavity for complication after surgery	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32120	Incision of chest cavity for complication after surgery	Service  intra	L051A	RN	0.51	Service total costs		12	
32120	Incision of chest cavity for complication after surgery	Post-service	L051A	RN	0.51	Post service total costs		80	
32124	Opening in chest with release of lung lining	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32124	Opening in chest with release of lung lining	Service  intra	L051A	RN	0.51	Service total costs		12	
32124	Opening in chest with release of lung lining	Post-service	L051A	RN	0.51	Post service total costs		80	
32140	Opening in chest with removal of lung cysts	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32140	Opening in chest with removal of lung cysts	Service  intra	L051A	RN	0.51	Service total costs		12	
32140	Opening in chest with removal of lung cysts	Post-service	L051A	RN	0.51	Post service total costs		80	
32141	Removal of air sac of lung	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32141	Removal of air sac of lung	Service  intra	L051A	RN	0.51	Service total costs		12	
32141	Removal of air sac of lung	Post-service	L051A	RN	0.51	Post service total costs		63	
32150	Removal of foreign body or clot protein deposit in lung lining	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32150	Removal of foreign body or clot protein deposit in lung lining	Service  intra	L051A	RN	0.51	Service total costs		12	
32150	Removal of foreign body or clot protein deposit in lung lining	Post-service	L051A	RN	0.51	Post service total costs		80	
32151	Removal of foreign body in lung	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32151	Removal of foreign body in lung	Service  intra	L051A	RN	0.51	Service total costs		12	
32151	Removal of foreign body in lung	Post-service	L051A	RN	0.51	Post service total costs		80	
32160	Massage of heart muscle through chest cavity	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32160	Massage of heart muscle through chest cavity	Service  intra	L051A	RN	0.51	Service total costs		12	
32160	Massage of heart muscle through chest cavity	Post-service	L051A	RN	0.51	Post service total costs		53	
32200	"Drainage of infected lung material or cyst, open procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32200	"Drainage of infected lung material or cyst, open procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
32200	"Drainage of infected lung material or cyst, open procedure"	Post-service	L051A	RN	0.51	Post service total costs		133	
32215	Creation of scarring on surface of lung	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32215	Creation of scarring on surface of lung	Service  intra	L051A	RN	0.51	Service total costs		12	
32215	Creation of scarring on surface of lung	Post-service	L051A	RN	0.51	Post service total costs		80	
32220	Removal of lung lining for lung expansion	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32220	Removal of lung lining for lung expansion	Service  intra	L051A	RN	0.51	Service total costs		12	
32220	Removal of lung lining for lung expansion	Post-service	L051A	RN	0.51	Post service total costs		179	
32225	Partial removal of lung lining for lung expansion	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32225	Partial removal of lung lining for lung expansion	Service  intra	L051A	RN	0.51	Service total costs		12	
32225	Partial removal of lung lining for lung expansion	Post-service	L051A	RN	0.51	Post service total costs		80	
32310	Removal of chest cavity lining	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32310	Removal of chest cavity lining	Service  intra	L051A	RN	0.51	Service total costs		12	
32310	Removal of chest cavity lining	Post-service	L051A	RN	0.51	Post service total costs		80	
32320	Removal of chest cavity and lung lining	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32320	Removal of chest cavity and lung lining	Service  intra	L051A	RN	0.51	Service total costs		12	
32320	Removal of chest cavity and lung lining	Post-service	L051A	RN	0.51	Post service total costs		152	
32400	"Needle biopsy of lining of lung, accessed through the skin"	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs	15	0	
32400	"Needle biopsy of lining of lung, accessed through the skin"	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	78	0	
32400	"Needle biopsy of lining of lung, accessed through the skin"	Post-service	L047C	RN/Respiratory Therapist	0.47	Post service total costs	3	0	
32405	"Needle biopsy of lung or chest tissue, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	16	
32405	"Needle biopsy of lung or chest tissue, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	52	0	
32405	"Needle biopsy of lung or chest tissue, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	92	0	
32405	"Needle biopsy of lung or chest tissue, accessed through the skin"	Post-service	L041B	Radiologic Technologist	0.41	Post service total costs	3	3	
32440	Removal of lung	Pre-service	L051A	RN	0.51	Preservice total costs		75	
32440	Removal of lung	Service  intra	L051A	RN	0.51	Service total costs		12	
32440	Removal of lung	Post-service	L051A	RN	0.51	Post service total costs		90	
32442	Removal of lung and portion of windpipe cartilage	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32442	Removal of lung and portion of windpipe cartilage	Service  intra	L051A	RN	0.51	Service total costs		12	
32442	Removal of lung and portion of windpipe cartilage	Post-service	L051A	RN	0.51	Post service total costs		72	
32445	Removal of lung and chest cavity lining	Pre-service	L051A	RN	0.51	Preservice total costs		75	
32445	Removal of lung and chest cavity lining	Service  intra	L051A	RN	0.51	Service total costs		12	
32445	Removal of lung and chest cavity lining	Post-service	L051A	RN	0.51	Post service total costs		169	
32480	Removal of one lobe of lung	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32480	Removal of one lobe of lung	Service  intra	L051A	RN	0.51	Service total costs		12	
32480	Removal of one lobe of lung	Post-service	L051A	RN	0.51	Post service total costs		90	
32482	Removal of two lobes of lung	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32482	Removal of two lobes of lung	Service  intra	L051A	RN	0.51	Service total costs		12	
32482	Removal of two lobes of lung	Post-service	L051A	RN	0.51	Post service total costs		116	
32484	Removal of a segment of lung tissue	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32484	Removal of a segment of lung tissue	Service  intra	L051A	RN	0.51	Service total costs		12	
32484	Removal of a segment of lung tissue	Post-service	L051A	RN	0.51	Post service total costs		63	
32486	Removal portion of lung tissue and segment of lung airway	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32486	Removal portion of lung tissue and segment of lung airway	Service  intra	L051A	RN	0.51	Service total costs		12	
32486	Removal portion of lung tissue and segment of lung airway	Post-service	L051A	RN	0.51	Post service total costs		63	
32488	Removal of remaining lung after prior lung surgery	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32488	Removal of remaining lung after prior lung surgery	Service  intra	L051A	RN	0.51	Service total costs		12	
32488	Removal of remaining lung after prior lung surgery	Post-service	L051A	RN	0.51	Post service total costs		116	
32491	Removal of a lung segment to reduce lung volume	Pre-service	L051A	RN	0.51	Preservice total costs		75	
32491	Removal of a lung segment to reduce lung volume	Service  intra	L051A	RN	0.51	Service total costs		12	
32491	Removal of a lung segment to reduce lung volume	Post-service	L051A	RN	0.51	Post service total costs		108	
32503	Removal of lung growth and chest wall	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32503	Removal of lung growth and chest wall	Service  intra	L051A	RN	0.51	Service total costs		12	
32503	Removal of lung growth and chest wall	Post-service	L051A	RN	0.51	Post service total costs		99	
32504	Removal of lung growth and repair of chest wall	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32504	Removal of lung growth and repair of chest wall	Service  intra	L051A	RN	0.51	Service total costs		12	
32504	Removal of lung growth and repair of chest wall	Post-service	L051A	RN	0.51	Post service total costs		99	
32505	Opening in chest with partial removal of lung tissue	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32505	Opening in chest with partial removal of lung tissue	Service  intra	L051A	RN	0.51	Service total costs		12	
32505	Opening in chest with partial removal of lung tissue	Post-service	L051A	RN	0.51	Post service total costs		63	
32540	Removal of infected material between lung and chest wall	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32540	Removal of infected material between lung and chest wall	Service  intra	L051A	RN	0.51	Service total costs		12	
32540	Removal of infected material between lung and chest wall	Post-service	L051A	RN	0.51	Post service total costs		108	
32550	Insertion of permanent catheter for drainage of lung fluid	Pre-service	L042B	Respiratory Therapist	0.42	Preservice total costs	5	20	
32550	Insertion of permanent catheter for drainage of lung fluid	Service  intra	L042B	Respiratory Therapist	0.42	Service total costs	49	0	
32550	Insertion of permanent catheter for drainage of lung fluid	Service  intra	L051A	RN	0.51	Service total costs	47	0	
32550	Insertion of permanent catheter for drainage of lung fluid	Post-service	L042B	Respiratory Therapist	0.42	Post service total costs	3	3	
32551	"Removal of fluid from between lung and chest cavity, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		6	
32552	Removal of tunneled catheter in lung lining	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	19	
32552	Removal of tunneled catheter in lung lining	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	6	
32552	Removal of tunneled catheter in lung lining	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
32553	"Insertion of devices in chest cavity for radiation therapy guidance, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	11	
32553	"Insertion of devices in chest cavity for radiation therapy guidance, accessed through the skin"	Service  intra	L046A	CT Technologist	0.46	Service total costs	36	0	
32553	"Insertion of devices in chest cavity for radiation therapy guidance, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	107	0	
32553	"Insertion of devices in chest cavity for radiation therapy guidance, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	0	
32553	"Insertion of devices in chest cavity for radiation therapy guidance, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
32554	Removal of fluid from chest cavity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
32554	Removal of fluid from chest cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	52	0	
32554	Removal of fluid from chest cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
32555	Removal of fluid from chest cavity with imaging guidance	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	12	0	
32555	Removal of fluid from chest cavity with imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	60	0	
32555	Removal of fluid from chest cavity with imaging guidance	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	5	0	
32555	Removal of fluid from chest cavity with imaging guidance	Post-service	L041B	Radiologic Technologist	0.41	Post service total costs	3	0	
32556	"Removal of fluid from chest cavity with insertion of indwelling catheter, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
32556	"Removal of fluid from chest cavity with insertion of indwelling catheter, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	0	
32556	"Removal of fluid from chest cavity with insertion of indwelling catheter, accessed through the skin"	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	3	0	
32556	"Removal of fluid from chest cavity with insertion of indwelling catheter, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
32557	"Removal of fluid from chest cavity with insertion of indwelling catheter and imaging guidance, accessed through the skin"	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	15	0	
32557	"Removal of fluid from chest cavity with insertion of indwelling catheter and imaging guidance, accessed through the skin"	Service  intra	L046A	CT Technologist	0.46	Service total costs	58	0	
32557	"Removal of fluid from chest cavity with insertion of indwelling catheter and imaging guidance, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	15	0	
32557	"Removal of fluid from chest cavity with insertion of indwelling catheter and imaging guidance, accessed through the skin"	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	5	0	
32557	"Removal of fluid from chest cavity with insertion of indwelling catheter and imaging guidance, accessed through the skin"	Post-service	L046A	CT Technologist	0.46	Post service total costs	3	0	
32560	Catheter instillation of agent onto lung surface	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs	3	0	
32560	Catheter instillation of agent onto lung surface	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	41	0	
32561	Catheter instillations of agent onto lung lining to break up scar tissue	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs	3	0	
32561	Catheter instillations of agent onto lung lining to break up scar tissue	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	29	0	
32562	Catheter instillations of agent onto lung lining to break up scar tissue	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs	3	0	
32562	Catheter instillations of agent onto lung lining to break up scar tissue	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	24	0	
32601	"Diagnostic examination of lungs, heart sac, mid-chest cavity, or lung lining using an endoscope"	Pre-service	L051A	RN	0.51	Preservice total costs		30	
32604	Biopsy of sac that covers the heart using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		30	
32604	Biopsy of sac that covers the heart using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		3	
32606	Biopsy of tissue in mid-chest using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		30	
32606	Biopsy of tissue in mid-chest using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		3	
32607	Biopsy of fluid collection in one lung using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		30	
32608	Biopsy of growths in one lung using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		30	
32609	Biopsy of lung lining using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		30	
32650	Adhesion of the lung linings using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32650	Adhesion of the lung linings using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32650	Adhesion of the lung linings using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		54	
32651	Partial removal of chest cavity lining and lung using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32651	Partial removal of chest cavity lining and lung using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32651	Partial removal of chest cavity lining and lung using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		63	
32652	Complete removal of inside lining of chest cavity and lung using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32652	Complete removal of inside lining of chest cavity and lung using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32652	Complete removal of inside lining of chest cavity and lung using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		99	
32653	Removal of foreign body from lining of chest cavity using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32653	Removal of foreign body from lining of chest cavity using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32653	Removal of foreign body from lining of chest cavity using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		63	
32654	Control of bleeding in chest using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32654	Control of bleeding in chest using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32654	Control of bleeding in chest using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		63	
32655	Removal of air sac of lung using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32655	Removal of air sac of lung using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32655	Removal of air sac of lung using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		63	
32656	Removal of lining of lung using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32656	Removal of lining of lung using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32656	Removal of lining of lung using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		63	
32658	Removal of blood clot or foreign body from sac that covers the heart using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32658	Removal of blood clot or foreign body from sac that covers the heart using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32658	Removal of blood clot or foreign body from sac that covers the heart using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		54	
32659	Creation of opening or partial removal of sac that covers the heart using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32659	Creation of opening or partial removal of sac that covers the heart using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32659	Creation of opening or partial removal of sac that covers the heart using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		63	
32661	Removal of cyst or growth from sac that covers the heart using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32661	Removal of cyst or growth from sac that covers the heart using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32661	Removal of cyst or growth from sac that covers the heart using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		54	
32662	Removal of cyst or growth from mid-chest cavity using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32662	Removal of cyst or growth from mid-chest cavity using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32662	Removal of cyst or growth from mid-chest cavity using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		63	
32663	Examination of lung with removal of lung lobe using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32663	Examination of lung with removal of lung lobe using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32663	Examination of lung with removal of lung lobe using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		63	
32664	Removal of nerves to chest cavity using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32664	Removal of nerves to chest cavity using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32664	Removal of nerves to chest cavity using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		54	
32665	Repair of esophagus using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32665	Repair of esophagus using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32665	Repair of esophagus using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		63	
32666	Partial removal of tissue of one lung using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32666	Partial removal of tissue of one lung using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32666	Partial removal of tissue of one lung using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		63	
32669	Removal of a segment of lung tissue using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32669	Removal of a segment of lung tissue using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32669	Removal of a segment of lung tissue using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		63	
32670	Removal of two lobes of lung using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32670	Removal of two lobes of lung using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32670	Removal of two lobes of lung using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		63	
32671	Removal of lung using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32671	Removal of lung using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32671	Removal of lung using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		63	
32672	Partial removal of one lung to reduce lung volume using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32672	Partial removal of one lung to reduce lung volume using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32672	Partial removal of one lung to reduce lung volume using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		63	
32673	Removal of thymus gland using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32673	Removal of thymus gland using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
32673	Removal of thymus gland using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		63	
32800	Repair of lung herniation through chest wall	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32800	Repair of lung herniation through chest wall	Service  intra	L051A	RN	0.51	Service total costs		12	
32800	Repair of lung herniation through chest wall	Post-service	L051A	RN	0.51	Post service total costs		80	
32810	Closure of chest wall after open drainage of infected lung	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32810	Closure of chest wall after open drainage of infected lung	Service  intra	L051A	RN	0.51	Service total costs		12	
32810	Closure of chest wall after open drainage of infected lung	Post-service	L051A	RN	0.51	Post service total costs		80	
32815	"Closure of abnormal drainage tract from chest cavity to lung airway, open procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32815	"Closure of abnormal drainage tract from chest cavity to lung airway, open procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
32815	"Closure of abnormal drainage tract from chest cavity to lung airway, open procedure"	Post-service	L051A	RN	0.51	Post service total costs		169	
32820	Reconstruction of the chest wall after injury	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32820	Reconstruction of the chest wall after injury	Service  intra	L051A	RN	0.51	Service total costs		12	
32820	Reconstruction of the chest wall after injury	Post-service	L051A	RN	0.51	Post service total costs		125	
32851	Transplant of lung	Pre-service	L051A	RN	0.51	Preservice total costs		90	
32851	Transplant of lung	Service  intra	L051A	RN	0.51	Service total costs		15	
32851	Transplant of lung	Post-service	L051A	RN	0.51	Post service total costs		116	
32852	Transplant of lung on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		90	
32852	Transplant of lung on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		15	
32852	Transplant of lung on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		116	
32853	Transplant of both lungs	Pre-service	L051A	RN	0.51	Preservice total costs		90	
32853	Transplant of both lungs	Service  intra	L051A	RN	0.51	Service total costs		15	
32853	Transplant of both lungs	Post-service	L051A	RN	0.51	Post service total costs		116	
32854	Transplant of both lungs on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		90	
32854	Transplant of both lungs on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		15	
32854	Transplant of both lungs on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		116	
32900	Removal of ribs	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32900	Removal of ribs	Service  intra	L051A	RN	0.51	Service total costs		12	
32900	Removal of ribs	Post-service	L051A	RN	0.51	Post service total costs		80	
32905	Removal of infected area of chest cavity	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32905	Removal of infected area of chest cavity	Service  intra	L051A	RN	0.51	Service total costs		12	
32905	Removal of infected area of chest cavity	Post-service	L051A	RN	0.51	Post service total costs		80	
32906	Removal of infected area in chest cavity and closure of abnormal drainage tract	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32906	Removal of infected area in chest cavity and closure of abnormal drainage tract	Service  intra	L051A	RN	0.51	Service total costs		12	
32906	Removal of infected area in chest cavity and closure of abnormal drainage tract	Post-service	L051A	RN	0.51	Post service total costs		80	
32940	Release of lining covering lung from chest wall	Pre-service	L051A	RN	0.51	Preservice total costs		60	
32940	Release of lining covering lung from chest wall	Service  intra	L051A	RN	0.51	Service total costs		12	
32940	Release of lining covering lung from chest wall	Post-service	L051A	RN	0.51	Post service total costs		80	
32960	Injection of air into chest cavity to collapse lung	Pre-service	L051A	RN	0.51	Preservice total costs	0	10	
32960	Injection of air into chest cavity to collapse lung	Service  intra	L051A	RN	0.51	Service total costs	50	0	
32998	"Destruction of growths in one lung, accessed through the skin"	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6	0	
32998	"Destruction of growths in one lung, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	10	
32998	"Destruction of growths in one lung, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	62	0	
32998	"Destruction of growths in one lung, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25	0	
32998	"Destruction of growths in one lung, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
33015	Insertion of catheter for drainage into sac that covers the heart	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33015	Insertion of catheter for drainage into sac that covers the heart	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33015	Insertion of catheter for drainage into sac that covers the heart	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
33020	Removal of blood clot or foreign body from sac that covers the heart	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33020	Removal of blood clot or foreign body from sac that covers the heart	Service  intra	L051A	RN	0.51	Service total costs		12	
33020	Removal of blood clot or foreign body from sac that covers the heart	Post-service	L051A	RN	0.51	Post service total costs		53	
33025	Creation of opening or partial removal of sac that covers the heart	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33025	Creation of opening or partial removal of sac that covers the heart	Service  intra	L051A	RN	0.51	Service total costs		12	
33025	Creation of opening or partial removal of sac that covers the heart	Post-service	L051A	RN	0.51	Post service total costs		36	
33030	Removal of sac that covers the heart	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33030	Removal of sac that covers the heart	Service  intra	L051A	RN	0.51	Service total costs		12	
33030	Removal of sac that covers the heart	Post-service	L051A	RN	0.51	Post service total costs		89.5	
33031	Removal of sac that covers the heart on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33031	Removal of sac that covers the heart on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		15	
33031	Removal of sac that covers the heart on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		89	
33050	Removal of cyst or growth from sac that covers the heart	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33050	Removal of cyst or growth from sac that covers the heart	Service  intra	L051A	RN	0.51	Service total costs		12	
33050	Removal of cyst or growth from sac that covers the heart	Post-service	L051A	RN	0.51	Post service total costs		80	
33120	Removal of growth in heart on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33120	Removal of growth in heart on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33120	Removal of growth in heart on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		53.5	
33130	Removal of growth on outside of heart	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33130	Removal of growth on outside of heart	Service  intra	L051A	RN	0.51	Service total costs		12	
33130	Removal of growth on outside of heart	Post-service	L051A	RN	0.51	Post service total costs		80	
33140	Laser treatment of heart muscle to improve blood flow	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33140	Laser treatment of heart muscle to improve blood flow	Service  intra	L051A	RN	0.51	Service total costs		12	
33140	Laser treatment of heart muscle to improve blood flow	Post-service	L051A	RN	0.51	Post service total costs		53	
33202	"Insertion of electrodes to outer layer of heart, open procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33202	"Insertion of electrodes to outer layer of heart, open procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
33202	"Insertion of electrodes to outer layer of heart, open procedure"	Post-service	L051A	RN	0.51	Post service total costs		36	
33203	Insertion of electrodes to outer layer of heart using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33203	Insertion of electrodes to outer layer of heart using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
33203	Insertion of electrodes to outer layer of heart using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		36	
33206	Insertion or replacement of permanent pacemaker and upper chamber electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33206	Insertion or replacement of permanent pacemaker and upper chamber electrodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33206	Insertion or replacement of permanent pacemaker and upper chamber electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
33207	Insertion or replacement of permanent pacemaker and lower chamber electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33207	Insertion or replacement of permanent pacemaker and lower chamber electrodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33207	Insertion or replacement of permanent pacemaker and lower chamber electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33208	Insertion of new or replacement of permanent pacemaker including upper and lower chamber electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33208	Insertion of new or replacement of permanent pacemaker including upper and lower chamber electrodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33208	Insertion of new or replacement of permanent pacemaker including upper and lower chamber electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33212	Insertion of pacemaker pulse generator with existing single lead	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33212	Insertion of pacemaker pulse generator with existing single lead	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33212	Insertion of pacemaker pulse generator with existing single lead	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33213	Insertion of pacemaker pulse generator with existing dual leads	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33213	Insertion of pacemaker pulse generator with existing dual leads	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33213	Insertion of pacemaker pulse generator with existing dual leads	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33214	Conversion to two chamber pacemaker system	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33214	Conversion to two chamber pacemaker system	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33214	Conversion to two chamber pacemaker system	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
33215	Repositioning of implanted pacemaker or defibrillator device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33215	Repositioning of implanted pacemaker or defibrillator device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33215	Repositioning of implanted pacemaker or defibrillator device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
33216	Insertion of electrode for permanent pacemaker or pacing defibrillator device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33216	Insertion of electrode for permanent pacemaker or pacing defibrillator device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33216	Insertion of electrode for permanent pacemaker or pacing defibrillator device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
33217	Insertion of electrodes for permanent pacemaker or pacing defibrillator device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33217	Insertion of electrodes for permanent pacemaker or pacing defibrillator device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33217	Insertion of electrodes for permanent pacemaker or pacing defibrillator device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
33218	Repair of electrode for permanent pacemaker or defibrillator device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33218	Repair of electrode for permanent pacemaker or defibrillator device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33218	Repair of electrode for permanent pacemaker or defibrillator device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
33220	Repair of 2 electrodes for permanent pacemaker or defibrillator device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33220	Repair of 2 electrodes for permanent pacemaker or defibrillator device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33220	Repair of 2 electrodes for permanent pacemaker or defibrillator device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
33221	Insertion of pacemaker pulse generator with existing multiple leads	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33221	Insertion of pacemaker pulse generator with existing multiple leads	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33221	Insertion of pacemaker pulse generator with existing multiple leads	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33222	Relocation of pacemaker generator skin pocket	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33222	Relocation of pacemaker generator skin pocket	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33222	Relocation of pacemaker generator skin pocket	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
33223	Relocation of defibrillator device skin pocket	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33223	Relocation of defibrillator device skin pocket	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33223	Relocation of defibrillator device skin pocket	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
33224	Insertion of left heart electrode with attachment to pacemaker or pacing defibrillator device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
33224	Insertion of left heart electrode with attachment to pacemaker or pacing defibrillator device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
33226	Repositioning of implanted left heart electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
33226	Repositioning of implanted left heart electrode	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
33227	Removal and replacement of single lead permanent pacemaker pulse generator	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33227	Removal and replacement of single lead permanent pacemaker pulse generator	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33227	Removal and replacement of single lead permanent pacemaker pulse generator	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33228	Removal and replacement of dual lead permanent pacemaker pulse generator	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33228	Removal and replacement of dual lead permanent pacemaker pulse generator	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33228	Removal and replacement of dual lead permanent pacemaker pulse generator	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33229	Removal and replacement of multiple lead permanent pacemaker pulse generator	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33229	Removal and replacement of multiple lead permanent pacemaker pulse generator	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33229	Removal and replacement of multiple lead permanent pacemaker pulse generator	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33230	Insertion of pacing defibrillator pulse generator with existing dual leads	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33230	Insertion of pacing defibrillator pulse generator with existing dual leads	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33230	Insertion of pacing defibrillator pulse generator with existing dual leads	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33231	Insertion of pacing defibrillator pulse generator with existing multiple leads	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33231	Insertion of pacing defibrillator pulse generator with existing multiple leads	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33231	Insertion of pacing defibrillator pulse generator with existing multiple leads	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33233	Removal of permanent pacemaker pulse generator	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33233	Removal of permanent pacemaker pulse generator	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33233	Removal of permanent pacemaker pulse generator	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
33234	Removal of electrode from right heart	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33234	Removal of electrode from right heart	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33234	Removal of electrode from right heart	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
33235	Removal of electrodes from right heart	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33235	Removal of electrodes from right heart	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33235	Removal of electrodes from right heart	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
33236	Removal of permanent right heart electrodes and pacemaker	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33236	Removal of permanent right heart electrodes and pacemaker	Service  intra	L051A	RN	0.51	Service total costs		12	
33236	Removal of permanent right heart electrodes and pacemaker	Post-service	L051A	RN	0.51	Post service total costs		81	
33237	Removal of permanent right heart electrodes and pacemaker	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33237	Removal of permanent right heart electrodes and pacemaker	Service  intra	L051A	RN	0.51	Service total costs		12	
33237	Removal of permanent right heart electrodes and pacemaker	Post-service	L051A	RN	0.51	Post service total costs		81	
33238	Removal of permanent pacemaker venous electrodes	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33238	Removal of permanent pacemaker venous electrodes	Service  intra	L051A	RN	0.51	Service total costs		12	
33238	Removal of permanent pacemaker venous electrodes	Post-service	L051A	RN	0.51	Post service total costs		108	
33240	Insertion of pacing defibrillator pulse generator with existing single lead	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33240	Insertion of pacing defibrillator pulse generator with existing single lead	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33240	Insertion of pacing defibrillator pulse generator with existing single lead	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33241	Removal of defibrillator pulse generator	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33241	Removal of defibrillator pulse generator	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33241	Removal of defibrillator pulse generator	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
33243	Removal of defibrillator electrodes	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33243	Removal of defibrillator electrodes	Service  intra	L051A	RN	0.51	Service total costs		12	
33243	Removal of defibrillator electrodes	Post-service	L051A	RN	0.51	Post service total costs		108	
33244	Removal of defibrillator electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33244	Removal of defibrillator electrodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33244	Removal of defibrillator electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
33249	Insertion or replacement of single or dual chamber pacing defibrillator leads	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33249	Insertion or replacement of single or dual chamber pacing defibrillator leads	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33249	Insertion or replacement of single or dual chamber pacing defibrillator leads	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
33250	Destruction of pathway of abnormal heart beats	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33250	Destruction of pathway of abnormal heart beats	Service  intra	L051A	RN	0.51	Service total costs		12	
33250	Destruction of pathway of abnormal heart beats	Post-service	L051A	RN	0.51	Post service total costs		80	
33251	Destruction of pathway of abnormal heart beats on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33251	Destruction of pathway of abnormal heart beats on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33251	Destruction of pathway of abnormal heart beats on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		80	
33254	Partial destruction and reconstruction of upper heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33254	Partial destruction and reconstruction of upper heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33254	Partial destruction and reconstruction of upper heart chamber	Post-service	L051A	RN	0.51	Post service total costs		89	
33255	Partial destruction and reconstruction of right upper heart	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33255	Partial destruction and reconstruction of right upper heart	Service  intra	L051A	RN	0.51	Service total costs		12	
33255	Partial destruction and reconstruction of right upper heart	Post-service	L051A	RN	0.51	Post service total costs		89	
33256	Destruction and reconstruction of right upper heart on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33256	Destruction and reconstruction of right upper heart on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33256	Destruction and reconstruction of right upper heart on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		89	
33257	Destruction and reconstruction of right upper heart	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33257	Destruction and reconstruction of right upper heart	Service  intra	L051A	RN	0.51	Service total costs		6	
33257	Destruction and reconstruction of right upper heart	Post-service	L051A	RN	0.51	Post service total costs		36	
33258	Destruction and reconstruction of right upper heart	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33258	Destruction and reconstruction of right upper heart	Service  intra	L051A	RN	0.51	Service total costs		6	
33258	Destruction and reconstruction of right upper heart	Post-service	L051A	RN	0.51	Post service total costs		36	
33259	Destruction of tissue and reconstruction of right upper heart on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33259	Destruction of tissue and reconstruction of right upper heart on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		6	
33259	Destruction of tissue and reconstruction of right upper heart on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		72	
33261	Destruction of tissue and reconstruction of right lower heart on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33261	Destruction of tissue and reconstruction of right lower heart on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33261	Destruction of tissue and reconstruction of right lower heart on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		80	
33262	Removal and replacement of defibrillator pulse generator	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33262	Removal and replacement of defibrillator pulse generator	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33262	Removal and replacement of defibrillator pulse generator	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33263	Removal and replacement of defibrillator pulse generator	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33263	Removal and replacement of defibrillator pulse generator	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33263	Removal and replacement of defibrillator pulse generator	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33264	Removal and replacement of defibrillator pulse generator	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33264	Removal and replacement of defibrillator pulse generator	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33264	Removal and replacement of defibrillator pulse generator	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33265	Reconstruction of upper heart chamber tissue and alteration of electrical pathway using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33265	Reconstruction of upper heart chamber tissue and alteration of electrical pathway using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
33265	Reconstruction of upper heart chamber tissue and alteration of electrical pathway using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		89	
33266	Reconstruction of upper heart chamber tissue and alteration of electrical pathway using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33266	Reconstruction of upper heart chamber tissue and alteration of electrical pathway using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
33266	Reconstruction of upper heart chamber tissue and alteration of electrical pathway using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		89	
33270	Insertion or replacement of permanent subcutaneous implantable defibrillator system; with subcutaneous electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
33270	Insertion or replacement of permanent subcutaneous implantable defibrillator system; with subcutaneous electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
33270	Insertion or replacement of permanent subcutaneous implantable defibrillator system; with subcutaneous electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
33270	Insertion or replacement of permanent subcutaneous implantable defibrillator system; with subcutaneous electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
33270	Insertion or replacement of permanent subcutaneous implantable defibrillator system; with subcutaneous electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
33270	Insertion or replacement of permanent subcutaneous implantable defibrillator system; with subcutaneous electrode	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
33270	Insertion or replacement of permanent subcutaneous implantable defibrillator system; with subcutaneous electrode	Post-service	L037D	RN/LPN/MTA	0.37	99214    53  minutes		53	
33271	Insertion of subcutaneous implantable defibrillator electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
33271	Insertion of subcutaneous implantable defibrillator electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
33271	Insertion of subcutaneous implantable defibrillator electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
33271	Insertion of subcutaneous implantable defibrillator electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
33271	Insertion of subcutaneous implantable defibrillator electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
33271	Insertion of subcutaneous implantable defibrillator electrode	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
33271	Insertion of subcutaneous implantable defibrillator electrode	Post-service	L037D	RN/LPN/MTA	0.37	99214    53  minutes		53	
33272	Removal of subcutaneous implantable defibrillator electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
33272	Removal of subcutaneous implantable defibrillator electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
33272	Removal of subcutaneous implantable defibrillator electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
33272	Removal of subcutaneous implantable defibrillator electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
33272	Removal of subcutaneous implantable defibrillator electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
33272	Removal of subcutaneous implantable defibrillator electrode	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
33272	Removal of subcutaneous implantable defibrillator electrode	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		36	
33273	Repositioning of previously implanted subcutaneous implantable defibrillator electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
33273	Repositioning of previously implanted subcutaneous implantable defibrillator electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
33273	Repositioning of previously implanted subcutaneous implantable defibrillator electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
33273	Repositioning of previously implanted subcutaneous implantable defibrillator electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
33273	Repositioning of previously implanted subcutaneous implantable defibrillator electrode	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
33273	Repositioning of previously implanted subcutaneous implantable defibrillator electrode	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
33273	Repositioning of previously implanted subcutaneous implantable defibrillator electrode	Post-service	L037D	RN/LPN/MTA	0.37	99214    53  minutes		53	
33282	Implantation patient-activated heart monitoring device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33282	Implantation patient-activated heart monitoring device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33282	Implantation patient-activated heart monitoring device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33284	Removal of implantable patient-activated heart monitoring device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33284	Removal of implantable patient-activated heart monitoring device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33284	Removal of implantable patient-activated heart monitoring device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33300	Repair of wound to heart	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33300	Repair of wound to heart	Service  intra	L051A	RN	0.51	Service total costs		12	
33300	Repair of wound to heart	Post-service	L051A	RN	0.51	Post service total costs		53	
33305	Repair of wound to heart on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33305	Repair of wound to heart on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33305	Repair of wound to heart on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		53	
33310	"Incision, exploration, and removal of foreign body of upper or lower heart chamber"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33310	"Incision, exploration, and removal of foreign body of upper or lower heart chamber"	Service  intra	L051A	RN	0.51	Service total costs		12	
33310	"Incision, exploration, and removal of foreign body of upper or lower heart chamber"	Post-service	L051A	RN	0.51	Post service total costs		80	
33315	"Incision, exploration, and removal of foreign body of upper or lower heart chamber on heart-lung machine"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33315	"Incision, exploration, and removal of foreign body of upper or lower heart chamber on heart-lung machine"	Service  intra	L051A	RN	0.51	Service total costs		12	
33315	"Incision, exploration, and removal of foreign body of upper or lower heart chamber on heart-lung machine"	Post-service	L051A	RN	0.51	Post service total costs		53.5	
33320	Suture repair of great vessels of heart and chest	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33320	Suture repair of great vessels of heart and chest	Service  intra	L051A	RN	0.51	Service total costs		12	
33320	Suture repair of great vessels of heart and chest	Post-service	L051A	RN	0.51	Post service total costs		54	
33321	Insertion of blood flow shunt from heart and great vessels	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33321	Insertion of blood flow shunt from heart and great vessels	Service  intra	L051A	RN	0.51	Service total costs		12	
33321	Insertion of blood flow shunt from heart and great vessels	Post-service	L051A	RN	0.51	Post service total costs		72	
33322	Suture repair of great vessels and heart on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33322	Suture repair of great vessels and heart on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33322	Suture repair of great vessels and heart on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		80	
33330	Insertion of great vessel graft	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33330	Insertion of great vessel graft	Service  intra	L051A	RN	0.51	Service total costs		12	
33330	Insertion of great vessel graft	Post-service	L051A	RN	0.51	Post service total costs		80	
33335	Insertion of great vessel graft on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33335	Insertion of great vessel graft on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33335	Insertion of great vessel graft on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		80	
33361	"Replacement of aortic valve with prosthetic valve, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33362	"Replacement of aortic valve with prosthetic valve, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33363	"Replacement of aortic valve with prosthetic valve, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33364	"Replacement of aortic valve with prosthetic valve, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33365	Replacement of aortic valve with prosthetic valve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33366	"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; transapical exposure (eg, left thoracotomy)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33400	"Repair of left lower heart valve on heart-lung machine, open procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33400	"Repair of left lower heart valve on heart-lung machine, open procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
33400	"Repair of left lower heart valve on heart-lung machine, open procedure"	Post-service	L051A	RN	0.51	Post service total costs		89	
33401	"Repair of left lower heart valve, open procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33401	"Repair of left lower heart valve, open procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
33401	"Repair of left lower heart valve, open procedure"	Post-service	L051A	RN	0.51	Post service total costs		126	
33403	Repair of left lower heart valve on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33403	Repair of left lower heart valve on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33403	Repair of left lower heart valve on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		126	
33404	Creation of blood flow from left lower heart chamber to aorta	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33404	Creation of blood flow from left lower heart chamber to aorta	Service  intra	L051A	RN	0.51	Service total costs		12	
33404	Creation of blood flow from left lower heart chamber to aorta	Post-service	L051A	RN	0.51	Post service total costs		80	
33405	Replacement of left lower heart chamber valve using artificial valve on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33405	Replacement of left lower heart chamber valve using artificial valve on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33405	Replacement of left lower heart chamber valve using artificial valve on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		89	
33406	Replacement of left lower heart chamber valve using artificial valve on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33406	Replacement of left lower heart chamber valve using artificial valve on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33406	Replacement of left lower heart chamber valve using artificial valve on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		89	
33410	Replacement of left lower heart chamber valve using tissue valve on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33410	Replacement of left lower heart chamber valve using tissue valve on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33410	Replacement of left lower heart chamber valve using tissue valve on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		89	
33411	Replacement and enlargement of left lower heart valve	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33411	Replacement and enlargement of left lower heart valve	Service  intra	L051A	RN	0.51	Service total costs		12	
33411	Replacement and enlargement of left lower heart valve	Post-service	L051A	RN	0.51	Post service total costs		89	
33412	Replacement of left lower heart chamber valve with enlargement of tissue ring at base of valve	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33412	Replacement of left lower heart chamber valve with enlargement of tissue ring at base of valve	Service  intra	L051A	RN	0.51	Service total costs		12	
33412	Replacement of left lower heart chamber valve with enlargement of tissue ring at base of valve	Post-service	L051A	RN	0.51	Post service total costs		53	
33413	Repair and enlargement of blood outflow tract to great vessels from the left or right lower heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33413	Repair and enlargement of blood outflow tract to great vessels from the left or right lower heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33413	Repair and enlargement of blood outflow tract to great vessels from the left or right lower heart chamber	Post-service	L051A	RN	0.51	Post service total costs		89	
33414	Repair and enlargement of blood outflow tract of left lower heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33414	Repair and enlargement of blood outflow tract of left lower heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33414	Repair and enlargement of blood outflow tract of left lower heart chamber	Post-service	L051A	RN	0.51	Post service total costs		53	
33415	Incision or removal of tissue below left lower heart valve	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33415	Incision or removal of tissue below left lower heart valve	Service  intra	L051A	RN	0.51	Service total costs		12	
33415	Incision or removal of tissue below left lower heart valve	Post-service	L051A	RN	0.51	Post service total costs		53	
33416	Removal of thickened heart muscle at left lower heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33416	Removal of thickened heart muscle at left lower heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33416	Removal of thickened heart muscle at left lower heart chamber	Post-service	L051A	RN	0.51	Post service total costs		89	
33417	Repair of aorta at heart	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33417	Repair of aorta at heart	Service  intra	L051A	RN	0.51	Service total costs		12	
33417	Repair of aorta at heart	Post-service	L051A	RN	0.51	Post service total costs		106	
33418	Transcatheter mitral valve repair; initial prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
33418	Transcatheter mitral valve repair; initial prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
33418	Transcatheter mitral valve repair; initial prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
33418	Transcatheter mitral valve repair; initial prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
33418	Transcatheter mitral valve repair; initial prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
33418	Transcatheter mitral valve repair; initial prosthesis	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		0	
33418	Transcatheter mitral valve repair; initial prosthesis	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99239 -- 15 minutes		15	
33418	Transcatheter mitral valve repair; initial prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	99214    53  minutes		106	
33420	"Removal of scar tissue of valve between left heart chambers, closed heart procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33420	"Removal of scar tissue of valve between left heart chambers, closed heart procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
33420	"Removal of scar tissue of valve between left heart chambers, closed heart procedure"	Post-service	L051A	RN	0.51	Post service total costs		80	
33422	"Removal of valve scar tissue between left heart chambers on heart-lung machine, open procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33422	"Removal of valve scar tissue between left heart chambers on heart-lung machine, open procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
33422	"Removal of valve scar tissue between left heart chambers on heart-lung machine, open procedure"	Post-service	L051A	RN	0.51	Post service total costs		80	
33425	Repair of valve between left heart chambers on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33425	Repair of valve between left heart chambers on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33425	Repair of valve between left heart chambers on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		89	
33426	Insertion of artificial valve between left heart chambers on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33426	Insertion of artificial valve between left heart chambers on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33426	Insertion of artificial valve between left heart chambers on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		89	
33427	Repair of valve flaps between left heart chambers on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33427	Repair of valve flaps between left heart chambers on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33427	Repair of valve flaps between left heart chambers on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		63	
33430	Replacement of valve between left upper and lower chambers on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33430	Replacement of valve between left upper and lower chambers on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		15	
33430	Replacement of valve between left upper and lower chambers on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		125	
33460	Removal of valve between right upper and lower chambers on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33460	Removal of valve between right upper and lower chambers on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33460	Removal of valve between right upper and lower chambers on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		53	
33463	Repair of valve between right upper and lower heart chambers	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33463	Repair of valve between right upper and lower heart chambers	Service  intra	L051A	RN	0.51	Service total costs		12	
33463	Repair of valve between right upper and lower heart chambers	Post-service	L051A	RN	0.51	Post service total costs		89	
33464	Repair of heart valve between right chambers with insertion of prosthetic valve ring	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33464	Repair of heart valve between right chambers with insertion of prosthetic valve ring	Service  intra	L051A	RN	0.51	Service total costs		12	
33464	Repair of heart valve between right chambers with insertion of prosthetic valve ring	Post-service	L051A	RN	0.51	Post service total costs		89	
33465	Replacement of valve between right heart chambers on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33465	Replacement of valve between right heart chambers on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33465	Replacement of valve between right heart chambers on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		89	
33468	Repositioning of valve between right heart chambers	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33468	Repositioning of valve between right heart chambers	Service  intra	L051A	RN	0.51	Service total costs		12	
33468	Repositioning of valve between right heart chambers	Post-service	L051A	RN	0.51	Post service total costs		53.5	
33470	"Dilation of valve between right heart chambers, closed heart procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33470	"Dilation of valve between right heart chambers, closed heart procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33470	"Dilation of valve between right heart chambers, closed heart procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
33471	"Dilation of valve between right heart chambers, closed heart procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33471	"Dilation of valve between right heart chambers, closed heart procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
33471	"Dilation of valve between right heart chambers, closed heart procedure"	Post-service	L051A	RN	0.51	Post service total costs		89	
33474	"Incision of valve at right lower heart chamber on heart-lung machine, open procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33474	"Incision of valve at right lower heart chamber on heart-lung machine, open procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
33474	"Incision of valve at right lower heart chamber on heart-lung machine, open procedure"	Post-service	L051A	RN	0.51	Post service total costs		89	
33475	Replacement of valve at right lower heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33475	Replacement of valve at right lower heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33475	Replacement of valve at right lower heart chamber	Post-service	L051A	RN	0.51	Post service total costs		89	
33476	Release of restrictive muscle bands or valve leaflets at right lower heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33476	Release of restrictive muscle bands or valve leaflets at right lower heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33476	Release of restrictive muscle bands or valve leaflets at right lower heart chamber	Post-service	L051A	RN	0.51	Post service total costs		106	
33477	"Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
33477	"Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
33477	"Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
33477	"Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
33477	"Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
33478	Enlargement of blood outflow tract in right lower heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33478	Enlargement of blood outflow tract in right lower heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33478	Enlargement of blood outflow tract in right lower heart chamber	Post-service	L051A	RN	0.51	Post service total costs		106	
33496	Repair of artificial heart valve on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33496	Repair of artificial heart valve on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33496	Repair of artificial heart valve on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		89	
33500	Repair of drainage of heart artery and vein on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33500	Repair of drainage of heart artery and vein on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33500	Repair of drainage of heart artery and vein on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		80	
33501	Repair of drainage of heart artery and vein	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33501	Repair of drainage of heart artery and vein	Service  intra	L051A	RN	0.51	Service total costs		12	
33501	Repair of drainage of heart artery and vein	Post-service	L051A	RN	0.51	Post service total costs		63	
33502	Repair of abnormal heart artery	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33502	Repair of abnormal heart artery	Service  intra	L051A	RN	0.51	Service total costs		12	
33502	Repair of abnormal heart artery	Post-service	L051A	RN	0.51	Post service total costs		106	
33503	Placement of graft to repair abnormal heart artery	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33503	Placement of graft to repair abnormal heart artery	Service  intra	L051A	RN	0.51	Service total costs		12	
33503	Placement of graft to repair abnormal heart artery	Post-service	L051A	RN	0.51	Post service total costs		126	
33504	Repair of abnormal heart artery on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33504	Repair of abnormal heart artery on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33504	Repair of abnormal heart artery on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		106	
33505	Repair of abnormal heart artery with diversion of blood flow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33505	Repair of abnormal heart artery with diversion of blood flow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33505	Repair of abnormal heart artery with diversion of blood flow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33506	Repair of abnormal heart artery with diversion of blood flow to aorta	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33506	Repair of abnormal heart artery with diversion of blood flow to aorta	Service  intra	L051A	RN	0.51	Service total costs		6	
33506	Repair of abnormal heart artery with diversion of blood flow to aorta	Post-service	L051A	RN	0.51	Post service total costs		36	
33507	Repair of abnormal heart artery at its aortic origin	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33507	Repair of abnormal heart artery at its aortic origin	Service  intra	L051A	RN	0.51	Service total costs		12	
33507	Repair of abnormal heart artery at its aortic origin	Post-service	L051A	RN	0.51	Post service total costs		36	
33510	Heart artery bypass to repair one artery	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33510	Heart artery bypass to repair one artery	Service  intra	L051A	RN	0.51	Service total costs		12	
33510	Heart artery bypass to repair one artery	Post-service	L051A	RN	0.51	Post service total costs		80	
33511	Heart artery bypass to repair multiple arteries	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33511	Heart artery bypass to repair multiple arteries	Service  intra	L051A	RN	0.51	Service total costs		12	
33511	Heart artery bypass to repair multiple arteries	Post-service	L051A	RN	0.51	Post service total costs		80	
33512	Heart artery bypass to repair multiple arteries	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33512	Heart artery bypass to repair multiple arteries	Service  intra	L051A	RN	0.51	Service total costs		12	
33512	Heart artery bypass to repair multiple arteries	Post-service	L051A	RN	0.51	Post service total costs		80	
33513	Heart artery bypass to repair multiple arteries	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33513	Heart artery bypass to repair multiple arteries	Service  intra	L051A	RN	0.51	Service total costs		12	
33513	Heart artery bypass to repair multiple arteries	Post-service	L051A	RN	0.51	Post service total costs		80	
33514	Heart artery bypass to repair multiple arteries	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33514	Heart artery bypass to repair multiple arteries	Service  intra	L051A	RN	0.51	Service total costs		12	
33514	Heart artery bypass to repair multiple arteries	Post-service	L051A	RN	0.51	Post service total costs		80	
33516	Heart artery bypass to repair multiple arteries	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33516	Heart artery bypass to repair multiple arteries	Service  intra	L051A	RN	0.51	Service total costs		12	
33516	Heart artery bypass to repair multiple arteries	Post-service	L051A	RN	0.51	Post service total costs		80	
33533	Heart artery bypass to repair one artery	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33533	Heart artery bypass to repair one artery	Service  intra	L051A	RN	0.51	Service total costs		12	
33533	Heart artery bypass to repair one artery	Post-service	L051A	RN	0.51	Post service total costs		80	
33534	Heart artery bypass to repair multiple arteries	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33534	Heart artery bypass to repair multiple arteries	Service  intra	L051A	RN	0.51	Service total costs		12	
33534	Heart artery bypass to repair multiple arteries	Post-service	L051A	RN	0.51	Post service total costs		80	
33535	Heart artery bypass to repair multiple arteries	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33535	Heart artery bypass to repair multiple arteries	Service  intra	L051A	RN	0.51	Service total costs		12	
33535	Heart artery bypass to repair multiple arteries	Post-service	L051A	RN	0.51	Post service total costs		80	
33536	Heart artery bypass to repair multiple arteries	Pre-service	L051A	RN	0.51	Preservice total costs		75	
33536	Heart artery bypass to repair multiple arteries	Service  intra	L051A	RN	0.51	Service total costs		12	
33536	Heart artery bypass to repair multiple arteries	Post-service	L051A	RN	0.51	Post service total costs		80	
33542	Partial removal of heart muscle	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33542	Partial removal of heart muscle	Service  intra	L051A	RN	0.51	Service total costs		12	
33542	Partial removal of heart muscle	Post-service	L051A	RN	0.51	Post service total costs		89	
33545	Repair of lower heart chamber defect following heart attack	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33545	Repair of lower heart chamber defect following heart attack	Service  intra	L051A	RN	0.51	Service total costs		12	
33545	Repair of lower heart chamber defect following heart attack	Post-service	L051A	RN	0.51	Post service total costs		89	
33548	Restoration and reshaping of left lower heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33548	Restoration and reshaping of left lower heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33548	Restoration and reshaping of left lower heart chamber	Post-service	L051A	RN	0.51	Post service total costs		125	
33600	Suture or patch of valve between right heart chambers	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33600	Suture or patch of valve between right heart chambers	Service  intra	L051A	RN	0.51	Service total costs		12	
33600	Suture or patch of valve between right heart chambers	Post-service	L051A	RN	0.51	Post service total costs		106	
33602	Suture or patch of two-leaflet heart valve	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33602	Suture or patch of two-leaflet heart valve	Service  intra	L051A	RN	0.51	Service total costs		12	
33602	Suture or patch of two-leaflet heart valve	Post-service	L051A	RN	0.51	Post service total costs		106	
33606	Connection of pulmonary (lung) artery to aorta	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33606	Connection of pulmonary (lung) artery to aorta	Service  intra	L051A	RN	0.51	Service total costs		6	
33606	Connection of pulmonary (lung) artery to aorta	Post-service	L051A	RN	0.51	Post service total costs		106	
33608	Repair of congenital defect in right or left heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33608	Repair of congenital defect in right or left heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33608	Repair of congenital defect in right or left heart chamber	Post-service	L051A	RN	0.51	Post service total costs		106	
33610	Enlargement of congenital defect in wall between two lower heart chambers	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33610	Enlargement of congenital defect in wall between two lower heart chambers	Service  intra	L051A	RN	0.51	Service total costs		12	
33610	Enlargement of congenital defect in wall between two lower heart chambers	Post-service	L051A	RN	0.51	Post service total costs		106	
33611	Repair of double outlet defect of right lower heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33611	Repair of double outlet defect of right lower heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33611	Repair of double outlet defect of right lower heart chamber	Post-service	L051A	RN	0.51	Post service total costs		53	
33612	Repair of double outlet defect and outflow track of right lower heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33612	Repair of double outlet defect and outflow track of right lower heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33612	Repair of double outlet defect and outflow track of right lower heart chamber	Post-service	L051A	RN	0.51	Post service total costs		53	
33615	Closure of congenital defect in wall between two upper heart chambers	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33615	Closure of congenital defect in wall between two upper heart chambers	Service  intra	L051A	RN	0.51	Service total costs		12	
33615	Closure of congenital defect in wall between two upper heart chambers	Post-service	L051A	RN	0.51	Post service total costs		89	
33617	Repair to improve congenital blood flow defect from right upper heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33617	Repair to improve congenital blood flow defect from right upper heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33617	Repair to improve congenital blood flow defect from right upper heart chamber	Post-service	L051A	RN	0.51	Post service total costs		89	
33619	Repair to improve congenital blood flow defect from single lower heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33619	Repair to improve congenital blood flow defect from single lower heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33619	Repair to improve congenital blood flow defect from single lower heart chamber	Post-service	L051A	RN	0.51	Post service total costs		160	
33620	"Placement of bands around the right and left pulmonary (lung) arteries, hybrid approach"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33620	"Placement of bands around the right and left pulmonary (lung) arteries, hybrid approach"	Service  intra	L051A	RN	0.51	Service total costs		12	
33620	"Placement of bands around the right and left pulmonary (lung) arteries, hybrid approach"	Post-service	L051A	RN	0.51	Post service total costs		36	
33621	Insertion of stent in defect between upper heart chambers	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33621	Insertion of stent in defect between upper heart chambers	Service  intra	L051A	RN	0.51	Service total costs		12	
33621	Insertion of stent in defect between upper heart chambers	Post-service	L051A	RN	0.51	Post service total costs		36	
33622	Reconstruction of complex cardiac defects	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33622	Reconstruction of complex cardiac defects	Service  intra	L051A	RN	0.51	Service total costs		12	
33622	Reconstruction of complex cardiac defects	Post-service	L051A	RN	0.51	Post service total costs		53	
33641	Repair of hole between upper heart chambers on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33641	Repair of hole between upper heart chambers on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33641	Repair of hole between upper heart chambers on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		53	
33645	Direct or patch closure of extra tissue between two upper heart chambers	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33645	Direct or patch closure of extra tissue between two upper heart chambers	Service  intra	L051A	RN	0.51	Service total costs		12	
33645	Direct or patch closure of extra tissue between two upper heart chambers	Post-service	L051A	RN	0.51	Post service total costs		53.5	
33647	Repair of congenital defect in wall between both upper and lower heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33647	Repair of congenital defect in wall between both upper and lower heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33647	Repair of congenital defect in wall between both upper and lower heart chamber	Post-service	L051A	RN	0.51	Post service total costs		53	
33660	Repair of congenital defect between both upper and lower heart chambers	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33660	Repair of congenital defect between both upper and lower heart chambers	Service  intra	L051A	RN	0.51	Service total costs		12	
33660	Repair of congenital defect between both upper and lower heart chambers	Post-service	L051A	RN	0.51	Post service total costs		53	
33665	Repair of congenital defect in valve between upper and lower heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33665	Repair of congenital defect in valve between upper and lower heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33665	Repair of congenital defect in valve between upper and lower heart chamber	Post-service	L051A	RN	0.51	Post service total costs		53	
33670	Repair of congenital valve defect between upper and lower heart chamber	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33670	Repair of congenital valve defect between upper and lower heart chamber	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33670	Repair of congenital valve defect between upper and lower heart chamber	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33675	Closure of congenital multiple opening defects in wall between two upper and lower heart chambers	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33675	Closure of congenital multiple opening defects in wall between two upper and lower heart chambers	Service  intra	L051A	RN	0.51	Service total costs		12	
33675	Closure of congenital multiple opening defects in wall between two upper and lower heart chambers	Post-service	L051A	RN	0.51	Post service total costs		53	
33676	Closure of congenital multiple opening defects in wall between two upper and lower heart chambers with release of valve tissue	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33676	Closure of congenital multiple opening defects in wall between two upper and lower heart chambers with release of valve tissue	Service  intra	L051A	RN	0.51	Service total costs		12	
33676	Closure of congenital multiple opening defects in wall between two upper and lower heart chambers with release of valve tissue	Post-service	L051A	RN	0.51	Post service total costs		53	
33677	Closure of congenital multiple opening defect in wall between two upper and lower heart chambers	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33677	Closure of congenital multiple opening defect in wall between two upper and lower heart chambers	Service  intra	L051A	RN	0.51	Service total costs		12	
33677	Closure of congenital multiple opening defect in wall between two upper and lower heart chambers	Post-service	L051A	RN	0.51	Post service total costs		53	
33681	Closure of congenital single opening in wall between lower heart chambers	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33681	Closure of congenital single opening in wall between lower heart chambers	Service  intra	L051A	RN	0.51	Service total costs		12	
33681	Closure of congenital single opening in wall between lower heart chambers	Post-service	L051A	RN	0.51	Post service total costs		125	
33684	Closure of congenital single opening in wall between lower heart chambers and release of valve tissue	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33684	Closure of congenital single opening in wall between lower heart chambers and release of valve tissue	Service  intra	L051A	RN	0.51	Service total costs		12	
33684	Closure of congenital single opening in wall between lower heart chambers and release of valve tissue	Post-service	L051A	RN	0.51	Post service total costs		53	
33688	Closure and reinforcement of congenital opening in wall between lower heart chambers	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33688	Closure and reinforcement of congenital opening in wall between lower heart chambers	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33688	Closure and reinforcement of congenital opening in wall between lower heart chambers	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		53	
33690	Banding pulmonary (lung) artery	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33690	Banding pulmonary (lung) artery	Service  intra	L051A	RN	0.51	Service total costs		12	
33690	Banding pulmonary (lung) artery	Post-service	L051A	RN	0.51	Post service total costs		106	
33692	Repair and correction of four congenital heart defects	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33692	Repair and correction of four congenital heart defects	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33692	Repair and correction of four congenital heart defects	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		53	
33694	Repair and correction of four congenital heart defects	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33694	Repair and correction of four congenital heart defects	Service  intra	L051A	RN	0.51	Service total costs		12	
33694	Repair and correction of four congenital heart defects	Post-service	L051A	RN	0.51	Post service total costs		53	
33697	Repair and correction of four congenital heart defects	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33697	Repair and correction of four congenital heart defects	Service  intra	L051A	RN	0.51	Service total costs		12	
33697	Repair and correction of four congenital heart defects	Post-service	L051A	RN	0.51	Post service total costs		53	
33702	Repair to improve blood flow to lung or heart on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33702	Repair to improve blood flow to lung or heart on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33702	Repair to improve blood flow to lung or heart on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		89	
33710	Repair of opening in wall between lower heart chambers on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33710	Repair of opening in wall between lower heart chambers on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33710	Repair of opening in wall between lower heart chambers on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		53	
33720	Repair of bulging vessel (aneurysm) above heart valve to lung on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33720	Repair of bulging vessel (aneurysm) above heart valve to lung on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33720	Repair of bulging vessel (aneurysm) above heart valve to lung on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		89	
33722	Repair of extra blood flow tract from left heart chamber to aorta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33722	Repair of extra blood flow tract from left heart chamber to aorta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33722	Repair of extra blood flow tract from left heart chamber to aorta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
33724	Repair of abnormal lung vein blood return to left upper heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33724	Repair of abnormal lung vein blood return to left upper heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33724	Repair of abnormal lung vein blood return to left upper heart chamber	Post-service	L051A	RN	0.51	Post service total costs		53	
33726	Repair of abnormal blockage of pulmonary (lung) vein to left upper heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33726	Repair of abnormal blockage of pulmonary (lung) vein to left upper heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33726	Repair of abnormal blockage of pulmonary (lung) vein to left upper heart chamber	Post-service	L051A	RN	0.51	Post service total costs		53	
33730	Repair of abnormal pulmonary (lung) vein blood flow to left upper heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33730	Repair of abnormal pulmonary (lung) vein blood flow to left upper heart chamber	Service  intra	L051A	RN	0.51	Service total costs		6	
33730	Repair of abnormal pulmonary (lung) vein blood flow to left upper heart chamber	Post-service	L051A	RN	0.51	Post service total costs		89	
33732	Removal of congenital membrane at left upper heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33732	Removal of congenital membrane at left upper heart chamber	Service  intra	L051A	RN	0.51	Service total costs		12	
33732	Removal of congenital membrane at left upper heart chamber	Post-service	L051A	RN	0.51	Post service total costs		106	
33735	"Balloon enlargement of wall between two upper heart chambers, closed heart procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33735	"Balloon enlargement of wall between two upper heart chambers, closed heart procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
33735	"Balloon enlargement of wall between two upper heart chambers, closed heart procedure"	Post-service	L051A	RN	0.51	Post service total costs		106	
33736	"Enlargement of wall between two upper heart chambers, open heart procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33736	"Enlargement of wall between two upper heart chambers, open heart procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
33736	"Enlargement of wall between two upper heart chambers, open heart procedure"	Post-service	L051A	RN	0.51	Post service total costs		106	
33737	"Enlargement of wall between two upper heart chambers with correction of blood flow, open heart procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33737	"Enlargement of wall between two upper heart chambers with correction of blood flow, open heart procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
33737	"Enlargement of wall between two upper heart chambers with correction of blood flow, open heart procedure"	Post-service	L051A	RN	0.51	Post service total costs		89	
33750	Placement of shunt from a chest artery to pulmonary (lung) artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33750	Placement of shunt from a chest artery to pulmonary (lung) artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33750	Placement of shunt from a chest artery to pulmonary (lung) artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
33755	Placement of shunt from the aorta to pulmonary (lung) artery	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33755	Placement of shunt from the aorta to pulmonary (lung) artery	Service  intra	L051A	RN	0.51	Service total costs		12	
33755	Placement of shunt from the aorta to pulmonary (lung) artery	Post-service	L051A	RN	0.51	Post service total costs		106	
33762	Placement of shunt from the aorta to pulmonary (lung) artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33762	Placement of shunt from the aorta to pulmonary (lung) artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33762	Placement of shunt from the aorta to pulmonary (lung) artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
33764	Placement of shunt and artificial graft from the aorta to pulmonary (lung) artery	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33764	Placement of shunt and artificial graft from the aorta to pulmonary (lung) artery	Service  intra	L051A	RN	0.51	Service total costs		12	
33764	Placement of shunt and artificial graft from the aorta to pulmonary (lung) artery	Post-service	L051A	RN	0.51	Post service total costs		106	
33766	Placement of shunt from vena cava to pulmonary (lung) artery to improve blood flow to lung	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33766	Placement of shunt from vena cava to pulmonary (lung) artery to improve blood flow to lung	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33766	Placement of shunt from vena cava to pulmonary (lung) artery to improve blood flow to lung	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
33767	Placement of shunt from vena cava to pulmonary (lung) artery to improve blood flow to lung	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33767	Placement of shunt from vena cava to pulmonary (lung) artery to improve blood flow to lung	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33767	Placement of shunt from vena cava to pulmonary (lung) artery to improve blood flow to lung	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
33770	Repair of a group of congenital heart defects with reversal of blood flow	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33770	Repair of a group of congenital heart defects with reversal of blood flow	Service  intra	L051A	RN	0.51	Service total costs		6	
33770	Repair of a group of congenital heart defects with reversal of blood flow	Post-service	L051A	RN	0.51	Post service total costs		36	
33771	Repair of a group of congenital heart defects with reversal of blood flow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33771	Repair of a group of congenital heart defects with reversal of blood flow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33771	Repair of a group of congenital heart defects with reversal of blood flow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33774	Repair of a group of congenital heart defects with reversal of blood flow on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33774	Repair of a group of congenital heart defects with reversal of blood flow on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33774	Repair of a group of congenital heart defects with reversal of blood flow on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		116	
33775	Repair of a group of congenital heart defects with reversal of blood flow on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33775	Repair of a group of congenital heart defects with reversal of blood flow on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		6	
33775	Repair of a group of congenital heart defects with reversal of blood flow on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		106	
33776	Repair of a group of congenital heart defects with reversal of blood flow on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33776	Repair of a group of congenital heart defects with reversal of blood flow on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		6	
33776	Repair of a group of congenital heart defects with reversal of blood flow on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		126	
33777	Repair of a group of congenital heart defects with reversal of blood flow on heart-lung machine	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33777	Repair of a group of congenital heart defects with reversal of blood flow on heart-lung machine	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33777	Repair of a group of congenital heart defects with reversal of blood flow on heart-lung machine	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
33778	Repair of a group of congenital heart defects with redirection of blood flow	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33778	Repair of a group of congenital heart defects with redirection of blood flow	Service  intra	L051A	RN	0.51	Service total costs		6	
33778	Repair of a group of congenital heart defects with redirection of blood flow	Post-service	L051A	RN	0.51	Post service total costs		89	
33779	Repair of a group of congenital heart defects with redirection of blood flow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33779	Repair of a group of congenital heart defects with redirection of blood flow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33779	Repair of a group of congenital heart defects with redirection of blood flow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		53	
33780	Repair of a group of congenital heart defects with redirection of blood flow	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33780	Repair of a group of congenital heart defects with redirection of blood flow	Service  intra	L051A	RN	0.51	Service total costs		6	
33780	Repair of a group of congenital heart defects with redirection of blood flow	Post-service	L051A	RN	0.51	Post service total costs		36	
33781	Repair of a group of congenital heart defects with redirection of blood flow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33781	Repair of a group of congenital heart defects with redirection of blood flow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33781	Repair of a group of congenital heart defects with redirection of blood flow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
33782	Relocation of aorta and repair of wall between two lower heart chambers	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33782	Relocation of aorta and repair of wall between two lower heart chambers	Service  intra	L051A	RN	0.51	Service total costs		12	
33782	Relocation of aorta and repair of wall between two lower heart chambers	Post-service	L051A	RN	0.51	Post service total costs		53	
33783	Relocation of aorta and repair of wall between two lower heart chambers	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33783	Relocation of aorta and repair of wall between two lower heart chambers	Service  intra	L051A	RN	0.51	Service total costs		12	
33783	Relocation of aorta and repair of wall between two lower heart chambers	Post-service	L051A	RN	0.51	Post service total costs		53	
33786	Repair of a group of congenital heart defects with redirection of blood flow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33786	Repair of a group of congenital heart defects with redirection of blood flow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33786	Repair of a group of congenital heart defects with redirection of blood flow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		89	
33788	Reimplantation of abnormal pulmonary (lung) artery to heart	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33788	Reimplantation of abnormal pulmonary (lung) artery to heart	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33788	Reimplantation of abnormal pulmonary (lung) artery to heart	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
33800	Suture of aorta to chest bone	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33800	Suture of aorta to chest bone	Service  intra	L051A	RN	0.51	Service total costs		12	
33800	Suture of aorta to chest bone	Post-service	L051A	RN	0.51	Post service total costs		36	
33802	Division of extra arch of aorta	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33802	Division of extra arch of aorta	Service  intra	L051A	RN	0.51	Service total costs		12	
33802	Division of extra arch of aorta	Post-service	L051A	RN	0.51	Post service total costs		89	
33803	Division and reconnection of extra arch of aorta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33803	Division and reconnection of extra arch of aorta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
33803	Division and reconnection of extra arch of aorta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		89	
33813	Repair of defect of wall between aorta and pulmonary (lung) artery	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33813	Repair of defect of wall between aorta and pulmonary (lung) artery	Service  intra	L051A	RN	0.51	Service total costs		12	
33813	Repair of defect of wall between aorta and pulmonary (lung) artery	Post-service	L051A	RN	0.51	Post service total costs		89	
33814	Repair of defect of wall between two lower heart chambers on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33814	Repair of defect of wall between two lower heart chambers on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33814	Repair of defect of wall between two lower heart chambers on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		106	
33820	Tying off congenital blood flow tract defect	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33820	Tying off congenital blood flow tract defect	Service  intra	L051A	RN	0.51	Service total costs		12	
33820	Tying off congenital blood flow tract defect	Post-service	L051A	RN	0.51	Post service total costs		53	
33822	"Repair of congenital heart defect from pulmonary (lung) artery to aorta, patient younger than 18 years"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33822	"Repair of congenital heart defect from pulmonary (lung) artery to aorta, patient younger than 18 years"	Service  intra	L051A	RN	0.51	Service total costs		12	
33822	"Repair of congenital heart defect from pulmonary (lung) artery to aorta, patient younger than 18 years"	Post-service	L051A	RN	0.51	Post service total costs		53	
33824	"Repair of congenital heart defect from pulmonary (lung) artery to aorta, patient 18 years and older"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33824	"Repair of congenital heart defect from pulmonary (lung) artery to aorta, patient 18 years and older"	Service  intra	L051A	RN	0.51	Service total costs		12	
33824	"Repair of congenital heart defect from pulmonary (lung) artery to aorta, patient 18 years and older"	Post-service	L051A	RN	0.51	Post service total costs		89	
33840	Repair of congenital narrowing of aorta and pulmonary (lung) artery to aorta	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33840	Repair of congenital narrowing of aorta and pulmonary (lung) artery to aorta	Service  intra	L051A	RN	0.51	Service total costs		12	
33840	Repair of congenital narrowing of aorta and pulmonary (lung) artery to aorta	Post-service	L051A	RN	0.51	Post service total costs		89	
33845	Repair of narrowed aorta with graft	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33845	Repair of narrowed aorta with graft	Service  intra	L051A	RN	0.51	Service total costs		12	
33845	Repair of narrowed aorta with graft	Post-service	L051A	RN	0.51	Post service total costs		106	
33851	Repair of narrowed aorta using left chest artery or prosthetic material	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33851	Repair of narrowed aorta using left chest artery or prosthetic material	Service  intra	L051A	RN	0.51	Service total costs		12	
33851	Repair of narrowed aorta using left chest artery or prosthetic material	Post-service	L051A	RN	0.51	Post service total costs		89	
33852	Repair of abnormal aortic arch	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33852	Repair of abnormal aortic arch	Service  intra	L051A	RN	0.51	Service total costs		12	
33852	Repair of abnormal aortic arch	Post-service	L051A	RN	0.51	Post service total costs		89	
33853	Repair of abnormal aortic arch on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33853	Repair of abnormal aortic arch on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33853	Repair of abnormal aortic arch on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		106	
33860	Placement of graft to aorta on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33860	Placement of graft to aorta on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33860	Placement of graft to aorta on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		89	
33863	Placement of graft to aorta on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33863	Placement of graft to aorta on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33863	Placement of graft to aorta on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		53	
33864	Placement of graft to aorta on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33864	Placement of graft to aorta on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33864	Placement of graft to aorta on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		53	
33870	Placement of graft to aorta on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33870	Placement of graft to aorta on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33870	Placement of graft to aorta on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		99	
33875	Placement of graft to first portion of aorta	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33875	Placement of graft to first portion of aorta	Service  intra	L051A	RN	0.51	Service total costs		15	
33875	Placement of graft to first portion of aorta	Post-service	L051A	RN	0.51	Post service total costs		89	
33877	Repair of bulging defect (aneurysm) of aorta	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33877	Repair of bulging defect (aneurysm) of aorta	Service  intra	L051A	RN	0.51	Service total costs		12	
33877	Repair of bulging defect (aneurysm) of aorta	Post-service	L051A	RN	0.51	Post service total costs		125	
33880	Repair of defect of aorta in chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33880	Repair of defect of aorta in chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33880	Repair of defect of aorta in chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
33881	Repair of defect of aorta in chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33881	Repair of defect of aorta in chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33881	Repair of defect of aorta in chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
33883	Repair of defect of aorta in chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33883	Repair of defect of aorta in chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33883	Repair of defect of aorta in chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
33886	Repair of defect of aorta in chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33886	Repair of defect of aorta in chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33886	Repair of defect of aorta in chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
33910	Removal of blood clot in pulmonary (lung) artery on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33910	Removal of blood clot in pulmonary (lung) artery on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33910	Removal of blood clot in pulmonary (lung) artery on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		89.5	
33915	Removal of blood clot in pulmonary (lung) artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33915	Removal of blood clot in pulmonary (lung) artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33915	Removal of blood clot in pulmonary (lung) artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		80	
33916	Removal of plaque from pulmonary (lung) artery on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33916	Removal of plaque from pulmonary (lung) artery on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33916	Removal of plaque from pulmonary (lung) artery on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		89.5	
33917	Repair of narrowing of pulmonary (lung) artery on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33917	Repair of narrowing of pulmonary (lung) artery on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33917	Repair of narrowing of pulmonary (lung) artery on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		106	
33920	Removal of obstructive material from wall between two lower heart chambers	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
33920	Removal of obstructive material from wall between two lower heart chambers	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
33920	Removal of obstructive material from wall between two lower heart chambers	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
33922	Incision of lung artery on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33922	Incision of lung artery on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33922	Incision of lung artery on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		89	
33925	Repair of defect of pulmonary (lung) artery	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33925	Repair of defect of pulmonary (lung) artery	Service  intra	L051A	RN	0.51	Service total costs		12	
33925	Repair of defect of pulmonary (lung) artery	Post-service	L051A	RN	0.51	Post service total costs		36	
33926	Repair of defect of pulmonary (lung) artery on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33926	Repair of defect of pulmonary (lung) artery on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
33926	Repair of defect of pulmonary (lung) artery on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		36	
33935	Transplantation of donor heart and lung	Pre-service	L051A	RN	0.51	Preservice total costs		90	
33935	Transplantation of donor heart and lung	Service  intra	L051A	RN	0.51	Service total costs		15	
33935	Transplantation of donor heart and lung	Post-service	L051A	RN	0.51	Post service total costs		152	
33945	Transplantation of donor heart	Pre-service	L051A	RN	0.51	Preservice total costs		90	
33945	Transplantation of donor heart	Service  intra	L051A	RN	0.51	Service total costs		12	
33945	Transplantation of donor heart	Post-service	L051A	RN	0.51	Post service total costs		152	
33951	"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support ecls) provided by physician;insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33952	"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support ecls) provided by physician;insertion of central cannula(e) by sternotomy or thoracotomy, 6 years and older"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33953	"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support ecls) provided by physician;insertion of peripheral (arterial and/or venous) cannula(e), open birth through 5 years of age  "	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33954	"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support ecls) provided by physician;insertion of peripheral (arterial and/or venous) cannula(e), open, 6 years and older"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33955	"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support ecls) provided by physician;insertion of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33956	"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, 6 years and older"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33957	"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous,  birth through 5 years of age (includes fluoroscopic guidance, when performed)"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33958	"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous,  6 years and older (includes fluoroscopic guidance, when performed)"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33959	"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age (includes fluoroscopic guidance, when performed)"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33962	"Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula, open, 6 years and older (includes fluoroscopic guidance, when performed)"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33963	"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support ecls) provided by physician;reposition of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33964	"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support ecls) provided by physician;reposition central cannula(e) by sternotomy or thoracotomy, 6 years and older"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33965	"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support ecls) provided by physician;removal of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33966	"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support ecls) provided by physician;removal of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33969	"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support ecls) provided by physician;removal of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33971	Removal of blood flow assist device in aorta	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33971	Removal of blood flow assist device in aorta	Service  intra	L051A	RN	0.51	Service total costs		12	
33971	Removal of blood flow assist device in aorta	Post-service	L051A	RN	0.51	Post service total costs		53	
33974	Removal of blood flow assist device and repair of aorta	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33974	Removal of blood flow assist device and repair of aorta	Service  intra	L051A	RN	0.51	Service total costs		12	
33974	Removal of blood flow assist device and repair of aorta	Post-service	L051A	RN	0.51	Post service total costs		72	
33977	Removal of assistive blood flow device from one lower heart chamber	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33978	Removal of assistive blood flow device from both lower heart chambers	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33980	Removal of lower heart chamber assistive blood flow device	Pre-service	L051A	RN	0.51	Preservice total costs		60	
33984	"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support ecls) provided by physician;removal of peripheral (arterial and/or venous) cannula(e), open, 6 years and older"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33985	"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support ecls) provided by physician;removal of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33986	"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support ecls) provided by physician;removal of central cannula(e) by sternotomy or thoracotomy, 6 years and older"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33988	Insertion of left heart vent by thoracic incision for ecmo/ecls	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
33989	Removal of left heart vent by thoracic incision for ecmo/ecls	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
34001	Removal of blood clot in artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34001	Removal of blood clot in artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34001	Removal of blood clot in artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
34051	Removal of blood clot in artery	Pre-service	L051A	RN	0.51	Preservice total costs		60	
34051	Removal of blood clot in artery	Service  intra	L051A	RN	0.51	Service total costs		12	
34051	Removal of blood clot in artery	Post-service	L051A	RN	0.51	Post service total costs		68	
34101	Removal of blood clot in artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34101	Removal of blood clot in artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34101	Removal of blood clot in artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
34111	Removal of blood clot in artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34111	Removal of blood clot in artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34111	Removal of blood clot in artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
34151	Removal of blood clot in artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34151	Removal of blood clot in artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34151	Removal of blood clot in artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
34201	Removal of blood clot in artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34201	Removal of blood clot in artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34201	Removal of blood clot in artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
34203	Removal of blood clot in artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34203	Removal of blood clot in artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34203	Removal of blood clot in artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
34401	Removal of blood clot in vena cava	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34401	Removal of blood clot in vena cava	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34401	Removal of blood clot in vena cava	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
34421	"Removal of blood clot in vena cava, pelvic or thigh artery"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34421	"Removal of blood clot in vena cava, pelvic or thigh artery"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34421	"Removal of blood clot in vena cava, pelvic or thigh artery"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
34451	"Removal of blood clot in vena cava, pelvic or thigh artery"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34451	"Removal of blood clot in vena cava, pelvic or thigh artery"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34451	"Removal of blood clot in vena cava, pelvic or thigh artery"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
34471	Removal of blood clot in neck vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34471	Removal of blood clot in neck vein	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34471	Removal of blood clot in neck vein	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
34490	Removal of blood clot in underarm or upper chest vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34490	Removal of blood clot in underarm or upper chest vein	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
34490	Removal of blood clot in underarm or upper chest vein	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
34501	Repair of upper leg vein valve	Pre-service	L051A	RN	0.51	Preservice total costs		60	
34501	Repair of upper leg vein valve	Service  intra	L051A	RN	0.51	Service total costs		12	
34501	Repair of upper leg vein valve	Post-service	L051A	RN	0.51	Post service total costs		90	
34502	Reconstruction of vena cava	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34502	Reconstruction of vena cava	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34502	Reconstruction of vena cava	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		142	
34510	Relocation of vein valve to another vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34510	Relocation of vein valve to another vein	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34510	Relocation of vein valve to another vein	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
34520	Removal of vein segment due to nonfunctioning valves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34520	Removal of vein segment due to nonfunctioning valves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34520	Removal of vein segment due to nonfunctioning valves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
34530	Connection of two leg veins at back of knee	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34530	Connection of two leg veins at back of knee	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34530	Connection of two leg veins at back of knee	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
34800	Repair of bulging (aneurysm) wall or tear in abdominal aorta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34800	Repair of bulging (aneurysm) wall or tear in abdominal aorta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34800	Repair of bulging (aneurysm) wall or tear in abdominal aorta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
34802	Repair of bulging (aneurysm) or tear in abdominal aorta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34802	Repair of bulging (aneurysm) or tear in abdominal aorta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34802	Repair of bulging (aneurysm) or tear in abdominal aorta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
34803	Repair of bulging (aneurysm) or tear in abdominal aorta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34803	Repair of bulging (aneurysm) or tear in abdominal aorta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34803	Repair of bulging (aneurysm) or tear in abdominal aorta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
34804	Repair of bulging (aneurysm) or tear in abdominal aorta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34804	Repair of bulging (aneurysm) or tear in abdominal aorta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34804	Repair of bulging (aneurysm) or tear in abdominal aorta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
34805	Repair of bulging (aneurysm) or tear in abdominal aorta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34805	Repair of bulging (aneurysm) or tear in abdominal aorta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34805	Repair of bulging (aneurysm) or tear in abdominal aorta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
34825	Insertion of prosthetic repair of bulging (aneurysm) abdominal or groin artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34825	Insertion of prosthetic repair of bulging (aneurysm) abdominal or groin artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34825	Insertion of prosthetic repair of bulging (aneurysm) abdominal or groin artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
34830	"Repair of bulging (aneurysm) of aorta with prosthesis, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34830	"Repair of bulging (aneurysm) of aorta with prosthesis, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34830	"Repair of bulging (aneurysm) of aorta with prosthesis, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
34831	"Repair of bulging (aneurysm) of aorta or groin arteries with prosthesis, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34831	"Repair of bulging (aneurysm) of aorta or groin arteries with prosthesis, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34831	"Repair of bulging (aneurysm) of aorta or groin arteries with prosthesis, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
34832	"Repair of bulging (aneurysm) of aorta or upper thigh arteries with prosthesis, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34832	"Repair of bulging (aneurysm) of aorta or upper thigh arteries with prosthesis, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
34832	"Repair of bulging (aneurysm) of aorta or upper thigh arteries with prosthesis, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
34833	"Incision of artery in one groin for insertion of prosthesis, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		25	
34833	"Incision of artery in one groin for insertion of prosthesis, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
34834	"Incision of artery in one arm for insertion of prosthesis, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		25	
34834	"Incision of artery in one arm for insertion of prosthesis, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
34900	Placement of graft for repair of groin artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
34900	Placement of graft for repair of groin artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
34900	Placement of graft for repair of groin artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
35001	Repair of diseased or bulging (aneurysm) artery of neck or upper chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35001	Repair of diseased or bulging (aneurysm) artery of neck or upper chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35001	Repair of diseased or bulging (aneurysm) artery of neck or upper chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
35002	Repair of diseased or ruptured bulging (aneurysm) artery of neck or upper chest	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35002	Repair of diseased or ruptured bulging (aneurysm) artery of neck or upper chest	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35002	Repair of diseased or ruptured bulging (aneurysm) artery of neck or upper chest	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
35005	Repair of diseased or bulging (aneurysm) artery of head	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35005	Repair of diseased or bulging (aneurysm) artery of head	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35005	Repair of diseased or bulging (aneurysm) artery of head	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
35011	Repair of diseased or bulging (aneurysm) artery of arm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35011	Repair of diseased or bulging (aneurysm) artery of arm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35011	Repair of diseased or bulging (aneurysm) artery of arm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35013	Repair of diseased or ruptured bulging (aneurysm) artery of arm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35013	Repair of diseased or ruptured bulging (aneurysm) artery of arm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35013	Repair of diseased or ruptured bulging (aneurysm) artery of arm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35021	Repair of diseased or bulging (aneurysm) artery of upper chest or neck	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35021	Repair of diseased or bulging (aneurysm) artery of upper chest or neck	Service  intra	L051A	RN	0.51	Service total costs		12	
35021	Repair of diseased or bulging (aneurysm) artery of upper chest or neck	Post-service	L051A	RN	0.51	Post service total costs		68	
35022	Repair of diseased or ruptured bulging (aneurysm) artery of upper chest or neck	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35022	Repair of diseased or ruptured bulging (aneurysm) artery of upper chest or neck	Service  intra	L051A	RN	0.51	Service total costs		12	
35022	Repair of diseased or ruptured bulging (aneurysm) artery of upper chest or neck	Post-service	L051A	RN	0.51	Post service total costs		68	
35045	Repair of diseased or bulging (aneurysm) artery of forearm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35045	Repair of diseased or bulging (aneurysm) artery of forearm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35045	Repair of diseased or bulging (aneurysm) artery of forearm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		50	
35081	Repair of diseased or bulging (aneurysm) artery of abdominal aorta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35081	Repair of diseased or bulging (aneurysm) artery of abdominal aorta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35081	Repair of diseased or bulging (aneurysm) artery of abdominal aorta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
35082	Repair of diseased or ruptured bulging (aneurysm) artery of abdominal aorta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35082	Repair of diseased or ruptured bulging (aneurysm) artery of abdominal aorta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35082	Repair of diseased or ruptured bulging (aneurysm) artery of abdominal aorta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
35091	Repair of diseased or bulging (aneurysm) artery of abdominal organ	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35091	Repair of diseased or bulging (aneurysm) artery of abdominal organ	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35091	Repair of diseased or bulging (aneurysm) artery of abdominal organ	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		40	
35092	Repair of diseased or ruptured bulging (aneurysm) artery of abdominal organ	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35092	Repair of diseased or ruptured bulging (aneurysm) artery of abdominal organ	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35092	Repair of diseased or ruptured bulging (aneurysm) artery of abdominal organ	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
35102	Repair of diseased or ruptured bulging (aneurysm) of abdominal aorta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35102	Repair of diseased or ruptured bulging (aneurysm) of abdominal aorta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35102	Repair of diseased or ruptured bulging (aneurysm) of abdominal aorta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
35103	Repair of diseased or ruptured bulging (aneurysm) of abdominal aorta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35103	Repair of diseased or ruptured bulging (aneurysm) of abdominal aorta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35103	Repair of diseased or ruptured bulging (aneurysm) of abdominal aorta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35111	Repair of diseased or bulging (aneurysm) artery of spleen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35111	Repair of diseased or bulging (aneurysm) artery of spleen	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35111	Repair of diseased or bulging (aneurysm) artery of spleen	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
35112	Repair of diseased or ruptured bulging (aneurysm) artery of spleen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35112	Repair of diseased or ruptured bulging (aneurysm) artery of spleen	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35112	Repair of diseased or ruptured bulging (aneurysm) artery of spleen	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35121	Repair of diseased or bulging (aneurysm) artery of abdominal organ	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35121	Repair of diseased or bulging (aneurysm) artery of abdominal organ	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35121	Repair of diseased or bulging (aneurysm) artery of abdominal organ	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
35122	Repair of diseased or ruptured bulging (aneurysm) artery of abdominal organ	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35122	Repair of diseased or ruptured bulging (aneurysm) artery of abdominal organ	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35122	Repair of diseased or ruptured bulging (aneurysm) artery of abdominal organ	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35131	Repair of diseased or bulging (aneurysm) artery of groin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35131	Repair of diseased or bulging (aneurysm) artery of groin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35131	Repair of diseased or bulging (aneurysm) artery of groin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
35132	Repair of diseased or ruptured bulging (aneurysm) artery of groin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35132	Repair of diseased or ruptured bulging (aneurysm) artery of groin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35132	Repair of diseased or ruptured bulging (aneurysm) artery of groin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35141	Repair of diseased or bulging (aneurysm) artery of upper thigh	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35141	Repair of diseased or bulging (aneurysm) artery of upper thigh	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35141	Repair of diseased or bulging (aneurysm) artery of upper thigh	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35142	Repair of diseased or ruptured bulging (aneurysm) artery of upper thigh	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35142	Repair of diseased or ruptured bulging (aneurysm) artery of upper thigh	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35142	Repair of diseased or ruptured bulging (aneurysm) artery of upper thigh	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35151	Repair of diseased or bulging (aneurysm) artery of lower leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35151	Repair of diseased or bulging (aneurysm) artery of lower leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35151	Repair of diseased or bulging (aneurysm) artery of lower leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
35152	Repair of diseased or ruptured bulging (aneurysm) artery of lower leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35152	Repair of diseased or ruptured bulging (aneurysm) artery of lower leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35152	Repair of diseased or ruptured bulging (aneurysm) artery of lower leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35180	Repair of congenital abnormal blood vessel of head and neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35180	Repair of congenital abnormal blood vessel of head and neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
35180	Repair of congenital abnormal blood vessel of head and neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
35182	Repair of congenital abnormal artery-vein connection in chest and abdomen	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35182	Repair of congenital abnormal artery-vein connection in chest and abdomen	Service  intra	L051A	RN	0.51	Service total costs		12	
35182	Repair of congenital abnormal artery-vein connection in chest and abdomen	Post-service	L051A	RN	0.51	Post service total costs		99	
35184	Repair of congenital abnormal artery-vein connection in arms or legs	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35184	Repair of congenital abnormal artery-vein connection in arms or legs	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35184	Repair of congenital abnormal artery-vein connection in arms or legs	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		77	
35188	Repair of abnormal artery and vein connection of head and neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35188	Repair of abnormal artery and vein connection of head and neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35188	Repair of abnormal artery and vein connection of head and neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63.5	
35189	Repair of abnormal artery-vein connection in chest and abdomen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35189	Repair of abnormal artery-vein connection in chest and abdomen	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35189	Repair of abnormal artery-vein connection in chest and abdomen	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35190	Repair of abnormal artery-vein connection in arms or legs	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35190	Repair of abnormal artery-vein connection in arms or legs	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35190	Repair of abnormal artery-vein connection in arms or legs	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
35201	Repair of blood vessel of neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35201	Repair of blood vessel of neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35201	Repair of blood vessel of neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
35206	Repair of blood vessel of arm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35206	Repair of blood vessel of arm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35206	Repair of blood vessel of arm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35207	Repair of blood vessel of hand or finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35207	Repair of blood vessel of hand or finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
35207	Repair of blood vessel of hand or finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
35211	Repair of blood vessel of chest on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35211	Repair of blood vessel of chest on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
35211	Repair of blood vessel of chest on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		68	
35216	Repair of blood vessel of chest	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35216	Repair of blood vessel of chest	Service  intra	L051A	RN	0.51	Service total costs		12	
35216	Repair of blood vessel of chest	Post-service	L051A	RN	0.51	Post service total costs		105	
35221	Repair of blood vessel of abdomen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35221	Repair of blood vessel of abdomen	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35221	Repair of blood vessel of abdomen	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35226	Repair of blood vessel of leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35226	Repair of blood vessel of leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35226	Repair of blood vessel of leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35231	Repair of blood vessel of neck with vein graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35231	Repair of blood vessel of neck with vein graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35231	Repair of blood vessel of neck with vein graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35236	Repair of blood vessel of arm with vein graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35236	Repair of blood vessel of arm with vein graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35236	Repair of blood vessel of arm with vein graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35241	Repair of blood vessel of chest with vein graft on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35241	Repair of blood vessel of chest with vein graft on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
35241	Repair of blood vessel of chest with vein graft on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		68	
35246	Repair of blood vessel in chest with vein graft	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35246	Repair of blood vessel in chest with vein graft	Service  intra	L051A	RN	0.51	Service total costs		12	
35246	Repair of blood vessel in chest with vein graft	Post-service	L051A	RN	0.51	Post service total costs		63	
35251	Repair of blood vessel of abdomen with vein graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35251	Repair of blood vessel of abdomen with vein graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35251	Repair of blood vessel of abdomen with vein graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35256	Repair of blood vessel of leg with vein graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35256	Repair of blood vessel of leg with vein graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35256	Repair of blood vessel of leg with vein graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35261	Repair of blood vessel of neck with graft	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35261	Repair of blood vessel of neck with graft	Service  intra	L051A	RN	0.51	Service total costs		12	
35261	Repair of blood vessel of neck with graft	Post-service	L051A	RN	0.51	Post service total costs		63	
35266	Repair of blood vessel of arm with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35266	Repair of blood vessel of arm with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35266	Repair of blood vessel of arm with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35271	Repair of blood vessel of chest with graft on heart-lung machine	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35271	Repair of blood vessel of chest with graft on heart-lung machine	Service  intra	L051A	RN	0.51	Service total costs		12	
35271	Repair of blood vessel of chest with graft on heart-lung machine	Post-service	L051A	RN	0.51	Post service total costs		68	
35276	Repair of blood vessel of chest with graft	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35276	Repair of blood vessel of chest with graft	Service  intra	L051A	RN	0.51	Service total costs		12	
35276	Repair of blood vessel of chest with graft	Post-service	L051A	RN	0.51	Post service total costs		81	
35281	Repair of blood vessel of abdomen with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35281	Repair of blood vessel of abdomen with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35281	Repair of blood vessel of abdomen with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35286	Repair of blood vessel of leg with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35286	Repair of blood vessel of leg with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35286	Repair of blood vessel of leg with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35301	Removal of blood clot and portion of artery of neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35301	Removal of blood clot and portion of artery of neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35301	Removal of blood clot and portion of artery of neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
35302	Removal of blood clot and portion of artery of upper thigh	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35302	Removal of blood clot and portion of artery of upper thigh	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35302	Removal of blood clot and portion of artery of upper thigh	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35303	Removal of blood clot and portion of artery of lower leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35303	Removal of blood clot and portion of artery of lower leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35303	Removal of blood clot and portion of artery of lower leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35304	Removal of blood clot and portion of artery of lower leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35304	Removal of blood clot and portion of artery of lower leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35304	Removal of blood clot and portion of artery of lower leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35305	Removal of blood clot and portion of artery of lower leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35305	Removal of blood clot and portion of artery of lower leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35305	Removal of blood clot and portion of artery of lower leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35311	Removal of blood clot and portion of artery of neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35311	Removal of blood clot and portion of artery of neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35311	Removal of blood clot and portion of artery of neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35321	Removal of blood clot and portion of artery of upper arm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35321	Removal of blood clot and portion of artery of upper arm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35321	Removal of blood clot and portion of artery of upper arm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35331	Removal of blood clot and portion of artery of abdominal aorta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35331	Removal of blood clot and portion of artery of abdominal aorta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35331	Removal of blood clot and portion of artery of abdominal aorta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
35341	Removal of blood clot and portion of artery of abdominal organ	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35341	Removal of blood clot and portion of artery of abdominal organ	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35341	Removal of blood clot and portion of artery of abdominal organ	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
35351	Removal of blood clot and portion of artery of groin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35351	Removal of blood clot and portion of artery of groin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35351	Removal of blood clot and portion of artery of groin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35355	Removal of blood clot and portion of artery of upper thigh	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35355	Removal of blood clot and portion of artery of upper thigh	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35355	Removal of blood clot and portion of artery of upper thigh	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35361	Removal of blood clot and portion of artery of abdominal aorta and groin artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35361	Removal of blood clot and portion of artery of abdominal aorta and groin artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35361	Removal of blood clot and portion of artery of abdominal aorta and groin artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35363	Removal of blood clot and portion of artery of abdominal aorta and upper thigh artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35363	Removal of blood clot and portion of artery of abdominal aorta and upper thigh artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35363	Removal of blood clot and portion of artery of abdominal aorta and upper thigh artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35371	Removal of blood clot and portion of artery of upper thigh artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35371	Removal of blood clot and portion of artery of upper thigh artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35371	Removal of blood clot and portion of artery of upper thigh artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35372	Removal of blood clot and portion of artery of upper thigh artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35372	Removal of blood clot and portion of artery of upper thigh artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35372	Removal of blood clot and portion of artery of upper thigh artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35450	"Balloon dilation of narrowed or blocked kidney or abdominal organ artery, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		20	
35450	"Balloon dilation of narrowed or blocked kidney or abdominal organ artery, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
35452	"Balloon dilation of narrowed or blocked aorta, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		20	
35452	"Balloon dilation of narrowed or blocked aorta, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
35458	"Balloon dilation of narrowed or blocked upper arm artery, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		20	
35458	"Balloon dilation of narrowed or blocked upper arm artery, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
35460	"Balloon dilation of narrowed or blocked vein, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		20	
35460	"Balloon dilation of narrowed or blocked vein, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
35471	"Balloon dilation of narrowed or blocked organ artery, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	23	
35471	"Balloon dilation of narrowed or blocked organ artery, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	81	0	
35471	"Balloon dilation of narrowed or blocked organ artery, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	161	0	
35471	"Balloon dilation of narrowed or blocked organ artery, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
35471	"Balloon dilation of narrowed or blocked organ artery, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
35472	"Balloon dilation of narrowed or blocked aorta, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	23	
35472	"Balloon dilation of narrowed or blocked aorta, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	77	0	
35472	"Balloon dilation of narrowed or blocked aorta, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	102	0	
35472	"Balloon dilation of narrowed or blocked aorta, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
35472	"Balloon dilation of narrowed or blocked aorta, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
35475	"Balloon dilation of narrowed or blocked upper arm artery, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	21	
35475	"Balloon dilation of narrowed or blocked upper arm artery, accessed through the skin"	Service  intra	L041A	Angio Technician	0.41	Service total costs	43	0	
35475	"Balloon dilation of narrowed or blocked upper arm artery, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	42	0	
35475	"Balloon dilation of narrowed or blocked upper arm artery, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	75	0	
35475	"Balloon dilation of narrowed or blocked upper arm artery, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25	0	
35476	"Balloon dilation of narrowed or blocked vein, accessed through the skin"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	0	21	
35476	"Balloon dilation of narrowed or blocked vein, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	21	
35476	"Balloon dilation of narrowed or blocked vein, accessed through the skin"	Service  intra	L041A	Angio Technician	0.41	Service total costs	35	0	
35476	"Balloon dilation of narrowed or blocked vein, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	33	0	
35476	"Balloon dilation of narrowed or blocked vein, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	67	0	
35476	"Balloon dilation of narrowed or blocked vein, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	0	
35501	Bypass of diseased or blocked artery (neck to brain artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35501	Bypass of diseased or blocked artery (neck to brain artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35501	Bypass of diseased or blocked artery (neck to brain artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
35506	Bypass of diseased or blocked artery (neck to chest artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35506	Bypass of diseased or blocked artery (neck to chest artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35506	Bypass of diseased or blocked artery (neck to chest artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
35508	Bypass of diseased or blocked artery (neck to brain artery)	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35508	Bypass of diseased or blocked artery (neck to brain artery)	Service  intra	L051A	RN	0.51	Service total costs		12	
35508	Bypass of diseased or blocked artery (neck to brain artery)	Post-service	L051A	RN	0.51	Post service total costs		72	
35509	Bypass of diseased or blocked artery (neck to opposite neck artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35509	Bypass of diseased or blocked artery (neck to opposite neck artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35509	Bypass of diseased or blocked artery (neck to opposite neck artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
35510	Bypass of diseased or blocked artery (neck to arm artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35510	Bypass of diseased or blocked artery (neck to arm artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35510	Bypass of diseased or blocked artery (neck to arm artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
35511	Bypass of diseased or blocked artery (chest to opposite chest artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35511	Bypass of diseased or blocked artery (chest to opposite chest artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35511	Bypass of diseased or blocked artery (chest to opposite chest artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35512	Bypass of diseased or blocked artery (chest to arm artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35512	Bypass of diseased or blocked artery (chest to arm artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35512	Bypass of diseased or blocked artery (chest to arm artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
35515	Bypass of diseased or blocked artery (chest to brain artery)	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35515	Bypass of diseased or blocked artery (chest to brain artery)	Service  intra	L051A	RN	0.51	Service total costs		12	
35515	Bypass of diseased or blocked artery (chest to brain artery)	Post-service	L051A	RN	0.51	Post service total costs		72	
35516	Bypass of diseased or blocked artery (chest to arm artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35516	Bypass of diseased or blocked artery (chest to arm artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35516	Bypass of diseased or blocked artery (chest to arm artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
35518	Bypass of diseased or blocked artery (arm to opposite arm artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35518	Bypass of diseased or blocked artery (arm to opposite arm artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35518	Bypass of diseased or blocked artery (arm to opposite arm artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35521	Bypass of diseased or blocked artery (arm to upper leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35521	Bypass of diseased or blocked artery (arm to upper leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35521	Bypass of diseased or blocked artery (arm to upper leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35522	Bypass of diseased or blocked artery (arm to arm artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35522	Bypass of diseased or blocked artery (arm to arm artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35522	Bypass of diseased or blocked artery (arm to arm artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
35523	Bypass of diseased or blocked artery (arm to arm artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35523	Bypass of diseased or blocked artery (arm to arm artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35523	Bypass of diseased or blocked artery (arm to arm artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35525	Bypass of diseased or blocked artery (arm to opposite arm artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35525	Bypass of diseased or blocked artery (arm to opposite arm artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35525	Bypass of diseased or blocked artery (arm to opposite arm artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
35526	Bypass of diseased or blocked artery (chest to neck artery)	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35526	Bypass of diseased or blocked artery (chest to neck artery)	Service  intra	L051A	RN	0.51	Service total costs		6	
35526	Bypass of diseased or blocked artery (chest to neck artery)	Post-service	L051A	RN	0.51	Post service total costs		63	
35531	Bypass of diseased or blocked artery (abdominal to abdominal artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35531	Bypass of diseased or blocked artery (abdominal to abdominal artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35531	Bypass of diseased or blocked artery (abdominal to abdominal artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35533	Bypass of diseased or blocked artery (arm to upper leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35533	Bypass of diseased or blocked artery (arm to upper leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35533	Bypass of diseased or blocked artery (arm to upper leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35535	Bypass of diseased or blocked artery (liver to kidney artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35535	Bypass of diseased or blocked artery (liver to kidney artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35535	Bypass of diseased or blocked artery (liver to kidney artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35536	Bypass of diseased or blocked artery (spleen to kidney artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35536	Bypass of diseased or blocked artery (spleen to kidney artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35536	Bypass of diseased or blocked artery (spleen to kidney artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35537	Bypass of diseased or blocked artery (aorta to groin artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35537	Bypass of diseased or blocked artery (aorta to groin artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35537	Bypass of diseased or blocked artery (aorta to groin artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35538	Bypass of diseased or blocked artery (aorta to groin and opposite groin artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35538	Bypass of diseased or blocked artery (aorta to groin and opposite groin artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35538	Bypass of diseased or blocked artery (aorta to groin and opposite groin artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35539	Bypass of diseased or blocked artery (aorta to upper leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35539	Bypass of diseased or blocked artery (aorta to upper leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35539	Bypass of diseased or blocked artery (aorta to upper leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35540	Bypass of diseased or blocked artery (aorta to upper leg and opposite upper leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35540	Bypass of diseased or blocked artery (aorta to upper leg and opposite upper leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35540	Bypass of diseased or blocked artery (aorta to upper leg and opposite upper leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35556	Bypass of diseased or blocked artery (upper to lower leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35556	Bypass of diseased or blocked artery (upper to lower leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35556	Bypass of diseased or blocked artery (upper to lower leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35558	Bypass of diseased or blocked artery (upper leg to opposite upper leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35558	Bypass of diseased or blocked artery (upper leg to opposite upper leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35558	Bypass of diseased or blocked artery (upper leg to opposite upper leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35560	Bypass of diseased or blocked artery (aorta to kidney artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35560	Bypass of diseased or blocked artery (aorta to kidney artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35560	Bypass of diseased or blocked artery (aorta to kidney artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35563	Bypass of diseased or blocked artery (groin to opposite groin artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35563	Bypass of diseased or blocked artery (groin to opposite groin artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35563	Bypass of diseased or blocked artery (groin to opposite groin artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35565	Bypass of diseased or blocked artery (groin to upper leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35565	Bypass of diseased or blocked artery (groin to upper leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35565	Bypass of diseased or blocked artery (groin to upper leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35566	Bypass of diseased or blocked artery (upper leg to lower leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35566	Bypass of diseased or blocked artery (upper leg to lower leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35566	Bypass of diseased or blocked artery (upper leg to lower leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35570	Bypass of diseased or blocked artery (lower leg to opposite lower leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35570	Bypass of diseased or blocked artery (lower leg to opposite lower leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35570	Bypass of diseased or blocked artery (lower leg to opposite lower leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
35571	Bypass of diseased or blocked artery (lower leg to lower leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35571	Bypass of diseased or blocked artery (lower leg to lower leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35571	Bypass of diseased or blocked artery (lower leg to lower leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35583	Bypass of diseased or blocked artery (upper leg to lower thigh artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35583	Bypass of diseased or blocked artery (upper leg to lower thigh artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35583	Bypass of diseased or blocked artery (upper leg to lower thigh artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35585	Bypass of diseased or blocked artery (upper leg to lower leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35585	Bypass of diseased or blocked artery (upper leg to lower leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35585	Bypass of diseased or blocked artery (upper leg to lower leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35587	Bypass of diseased or blocked artery (lower thigh to lower leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35587	Bypass of diseased or blocked artery (lower thigh to lower leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35587	Bypass of diseased or blocked artery (lower thigh to lower leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35601	Bypass of diseased or blocked artery (neck to brain artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35601	Bypass of diseased or blocked artery (neck to brain artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35601	Bypass of diseased or blocked artery (neck to brain artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
35606	Bypass of diseased or blocked artery (neck to chest artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35606	Bypass of diseased or blocked artery (neck to chest artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35606	Bypass of diseased or blocked artery (neck to chest artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
35612	Bypass of diseased or blocked artery (chest to opposite chest artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35612	Bypass of diseased or blocked artery (chest to opposite chest artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35612	Bypass of diseased or blocked artery (chest to opposite chest artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99.5	
35616	Bypass of diseased or blocked artery (chest to arm artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35616	Bypass of diseased or blocked artery (chest to arm artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35616	Bypass of diseased or blocked artery (chest to arm artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35621	Bypass of diseased or blocked artery (arm to chest artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35621	Bypass of diseased or blocked artery (arm to chest artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35621	Bypass of diseased or blocked artery (arm to chest artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35623	Bypass of diseased or blocked artery (arm to lower leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35623	Bypass of diseased or blocked artery (arm to lower leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35623	Bypass of diseased or blocked artery (arm to lower leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35626	Bypass of diseased or blocked artery (arm to lower thigh or leg artery)	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35626	Bypass of diseased or blocked artery (arm to lower thigh or leg artery)	Service  intra	L051A	RN	0.51	Service total costs		12	
35626	Bypass of diseased or blocked artery (arm to lower thigh or leg artery)	Post-service	L051A	RN	0.51	Post service total costs		63	
35631	Bypass of diseased or blocked artery (aorta to abdominal or kidney artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35631	Bypass of diseased or blocked artery (aorta to abdominal or kidney artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35631	Bypass of diseased or blocked artery (aorta to abdominal or kidney artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35632	Bypass of diseased or blocked artery (groin to abdominal artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35632	Bypass of diseased or blocked artery (groin to abdominal artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35632	Bypass of diseased or blocked artery (groin to abdominal artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35633	Bypass of diseased or blocked artery (groin to abdominal artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35633	Bypass of diseased or blocked artery (groin to abdominal artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35633	Bypass of diseased or blocked artery (groin to abdominal artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35634	Bypass of diseased or blocked artery (groin to abdominal artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35634	Bypass of diseased or blocked artery (groin to abdominal artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35634	Bypass of diseased or blocked artery (groin to abdominal artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35636	Bypass of diseased or blocked artery (spleen to kidney artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35636	Bypass of diseased or blocked artery (spleen to kidney artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35636	Bypass of diseased or blocked artery (spleen to kidney artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35637	Bypass of diseased or blocked artery (aorta to groin artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35637	Bypass of diseased or blocked artery (aorta to groin artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35637	Bypass of diseased or blocked artery (aorta to groin artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35638	Bypass of diseased or blocked artery (aorta to groin to opposite groin artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35638	Bypass of diseased or blocked artery (aorta to groin to opposite groin artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35638	Bypass of diseased or blocked artery (aorta to groin to opposite groin artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35642	Bypass of diseased or blocked artery (neck to brain artery)	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35642	Bypass of diseased or blocked artery (neck to brain artery)	Service  intra	L051A	RN	0.51	Service total costs		6	
35642	Bypass of diseased or blocked artery (neck to brain artery)	Post-service	L051A	RN	0.51	Post service total costs		81	
35645	Bypass of diseased or blocked artery (chest to brain artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35645	Bypass of diseased or blocked artery (chest to brain artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35645	Bypass of diseased or blocked artery (chest to brain artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
35646	Bypass of diseased or blocked artery (aorta to upper leg and opposite upper leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35646	Bypass of diseased or blocked artery (aorta to upper leg and opposite upper leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35646	Bypass of diseased or blocked artery (aorta to upper leg and opposite upper leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		107	
35647	Bypass of diseased or blocked artery (aorta to upper leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35647	Bypass of diseased or blocked artery (aorta to upper leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35647	Bypass of diseased or blocked artery (aorta to upper leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
35650	Bypass of diseased or blocked artery (arm to opposite arm artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35650	Bypass of diseased or blocked artery (arm to opposite arm artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35650	Bypass of diseased or blocked artery (arm to opposite arm artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35654	Bypass of diseased or blocked artery (arm to both lower thigh arteries)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35654	Bypass of diseased or blocked artery (arm to both lower thigh arteries)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35654	Bypass of diseased or blocked artery (arm to both lower thigh arteries)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
35656	Bypass of diseased or blocked artery (upper leg to lower thigh artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35656	Bypass of diseased or blocked artery (upper leg to lower thigh artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35656	Bypass of diseased or blocked artery (upper leg to lower thigh artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35661	Bypass of diseased or blocked artery (upper leg to opposite upper leg artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35661	Bypass of diseased or blocked artery (upper leg to opposite upper leg artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35661	Bypass of diseased or blocked artery (upper leg to opposite upper leg artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35663	Bypass of diseased or blocked artery (groin to opposite groin artery)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35663	Bypass of diseased or blocked artery (groin to opposite groin artery)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35663	Bypass of diseased or blocked artery (groin to opposite groin artery)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35665	Bypass on diseased or blocked groin to upper leg artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35665	Bypass on diseased or blocked groin to upper leg artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35665	Bypass on diseased or blocked groin to upper leg artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35666	Bypass of diseased or blocked artery (upper leg to lower leg arteries)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35666	Bypass of diseased or blocked artery (upper leg to lower leg arteries)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35666	Bypass of diseased or blocked artery (upper leg to lower leg arteries)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35671	Bypass of diseased or blocked artery (upper leg to lower leg arteries)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35671	Bypass of diseased or blocked artery (upper leg to lower leg arteries)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35671	Bypass of diseased or blocked artery (upper leg to lower leg arteries)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35691	Transfer and/or reimplantation of vertebral (brain) artery to carotid (neck) artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35691	Transfer and/or reimplantation of vertebral (brain) artery to carotid (neck) artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35691	Transfer and/or reimplantation of vertebral (brain) artery to carotid (neck) artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
35693	Transfer and/or reimplantation of vertebral (brain) artery to subclavian (chest) artery	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35693	Transfer and/or reimplantation of vertebral (brain) artery to subclavian (chest) artery	Service  intra	L051A	RN	0.51	Service total costs		12	
35693	Transfer and/or reimplantation of vertebral (brain) artery to subclavian (chest) artery	Post-service	L051A	RN	0.51	Post service total costs		81	
35694	Transfer and/or reimplantation of subclavian (chest) artery to carotid (neck) artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35694	Transfer and/or reimplantation of subclavian (chest) artery to carotid (neck) artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35694	Transfer and/or reimplantation of subclavian (chest) artery to carotid (neck) artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
35695	Transfer and/or reimplantation of carotid (neck) artery to subclavian (chest) artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35695	Transfer and/or reimplantation of carotid (neck) artery to subclavian (chest) artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35695	Transfer and/or reimplantation of carotid (neck) artery to subclavian (chest) artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
35701	Exploration of neck artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35701	Exploration of neck artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35701	Exploration of neck artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35721	Exploration of upper thigh artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35721	Exploration of upper thigh artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35721	Exploration of upper thigh artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
35741	Exploration of lower leg artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35741	Exploration of lower leg artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35741	Exploration of lower leg artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35761	Exploration of blood vessel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35761	Exploration of blood vessel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35761	Exploration of blood vessel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
35800	"Exploration of neck for postsurgical bleeding, blood clot, or infection"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35800	"Exploration of neck for postsurgical bleeding, blood clot, or infection"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35800	"Exploration of neck for postsurgical bleeding, blood clot, or infection"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90.5	
35820	"Exploration of chest for postsurgical bleeding, blood clot, or infection"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
35820	"Exploration of chest for postsurgical bleeding, blood clot, or infection"	Service  intra	L051A	RN	0.51	Service total costs		12	
35820	"Exploration of chest for postsurgical bleeding, blood clot, or infection"	Post-service	L051A	RN	0.51	Post service total costs		53	
35840	"Exploration of abdomen for postsurgical bleeding, blood clot, or infection"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35840	"Exploration of abdomen for postsurgical bleeding, blood clot, or infection"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35840	"Exploration of abdomen for postsurgical bleeding, blood clot, or infection"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
35860	"Exploration of arm or leg for postsurgical bleeding, blood clot, or infection"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35860	"Exploration of arm or leg for postsurgical bleeding, blood clot, or infection"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35860	"Exploration of arm or leg for postsurgical bleeding, blood clot, or infection"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90.5	
35870	Repair of abnormal drainage tract of blood vessel graft and bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35870	Repair of abnormal drainage tract of blood vessel graft and bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35870	Repair of abnormal drainage tract of blood vessel graft and bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
35875	Removal of blood clot of arterial or venous graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35875	Removal of blood clot of arterial or venous graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35875	Removal of blood clot of arterial or venous graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35876	Removal of blood clot and revision of arterial or venous graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35876	Removal of blood clot and revision of arterial or venous graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35876	Removal of blood clot and revision of arterial or venous graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35879	"Revision of arterial bypass of leg with placement of vein patch, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35879	"Revision of arterial bypass of leg with placement of vein patch, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35879	"Revision of arterial bypass of leg with placement of vein patch, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		89	
35881	"Revision of arterial bypass of leg with placement of relocated vein, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35881	"Revision of arterial bypass of leg with placement of relocated vein, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35881	"Revision of arterial bypass of leg with placement of relocated vein, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35883	"Revision of arterial bypass of groin with placement synthetic graft, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35883	"Revision of arterial bypass of groin with placement synthetic graft, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35883	"Revision of arterial bypass of groin with placement synthetic graft, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35884	"Revision of arterial bypass of groin with vein patch graft, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35884	"Revision of arterial bypass of groin with vein patch graft, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35884	"Revision of arterial bypass of groin with vein patch graft, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
35901	Removal of infected neck graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35901	Removal of infected neck graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35901	Removal of infected neck graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
35903	Removal of infected graft of arm or leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35903	Removal of infected graft of arm or leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35903	Removal of infected graft of arm or leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
35905	Removal of infected chest graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35905	Removal of infected chest graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35905	Removal of infected chest graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
35907	Removal of infected abdominal graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
35907	Removal of infected abdominal graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
35907	Removal of infected abdominal graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
36000	Insertion of needle or catheter into a vein	Service  intra	L051A	RN	0.51	Service total costs	19	0	
36002	"Injection to cause blood clot in a diseased or bulging vessel of arm or leg, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	5	20	
36002	"Injection to cause blood clot in a diseased or bulging vessel of arm or leg, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	33	0	
36002	"Injection to cause blood clot in a diseased or bulging vessel of arm or leg, accessed through the skin"	Service  intra	L054A	Vascular Technologist	0.54	Service total costs	41	0	
36002	"Injection to cause blood clot in a diseased or bulging vessel of arm or leg, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
36005	Injection for X-ray imaging procedure on veins of arm or leg	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	43	0	
36010	Introduction of catheter into the upper or lower major vein (vena cava)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36010	Introduction of catheter into the upper or lower major vein (vena cava)	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	37	0	
36010	Introduction of catheter into the upper or lower major vein (vena cava)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	39	0	
36010	Introduction of catheter into the upper or lower major vein (vena cava)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
36011	Insertion of catheter into vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36011	Insertion of catheter into vein	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	46	0	
36011	Insertion of catheter into vein	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	39	0	
36011	Insertion of catheter into vein	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36012	Insertion of catheter into vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36012	Insertion of catheter into vein	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	50	0	
36012	Insertion of catheter into vein	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	39	0	
36012	Insertion of catheter into vein	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36013	Insertion of catheter into right heart or main pulmonary (lung) artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36013	Insertion of catheter into right heart or main pulmonary (lung) artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	39	0	
36013	Insertion of catheter into right heart or main pulmonary (lung) artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
36013	Insertion of catheter into right heart or main pulmonary (lung) artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36014	Insertion of catheter into left or right pulmonary (lung) artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36014	Insertion of catheter into left or right pulmonary (lung) artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	45	0	
36014	Insertion of catheter into left or right pulmonary (lung) artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
36014	Insertion of catheter into left or right pulmonary (lung) artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36015	Insertion of catheter into an artery of a lobe of the lung	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36015	Insertion of catheter into an artery of a lobe of the lung	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	50	0	
36015	Insertion of catheter into an artery of a lobe of the lung	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
36015	Insertion of catheter into an artery of a lobe of the lung	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36100	Insertion of needle or catheter into the carotid (neck) or vertebral (brain) artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36100	Insertion of needle or catheter into the carotid (neck) or vertebral (brain) artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	31	0	
36100	Insertion of needle or catheter into the carotid (neck) or vertebral (brain) artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	0	
36100	Insertion of needle or catheter into the carotid (neck) or vertebral (brain) artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
36120	Insertion of needle or catheter into the brachial (arm) artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36120	Insertion of needle or catheter into the brachial (arm) artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	33	0	
36120	Insertion of needle or catheter into the brachial (arm) artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	0	
36120	Insertion of needle or catheter into the brachial (arm) artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
36140	Insertion of needle or catheter into an artery of arm or leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36140	Insertion of needle or catheter into an artery of arm or leg	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	36	0	
36140	Insertion of needle or catheter into an artery of arm or leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	0	
36140	Insertion of needle or catheter into an artery of arm or leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
36147	Insertion of needle and/or catheter for dialysis	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6	0	
36147	Insertion of needle and/or catheter for dialysis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	3	
36147	Insertion of needle and/or catheter for dialysis	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	88	0	
36147	Insertion of needle and/or catheter for dialysis	Service  intra	L051A	RN	0.51	Service total costs	77	0	
36147	Insertion of needle and/or catheter for dialysis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	0	
36147	Insertion of needle and/or catheter for dialysis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36148	Insertion of needle and/or catheter into an artery-vein dialysis shunt or graft	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	15	0	
36148	Insertion of needle and/or catheter into an artery-vein dialysis shunt or graft	Service  intra	L051A	RN	0.51	Service total costs	15	0	
36160	Insertion of needle or catheter into aorta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36160	Insertion of needle or catheter into aorta	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	40	0	
36160	Insertion of needle or catheter into aorta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	0	
36160	Insertion of needle or catheter into aorta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
36200	Insertion of catheter into aorta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	0	
36200	Insertion of catheter into aorta	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	8	0	
36200	Insertion of catheter into aorta	Service  intra	L051A	RN	0.51	Service total costs	92	0	
36200	Insertion of catheter into aorta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	0	
36200	Insertion of catheter into aorta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
36215	Insertion of catheter into chest or arm artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36215	Insertion of catheter into chest or arm artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	72	0	
36215	Insertion of catheter into chest or arm artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
36215	Insertion of catheter into chest or arm artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36216	Insertion of catheter into chest or arm artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36216	Insertion of catheter into chest or arm artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	83	0	
36216	Insertion of catheter into chest or arm artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
36216	Insertion of catheter into chest or arm artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36217	Insertion of catheter into chest or arm artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36217	Insertion of catheter into chest or arm artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	97	0	
36217	Insertion of catheter into chest or arm artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
36217	Insertion of catheter into chest or arm artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36218	Insertion of catheter into chest or arm artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	14	0	
36221	Insertion of catheter into chest aorta for diagnosis or treatment including radiological supervision and interpretation	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
36221	Insertion of catheter into chest aorta for diagnosis or treatment including radiological supervision and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
36221	Insertion of catheter into chest aorta for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L041A	Angio Technician	0.41	Service total costs	38	0	
36221	Insertion of catheter into chest aorta for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	35	0	
36221	Insertion of catheter into chest aorta for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L051A	RN	0.51	Service total costs	92	0	
36221	Insertion of catheter into chest aorta for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	22	0	
36221	Insertion of catheter into chest aorta for diagnosis or treatment including radiological supervision and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36222	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
36222	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
36222	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L041A	Angio Technician	0.41	Service total costs	43	0	
36222	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	42	0	
36222	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L051A	RN	0.51	Service total costs	102	0	
36222	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	24	0	
36222	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36223	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
36223	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
36223	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L041A	Angio Technician	0.41	Service total costs	58	0	
36223	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	46	0	
36223	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L051A	RN	0.51	Service total costs	107	0	
36223	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25	0	
36223	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36224		Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
36224		Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
36224		Service  intra	L041A	Angio Technician	0.41	Service total costs	63	0	
36224		Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	50	0	
36224		Service  intra	L051A	RN	0.51	Service total costs	112	0	
36224		Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	0	
36224		Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36225	Insertion of catheter into artery on one side of chest for diagnosis or treatment including radiological supervision and interpretation	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
36225	Insertion of catheter into artery on one side of chest for diagnosis or treatment including radiological supervision and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
36225	Insertion of catheter into artery on one side of chest for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L041A	Angio Technician	0.41	Service total costs	58	0	
36225	Insertion of catheter into artery on one side of chest for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	48	0	
36225	Insertion of catheter into artery on one side of chest for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L051A	RN	0.51	Service total costs	107	0	
36225	Insertion of catheter into artery on one side of chest for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25	0	
36225	Insertion of catheter into artery on one side of chest for diagnosis or treatment including radiological supervision and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36226	Insertion of catheter into chest artery for diagnosis or treatment including radiological supervision and interpretation	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
36226	Insertion of catheter into chest artery for diagnosis or treatment including radiological supervision and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
36226	Insertion of catheter into chest artery for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L041A	Angio Technician	0.41	Service total costs	63	0	
36226	Insertion of catheter into chest artery for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	50	0	
36226	Insertion of catheter into chest artery for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L051A	RN	0.51	Service total costs	112	0	
36226	Insertion of catheter into chest artery for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	0	
36226	Insertion of catheter into chest artery for diagnosis or treatment including radiological supervision and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36227	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L041A	Angio Technician	0.41	Service total costs	17	0	
36227	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	11	0	
36227	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L051A	RN	0.51	Service total costs	15	0	
36227	Insertion of catheter into artery on one side of neck for diagnosis or treatment including radiological supervision and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	4	0	
36228		Service  intra	L041A	Angio Technician	0.41	Service total costs	32	0	
36228		Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	23	0	
36228		Service  intra	L051A	RN	0.51	Service total costs	30	0	
36228		Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8	0	
36245	Insertion of catheter into abdominal pelvic or leg artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
36245	Insertion of catheter into abdominal pelvic or leg artery	Service  intra	L041A	Angio Technician	0.41	Service total costs	48	0	
36245	Insertion of catheter into abdominal pelvic or leg artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	4	0	
36245	Insertion of catheter into abdominal pelvic or leg artery	Service  intra	L051A	RN	0.51	Service total costs	107	0	
36245	Insertion of catheter into abdominal pelvic or leg artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	13	0	
36245	Insertion of catheter into abdominal pelvic or leg artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36246	Insertion of catheter into abdominal pelvic or leg artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	0	
36246	Insertion of catheter into abdominal pelvic or leg artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	8	0	
36246	Insertion of catheter into abdominal pelvic or leg artery	Service  intra	L051A	RN	0.51	Service total costs	107	0	
36246	Insertion of catheter into abdominal pelvic or leg artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	64	0	
36246	Insertion of catheter into abdominal pelvic or leg artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36247	Insertion of catheter into abdominal pelvic or leg artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	0	
36247	Insertion of catheter into abdominal pelvic or leg artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	8	0	
36247	Insertion of catheter into abdominal pelvic or leg artery	Service  intra	L051A	RN	0.51	Service total costs	122	0	
36247	Insertion of catheter into abdominal pelvic or leg artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	79	0	
36247	Insertion of catheter into abdominal pelvic or leg artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36248	"Insertion of catheter into each additional abdominal, pelvic or leg artery"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	14	0	
36251	Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
36251	Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
36251	Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation	Service  intra	L041A	Angio Technician	0.41	Service total costs	53	0	
36251	Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	46	0	
36251	Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation	Service  intra	L051A	RN	0.51	Service total costs	107	0	
36251	Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	0	
36251	Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36252	Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
36252	Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
36252	Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation	Service  intra	L041A	Angio Technician	0.41	Service total costs	61	0	
36252	Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	52	0	
36252	Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation	Service  intra	L051A	RN	0.51	Service total costs	115	0	
36252	Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	29	0	
36252	Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36253	Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
36253	Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
36253	Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation	Service  intra	L041A	Angio Technician	0.41	Service total costs	68	0	
36253	Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	57	0	
36253	Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation	Service  intra	L051A	RN	0.51	Service total costs	122	0	
36253	Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	31	0	
36253	Insertion of catheters into main and accessory arteries of one kidney for imaging including radiological supervision and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36254	Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
36254	Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
36254	Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation	Service  intra	L041A	Angio Technician	0.41	Service total costs	76	0	
36254	Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	63	0	
36254	Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation	Service  intra	L051A	RN	0.51	Service total costs	130	0	
36254	Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	33	0	
36254	Insertion of catheters into main and accessory arteries of both kidneys for imaging including radiological supervision and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36260	Insertion of implantable arterial infusion pump	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
36260	Insertion of implantable arterial infusion pump	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
36260	Insertion of implantable arterial infusion pump	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
36261	Revision of implanted arterial infusion pump	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
36261	Revision of implanted arterial infusion pump	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
36261	Revision of implanted arterial infusion pump	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
36262	Removal of implanted arterial infusion pump	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
36262	Removal of implanted arterial infusion pump	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
36262	Removal of implanted arterial infusion pump	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
36400	"Insertion of needle into upper leg or neck vein, patient younger than 3 years"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
36405	"Insertion of needle into scalp vein, patient younger than 3 years"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
36406	"Insertion of needle into vein, patient younger than 3 years"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
36410	"Insertion of needle into vein, patient 3 years or older"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	13	0	
36430	Transfusion of blood or blood products	Service  intra	L042A	RN/LPN	0.42	Service total costs	45		
36430	Transfusion of blood or blood products	Post-service	L042A	RN/LPN	0.42	Post service total costs	3		
36470	Injection of chemical agent into single vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	20	0	
36470	Injection of chemical agent into single vein	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	6	
36470	Injection of chemical agent into single vein	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	46	46	
36471	Injection of chemical agent into multiple veins of same leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	20	0	
36471	Injection of chemical agent into multiple veins of same leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	74	6	
36471	Injection of chemical agent into multiple veins of same leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	13.5	13.5	
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	2		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	2	2	
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	4		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Service  pre	L042A	RN/LPN	0.42	Prepare and position pt/ monitor pt/ set up IV	2		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Service  pre	L054A	Vascular Technologist	0.54	Setup scope (non facility setting only) (Set up US Equip)	2		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Service  intra	L042A	RN/LPN	0.42	Assist physician in performing procedure	45		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Service  intra	L054A	Vascular Technologist	0.54	Assist with image acquisition (75%)	34		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulating throughout procedure	11		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	5		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	7		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	2		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Service  post	L054A	Vascular Technologist	0.54	"Technologist QCs images US machine, checking for all images, reformats, and dose page"	2		
36475	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
36476	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  intra	L042A	RN/LPN	0.42	Assist physician in performing procedure	30		
36476	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  intra	L054A	Vascular Technologist	0.54	Assist with image acquisition (75%)	23		
36476	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulating throughout procedure	7		
36476	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	0		
36476	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  post	L054A	Vascular Technologist	0.54	"Technologist QCs images US machine, checking for all images, reformats, and dose page"	0		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	2		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	2	2	
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	0		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	4		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  pre	L042A	RN/LPN	0.42	Prepare and position pt/ monitor pt/ set up IV	2		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  pre	L054A	Vascular Technologist	0.54	Setup scope (non facility setting only) (Set up US Equip)	2		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  intra	L042A	RN/LPN	0.42	Assist physician in performing procedure	45		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  intra	L054A	Vascular Technologist	0.54	Assist with image acquisition (75%)	34		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulating throughout procedure	11		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  post	L037D	RN/LPN/MTA	0.37	Apply multi-layer comprehensive dressing	5		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	7		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	2		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  post	L054A	Vascular Technologist	0.54	"Technologist QCs images US machine, checking for all images, reformats, and dose page"	2		
36478	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
36479	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  intra	L042A	RN/LPN	0.42	Assist physician in performing procedure	30		
36479	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  intra	L054A	Vascular Technologist	0.54	Assist with image acquisition (75%)	23		
36479	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulating throughout procedure	7		
36479	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	0		
36479	"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; second and subsequent veins treated in a single extremity, each through separate access sites"	Service  post	L054A	Vascular Technologist	0.54	"Technologist QCs images US machine, checking for all images, reformats, and dose page"	0		
36481	"Insertion of catheter into portal vein of liver, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	10	
36481	"Insertion of catheter into portal vein of liver, accessed through the skin"	Service  intra	L041A	Angio Technician	0.41	Service total costs	84	0	
36481	"Insertion of catheter into portal vein of liver, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	137	0	
36481	"Insertion of catheter into portal vein of liver, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	0	
36481	"Insertion of catheter into portal vein of liver, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36510	"Insertion of catheter into vein of navel, newborn"	Service  intra	L042A	RN/LPN	0.42	Service total costs	45	0	
36510	"Insertion of catheter into vein of navel, newborn"	Post-service	L042A	RN/LPN	0.42	Post service total costs	3	0	
36514	Mechanical separation of plasma from opening blood	Pre-service	L042A	RN/LPN	0.42	Preservice total costs	11	0	
36514	Mechanical separation of plasma from opening blood	Service  intra	L042A	RN/LPN	0.42	Service total costs	169	0	
36514	Mechanical separation of plasma from opening blood	Post-service	L042A	RN/LPN	0.42	Post service total costs	3	0	
36515	Mechanical separation of plasma and abnormal antibodies from blood	Pre-service	L042A	RN/LPN	0.42	Preservice total costs	11	0	
36515	Mechanical separation of plasma and abnormal antibodies from blood	Service  intra	L042A	RN/LPN	0.42	Service total costs	184	0	
36515	Mechanical separation of plasma and abnormal antibodies from blood	Post-service	L042A	RN/LPN	0.42	Post service total costs	3	0	
36516	Mechanical separation of plasma and abnormal antibodies from blood	Pre-service	L042A	RN/LPN	0.42	Preservice total costs	11	0	
36516	Mechanical separation of plasma and abnormal antibodies from blood	Service  intra	L042A	RN/LPN	0.42	Service total costs	324	0	
36516	Mechanical separation of plasma and abnormal antibodies from blood	Post-service	L042A	RN/LPN	0.42	Post service total costs	3	0	
36522	Mechanical separation of white blood cells and platelets from blood	Pre-service	L051A	RN	0.51	Preservice total costs	11	15	
36522	Mechanical separation of white blood cells and platelets from blood	Service  intra	L051A	RN	0.51	Service total costs	167	0	
36522	Mechanical separation of white blood cells and platelets from blood	Post-service	L051A	RN	0.51	Post service total costs	3	0	
36555	"Insertion of central venous catheter for infusion, patient younger than 5 years"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36555	"Insertion of central venous catheter for infusion, patient younger than 5 years"	Service  intra	L051A	RN	0.51	Service total costs	37	0	
36555	"Insertion of central venous catheter for infusion, patient younger than 5 years"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	0	
36555	"Insertion of central venous catheter for infusion, patient younger than 5 years"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36556	"Insertion of central venous catheter for infusion, patient 5 years or older"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	0	
36556	"Insertion of central venous catheter for infusion, patient 5 years or older"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	0	
36556	"Insertion of central venous catheter for infusion, patient 5 years or older"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36557	"Insertion of central venous catheter for infusion, patient younger than 5 years"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	26	
36557	"Insertion of central venous catheter for infusion, patient younger than 5 years"	Service  intra	L051A	RN	0.51	Service total costs	47	6	
36557	"Insertion of central venous catheter for infusion, patient younger than 5 years"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36557	"Insertion of central venous catheter for infusion, patient younger than 5 years"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36558	"Insertion of central venous catheter for infusion, patient 5 years or older"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	26	
36558	"Insertion of central venous catheter for infusion, patient 5 years or older"	Service  intra	L051A	RN	0.51	Service total costs	47	6	
36558	"Insertion of central venous catheter for infusion, patient 5 years or older"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36558	"Insertion of central venous catheter for infusion, patient 5 years or older"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36560	"Insertion of central venous catheter and implanted device for infusion beneath the skin, patient younger than 5 years"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	26	
36560	"Insertion of central venous catheter and implanted device for infusion beneath the skin, patient younger than 5 years"	Service  intra	L051A	RN	0.51	Service total costs	62	6	
36560	"Insertion of central venous catheter and implanted device for infusion beneath the skin, patient younger than 5 years"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36560	"Insertion of central venous catheter and implanted device for infusion beneath the skin, patient younger than 5 years"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36561	"Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	26	
36561	"Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older"	Service  intra	L051A	RN	0.51	Service total costs	62	6	
36561	"Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36561	"Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36563	Insertion of central venous catheter and implanted device for infusion beneath the skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	26	
36563	Insertion of central venous catheter and implanted device for infusion beneath the skin	Service  intra	L051A	RN	0.51	Service total costs	77	6	
36563	Insertion of central venous catheter and implanted device for infusion beneath the skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36563	Insertion of central venous catheter and implanted device for infusion beneath the skin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36565	"Insertion of central venous catheters for infusion, two catheters in two veins"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	26	
36565	"Insertion of central venous catheters for infusion, two catheters in two veins"	Service  intra	L051A	RN	0.51	Service total costs	62	6	
36565	"Insertion of central venous catheters for infusion, two catheters in two veins"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36565	"Insertion of central venous catheters for infusion, two catheters in two veins"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36566	"Insertion of central venous catheters, two catheters in two veins, and implanted devices for infusion beneath the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	26	
36566	"Insertion of central venous catheters, two catheters in two veins, and implanted devices for infusion beneath the skin"	Service  intra	L051A	RN	0.51	Service total costs	77	6	
36566	"Insertion of central venous catheters, two catheters in two veins, and implanted devices for infusion beneath the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36566	"Insertion of central venous catheters, two catheters in two veins, and implanted devices for infusion beneath the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36568	"Insertion of central venous catheter for infusion, patient younger than 5 years"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36568	"Insertion of central venous catheter for infusion, patient younger than 5 years"	Service  intra	L051A	RN	0.51	Service total costs	37	0	
36568	"Insertion of central venous catheter for infusion, patient younger than 5 years"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	0	
36568	"Insertion of central venous catheter for infusion, patient younger than 5 years"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36569	"Insertion of central venous catheter for infusion, patient 5 years or older"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	0	
36569	"Insertion of central venous catheter for infusion, patient 5 years or older"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	0	
36569	"Insertion of central venous catheter for infusion, patient 5 years or older"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36570	"Insertion of central venous catheter for infusion with port beneath the skin, patient younger than 5 years"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	26	
36570	"Insertion of central venous catheter for infusion with port beneath the skin, patient younger than 5 years"	Service  intra	L051A	RN	0.51	Service total costs	62	6	
36570	"Insertion of central venous catheter for infusion with port beneath the skin, patient younger than 5 years"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36570	"Insertion of central venous catheter for infusion with port beneath the skin, patient younger than 5 years"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36571	"Insertion of central venous catheter for infusion with port beneath the skin, patient 5 years or older"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	26	
36571	"Insertion of central venous catheter for infusion with port beneath the skin, patient 5 years or older"	Service  intra	L051A	RN	0.51	Service total costs	67	6	
36571	"Insertion of central venous catheter for infusion with port beneath the skin, patient 5 years or older"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36571	"Insertion of central venous catheter for infusion with port beneath the skin, patient 5 years or older"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36575	Repair of central venous catheter for infusion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	12	0	
36575	Repair of central venous catheter for infusion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36576	Repair of central venous catheter for infusion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36576	Repair of central venous catheter for infusion	Service  intra	L051A	RN	0.51	Service total costs	50	6	
36576	Repair of central venous catheter for infusion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36576	Repair of central venous catheter for infusion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36578	Catheter replacement of central venous access device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	26	
36578	Catheter replacement of central venous access device	Service  intra	L051A	RN	0.51	Service total costs	47	6	
36578	Catheter replacement of central venous access device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36578	Catheter replacement of central venous access device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36580	Replacement of central venous catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	0	
36580	Replacement of central venous catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	0	
36580	Replacement of central venous catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36581	Replacement of central venous catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
36581	Replacement of central venous catheter	Service  intra	L051A	RN	0.51	Service total costs	47	6	
36581	Replacement of central venous catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36581	Replacement of central venous catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36582	Replacement of central venous catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	26	
36582	Replacement of central venous catheter	Service  intra	L051A	RN	0.51	Service total costs	77	6	
36582	Replacement of central venous catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36582	Replacement of central venous catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36583	Replacement of central venous catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	26	
36583	Replacement of central venous catheter	Service  intra	L051A	RN	0.51	Service total costs	77	6	
36583	Replacement of central venous catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36583	Replacement of central venous catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36584	Replacement of peripheral venous catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	15	
36584	Replacement of peripheral venous catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	0	
36584	Replacement of peripheral venous catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36585	Replacement of peripheral venous catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	26	
36585	Replacement of peripheral venous catheter	Service  intra	L051A	RN	0.51	Service total costs	77	6	
36585	Replacement of peripheral venous catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36585	Replacement of peripheral venous catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36589	Removal of central venous catheter for infusion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	15	
36589	Removal of central venous catheter for infusion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	6	
36589	Removal of central venous catheter for infusion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	16	16	
36590	Removal of peripheral venous catheter for infusion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	15	
36590	Removal of peripheral venous catheter for infusion	Service  intra	L051A	RN	0.51	Service total costs	47	6	
36590	Removal of peripheral venous catheter for infusion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
36590	Removal of peripheral venous catheter for infusion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
36591	Collection of blood specimen from a completely implantable venous access device	Service  intra	L051A	RN	0.51	Service total costs	19		
36592	Collection of blood specimen from central or peripheral venous catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23		
36593	Declotting infusion of implanted central venous access device or catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	37		
36595	Mechanical removal of obstructive material from central venous catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	10	15	
36595	Mechanical removal of obstructive material from central venous catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	90	0	
36595	Mechanical removal of obstructive material from central venous catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36596	Mechanical removal of tissue or obstructive material in central venous catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	10	15	
36596	Mechanical removal of tissue or obstructive material in central venous catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
36596	Mechanical removal of tissue or obstructive material in central venous catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36597	Repositioning of central venous catheter using fluoroscopic guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	0	
36597	Repositioning of central venous catheter using fluoroscopic guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	0	
36597	Repositioning of central venous catheter using fluoroscopic guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
36598	Contrast injections for X-ray imaging procedure to evaluate central venous access device	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	19	0	
36598	Contrast injections for X-ray imaging procedure to evaluate central venous access device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	12	0	
36598	Contrast injections for X-ray imaging procedure to evaluate central venous access device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
36600	Arterial puncture withdrawal of blood for diagnosis	Service  intra	L051A	RN	0.51	Service total costs	5	0	
36600	Arterial puncture withdrawal of blood for diagnosis	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	11	0	
36640	Insertion of arterial catheter for blood sampling or infusion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
36680	Insertion of needle for infusion into bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
36810	Insertion of external tube from artery to vein for dialysis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
36815	Repositioning or removal of external dialysis tube from vein to artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
36818	Av fuse uppr arm cephalic	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
36818	Av fuse uppr arm cephalic	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
36818	Av fuse uppr arm cephalic	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
36818	Av fuse uppr arm cephalic	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
36818	Av fuse uppr arm cephalic	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
36818	Av fuse uppr arm cephalic	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
36818	Av fuse uppr arm cephalic	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		27	
36818	Av fuse uppr arm cephalic	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		36	
36819	Av fuse uppr arm basilic	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
36819	Av fuse uppr arm basilic	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
36819	Av fuse uppr arm basilic	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
36819	Av fuse uppr arm basilic	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
36819	Av fuse uppr arm basilic	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
36819	Av fuse uppr arm basilic	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
36819	Av fuse uppr arm basilic	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		27	
36819	Av fuse uppr arm basilic	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		36	
36820	Av fusion/forearm vein	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
36820	Av fusion/forearm vein	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
36820	Av fusion/forearm vein	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
36820	Av fusion/forearm vein	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
36820	Av fusion/forearm vein	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
36820	Av fusion/forearm vein	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
36820	Av fusion/forearm vein	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		27	
36820	Av fusion/forearm vein	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		36	
36821	Av fusion direct any site	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
36821	Av fusion direct any site	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
36821	Av fusion direct any site	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
36821	Av fusion direct any site	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
36821	Av fusion direct any site	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
36821	Av fusion direct any site	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
36821	Av fusion direct any site	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		27	
36821	Av fusion direct any site	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		36	
36823	Insertion of tubes into arm or leg for blood circulation with chemotherapy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
36823	Insertion of tubes into arm or leg for blood circulation with chemotherapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
36823	Insertion of tubes into arm or leg for blood circulation with chemotherapy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
36825	Artery-vein autograft	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
36825	Artery-vein autograft	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
36825	Artery-vein autograft	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
36825	Artery-vein autograft	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
36825	Artery-vein autograft	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
36825	Artery-vein autograft	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
36825	Artery-vein autograft	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		27	
36825	Artery-vein autograft	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
36830	Artery-vein nonautograft	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
36830	Artery-vein nonautograft	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
36830	Artery-vein nonautograft	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
36830	Artery-vein nonautograft	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
36830	Artery-vein nonautograft	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
36830	Artery-vein nonautograft	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
36830	Artery-vein nonautograft	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		27	
36830	Artery-vein nonautograft	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		36	
36831	Open thrombect av fistula	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
36831	Open thrombect av fistula	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
36831	Open thrombect av fistula	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
36831	Open thrombect av fistula	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
36831	Open thrombect av fistula	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
36831	Open thrombect av fistula	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
36831	Open thrombect av fistula	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		27	
36831	Open thrombect av fistula	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		36	
36832	Av fistula revision open	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
36832	Av fistula revision open	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
36832	Av fistula revision open	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
36832	Av fistula revision open	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
36832	Av fistula revision open	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
36832	Av fistula revision open	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
36832	Av fistula revision open	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		27	
36832	Av fistula revision open	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
36833	Av fistula revision	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
36833	Av fistula revision	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
36833	Av fistula revision	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
36833	Av fistula revision	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
36833	Av fistula revision	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
36833	Av fistula revision	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
36833	Av fistula revision	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		27	
36833	Av fistula revision	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
36835	Insertion of synthetic dialysis shunt in artery or vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
36835	Insertion of synthetic dialysis shunt in artery or vein	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
36835	Insertion of synthetic dialysis shunt in artery or vein	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
36838	Repair of dialysis access in arm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
36838	Repair of dialysis access in arm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
36838	Repair of dialysis access in arm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
36860	Injection for removal of blood clot from external dialysis cannula	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	10	0	
36860	Injection for removal of blood clot from external dialysis cannula	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	70	0	
36860	Injection for removal of blood clot from external dialysis cannula	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
36870	"Catheter removal of blood clot from dialysis graft, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
36870	"Catheter removal of blood clot from dialysis graft, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	77	0	
36870	"Catheter removal of blood clot from dialysis graft, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	94	6	
36870	"Catheter removal of blood clot from dialysis graft, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
37140	"Connection of vena cava and portal vein of liver, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37140	"Connection of vena cava and portal vein of liver, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
37140	"Connection of vena cava and portal vein of liver, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108.5	
37145	"Connection of renal (kidney) vein and portal vein of liver, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37145	"Connection of renal (kidney) vein and portal vein of liver, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
37145	"Connection of renal (kidney) vein and portal vein of liver, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108.5	
37160	"Connection of vena cava and abdominal vein, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37160	"Connection of vena cava and abdominal vein, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
37160	"Connection of vena cava and abdominal vein, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108.5	
37180	"Connection of splenic (spleen) and renal (kidney) vein near aorta, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37180	"Connection of splenic (spleen) and renal (kidney) vein near aorta, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
37180	"Connection of splenic (spleen) and renal (kidney) vein near aorta, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108.5	
37181	"Connection of splenic (spleen) and renal (kidney) vein, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37181	"Connection of splenic (spleen) and renal (kidney) vein, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
37181	"Connection of splenic (spleen) and renal (kidney) vein, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108.5	
37182	Insertion of shunts to bypass blood flow to liver using imaging guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
37182	Insertion of shunts to bypass blood flow to liver using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
37183	Revision of shunts to bypass blood flow to liver using imaging guidance	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37183	Revision of shunts to bypass blood flow to liver using imaging guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	10	
37183	Revision of shunts to bypass blood flow to liver using imaging guidance	Service  intra	L041A	Angio Technician	0.41	Service total costs	93.5	0	
37183	Revision of shunts to bypass blood flow to liver using imaging guidance	Service  intra	L051A	RN	0.51	Service total costs	142.5	0	
37183	Revision of shunts to bypass blood flow to liver using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
37183	Revision of shunts to bypass blood flow to liver using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37184	"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	23	
37184	"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	79	0	
37184	"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel"	Service  intra	L051A	RN	0.51	Service total costs	107	0	
37184	"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
37184	"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel"	Post-service	L051A	RN	0.51	Post service total costs	3	3	
37184	"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37185	"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); second and all subsequent vessel(s) within the same vascular family (List separately in addition to code for primary mechanical thrombectomy procedure)"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	32	0	
37185	"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); second and all subsequent vessel(s) within the same vascular family (List separately in addition to code for primary mechanical thrombectomy procedure)"	Service  intra	L051A	RN	0.51	Service total costs	40	0	
37186	"Secondary percutaneous transluminal thrombectomy (eg, nonprimary mechanical, snare basket, suction technique), noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injections, provided in conjunction with another percutaneous intervention other than primary mechanical thrombectomy (List separately in addition to code for primary procedure)"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	48	0	
37186	"Secondary percutaneous transluminal thrombectomy (eg, nonprimary mechanical, snare basket, suction technique), noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injections, provided in conjunction with another percutaneous intervention other than primary mechanical thrombectomy (List separately in addition to code for primary procedure)"	Service  intra	L051A	RN	0.51	Service total costs	60	0	
37187	Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	23	
37187	Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	75	0	
37187	Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance	Service  intra	L051A	RN	0.51	Service total costs	102	0	
37187	Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
37187	Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance	Post-service	L051A	RN	0.51	Post service total costs	3	3	
37187	Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37188	Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	23	
37188	Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	53	0	
37188	Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance	Service  intra	L051A	RN	0.51	Service total costs	75	0	
37188	Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
37188	Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance	Post-service	L051A	RN	0.51	Post service total costs	3	3	
37188	Removal of blood clot and injections (accessed through the skin) to dissolve blood clot from veins using fluoroscopic guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37191	"Insertion of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37191	"Insertion of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37191	"Insertion of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Service  intra	L041A	Angio Technician	0.41	Service total costs	38	0	
37191	"Insertion of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	35	0	
37191	"Insertion of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Service  intra	L051A	RN	0.51	Service total costs	62	0	
37191	"Insertion of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
37191	"Insertion of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37192	"Repositioning of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37192	"Repositioning of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37192	"Repositioning of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Service  intra	L041A	Angio Technician	0.41	Service total costs	53	0	
37192	"Repositioning of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	46	0	
37192	"Repositioning of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Service  intra	L051A	RN	0.51	Service total costs	107	0	
37192	"Repositioning of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	29	0	
37192	"Repositioning of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37193	"Removal of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37193	"Removal of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37193	"Removal of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Service  intra	L041A	Angio Technician	0.41	Service total costs	53	0	
37193	"Removal of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	46	0	
37193	"Removal of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Service  intra	L051A	RN	0.51	Service total costs	107	0	
37193	"Removal of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	29	0	
37193	"Removal of vena cava filter by endovascular approach, including radiological supervision and interpretation"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37197	"Retrieval of foreign body of blood vessels, accessed through the skin including radiological supervision and interpretation"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37197	"Retrieval of foreign body of blood vessels, accessed through the skin including radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37197	"Retrieval of foreign body of blood vessels, accessed through the skin including radiological supervision and interpretation"	Service  intra	L041A	Angio Technician	0.41	Service total costs	68	0	
37197	"Retrieval of foreign body of blood vessels, accessed through the skin including radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	52	0	
37197	"Retrieval of foreign body of blood vessels, accessed through the skin including radiological supervision and interpretation"	Service  intra	L051A	RN	0.51	Service total costs	122	0	
37197	"Retrieval of foreign body of blood vessels, accessed through the skin including radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	29	0	
37197	"Retrieval of foreign body of blood vessels, accessed through the skin including radiological supervision and interpretation"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37215	"Transcatheter placement of intravascular stent(s), cervical carotid artery, percutaneous; with distal embolic protection"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
37215	"Transcatheter placement of intravascular stent(s), cervical carotid artery, percutaneous; with distal embolic protection"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
37215	"Transcatheter placement of intravascular stent(s), cervical carotid artery, percutaneous; with distal embolic protection"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
37215	"Transcatheter placement of intravascular stent(s), cervical carotid artery, percutaneous; with distal embolic protection"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
37215	"Transcatheter placement of intravascular stent(s), cervical carotid artery, percutaneous; with distal embolic protection"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
37215	"Transcatheter placement of intravascular stent(s), cervical carotid artery, percutaneous; with distal embolic protection"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
37215	"Transcatheter placement of intravascular stent(s), cervical carotid artery, percutaneous; with distal embolic protection"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
37217	Insertion of intravascular stents in neck artery with radiological supervision and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37217	Insertion of intravascular stents in neck artery with radiological supervision and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
37217	Insertion of intravascular stents in neck artery with radiological supervision and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
37218	"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
37218	"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
37218	"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
37218	"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
37218	"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
37218	"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
37218	"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
37220	"Balloon dilation of artery in one side of groin, endovascular, accessed through the skin or open procedure"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37220	"Balloon dilation of artery in one side of groin, endovascular, accessed through the skin or open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37220	"Balloon dilation of artery in one side of groin, endovascular, accessed through the skin or open procedure"	Service  intra	L041A	Angio Technician	0.41	Service total costs	65	0	
37220	"Balloon dilation of artery in one side of groin, endovascular, accessed through the skin or open procedure"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	60	0	
37220	"Balloon dilation of artery in one side of groin, endovascular, accessed through the skin or open procedure"	Service  intra	L051A	RN	0.51	Service total costs	122	0	
37220	"Balloon dilation of artery in one side of groin, endovascular, accessed through the skin or open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	33	0	
37220	"Balloon dilation of artery in one side of groin, endovascular, accessed through the skin or open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37221	"Insertion of stents in artery in one side of groin, endovascular, accessed through the skin or open procedure"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37221	"Insertion of stents in artery in one side of groin, endovascular, accessed through the skin or open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37221	"Insertion of stents in artery in one side of groin, endovascular, accessed through the skin or open procedure"	Service  intra	L041A	Angio Technician	0.41	Service total costs	95	0	
37221	"Insertion of stents in artery in one side of groin, endovascular, accessed through the skin or open procedure"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	83	0	
37221	"Insertion of stents in artery in one side of groin, endovascular, accessed through the skin or open procedure"	Service  intra	L051A	RN	0.51	Service total costs	152	0	
37221	"Insertion of stents in artery in one side of groin, endovascular, accessed through the skin or open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	0	
37221	"Insertion of stents in artery in one side of groin, endovascular, accessed through the skin or open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37222	"Balloon dilation of groin artery, endovascular, open, or percutaneous approach"	Service  intra	L041A	Angio Technician	0.41	Service total costs	42	0	
37222	"Balloon dilation of groin artery, endovascular, open, or percutaneous approach"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	30	0	
37222	"Balloon dilation of groin artery, endovascular, open, or percutaneous approach"	Service  intra	L051A	RN	0.51	Service total costs	40	0	
37222	"Balloon dilation of groin artery, endovascular, open, or percutaneous approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	10	0	
37223	"Insertion of stents into groin artery, endovascular, accessed through the skin or open procedure"	Service  intra	L041A	Angio Technician	0.41	Service total costs	47	0	
37223	"Insertion of stents into groin artery, endovascular, accessed through the skin or open procedure"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	34	0	
37223	"Insertion of stents into groin artery, endovascular, accessed through the skin or open procedure"	Service  intra	L051A	RN	0.51	Service total costs	45	0	
37223	"Insertion of stents into groin artery, endovascular, accessed through the skin or open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	11	0	
37224	"Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37224	"Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37224	"Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041A	Angio Technician	0.41	Service total costs	85	0	
37224	"Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	75	0	
37224	"Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L051A	RN	0.51	Service total costs	142	0	
37224	"Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	0	
37224	"Balloon dilation of arteries in one leg, endovascular, accessed through the skin or open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37225	"Removal of plaque in arteries in one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37225	"Removal of plaque in arteries in one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37225	"Removal of plaque in arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041A	Angio Technician	0.41	Service total costs	123	0	
37225	"Removal of plaque in arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	104	0	
37225	"Removal of plaque in arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L051A	RN	0.51	Service total costs	180	0	
37225	"Removal of plaque in arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	0	
37225	"Removal of plaque in arteries in one leg, endovascular, accessed through the skin or open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37226	"Insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37226	"Insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37226	"Insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041A	Angio Technician	0.41	Service total costs	95	0	
37226	"Insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	83	0	
37226	"Insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L051A	RN	0.51	Service total costs	152	0	
37226	"Insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	0	
37226	"Insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37227	"Removal of plaque and insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37227	"Removal of plaque and insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37227	"Removal of plaque and insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041A	Angio Technician	0.41	Service total costs	130	0	
37227	"Removal of plaque and insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	109	0	
37227	"Removal of plaque and insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L051A	RN	0.51	Service total costs	187	0	
37227	"Removal of plaque and insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	0	
37227	"Removal of plaque and insertion of stents into arteries in one leg, endovascular, accessed through the skin or open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37228	"Balloon dilation of artery of one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37228	"Balloon dilation of artery of one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37228	"Balloon dilation of artery of one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041A	Angio Technician	0.41	Service total costs	95	0	
37228	"Balloon dilation of artery of one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	83	0	
37228	"Balloon dilation of artery of one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L051A	RN	0.51	Service total costs	152	0	
37228	"Balloon dilation of artery of one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	0	
37228	"Balloon dilation of artery of one leg, endovascular, accessed through the skin or open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37229	"Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37229	"Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37229	"Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041A	Angio Technician	0.41	Service total costs	125	0	
37229	"Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	105	0	
37229	"Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L051A	RN	0.51	Service total costs	182	0	
37229	"Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	0	
37229	"Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37230	"Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37230	"Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37230	"Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041A	Angio Technician	0.41	Service total costs	125	0	
37230	"Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	105	0	
37230	"Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L051A	RN	0.51	Service total costs	182	0	
37230	"Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	0	
37230	"Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37231	"Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37231	"Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37231	"Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041A	Angio Technician	0.41	Service total costs	140	0	
37231	"Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	116	0	
37231	"Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L051A	RN	0.51	Service total costs	197	0	
37231	"Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	52	0	
37231	"Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37232	"Balloon dilation of artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041A	Angio Technician	0.41	Service total costs	42	0	
37232	"Balloon dilation of artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	30	0	
37232	"Balloon dilation of artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L051A	RN	0.51	Service total costs	40	0	
37232	"Balloon dilation of artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	10	0	
37233	"Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041A	Angio Technician	0.41	Service total costs	62	0	
37233	"Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	45	0	
37233	"Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L051A	RN	0.51	Service total costs	60	0	
37233	"Removal of plaque in artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
37234	"Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041A	Angio Technician	0.41	Service total costs	62	0	
37234	"Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	45	0	
37234	"Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L051A	RN	0.51	Service total costs	60	0	
37234	"Insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
37235	"Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041A	Angio Technician	0.41	Service total costs	82	0	
37235	"Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	60	0	
37235	"Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L051A	RN	0.51	Service total costs	80	0	
37235	"Removal of plaque and insertion of stents into artery in one leg, endovascular, accessed through the skin or open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
37236	"Insertion of intravascular stents in artery (except lower extremity, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or accessed through the skin, with radiological supervision and interpretation"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37236	"Insertion of intravascular stents in artery (except lower extremity, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or accessed through the skin, with radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37236	"Insertion of intravascular stents in artery (except lower extremity, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or accessed through the skin, with radiological supervision and interpretation"	Service  intra	L041A	Angio Technician	0.41	Service total costs	163	0	
37236	"Insertion of intravascular stents in artery (except lower extremity, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or accessed through the skin, with radiological supervision and interpretation"	Service  intra	L051A	RN	0.51	Service total costs	152	0	
37236	"Insertion of intravascular stents in artery (except lower extremity, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or accessed through the skin, with radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
37236	"Insertion of intravascular stents in artery (except lower extremity, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or accessed through the skin, with radiological supervision and interpretation"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37237	"Insertion of intravascular stents in artery (except lower extremity, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or accessed through the skin, with radiological supervision and interpretation"	Service  intra	L041A	Angio Technician	0.41	Service total costs	84	0	
37237	"Insertion of intravascular stents in artery (except lower extremity, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or accessed through the skin, with radiological supervision and interpretation"	Service  intra	L051A	RN	0.51	Service total costs	45	0	
37237	"Insertion of intravascular stents in artery (except lower extremity, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or accessed through the skin, with radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	12	0	
37238	"Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37238	"Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37238	"Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation"	Service  intra	L041A	Angio Technician	0.41	Service total costs	110	0	
37238	"Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation"	Service  intra	L051A	RN	0.51	Service total costs	107	0	
37238	"Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	0	
37238	"Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
37239	"Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation"	Service  intra	L041A	Angio Technician	0.41	Service total costs	58	0	
37239	"Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation"	Service  intra	L051A	RN	0.51	Service total costs	30	0	
37239	"Insertion of intravascular stents in vein, open or accessed through the skin, with radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8	0	
37241	"Occlusion of venous malformations (other than hemorrhage) with radiological supervision and interpretation, roadmapping, and imaging guidance"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37241	"Occlusion of venous malformations (other than hemorrhage) with radiological supervision and interpretation, roadmapping, and imaging guidance"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37241	"Occlusion of venous malformations (other than hemorrhage) with radiological supervision and interpretation, roadmapping, and imaging guidance"	Service  intra	L041A	Angio Technician	0.41	Service total costs	178	0	
37241	"Occlusion of venous malformations (other than hemorrhage) with radiological supervision and interpretation, roadmapping, and imaging guidance"	Service  intra	L051A	RN	0.51	Service total costs	140	0	
37241	"Occlusion of venous malformations (other than hemorrhage) with radiological supervision and interpretation, roadmapping, and imaging guidance"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	0	
37241	"Occlusion of venous malformations (other than hemorrhage) with radiological supervision and interpretation, roadmapping, and imaging guidance"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
37242	"Occlusion of artery (other than hemorrhage or tumor) with radiological supervision and interpretation, roadmapping, and imaging guidance"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37242	"Occlusion of artery (other than hemorrhage or tumor) with radiological supervision and interpretation, roadmapping, and imaging guidance"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37242	"Occlusion of artery (other than hemorrhage or tumor) with radiological supervision and interpretation, roadmapping, and imaging guidance"	Service  intra	L041A	Angio Technician	0.41	Service total costs	195	0	
37242	"Occlusion of artery (other than hemorrhage or tumor) with radiological supervision and interpretation, roadmapping, and imaging guidance"	Service  intra	L051A	RN	0.51	Service total costs	165	0	
37242	"Occlusion of artery (other than hemorrhage or tumor) with radiological supervision and interpretation, roadmapping, and imaging guidance"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	0	
37242	"Occlusion of artery (other than hemorrhage or tumor) with radiological supervision and interpretation, roadmapping, and imaging guidance"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
37243	"Occlusion of tumors or obstructed blood vessel with radiological supervision and interpretation, roadmapping, and imaging guidance"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37243	"Occlusion of tumors or obstructed blood vessel with radiological supervision and interpretation, roadmapping, and imaging guidance"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37243	"Occlusion of tumors or obstructed blood vessel with radiological supervision and interpretation, roadmapping, and imaging guidance"	Service  intra	L041A	Angio Technician	0.41	Service total costs	230	0	
37243	"Occlusion of tumors or obstructed blood vessel with radiological supervision and interpretation, roadmapping, and imaging guidance"	Service  intra	L051A	RN	0.51	Service total costs	185	0	
37243	"Occlusion of tumors or obstructed blood vessel with radiological supervision and interpretation, roadmapping, and imaging guidance"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	0	
37243	"Occlusion of tumors or obstructed blood vessel with radiological supervision and interpretation, roadmapping, and imaging guidance"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
37244	"Occlusion of arterial or venous hemorrhage with radiological supervision and interpretation, roadmapping, and imaging guidance"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
37244	"Occlusion of arterial or venous hemorrhage with radiological supervision and interpretation, roadmapping, and imaging guidance"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	6	
37244	"Occlusion of arterial or venous hemorrhage with radiological supervision and interpretation, roadmapping, and imaging guidance"	Service  intra	L041A	Angio Technician	0.41	Service total costs	178	0	
37244	"Occlusion of arterial or venous hemorrhage with radiological supervision and interpretation, roadmapping, and imaging guidance"	Service  intra	L051A	RN	0.51	Service total costs	155	0	
37244	"Occlusion of arterial or venous hemorrhage with radiological supervision and interpretation, roadmapping, and imaging guidance"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	0	
37244	"Occlusion of arterial or venous hemorrhage with radiological supervision and interpretation, roadmapping, and imaging guidance"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
37252	"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial non-coronary vessel (List separately in addition to code for primary procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	1		
37252	"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial non-coronary vessel (List separately in addition to code for primary procedure)"	Service  intra	L041A	Angio Technician	0.41	Acquire images (75%)	15		
37252	"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial non-coronary vessel (List separately in addition to code for primary procedure)"	Service  intra	L041A	Angio Technician	0.41	Assist physician in performing procedure	20		
37252	"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial non-coronary vessel (List separately in addition to code for primary procedure)"	Service  intra	L051A	RN	0.51	Assist physician with conscious sedation monitoring	20		
37252	"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial non-coronary vessel (List separately in addition to code for primary procedure)"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulating throughout procedure (25%)	5		
37252	"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial non-coronary vessel (List separately in addition to code for primary procedure)"	Service  post	L041A	Angio Technician	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
37252	"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial non-coronary vessel (List separately in addition to code for primary procedure)"	Service  post	L041A	Angio Technician	0.41	Review examination with interpreting MD	2		
37252	"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial non-coronary vessel (List separately in addition to code for primary procedure)"	Service  post	L041A	Angio Technician	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
37253	"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure)"	Service  intra	L041A	Angio Technician	0.41	Acquire images (75%)	15		
37253	"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure)"	Service  intra	L041A	Angio Technician	0.41	Assist physician in performing procedure	20		
37253	"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure)"	Service  intra	L051A	RN	0.51	Assist physician with conscious sedation monitoring	20		
37253	"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure)"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulating throughout procedure (25%)	5		
37253	"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure)"	Service  post	L041A	Angio Technician	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
37253	"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure)"	Service  post	L041A	Angio Technician	0.41	Review examination with interpreting MD	1		
37253	"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure)"	Service  post	L041A	Angio Technician	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	1		
37500	Tying of perforator veins in leg muscles using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37500	Tying of perforator veins in leg muscles using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
37500	Tying of perforator veins in leg muscles using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
37565	Tying internal jugular vein (neck)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37565	Tying internal jugular vein (neck)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
37565	Tying internal jugular vein (neck)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
37600	Tying external carotid artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37600	Tying external carotid artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
37600	Tying external carotid artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
37605	Tying internal or common carotid artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37605	Tying internal or common carotid artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
37605	Tying internal or common carotid artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
37606	Tying and gradual clamping of neck artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37606	Tying and gradual clamping of neck artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
37606	Tying and gradual clamping of neck artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
37607	Tying or banding of a passage between an artery and vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37607	Tying or banding of a passage between an artery and vein	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
37607	Tying or banding of a passage between an artery and vein	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
37609	Tying or biopsy of temporal artery (side of skull)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
37609	Tying or biopsy of temporal artery (side of skull)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	64	6	
37609	Tying or biopsy of temporal artery (side of skull)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
37615	Tying of major neck artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37615	Tying of major neck artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
37615	Tying of major neck artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
37616	Tying of major chest artery	Pre-service	L051A	RN	0.51	Preservice total costs		60	
37616	Tying of major chest artery	Service  intra	L051A	RN	0.51	Service total costs		12	
37616	Tying of major chest artery	Post-service	L051A	RN	0.51	Post service total costs		68	
37617	Tying of major artery of the abdomen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37617	Tying of major artery of the abdomen	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
37617	Tying of major artery of the abdomen	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
37618	Tying of major artery of arm or leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37618	Tying of major artery of arm or leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
37618	Tying of major artery of arm or leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
37619	Tying inferior vena cava	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
37619	Tying inferior vena cava	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
37650	Tying femoral vein (upper leg vein)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37650	Tying femoral vein (upper leg vein)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
37650	Tying femoral vein (upper leg vein)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
37660	Tying common iliac vein (groin vein)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37660	Tying common iliac vein (groin vein)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
37660	Tying common iliac vein (groin vein)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
37700	Tying and incision leg vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37700	Tying and incision leg vein	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
37700	Tying and incision leg vein	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
37718	Suturing incision and stripping leg vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37718	Suturing incision and stripping leg vein	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
37718	Suturing incision and stripping leg vein	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
37722	Tying incision and stripping leg veins	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37722	Tying incision and stripping leg veins	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
37722	Tying incision and stripping leg veins	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
37735	Tying incision and complete stripping leg veins with removal of ulcer skin graft deep tissue and/or interruption of connection with veins of the leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37735	Tying incision and complete stripping leg veins with removal of ulcer skin graft deep tissue and/or interruption of connection with veins of the leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
37735	Tying incision and complete stripping leg veins with removal of ulcer skin graft deep tissue and/or interruption of connection with veins of the leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
37760	"Tying of varicosed veins in one leg, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37760	"Tying of varicosed veins in one leg, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
37760	"Tying of varicosed veins in one leg, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
37761	"Tying of varicosed veins in one leg, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37761	"Tying of varicosed veins in one leg, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
37761	"Tying of varicosed veins in one leg, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
37765	Multiple incisions for removal of varicose veins of arm or leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
37765	Multiple incisions for removal of varicose veins of arm or leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	91	0	
37765	Multiple incisions for removal of varicose veins of arm or leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	66	63	
37766	Multiple incisions for removal of varicose veins of arm or leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
37766	Multiple incisions for removal of varicose veins of arm or leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	121	0	
37766	Multiple incisions for removal of varicose veins of arm or leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	66	63	
37780	Tying and incision leg vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37780	Tying and incision leg vein	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
37780	Tying and incision leg vein	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
37785	Tying incision and/or removal of varicose vein clusters of leg	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
37785	Tying incision and/or removal of varicose vein clusters of leg	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	94	6	
37785	Tying incision and/or removal of varicose vein clusters of leg	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
37788	Restoration of blood flow in penile artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37788	Restoration of blood flow in penile artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
37788	Restoration of blood flow in penile artery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
37790	Occlusion of penile vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
37790	Occlusion of penile vein	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
37790	Occlusion of penile vein	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
38100	Removal of spleen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38100	Removal of spleen	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38100	Removal of spleen	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
38101	Partial removal of spleen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38101	Partial removal of spleen	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38101	Partial removal of spleen	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
38115	Repair of ruptured spleen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38115	Repair of ruptured spleen	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38115	Repair of ruptured spleen	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
38120	Examination of spleen using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38120	Examination of spleen using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38120	Examination of spleen using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		114	
38220	Bone marrow aspiration	Service  intra	L033A	Lab Technician	0.33	Service total costs	9	0	
38220	Bone marrow aspiration	Service  intra	L051A	RN	0.51	Service total costs	69	0	
38220	Bone marrow aspiration	Post-service	L051A	RN	0.51	Post service total costs	3	0	
38221	Needle or trocar bone marrow biopsy	Service  intra	L033A	Lab Technician	0.33	Service total costs	7	0	
38221	Needle or trocar bone marrow biopsy	Service  intra	L051A	RN	0.51	Service total costs	74	0	
38221	Needle or trocar bone marrow biopsy	Post-service	L051A	RN	0.51	Post service total costs	3	0	
38300	Drainage of lymph node abscess or inflammation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
38300	Drainage of lymph node abscess or inflammation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	54	6	
38300	Drainage of lymph node abscess or inflammation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	63	63	
38305	Drainage of extensive lymph node abscess or inflammation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38305	Drainage of extensive lymph node abscess or inflammation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38305	Drainage of extensive lymph node abscess or inflammation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
38308	Removal of growth of lymph node	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38308	Removal of growth of lymph node	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
38308	Removal of growth of lymph node	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
38380	Suture and/or tying chest lymph duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38380	Suture and/or tying chest lymph duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38380	Suture and/or tying chest lymph duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
38381	Suture and/or tying chest lymph duct	Pre-service	L051A	RN	0.51	Preservice total costs		60	
38381	Suture and/or tying chest lymph duct	Service  intra	L051A	RN	0.51	Service total costs		12	
38381	Suture and/or tying chest lymph duct	Post-service	L051A	RN	0.51	Post service total costs		54	
38382	Suture and/or tying chest lymph duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38382	Suture and/or tying chest lymph duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38382	Suture and/or tying chest lymph duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
38500	"Biopsy or removal of lymph nodes, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
38500	"Biopsy or removal of lymph nodes, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
38500	"Biopsy or removal of lymph nodes, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
38505	Needle biopsy or removal of lymph nodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
38505	Needle biopsy or removal of lymph nodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	0	
38505	Needle biopsy or removal of lymph nodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
38510	"Biopsy or removal of lymph nodes of neck, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
38510	"Biopsy or removal of lymph nodes of neck, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	6	
38510	"Biopsy or removal of lymph nodes of neck, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
38520	"Biopsy or removal of lymph nodes of neck, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38520	"Biopsy or removal of lymph nodes of neck, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
38520	"Biopsy or removal of lymph nodes of neck, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
38525	"Biopsy or removal of lymph nodes of under the arm, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38525	"Biopsy or removal of lymph nodes of under the arm, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
38525	"Biopsy or removal of lymph nodes of under the arm, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
38530	"Biopsy or removal of breast lymph nodes, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38530	"Biopsy or removal of breast lymph nodes, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38530	"Biopsy or removal of breast lymph nodes, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
38542	Removal of lymph nodes of neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38542	Removal of lymph nodes of neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
38542	Removal of lymph nodes of neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
38550	Removal of congenital defect of lymph nodes at underarm or neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38550	Removal of congenital defect of lymph nodes at underarm or neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
38550	Removal of congenital defect of lymph nodes at underarm or neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
38555	Removal of congenital defect of lymph nodes at underarm or neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38555	Removal of congenital defect of lymph nodes at underarm or neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38555	Removal of congenital defect of lymph nodes at underarm or neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		149	
38562	Removal of pelvic or aortic lymph nodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38562	Removal of pelvic or aortic lymph nodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38562	Removal of pelvic or aortic lymph nodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
38564	Removal of lymph nodes behind abdominal cavity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38564	Removal of lymph nodes behind abdominal cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38564	Removal of lymph nodes behind abdominal cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
38570	Removal of abdominal cavity lymph nodes using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
38570	Removal of abdominal cavity lymph nodes using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
38570	Removal of abdominal cavity lymph nodes using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
38570	Removal of abdominal cavity lymph nodes using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
38570	Removal of abdominal cavity lymph nodes using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
38570	Removal of abdominal cavity lymph nodes using an endoscope	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
38570	Removal of abdominal cavity lymph nodes using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		27	
38570	Removal of abdominal cavity lymph nodes using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		36	
38571	Removal of total lymph nodes of both sides of pelvis using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
38571	Removal of total lymph nodes of both sides of pelvis using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
38571	Removal of total lymph nodes of both sides of pelvis using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
38571	Removal of total lymph nodes of both sides of pelvis using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
38571	Removal of total lymph nodes of both sides of pelvis using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
38571	Removal of total lymph nodes of both sides of pelvis using an endoscope	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
38571	Removal of total lymph nodes of both sides of pelvis using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		27	
38571	Removal of total lymph nodes of both sides of pelvis using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		36	
38572	Removal of total lymph nodes of both sides of pelvis and abdominal lymph node biopsy using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
38572	Removal of total lymph nodes of both sides of pelvis and abdominal lymph node biopsy using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
38572	Removal of total lymph nodes of both sides of pelvis and abdominal lymph node biopsy using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
38572	Removal of total lymph nodes of both sides of pelvis and abdominal lymph node biopsy using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
38572	Removal of total lymph nodes of both sides of pelvis and abdominal lymph node biopsy using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
38572	Removal of total lymph nodes of both sides of pelvis and abdominal lymph node biopsy using an endoscope	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
38572	Removal of total lymph nodes of both sides of pelvis and abdominal lymph node biopsy using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		36	
38572	Removal of total lymph nodes of both sides of pelvis and abdominal lymph node biopsy using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	99214    53  minutes		53	
38700	Removal of lymph nodes from chin to thyroid cartilage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38700	Removal of lymph nodes from chin to thyroid cartilage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38700	Removal of lymph nodes from chin to thyroid cartilage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
38720	Removal of neck lymph nodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38720	Removal of neck lymph nodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38720	Removal of neck lymph nodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		161	
38724	"Removal of lymph nodes, muscle, and tissue of neck"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38724	"Removal of lymph nodes, muscle, and tissue of neck"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38724	"Removal of lymph nodes, muscle, and tissue of neck"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		161	
38740	Removal of underarm lymph nodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38740	Removal of underarm lymph nodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
38740	Removal of underarm lymph nodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
38745	Removal of all underarm lymph nodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38745	Removal of all underarm lymph nodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
38745	Removal of all underarm lymph nodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
38760	Removal of lymph nodes at groin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38760	Removal of lymph nodes at groin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
38760	Removal of lymph nodes at groin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
38765	Removal of lymph nodes at groin and pelvis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38765	Removal of lymph nodes at groin and pelvis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38765	Removal of lymph nodes at groin and pelvis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
38770	Removal of lymph nodes at groin and pelvis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38770	Removal of lymph nodes at groin and pelvis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38770	Removal of lymph nodes at groin and pelvis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
38780	Removal of abdominal cavity lymph nodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38780	Removal of abdominal cavity lymph nodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
38780	Removal of abdominal cavity lymph nodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
38790	Injection procedure for X-ray imaging of the lymphatic system	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
38790	Injection procedure for X-ray imaging of the lymphatic system	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
38792	Injection of radioactive dye for X-ray identification of lymph node	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
38794	Exposure of lymph node of chest cavity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
38794	Exposure of lymph node of chest cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
38794	Exposure of lymph node of chest cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
39000	"Drainage, biopsy, or removal of foreign body of chest cavity"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
39000	"Drainage, biopsy, or removal of foreign body of chest cavity"	Service  intra	L051A	RN	0.51	Service total costs		12	
39000	"Drainage, biopsy, or removal of foreign body of chest cavity"	Post-service	L051A	RN	0.51	Post service total costs		54	
39010	"Drainage, biopsy, or removal of foreign body of chest cavity"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
39010	"Drainage, biopsy, or removal of foreign body of chest cavity"	Service  intra	L051A	RN	0.51	Service total costs		12	
39010	"Drainage, biopsy, or removal of foreign body of chest cavity"	Post-service	L051A	RN	0.51	Post service total costs		54	
39200	Removal of cyst below breast bone	Pre-service	L051A	RN	0.51	Preservice total costs		60	
39200	Removal of cyst below breast bone	Service  intra	L051A	RN	0.51	Service total costs		12	
39200	Removal of cyst below breast bone	Post-service	L051A	RN	0.51	Post service total costs		36	
39220	Removal of tumor below breast bone	Pre-service	L051A	RN	0.51	Preservice total costs		60	
39220	Removal of tumor below breast bone	Service  intra	L051A	RN	0.51	Service total costs		12	
39220	Removal of tumor below breast bone	Post-service	L051A	RN	0.51	Post service total costs		63	
39401	"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed"	Pre-service	L051A	RN	0.51	Complete pre-service diagnostic and referral forms		5	
39401	"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed"	Pre-service	L051A	RN	0.51	Coordinate pre-surgery services		10	
39401	"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed"	Pre-service	L051A	RN	0.51	Follow-up phone calls and prescriptions		3	
39401	"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed"	Pre-service	L051A	RN	0.51	Provide pre-service education/obtain consent		7	
39401	"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
39401	"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed"	Service  post	L051A	RN	0.51	Discharge day management 99238 --12 minutes		6	
39402	"Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging)"	Pre-service	L051A	RN	0.51	Complete pre-service diagnostic and referral forms		5	
39402	"Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging)"	Pre-service	L051A	RN	0.51	Coordinate pre-surgery services		10	
39402	"Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging)"	Pre-service	L051A	RN	0.51	Follow-up phone calls and prescriptions		3	
39402	"Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging)"	Pre-service	L051A	RN	0.51	Provide pre-service education/obtain consent		7	
39402	"Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging)"	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		5	
39402	"Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging)"	Service  post	L051A	RN	0.51	Discharge day management 99238 --12 minutes		6	
39501	Repair of muscle tissue separating the chest and abdominal cavities	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
39501	Repair of muscle tissue separating the chest and abdominal cavities	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
39501	Repair of muscle tissue separating the chest and abdominal cavities	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
39503	"Repair of congenital defect of muscle separating the chest and abdominal cavities, neonate"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
39503	"Repair of congenital defect of muscle separating the chest and abdominal cavities, neonate"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
39503	"Repair of congenital defect of muscle separating the chest and abdominal cavities, neonate"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		179	
39540	Repair of injury to muscle separating the chest and abdominal cavities	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
39540	Repair of injury to muscle separating the chest and abdominal cavities	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
39540	Repair of injury to muscle separating the chest and abdominal cavities	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
39541	Repair of injury to muscle separating the chest and abdominal cavities	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
39541	Repair of injury to muscle separating the chest and abdominal cavities	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
39541	Repair of injury to muscle separating the chest and abdominal cavities	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
39545	Suture of muscle separating the chest and abdominal cavities to restore function	Pre-service	L051A	RN	0.51	Preservice total costs		60	
39545	Suture of muscle separating the chest and abdominal cavities to restore function	Service  intra	L051A	RN	0.51	Service total costs		12	
39545	Suture of muscle separating the chest and abdominal cavities to restore function	Post-service	L051A	RN	0.51	Post service total costs		81	
39560	Repair of the muscle separating the chest and abdominal cavities	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
39560	Repair of the muscle separating the chest and abdominal cavities	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
39560	Repair of the muscle separating the chest and abdominal cavities	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
39561	Repair of muscle separating chest and abdominal cavities	Pre-service	L051A	RN	0.51	Preservice total costs		60	
39561	Repair of muscle separating chest and abdominal cavities	Service  intra	L051A	RN	0.51	Service total costs		12	
39561	Repair of muscle separating chest and abdominal cavities	Post-service	L051A	RN	0.51	Post service total costs		159	
40490	Biopsy of lip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	0	
40500	Removal of border of lip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40500	Removal of border of lip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	115	6	
40500	Removal of border of lip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
40510	Removal of wedge of lip tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40510	Removal of wedge of lip tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	94	6	
40510	Removal of wedge of lip tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
40520	V-shaped removal of lip tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40520	V-shaped removal of lip tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	93	6	
40520	V-shaped removal of lip tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
40525	Removal of lip with skin flap repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
40525	Removal of lip with skin flap repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
40525	Removal of lip with skin flap repair	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
40527	Removal of lip with skin flap repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
40527	Removal of lip with skin flap repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
40527	Removal of lip with skin flap repair	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
40530	Partial removal of lip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40530	Partial removal of lip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	103	6	
40530	Partial removal of lip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
40650	Repair of lip and border	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40650	Repair of lip and border	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	6	
40650	Repair of lip and border	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
40652	Repair of vertical lip wound extending to half of lip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40652	Repair of vertical lip wound extending to half of lip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	81	6	
40652	Repair of vertical lip wound extending to half of lip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
40654	Repair of vertical lip wound extending to over half of lip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40654	Repair of vertical lip wound extending to over half of lip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	103	6	
40654	Repair of vertical lip wound extending to over half of lip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	95	95	
40700	Plastic repair of deformity present at birth on one side of the nose or lip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
40700	Plastic repair of deformity present at birth on one side of the nose or lip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
40700	Plastic repair of deformity present at birth on one side of the nose or lip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
40701	Plastic repair of deformity present at birth on both sides of the nose or lip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
40701	Plastic repair of deformity present at birth on both sides of the nose or lip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
40701	Plastic repair of deformity present at birth on both sides of the nose or lip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
40702	Plastic repair of deformity present at birth on both sides of the nose or lip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
40702	Plastic repair of deformity present at birth on both sides of the nose or lip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
40702	Plastic repair of deformity present at birth on both sides of the nose or lip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
40720	Plastic repair of nasal and lip deformity present at birth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
40720	Plastic repair of nasal and lip deformity present at birth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
40720	Plastic repair of nasal and lip deformity present at birth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
40761	Plastic repair of nasal and lip deformity present at birth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
40761	Plastic repair of nasal and lip deformity present at birth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
40761	Plastic repair of nasal and lip deformity present at birth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
40800	"Incision of abscess, cyst, or blood accumulation in mouth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
40800	"Incision of abscess, cyst, or blood accumulation in mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	54	6	
40800	"Incision of abscess, cyst, or blood accumulation in mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	43	43	
40801	"Incision of abscess, cyst, or blood accumulation in mouth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
40801	"Incision of abscess, cyst, or blood accumulation in mouth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	64	12	
40801	"Incision of abscess, cyst, or blood accumulation in mouth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0	5	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	0	10	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	0	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	0	7	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0	5	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	0	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	0	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	0	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	20	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	0	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	10	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	0	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  post	L037D	RN/LPN/MTA	0.37	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains"	5	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Service  post	L037D	RN/LPN/MTA	0.37	"Review/read X-ray, lab, and pathology reports"	0	0	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Post-service	L037D	RN/LPN/MTA	0.37	99211     16 minutes	16	16	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes	27	27	
40804	"Removal of embedded foreign body, vestibule of mouth; simple"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	0	0	
40805	Removal of embedded foreign body of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
40805	Removal of embedded foreign body of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	69	12	
40805	Removal of embedded foreign body of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
40806	Incision of tissue joining lip and gums	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
40806	Incision of tissue joining lip and gums	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	0	
40806	Incision of tissue joining lip and gums	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
40808	Biopsy of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
40808	Biopsy of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	54	6	
40808	Biopsy of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
40810	Removal of growth of tissue of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
40810	Removal of growth of tissue of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	54	6	
40810	Removal of growth of tissue of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
40812	Removal of growth of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
40812	Removal of growth of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	6	
40812	Removal of growth of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	43	43	
40814	Removal of growth of mouth with plastic repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40814	Removal of growth of mouth with plastic repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	69	6	
40814	Removal of growth of mouth with plastic repair	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	70	70	
40816	Removal of tissue and muscle growth of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40816	Removal of tissue and muscle growth of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	79	6	
40816	Removal of tissue and muscle growth of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	70	70	
40818	Removal of mouth tissue for grafting	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40818	Removal of mouth tissue for grafting	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	77	6	
40818	Removal of mouth tissue for grafting	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
40819	Removal of tissue at dental edge and cheek	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40819	Removal of tissue at dental edge and cheek	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	6	
40819	Removal of tissue at dental edge and cheek	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
40820	Destruction of growth or scar of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	23	
40820	Destruction of growth or scar of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	6	
40820	Destruction of growth or scar of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	43	43	
40830	Suture of (2.5 centimeter or less) mouth laceration	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
40830	Suture of (2.5 centimeter or less) mouth laceration	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	6	
40830	Suture of (2.5 centimeter or less) mouth laceration	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	43	43	
40831	Suture of (over 2.5 centimeter) mouth laceration	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
40831	Suture of (over 2.5 centimeter) mouth laceration	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	70	6	
40831	Suture of (over 2.5 centimeter) mouth laceration	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	70	70	
40840	Repair to increase depth of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40840	Repair to increase depth of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	155	6	
40840	Repair to increase depth of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	106	106	
40842	Repair to increase depth on one side of the mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40842	Repair to increase depth on one side of the mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	155	6	
40842	Repair to increase depth on one side of the mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	106	106	
40843	Repair to increase depth on both sides of the mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40843	Repair to increase depth on both sides of the mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	215	6	
40843	Repair to increase depth on both sides of the mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	79	79	
40844	Repair to increase depth of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40844	Repair to increase depth of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	215	6	
40844	Repair to increase depth of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	169	169	
40845	Repair to increase depth of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
40845	Repair to increase depth of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	195	12	
40845	Repair to increase depth of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	169	169	
41000	"Drainage of abscess, cyst, or blood accumulation of tongue"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
41000	"Drainage of abscess, cyst, or blood accumulation of tongue"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	12	
41000	"Drainage of abscess, cyst, or blood accumulation of tongue"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
41005	"Drainage of abscess, cyst, or blood accumulation under the tongue"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41005	"Drainage of abscess, cyst, or blood accumulation under the tongue"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	6	
41005	"Drainage of abscess, cyst, or blood accumulation under the tongue"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
41006	"Drainage of abscess, cyst, or blood accumulation under the tongue"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41006	"Drainage of abscess, cyst, or blood accumulation under the tongue"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
41006	"Drainage of abscess, cyst, or blood accumulation under the tongue"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
41007	"Drainage of abscess, cyst, or blood accumulation under the tongue or lower lip"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41007	"Drainage of abscess, cyst, or blood accumulation under the tongue or lower lip"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	6	
41007	"Drainage of abscess, cyst, or blood accumulation under the tongue or lower lip"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
41008	"Drainage of abscess, cyst, or blood accumulation under the jaw bone"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41008	"Drainage of abscess, cyst, or blood accumulation under the jaw bone"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	64	6	
41008	"Drainage of abscess, cyst, or blood accumulation under the jaw bone"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
41009	"Drainage of abscess, cyst, or blood accumulation under lower teeth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41009	"Drainage of abscess, cyst, or blood accumulation under lower teeth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	6	
41009	"Drainage of abscess, cyst, or blood accumulation under lower teeth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
41010	Incision of tissue connecting tongue and floor of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	23	
41010	Incision of tissue connecting tongue and floor of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	37	6	
41010	Incision of tissue connecting tongue and floor of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
41015	"Drainage of abscess, cyst, or blood accumulation under the tongue"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41015	"Drainage of abscess, cyst, or blood accumulation under the tongue"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	6	
41015	"Drainage of abscess, cyst, or blood accumulation under the tongue"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
41016	"Drainage of abscess, cyst, or blood accumulation under the tongue or lower lip"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41016	"Drainage of abscess, cyst, or blood accumulation under the tongue or lower lip"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	70	12	
41016	"Drainage of abscess, cyst, or blood accumulation under the tongue or lower lip"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
41017	"Drainage of abscess, cyst, or blood accumulation under the tongue or jaw bone"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41017	"Drainage of abscess, cyst, or blood accumulation under the tongue or jaw bone"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	12	
41017	"Drainage of abscess, cyst, or blood accumulation under the tongue or jaw bone"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
41018	"Drainage of abscess, cyst, or blood accumulation under the tongue or lower teeth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41018	"Drainage of abscess, cyst, or blood accumulation under the tongue or lower teeth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	77	12	
41018	"Drainage of abscess, cyst, or blood accumulation under the tongue or lower teeth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
41019	"Insertion of needles, catheters, or devices into head and/or neck for radiation delivery"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
41019	"Insertion of needles, catheters, or devices into head and/or neck for radiation delivery"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
41100	Biopsy of tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	12	
41100	Biopsy of tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	6	
41100	Biopsy of tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
41105	Biopsy of tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	12	
41105	Biopsy of tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	6	
41105	Biopsy of tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	29	29	
41108	Biopsy of floor of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	12	
41108	Biopsy of floor of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	6	
41108	Biopsy of floor of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	29	29	
41110	Removal of growth of tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
41110	Removal of growth of tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	6	
41110	Removal of growth of tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	16	16	
41112	Removal of growth of tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41112	Removal of growth of tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	70	6	
41112	Removal of growth of tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
41113	Removal of growth of tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41113	Removal of growth of tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	6	
41113	Removal of growth of tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
41114	Removal of growth of tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
41114	Removal of growth of tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
41114	Removal of growth of tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
41115	Removal of tissue connecting tongue and floor of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	23	
41115	Removal of tissue connecting tongue and floor of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	6	
41115	Removal of tissue connecting tongue and floor of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
41116	Removal of growth of floor of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41116	Removal of growth of floor of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	6	
41116	Removal of growth of floor of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	41	41	
41120	Partial removal of tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
41120	Partial removal of tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
41120	Partial removal of tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		161	
41130	Partial removal of tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
41130	Partial removal of tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
41130	Partial removal of tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		161	
41135	Partial removal of tongue and surrounding lymph nodes on one side of neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
41135	Partial removal of tongue and surrounding lymph nodes on one side of neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
41135	Partial removal of tongue and surrounding lymph nodes on one side of neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		224	
41140	Complete removal of tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
41140	Complete removal of tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
41140	Complete removal of tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		241	
41145	Complete removal of tongue and surrounding lymph nodes on one side of neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
41145	Complete removal of tongue and surrounding lymph nodes on one side of neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
41145	Complete removal of tongue and surrounding lymph nodes on one side of neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		241	
41150	"Removal of tongue, floor of mouth, and jaw bone"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
41150	"Removal of tongue, floor of mouth, and jaw bone"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
41150	"Removal of tongue, floor of mouth, and jaw bone"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		241	
41153	"Removal of tongue, floor of mouth, soft tissue, and lymph nodes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
41153	"Removal of tongue, floor of mouth, soft tissue, and lymph nodes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
41153	"Removal of tongue, floor of mouth, soft tissue, and lymph nodes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		224	
41155	"Removal of tongue, floor of mouth, jaw bone, tissue, and lymph nodes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
41155	"Removal of tongue, floor of mouth, jaw bone, tissue, and lymph nodes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
41155	"Removal of tongue, floor of mouth, jaw bone, tissue, and lymph nodes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		241	
41250	Repair of (2.5 centimeter or less) laceration to floor of mouth and/or tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	20	
41250	Repair of (2.5 centimeter or less) laceration to floor of mouth and/or tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	66	6	
41250	Repair of (2.5 centimeter or less) laceration to floor of mouth and/or tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
41251	Repair of (2.5 centimeter or less) laceration to floor of mouth or tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	20	
41251	Repair of (2.5 centimeter or less) laceration to floor of mouth or tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	6	
41251	Repair of (2.5 centimeter or less) laceration to floor of mouth or tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
41252	Repair of (over 2.6 laceration) to floor of mouth or tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	20	
41252	Repair of (over 2.6 laceration) to floor of mouth or tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	79	6	
41252	Repair of (over 2.6 laceration) to floor of mouth or tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
41500	Wiring of tongue to jaw bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
41500	Wiring of tongue to jaw bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
41500	Wiring of tongue to jaw bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		101	
41510	Suture of tongue to lip	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
41510	Suture of tongue to lip	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
41510	Suture of tongue to lip	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		101	
41512	Suture of tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
41512	Suture of tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
41512	Suture of tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
41520	Revision of tissue connecting tongue to floor of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41520	Revision of tissue connecting tongue to floor of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	6	
41520	Revision of tissue connecting tongue to floor of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
41530	"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	5	5	
41530	"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	10	
41530	"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
41530	"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	7	7	
41530	"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0	5	
41530	"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	30	0	
41530	"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3	0	
41530	"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3	0	
41530	"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30	0	
41530	"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session"	Service  post	L037D	RN/LPN/MTA	0.37	Dischrg mgmt (0.5 x 99238) (enter 6 min)		6	
41530	"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session"	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes	27	27	
41530	"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes	36	36	
41800	"Drainage of abscess, cyst, or blood accumulation of dental bone"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	18	
41800	"Drainage of abscess, cyst, or blood accumulation of dental bone"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	6	
41800	"Drainage of abscess, cyst, or blood accumulation of dental bone"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
41805	Removal of embedded foreign body from soft tissue of tooth bearing bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	18	
41805	Removal of embedded foreign body from soft tissue of tooth bearing bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	6	
41805	Removal of embedded foreign body from soft tissue of tooth bearing bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
41806	Removal of foreign body in dental bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	18	
41806	Removal of foreign body in dental bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	68	6	
41806	Removal of foreign body in dental bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
41822	Removal of tissue fiber at dental bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	18	
41822	Removal of tissue fiber at dental bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	79	6	
41822	Removal of tissue fiber at dental bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
41823	Removal of dental bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41823	Removal of dental bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	76	6	
41823	Removal of dental bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	117	117	
41825	Removal of growth of dental bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	18	
41825	Removal of growth of dental bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	6	
41825	Removal of growth of dental bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
41826	Removal of growth of dental bone with repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	18	
41826	Removal of growth of dental bone with repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	6	
41826	Removal of growth of dental bone with repair	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
41827	Removal of growth of dental bone with repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41827	Removal of growth of dental bone with repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	92	6	
41827	Removal of growth of dental bone with repair	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
41828	Removal of enlarged membrane covering of teeth or tooth socket	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	18	
41828	Removal of enlarged membrane covering of teeth or tooth socket	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	85	6	
41828	Removal of enlarged membrane covering of teeth or tooth socket	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
41830	Removal of tissue overgrowth at teeth or tooth socket	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	18	
41830	Removal of tissue overgrowth at teeth or tooth socket	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	95	6	
41830	Removal of tissue overgrowth at teeth or tooth socket	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	70	70	
41872	Relocation of mouth tissue to gum surface	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41872	Relocation of mouth tissue to gum surface	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	92	6	
41872	Relocation of mouth tissue to gum surface	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	99	99	
41874	Reshaping of tooth bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
41874	Reshaping of tooth bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	92	6	
41874	Reshaping of tooth bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
42000	Incision and drainage of roof of mouth or its soft tissue projection	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
42000	Incision and drainage of roof of mouth or its soft tissue projection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	6	
42000	Incision and drainage of roof of mouth or its soft tissue projection	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42100	Biopsy of roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
42100	Biopsy of roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	31	6	
42100	Biopsy of roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42104	Removal of growth of roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
42104	Removal of growth of roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	6	
42104	Removal of growth of roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42106	Removal of growth of roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
42106	Removal of growth of roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	67	6	
42106	Removal of growth of roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42107	Removal of growth of roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
42107	Removal of growth of roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	101	6	
42107	Removal of growth of roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
42120	Partial removal of roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42120	Partial removal of roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42120	Partial removal of roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
42140	Removal of soft tissue at roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
42140	Removal of soft tissue at roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	6	
42140	Removal of soft tissue at roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	41	41	
42145	Removal of soft tissue at roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42145	Removal of soft tissue at roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
42145	Removal of soft tissue at roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
42160	Destruction of growth or soft tissue at roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
42160	Destruction of growth or soft tissue at roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	6	
42160	Destruction of growth or soft tissue at roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42180	Repair of (up to 2 centimeters) laceration at roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
42180	Repair of (up to 2 centimeters) laceration at roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	12	
42180	Repair of (up to 2 centimeters) laceration at roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42182	Repair of (over 2 centimeters) laceration at roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
42182	Repair of (over 2 centimeters) laceration at roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	52	12	
42182	Repair of (over 2 centimeters) laceration at roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42200	Repair of defect of roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42200	Repair of defect of roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42200	Repair of defect of roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
42205	Repair of defect of roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42205	Repair of defect of roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42205	Repair of defect of roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
42210	Repair of defect of roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42210	Repair of defect of roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42210	Repair of defect of roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
42215	Repair of defect of roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42215	Repair of defect of roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42215	Repair of defect of roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
42220	Lengthening of roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42220	Lengthening of roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42220	Lengthening of roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
42225	Repair of defect of roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42225	Repair of defect of roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42225	Repair of defect of roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		176	
42226	Lengthening of roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42226	Lengthening of roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42226	Lengthening of roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		176	
42227	Lengthening of roof of mouth using mucous membrane flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42227	Lengthening of roof of mouth using mucous membrane flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42227	Lengthening of roof of mouth using mucous membrane flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		150	
42235	Lengthening of roof of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42235	Lengthening of roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42235	Lengthening of roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		150	
42260	Repair of abnormal connection from nasal sinus to skin surface	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
42260	Repair of abnormal connection from nasal sinus to skin surface	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	125	6	
42260	Repair of abnormal connection from nasal sinus to skin surface	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	106	106	
42280	Impression of cheek bone for prosthesis at roof of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	33	0	
42280	Impression of cheek bone for prosthesis at roof of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42281	Insertion of roof of mouth prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
42281	Insertion of roof of mouth prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	12	
42281	Insertion of roof of mouth prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42300	Drainage of abscess of salivary gland	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
42300	Drainage of abscess of salivary gland	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	12	
42300	Drainage of abscess of salivary gland	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42305	Drainage of abscess of salivary gland	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42305	Drainage of abscess of salivary gland	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42305	Drainage of abscess of salivary gland	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
42310	Drainage of lower jaw abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
42310	Drainage of lower jaw abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	12	
42310	Drainage of lower jaw abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42320	Drainage of lower jaw abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
42320	Drainage of lower jaw abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	12	
42320	Drainage of lower jaw abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42330	Removal of salivary gland stone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
42330	Removal of salivary gland stone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	54	6	
42330	Removal of salivary gland stone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42335	Removal of salivary gland stone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
42335	Removal of salivary gland stone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	6	
42335	Removal of salivary gland stone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
42340	Removal of salivary gland stone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
42340	Removal of salivary gland stone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	87	6	
42340	Removal of salivary gland stone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
42400	Needle biopsy of salivary gland	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
42400	Needle biopsy of salivary gland	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	0	
42400	Needle biopsy of salivary gland	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
42405	Biopsy of salivary gland	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
42405	Biopsy of salivary gland	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	6	
42405	Biopsy of salivary gland	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42408	Removal of salivary cyst under tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
42408	Removal of salivary cyst under tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	86	6	
42408	Removal of salivary cyst under tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
42409	Creation of tract to drain salivary gland cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
42409	Creation of tract to drain salivary gland cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	6	
42409	Creation of tract to drain salivary gland cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
42410	"Removal of salivary gland growth or salivary gland, lateral lobe"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42410	"Removal of salivary gland growth or salivary gland, lateral lobe"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
42410	"Removal of salivary gland growth or salivary gland, lateral lobe"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
42415	Partial removal of salivary gland growth with release of facial nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42415	Partial removal of salivary gland growth with release of facial nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42415	Partial removal of salivary gland growth with release of facial nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
42420	Removal of total salivary gland growth or salivary gland with release of facial nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42420	Removal of total salivary gland growth or salivary gland with release of facial nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42420	Removal of total salivary gland growth or salivary gland with release of facial nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
42425	Removal of total salivary gland growth or salivary gland and facial nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42425	Removal of total salivary gland growth or salivary gland and facial nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42425	Removal of total salivary gland growth or salivary gland and facial nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
42426	Removal of total salivary gland growth or salivary gland and surrounding lymph nodes on one side of neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42426	Removal of total salivary gland growth or salivary gland and surrounding lymph nodes on one side of neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42426	Removal of total salivary gland growth or salivary gland and surrounding lymph nodes on one side of neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
42440	Removal of salivary gland under floor of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42440	Removal of salivary gland under floor of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
42440	Removal of salivary gland under floor of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
42450	Removal of salivary gland under tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
42450	Removal of salivary gland under tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	90	6	
42450	Removal of salivary gland under tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
42500	Plastic repair of salivary duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
42500	Plastic repair of salivary duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	85	6	
42500	Plastic repair of salivary duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
42505	Plastic repair of salivary duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
42505	Plastic repair of salivary duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	106	6	
42505	Plastic repair of salivary duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	81	81	
42507	Creation of new drainage tracts of major salivary gland ducts on both sides of mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42507	Creation of new drainage tracts of major salivary gland ducts on both sides of mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42507	Creation of new drainage tracts of major salivary gland ducts on both sides of mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
42509	Creation of new drainage tracts of major salivary gland ducts on both sides of mouth with excision of both salivary glands	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42509	Creation of new drainage tracts of major salivary gland ducts on both sides of mouth with excision of both salivary glands	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42509	Creation of new drainage tracts of major salivary gland ducts on both sides of mouth with excision of both salivary glands	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
42510	Creation of new drainage tracts of major salivary gland ducts on both sides of mouth with tying of salivary gland ducts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42510	Creation of new drainage tracts of major salivary gland ducts on both sides of mouth with tying of salivary gland ducts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42510	Creation of new drainage tracts of major salivary gland ducts on both sides of mouth with tying of salivary gland ducts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
42550	Injection of dye for X-ray of salivary glands	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	22	0	
42600	Closure of abnormal salivary gland drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
42600	Closure of abnormal salivary gland drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	94	6	
42600	Closure of abnormal salivary gland drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
42650	Insertion of probe for salivary gland duct dilation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
42650	Insertion of probe for salivary gland duct dilation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
42650	Insertion of probe for salivary gland duct dilation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
42660	Salivary gland duct dilation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
42660	Salivary gland duct dilation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	31	0	
42660	Salivary gland duct dilation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
42665	Tying salivary gland duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
42665	Tying salivary gland duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	6	
42665	Tying salivary gland duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
42700	Drainage of tonsil abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
42700	Drainage of tonsil abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	6	
42700	Drainage of tonsil abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42720	Drainage of throat abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
42720	Drainage of throat abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	6	
42720	Drainage of throat abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42725	Drainage of throat abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42725	Drainage of throat abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42725	Drainage of throat abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
42800	Biopsy of back of throat	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
42800	Biopsy of back of throat	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	6	
42800	Biopsy of back of throat	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42804	Biopsy of throat lesion behind nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
42804	Biopsy of throat lesion behind nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	6	
42804	Biopsy of throat lesion behind nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	34	34	
42806	Biopsy of throat lesion behind nose	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
42806	Biopsy of throat lesion behind nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	68	6	
42806	Biopsy of throat lesion behind nose	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	34	34	
42808	Removal or destruction of throat growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
42808	Removal or destruction of throat growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	6	
42808	Removal or destruction of throat growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
42809	Removal of foreign body from pharynx	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0	0	
42809	Removal of foreign body from pharynx	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	0	0	
42809	Removal of foreign body from pharynx	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	0	3	
42809	Removal of foreign body from pharynx	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	0	7	
42809	Removal of foreign body from pharynx	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0	5	
42809	Removal of foreign body from pharynx	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3	0	
42809	Removal of foreign body from pharynx	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3	0	
42809	Removal of foreign body from pharynx	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2	0	
42809	Removal of foreign body from pharynx	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2	0	
42809	Removal of foreign body from pharynx	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2	0	
42809	Removal of foreign body from pharynx	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2	0	
42809	Removal of foreign body from pharynx	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5	0	
42809	Removal of foreign body from pharynx	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	17	0	
42809	Removal of foreign body from pharynx	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3	0	
42809	Removal of foreign body from pharynx	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3	0	
42809	Removal of foreign body from pharynx	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30	0	
42809	Removal of foreign body from pharynx	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	10	0	
42809	Removal of foreign body from pharynx	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3	0	
42809	Removal of foreign body from pharynx	Service  post	L037D	RN/LPN/MTA	0.37	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		0	
42809	Removal of foreign body from pharynx	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains"	5	0	
42809	Removal of foreign body from pharynx	Service  post	L037D	RN/LPN/MTA	0.37	"Review/read X-ray, lab, and pathology reports"	0	0	
42809	Removal of foreign body from pharynx	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes	27	27	
42809	Removal of foreign body from pharynx	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	0	0	
42810	Removal of congenital skin and tissue cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
42810	Removal of congenital skin and tissue cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	6	
42810	Removal of congenital skin and tissue cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	68	68	
42815	Removal of congenital cyst or abnormal drainage tract into mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42815	Removal of congenital cyst or abnormal drainage tract into mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42815	Removal of congenital cyst or abnormal drainage tract into mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
42820	Removal of tonsils and adenoid glands patient younger than age 12	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42820	Removal of tonsils and adenoid glands patient younger than age 12	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
42820	Removal of tonsils and adenoid glands patient younger than age 12	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
42821	Removal of tonsils and adenoid glands patient age 12 or over	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42821	Removal of tonsils and adenoid glands patient age 12 or over	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
42821	Removal of tonsils and adenoid glands patient age 12 or over	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		41	
42825	Removal of tonsils patient younger than age 12	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42825	Removal of tonsils patient younger than age 12	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
42825	Removal of tonsils patient younger than age 12	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
42826	Removal of tonsils patient age 12 or over	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42826	Removal of tonsils patient age 12 or over	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
42826	Removal of tonsils patient age 12 or over	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		41	
42830	Removal of adenoids patient younger than age 12	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42830	Removal of adenoids patient younger than age 12	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
42830	Removal of adenoids patient younger than age 12	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		41	
42831	Removal of adenoids patient age 12 or over	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42831	Removal of adenoids patient age 12 or over	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
42831	Removal of adenoids patient age 12 or over	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
42835	Removal of adenoids patient younger than age 12	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42835	Removal of adenoids patient younger than age 12	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
42835	Removal of adenoids patient younger than age 12	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		41	
42836	Removal of adenoids patient age 12 or over	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42836	Removal of adenoids patient age 12 or over	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
42836	Removal of adenoids patient age 12 or over	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		41	
42842	"Removal of tonsils, tissue, muscle, and bone"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42842	"Removal of tonsils, tissue, muscle, and bone"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42842	"Removal of tonsils, tissue, muscle, and bone"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
42844	"Removal of tonsils, tissue, muscle, and bone"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42844	"Removal of tonsils, tissue, muscle, and bone"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42844	"Removal of tonsils, tissue, muscle, and bone"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
42845	"Removal of tonsils, tissue, muscle, and bone"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42845	"Removal of tonsils, tissue, muscle, and bone"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42845	"Removal of tonsils, tissue, muscle, and bone"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
42860	Removal of remaining tonsil tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42860	Removal of remaining tonsil tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
42860	Removal of remaining tonsil tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		41	
42870	Removal or destruction of growth of tongue lymph node	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42870	Removal or destruction of growth of tongue lymph node	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42870	Removal or destruction of growth of tongue lymph node	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		114	
42890	Partial removal of throat	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42890	Partial removal of throat	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42890	Partial removal of throat	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
42892	Removal of throat tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42892	Removal of throat tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42892	Removal of throat tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		188	
42894	Removal of throat tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42894	Removal of throat tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42894	Removal of throat tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		224	
42900	Suture of wound or injury in the throat	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
42900	Suture of wound or injury in the throat	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42900	Suture of wound or injury in the throat	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
42950	Plastic or reconstructive repair of the throat	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42950	Plastic or reconstructive repair of the throat	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42950	Plastic or reconstructive repair of the throat	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		141	
42953	Repair of the throat at esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42953	Repair of the throat at esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42953	Repair of the throat at esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		178	
42955	Incision of throat for feeding	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42955	Incision of throat for feeding	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42955	Incision of throat for feeding	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		128	
42960	Control of bleeding of throat	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42960	Control of bleeding of throat	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
42961	Control of bleeding of throat requiring hospitalization	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42961	Control of bleeding of throat requiring hospitalization	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42961	Control of bleeding of throat requiring hospitalization	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
42962	Control of bleeding of throat	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42962	Control of bleeding of throat	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42962	Control of bleeding of throat	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
42970	Control of bleeding of throat with insertion of packing	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42970	Control of bleeding of throat with insertion of packing	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42970	Control of bleeding of throat with insertion of packing	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
42971	Control of bleeding of throat with insertion of packing requiring hospitalization	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42971	Control of bleeding of throat with insertion of packing requiring hospitalization	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42971	Control of bleeding of throat with insertion of packing requiring hospitalization	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
42972	Control of bleeding of throat with insertion of packing	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
42972	Control of bleeding of throat with insertion of packing	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
42972	Control of bleeding of throat with insertion of packing	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
43020	Removal of foreign body in esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43020	Removal of foreign body in esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43020	Removal of foreign body in esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
43030	Severing of muscle at upper esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43030	Severing of muscle at upper esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43030	Severing of muscle at upper esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
43045	Removal of foreign body in esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43045	Removal of foreign body in esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43045	Removal of foreign body in esophagus	Post-service	L051A	RN	0.51	Post service total costs		126	
43100	Removal of growth of esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43100	Removal of growth of esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43100	Removal of growth of esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
43101	Removal of growth of esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43101	Removal of growth of esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43101	Removal of growth of esophagus	Post-service	L051A	RN	0.51	Post service total costs		68	
43107	Removal of esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		75	
43107	Removal of esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43107	Removal of esophagus	Post-service	L051A	RN	0.51	Post service total costs		152	
43108	Removal of esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43108	Removal of esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43108	Removal of esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
43112	Removal of esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		75	
43112	Removal of esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43112	Removal of esophagus	Post-service	L051A	RN	0.51	Post service total costs		133	
43113	Removal of esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43113	Removal of esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43113	Removal of esophagus	Post-service	L051A	RN	0.51	Post service total costs		152	
43116	Partial removal of upper esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43116	Partial removal of upper esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43116	Partial removal of upper esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
43117	Partial removal of lower esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		75	
43117	Partial removal of lower esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43117	Partial removal of lower esophagus	Post-service	L051A	RN	0.51	Post service total costs		99	
43118	"Partial removal of lower esophagus, open chest and abdominal procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43118	"Partial removal of lower esophagus, open chest and abdominal procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43118	"Partial removal of lower esophagus, open chest and abdominal procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
43121	"Partial removal of lower esophagus, open chest procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43121	"Partial removal of lower esophagus, open chest procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
43121	"Partial removal of lower esophagus, open chest procedure"	Post-service	L051A	RN	0.51	Post service total costs		152	
43122	"Partial removal of lower esophagus, open chest and abdominal procedure or open abdominal procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43122	"Partial removal of lower esophagus, open chest and abdominal procedure or open abdominal procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
43122	"Partial removal of lower esophagus, open chest and abdominal procedure or open abdominal procedure"	Post-service	L051A	RN	0.51	Post service total costs		152	
43123	Partial removal of esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43123	Partial removal of esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43123	Partial removal of esophagus	Post-service	L051A	RN	0.51	Post service total costs		152	
43124	Removal of esophagus with creation of artificial opening into the esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43124	Removal of esophagus with creation of artificial opening into the esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43124	Removal of esophagus with creation of artificial opening into the esophagus	Post-service	L051A	RN	0.51	Post service total costs		188	
43130	Removal of defect in wall of esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43130	Removal of defect in wall of esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43130	Removal of defect in wall of esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
43135	Removal of defect in wall of esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43135	Removal of defect in wall of esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43135	Removal of defect in wall of esophagus	Post-service	L051A	RN	0.51	Post service total costs		63	
43180	"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker’s diverticulum)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
43180	"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker’s diverticulum)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
43180	"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker’s diverticulum)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
43180	"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker’s diverticulum)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
43180	"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker’s diverticulum)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
43180	"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker’s diverticulum)"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
43180	"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, Zenker’s diverticulum)"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		36	
43191	Diagnostic examination of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
43191	Diagnostic examination of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
43192	Injections of substance in tissue lining of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
43192	Injections of substance in tissue lining of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
43193	Biopsy of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
43193	Biopsy of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
43194	Removal of foreign bodies of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
43195	Balloon dilation of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
43195	Balloon dilation of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
43196	Insertion of wire and dilation of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
43196	Insertion of wire and dilation of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
43197	Diagnostic examination of esophagus using an endoscope	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	69	0	
43197	Diagnostic examination of esophagus using an endoscope	Post-service	L026A	Medical/Technical Assistant	0.26	Post service total costs	3	0	
43198	Biopsy of esophagus using an endoscope	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	76	0	
43198	Biopsy of esophagus using an endoscope	Post-service	L026A	Medical/Technical Assistant	0.26	Post service total costs	3	0	
43200	Diagnostic examination of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43200	Diagnostic examination of esophagus using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	32	0	
43200	Diagnostic examination of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	73	0	
43200	Diagnostic examination of esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43201	Injections into esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43201	Injections into esophagus using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	32	0	
43201	Injections into esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	73	0	
43201	Injections into esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43202	Biopsy of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43202	Biopsy of esophagus using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	32	0	
43202	Biopsy of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	73	0	
43202	Biopsy of esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43204	Injection of dilated esophageal veins using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43204	Injection of dilated esophageal veins using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43205	Tying of esophageal veins using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43205	Tying of esophageal veins using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43206	Microscopic examination of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43206	Microscopic examination of esophagus using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	47	0	
43206	Microscopic examination of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	91	0	
43206	Microscopic examination of esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43210	"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
43210	"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
43210	"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
43210	"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
43210	"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
43211	Removal of tissue lining of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43211	Removal of tissue lining of esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43212	Placement of stent on esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43213	Dilation of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43213	Dilation of esophagus using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	62	0	
43213	Dilation of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	103	0	
43213	Dilation of esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43214	Balloon dilation of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43214	Balloon dilation of esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43215	Removal of foreign bodies in esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43215	Removal of foreign bodies in esophagus using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	37	0	
43215	Removal of foreign bodies in esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	0	
43215	Removal of foreign bodies in esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43216	Removal of esophageal polyps or growths using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43216	Removal of esophageal polyps or growths using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	39	0	
43216	Removal of esophageal polyps or growths using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	80	0	
43216	Removal of esophageal polyps or growths using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43217	Removal of esophageal polyps or growths using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43217	Removal of esophageal polyps or growths using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	47	0	
43217	Removal of esophageal polyps or growths using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	0	
43217	Removal of esophageal polyps or growths using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43220	Balloon dilation of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43220	Balloon dilation of esophagus using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	37	0	
43220	Balloon dilation of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	0	
43220	Balloon dilation of esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43226	Insertion of guide wire for dilation of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43226	Insertion of guide wire for dilation of esophagus using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	42	0	
43226	Insertion of guide wire for dilation of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	93	0	
43226	Insertion of guide wire for dilation of esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43227	Control of esophageal bleeding using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43227	Control of esophageal bleeding using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	47	0	
43227	Control of esophageal bleeding using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	0	
43227	Control of esophageal bleeding using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43229	Destruction of growths of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43229	Destruction of growths of esophagus using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	62	0	
43229	Destruction of growths of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	103	0	
43229	Destruction of growths of esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43231	Ultrasound examination of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43231	Ultrasound examination of esophagus using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	47	0	
43231	Ultrasound examination of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	0	
43231	Ultrasound examination of esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43232	Ultrasound guided fine needle aspiration or biopsy of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43232	Ultrasound guided fine needle aspiration or biopsy of esophagus using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	62	0	
43232	Ultrasound guided fine needle aspiration or biopsy of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	103	0	
43232	Ultrasound guided fine needle aspiration or biopsy of esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43233	"Balloon dilation of esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43233	"Balloon dilation of esophagus, stomach, and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43235	"Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43235	"Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L051A	RN	0.51	Service total costs	32	0	
43235	"Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	73	0	
43235	"Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43236	"Injections of esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43236	"Injections of esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L051A	RN	0.51	Service total costs	37	0	
43236	"Injections of esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	0	
43236	"Injections of esophagus, stomach, and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43237	"Ultrasound examination of esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43237	"Ultrasound examination of esophagus, stomach, and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43238	Ultrasound guided needle aspiration or biopsies of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43238	Ultrasound guided needle aspiration or biopsies of esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43239	"Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43239	"Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L051A	RN	0.51	Service total costs	32	0	
43239	"Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	73	0	
43239	"Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43240	"Drainage of cyst of the esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43240	"Drainage of cyst of the esophagus, stomach, and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43241	Insertion of catheter or tube in esophagus stomach and/or upper small bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43242	"Ultrasound guided needle aspiration or biopsy of esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43242	"Ultrasound guided needle aspiration or biopsy of esophagus, stomach, and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43243	Injection of dilated veins of stomach and/or esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43244	Tying of dilated veins of stomach and/or esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43244	Tying of dilated veins of stomach and/or esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43245	Dilation of stomach outlet using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43245	Dilation of stomach outlet using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	40	0	
43245	Dilation of stomach outlet using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	81	0	
43245	Dilation of stomach outlet using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43246	Insertion of stomach tube using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43247	"Removal of foreign bodies of esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43247	"Removal of foreign bodies of esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L051A	RN	0.51	Service total costs	47	0	
43247	"Removal of foreign bodies of esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	0	
43247	"Removal of foreign bodies of esophagus, stomach, and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43248	Insertion of guide wire with dilation of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43248	Insertion of guide wire with dilation of esophagus using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	37	0	
43248	Insertion of guide wire with dilation of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	0	
43248	Insertion of guide wire with dilation of esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43249	Balloon dilation of esophagus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43249	Balloon dilation of esophagus using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	37	0	
43249	Balloon dilation of esophagus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	0	
43249	Balloon dilation of esophagus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43250	"Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43250	"Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L051A	RN	0.51	Service total costs	37	0	
43250	"Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	0	
43250	"Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43251	"Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43251	"Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L051A	RN	0.51	Service total costs	37	0	
43251	"Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	0	
43251	"Removal of polyps or growths of esophagus, stomach, and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43252	"Microscopic examination of esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43252	"Microscopic examination of esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L051A	RN	0.51	Service total costs	47	0	
43252	"Microscopic examination of esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	91	0	
43252	"Microscopic examination of esophagus, stomach, and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43253	"Injection of diagnostic or therapeutic substances or markers in esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43253	"Injection of diagnostic or therapeutic substances or markers in esophagus, stomach, and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43254	"Removal of tissue lining of esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43254	"Removal of tissue lining of esophagus, stomach, and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43255	"Control of bleeding of esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43255	"Control of bleeding of esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L051A	RN	0.51	Service total costs	47	0	
43255	"Control of bleeding of esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	0	
43255	"Control of bleeding of esophagus, stomach, and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43257	Heat delivery to muscle at esophagus and/or stomach to treat gastric reflux using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43257	Heat delivery to muscle at esophagus and/or stomach to treat gastric reflux using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43259	"Ultrasound examination of esophagus, stomach and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43259	"Ultrasound examination of esophagus, stomach and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43260	"Diagnostic examination of gallbladder and pancreatic, liver, and bile ducts using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43260	"Diagnostic examination of gallbladder and pancreatic, liver, and bile ducts using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43261	"Biopsy of gallbladder, pancreatic, liver, and bile ducts using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43261	"Biopsy of gallbladder, pancreatic, liver, and bile ducts using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43262	Incision of pancreatic outlet muscle using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43262	Incision of pancreatic outlet muscle using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43263	Pressure measurement of pancreatic or bile duct using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43263	Pressure measurement of pancreatic or bile duct using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43264	Removal of stone from bile or pancreatic duct using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43264	Removal of stone from bile or pancreatic duct using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43265	Destruction of stone in bile or pancreatic duct using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43265	Destruction of stone in bile or pancreatic duct using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43266	"Placement of stent in esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43270	"Destruction of growths on esophagus, stomach, and/or upper small bowel using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43270	"Destruction of growths on esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L051A	RN	0.51	Service total costs	62	0	
43270	"Destruction of growths on esophagus, stomach, and/or upper small bowel using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	103	0	
43270	"Destruction of growths on esophagus, stomach, and/or upper small bowel using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43274	Placement of stent pancreatic or bile duct using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43274	Placement of stent pancreatic or bile duct using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43275	Removal of foreign body or stent from pancreatic or bile duct using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43275	Removal of foreign body or stent from pancreatic or bile duct using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43276	Replacement of stent pancreatic or bile duct using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43276	Replacement of stent pancreatic or bile duct using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43277	Balloon dilation of pancreatic or bile duct using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43277	Balloon dilation of pancreatic or bile duct using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43278	"Destruction of mass on gallbladder, pancreatic, liver, and bile ducts using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
43278	"Destruction of mass on gallbladder, pancreatic, liver, and bile ducts using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
43279	Repair of muscle to lower esophagus and stomach using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43279	Repair of muscle to lower esophagus and stomach using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43279	Repair of muscle to lower esophagus and stomach using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
43280	Repair of muscle at esophagus and stomach using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43280	Repair of muscle at esophagus and stomach using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43280	Repair of muscle at esophagus and stomach using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
43281	Repair of hernia of muscle at esophagus and stomach using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43281	Repair of hernia of muscle at esophagus and stomach using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43281	Repair of hernia of muscle at esophagus and stomach using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
43282	Repair of hernia of muscle at esophagus and stomach with implantation of mesh using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43282	Repair of hernia of muscle at esophagus and stomach with implantation of mesh using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43282	Repair of hernia of muscle at esophagus and stomach with implantation of mesh using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
43300	Repair and reconstruction of defect of esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43300	Repair and reconstruction of defect of esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43300	Repair and reconstruction of defect of esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
43305	Repair of esophageal defect with repair of abnormal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43305	Repair of esophageal defect with repair of abnormal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
43305	Repair of esophageal defect with repair of abnormal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
43310	Repair of esophageal defect with repair of abnormal drainage tract	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43310	Repair of esophageal defect with repair of abnormal drainage tract	Service  intra	L051A	RN	0.51	Service total costs		12	
43310	Repair of esophageal defect with repair of abnormal drainage tract	Post-service	L051A	RN	0.51	Post service total costs		68	
43312	Repair of esophageal defect with repair of abnormal drainage tract	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43312	Repair of esophageal defect with repair of abnormal drainage tract	Service  intra	L051A	RN	0.51	Service total costs		12	
43312	Repair of esophageal defect with repair of abnormal drainage tract	Post-service	L051A	RN	0.51	Post service total costs		14	
43313	Repair of congenital esophageal defect	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43313	Repair of congenital esophageal defect	Service  intra	L051A	RN	0.51	Service total costs		6	
43313	Repair of congenital esophageal defect	Post-service	L051A	RN	0.51	Post service total costs		197	
43314	Repair of congenital esophageal defect and repair abnormal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43314	Repair of congenital esophageal defect and repair abnormal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
43314	Repair of congenital esophageal defect and repair abnormal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		197	
43320	Repair of muscle at lower esophagus and stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43320	Repair of muscle at lower esophagus and stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43320	Repair of muscle at lower esophagus and stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43325	Repair of muscle at lower esophagus and stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43325	Repair of muscle at lower esophagus and stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43325	Repair of muscle at lower esophagus and stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43327	Repair of muscle at lower esophagus and stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43327	Repair of muscle at lower esophagus and stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43327	Repair of muscle at lower esophagus and stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
43328	Repair of muscle at lower esophagus and stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43328	Repair of muscle at lower esophagus and stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43328	Repair of muscle at lower esophagus and stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
43330	Repair of esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43330	Repair of esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43330	Repair of esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43331	Repair of esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43331	Repair of esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43331	Repair of esophagus	Post-service	L051A	RN	0.51	Post service total costs		99	
43332	Repair of paraesophageal hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43332	Repair of paraesophageal hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43332	Repair of paraesophageal hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
43333	Repair of paraesophageal hernia with mesh implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43333	Repair of paraesophageal hernia with mesh implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43333	Repair of paraesophageal hernia with mesh implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
43334	Repair of paraesophageal hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43334	Repair of paraesophageal hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43334	Repair of paraesophageal hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
43335	Repair of paraesophageal hernia with mesh implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43335	Repair of paraesophageal hernia with mesh implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43335	Repair of paraesophageal hernia with mesh implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
43336	Repair of paraesophageal hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43336	Repair of paraesophageal hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43336	Repair of paraesophageal hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43337	Repair of paraesophageal hernia with mesh implant	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43337	Repair of paraesophageal hernia with mesh implant	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43337	Repair of paraesophageal hernia with mesh implant	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43340	Partial removal of esophagus and stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43340	Partial removal of esophagus and stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43340	Partial removal of esophagus and stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43341	Partial removal of esophagus and stomach	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43341	Partial removal of esophagus and stomach	Service  intra	L051A	RN	0.51	Service total costs		12	
43341	Partial removal of esophagus and stomach	Post-service	L051A	RN	0.51	Post service total costs		99	
43351	Relocation of esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43351	Relocation of esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43351	Relocation of esophagus	Post-service	L051A	RN	0.51	Post service total costs		135	
43352	Relocation of esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43352	Relocation of esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43352	Relocation of esophagus	Post-service	L051A	RN	0.51	Post service total costs		99	
43360	Repositioning of remnant stomach to esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43360	Repositioning of remnant stomach to esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43360	Repositioning of remnant stomach to esophagus	Post-service	L051A	RN	0.51	Post service total costs		133	
43361	Repositioning of remnant stomach to esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43361	Repositioning of remnant stomach to esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43361	Repositioning of remnant stomach to esophagus	Post-service	L051A	RN	0.51	Post service total costs		135	
43400	Tying dilated esophagus veins	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43400	Tying dilated esophagus veins	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43400	Tying dilated esophagus veins	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43401	Incision and repair esophagus for varicose veins	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43401	Incision and repair esophagus for varicose veins	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43401	Incision and repair esophagus for varicose veins	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43405	Tying or stapling of perforation at junction of esophagus and stomach	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43405	Tying or stapling of perforation at junction of esophagus and stomach	Service  intra	L051A	RN	0.51	Service total costs		12	
43405	Tying or stapling of perforation at junction of esophagus and stomach	Post-service	L051A	RN	0.51	Post service total costs		135	
43410	Suture of wound or injury to esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43410	Suture of wound or injury to esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43410	Suture of wound or injury to esophagus	Post-service	L051A	RN	0.51	Post service total costs		99	
43415	Suture of wound or injury to esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43415	Suture of wound or injury to esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43415	Suture of wound or injury to esophagus	Post-service	L051A	RN	0.51	Post service total costs		169	
43420	Repair of abnormal drainage tract of esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43420	Repair of abnormal drainage tract of esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43420	Repair of abnormal drainage tract of esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43425	Repair of abnormal drainage tract of esophagus	Pre-service	L051A	RN	0.51	Preservice total costs		60	
43425	Repair of abnormal drainage tract of esophagus	Service  intra	L051A	RN	0.51	Service total costs		12	
43425	Repair of abnormal drainage tract of esophagus	Post-service	L051A	RN	0.51	Post service total costs		99	
43450	Dilation of esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43450	Dilation of esophagus	Service  intra	L051A	RN	0.51	Service total costs	32	0	
43450	Dilation of esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
43450	Dilation of esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43453	Dilation of esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43453	Dilation of esophagus	Service  intra	L051A	RN	0.51	Service total costs	37	0	
43453	Dilation of esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	0	
43453	Dilation of esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
43460	Control of esophageal bleeding	Pre-service	L051A	RN	0.51	Preservice total costs		15	
43500	Removal of foreign body from stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43500	Removal of foreign body from stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43500	Removal of foreign body from stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
43501	Suture of bleeding stomach ulcer	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43501	Suture of bleeding stomach ulcer	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43501	Suture of bleeding stomach ulcer	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43502	Suture of stomach laceration	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43502	Suture of stomach laceration	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43502	Suture of stomach laceration	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43510	Insertion of permanent stomach tube with dilation of esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43510	Insertion of permanent stomach tube with dilation of esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43510	Insertion of permanent stomach tube with dilation of esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43520	Severing of muscle at stomach outlet to upper small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43520	Severing of muscle at stomach outlet to upper small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43520	Severing of muscle at stomach outlet to upper small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
43605	Biopsy of stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43605	Biopsy of stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43605	Biopsy of stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
43610	Removal of stomach ulcer or growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43610	Removal of stomach ulcer or growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43610	Removal of stomach ulcer or growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
43611	Removal of malignant growth of stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43611	Removal of malignant growth of stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43611	Removal of malignant growth of stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43620	Removal of stomach with upper small bowel attachment to esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43620	Removal of stomach with upper small bowel attachment to esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43620	Removal of stomach with upper small bowel attachment to esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43621	Removal of stomach with lower small bowel attachment to esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43621	Removal of stomach with lower small bowel attachment to esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43621	Removal of stomach with lower small bowel attachment to esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43622	Removal of stomach with intestinal pouch attachment to esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43622	Removal of stomach with intestinal pouch attachment to esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43622	Removal of stomach with intestinal pouch attachment to esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43631	Partial removal of stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43631	Partial removal of stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43631	Partial removal of stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43632	Partial removal of stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43632	Partial removal of stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43632	Partial removal of stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43633	Removal of end portion of stomach with attachment to small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43633	Removal of end portion of stomach with attachment to small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43633	Removal of end portion of stomach with attachment to small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43634	Partial removal of stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43634	Partial removal of stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43634	Partial removal of stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43640	Severing of vagus nerve to stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43640	Severing of vagus nerve to stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43640	Severing of vagus nerve to stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43641	Repair of stomach outlet muscle and severing of vagus nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43641	Repair of stomach outlet muscle and severing of vagus nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43641	Repair of stomach outlet muscle and severing of vagus nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43644	Bypass operation of stomach using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43644	Bypass operation of stomach using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43644	Bypass operation of stomach using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
43645	Bypass operation of stomach with reconstruction of small bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43645	Bypass operation of stomach with reconstruction of small bowel using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43645	Bypass operation of stomach with reconstruction of small bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
43651	Incision of vagus nerves in stomach using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43651	Incision of vagus nerves in stomach using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43651	Incision of vagus nerves in stomach using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		76	
43652	Incision of vagus nerves of stomach using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43652	Incision of vagus nerves of stomach using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43652	Incision of vagus nerves of stomach using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		76	
43653	Creation of stomach feeding tube using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43653	Creation of stomach feeding tube using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43653	Creation of stomach feeding tube using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
43754	Diagnostic insertion of stomach tube and aspiration of gastric contents	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43754	Diagnostic insertion of stomach tube and aspiration of gastric contents	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	0	
43754	Diagnostic insertion of stomach tube and aspiration of gastric contents	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
43755	Diagnostic insertion of stomach tube and multiple aspirations of gastric contents	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43755	Diagnostic insertion of stomach tube and multiple aspirations of gastric contents	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	0	
43755	Diagnostic insertion of stomach tube and multiple aspirations of gastric contents	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
43756	Diagnostic insertion of small bowel tube and specimen collection using imaging guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43756	Diagnostic insertion of small bowel tube and specimen collection using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	0	
43756	Diagnostic insertion of small bowel tube and specimen collection using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
43757	Diagnostic insertion of small bowel tube and multiple specimen collection using imaging guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
43757	Diagnostic insertion of small bowel tube and multiple specimen collection using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	0	
43757	Diagnostic insertion of small bowel tube and multiple specimen collection using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
43760	"Change of stomach feeding, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	3	
43760	"Change of stomach feeding, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	0	
43761	Repositioning of stomach feeding tube	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	6	0	
43770	Insertion of adjustable stomach reduction device using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43770	Insertion of adjustable stomach reduction device using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43770	Insertion of adjustable stomach reduction device using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
43771	Revision of stomach reduction device using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43771	Revision of stomach reduction device using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43771	Revision of stomach reduction device using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
43772	Removal of stomach reduction device using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43772	Removal of stomach reduction device using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43772	Removal of stomach reduction device using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
43773	Replacement of stomach reduction device using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43773	Replacement of stomach reduction device using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43773	Replacement of stomach reduction device using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
43774	Removal of stomach reduction device and port beneath the skin using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43774	Removal of stomach reduction device and port beneath the skin using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43774	Removal of stomach reduction device and port beneath the skin using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
43800	Repair of muscle of stomach outlet into upper small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43800	Repair of muscle of stomach outlet into upper small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43800	Repair of muscle of stomach outlet into upper small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
43810	Removal of end portion of stomach with attachment to upper small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43810	Removal of end portion of stomach with attachment to upper small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43810	Removal of end portion of stomach with attachment to upper small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
43820	Partial removal of stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43820	Partial removal of stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43820	Partial removal of stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43825	Partial removal of stomach and severing of vagus nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43825	Partial removal of stomach and severing of vagus nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43825	Partial removal of stomach and severing of vagus nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43830	"Insertion of stomach feeding tube, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43830	"Insertion of stomach feeding tube, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43830	"Insertion of stomach feeding tube, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
43831	"Insertion of stomach feeding tube, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43831	"Insertion of stomach feeding tube, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43831	"Insertion of stomach feeding tube, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
43832	"Creation of stomach feeding tube, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43832	"Creation of stomach feeding tube, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43832	"Creation of stomach feeding tube, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
43840	"Suture of perforated ulcer, wound, or injury of stomach or upper small bowel"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43840	"Suture of perforated ulcer, wound, or injury of stomach or upper small bowel"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43840	"Suture of perforated ulcer, wound, or injury of stomach or upper small bowel"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43842	Banding of upper stomach to reduce size	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43842	Banding of upper stomach to reduce size	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43842	Banding of upper stomach to reduce size	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43843	Reduction of size of upper stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43843	Reduction of size of upper stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43843	Reduction of size of upper stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43845	Partial removal of stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43845	Partial removal of stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43845	Partial removal of stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
43846	Partial removal of stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43846	Partial removal of stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43846	Partial removal of stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
43847	Partial removal of stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43847	Partial removal of stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43847	Partial removal of stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
43848	"Revision of upper stomach bypass, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43848	"Revision of upper stomach bypass, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43848	"Revision of upper stomach bypass, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
43850	Revision of attachment of stomach and small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43850	Revision of attachment of stomach and small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43850	Revision of attachment of stomach and small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43855	Revision of attachment of stomach to upper small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43855	Revision of attachment of stomach to upper small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43855	Revision of attachment of stomach to upper small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43860	Revision of attachment of stomach to small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43860	Revision of attachment of stomach to small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43860	Revision of attachment of stomach to small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43865	Revision of attachment of stomach to small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43865	Revision of attachment of stomach to small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43865	Revision of attachment of stomach to small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43870	Closure of skin opening to stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43870	Closure of skin opening to stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43870	Closure of skin opening to stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
43880	Closure of abnormal drainage tract from stomach to large bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43880	Closure of abnormal drainage tract from stomach to large bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
43880	Closure of abnormal drainage tract from stomach to large bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
43886	"Revision of skin level port of stomach banding device, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43886	"Revision of skin level port of stomach banding device, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
43886	"Revision of skin level port of stomach banding device, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
43887	"Removal of skin level port of stomach banding device, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43887	"Removal of skin level port of stomach banding device, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
43887	"Removal of skin level port of stomach banding device, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
43888	"Removal and replacement of skin level port of stomach banding device, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
43888	"Removal and replacement of skin level port of stomach banding device, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
43888	"Removal and replacement of skin level port of stomach banding device, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
44005	Release of intestinal scar tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44005	Release of intestinal scar tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44005	Release of intestinal scar tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44010	Biopsy or foreign body removal in small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44010	Biopsy or foreign body removal in small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44010	Biopsy or foreign body removal in small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44020	"Incision of small bowel for exploration, biopsy, or foreign body removal"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44020	"Incision of small bowel for exploration, biopsy, or foreign body removal"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44020	"Incision of small bowel for exploration, biopsy, or foreign body removal"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44021	Incision of small bowel for insertion of tube	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44021	Incision of small bowel for insertion of tube	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44021	Incision of small bowel for insertion of tube	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44025	Biopsy or foreign body removal in large bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44025	Biopsy or foreign body removal in large bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44025	Biopsy or foreign body removal in large bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44050	Incisional repair of twisted or herniated small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44050	Incisional repair of twisted or herniated small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44050	Incisional repair of twisted or herniated small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44055	Incisional correction of abnormal rotation of small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44055	Incisional correction of abnormal rotation of small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44055	Incisional correction of abnormal rotation of small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
44110	Removal of growth of small or large bowels	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44110	Removal of growth of small or large bowels	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44110	Removal of growth of small or large bowels	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44111	Removal of multiple small or large bowel growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44111	Removal of multiple small or large bowel growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44111	Removal of multiple small or large bowel growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44120	Partial removal of small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44120	Partial removal of small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44120	Partial removal of small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44125	Partial removal of small bowel with creation of drainage tract to skin surface	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44125	Partial removal of small bowel with creation of drainage tract to skin surface	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44125	Partial removal of small bowel with creation of drainage tract to skin surface	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
44126	Partial removal of small bowel to correct congenital defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44126	Partial removal of small bowel to correct congenital defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44126	Partial removal of small bowel to correct congenital defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
44127	Partial removal of small bowel to correct congenital defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44127	Partial removal of small bowel to correct congenital defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
44127	Partial removal of small bowel to correct congenital defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
44130	Creation of connection between two segments of small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44130	Creation of connection between two segments of small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44130	Creation of connection between two segments of small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
44140	Partial removal of large bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44140	Partial removal of large bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44140	Partial removal of large bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
44141	Partial removal of large bowel with creation of opening to the skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
44141	Partial removal of large bowel with creation of opening to the skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44141	Partial removal of large bowel with creation of opening to the skin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
44143	Partial removal of large bowel with creation of opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
44143	Partial removal of large bowel with creation of opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44143	Partial removal of large bowel with creation of opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
44144	Partial removal of large bowel with creation of small or large bowel opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
44144	Partial removal of large bowel with creation of small or large bowel opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44144	Partial removal of large bowel with creation of small or large bowel opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
44145	Partial removal of large bowel and reattachment to rectum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44145	Partial removal of large bowel and reattachment to rectum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44145	Partial removal of large bowel and reattachment to rectum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
44146	Partial removal of large bowel and reattachment to rectum and creation of large bowel opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44146	Partial removal of large bowel and reattachment to rectum and creation of large bowel opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44146	Partial removal of large bowel and reattachment to rectum and creation of large bowel opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
44147	Partial removal of large bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44147	Partial removal of large bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44147	Partial removal of large bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
44150	Removal of large bowel with attachment of small bowel to rectum or creation of small bowel opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
44150	Removal of large bowel with attachment of small bowel to rectum or creation of small bowel opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44150	Removal of large bowel with attachment of small bowel to rectum or creation of small bowel opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		143	
44151	Removal of large bowel with creation of small bowel opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
44151	Removal of large bowel with creation of small bowel opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44151	Removal of large bowel with creation of small bowel opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		143	
44155	Removal of large bowel and rectum with creation of small bowel opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
44155	Removal of large bowel and rectum with creation of small bowel opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44155	Removal of large bowel and rectum with creation of small bowel opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		143	
44156	Removal of large bowel and rectum with creation of small bowel opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44156	Removal of large bowel and rectum with creation of small bowel opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44156	Removal of large bowel and rectum with creation of small bowel opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		143	
44157	Removal of large bowel and rectum with attachment of small bowel to anus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44157	Removal of large bowel and rectum with attachment of small bowel to anus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44157	Removal of large bowel and rectum with attachment of small bowel to anus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		159	
44158	Removal of large bowel and rectum with attachment of small bowel to anus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44158	Removal of large bowel and rectum with attachment of small bowel to anus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44158	Removal of large bowel and rectum with attachment of small bowel to anus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		159	
44160	Partial removal of small and large bowel with attachment of small and large bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44160	Partial removal of small and large bowel with attachment of small and large bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44160	Partial removal of small and large bowel with attachment of small and large bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
44180	Release of small bowel scar tissue using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44180	Release of small bowel scar tissue using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44180	Release of small bowel scar tissue using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44186	Creation of small bowel opening using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44186	Creation of small bowel opening using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44186	Creation of small bowel opening using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44187	Creation of small bowel opening using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44187	Creation of small bowel opening using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44187	Creation of small bowel opening using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
44188	Creation of large bowel opening using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44188	Creation of large bowel opening using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44188	Creation of large bowel opening using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		115	
44202	Partial removal of small bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44202	Partial removal of small bowel using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44202	Partial removal of small bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
44204	Partial removal of large bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44204	Partial removal of large bowel using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44204	Partial removal of large bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
44205	Partial removal of small and large bowel with attachment of small and large bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44205	Partial removal of small and large bowel with attachment of small and large bowel using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44205	Partial removal of small and large bowel with attachment of small and large bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
44206	Partial removal of large bowel with creation of opening using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
44206	Partial removal of large bowel with creation of opening using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
44206	Partial removal of large bowel with creation of opening using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		137	
44207	Partial removal of large bowel and reattachment to rectum using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44207	Partial removal of large bowel and reattachment to rectum using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
44207	Partial removal of large bowel and reattachment to rectum using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
44208	Partial removal of large bowel and reattachment to rectum and creation of large bowel opening using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44208	Partial removal of large bowel and reattachment to rectum and creation of large bowel opening using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
44208	Partial removal of large bowel and reattachment to rectum and creation of large bowel opening using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		120	
44210	Removal of large bowel with attachment of small bowel to rectum or creation of small bowel opening using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44210	Removal of large bowel with attachment of small bowel to rectum or creation of small bowel opening using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
44210	Removal of large bowel with attachment of small bowel to rectum or creation of small bowel opening using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		166	
44211	Removal of large bowel and rectum with attachment of small bowel to anus and creation of small bowel opening using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44211	Removal of large bowel and rectum with attachment of small bowel to anus and creation of small bowel opening using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
44211	Removal of large bowel and rectum with attachment of small bowel to anus and creation of small bowel opening using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
44212	Removal of large bowel and rectum with creation of small bowel opening using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44212	Removal of large bowel and rectum with creation of small bowel opening using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
44212	Removal of large bowel and rectum with creation of small bowel opening using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
44227	Closure of large or small bowel opening using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44227	Closure of large or small bowel opening using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44227	Closure of large or small bowel opening using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
44300	"Insertion of small bowel tube, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44300	"Insertion of small bowel tube, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44300	"Insertion of small bowel tube, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
44310	Creation of small bowel feeding tube	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44310	Creation of small bowel feeding tube	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44310	Creation of small bowel feeding tube	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
44312	Revision of small bowel opening and scar tissue release	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44312	Revision of small bowel opening and scar tissue release	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44312	Revision of small bowel opening and scar tissue release	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
44314	Reconstruction of small bowel opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44314	Reconstruction of small bowel opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44314	Reconstruction of small bowel opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
44316	Creation of small bowel pouch with valve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
44316	Creation of small bowel pouch with valve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44316	Creation of small bowel pouch with valve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
44320	Creation of large bowel drainage tract to skin surface	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44320	Creation of large bowel drainage tract to skin surface	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44320	Creation of large bowel drainage tract to skin surface	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
44322	Creation of large bowel opening with multiple biopsies	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44322	Creation of large bowel opening with multiple biopsies	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44322	Creation of large bowel opening with multiple biopsies	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		156	
44340	Revision of large bowel opening and scar tissue release	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44340	Revision of large bowel opening and scar tissue release	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44340	Revision of large bowel opening and scar tissue release	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
44345	Reconstruction of large bowel opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44345	Reconstruction of large bowel opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44345	Reconstruction of large bowel opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
44346	Revision of large bowel opening and hernia repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44346	Revision of large bowel opening and hernia repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44346	Revision of large bowel opening and hernia repair	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
44360	Examination of small bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
44360	Examination of small bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
44361	Biopsy of small bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
44361	Biopsy of small bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
44363	Removal of foreign bodies in small bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
44363	Removal of foreign bodies in small bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
44364	Removal of small bowel polyps or growths using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
44364	Removal of small bowel polyps or growths using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
44365	Removal of small bowel polyps or growths using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
44365	Removal of small bowel polyps or growths using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
44366	Control of bleeding in small bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
44366	Control of bleeding in small bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
44369	Destruction of small bowel polyps or growths using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
44369	Destruction of small bowel polyps or growths using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
44370	Insertion of small bowel stent using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
44370	Insertion of small bowel stent using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
44372	Insertion of feeding tube (accessed beneath the skin) into small bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
44372	Insertion of feeding tube (accessed beneath the skin) into small bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
44373	Convert stomach tube to small bowel tube (accessed beneath the skin) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
44373	Convert stomach tube to small bowel tube (accessed beneath the skin) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
44376	Diagnostic examination of small bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
44376	Diagnostic examination of small bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
44377	Biopsy of small bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
44377	Biopsy of small bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
44378	Control of bleeding beyond second portion of small bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
44378	Control of bleeding beyond second portion of small bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
44379	Insertion of small bowel stent using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
44379	Insertion of small bowel stent using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	15		
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  intra	L051A	RN	0.51	Moderate sedation	15		
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
44380	"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	25		
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Service  intra	L051A	RN	0.51	Moderate sedation	25		
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
44381	"Ileoscopy, through stoma; with transendoscopic balloon dilation"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	20		
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Service  intra	L051A	RN	0.51	Moderate sedation	20		
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
44382	"Ileoscopy, through stoma; with biopsy, single or multiple"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
44384	"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0	3	
44384	"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	0	5	
44384	"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	0	3	
44384	"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	0	5	
44384	"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0	3	
44384	"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	0	3	
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	15		
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  intra	L051A	RN	0.51	Moderate sedation	15		
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (second staff type)"	15		
44385	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	17		
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Service  intra	L051A	RN	0.51	Moderate sedation	17		
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (second staff type)"	15		
44386	"Endoscopic evaluation of small intestinal pouch (eg, Kock pouch, ileal reservoir [S or J]); with biopsy, single or multiple"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	25		
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	25		
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
44388	"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	30		
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	30		
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
44389	"Colonoscopy through stoma; with biopsy, single or multiple"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
44390	Colonoscopy through stoma; with removal of foreign body	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
44390	Colonoscopy through stoma; with removal of foreign body	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
44390	Colonoscopy through stoma; with removal of foreign body	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
44390	Colonoscopy through stoma; with removal of foreign body	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44390	Colonoscopy through stoma; with removal of foreign body	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44390	Colonoscopy through stoma; with removal of foreign body	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
44390	Colonoscopy through stoma; with removal of foreign body	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
44390	Colonoscopy through stoma; with removal of foreign body	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
44390	Colonoscopy through stoma; with removal of foreign body	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
44390	Colonoscopy through stoma; with removal of foreign body	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
44390	Colonoscopy through stoma; with removal of foreign body	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
44390	Colonoscopy through stoma; with removal of foreign body	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
44390	Colonoscopy through stoma; with removal of foreign body	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	35		
44390	Colonoscopy through stoma; with removal of foreign body	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	35		
44390	Colonoscopy through stoma; with removal of foreign body	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
44390	Colonoscopy through stoma; with removal of foreign body	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
44390	Colonoscopy through stoma; with removal of foreign body	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
44390	Colonoscopy through stoma; with removal of foreign body	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
44390	Colonoscopy through stoma; with removal of foreign body	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
44390	Colonoscopy through stoma; with removal of foreign body	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	40		
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	40		
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
44391	"Colonoscopy through stoma; with control of bleeding, any method"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	30		
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	30		
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
44392	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	30		
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	30		
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
44394	"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	30		
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	30		
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
44401	"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion (includes pre-and post-dilation and guide wire passage, when performed)"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
44402	"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guidewire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
44402	"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guidewire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
44402	"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guidewire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
44402	"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guidewire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44402	"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guidewire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44402	"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guidewire passage, when performed)"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions		3	
44403	Colonoscopy through stoma; with endoscopic mucosal resection	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
44403	Colonoscopy through stoma; with endoscopic mucosal resection	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
44403	Colonoscopy through stoma; with endoscopic mucosal resection	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
44403	Colonoscopy through stoma; with endoscopic mucosal resection	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44403	Colonoscopy through stoma; with endoscopic mucosal resection	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44403	Colonoscopy through stoma; with endoscopic mucosal resection	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions		3	
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	30		
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	30		
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
44404	"Colonoscopy through stoma; with directed submucosal injection(s), any substance"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	38		
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	38		
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
44405	Colonoscopy through stoma; with transendoscopic balloon dilation	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
44406	"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
44406	"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
44406	"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
44406	"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44406	"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44406	"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions		3	
44407	"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjace"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
44407	"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjace"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
44407	"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjace"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
44407	"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjace"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44407	"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjace"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44407	"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjace"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions		3	
44408	"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
44408	"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
44408	"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
44408	"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
44408	"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
44408	"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions		3	
44602	"Suture of small bowel for perforated ulcer, pouch, wound, injury or rupture"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
44602	"Suture of small bowel for perforated ulcer, pouch, wound, injury or rupture"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44602	"Suture of small bowel for perforated ulcer, pouch, wound, injury or rupture"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44603	"Suture of multiple small bowel ulcers, defects, wounds, injuries, or rupture"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
44603	"Suture of multiple small bowel ulcers, defects, wounds, injuries, or rupture"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44603	"Suture of multiple small bowel ulcers, defects, wounds, injuries, or rupture"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
44604	"Suture of large bowel ulcer, defect, wound, injury, or rupture"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
44604	"Suture of large bowel ulcer, defect, wound, injury, or rupture"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44604	"Suture of large bowel ulcer, defect, wound, injury, or rupture"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
44605	"Suture of large bowel ulcer, defect, wound, injury, or rupture with creation of opening"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
44605	"Suture of large bowel ulcer, defect, wound, injury, or rupture with creation of opening"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44605	"Suture of large bowel ulcer, defect, wound, injury, or rupture with creation of opening"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		70	
44615	Release of small bowel obstruction	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44615	Release of small bowel obstruction	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44615	Release of small bowel obstruction	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44620	Closure of large or small bowel opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44620	Closure of large or small bowel opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44620	Closure of large or small bowel opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44625	Closure of large or small bowel opening with bowel removal and reattachment	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44625	Closure of large or small bowel opening with bowel removal and reattachment	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44625	Closure of large or small bowel opening with bowel removal and reattachment	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44626	Closure of large or small bowel opening with bowel removal and reattachment of large bowel and rectum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44626	Closure of large or small bowel opening with bowel removal and reattachment of large bowel and rectum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44626	Closure of large or small bowel opening with bowel removal and reattachment of large bowel and rectum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44640	Closure of abnormal drainage tract of small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44640	Closure of abnormal drainage tract of small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44640	Closure of abnormal drainage tract of small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44650	Closure of abnormal drainage tract within small bowel or small to large bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44650	Closure of abnormal drainage tract within small bowel or small to large bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44650	Closure of abnormal drainage tract within small bowel or small to large bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44660	Closure of abnormal drainage tract of small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44660	Closure of abnormal drainage tract of small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44660	Closure of abnormal drainage tract of small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44661	Closure of abnormal drainage tract from small bowel into urinary bladder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44661	Closure of abnormal drainage tract from small bowel into urinary bladder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44661	Closure of abnormal drainage tract from small bowel into urinary bladder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44680	Surgical folding of upper small bowel upon itself	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44680	Surgical folding of upper small bowel upon itself	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44680	Surgical folding of upper small bowel upon itself	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44700	Suspension of small bowel using mesh or prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44700	Suspension of small bowel using mesh or prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44700	Suspension of small bowel using mesh or prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44800	Repair of congenital bowel defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44800	Repair of congenital bowel defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44800	Repair of congenital bowel defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
44820	Removal of growth from abdominal cavity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44820	Removal of growth from abdominal cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44820	Removal of growth from abdominal cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
44850	Suture of abdominal cavity tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44850	Suture of abdominal cavity tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44850	Suture of abdominal cavity tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44900	"Drainage of abscess of appendix, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
44900	"Drainage of abscess of appendix, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44900	"Drainage of abscess of appendix, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
44950	Removal of appendix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
44950	Removal of appendix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44950	Removal of appendix	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
44960	Removal of ruptured infected appendix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
44960	Removal of ruptured infected appendix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44960	Removal of ruptured infected appendix	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
44970	Removal of appendix using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
44970	Removal of appendix using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
44970	Removal of appendix using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
45000	Drainage of pelvic abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45000	Drainage of pelvic abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45000	Drainage of pelvic abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
45005	Drainage of rectal abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
45005	Drainage of rectal abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	6	
45005	Drainage of rectal abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	17	17	
45020	Drainage of pelvic or rectal abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45020	Drainage of pelvic or rectal abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45020	Drainage of pelvic or rectal abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
45100	Biopsy of rectum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45100	Biopsy of rectum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
45100	Biopsy of rectum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
45108	Removal of rectal muscle growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45108	Removal of rectal muscle growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
45108	Removal of rectal muscle growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
45110	"Removal of rectum with creation of large bowel opening, open abdominal and rectal procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		65	
45110	"Removal of rectum with creation of large bowel opening, open abdominal and rectal procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45110	"Removal of rectum with creation of large bowel opening, open abdominal and rectal procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		150	
45111	"Partial removal of rectum, open abdominal procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45111	"Partial removal of rectum, open abdominal procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45111	"Partial removal of rectum, open abdominal procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
45112	"Removal of rectum, open abdominal and rectal procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45112	"Removal of rectum, open abdominal and rectal procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45112	"Removal of rectum, open abdominal and rectal procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
45113	Partial removal of rectum and attachment of small bowel to anus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45113	Partial removal of rectum and attachment of small bowel to anus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45113	Partial removal of rectum and attachment of small bowel to anus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
45114	Partial removal of rectum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45114	Partial removal of rectum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45114	Partial removal of rectum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
45116	Partial removal of rectum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45116	Partial removal of rectum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45116	Partial removal of rectum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
45119	"Removal of rectum, open abdominal and rectal procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45119	"Removal of rectum, open abdominal and rectal procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45119	"Removal of rectum, open abdominal and rectal procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
45120	Removal of congenital rectal defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45120	Removal of congenital rectal defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45120	Removal of congenital rectal defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
45121	"Removal of congenital rectal defect and large bowel with multiple biopsies, open abdominal and rectal procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45121	"Removal of congenital rectal defect and large bowel with multiple biopsies, open abdominal and rectal procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45121	"Removal of congenital rectal defect and large bowel with multiple biopsies, open abdominal and rectal procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
45123	Partial removal of rectum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45123	Partial removal of rectum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45123	Partial removal of rectum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
45126	"Removal of large bowel, rectum, prostate, urinary structures and/or uterus and cervix"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45126	"Removal of large bowel, rectum, prostate, urinary structures and/or uterus and cervix"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45126	"Removal of large bowel, rectum, prostate, urinary structures and/or uterus and cervix"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		159	
45130	Repair of prolapsed rectum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45130	Repair of prolapsed rectum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45130	Repair of prolapsed rectum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
45135	Repair of prolapsed rectum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45135	Repair of prolapsed rectum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45135	Repair of prolapsed rectum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
45136	Removal of small bowel pouch with creation of small bowel opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45136	Removal of small bowel pouch with creation of small bowel opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45136	Removal of small bowel pouch with creation of small bowel opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		143	
45150	Removal of scar tissue in rectum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45150	Removal of scar tissue in rectum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
45150	Removal of scar tissue in rectum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
45160	Removal of rectal growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45160	Removal of rectal growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45160	Removal of rectal growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
45171	Removal of rectal growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45171	Removal of rectal growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
45171	Removal of rectal growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		109	
45172	Removal of rectal muscle growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45172	Removal of rectal muscle growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
45172	Removal of rectal muscle growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		109	
45190	Destruction of rectal growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45190	Destruction of rectal growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
45190	Destruction of rectal growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
45300	Diagnostic examination of rectum and large bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
45300	Diagnostic examination of rectum and large bowel using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	0	
45300	Diagnostic examination of rectum and large bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
45303	Dilation of rectum and large bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
45303	Dilation of rectum and large bowel using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	32	0	
45303	Dilation of rectum and large bowel using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	0	
45303	Dilation of rectum and large bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
45305	Biopsy of rectum and large bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
45305	Biopsy of rectum and large bowel using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	27	0	
45305	Biopsy of rectum and large bowel using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	0	
45305	Biopsy of rectum and large bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
45307	Foreign body removal in rectum and large bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
45307	Foreign body removal in rectum and large bowel using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	32	0	
45307	Foreign body removal in rectum and large bowel using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	0	
45307	Foreign body removal in rectum and large bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
45308	Removal of polyp or growth of rectum and large bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
45308	Removal of polyp or growth of rectum and large bowel using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	32	0	
45308	Removal of polyp or growth of rectum and large bowel using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	0	
45308	Removal of polyp or growth of rectum and large bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
45309	Removal of polyp or growth of rectum and large bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
45309	Removal of polyp or growth of rectum and large bowel using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	32	0	
45309	Removal of polyp or growth of rectum and large bowel using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	0	
45309	Removal of polyp or growth of rectum and large bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
45315	Removal of multiple polyps or growths in rectum and large bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
45315	Removal of multiple polyps or growths in rectum and large bowel using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	37	0	
45315	Removal of multiple polyps or growths in rectum and large bowel using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	0	
45315	Removal of multiple polyps or growths in rectum and large bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
45317	Control of bleeding in rectum and large bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
45317	Control of bleeding in rectum and large bowel using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	37	0	
45317	Control of bleeding in rectum and large bowel using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	0	
45317	Control of bleeding in rectum and large bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
45320	Destruction of polyps or growths of the rectum and large bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
45320	Destruction of polyps or growths of the rectum and large bowel using an endoscope	Service  intra	L051A	RN	0.51	Service total costs	40	0	
45320	Destruction of polyps or growths of the rectum and large bowel using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
45320	Destruction of polyps or growths of the rectum and large bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
45321	Release of twisted bowel in rectum and large bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
45321	Release of twisted bowel in rectum and large bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
45327	Insertion of rectal or large bowel stent using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
45327	Insertion of rectal or large bowel stent using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	10		
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	2		
45330	"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing when performed"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	15		
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	2		
45331	"Sigmoidoscopy, flexible; with biopsy, single or multiple"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	20		
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Service  intra	L051A	RN	0.51	Moderate sedation	20		
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45332	"Sigmoidoscopy, flexible;  with removal of foreign body"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	15		
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Service  intra	L051A	RN	0.51	Moderate sedation	15		
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45333	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	20		
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Service  intra	L051A	RN	0.51	Moderate sedation	20		
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45334	"Sigmoidoscopy, flexible; with control of bleeding, any method"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	15		
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Service  intra	L051A	RN	0.51	Moderate sedation	15		
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45335	"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45337	"Sigmoidoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		3	
45337	"Sigmoidoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	15		
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  intra	L051A	RN	0.51	Moderate sedation	15		
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45338	"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	20		
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Service  intra	L051A	RN	0.51	Moderate sedation	20		
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45340	"Sigmoidoscopy, flexible; with transendoscopic balloon dilation"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45341	"Sigmoidoscopy, flexible; with endoscopic ultrasound examination"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
45341	"Sigmoidoscopy, flexible; with endoscopic ultrasound examination"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
45341	"Sigmoidoscopy, flexible; with endoscopic ultrasound examination"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
45341	"Sigmoidoscopy, flexible; with endoscopic ultrasound examination"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45341	"Sigmoidoscopy, flexible; with endoscopic ultrasound examination"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45341	"Sigmoidoscopy, flexible; with endoscopic ultrasound examination"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions		3	
45342	"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
45342	"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
45342	"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
45342	"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45342	"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45342	"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions		3	
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	20		
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  intra	L051A	RN	0.51	Moderate sedation	20		
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45346	"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45347	"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
45347	"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
45347	"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
45347	"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45347	"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45349	"Sigmoidoscopy, flexible; with endoscopic mucosal resection"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
45349	"Sigmoidoscopy, flexible; with endoscopic mucosal resection"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
45349	"Sigmoidoscopy, flexible; with endoscopic mucosal resection"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
45349	"Sigmoidoscopy, flexible; with endoscopic mucosal resection"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45349	"Sigmoidoscopy, flexible; with endoscopic mucosal resection"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45349	"Sigmoidoscopy, flexible; with endoscopic mucosal resection"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions		3	
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	20		
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	20		
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Service  post	L051A	RN	0.51	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	15		
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45350	"Sigmoidoscopy, flexible;with banding (eg, hemorrhoids)"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	25		
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	25		
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45378	"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed, (separate procedure)"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45379	"Colonoscopy, flexible; with removal of foreign body"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45379	"Colonoscopy, flexible; with removal of foreign body"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45379	"Colonoscopy, flexible; with removal of foreign body"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45379	"Colonoscopy, flexible; with removal of foreign body"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45379	"Colonoscopy, flexible; with removal of foreign body"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45379	"Colonoscopy, flexible; with removal of foreign body"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
45379	"Colonoscopy, flexible; with removal of foreign body"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45379	"Colonoscopy, flexible; with removal of foreign body"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45379	"Colonoscopy, flexible; with removal of foreign body"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45379	"Colonoscopy, flexible; with removal of foreign body"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
45379	"Colonoscopy, flexible; with removal of foreign body"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45379	"Colonoscopy, flexible; with removal of foreign body"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45379	"Colonoscopy, flexible; with removal of foreign body"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	35		
45379	"Colonoscopy, flexible; with removal of foreign body"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	35		
45379	"Colonoscopy, flexible; with removal of foreign body"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45379	"Colonoscopy, flexible; with removal of foreign body"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45379	"Colonoscopy, flexible; with removal of foreign body"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45379	"Colonoscopy, flexible; with removal of foreign body"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45379	"Colonoscopy, flexible; with removal of foreign body"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45379	"Colonoscopy, flexible; with removal of foreign body"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	28		
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	28		
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45380	"Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	28		
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	28		
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45381	"Colonoscopy, flexible; with directed submucosal injection(s), any substance"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	40		
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	40		
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45382	"Colonoscopy, flexible; with control of bleeding, any method"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	28		
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	28		
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45384	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	30		
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	30		
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45385	"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	35		
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	35		
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45386	"Colonoscopy, flexible; with transendoscopic balloon dilation"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	35		
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	35		
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45388	"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45389	"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
45389	"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
45389	"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
45389	"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45389	"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45389	"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions		3	
45390	"Colonoscopy, flexible; with endoscopic mucosal resection"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
45390	"Colonoscopy, flexible; with endoscopic mucosal resection"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
45390	"Colonoscopy, flexible; with endoscopic mucosal resection"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
45390	"Colonoscopy, flexible; with endoscopic mucosal resection"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45390	"Colonoscopy, flexible; with endoscopic mucosal resection"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45390	"Colonoscopy, flexible; with endoscopic mucosal resection"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions		3	
45391	"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
45391	"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
45391	"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
45391	"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45391	"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45391	"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions		3	
45392	"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and a"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
45392	"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and a"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
45392	"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and a"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
45392	"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and a"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45392	"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and a"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45392	"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and a"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions		3	
45393	"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		3	
45393	"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45395	"Removal of rectum with creation of large bowel opening through using an endoscope, abdominoperineal approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45395	"Removal of rectum with creation of large bowel opening through using an endoscope, abdominoperineal approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45395	"Removal of rectum with creation of large bowel opening through using an endoscope, abdominoperineal approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		159	
45397	"Removal of rectum using an endoscope, abdominoperineal approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45397	"Removal of rectum using an endoscope, abdominoperineal approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45397	"Removal of rectum using an endoscope, abdominoperineal approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		159	
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	5	
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	20		
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	20		
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
45398	"Colonoscopy, flexible; with banding, (eg, hemorrhoids)"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
45400	Repair of rectal prolapse using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45400	Repair of rectal prolapse using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45400	Repair of rectal prolapse using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
45402	Repair of rectal prolapse with partial removal of lower large bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45402	Repair of rectal prolapse with partial removal of lower large bowel using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45402	Repair of rectal prolapse with partial removal of lower large bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
45500	Release of scar tissue and repair of rectum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45500	Release of scar tissue and repair of rectum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
45500	Release of scar tissue and repair of rectum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
45505	Repair of rectal prolapse	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45505	Repair of rectal prolapse	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
45505	Repair of rectal prolapse	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
45520	Injection of veins in rectum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
45520	Injection of veins in rectum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	0	
45520	Injection of veins in rectum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
45540	"Fixation of rectum to sacrum, open abdominal procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45540	"Fixation of rectum to sacrum, open abdominal procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45540	"Fixation of rectum to sacrum, open abdominal procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
45541	"Fixation of rectum to sacrum, perineal approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45541	"Fixation of rectum to sacrum, perineal approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45541	"Fixation of rectum to sacrum, perineal approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
45550	"Fixation of rectum to sacrum with removal of large bowel, open abdominal procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45550	"Fixation of rectum to sacrum with removal of large bowel, open abdominal procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45550	"Fixation of rectum to sacrum with removal of large bowel, open abdominal procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
45560	Repair of herniated rectum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45560	Repair of herniated rectum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45560	Repair of herniated rectum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
45562	Repair of rectal wound	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45562	Repair of rectal wound	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45562	Repair of rectal wound	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
45563	Repair of rectal wound	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45563	Repair of rectal wound	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45563	Repair of rectal wound	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
45800	Repair of herniated rectum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45800	Repair of herniated rectum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45800	Repair of herniated rectum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
45805	Repair of herniated rectum with creation of large bowel opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45805	Repair of herniated rectum with creation of large bowel opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45805	Repair of herniated rectum with creation of large bowel opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
45820	Repair of abnormal rectal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45820	Repair of abnormal rectal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45820	Repair of abnormal rectal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
45825	Repair of abnormal rectal drainage tract with creation of large bowel opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
45825	Repair of abnormal rectal drainage tract with creation of large bowel opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
45825	Repair of abnormal rectal drainage tract with creation of large bowel opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
45900	Repair of rectal prolapse under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
45900	Repair of rectal prolapse under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
45900	Repair of rectal prolapse under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
45905	Dilation of anal muscle under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
45905	Dilation of anal muscle under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
45905	Dilation of anal muscle under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
45910	Dilation of rectal scar tissue under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
45910	Dilation of rectal scar tissue under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
45910	Dilation of rectal scar tissue under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
45915	Removal of impacted stool or foreign body under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
45915	Removal of impacted stool or foreign body under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	69	6	
45915	Removal of impacted stool or foreign body under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	30	30	
45990	Diagnostic examination of anus and rectum under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
45990	Diagnostic examination of anus and rectum under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
46020	Insertion of drain device in anus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
46020	Insertion of drain device in anus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	6	
46020	Insertion of drain device in anus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
46030	Removal of drain device from anus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46030	Removal of drain device from anus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	6	
46030	Removal of drain device from anus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	14	14	
46040	Drainage of rectal abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
46040	Drainage of rectal abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	6	
46040	Drainage of rectal abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
46045	Drainage of rectal abscess under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46045	Drainage of rectal abscess under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
46045	Drainage of rectal abscess under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
46050	Drainage of rectal abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46050	Drainage of rectal abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	6	
46050	Drainage of rectal abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
46060	Drainage of anal abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46060	Drainage of anal abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46060	Drainage of anal abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
46070	"Incision of anal tissue, infant"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46070	"Incision of anal tissue, infant"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46070	"Incision of anal tissue, infant"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		41	
46080	Division of muscle of anus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46080	Division of muscle of anus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	68	6	
46080	Division of muscle of anus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	14	14	
46083	Incision of engorged external hemorrhoid	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46083	Incision of engorged external hemorrhoid	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	6	
46083	Incision of engorged external hemorrhoid	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
46200	Excision of abnormal anal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
46200	Excision of abnormal anal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	64	12	
46200	Excision of abnormal anal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	98	98	
46220	Removal of anal growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46220	Removal of anal growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	6	
46220	Removal of anal growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
46221	Removal of hemorrhoid by rubber banding	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46221	Removal of hemorrhoid by rubber banding	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	6	
46221	Removal of hemorrhoid by rubber banding	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
46230	Removal of multiple external anal growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46230	Removal of multiple external anal growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	70	6	
46230	Removal of multiple external anal growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
46250	Removal of multiple external hemorrhoids	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46250	Removal of multiple external hemorrhoids	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	74	6	
46250	Removal of multiple external hemorrhoids	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	66	66	
46255	Removal of internal and external hemorrhoids	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46255	Removal of internal and external hemorrhoids	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	79	6	
46255	Removal of internal and external hemorrhoids	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	66	66	
46257	Removal of internal and external hemorrhoids with excision of abnormal anal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46257	Removal of internal and external hemorrhoids with excision of abnormal anal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46257	Removal of internal and external hemorrhoids with excision of abnormal anal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
46258	Removal of internal and external hemorrhoids with repair of abnormal anal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46258	Removal of internal and external hemorrhoids with repair of abnormal anal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46258	Removal of internal and external hemorrhoids with repair of abnormal anal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
46260	Removal of multiple internal and external hemorrhoids	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46260	Removal of multiple internal and external hemorrhoids	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46260	Removal of multiple internal and external hemorrhoids	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
46261	Removal of multiple internal and external hemorrhoids with excision of abnormal anal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46261	Removal of multiple internal and external hemorrhoids with excision of abnormal anal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46261	Removal of multiple internal and external hemorrhoids with excision of abnormal anal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
46262	Removal of multiple internal and external hemorrhoids with repair of abnormal anal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46262	Removal of multiple internal and external hemorrhoids with repair of abnormal anal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46262	Removal of multiple internal and external hemorrhoids with repair of abnormal anal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
46270	Repair of abnormal anal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
46270	Repair of abnormal anal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	6	
46270	Repair of abnormal anal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
46275	Repair of anal muscle and abnormal anal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
46275	Repair of anal muscle and abnormal anal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	6	
46275	Repair of anal muscle and abnormal anal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
46280	Repair of anal muscle and abnormal anal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46280	Repair of anal muscle and abnormal anal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46280	Repair of anal muscle and abnormal anal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
46285	Repair of abnormal anal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
46285	Repair of abnormal anal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	6	
46285	Repair of abnormal anal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
46288	Repair of abnormal anal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46288	Repair of abnormal anal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46288	Repair of abnormal anal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
46320	Removal of engorged hemorrhoid	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46320	Removal of engorged hemorrhoid	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	6	
46320	Removal of engorged hemorrhoid	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	14	14	
46500	Injection of hemorrhoids	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		0	
46500	Injection of hemorrhoids	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		0	
46500	Injection of hemorrhoids	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
46500	Injection of hemorrhoids	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		0	
46500	Injection of hemorrhoids	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
46500	Injection of hemorrhoids	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
46500	Injection of hemorrhoids	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
46500	Injection of hemorrhoids	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2		
46500	Injection of hemorrhoids	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
46500	Injection of hemorrhoids	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	10		
46500	Injection of hemorrhoids	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
46500	Injection of hemorrhoids	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
46500	Injection of hemorrhoids	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	5		
46500	Injection of hemorrhoids	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management  same day 99238 --6 minutes		0	
46500	Injection of hemorrhoids	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes	36	36	
46500	Injection of hemorrhoids	Post-service	L037D	RN/LPN/MTA	0.37	Cleaning scope at POV	0	0	
46500	Injection of hemorrhoids	Post-service	L037D	RN/LPN/MTA	0.37	Setup scope at POV	0	0	
46505	Injection of agent to paralyze anal muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
46505	Injection of agent to paralyze anal muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	6	
46505	Injection of agent to paralyze anal muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	42	42	
46600	Diagnostic examination of the anus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46600	Diagnostic examination of the anus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	13	0	
46600	Diagnostic examination of the anus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
46601	"Anoscopy; diagnostic, with high-resolution magnification"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
46601	"Anoscopy; diagnostic, with high-resolution magnification"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		3	
46601	"Anoscopy; diagnostic, with high-resolution magnification"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
46601	"Anoscopy; diagnostic, with high-resolution magnification"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		3	
46601	"Anoscopy; diagnostic, with high-resolution magnification"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
46601	"Anoscopy; diagnostic, with high-resolution magnification"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
46601	"Anoscopy; diagnostic, with high-resolution magnification"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
46601	"Anoscopy; diagnostic, with high-resolution magnification"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	5		
46601	"Anoscopy; diagnostic, with high-resolution magnification"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
46601	"Anoscopy; diagnostic, with high-resolution magnification"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	2		
46601	"Anoscopy; diagnostic, with high-resolution magnification"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	20		
46601	"Anoscopy; diagnostic, with high-resolution magnification"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
46601	"Anoscopy; diagnostic, with high-resolution magnification"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
46604	Dilation of anus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46604	Dilation of anus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	0	
46604	Dilation of anus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
46606	Biopsy of anus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46606	Biopsy of anus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	0	
46606	Biopsy of anus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
46607	"Anoscopy; with high-resolution magnification (hra) , with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		3	
46607	"Anoscopy; with high-resolution magnification (hra) , with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		3	
46607	"Anoscopy; with high-resolution magnification (hra) , with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
46607	"Anoscopy; with high-resolution magnification (hra) , with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		3	
46607	"Anoscopy; with high-resolution magnification (hra) , with biopsy, single or multiple"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
46607	"Anoscopy; with high-resolution magnification (hra) , with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
46607	"Anoscopy; with high-resolution magnification (hra) , with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
46607	"Anoscopy; with high-resolution magnification (hra) , with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	5		
46607	"Anoscopy; with high-resolution magnification (hra) , with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
46607	"Anoscopy; with high-resolution magnification (hra) , with biopsy, single or multiple"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	2		
46607	"Anoscopy; with high-resolution magnification (hra) , with biopsy, single or multiple"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	25		
46607	"Anoscopy; with high-resolution magnification (hra) , with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
46607	"Anoscopy; with high-resolution magnification (hra) , with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
46607	"Anoscopy; with high-resolution magnification (hra) , with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	10		
46607	"Anoscopy; with high-resolution magnification (hra) , with biopsy, single or multiple"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
46608	Removal of foreign body in anus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46608	Removal of foreign body in anus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
46608	Removal of foreign body in anus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
46610	Removal of anal polyps or growths using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46610	Removal of anal polyps or growths using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
46610	Removal of anal polyps or growths using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
46611	Removal of single anal polyp or growth using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46611	Removal of single anal polyp or growth using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	0	
46611	Removal of single anal polyp or growth using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
46612	Removal of multiple anal polyps or growths using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46612	Removal of multiple anal polyps or growths using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	0	
46612	Removal of multiple anal polyps or growths using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
46614	Control of anal bleeding using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46614	Control of anal bleeding using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	0	
46614	Control of anal bleeding using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
46615	Destruction of anal polyps or growths using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46615	Destruction of anal polyps or growths using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	16	0	
46615	Destruction of anal polyps or growths using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
46700	"Plastic repair of anal stricture, adult"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46700	"Plastic repair of anal stricture, adult"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46700	"Plastic repair of anal stricture, adult"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
46705	"Plastic repair of anal stricture, infant"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46705	"Plastic repair of anal stricture, infant"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
46705	"Plastic repair of anal stricture, infant"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
46706	Repair of abnormal anal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		35	
46706	Repair of abnormal anal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46706	Repair of abnormal anal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
46707	Repair of abnormal anal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46707	Repair of abnormal anal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46707	Repair of abnormal anal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
46710	Repair of abnormal anal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46710	Repair of abnormal anal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
46710	Repair of abnormal anal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		105	
46712	Repair of abnormal anal drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46712	Repair of abnormal anal drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
46712	Repair of abnormal anal drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		112	
46715	Creation of an anal opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46715	Creation of an anal opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46715	Creation of an anal opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
46716	Reconstruction of absent anal opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46716	Reconstruction of absent anal opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46716	Reconstruction of absent anal opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		265	
46730	Repair of absent anal opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46730	Repair of absent anal opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46730	Repair of absent anal opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		318	
46735	Repair of absent anal opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46735	Repair of absent anal opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46735	Repair of absent anal opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		318	
46740	Repair of absent anal opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46740	Repair of absent anal opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
46740	Repair of absent anal opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		318	
46742	Repair of absent anal opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46742	Repair of absent anal opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46742	Repair of absent anal opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		318	
46744	"Repair of defect for single channel outlet of rectum, vagina, and urinary tract"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46744	"Repair of defect for single channel outlet of rectum, vagina, and urinary tract"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
46744	"Repair of defect for single channel outlet of rectum, vagina, and urinary tract"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		318	
46746	"Repair of defect for single channel outlet of rectum, vagina, and urinary tract"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46746	"Repair of defect for single channel outlet of rectum, vagina, and urinary tract"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46746	"Repair of defect for single channel outlet of rectum, vagina, and urinary tract"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		328	
46748	"Repair of defect for single channel outlet of rectum, vagina, and urinary tract"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46748	"Repair of defect for single channel outlet of rectum, vagina, and urinary tract"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46748	"Repair of defect for single channel outlet of rectum, vagina, and urinary tract"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		328	
46750	"Repair of anal muscle for incontinence or prolapse, adult"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46750	"Repair of anal muscle for incontinence or prolapse, adult"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
46750	"Repair of anal muscle for incontinence or prolapse, adult"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
46751	"Repair of anal muscle for incontinence or prolapse, child"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46751	"Repair of anal muscle for incontinence or prolapse, child"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46751	"Repair of anal muscle for incontinence or prolapse, child"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
46753	Repair of muscle of anus for incontinence and/or prolapse using wire or suture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46753	Repair of muscle of anus for incontinence and/or prolapse using wire or suture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
46753	Repair of muscle of anus for incontinence and/or prolapse using wire or suture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
46754	Removal of anal muscle wire or suture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46754	Removal of anal muscle wire or suture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60	6	
46754	Removal of anal muscle wire or suture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	99	99	
46760	"Repair of anal muscle to correct incontinence, adult"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46760	"Repair of anal muscle to correct incontinence, adult"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
46760	"Repair of anal muscle to correct incontinence, adult"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		179	
46761	"Repair of anal muscle to correct incontinence, adult"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46761	"Repair of anal muscle to correct incontinence, adult"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
46761	"Repair of anal muscle to correct incontinence, adult"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
46762	"Repair of anal muscle to correct incontinence with implant, adult"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46762	"Repair of anal muscle to correct incontinence with implant, adult"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
46762	"Repair of anal muscle to correct incontinence with implant, adult"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
46900	Chemical destruction of anal growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46900	Chemical destruction of anal growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	70	6	
46900	Chemical destruction of anal growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
46910	Destruction of anal growths using electric current	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46910	Destruction of anal growths using electric current	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	6	
46910	Destruction of anal growths using electric current	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
46916	Freezing destruction of anal growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46916	Freezing destruction of anal growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	6	
46916	Freezing destruction of anal growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
46917	Laser destruction of anal growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46917	Laser destruction of anal growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	6	
46917	Laser destruction of anal growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
46922	Excisional destruction of anal growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46922	Excisional destruction of anal growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	75	6	
46922	Excisional destruction of anal growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
46924	Destruction of anal growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46924	Destruction of anal growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	6	
46924	Destruction of anal growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
46930	Destruction of internal anal hemorrhoids	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46930	Destruction of internal anal hemorrhoids	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	37	6	
46930	Destruction of internal anal hemorrhoids	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
46940	Repair of anal tear with dilation of anal muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46940	Repair of anal tear with dilation of anal muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	6	
46940	Repair of anal tear with dilation of anal muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	14	14	
46942	Repair of anal tear with dilation of anal muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
46942	Repair of anal tear with dilation of anal muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	68	6	
46942	Repair of anal tear with dilation of anal muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	14	14	
46945	Removal and tying hemorrhoid group	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
46945	Removal and tying hemorrhoid group	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	6	
46945	Removal and tying hemorrhoid group	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	66	66	
46946	Removal and tying 2 or more hemorrhoid group	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
46946	Removal and tying 2 or more hemorrhoid group	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	54	6	
46946	Removal and tying 2 or more hemorrhoid group	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	30	30	
46947	Repair of prolapsing hemorrhoids	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
46947	Repair of prolapsing hemorrhoids	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
46947	Repair of prolapsing hemorrhoids	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
47000	"Needle biopsy of liver, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	16	
47000	"Needle biopsy of liver, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	48	0	
47000	"Needle biopsy of liver, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	82	0	
47000	"Needle biopsy of liver, accessed through the skin"	Post-service	L041B	Radiologic Technologist	0.41	Post service total costs	3	3	
47010	"Drainage of liver abscess or cyst, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47010	"Drainage of liver abscess or cyst, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47010	"Drainage of liver abscess or cyst, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47015	Injection and/or drainage of liver abscesses or cysts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47015	Injection and/or drainage of liver abscesses or cysts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47015	Injection and/or drainage of liver abscesses or cysts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47100	Partial removal of liver tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47100	Partial removal of liver tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47100	Partial removal of liver tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47120	Partial removal of liver lobe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47120	Partial removal of liver lobe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47120	Partial removal of liver lobe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		143	
47122	Removal of right liver lobe with partial removal of left liver lobe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47122	Removal of right liver lobe with partial removal of left liver lobe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47122	Removal of right liver lobe with partial removal of left liver lobe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47125	Removal of left liver lobe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47125	Removal of left liver lobe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47125	Removal of left liver lobe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47130	Removal of right liver lobe	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47130	Removal of right liver lobe	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47130	Removal of right liver lobe	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47135	Transplantation of donor liver to anatomic position	Pre-service	L051A	RN	0.51	Complete pre-service diagnostic and referral forms		5	
47135	Transplantation of donor liver to anatomic position	Pre-service	L051A	RN	0.51	Complex multidisciplinary coordination of care		30	
47135	Transplantation of donor liver to anatomic position	Pre-service	L051A	RN	0.51	Coordinate pre-surgery services		20	
47135	Transplantation of donor liver to anatomic position	Pre-service	L051A	RN	0.51	Follow-up phone calls and prescriptions		7	
47135	Transplantation of donor liver to anatomic position	Pre-service	L051A	RN	0.51	Provide pre-service education/obtain consent		20	
47135	Transplantation of donor liver to anatomic position	Pre-service	L051A	RN	0.51	Schedule space and equipment in facility		8	
47135	Transplantation of donor liver to anatomic position	Service  post	L051A	RN	0.51	Discharge day management 99239 -- 15 minutes		15	
47135	Transplantation of donor liver to anatomic position	Post-service	L051A	RN	0.51	99213    36  minutes		36	
47135	Transplantation of donor liver to anatomic position	Post-service	L051A	RN	0.51	99214    53  minutes		318	
47135	Transplantation of donor liver to anatomic position	Post-service	L051A	RN	0.51	99215    63  minutes		63	
47140	Partial removal of donor liver left segment	Pre-service	L051A	RN	0.51	Preservice total costs		210	
47140	Partial removal of donor liver left segment	Service  intra	L051A	RN	0.51	Service total costs		12	
47140	Partial removal of donor liver left segment	Post-service	L051A	RN	0.51	Post service total costs		135	
47141	Removal of donor liver left lobe	Pre-service	L051A	RN	0.51	Preservice total costs		210	
47141	Removal of donor liver left lobe	Service  intra	L051A	RN	0.51	Service total costs		12	
47141	Removal of donor liver left lobe	Post-service	L051A	RN	0.51	Post service total costs		171	
47142	Removal of donor liver right lobe	Pre-service	L051A	RN	0.51	Preservice total costs		210	
47142	Removal of donor liver right lobe	Service  intra	L051A	RN	0.51	Service total costs		12	
47142	Removal of donor liver right lobe	Post-service	L051A	RN	0.51	Post service total costs		171	
47300	Creation of tract to drain liver cyst or abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47300	Creation of tract to drain liver cyst or abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47300	Creation of tract to drain liver cyst or abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47350	Suture of liver wound to control bleeding	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47350	Suture of liver wound to control bleeding	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47350	Suture of liver wound to control bleeding	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47360	Suturing liver wound to control bleeding	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47360	Suturing liver wound to control bleeding	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47360	Suturing liver wound to control bleeding	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47361	Suture of liver wound to control bleeding	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47361	Suture of liver wound to control bleeding	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47361	Suture of liver wound to control bleeding	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47362	Re-exploration of liver wound with removal of packing	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47362	Re-exploration of liver wound with removal of packing	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47362	Re-exploration of liver wound with removal of packing	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47370	Destruction of liver growths using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47370	Destruction of liver growths using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47370	Destruction of liver growths using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47371	Freezing of liver growths using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47371	Freezing of liver growths using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47371	Freezing of liver growths using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47380	"Destruction of 1 or more growths on liver, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47380	"Destruction of 1 or more growths on liver, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47380	"Destruction of 1 or more growths on liver, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47381	"Destruction of 1 or more growths on liver, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47381	"Destruction of 1 or more growths on liver, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47381	"Destruction of 1 or more growths on liver, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47382	"Destruction of 1 or more growths in liver, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	14	23	
47382	"Destruction of 1 or more growths in liver, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	153	0	
47382	"Destruction of 1 or more growths in liver, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	197	0	
47382	"Destruction of 1 or more growths in liver, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	6	
47382	"Destruction of 1 or more growths in liver, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	5	5	
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	10	
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Pre-service	L046A	CT Technologist	0.46	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	6		
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	7	7	
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Service  pre	L046A	CT Technologist	0.46	Prepare and position pt/ monitor pt/ set up IV	2		
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Service  pre	L046A	CT Technologist	0.46	"Prepare room, equipment, supplies"	4		
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Service  intra	L046A	CT Technologist	0.46	Assist physician in performing procedure	90		
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure	90		
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	23		
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Service  post	L037D	RN/LPN/MTA	0.37	Clean RFA equipment	3		
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
47383	"Ablation, 1 or more liver tumor(s), cryoablation"	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes	27	27	
47400	Drainage or removal of liver duct stone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47400	Drainage or removal of liver duct stone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47400	Drainage or removal of liver duct stone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47420	Drainage or removal of liver duct stone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47420	Drainage or removal of liver duct stone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47420	Drainage or removal of liver duct stone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
47425	Drainage or removal of bile duct stone with redirection of bile flow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47425	Drainage or removal of bile duct stone with redirection of bile flow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47425	Drainage or removal of bile duct stone with redirection of bile flow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
47460	Repair of bile duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47460	Repair of bile duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47460	Repair of bile duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
47480	"Drainage or removal of stones from gallbladder, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47480	"Drainage or removal of stones from gallbladder, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47480	"Drainage or removal of stones from gallbladder, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47490	Insertion of catheter (accessed through the skin) into gallbladder using imaging guidance including radiological supervision and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47490	Insertion of catheter (accessed through the skin) into gallbladder using imaging guidance including radiological supervision and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47490	Insertion of catheter (accessed through the skin) into gallbladder using imaging guidance including radiological supervision and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	0		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	15		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	20		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	0		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	5		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	15		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
47531	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	30		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	40		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	40		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	10		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
47532	"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	45		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	60		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	60		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	15		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
47533	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	58		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	78		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	78		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	20		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
47534	"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	34		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	45		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	45		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	11		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
47535	"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	23		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	30		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	30		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	7		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	15		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
47536	"Exchange of biliary drainage catheter (eg. external, internal-external, or conversion of internal/-external  to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	0		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	15		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	20		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	0		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	5		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	15		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
47537	"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		5	
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	41		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	55		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	55		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	14		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
47538	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; existing access"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	60		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	80		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	80		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	20		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
47539	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, without placement of separate biliary drainage catheter"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	68		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	90		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	90		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	22		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
47540	"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange or removal when performed, and all associated radiological supervision and interpretation, each stent; new access, with placement of separate biliary drainage catheter (eg, external or internal-external)"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		5	
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	45		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	60		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	60		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	15		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
47541	"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation, new access"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
47542	"Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, each duct (List separately in addition to code for primary procedure)"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	26		
47542	"Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, each duct (List separately in addition to code for primary procedure)"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	35		
47542	"Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, each duct (List separately in addition to code for primary procedure)"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	35		
47542	"Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, each duct (List separately in addition to code for primary procedure)"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	9		
47543	"Endoluminal biopsy(ies) of biliary tree, percutaneous, any method(s) (eg, brush, forceps, and/or needle), including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, single or multiple (List separately in addition to code for primary procedure)"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	32		
47543	"Endoluminal biopsy(ies) of biliary tree, percutaneous, any method(s) (eg, brush, forceps, and/or needle), including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, single or multiple (List separately in addition to code for primary procedure)"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	43		
47543	"Endoluminal biopsy(ies) of biliary tree, percutaneous, any method(s) (eg, brush, forceps, and/or needle), including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, single or multiple (List separately in addition to code for primary procedure)"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	43		
47543	"Endoluminal biopsy(ies) of biliary tree, percutaneous, any method(s) (eg, brush, forceps, and/or needle), including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, single or multiple (List separately in addition to code for primary procedure)"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	10		
47544	"Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	45		
47544	"Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	60		
47544	"Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	60		
47544	"Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	15		
47552	"Diagnostic examination of bile ducts using an endoscope, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
47552	"Diagnostic examination of bile ducts using an endoscope, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
47554	"Removal of bile duct stones using an endoscope, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
47554	"Removal of bile duct stones using an endoscope, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
47562	Removal of gallbladder using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47562	Removal of gallbladder using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
47562	Removal of gallbladder using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
47563	Removal of gallbladder with X-ray study of bile ducts using endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47563	Removal of gallbladder with X-ray study of bile ducts using endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
47563	Removal of gallbladder with X-ray study of bile ducts using endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63.5	
47564	Removal of gallbladder with exploration of common bile duct using endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47564	Removal of gallbladder with exploration of common bile duct using endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47564	Removal of gallbladder with exploration of common bile duct using endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
47570	Connection of gall bladder to bowel using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47570	Connection of gall bladder to bowel using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47570	Connection of gall bladder to bowel using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
47600	Removal of gallbladder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47600	Removal of gallbladder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47600	Removal of gallbladder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47605	Removal of gallbladder with X-ray study of bile ducts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47605	Removal of gallbladder with X-ray study of bile ducts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47605	Removal of gallbladder with X-ray study of bile ducts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47610	Removal of gallbladder with exploration of common bile duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47610	Removal of gallbladder with exploration of common bile duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47610	Removal of gallbladder with exploration of common bile duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
47612	Removal of gallbladder and creation of bile duct drainage to bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47612	Removal of gallbladder and creation of bile duct drainage to bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47612	Removal of gallbladder and creation of bile duct drainage to bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
47620	Removal of gallbladder and creation of bile duct drainage to bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47620	Removal of gallbladder and creation of bile duct drainage to bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47620	Removal of gallbladder and creation of bile duct drainage to bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
47700	Exploration of congenital bile duct defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47700	Exploration of congenital bile duct defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47700	Exploration of congenital bile duct defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
47701	Connection of portion of upper small bowel to bile duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47701	Connection of portion of upper small bowel to bile duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47701	Connection of portion of upper small bowel to bile duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
47711	Removal of bile duct growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47711	Removal of bile duct growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47711	Removal of bile duct growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47712	Removal of bile duct growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47712	Removal of bile duct growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47712	Removal of bile duct growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47715	Removal of gallbladder cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47715	Removal of gallbladder cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47715	Removal of gallbladder cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47720	Incision of gallbladder cyst with creation of drainage tract into abdomen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47720	Incision of gallbladder cyst with creation of drainage tract into abdomen	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47720	Incision of gallbladder cyst with creation of drainage tract into abdomen	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47721	Incision of gallbladder cyst with creation of drainage tract to small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47721	Incision of gallbladder cyst with creation of drainage tract to small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47721	Incision of gallbladder cyst with creation of drainage tract to small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47740	Incision of gallbladder cyst with creation of drainage tract from bile duct in liver to small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47740	Incision of gallbladder cyst with creation of drainage tract from bile duct in liver to small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47740	Incision of gallbladder cyst with creation of drainage tract from bile duct in liver to small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47741	Incision of gallbladder cyst with creation of drainage tract to stomach and small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47741	Incision of gallbladder cyst with creation of drainage tract to stomach and small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47741	Incision of gallbladder cyst with creation of drainage tract to stomach and small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47760	Connection of bile duct to small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47760	Connection of bile duct to small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47760	Connection of bile duct to small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
47765	Connection of bile duct to small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47765	Connection of bile duct to small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47765	Connection of bile duct to small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
47780	Connection of bile duct to small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47780	Connection of bile duct to small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47780	Connection of bile duct to small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
47785	Connection of bile duct to small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47785	Connection of bile duct to small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47785	Connection of bile duct to small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
47800	Reconstruction of bile duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47800	Reconstruction of bile duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47800	Reconstruction of bile duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47801	Insertion of stent into bile duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47801	Insertion of stent into bile duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47801	Insertion of stent into bile duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47802	Creation of drainage from liver bile duct to bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47802	Creation of drainage from liver bile duct to bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47802	Creation of drainage from liver bile duct to bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
47900	Suture of injured bile duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
47900	Suture of injured bile duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
47900	Suture of injured bile duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
48000	"Insertion of external drains from gallbladder, bile duct and small bowel"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48000	"Insertion of external drains from gallbladder, bile duct and small bowel"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48000	"Insertion of external drains from gallbladder, bile duct and small bowel"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
48001	"Insertion of external drains from gallbladder, bile duct and small bowel"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48001	"Insertion of external drains from gallbladder, bile duct and small bowel"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48001	"Insertion of external drains from gallbladder, bile duct and small bowel"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
48020	Removal of pancreatic duct stones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48020	Removal of pancreatic duct stones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48020	Removal of pancreatic duct stones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
48100	"Biopsy of pancreas, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48100	"Biopsy of pancreas, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48100	"Biopsy of pancreas, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
48102	"Needle biopsy of pancreas, accessed through the skin"	Service  intra	L042B	Respiratory Therapist	0.42	Service total costs	40	6	
48102	"Needle biopsy of pancreas, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	15	0	
48102	"Needle biopsy of pancreas, accessed through the skin"	Post-service	L042B	Respiratory Therapist	0.42	Post service total costs	14	14	
48105	Removal of pancreatic tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48105	Removal of pancreatic tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48105	Removal of pancreatic tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
48120	Removal of growth of pancreas	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48120	Removal of growth of pancreas	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48120	Removal of growth of pancreas	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
48140	Partial removal of pancreas	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48140	Partial removal of pancreas	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48140	Partial removal of pancreas	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
48145	Partial removal of pancreas with connection of pancreas to small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48145	Partial removal of pancreas with connection of pancreas to small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48145	Partial removal of pancreas with connection of pancreas to small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
48146	Partial removal of pancreas	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48146	Partial removal of pancreas	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48146	Partial removal of pancreas	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
48148	Partial removal of pancreatic and common bile ducts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48148	Partial removal of pancreatic and common bile ducts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48148	Partial removal of pancreatic and common bile ducts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
48150	"Partial removal of pancreas, bile duct and small bowel with connection of pancreas to small bowel"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48150	"Partial removal of pancreas, bile duct and small bowel with connection of pancreas to small bowel"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48150	"Partial removal of pancreas, bile duct and small bowel with connection of pancreas to small bowel"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
48152	"Partial removal of pancreas, bile duct and small bowel"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48152	"Partial removal of pancreas, bile duct and small bowel"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48152	"Partial removal of pancreas, bile duct and small bowel"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
48153	"Partial removal of pancreas, bile duct and small bowel with connection of pancreas to small bowel"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48153	"Partial removal of pancreas, bile duct and small bowel with connection of pancreas to small bowel"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48153	"Partial removal of pancreas, bile duct and small bowel with connection of pancreas to small bowel"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
48154	"Partial removal of pancreas, bile duct, and small bowel"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48154	"Partial removal of pancreas, bile duct, and small bowel"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48154	"Partial removal of pancreas, bile duct, and small bowel"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
48155	Removal of pancreas	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48155	Removal of pancreas	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48155	Removal of pancreas	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
48500	Creation of drainage tract of pancreatic cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48500	Creation of drainage tract of pancreatic cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48500	Creation of drainage tract of pancreatic cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
48510	"Insertion of drain from pancreatic cyst into abdominal cavity, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48510	"Insertion of drain from pancreatic cyst into abdominal cavity, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48510	"Insertion of drain from pancreatic cyst into abdominal cavity, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
48520	Creation of drainage tract from pancreatic cyst to small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48520	Creation of drainage tract from pancreatic cyst to small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48520	Creation of drainage tract from pancreatic cyst to small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
48540	Creation of drainage tract from pancreatic cyst to small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48540	Creation of drainage tract from pancreatic cyst to small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48540	Creation of drainage tract from pancreatic cyst to small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
48545	Suture of pancreatic injury	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48545	Suture of pancreatic injury	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48545	Suture of pancreatic injury	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
48547	Repair of pancreatic injury	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48547	Repair of pancreatic injury	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48547	Repair of pancreatic injury	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
48548	Creation of pancreatic drainage tract from pancreas and upper small bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
48548	Creation of pancreatic drainage tract from pancreas and upper small bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
48548	Creation of pancreatic drainage tract from pancreas and upper small bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
48554	Transplantation of donor pancreas	Pre-service	L051A	RN	0.51	Preservice total costs		90	
48554	Transplantation of donor pancreas	Service  intra	L051A	RN	0.51	Service total costs		12	
48554	Transplantation of donor pancreas	Post-service	L051A	RN	0.51	Post service total costs		492	
48556	Removal of transplanted donor pancreas	Pre-service	L051A	RN	0.51	Preservice total costs		60	
48556	Removal of transplanted donor pancreas	Service  intra	L051A	RN	0.51	Service total costs		12	
48556	Removal of transplanted donor pancreas	Post-service	L051A	RN	0.51	Post service total costs		161	
49000	Exploration of abdomen and abdominal organs	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49000	Exploration of abdomen and abdominal organs	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49000	Exploration of abdomen and abdominal organs	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
49002	Reopening of recent abdominal incision	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49002	Reopening of recent abdominal incision	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49002	Reopening of recent abdominal incision	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49010	Exploration behind abdominal cavity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49010	Exploration behind abdominal cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49010	Exploration behind abdominal cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49020	"Drainage of abdominal abscess or infection, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49020	"Drainage of abdominal abscess or infection, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49020	"Drainage of abdominal abscess or infection, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
49040	"Drainage of abscess of muscle separating chest and abdomen (diaphragm), open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49040	"Drainage of abscess of muscle separating chest and abdomen (diaphragm), open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49040	"Drainage of abscess of muscle separating chest and abdomen (diaphragm), open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
49060	"Drainage of abscess behind abdominal cavity, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49060	"Drainage of abscess behind abdominal cavity, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49060	"Drainage of abscess behind abdominal cavity, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
49062	"Drainage of accumulated abdominal lymph fluid, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49062	"Drainage of accumulated abdominal lymph fluid, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49062	"Drainage of accumulated abdominal lymph fluid, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
49082	Drainage of fluid from abdominal cavity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	17	
49082	Drainage of fluid from abdominal cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	0	
49082	Drainage of fluid from abdominal cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
49083	Drainage of fluid from abdominal cavity using imaging guidance	Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Preservice total costs	0	5	
49083	Drainage of fluid from abdominal cavity using imaging guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	7	12	
49083	Drainage of fluid from abdominal cavity using imaging guidance	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	40	0	
49083	Drainage of fluid from abdominal cavity using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	31	0	
49083	Drainage of fluid from abdominal cavity using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
49180	"Needle biopsy of abdominal cavity growth, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	48	0	
49180	"Needle biopsy of abdominal cavity growth, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	16	0	
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		3	
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		3	
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	23		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	30		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	0		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	7		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	15		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
49185	"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed"	Post-service	L041B	Radiologic Technologist	0.41	Conduct phone calls/call in prescriptions	3		
49203	"Removal or destruction of (5 centimeters or less) abdominal cavity growths, cysts, or abnormal tissue, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49203	"Removal or destruction of (5 centimeters or less) abdominal cavity growths, cysts, or abnormal tissue, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49203	"Removal or destruction of (5 centimeters or less) abdominal cavity growths, cysts, or abnormal tissue, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
49204	"Removal or destruction of (5.1 to 10.0 centimeters) abdominal cavity growths, cysts, or abnormal tissue, open abdominal procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49204	"Removal or destruction of (5.1 to 10.0 centimeters) abdominal cavity growths, cysts, or abnormal tissue, open abdominal procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49204	"Removal or destruction of (5.1 to 10.0 centimeters) abdominal cavity growths, cysts, or abnormal tissue, open abdominal procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
49205	"Removal or destruction of (greater than 10.0 centimeters) abdominal cavity growths, cysts, or abnormal tissue, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49205	"Removal or destruction of (greater than 10.0 centimeters) abdominal cavity growths, cysts, or abnormal tissue, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49205	"Removal or destruction of (greater than 10.0 centimeters) abdominal cavity growths, cysts, or abnormal tissue, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
49215	Removal of pelvic or tailbone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49215	Removal of pelvic or tailbone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49215	Removal of pelvic or tailbone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
49220	Liver and/or bone marrow biopsy with removal of spleen and lymph nodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49220	Liver and/or bone marrow biopsy with removal of spleen and lymph nodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49220	Liver and/or bone marrow biopsy with removal of spleen and lymph nodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
49250	Removal of navel and surrounding tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49250	Removal of navel and surrounding tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49250	Removal of navel and surrounding tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
49255	Removal of lining covering abdominal organs	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49255	Removal of lining covering abdominal organs	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49255	Removal of lining covering abdominal organs	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
49320	Diagnostic examination of the abdomen using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
49320	Diagnostic examination of the abdomen using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49320	Diagnostic examination of the abdomen using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
49321	Biopsy of abdomen using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
49321	Biopsy of abdomen using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49321	Biopsy of abdomen using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
49322	Aspiration of abdominal cavity or cyst using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
49322	Aspiration of abdominal cavity or cyst using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49322	Aspiration of abdominal cavity or cyst using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
49323	Drainage of lymph fluid to abdominal cavity using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49323	Drainage of lymph fluid to abdominal cavity using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49323	Drainage of lymph fluid to abdominal cavity using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
49324	Insertion of abdominal cavity catheter using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
49324	Insertion of abdominal cavity catheter using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49324	Insertion of abdominal cavity catheter using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
49325	Revision of abdominal cavity catheter using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
49325	Revision of abdominal cavity catheter using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49325	Revision of abdominal cavity catheter using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
49400	Injection of air or X-ray contrast material into abdominal cavity	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	23	0	
49402	Removal of foreign body from abdominal cavity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49402	Removal of foreign body from abdominal cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49402	Removal of foreign body from abdominal cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49405	"Fluid collection drainage by catheter using imaging guidance, accessed through the skin"	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	5	0	
49405	"Fluid collection drainage by catheter using imaging guidance, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	6	
49405	"Fluid collection drainage by catheter using imaging guidance, accessed through the skin"	Service  intra	L046A	CT Technologist	0.46	Service total costs	79	0	
49405	"Fluid collection drainage by catheter using imaging guidance, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	72	0	
49405	"Fluid collection drainage by catheter using imaging guidance, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25	0	
49406	"Fluid collection drainage by catheter using imaging guidance, accessed through the skin"	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	5	0	
49406	"Fluid collection drainage by catheter using imaging guidance, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	6	
49406	"Fluid collection drainage by catheter using imaging guidance, accessed through the skin"	Service  intra	L046A	CT Technologist	0.46	Service total costs	79	0	
49406	"Fluid collection drainage by catheter using imaging guidance, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	72	0	
49406	"Fluid collection drainage by catheter using imaging guidance, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25	0	
49407	"Fluid collection drainage by catheter using imaging guidance, accessed throug vagina or rectum"	Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Preservice total costs	5	0	
49407	"Fluid collection drainage by catheter using imaging guidance, accessed throug vagina or rectum"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	6	
49407	"Fluid collection drainage by catheter using imaging guidance, accessed throug vagina or rectum"	Service  intra	L051A	RN	0.51	Service total costs	77	0	
49407	"Fluid collection drainage by catheter using imaging guidance, accessed throug vagina or rectum"	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	88	0	
49407	"Fluid collection drainage by catheter using imaging guidance, accessed throug vagina or rectum"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
49411	"Insertion of devices in abdominal cavity for radiation therapy guidance, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	11	
49411	"Insertion of devices in abdominal cavity for radiation therapy guidance, accessed through the skin"	Service  intra	L046A	CT Technologist	0.46	Service total costs	32	0	
49411	"Insertion of devices in abdominal cavity for radiation therapy guidance, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	102	0	
49411	"Insertion of devices in abdominal cavity for radiation therapy guidance, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	0	
49411	"Insertion of devices in abdominal cavity for radiation therapy guidance, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
49418	Insertion of abdominal catheter through the skin using imaging guidance including radiological supervision and interpretation	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6	5	
49418	Insertion of abdominal catheter through the skin using imaging guidance including radiological supervision and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	5	15	
49418	Insertion of abdominal catheter through the skin using imaging guidance including radiological supervision and interpretation	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	96	0	
49418	Insertion of abdominal catheter through the skin using imaging guidance including radiological supervision and interpretation	Service  intra	L051A	RN	0.51	Service total costs	102	0	
49418	Insertion of abdominal catheter through the skin using imaging guidance including radiological supervision and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	0	
49418	Insertion of abdominal catheter through the skin using imaging guidance including radiological supervision and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
49419	Insertion of abdominal cavity catheter for drug delivery beneath the skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49419	Insertion of abdominal cavity catheter for drug delivery beneath the skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49419	Insertion of abdominal cavity catheter for drug delivery beneath the skin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
49421	"Insertion of abdominal cavity catheter for drainage or dialysis, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		8	
49421	"Insertion of abdominal cavity catheter for drainage or dialysis, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		6	
49422	Removal of abdominal cavity catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
49422	Removal of abdominal cavity catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49422	Removal of abdominal cavity catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
49423	Exchange of abdominal cavity drainage catheter using imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	6	0	
49423	Exchange of abdominal cavity drainage catheter using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	0	
49423	Exchange of abdominal cavity drainage catheter using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
49424	Injection of contrast through abdominal cavity catheter for X-ray study	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	6	0	
49424	Injection of contrast through abdominal cavity catheter for X-ray study	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
49424	Injection of contrast through abdominal cavity catheter for X-ray study	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
49425	Insertion of shunt from jugular vein to abdominal cavity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49425	Insertion of shunt from jugular vein to abdominal cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49425	Insertion of shunt from jugular vein to abdominal cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
49426	Revision of shunt from jugular vein to abdominal cavity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49426	Revision of shunt from jugular vein to abdominal cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49426	Revision of shunt from jugular vein to abdominal cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
49428	Closure of venous shunt abdominal cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49428	Closure of venous shunt abdominal cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49429	Removal of shunt from jugular vein to abdominal cavity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
49429	Removal of shunt from jugular vein to abdominal cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49429	Removal of shunt from jugular vein to abdominal cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
49436	Creation of abdominal cavity catheter exit site	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
49436	Creation of abdominal cavity catheter exit site	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49436	Creation of abdominal cavity catheter exit site	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
49440	Insertion of stomach tube (accessed through the skin) using fluoroscopic guidance with contrast	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
49440	Insertion of stomach tube (accessed through the skin) using fluoroscopic guidance with contrast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
49440	Insertion of stomach tube (accessed through the skin) using fluoroscopic guidance with contrast	Service  intra	L041A	Angio Technician	0.41	Service total costs	45	0	
49440	Insertion of stomach tube (accessed through the skin) using fluoroscopic guidance with contrast	Service  intra	L051A	RN	0.51	Service total costs	55	0	
49440	Insertion of stomach tube (accessed through the skin) using fluoroscopic guidance with contrast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	19	0	
49440	Insertion of stomach tube (accessed through the skin) using fluoroscopic guidance with contrast	Post-service	L051A	RN	0.51	Post service total costs	0	27	
49441	Percutaneous insertion of small bowel tube (accessed through the skin) using fluoroscopic guidance with contrast	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
49441	Percutaneous insertion of small bowel tube (accessed through the skin) using fluoroscopic guidance with contrast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
49441	Percutaneous insertion of small bowel tube (accessed through the skin) using fluoroscopic guidance with contrast	Service  intra	L041A	Angio Technician	0.41	Service total costs	52	0	
49441	Percutaneous insertion of small bowel tube (accessed through the skin) using fluoroscopic guidance with contrast	Service  intra	L051A	RN	0.51	Service total costs	62	0	
49441	Percutaneous insertion of small bowel tube (accessed through the skin) using fluoroscopic guidance with contrast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	19	0	
49441	Percutaneous insertion of small bowel tube (accessed through the skin) using fluoroscopic guidance with contrast	Post-service	L051A	RN	0.51	Post service total costs	0	27	
49442	Insertion of large bowel tube (accessed through the skin) using fluoroscopic guidance with contrast	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
49442	Insertion of large bowel tube (accessed through the skin) using fluoroscopic guidance with contrast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
49442	Insertion of large bowel tube (accessed through the skin) using fluoroscopic guidance with contrast	Service  intra	L041A	Angio Technician	0.41	Service total costs	37	0	
49442	Insertion of large bowel tube (accessed through the skin) using fluoroscopic guidance with contrast	Service  intra	L051A	RN	0.51	Service total costs	47	0	
49442	Insertion of large bowel tube (accessed through the skin) using fluoroscopic guidance with contrast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	16	0	
49442	Insertion of large bowel tube (accessed through the skin) using fluoroscopic guidance with contrast	Post-service	L051A	RN	0.51	Post service total costs	0	36	
49446	"Conversion of stomach tube to small bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
49446	"Conversion of stomach tube to small bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
49446	"Conversion of stomach tube to small bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Service  intra	L041A	Angio Technician	0.41	Service total costs	47	0	
49446	"Conversion of stomach tube to small bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	57	0	
49446	"Conversion of stomach tube to small bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	16	0	
49450	"Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
49450	"Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
49450	"Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Service  intra	L041A	Angio Technician	0.41	Service total costs	17	0	
49450	"Replacement of stomach or large bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	33	0	
49451	"Replacement of small bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
49451	"Replacement of small bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
49451	"Replacement of small bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Service  intra	L041A	Angio Technician	0.41	Service total costs	22	0	
49451	"Replacement of small bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	33	0	
49452	"Replacement of stomach to small bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
49452	"Replacement of stomach to small bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
49452	"Replacement of stomach to small bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Service  intra	L041A	Angio Technician	0.41	Service total costs	27	0	
49452	"Replacement of stomach to small bowel tube using fluoroscopic guidance with contrast, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	16	0	
49460	"Mechanical removal of obstructive material in stomach, large, or small bowel tube using fluoroscopic guidance with contrast"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
49460	"Mechanical removal of obstructive material in stomach, large, or small bowel tube using fluoroscopic guidance with contrast"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
49460	"Mechanical removal of obstructive material in stomach, large, or small bowel tube using fluoroscopic guidance with contrast"	Service  intra	L041A	Angio Technician	0.41	Service total costs	22	0	
49460	"Mechanical removal of obstructive material in stomach, large, or small bowel tube using fluoroscopic guidance with contrast"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	33	0	
49465	"Contrast injections for x-ray imaging through existing tube in stomach, small bowel or large bowel, accessed through the skin"	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6	0	
49465	"Contrast injections for x-ray imaging through existing tube in stomach, small bowel or large bowel, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
49465	"Contrast injections for x-ray imaging through existing tube in stomach, small bowel or large bowel, accessed through the skin"	Service  intra	L041A	Angio Technician	0.41	Service total costs	17	0	
49465	"Contrast injections for x-ray imaging through existing tube in stomach, small bowel or large bowel, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
49491	Repair of groin hernia preterm infant younger than 37 weeks gestation performed from birth to 50 weeks postconception	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49491	Repair of groin hernia preterm infant younger than 37 weeks gestation performed from birth to 50 weeks postconception	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49491	Repair of groin hernia preterm infant younger than 37 weeks gestation performed from birth to 50 weeks postconception	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
49492	Repair of trapped groin hernia preterm infant younger than 37 weeks gestation performed from birth to 50 weeks postconception	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49492	Repair of trapped groin hernia preterm infant younger than 37 weeks gestation performed from birth to 50 weeks postconception	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49492	Repair of trapped groin hernia preterm infant younger than 37 weeks gestation performed from birth to 50 weeks postconception	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
49495	Repair of groin hernia full term infant younger than age 6 months or preterm infant older than 50 weeks postconception age and younger than age 6 months at time of surgery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49495	Repair of groin hernia full term infant younger than age 6 months or preterm infant older than 50 weeks postconception age and younger than age 6 months at time of surgery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49495	Repair of groin hernia full term infant younger than age 6 months or preterm infant older than 50 weeks postconception age and younger than age 6 months at time of surgery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
49496	Repair of trapped groin hernia full term infant younger than age 6 months or preterm infant older than 50 weeks postconception age and younger than age 6 months at time of surgery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49496	Repair of trapped groin hernia full term infant younger than age 6 months or preterm infant older than 50 weeks postconception age and younger than age 6 months at time of surgery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49496	Repair of trapped groin hernia full term infant younger than age 6 months or preterm infant older than 50 weeks postconception age and younger than age 6 months at time of surgery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
49500	Repair of groin hernia patient age 6 months to younger than 5 years	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49500	Repair of groin hernia patient age 6 months to younger than 5 years	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49500	Repair of groin hernia patient age 6 months to younger than 5 years	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49501	Repair of trapped groin hernia patient age 6 months to younger than 5 years	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49501	Repair of trapped groin hernia patient age 6 months to younger than 5 years	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49501	Repair of trapped groin hernia patient age 6 months to younger than 5 years	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49505	Repair of groin hernia patient age 5 years or older	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49505	Repair of groin hernia patient age 5 years or older	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49505	Repair of groin hernia patient age 5 years or older	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49507	Repair of trapped groin hernia patient age 5 years or older	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49507	Repair of trapped groin hernia patient age 5 years or older	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49507	Repair of trapped groin hernia patient age 5 years or older	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49520	Repair of trapped groin hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49520	Repair of trapped groin hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49520	Repair of trapped groin hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49521	Repair of trapped groin hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49521	Repair of trapped groin hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49521	Repair of trapped groin hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49525	Repositioning of sliding groin hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49525	Repositioning of sliding groin hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49525	Repositioning of sliding groin hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49540	Repair of abdominal muscle herniation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49540	Repair of abdominal muscle herniation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49540	Repair of abdominal muscle herniation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49550	Repositioning of groin hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49550	Repositioning of groin hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49550	Repositioning of groin hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49553	Repositioning of trapped groin hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49553	Repositioning of trapped groin hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49553	Repositioning of trapped groin hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49555	Repositioning of groin hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49555	Repositioning of groin hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49555	Repositioning of groin hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49557	Repositioning of trapped groin hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49557	Repositioning of trapped groin hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49557	Repositioning of trapped groin hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49560	Repair of incisional or abdominal hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49560	Repair of incisional or abdominal hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49560	Repair of incisional or abdominal hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49561	Repair of trapped incisional or abdominal hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49561	Repair of trapped incisional or abdominal hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49561	Repair of trapped incisional or abdominal hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49565	Repair of incisional or abdominal hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49565	Repair of incisional or abdominal hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49565	Repair of incisional or abdominal hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49566	Repair of incisional or abdominal hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49566	Repair of incisional or abdominal hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49566	Repair of incisional or abdominal hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49570	Repair of trapped incisional or abdominal hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49570	Repair of trapped incisional or abdominal hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49570	Repair of trapped incisional or abdominal hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49572	Repair of trapped incisional or abdominal hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49572	Repair of trapped incisional or abdominal hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49572	Repair of trapped incisional or abdominal hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49580	Repair of hernia at navel patient younger than age 5 years	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49580	Repair of hernia at navel patient younger than age 5 years	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49580	Repair of hernia at navel patient younger than age 5 years	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49582	Repair of trapped hernia at navel patient younger than age 5 years	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49582	Repair of trapped hernia at navel patient younger than age 5 years	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49582	Repair of trapped hernia at navel patient younger than age 5 years	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49585	Repair of hernia at navel patient age 5 years or older	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49585	Repair of hernia at navel patient age 5 years or older	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49585	Repair of hernia at navel patient age 5 years or older	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49587	Repair of trapped hernia at navel patient age 5 years or older	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49587	Repair of trapped hernia at navel patient age 5 years or older	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49587	Repair of trapped hernia at navel patient age 5 years or older	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49590	Repair of hernia between abdominal muscles	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49590	Repair of hernia between abdominal muscles	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49590	Repair of hernia between abdominal muscles	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49600	Repair of fluid accumulation at navel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49600	Repair of fluid accumulation at navel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49600	Repair of fluid accumulation at navel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
49605	Repair of fluid accumulation or abdominal wall defect at navel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49605	Repair of fluid accumulation or abdominal wall defect at navel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49605	Repair of fluid accumulation or abdominal wall defect at navel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		159	
49606	Repair of fluid accumulation or abdominal wall defect at navel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49606	Repair of fluid accumulation or abdominal wall defect at navel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49606	Repair of fluid accumulation or abdominal wall defect at navel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
49610	Repair of fluid accumulation or abdominal wall defect at navel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49610	Repair of fluid accumulation or abdominal wall defect at navel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49610	Repair of fluid accumulation or abdominal wall defect at navel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
49611	Repair of fluid accumulation or abdominal wall defect at navel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49611	Repair of fluid accumulation or abdominal wall defect at navel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49611	Repair of fluid accumulation or abdominal wall defect at navel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
49650	Repair of groin hernia using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49650	Repair of groin hernia using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49650	Repair of groin hernia using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
49651	Repositioning of recurrent groin hernia using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49651	Repositioning of recurrent groin hernia using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49651	Repositioning of recurrent groin hernia using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
49652	Repair of hernia using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49652	Repair of hernia using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49652	Repair of hernia using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49653	Repair of trapped hernia using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49653	Repair of trapped hernia using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49653	Repair of trapped hernia using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
49654	Repair of incisional hernia using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49654	Repair of incisional hernia using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49654	Repair of incisional hernia using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49655	Repair of trapped incisional hernia using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49655	Repair of trapped incisional hernia using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49655	Repair of trapped incisional hernia using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
49656	Repair of incisional hernia using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49656	Repair of incisional hernia using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49656	Repair of incisional hernia using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
49657	Repair of trapped incisional hernia using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49657	Repair of trapped incisional hernia using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49657	Repair of trapped incisional hernia using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
49900	Suture of postsurgical abdominal wall opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49900	Suture of postsurgical abdominal wall opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
49900	Suture of postsurgical abdominal wall opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		159	
49904	Harvest of abdominal cavity lining for grafting	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
49904	Harvest of abdominal cavity lining for grafting	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
49904	Harvest of abdominal cavity lining for grafting	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		153	
50010	Exploration of kidney	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50010	Exploration of kidney	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50010	Exploration of kidney	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50020	"Incision and drainage of kidney abscess, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50020	"Incision and drainage of kidney abscess, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50020	"Incision and drainage of kidney abscess, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
50040	Insertion of tube for kidney drainage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50040	Insertion of tube for kidney drainage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50040	Insertion of tube for kidney drainage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50045	Exploration of kidney	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50045	Exploration of kidney	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50045	Exploration of kidney	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50060	Removal of kidney stone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50060	Removal of kidney stone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50060	Removal of kidney stone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50065	Removal of kidney stone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50065	Removal of kidney stone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50065	Removal of kidney stone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50070	Incision of kidney complicated by congenital abnormality	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50070	Incision of kidney complicated by congenital abnormality	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50070	Incision of kidney complicated by congenital abnormality	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50075	Removal of kidney stones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50075	Removal of kidney stones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50075	Removal of kidney stones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
50080	"Removal or crushing kidney stone (up to 2 centimeters) or insert kidney stent using an endoscope, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50080	"Removal or crushing kidney stone (up to 2 centimeters) or insert kidney stent using an endoscope, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50080	"Removal or crushing kidney stone (up to 2 centimeters) or insert kidney stent using an endoscope, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
50081	"Removal or crushing kidney stone (over 2 centimeters) or insert kidney stent using an endoscope, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50081	"Removal or crushing kidney stone (over 2 centimeters) or insert kidney stent using an endoscope, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50081	"Removal or crushing kidney stone (over 2 centimeters) or insert kidney stent using an endoscope, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
50100	Incision or repositioning of abnormal kidney blood vessels	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50100	Incision or repositioning of abnormal kidney blood vessels	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50100	Incision or repositioning of abnormal kidney blood vessels	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50120	Exploration of kidney	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50120	Exploration of kidney	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
50120	Exploration of kidney	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50125	Incision and drainage of kidney	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50125	Incision and drainage of kidney	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50125	Incision and drainage of kidney	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50130	Removal of kidney stone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50130	Removal of kidney stone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50130	Removal of kidney stone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50135	Incision of kidney complicated by congenital defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50135	Incision of kidney complicated by congenital defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50135	Incision of kidney complicated by congenital defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50200	"Needle biopsy of kidney, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	14	26	
50200	"Needle biopsy of kidney, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	51	0	
50200	"Needle biopsy of kidney, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	115	0	
50200	"Needle biopsy of kidney, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
50205	Biopsy of kidney	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50205	Biopsy of kidney	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50205	Biopsy of kidney	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
50220	"Removal of kidney and partial removal of urinary duct (ureter), open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50220	"Removal of kidney and partial removal of urinary duct (ureter), open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50220	"Removal of kidney and partial removal of urinary duct (ureter), open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50225	"Removal of kidney and partial removal of urinary duct (ureter), open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50225	"Removal of kidney and partial removal of urinary duct (ureter), open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50225	"Removal of kidney and partial removal of urinary duct (ureter), open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50230	"Removal of kidney, lymph nodes, and/or blood clot from major vein (vena cava) with partial removal of urinary duct (ureter), open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50230	"Removal of kidney, lymph nodes, and/or blood clot from major vein (vena cava) with partial removal of urinary duct (ureter), open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50230	"Removal of kidney, lymph nodes, and/or blood clot from major vein (vena cava) with partial removal of urinary duct (ureter), open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
50234	Removal of kidney and urinary duct (ureter) with partial removal of bladder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50234	Removal of kidney and urinary duct (ureter) with partial removal of bladder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50234	Removal of kidney and urinary duct (ureter) with partial removal of bladder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50236	Removal of kidney and urinary duct (ureter) with partial removal of bladder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50236	Removal of kidney and urinary duct (ureter) with partial removal of bladder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50236	Removal of kidney and urinary duct (ureter) with partial removal of bladder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
50240	Partial removal of kidney	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50240	Partial removal of kidney	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50240	Partial removal of kidney	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
50250	"Destruction of 1 or more growths in kidney, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50250	"Destruction of 1 or more growths in kidney, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50250	"Destruction of 1 or more growths in kidney, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
50280	Removal of kidney cysts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50280	Removal of kidney cysts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50280	Removal of kidney cysts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50290	Removal of kidney cysts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50290	Removal of kidney cysts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50290	Removal of kidney cysts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50320	"Removal of donor kidney, open procedure"	Pre-service	L051A	RN	0.51	Preservice total costs		165	
50320	"Removal of donor kidney, open procedure"	Service  intra	L051A	RN	0.51	Service total costs		12	
50320	"Removal of donor kidney, open procedure"	Post-service	L051A	RN	0.51	Post service total costs		135	
50340	Removal of kidney from patient receiving donor kidney	Pre-service	L051A	RN	0.51	Preservice total costs		60	
50340	Removal of kidney from patient receiving donor kidney	Service  intra	L051A	RN	0.51	Service total costs		12	
50340	Removal of kidney from patient receiving donor kidney	Post-service	L051A	RN	0.51	Post service total costs		126	
50360	Transplantation of donor kidney	Pre-service	L051A	RN	0.51	Preservice total costs		90	
50360	Transplantation of donor kidney	Service  intra	L051A	RN	0.51	Service total costs		12	
50360	Transplantation of donor kidney	Post-service	L051A	RN	0.51	Post service total costs		205	
50365	Removal of kidney and transplantation of donor kidney	Pre-service	L051A	RN	0.51	Preservice total costs		90	
50365	Removal of kidney and transplantation of donor kidney	Service  intra	L051A	RN	0.51	Service total costs		12	
50365	Removal of kidney and transplantation of donor kidney	Post-service	L051A	RN	0.51	Post service total costs		324	
50370	Removal of previously transplanted donor kidney	Pre-service	L051A	RN	0.51	Preservice total costs		60	
50370	Removal of previously transplanted donor kidney	Service  intra	L051A	RN	0.51	Service total costs		12	
50370	Removal of previously transplanted donor kidney	Post-service	L051A	RN	0.51	Post service total costs		144	
50380	Removal with relocation of kidney	Pre-service	L051A	RN	0.51	Preservice total costs		60	
50380	Removal with relocation of kidney	Service  intra	L051A	RN	0.51	Service total costs		12	
50380	Removal with relocation of kidney	Post-service	L051A	RN	0.51	Post service total costs		324	
50382	"Removal and replacement of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation, accessed through the skin"	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3	0	
50382	"Removal and replacement of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
50382	"Removal and replacement of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	56	0	
50382	"Removal and replacement of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	77	0	
50382	"Removal and replacement of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8	0	
50382	"Removal and replacement of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
50384	"Removal of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation, accessed through the skin"	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3	0	
50384	"Removal of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
50384	"Removal of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	52	0	
50384	"Removal of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	72	0	
50384	"Removal of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8	0	
50384	"Removal of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
50385	Removal and replacement of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15	23	
50385	Removal and replacement of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	79	0	
50385	Removal and replacement of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation	Service  intra	L051A	RN	0.51	Service total costs	62	0	
50385	Removal and replacement of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	0	
50385	Removal and replacement of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
50386	Removal of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15	23	
50386	Removal of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	54	0	
50386	Removal of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation	Service  intra	L051A	RN	0.51	Service total costs	47	0	
50386	Removal of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	0	
50386	Removal of indwelling stent in urinary duct (ureter) including radiological supervision and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
50387	"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3	0	
50387	"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
50387	"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	22	0	
50387	"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation"	Service  intra	L051A	RN	0.51	Service total costs	35	0	
50387	"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8	0	
50387	"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
50389	Removal of kidney drainage tube (ureter) using fluoroscopic guidance	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3	0	
50389	Removal of kidney drainage tube (ureter) using fluoroscopic guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
50389	Removal of kidney drainage tube (ureter) using fluoroscopic guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	8	0	
50389	Removal of kidney drainage tube (ureter) using fluoroscopic guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8	0	
50389	Removal of kidney drainage tube (ureter) using fluoroscopic guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
50391	Instillations of drug into kidney and/or urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	0	
50391	Instillations of drug into kidney and/or urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
50395	"Dilation of kidney and/or urinary duct (ureter) with creation of drainage tract, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
50396	Measurement of urine flow in kidneys and urinary ducts (ureters)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
50400	Reconstruction of kidney	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50400	Reconstruction of kidney	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50400	Reconstruction of kidney	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50405	Reconstruction of congenital kidney defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50405	Reconstruction of congenital kidney defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50405	Reconstruction of congenital kidney defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	5	
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	26		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	35		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	35		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	9		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	0		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
50430	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	5	
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	11		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	15		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	0		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	4		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
50431	"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	5	
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	36		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	48		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	48		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	12		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	0		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
50432	"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Post-service	L041B	Radiologic Technologist	0.41	Review examination with interpreting physician	2		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	5	
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	45		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	60		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	60		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	15		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	0		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
50433	"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	5	
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	34		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	45		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	45		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	11		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	0		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
50434	"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	5	
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	15		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	20		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	0		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	5		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	15		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
50435	"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
50500	Suture of wound or injury of kidney	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50500	Suture of wound or injury of kidney	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50500	Suture of wound or injury of kidney	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50520	Closure of abnormal drainage tract from kidney to skin surface	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50520	Closure of abnormal drainage tract from kidney to skin surface	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50520	Closure of abnormal drainage tract from kidney to skin surface	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50525	Closure of abnormal drainage tract from kidney to other abdominal organ	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50525	Closure of abnormal drainage tract from kidney to other abdominal organ	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
50525	Closure of abnormal drainage tract from kidney to other abdominal organ	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
50526	Closure of abnormal drainage tract from kidney to other abdominal organ	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50526	Closure of abnormal drainage tract from kidney to other abdominal organ	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
50526	Closure of abnormal drainage tract from kidney to other abdominal organ	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
50540	Repair of abnormally shaped kidney	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50540	Repair of abnormally shaped kidney	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50540	Repair of abnormally shaped kidney	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50541	Destruction of kidney cysts using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50541	Destruction of kidney cysts using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50541	Destruction of kidney cysts using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
50542	Destruction of kidney growths using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50542	Destruction of kidney growths using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
50542	Destruction of kidney growths using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
50543	Partial removal of kidney using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50543	Partial removal of kidney using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
50543	Partial removal of kidney using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		161	
50544	Repair of kidney using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50544	Repair of kidney using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50544	Repair of kidney using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
50545	Removal of kidney and lymph nodes using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50545	Removal of kidney and lymph nodes using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50545	Removal of kidney and lymph nodes using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		89	
50546	Removal of kidney and partial removal of urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50546	Removal of kidney and partial removal of urinary duct (ureter) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50546	Removal of kidney and partial removal of urinary duct (ureter) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
50547	Removal of kidney from living donor using an endoscope	Pre-service	L051A	RN	0.51	Preservice total costs		165	
50547	Removal of kidney from living donor using an endoscope	Service  intra	L051A	RN	0.51	Service total costs		12	
50547	Removal of kidney from living donor using an endoscope	Post-service	L051A	RN	0.51	Post service total costs		72	
50548	Removal of kidney and urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50548	Removal of kidney and urinary duct (ureter) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50548	Removal of kidney and urinary duct (ureter) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
50551	Examination of kidney using an endoscopy which is inserted through an already created kidney opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
50551	Examination of kidney using an endoscopy which is inserted through an already created kidney opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	0	
50551	Examination of kidney using an endoscopy which is inserted through an already created kidney opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
50553	Insertion of catheter into urinary duct (ureter) using an endoscopy which is inserted through an already created kidney opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
50553	Insertion of catheter into urinary duct (ureter) using an endoscopy which is inserted through an already created kidney opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	100	0	
50553	Insertion of catheter into urinary duct (ureter) using an endoscopy which is inserted through an already created kidney opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
50555	Kidney biopsy using an endoscopy which is inserted through an already created kidney opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
50555	Kidney biopsy using an endoscopy which is inserted through an already created kidney opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	100	0	
50555	Kidney biopsy using an endoscopy which is inserted through an already created kidney opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
50557	Destruction and/or removal of kidney growths using an endoscopy which is inserted through an already created kidney opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
50557	Destruction and/or removal of kidney growths using an endoscopy which is inserted through an already created kidney opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	104	0	
50557	Destruction and/or removal of kidney growths using an endoscopy which is inserted through an already created kidney opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
50561	Removal of kidney foreign body or stone using an endoscopy which is inserted through an already created kidney opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
50561	Removal of kidney foreign body or stone using an endoscopy which is inserted through an already created kidney opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	120	0	
50561	Removal of kidney foreign body or stone using an endoscopy which is inserted through an already created kidney opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
50562	Removal of kidney tumor using an endoscopy which is inserted through an already created kidney opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50562	Removal of kidney tumor using an endoscopy which is inserted through an already created kidney opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
50570	Examination of kidney using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
50572	Insertion of catheter into urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
50574	Kidney biopsy using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
50575	Dilation and urinary duct (ureter) stent insertion using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
50576	Destruction and/or removal of kidney growths using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
50580	Removal of kidney foreign body or stone using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
50590	Shock wave crushing of kidney stones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
50590	Shock wave crushing of kidney stones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	86	6	
50590	Shock wave crushing of kidney stones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	102	102	
50592	"Destruction of 1 or more growths in one kidney, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	14	23	
50592	"Destruction of 1 or more growths in one kidney, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	57	0	
50592	"Destruction of 1 or more growths in one kidney, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	77	0	
50592	"Destruction of 1 or more growths in one kidney, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	6	
50592	"Destruction of 1 or more growths in one kidney, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
50593	"Destruction of growths in one kidney, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	12	30	
50593	"Destruction of growths in one kidney, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	92	0	
50593	"Destruction of growths in one kidney, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs	152	0	
50593	"Destruction of growths in one kidney, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	6	
50593	"Destruction of growths in one kidney, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
50600	Exploration of urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50600	Exploration of urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
50600	Exploration of urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
50605	Insertion of stent in urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50605	Insertion of stent in urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50605	Insertion of stent in urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
50606	"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	0		
50606	"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	1		
50606	"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
50606	"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	34		
50606	"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	45		
50606	"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	45		
50606	"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	11		
50606	"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
50606	"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
50606	"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	1		
50610	Removal of stone from upper urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50610	Removal of stone from upper urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50610	Removal of stone from upper urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
50620	Removal of stone from middle urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50620	Removal of stone from middle urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50620	Removal of stone from middle urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
50630	Removal of stone from lower urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50630	Removal of stone from lower urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50630	Removal of stone from lower urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
50650	Removal of urinary duct (ureter) and partial removal of bladder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50650	Removal of urinary duct (ureter) and partial removal of bladder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50650	Removal of urinary duct (ureter) and partial removal of bladder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50660	Removal of an extra urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50660	Removal of an extra urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50660	Removal of an extra urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50684	Injection of urinary duct (ureter) for X-ray imaging	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
50684	Injection of urinary duct (ureter) for X-ray imaging	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	34	0	
50684	Injection of urinary duct (ureter) for X-ray imaging	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
50686	Measurement of urine flow in urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
50686	Measurement of urine flow in urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
50686	Measurement of urine flow in urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
50688	Change of tube or stent in urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
50688	Change of tube or stent in urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
50688	Change of tube or stent in urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		14	
50690	Injection of bladder and urinary duct (ureter) for X-ray imaging	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
50690	Injection of bladder and urinary duct (ureter) for X-ray imaging	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	32	0	
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	5	
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education	5		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	34		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	45		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	45		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	11		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	0		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
50693	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; pre-existing nephrostomy tract"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	5	
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education	5		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	46		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	62		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	62		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	16		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	0		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
50694	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter"	Post-service	L051A	RN	0.51	"Monitor pt. following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	5	
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		10	
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		3	
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		7	
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education	5		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	56		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	75		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	75		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	19		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  post	L051A	RN	0.51	Monitor pt following moderate sedation	15		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	45		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	0		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
50695	"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
50700	Reconstruction of urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50700	Reconstruction of urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50700	Reconstruction of urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50705	"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	0		
50705	"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	1		
50705	"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
50705	"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	45		
50705	"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	60		
50705	"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	60		
50705	"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	15		
50705	"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
50705	"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
50705	"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	1		
50706	"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	0		
50706	"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	1		
50706	"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
50706	"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images (75%)	45		
50706	"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	60		
50706	"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L051A	RN	0.51	Assist physician in performing procedure (CS)	60		
50706	"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  intra	L037D	RN/LPN/MTA	0.37	Circulator (25%)	15		
50706	"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
50706	"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
50706	"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	1		
50715	Release of scar tissue at urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50715	Release of scar tissue at urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50715	Release of scar tissue at urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50722	Release of abnormal veins blocking urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50722	Release of abnormal veins blocking urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50722	Release of abnormal veins blocking urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50725	Repair and repositioning of abnormally positioned duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50725	Repair and repositioning of abnormally positioned duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50725	Repair and repositioning of abnormally positioned duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50727	Revision of opening from urinary tract to skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50727	Revision of opening from urinary tract to skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50727	Revision of opening from urinary tract to skin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50728	Revision of opening from urinary tract to skin with repair of hernia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50728	Revision of opening from urinary tract to skin with repair of hernia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50728	Revision of opening from urinary tract to skin with repair of hernia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50740	Connection of urinary duct (ureter) to kidney	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50740	Connection of urinary duct (ureter) to kidney	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50740	Connection of urinary duct (ureter) to kidney	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50750	Connection of urinary duct (ureter) to kidney	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50750	Connection of urinary duct (ureter) to kidney	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50750	Connection of urinary duct (ureter) to kidney	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50760	Removal and reconnection of diseased or injured portion of urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50760	Removal and reconnection of diseased or injured portion of urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50760	Removal and reconnection of diseased or injured portion of urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50770	Partial removal of urinary duct (ureter) with connection to opposite urinary duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50770	Partial removal of urinary duct (ureter) with connection to opposite urinary duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50770	Partial removal of urinary duct (ureter) with connection to opposite urinary duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50780	Connection to bladder of lower portion of urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50780	Connection to bladder of lower portion of urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50780	Connection to bladder of lower portion of urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50782	Connection of extra urinary duct (ureter) to bladder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50782	Connection of extra urinary duct (ureter) to bladder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50782	Connection of extra urinary duct (ureter) to bladder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50783	Connection of lower portion of urinary duct (ureter) to bladder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50783	Connection of lower portion of urinary duct (ureter) to bladder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50783	Connection of lower portion of urinary duct (ureter) to bladder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50785	Repair of urinary duct (ureter) with creation of bladder and muscle flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50785	Repair of urinary duct (ureter) with creation of bladder and muscle flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50785	Repair of urinary duct (ureter) with creation of bladder and muscle flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50800	Connection of urinary duct (ureter) to bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50800	Connection of urinary duct (ureter) to bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50800	Connection of urinary duct (ureter) to bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
50810	Connection of urinary duct (ureter) to large bowel with creation of opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50810	Connection of urinary duct (ureter) to large bowel with creation of opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50810	Connection of urinary duct (ureter) to large bowel with creation of opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
50815	Connection of urinary duct (ureter) to large bowel with creation of opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50815	Connection of urinary duct (ureter) to large bowel with creation of opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50815	Connection of urinary duct (ureter) to large bowel with creation of opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
50820	Connection of urinary duct (ureter) to small bowel with creation of opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50820	Connection of urinary duct (ureter) to small bowel with creation of opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50820	Connection of urinary duct (ureter) to small bowel with creation of opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
50825	Connection of urinary duct (ureter) to large and/or small bowel with creation of opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50825	Connection of urinary duct (ureter) to large and/or small bowel with creation of opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50825	Connection of urinary duct (ureter) to large and/or small bowel with creation of opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
50830	Repair to restore urine flow in urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50830	Repair to restore urine flow in urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50830	Repair to restore urine flow in urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
50840	Replacement of urinary duct (ureter) using bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50840	Replacement of urinary duct (ureter) using bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50840	Replacement of urinary duct (ureter) using bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
50845	Connection of the bladder to pouch at junction of small and large bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50845	Connection of the bladder to pouch at junction of small and large bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50845	Connection of the bladder to pouch at junction of small and large bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
50860	Connection of urinary duct (ureter) to skin surface	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50860	Connection of urinary duct (ureter) to skin surface	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50860	Connection of urinary duct (ureter) to skin surface	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50900	Suture repair of urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50900	Suture repair of urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50900	Suture repair of urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50920	Closure of abnormal drainage tract from urinary duct (ureter) to skin surface	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50920	Closure of abnormal drainage tract from urinary duct (ureter) to skin surface	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50920	Closure of abnormal drainage tract from urinary duct (ureter) to skin surface	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50930	Closure of abnormal drainage tract from urinary duct (ureter) to an abdominal organ	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50930	Closure of abnormal drainage tract from urinary duct (ureter) to an abdominal organ	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50930	Closure of abnormal drainage tract from urinary duct (ureter) to an abdominal organ	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50940	Removal of previously-placed suture or wire in urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50940	Removal of previously-placed suture or wire in urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50940	Removal of previously-placed suture or wire in urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50945	Removal of stone from urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50945	Removal of stone from urinary duct (ureter) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50945	Removal of stone from urinary duct (ureter) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
50947	Repositioning of urinary duct (ureter) and insertion of stent using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50947	Repositioning of urinary duct (ureter) and insertion of stent using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50947	Repositioning of urinary duct (ureter) and insertion of stent using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
50948	Repositioning of urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
50948	Repositioning of urinary duct (ureter) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
50948	Repositioning of urinary duct (ureter) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		89	
50951	Examination of kidney and urinary duct (ureter) using an endoscopy which is inserted through an already created urinary duct (ureter) opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
50951	Examination of kidney and urinary duct (ureter) using an endoscopy which is inserted through an already created urinary duct (ureter) opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	91	0	
50951	Examination of kidney and urinary duct (ureter) using an endoscopy which is inserted through an already created urinary duct (ureter) opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
50953	Insertion of catheter into urinary duct (ureter) using an endoscopy which is inserted through an already created urinary duct (ureter) opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
50953	Insertion of catheter into urinary duct (ureter) using an endoscopy which is inserted through an already created urinary duct (ureter) opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	96	0	
50953	Insertion of catheter into urinary duct (ureter) using an endoscopy which is inserted through an already created urinary duct (ureter) opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
50955	Biopsy of kidney or urinary duct (ureter) using an endoscopy which is inserted through an already created urinary duct (ureter) opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
50955	Biopsy of kidney or urinary duct (ureter) using an endoscopy which is inserted through an already created urinary duct (ureter) opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	98	0	
50955	Biopsy of kidney or urinary duct (ureter) using an endoscopy which is inserted through an already created urinary duct (ureter) opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
50957	Destruction and/or removal of kidney or urinary duct (ureter) growths using an endoscopy which is inserted through an already created urinary duct (ureter) opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
50957	Destruction and/or removal of kidney or urinary duct (ureter) growths using an endoscopy which is inserted through an already created urinary duct (ureter) opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	102	0	
50957	Destruction and/or removal of kidney or urinary duct (ureter) growths using an endoscopy which is inserted through an already created urinary duct (ureter) opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
50961	Removal of foreign body or stone from kidney or urinary duct (ureter) using an endoscopy which is inserted through an already created urinary duct (ureter) opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
50961	Removal of foreign body or stone from kidney or urinary duct (ureter) using an endoscopy which is inserted through an already created urinary duct (ureter) opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	92	0	
50961	Removal of foreign body or stone from kidney or urinary duct (ureter) using an endoscopy which is inserted through an already created urinary duct (ureter) opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
50970	Examination of kidney and urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
50972	Insertion of catheter into urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
50974	Biopsy of kidney or urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
50976	Destruction and/or removal of kidney or urinary duct (ureter) growths using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
50980	Removal of foreign body or stone from kidney or urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
51020	Incision of bladder with destruction of growths and/or insertion of radioactive material	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51020	Incision of bladder with destruction of growths and/or insertion of radioactive material	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51020	Incision of bladder with destruction of growths and/or insertion of radioactive material	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
51030	Incision of bladder with destruction of bladder growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51030	Incision of bladder with destruction of bladder growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
51030	Incision of bladder with destruction of bladder growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
51040	Incision of bladder with drainage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51040	Incision of bladder with drainage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51040	Incision of bladder with drainage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
51045	Incision of bladder with insertion of catheter or stent in urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51045	Incision of bladder with insertion of catheter or stent in urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51045	Incision of bladder with insertion of catheter or stent in urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
51050	Incision of bladder with removal of bladder stone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51050	Incision of bladder with removal of bladder stone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51050	Incision of bladder with removal of bladder stone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
51060	Incision of bladder with removal of stone in urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51060	Incision of bladder with removal of stone in urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51060	Incision of bladder with removal of stone in urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
51065	Incision of bladder with basket removal and/or ultrasonic crushing of stones in urinary duct (ureter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51065	Incision of bladder with basket removal and/or ultrasonic crushing of stones in urinary duct (ureter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
51065	Incision of bladder with basket removal and/or ultrasonic crushing of stones in urinary duct (ureter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
51080	Incision and drainage of bladder abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51080	Incision and drainage of bladder abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51080	Incision and drainage of bladder abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
51100	Needle aspiration of bladder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	0	
51100	Needle aspiration of bladder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
51101	Aspiration of bladder using catheter or trocar	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25	0	
51101	Aspiration of bladder using catheter or trocar	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
51102	Aspiration of bladder with insertion of bladder tube to skin surface	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	4	
51102	Aspiration of bladder with insertion of bladder tube to skin surface	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	0	
51500	Repair of congenital bladder defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51500	Repair of congenital bladder defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51500	Repair of congenital bladder defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
51520	Removal of bladder neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51520	Removal of bladder neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51520	Removal of bladder neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
51525	Repair of ruptured bowel into bladder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51525	Repair of ruptured bowel into bladder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51525	Repair of ruptured bowel into bladder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
51530	Removal of bladder growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51530	Removal of bladder growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51530	Removal of bladder growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
51535	"Incision, removal, or repair of abnormal drainage tract from bladder into bowel"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51535	"Incision, removal, or repair of abnormal drainage tract from bladder into bowel"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51535	"Incision, removal, or repair of abnormal drainage tract from bladder into bowel"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
51550	Partial removal of bladder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51550	Partial removal of bladder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51550	Partial removal of bladder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
51555	Partial removal of bladder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51555	Partial removal of bladder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51555	Partial removal of bladder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
51565	Partial removal of bladder with reimplantation of urinary ducts (ureters)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51565	Partial removal of bladder with reimplantation of urinary ducts (ureters)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51565	Partial removal of bladder with reimplantation of urinary ducts (ureters)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
51570	Removal of bladder	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51570	Removal of bladder	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51570	Removal of bladder	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
51575	Removal of bladder and lymph nodes on both sides of pelvis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51575	Removal of bladder and lymph nodes on both sides of pelvis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51575	Removal of bladder and lymph nodes on both sides of pelvis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
51580	Removal of bladder with transplantation of urinary ducts (ureters)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51580	Removal of bladder with transplantation of urinary ducts (ureters)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51580	Removal of bladder with transplantation of urinary ducts (ureters)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
51585	Removal of bladder and lymph nodes on both sides of pelvis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51585	Removal of bladder and lymph nodes on both sides of pelvis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51585	Removal of bladder and lymph nodes on both sides of pelvis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
51590	Removal of bladder with transplantation of urinary ducts (ureters) to small or large bowel with creation of urinary opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51590	Removal of bladder with transplantation of urinary ducts (ureters) to small or large bowel with creation of urinary opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51590	Removal of bladder with transplantation of urinary ducts (ureters) to small or large bowel with creation of urinary opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
51595	Removal of bladder and lymph nodes on both sides of pelvis with transplantation of urinary ducts (ureters) to small or large bowel with creation of urinary opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51595	Removal of bladder and lymph nodes on both sides of pelvis with transplantation of urinary ducts (ureters) to small or large bowel with creation of urinary opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51595	Removal of bladder and lymph nodes on both sides of pelvis with transplantation of urinary ducts (ureters) to small or large bowel with creation of urinary opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
51596	"Removal of bladder and lymph nodes on both sides of pelvis with transplantation of urinary ducts (ureters) to small and/or large bowel with creation of urinary opening, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51596	"Removal of bladder and lymph nodes on both sides of pelvis with transplantation of urinary ducts (ureters) to small and/or large bowel with creation of urinary opening, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51596	"Removal of bladder and lymph nodes on both sides of pelvis with transplantation of urinary ducts (ureters) to small and/or large bowel with creation of urinary opening, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
51597	"Removal of bladder, urinary ducts (ureters)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51597	"Removal of bladder, urinary ducts (ureters)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51597	"Removal of bladder, urinary ducts (ureters)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
51600	Injection procedure for X-ray imaging of the bladder or during voiding	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	0	
51600	Injection procedure for X-ray imaging of the bladder or during voiding	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	0	
51605	Injection procedure for X-ray imaging of the bladder and bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
51610	Injection procedure through the bladder and bladder canal (urethra) for X-ray imaging	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	5	25	
51610	Injection procedure through the bladder and bladder canal (urethra) for X-ray imaging	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	0	
51610	Injection procedure through the bladder and bladder canal (urethra) for X-ray imaging	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
51700	Bladder irrigation and/or instillation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	0	
51700	Bladder irrigation and/or instillation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
51701	Insertion of temporary bladder catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	2	
51701	Insertion of temporary bladder catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
51701	Insertion of temporary bladder catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
51702	Insertion of indwelling bladder catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	9	
51702	Insertion of indwelling bladder catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
51702	Insertion of indwelling bladder catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
51703	Insertion of indwelling bladder catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	20	15	
51703	Insertion of indwelling bladder catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
51703	Insertion of indwelling bladder catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
51705	Removal of skin suture with change of bladder tube	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	10	10	
51705	Removal of skin suture with change of bladder tube	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	6	
51710	Removal of suture around skin surface tube with change of bladder tube	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	14	23	
51710	Removal of suture around skin surface tube with change of bladder tube	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	6	
51715	Injection or implant of synthetic material into bladder and/or bladder canal (urethra) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	22	
51715	Injection or implant of synthetic material into bladder and/or bladder canal (urethra) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	0	
51715	Injection or implant of synthetic material into bladder and/or bladder canal (urethra) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
51720	"Bladder instillation of cancer preventive, inhibiting, or suppressive agent"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	8	
51720	"Bladder instillation of cancer preventive, inhibiting, or suppressive agent"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	39	0	
51720	"Bladder instillation of cancer preventive, inhibiting, or suppressive agent"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
51725	Insertion of device into bladder to measure pressure of urine flow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	80		
51726	Insertion of electronic device into bladder with measurement of urine flow pressure	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	85		
51727	Insertion of electronic device into bladder with bladder canal (urethra) pressure studies	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	90		
51728	Insertion of electronic device into bladder with voiding pressure studies	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	90		
51729	Insertion of electronic device into bladder with voiding and bladder canal (urethra) pressure studies	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	95		
51736	Timed assessment of bladder emptying	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	9		
51741	Electronic assessment of bladder emptying	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	9		
51784	Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	22		
51784	Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	69		
51785	Needle measurement and recording of electrical activity of muscles at bladder and bowel openings	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	27		
51785	Needle measurement and recording of electrical activity of muscles at bladder and bowel openings	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	73		
51792	Assessment of muscle signal of pelvic nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	19		
51792	Assessment of muscle signal of pelvic nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	91		
51797	Insertion of device into the abdomen with measurement of pressure and urine flow rate	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	10		
51798	Ultrasound measurement of bladder capacity after voiding	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	7		
51798	Ultrasound measurement of bladder capacity after voiding	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23		
51800	Repair of bladder and/or bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51800	Repair of bladder and/or bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51800	Repair of bladder and/or bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
51820	"Repair of bladder, bladder canal (urethra) and urinary duct (ureter)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51820	"Repair of bladder, bladder canal (urethra) and urinary duct (ureter)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51820	"Repair of bladder, bladder canal (urethra) and urinary duct (ureter)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
51840	Suture of bladder neck to vaginal wall and pubic bone with bladder canal suspension	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51840	Suture of bladder neck to vaginal wall and pubic bone with bladder canal suspension	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51840	Suture of bladder neck to vaginal wall and pubic bone with bladder canal suspension	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
51841	Resuture of bladder neck to vaginal wall and pubic bone with bladder canal suspension	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51841	Resuture of bladder neck to vaginal wall and pubic bone with bladder canal suspension	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51841	Resuture of bladder neck to vaginal wall and pubic bone with bladder canal suspension	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
51845	Repair of female bladder neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51845	Repair of female bladder neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51845	Repair of female bladder neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
51860	"Suture of wound, injury, or rupture of the bladder"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51860	"Suture of wound, injury, or rupture of the bladder"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51860	"Suture of wound, injury, or rupture of the bladder"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
51865	"Suture of wound, injury, or rupture of bladder"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51865	"Suture of wound, injury, or rupture of bladder"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51865	"Suture of wound, injury, or rupture of bladder"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
51880	Closure of skin surface bladder tube site	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51880	Closure of skin surface bladder tube site	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51880	Closure of skin surface bladder tube site	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
51900	Repair of abnormal drainage tract from bladder into the vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51900	Repair of abnormal drainage tract from bladder into the vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51900	Repair of abnormal drainage tract from bladder into the vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
51920	Repair of abnormal drainage tract from bladder into the vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51920	Repair of abnormal drainage tract from bladder into the vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51920	Repair of abnormal drainage tract from bladder into the vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
51925	Repair of abnormal drainage tract from bladder into the vagina and removal of the uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51925	Repair of abnormal drainage tract from bladder into the vagina and removal of the uterus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
51925	Repair of abnormal drainage tract from bladder into the vagina and removal of the uterus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
51940	Repair of congenital bladder wall defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51940	Repair of congenital bladder wall defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51940	Repair of congenital bladder wall defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
51960	Enlargement of the bladder using a portion of bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51960	Enlargement of the bladder using a portion of bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51960	Enlargement of the bladder using a portion of bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
51980	Creation of a drainage tract from the bladder to the skin surface	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51980	Creation of a drainage tract from the bladder to the skin surface	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51980	Creation of a drainage tract from the bladder to the skin surface	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
51990	Suture suspension of bladder canal (urethra) to control leakage using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51990	Suture suspension of bladder canal (urethra) to control leakage using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51990	Suture suspension of bladder canal (urethra) to control leakage using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
51992	Creation of sling around bladder canal (urethra) to control leakage using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
51992	Creation of sling around bladder canal (urethra) to control leakage using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
51992	Creation of sling around bladder canal (urethra) to control leakage using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
52000	Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
52000	Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	0	
52000	Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
52001	Irrigation and removal of multiple blood clots from bladder and bladder canal (urethra) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
52001	Irrigation and removal of multiple blood clots from bladder and bladder canal (urethra) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
52001	Irrigation and removal of multiple blood clots from bladder and bladder canal (urethra) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
52005	Insertion of catheter into urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
52005	Insertion of catheter into urinary duct (ureter) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	0	
52005	Insertion of catheter into urinary duct (ureter) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
52007	Insertion of catheter into urinary duct (ureter) and biopsy of urinary duct and/or renal pelvis using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
52007	Insertion of catheter into urinary duct (ureter) and biopsy of urinary duct and/or renal pelvis using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	0	
52007	Insertion of catheter into urinary duct (ureter) and biopsy of urinary duct and/or renal pelvis using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
52010	Insertion of catheter into sperm duct using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
52010	Insertion of catheter into sperm duct using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	66	0	
52010	Insertion of catheter into sperm duct using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
52204	Biopsy of the bladder using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	24	
52204	Biopsy of the bladder using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	0	
52204	Biopsy of the bladder using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
52214	"Destruction of tissue in the bladder, bladder canal (urethra) or surrounding glands using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	95	0	
52214	"Destruction of tissue in the bladder, bladder canal (urethra) or surrounding glands using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
52224	Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	97	0	
52224	Destruction of (less than 0.5 centimeters) growths of the bladder and bladder canal (urethra) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
52234	Destruction and/or removal of (0.5 to 2.0 centimeters) small growths of the bladder using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52234	Destruction and/or removal of (0.5 to 2.0 centimeters) small growths of the bladder using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
52235	Destruction and/or removal of (2.0 to 5.0 centimeters) medium growths of the bladder and bladder canal (urethra) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52235	Destruction and/or removal of (2.0 to 5.0 centimeters) medium growths of the bladder and bladder canal (urethra) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		6	
52240	Destruction and/or removal of large growths of the bladder using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52240	Destruction and/or removal of large growths of the bladder using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		6	
52250	Insertion of radioactive substance of the bladder and bladder canal (urethra) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52250	Insertion of radioactive substance of the bladder and bladder canal (urethra) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
52260	Dilation of the bladder using an endoscope under general or spinal anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		28	
52260	Dilation of the bladder using an endoscope under general or spinal anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
52265	Dilation of the bladder including local anesthetic using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	28	
52265	Dilation of the bladder including local anesthetic using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	0	
52265	Dilation of the bladder including local anesthetic using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
52270	"Incision of the bladder canal (urethra) using an endoscope, female"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	28	
52270	"Incision of the bladder canal (urethra) using an endoscope, female"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	0	
52270	"Incision of the bladder canal (urethra) using an endoscope, female"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
52275	"Incision of the bladder canal (urethra) using an endoscope, male"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	28	
52275	"Incision of the bladder canal (urethra) using an endoscope, male"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	0	
52275	"Incision of the bladder canal (urethra) using an endoscope, male"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
52276	Incision of the bladder canal (urethra) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52276	Incision of the bladder canal (urethra) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
52277	Removal of muscles at urinary opening using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52277	Removal of muscles at urinary opening using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
52281	Dilation of bladder canal (urethra) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
52281	Dilation of bladder canal (urethra) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	0	
52281	Dilation of bladder canal (urethra) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
52282	Insertion of a permanent bladder canal (urethra) stent using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52282	Insertion of a permanent bladder canal (urethra) stent using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
52283	Steroid injection into bladder canal (urethra) stricture using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
52283	Steroid injection into bladder canal (urethra) stricture using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
52283	Steroid injection into bladder canal (urethra) stricture using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
52285	Examination of bladder and bladder canal (urethra) for treatment of female urethral syndrome using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
52285	Examination of bladder and bladder canal (urethra) for treatment of female urethral syndrome using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	0	
52285	Examination of bladder and bladder canal (urethra) for treatment of female urethral syndrome using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
52287	Examination with injections of chemical for destruction of bladder using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	15	
52287	Examination with injections of chemical for destruction of bladder using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	79	0	
52287	Examination with injections of chemical for destruction of bladder using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
52290	Incision of urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52290	Incision of urinary duct (ureter) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
52300	Removal or destruction of abnormal pouches of urinary duct (ureter) at bladder using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52300	Removal or destruction of abnormal pouches of urinary duct (ureter) at bladder using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
52301	Removal or destruction of abnormal pouches of urinary duct (ureter) at bladder using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52301	Removal or destruction of abnormal pouches of urinary duct (ureter) at bladder using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
52305	Removal of bladder pouches using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		26	
52305	Removal of bladder pouches using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
52310	"Removal of foreign body, stone, or stent from bladder canal (urethra) or bladder using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	21	
52310	"Removal of foreign body, stone, or stent from bladder canal (urethra) or bladder using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	86	0	
52310	"Removal of foreign body, stone, or stent from bladder canal (urethra) or bladder using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
52315	"Complicated removal of foreign body, stone, or stent from bladder canal (urethra) or bladder using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	28	
52315	"Complicated removal of foreign body, stone, or stent from bladder canal (urethra) or bladder using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	89	0	
52315	"Complicated removal of foreign body, stone, or stent from bladder canal (urethra) or bladder using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
52317	"Crushing, fragmenting, and removal of (less than 2.5 centimeters) bladder stone"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	21	
52317	"Crushing, fragmenting, and removal of (less than 2.5 centimeters) bladder stone"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	92	0	
52317	"Crushing, fragmenting, and removal of (less than 2.5 centimeters) bladder stone"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
52318	"Crushing, fragmenting, and removal of bladder stones, complicated or larger than 2.5 centimeters"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		23	
52318	"Crushing, fragmenting, and removal of bladder stones, complicated or larger than 2.5 centimeters"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		6	
52320	Removal of stone in urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		23	
52320	Removal of stone in urinary duct (ureter) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
52325	Fragmenting of stone in urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		24	
52325	Fragmenting of stone in urinary duct (ureter) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
52330	Manipulation of stone in urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	23	
52330	Manipulation of stone in urinary duct (ureter) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	79	0	
52330	Manipulation of stone in urinary duct (ureter) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
52332	Insertion of stent in urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
52332	Insertion of stent in urinary duct (ureter) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	0	
52332	Insertion of stent in urinary duct (ureter) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
52334	Insertion of guide wire through kidney into urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52334	Insertion of guide wire through kidney into urinary duct (ureter) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
52341	Treatment of stricture in urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52341	Treatment of stricture in urinary duct (ureter) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		6	
52342	Treatment of stricture at junction of kidney and urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52342	Treatment of stricture at junction of kidney and urinary duct (ureter) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		6	
52343	Treatment of kidney stricture using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52343	Treatment of kidney stricture using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		6	
52344	Treatment of stricture in urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52344	Treatment of stricture in urinary duct (ureter) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		6	
52345	Treatment of kidney stricture using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52345	Treatment of kidney stricture using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		6	
52346	Treatment of kidney stricture using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52346	Treatment of kidney stricture using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		6	
52351	"Diagnostic examination of the bladder, bladder canal (urethra), and urinary duct (ureter) or kidney using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52351	"Diagnostic examination of the bladder, bladder canal (urethra), and urinary duct (ureter) or kidney using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
52352	Removal or manipulation of stone in urinary duct (ureter) or kidney using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52352	Removal or manipulation of stone in urinary duct (ureter) or kidney using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		6	
52353	Crushing of stone in urinary duct (ureter) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52353	Crushing of stone in urinary duct (ureter) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		6	
52354	Biopsy and/or destruction of growth of urinary duct (ureter) or kidney using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52354	Biopsy and/or destruction of growth of urinary duct (ureter) or kidney using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		6	
52355	Removal of tumor urinary duct (ureter) or kidney using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52355	Removal of tumor urinary duct (ureter) or kidney using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		6	
52356	Crushing of stone in urinary duct (ureter) with stent using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
52356	Crushing of stone in urinary duct (ureter) with stent using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
52400	"Incision, destruction, or removal of congenital bladder and bladder canal (urethra) defects using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
52400	"Incision, destruction, or removal of congenital bladder and bladder canal (urethra) defects using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
52400	"Incision, destruction, or removal of congenital bladder and bladder canal (urethra) defects using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
52402	"Incision or removal of ejaculatory ducts using an endoscope, male"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		4	
52441	"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
52441	"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
52441	"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
52441	"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
52441	"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5		
52441	"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
52441	"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	30		
52441	"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	5		
52441	"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
52441	"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	30		
52441	"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	2		
52442	"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	25		
52450	Incision of prostate through bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
52450	Incision of prostate through bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
52450	Incision of prostate through bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
52500	Removal of bladder neck through bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
52500	Removal of bladder neck through bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
52500	Removal of bladder neck through bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
52601	Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
52601	Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
52601	Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
52630	Removal of remaining or regrown prostate tissue with control of bleeding using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
52630	Removal of remaining or regrown prostate tissue with control of bleeding using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
52630	Removal of remaining or regrown prostate tissue with control of bleeding using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
52640	Removal of postsurgical bladder neck contracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
52640	Removal of postsurgical bladder neck contracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
52640	Removal of postsurgical bladder neck contracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
52647	Laser destruction of prostate including control of bleeding using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
52647	Laser destruction of prostate including control of bleeding using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	134	6	
52647	Laser destruction of prostate including control of bleeding using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
52648	Laser vaporization of prostate including control of bleeding using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
52648	Laser vaporization of prostate including control of bleeding using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	144	6	
52648	Laser vaporization of prostate including control of bleeding using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
52649	Laser fragmentation of prostate tissue with control of bleeding using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
52649	Laser fragmentation of prostate tissue with control of bleeding using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
52649	Laser fragmentation of prostate tissue with control of bleeding using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
52700	Drainage of prostate abscess through bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
52700	Drainage of prostate abscess through bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
52700	Drainage of prostate abscess through bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
53000	Incision or repair of extra bladder canal (urethra) tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		23	
53000	Incision or repair of extra bladder canal (urethra) tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53000	Incision or repair of extra bladder canal (urethra) tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
53010	Incision or repair of abnormal bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53010	Incision or repair of abnormal bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53010	Incision or repair of abnormal bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
53020	Incision of external urinary opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
53025	"Incision of external urinary opening, infant"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		25	
53025	"Incision of external urinary opening, infant"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
53040	Drainage of abscess around bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53040	Drainage of abscess around bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53040	Drainage of abscess around bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
53060	"Drainage of abscess or cyst of Skene's glands, male"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	19	
53060	"Drainage of abscess or cyst of Skene's glands, male"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	37	12	
53060	"Drainage of abscess or cyst of Skene's glands, male"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
53080	Drainage of abnormal urine collection	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53080	Drainage of abnormal urine collection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53080	Drainage of abnormal urine collection	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
53085	Drainage of abnormal urine collection	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53085	Drainage of abnormal urine collection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53085	Drainage of abnormal urine collection	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
53200	Biopsy of bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	21	
53200	Biopsy of bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	0	
53200	Biopsy of bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
53210	"Removal of bladder and bladder canal (urethra), female"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53210	"Removal of bladder and bladder canal (urethra), female"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53210	"Removal of bladder and bladder canal (urethra), female"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
53215	"Removal of bladder and bladder canal (urethra), male"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53215	"Removal of bladder and bladder canal (urethra), male"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53215	"Removal of bladder and bladder canal (urethra), male"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
53220	Removal or destruction of bladder canal (urethra) malignancy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53220	Removal or destruction of bladder canal (urethra) malignancy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53220	Removal or destruction of bladder canal (urethra) malignancy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
53230	Removal of pouch of female bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53230	Removal of pouch of female bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53230	Removal of pouch of female bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
53235	Removal of pouch of male bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53235	Removal of pouch of male bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53235	Removal of pouch of male bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
53240	Creation of drainage tract from pouch of bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53240	Creation of drainage tract from pouch of bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53240	Creation of drainage tract from pouch of bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
53250	Removal of seminal fluid gland	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53250	Removal of seminal fluid gland	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53250	Removal of seminal fluid gland	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
53260	Removal or destruction of bladder canal (urethra) polyps	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	25	
53260	Removal or destruction of bladder canal (urethra) polyps	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	6	
53260	Removal or destruction of bladder canal (urethra) polyps	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
53265	Removal or destruction of growth of bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	25	
53265	Removal or destruction of growth of bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	6	
53265	Removal or destruction of growth of bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
53270	Removal or destruction of bladder canal (urethra) mucous glands	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	25	
53270	Removal or destruction of bladder canal (urethra) mucous glands	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	6	
53270	Removal or destruction of bladder canal (urethra) mucous glands	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
53275	Removal or destruction of prolapsed bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		25	
53275	Removal or destruction of prolapsed bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53275	Removal or destruction of prolapsed bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
53400	"Repair of bladder canal (urethra) for abnormal drainage tract, pouching, or narrowing"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53400	"Repair of bladder canal (urethra) for abnormal drainage tract, pouching, or narrowing"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53400	"Repair of bladder canal (urethra) for abnormal drainage tract, pouching, or narrowing"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
53405	Repair of bladder canal (urethra) with formation of urethra including creation of new urine drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53405	Repair of bladder canal (urethra) with formation of urethra including creation of new urine drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53405	Repair of bladder canal (urethra) with formation of urethra including creation of new urine drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
53410	"Reconstruction of bladder canal (urethra), male"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53410	"Reconstruction of bladder canal (urethra), male"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53410	"Reconstruction of bladder canal (urethra), male"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
53415	Reconstruction or repair of prostatic or membranous bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53415	Reconstruction or repair of prostatic or membranous bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53415	Reconstruction or repair of prostatic or membranous bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
53420	Reconstruction or repair of prostatic or membranous bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53420	Reconstruction or repair of prostatic or membranous bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53420	Reconstruction or repair of prostatic or membranous bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
53425	Reconstruction or repair of prostatic or membranous bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53425	Reconstruction or repair of prostatic or membranous bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53425	Reconstruction or repair of prostatic or membranous bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
53430	"Reconstruction of bladder canal (urethra), female"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53430	"Reconstruction of bladder canal (urethra), female"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53430	"Reconstruction of bladder canal (urethra), female"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
53431	Repair of bladder canal (urethra) and/or lower bladder for incontinence	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53431	Repair of bladder canal (urethra) and/or lower bladder for incontinence	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53431	Repair of bladder canal (urethra) and/or lower bladder for incontinence	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
53440	Creation of sling around male bladder canal (urethra) to control leakage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53440	Creation of sling around male bladder canal (urethra) to control leakage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53440	Creation of sling around male bladder canal (urethra) to control leakage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
53442	Removal or revision of sling for male urinary incontinence	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53442	Removal or revision of sling for male urinary incontinence	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53442	Removal or revision of sling for male urinary incontinence	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
53444	Insertion of tandem cuff artificial urinary sphincter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53444	Insertion of tandem cuff artificial urinary sphincter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53444	Insertion of tandem cuff artificial urinary sphincter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
53445	Insertion of inflatable bladder canal (urethra) or bladder neck sphincter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53445	Insertion of inflatable bladder canal (urethra) or bladder neck sphincter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53445	Insertion of inflatable bladder canal (urethra) or bladder neck sphincter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
53446	Removal of inflatable bladder canal (urethra) or bladder neck sphincter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53446	Removal of inflatable bladder canal (urethra) or bladder neck sphincter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53446	Removal of inflatable bladder canal (urethra) or bladder neck sphincter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
53447	Removal and replacement of inflatable bladder canal (urethra) or bladder neck sphincter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53447	Removal and replacement of inflatable bladder canal (urethra) or bladder neck sphincter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53447	Removal and replacement of inflatable bladder canal (urethra) or bladder neck sphincter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
53448	Removal and replacement of inflatable bladder canal (urethra) or bladder neck sphincter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53448	Removal and replacement of inflatable bladder canal (urethra) or bladder neck sphincter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53448	Removal and replacement of inflatable bladder canal (urethra) or bladder neck sphincter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
53449	"Repair of inflatable bladder canal (urethra) or bladder neck sphincter, including pump, reservoir, and cuff"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53449	"Repair of inflatable bladder canal (urethra) or bladder neck sphincter, including pump, reservoir, and cuff"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53449	"Repair of inflatable bladder canal (urethra) or bladder neck sphincter, including pump, reservoir, and cuff"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
53450	Repair of bladder canal (urethra) and urinary opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53450	Repair of bladder canal (urethra) and urinary opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53450	Repair of bladder canal (urethra) and urinary opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
53460	Repair and partial removal of bladder canal (urethra) and urinary opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53460	Repair and partial removal of bladder canal (urethra) and urinary opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
53460	Repair and partial removal of bladder canal (urethra) and urinary opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
53500	Release of bladder canal (urethra) scar tissue using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53500	Release of bladder canal (urethra) scar tissue using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53500	Release of bladder canal (urethra) scar tissue using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
53502	"Suture of bladder canal (urethra) wound or injury, female"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53502	"Suture of bladder canal (urethra) wound or injury, female"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53502	"Suture of bladder canal (urethra) wound or injury, female"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
53505	"Suture of bladder canal (urethra) wound or injury, penis"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53505	"Suture of bladder canal (urethra) wound or injury, penis"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53505	"Suture of bladder canal (urethra) wound or injury, penis"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
53510	Suture of bladder canal (urethra) wound or injury	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53510	Suture of bladder canal (urethra) wound or injury	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53510	Suture of bladder canal (urethra) wound or injury	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
53515	"Suture of bladder canal (urethra) wound or injury, prostate"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53515	"Suture of bladder canal (urethra) wound or injury, prostate"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53515	"Suture of bladder canal (urethra) wound or injury, prostate"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
53520	"Closure of abnormal drainage tract from bladder canal (urethra) to skin, male"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
53520	"Closure of abnormal drainage tract from bladder canal (urethra) to skin, male"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
53520	"Closure of abnormal drainage tract from bladder canal (urethra) to skin, male"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
53600	"Dilation of narrowing of bladder canal (urethra), male"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	4	
53600	"Dilation of narrowing of bladder canal (urethra), male"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
53600	"Dilation of narrowing of bladder canal (urethra), male"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
53601	"Dilation of narrowing of bladder canal (urethra), male"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	7	7	
53601	"Dilation of narrowing of bladder canal (urethra), male"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	0	
53601	"Dilation of narrowing of bladder canal (urethra), male"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
53620	"Dilation of narrowing of bladder canal (urethra), male"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	7	11	
53620	"Dilation of narrowing of bladder canal (urethra), male"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	0	
53620	"Dilation of narrowing of bladder canal (urethra), male"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
53621	"Dilation of narrowing of bladder canal (urethra), male"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	7	7	
53621	"Dilation of narrowing of bladder canal (urethra), male"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
53621	"Dilation of narrowing of bladder canal (urethra), male"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
53660	"Dilation of bladder canal (urethra), female"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	11	
53660	"Dilation of bladder canal (urethra), female"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
53660	"Dilation of bladder canal (urethra), female"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
53661	"Dilation of bladder canal (urethra), female"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	7	7	
53661	"Dilation of bladder canal (urethra), female"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
53661	"Dilation of bladder canal (urethra), female"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
53850	Destruction of prostate tissue through bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
53850	Destruction of prostate tissue through bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	88	6	
53850	Destruction of prostate tissue through bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	152	152	
53852	Destruction of prostate tissue through bladder canal (urethra)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
53852	Destruction of prostate tissue through bladder canal (urethra)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	6	
53852	Destruction of prostate tissue through bladder canal (urethra)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
53855	"Insertion of a temporary bladder canal (urethra) stent, male, using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	0	
53855	"Insertion of a temporary bladder canal (urethra) stent, male, using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
53860	Reconstruction of female bladder neck for stress urinary incontinence	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
53860	Reconstruction of female bladder neck for stress urinary incontinence	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
53860	Reconstruction of female bladder neck for stress urinary incontinence	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	72	0	
54000	Incision of newborn penile foreskin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	25	
54000	Incision of newborn penile foreskin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	12	
54000	Incision of newborn penile foreskin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
54001	Incision of penile foreskin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	25	
54001	Incision of penile foreskin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	6	
54001	Incision of penile foreskin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
54015	Incision and drainage of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
54015	Incision and drainage of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54015	Incision and drainage of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
54050	Chemical destruction of growths of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
54050	Chemical destruction of growths of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	6	
54050	Chemical destruction of growths of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
54055	Destruction of penile growths using electric current	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
54055	Destruction of penile growths using electric current	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	6	
54055	Destruction of penile growths using electric current	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	14	14	
54056	Freezing destruction of penile growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
54056	Freezing destruction of penile growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	6	
54056	Freezing destruction of penile growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
54057	Laser destruction of growths of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
54057	Laser destruction of growths of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	6	
54057	Laser destruction of growths of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
54060	Excisional destruction of penile growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
54060	Excisional destruction of penile growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	6	
54060	Excisional destruction of penile growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
54065	Destruction of multiple penile growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
54065	Destruction of multiple penile growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	6	
54065	Destruction of multiple penile growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
54100	Biopsy of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
54100	Biopsy of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	0	
54100	Biopsy of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
54105	Biopsy of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	30	
54105	Biopsy of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	6	
54105	Biopsy of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
54110	Removal of abnormally thickened tissue in penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54110	Removal of abnormally thickened tissue in penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54110	Removal of abnormally thickened tissue in penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54111	Removal of abnormally thickened tissue in penis with up to 5 centimeter graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54111	Removal of abnormally thickened tissue in penis with up to 5 centimeter graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54111	Removal of abnormally thickened tissue in penis with up to 5 centimeter graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54112	Removal of abnormally thickened tissue in penis with greater than 5 centimeter graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54112	Removal of abnormally thickened tissue in penis with greater than 5 centimeter graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54112	Removal of abnormally thickened tissue in penis with greater than 5 centimeter graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
54115	Removal of deep foreign body of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
54115	Removal of deep foreign body of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	6	
54115	Removal of deep foreign body of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	90	90	
54120	Partial amputation of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54120	Partial amputation of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54120	Partial amputation of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54125	Amputation of entire penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54125	Amputation of entire penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54125	Amputation of entire penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54130	Amputation of penis and removal of lymph nodes on both sides of the groin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54130	Amputation of penis and removal of lymph nodes on both sides of the groin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54130	Amputation of penis and removal of lymph nodes on both sides of the groin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
54135	Amputation of penis and removal of lymph nodes on both sides of the pelvis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54135	Amputation of penis and removal of lymph nodes on both sides of the pelvis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54135	Amputation of penis and removal of lymph nodes on both sides of the pelvis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
54150	Removal of foreskin of using clamp or device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	0	
54150	Removal of foreskin of using clamp or device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	29	0	
54150	Removal of foreskin of using clamp or device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
54160	"Removal of foreskin, neonate (28 days of age or less)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	3	
54160	"Removal of foreskin, neonate (28 days of age or less)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	6	
54160	"Removal of foreskin, neonate (28 days of age or less)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
54161	"Removal of foreskin, patient older than 28 days of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
54161	"Removal of foreskin, patient older than 28 days of age"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54161	"Removal of foreskin, patient older than 28 days of age"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
54162	Removal of scar tissue following penile foreskin removal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	30	
54162	Removal of scar tissue following penile foreskin removal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	6	
54162	Removal of scar tissue following penile foreskin removal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
54163	Repair of incomplete removal of penile foreskin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54163	Repair of incomplete removal of penile foreskin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54163	Repair of incomplete removal of penile foreskin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		40	
54164	Incision of the membrane attaching foreskin and penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54164	Incision of the membrane attaching foreskin and penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54164	Incision of the membrane attaching foreskin and penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		40	
54200	Injection procedure to correct abnormally thickened penile tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
54200	Injection procedure to correct abnormally thickened penile tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	39	6	
54200	Injection procedure to correct abnormally thickened penile tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
54205	Injection procedure and surgical exposure of abnormally thickened tissue in penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54205	Injection procedure and surgical exposure of abnormally thickened tissue in penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54205	Injection procedure and surgical exposure of abnormally thickened tissue in penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54220	Injection of drug into erectile tissue at sides and back of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
54220	Injection of drug into erectile tissue at sides and back of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	0	
54220	Injection of drug into erectile tissue at sides and back of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
54230	Injection procedure for X-ray imaging of penile erection	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	27	
54230	Injection procedure for X-ray imaging of penile erection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	0	
54230	Injection procedure for X-ray imaging of penile erection	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
54231	Assessment of erectile dysfunction including injection of drugs into the penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
54231	Assessment of erectile dysfunction including injection of drugs into the penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	0	
54231	Assessment of erectile dysfunction including injection of drugs into the penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
54235	Injection procedure to induce erection	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
54235	Injection procedure to induce erection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	0	
54235	Injection procedure to induce erection	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
54240	Assessment of penile blood flow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18		
54240	Assessment of penile blood flow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44		
54250	Assessment of nighttime erection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	17		
54300	Repair of curvature of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54300	Repair of curvature of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54300	Repair of curvature of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54304	Repair of curvature and urinary outlet of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54304	Repair of curvature and urinary outlet of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54304	Repair of curvature and urinary outlet of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54308	Repair of urinary outlet of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54308	Repair of urinary outlet of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54308	Repair of urinary outlet of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54312	Repair of urinary outlet of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54312	Repair of urinary outlet of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54312	Repair of urinary outlet of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
54316	Repair of urinary outlet of penis with skin graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54316	Repair of urinary outlet of penis with skin graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54316	Repair of urinary outlet of penis with skin graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
54318	Repair of urinary outlet of penis with release of penis from scrotum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54318	Repair of urinary outlet of penis with release of penis from scrotum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54318	Repair of urinary outlet of penis with release of penis from scrotum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
54322	Repair of urinary outlet of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54322	Repair of urinary outlet of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54322	Repair of urinary outlet of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54324	Repair of urinary outlet of penis with skin flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54324	Repair of urinary outlet of penis with skin flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54324	Repair of urinary outlet of penis with skin flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
54326	Repair of urinary outlet at underside of penis with skin flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54326	Repair of urinary outlet at underside of penis with skin flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54326	Repair of urinary outlet at underside of penis with skin flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
54328	Repair of urinary outlet at underside of penis with skin graft and/or flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54328	Repair of urinary outlet at underside of penis with skin graft and/or flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54328	Repair of urinary outlet at underside of penis with skin graft and/or flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
54332	Repair of urinary outlet at underside of penis with skin graft or flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54332	Repair of urinary outlet at underside of penis with skin graft or flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54332	Repair of urinary outlet at underside of penis with skin graft or flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
54336	Repair of urinary outlet at underside of penis with skin graft and/or flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54336	Repair of urinary outlet at underside of penis with skin graft and/or flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54336	Repair of urinary outlet at underside of penis with skin graft and/or flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
54340	Repair of urinary outlet of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54340	Repair of urinary outlet of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54340	Repair of urinary outlet of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54344	Repair of urinary outlet of penis with skin graft or flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54344	Repair of urinary outlet of penis with skin graft or flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54344	Repair of urinary outlet of penis with skin graft or flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
54348	Repair of urinary outlet of penis with skin graft or flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54348	Repair of urinary outlet of penis with skin graft or flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54348	Repair of urinary outlet of penis with skin graft or flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
54352	Repair of urinary outlet of penis with skin graft or flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54352	Repair of urinary outlet of penis with skin graft or flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54352	Repair of urinary outlet of penis with skin graft or flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
54360	Reconstructive surgery to correct angle penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54360	Reconstructive surgery to correct angle penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54360	Reconstructive surgery to correct angle penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54380	Plastic repair of urinary outlet of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54380	Plastic repair of urinary outlet of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54380	Plastic repair of urinary outlet of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
54385	Plastic repair of urinary outlet of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54385	Plastic repair of urinary outlet of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54385	Plastic repair of urinary outlet of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
54390	Plastic repair of urinary outlet of penis with creation of bladder opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54390	Plastic repair of urinary outlet of penis with creation of bladder opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54390	Plastic repair of urinary outlet of penis with creation of bladder opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
54400	Insertion of non-inflatable penile prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54400	Insertion of non-inflatable penile prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54400	Insertion of non-inflatable penile prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
54401	Insertion of inflatable penile prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54401	Insertion of inflatable penile prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54401	Insertion of inflatable penile prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		206	
54405	Insertion of multi-component inflatable penile prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54405	Insertion of multi-component inflatable penile prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54405	Insertion of multi-component inflatable penile prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54406	Removal of all components of inflatable penile prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54406	Removal of all components of inflatable penile prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54406	Removal of all components of inflatable penile prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
54408	Repair of components of a multi-component inflatable penile prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54408	Repair of components of a multi-component inflatable penile prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54408	Repair of components of a multi-component inflatable penile prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
54410	Removal and replacement of all components of a multi-component inflatable penile prosthesis at same surgery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54410	Removal and replacement of all components of a multi-component inflatable penile prosthesis at same surgery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54410	Removal and replacement of all components of a multi-component inflatable penile prosthesis at same surgery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
54411	Removal and replacement of infected components of inflatable penile prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54411	Removal and replacement of infected components of inflatable penile prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54411	Removal and replacement of infected components of inflatable penile prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
54415	Removal of non-inflatable or inflatable penile prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54415	Removal of non-inflatable or inflatable penile prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54415	Removal of non-inflatable or inflatable penile prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
54416	Removal and replacement of non-inflatable penile prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54416	Removal and replacement of non-inflatable penile prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54416	Removal and replacement of non-inflatable penile prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		152	
54417	Removal and replacement of infected non-inflatable penile prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54417	Removal and replacement of infected non-inflatable penile prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54417	Removal and replacement of infected non-inflatable penile prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
54420	Creation of blood flow tract from penis to groin vein	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54420	Creation of blood flow tract from penis to groin vein	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54420	Creation of blood flow tract from penis to groin vein	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54430	Creation of blood flow tract from penis to other penile anatomy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54430	Creation of blood flow tract from penis to other penile anatomy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54430	Creation of blood flow tract from penis to other penile anatomy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54435	Redirection of blood flow from penis with partial removal of head of penis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54435	Redirection of blood flow from penis with partial removal of head of penis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54435	Redirection of blood flow from penis with partial removal of head of penis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
54437	Repair of traumatic corporeal tear(s)	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
54437	Repair of traumatic corporeal tear(s)	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
54437	Repair of traumatic corporeal tear(s)	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
54437	Repair of traumatic corporeal tear(s)	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
54437	Repair of traumatic corporeal tear(s)	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
54437	Repair of traumatic corporeal tear(s)	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
54437	Repair of traumatic corporeal tear(s)	Post-service	L037D	RN/LPN/MTA	0.37	99212    27  minutes		27	
54437	Repair of traumatic corporeal tear(s)	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		108	
54438	"Replantation, penis, complete amputation including urethral repair"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
54438	"Replantation, penis, complete amputation including urethral repair"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
54438	"Replantation, penis, complete amputation including urethral repair"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
54438	"Replantation, penis, complete amputation including urethral repair"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
54438	"Replantation, penis, complete amputation including urethral repair"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
54438	"Replantation, penis, complete amputation including urethral repair"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management  same day 99238 -- 12 minutes		12	
54438	"Replantation, penis, complete amputation including urethral repair"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		144	
54450	Repositioning of foreskin including scar tissue removal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	24	0	
54450	Repositioning of foreskin including scar tissue removal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
54500	Needle biopsy of testis (testicle)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		21	
54505	Incisional biopsy of testis (testicle)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
54505	Incisional biopsy of testis (testicle)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54505	Incisional biopsy of testis (testicle)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
54512	Excision of testis (testicle) lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54512	Excision of testis (testicle) lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54512	Excision of testis (testicle) lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
54520	Removal of testis (testicle)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54520	Removal of testis (testicle)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54520	Removal of testis (testicle)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		41	
54522	Partial removal of testis (testicle)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54522	Partial removal of testis (testicle)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54522	Partial removal of testis (testicle)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
54530	Removal of one testis (testicle) for tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54530	Removal of one testis (testicle) for tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54530	Removal of one testis (testicle) for tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54535	Removal of one testis (testicle) for tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54535	Removal of one testis (testicle) for tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54535	Removal of one testis (testicle) for tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54550	Suture of spermatic veins to stop abnormal fluid collection using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54550	Suture of spermatic veins to stop abnormal fluid collection using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54550	Suture of spermatic veins to stop abnormal fluid collection using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
54560	Exploration for location of testicle in abdomen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54560	Exploration for location of testicle in abdomen	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54560	Exploration for location of testicle in abdomen	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54600	Repair of twisted testicle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54600	Repair of twisted testicle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54600	Repair of twisted testicle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
54620	Anchoring of opposite testicle to other testicle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
54620	Anchoring of opposite testicle to other testicle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54620	Anchoring of opposite testicle to other testicle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
54640	Repair of displaced testicle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54640	Repair of displaced testicle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54640	Repair of displaced testicle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
54650	Repair of congenital malpositioned testicle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54650	Repair of congenital malpositioned testicle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54650	Repair of congenital malpositioned testicle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
54660	Insertion of testicular prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54660	Insertion of testicular prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54660	Insertion of testicular prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
54670	Suture or repair of testicular injury	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54670	Suture or repair of testicular injury	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54670	Suture or repair of testicular injury	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
54680	Transplantation of one or both testicles to thigh	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54680	Transplantation of one or both testicles to thigh	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54680	Transplantation of one or both testicles to thigh	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54690	Removal of one or both testicles using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54690	Removal of one or both testicles using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54690	Removal of one or both testicles using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
54692	Removal of congenital malpositioned testicle using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54692	Removal of congenital malpositioned testicle using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54692	Removal of congenital malpositioned testicle using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
54700	"Incision and drainage of sperm reservoir, testis, and/or scrotal area"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
54700	"Incision and drainage of sperm reservoir, testis, and/or scrotal area"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
54700	"Incision and drainage of sperm reservoir, testis, and/or scrotal area"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
54800	Needle biopsy of sperm reservoir	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		21	
54830	Removal of sperm duct growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54830	Removal of sperm duct growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54830	Removal of sperm duct growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
54840	Removal of fluid accumulation in sperm reservoir	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54840	Removal of fluid accumulation in sperm reservoir	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54840	Removal of fluid accumulation in sperm reservoir	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		41	
54860	Removal of one sperm reservoir	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54860	Removal of one sperm reservoir	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54860	Removal of one sperm reservoir	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
54861	Removal of both sperm reservoirs	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54861	Removal of both sperm reservoirs	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54861	Removal of both sperm reservoirs	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
54865	Exploration of sperm reservoir	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54865	Exploration of sperm reservoir	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54865	Exploration of sperm reservoir	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
54900	Connection of one sperm reservoir to sperm duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54900	Connection of one sperm reservoir to sperm duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54900	Connection of one sperm reservoir to sperm duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
54901	Connection of both sperm reservoirs to sperm ducts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
54901	Connection of both sperm reservoirs to sperm ducts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
54901	Connection of both sperm reservoirs to sperm ducts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
55000	Aspiration of fluid collection in testicle and sperm reservoir	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	30	
55000	Aspiration of fluid collection in testicle and sperm reservoir	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	0	
55040	Removal of fluid accumulation in one testicle and sperm reservoir	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55040	Removal of fluid accumulation in one testicle and sperm reservoir	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55040	Removal of fluid accumulation in one testicle and sperm reservoir	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
55041	Removal of fluid accumulation in both testicles and sperm reservoirs	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55041	Removal of fluid accumulation in both testicles and sperm reservoirs	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55041	Removal of fluid accumulation in both testicles and sperm reservoirs	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
55060	Repair of fluid accumulation in testicle and sperm reservoir	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55060	Repair of fluid accumulation in testicle and sperm reservoir	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55060	Repair of fluid accumulation in testicle and sperm reservoir	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
55100	Incision and drainage of abscess in scrotal sac of testicle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
55100	Incision and drainage of abscess in scrotal sac of testicle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	12	
55100	Incision and drainage of abscess in scrotal sac of testicle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
55110	Exploration of the scrotal sac of testicle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55110	Exploration of the scrotal sac of testicle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55110	Exploration of the scrotal sac of testicle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
55120	Removal of foreign body in scrotal sac of testicle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55120	Removal of foreign body in scrotal sac of testicle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55120	Removal of foreign body in scrotal sac of testicle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
55150	Removal of diseased or injured scrotal skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55150	Removal of diseased or injured scrotal skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
55150	Removal of diseased or injured scrotal skin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
55175	Repair of the scrotum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55175	Repair of the scrotum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55175	Repair of the scrotum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
55180	Complicated repair of the scrotum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55180	Complicated repair of the scrotum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
55180	Complicated repair of the scrotum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
55200	Incision of the sperm duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
55200	Incision of the sperm duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	6	
55200	Incision of the sperm duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
55250	Removal of sperm duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	30	60	
55250	Removal of sperm duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	6	
55250	Removal of sperm duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
55300	Incision of sperm ducts for X-ray imaging procedure	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		27	
55400	Incision or repair of sperm duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55400	Incision or repair of sperm duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55400	Incision or repair of sperm duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
55450	"Tying of sperm ducts, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
55450	"Tying of sperm ducts, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	67	12	
55450	"Tying of sperm ducts, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
55500	Removal of fluid accumulation in one spermatic cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55500	Removal of fluid accumulation in one spermatic cord	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55500	Removal of fluid accumulation in one spermatic cord	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
55520	Removal of spermatic cord growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55520	Removal of spermatic cord growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55520	Removal of spermatic cord growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
55530	Removal of spermatic cord venous dilation or tying of spermatic veins	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55530	Removal of spermatic cord venous dilation or tying of spermatic veins	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55530	Removal of spermatic cord venous dilation or tying of spermatic veins	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
55535	Removal of spermatic cord venous dilation or suturing spermatic veins	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55535	Removal of spermatic cord venous dilation or suturing spermatic veins	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55535	Removal of spermatic cord venous dilation or suturing spermatic veins	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
55540	Removal of spermatic cord venous dilation or suturing spermatic veins with hernia repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55540	Removal of spermatic cord venous dilation or suturing spermatic veins with hernia repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55540	Removal of spermatic cord venous dilation or suturing spermatic veins with hernia repair	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
55550	Tying of spermatic veins using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55550	Tying of spermatic veins using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55550	Tying of spermatic veins using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
55600	Incision or puncture of fluid-producing glands for sperm movement (semen)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55600	Incision or puncture of fluid-producing glands for sperm movement (semen)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55600	Incision or puncture of fluid-producing glands for sperm movement (semen)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
55605	Complicated incision of fluid-producing glands for sperm movement (semen)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55605	Complicated incision of fluid-producing glands for sperm movement (semen)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
55605	Complicated incision of fluid-producing glands for sperm movement (semen)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
55650	Removal of fluid-producing glands for sperm movement (semen)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55650	Removal of fluid-producing glands for sperm movement (semen)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
55650	Removal of fluid-producing glands for sperm movement (semen)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
55680	Removal of congenital remnant of fluid-producing glands for sperm movement (semen)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55680	Removal of congenital remnant of fluid-producing glands for sperm movement (semen)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55680	Removal of congenital remnant of fluid-producing glands for sperm movement (semen)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
55700	Biopsy of prostate gland	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	19	20	
55700	Biopsy of prostate gland	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	73	0	
55700	Biopsy of prostate gland	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
55705	Incisional biopsy of prostate gland	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
55705	Incisional biopsy of prostate gland	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55705	Incisional biopsy of prostate gland	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
55706	Needle stereotactic and image-guided biopsy of prostate gland	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
55706	Needle stereotactic and image-guided biopsy of prostate gland	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55706	Needle stereotactic and image-guided biopsy of prostate gland	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		89	
55720	Incision and drainage of prostate gland abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55720	Incision and drainage of prostate gland abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
55720	Incision and drainage of prostate gland abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
55725	Complicated incision and drainage of prostate gland abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55725	Complicated incision and drainage of prostate gland abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
55725	Complicated incision and drainage of prostate gland abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
55801	Partial removal of prostate gland through incision between scrotum and anus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55801	Partial removal of prostate gland through incision between scrotum and anus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
55801	Partial removal of prostate gland through incision between scrotum and anus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
55810	"Removal of prostate gland, glands for sperm movement (semen), and sperm duct"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55810	"Removal of prostate gland, glands for sperm movement (semen), and sperm duct"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
55810	"Removal of prostate gland, glands for sperm movement (semen), and sperm duct"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
55812	Removal of prostate gland with lymph node biopsy through incision between scrotum and anus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55812	Removal of prostate gland with lymph node biopsy through incision between scrotum and anus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
55812	Removal of prostate gland with lymph node biopsy through incision between scrotum and anus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
55815	Removal of prostate gland through incision between scrotum and anus and removal of surrounding lymph nodes on both sides of the pelvis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55815	Removal of prostate gland through incision between scrotum and anus and removal of surrounding lymph nodes on both sides of the pelvis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
55815	Removal of prostate gland through incision between scrotum and anus and removal of surrounding lymph nodes on both sides of the pelvis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
55821	Partial removal of prostate gland	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55821	Partial removal of prostate gland	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
55821	Partial removal of prostate gland	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
55831	Partial removal of the prostate gland	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55831	Partial removal of the prostate gland	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
55831	Partial removal of the prostate gland	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
55840	"Prostatectomy, retropubic radical, with or without nerve sparing;"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
55840	"Prostatectomy, retropubic radical, with or without nerve sparing;"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
55840	"Prostatectomy, retropubic radical, with or without nerve sparing;"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
55840	"Prostatectomy, retropubic radical, with or without nerve sparing;"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
55840	"Prostatectomy, retropubic radical, with or without nerve sparing;"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
55840	"Prostatectomy, retropubic radical, with or without nerve sparing;"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
55840	"Prostatectomy, retropubic radical, with or without nerve sparing;"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
55840	"Prostatectomy, retropubic radical, with or without nerve sparing;"	Post-service	L037D	RN/LPN/MTA	0.37	99214    53  minutes		53	
55842	"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
55842	"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
55842	"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
55842	"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
55842	"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
55842	"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
55842	"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
55842	"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)"	Post-service	L037D	RN/LPN/MTA	0.37	99214    53  minutes		53	
55845	"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
55845	"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
55845	"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
55845	"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
55845	"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
55845	"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
55845	"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
55845	"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes"	Post-service	L037D	RN/LPN/MTA	0.37	99214    53  minutes		53	
55860	Surgical exposure of prostate gland for radiation therapy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55860	Surgical exposure of prostate gland for radiation therapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55860	Surgical exposure of prostate gland for radiation therapy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
55862	Exposure of prostate gland for radiation therapy with lymph node biopsy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55862	Exposure of prostate gland for radiation therapy with lymph node biopsy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
55862	Exposure of prostate gland for radiation therapy with lymph node biopsy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
55865	Exposure of prostate gland for radiation therapy with removal of surrounding lymph nodes on both sides of the pelvis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55865	Exposure of prostate gland for radiation therapy with removal of surrounding lymph nodes on both sides of the pelvis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
55865	Exposure of prostate gland for radiation therapy with removal of surrounding lymph nodes on both sides of the pelvis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
55866	"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
55866	"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
55866	"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
55866	"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
55866	"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
55866	"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed"	Service  post	L037D	RN/LPN/MTA	0.37	Dischrg mgmt (1.0 x 99238) (enter 12 min)		12	
55866	"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
55866	"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed"	Post-service	L037D	RN/LPN/MTA	0.37	99214    53  minutes		53	
55870	Insertion of device to enhance semen discharge	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
55870	Insertion of device to enhance semen discharge	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	82	0	
55873	Destruction of prostate gland using ultrasound guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
55873	Destruction of prostate gland using ultrasound guidance	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	75	0	
55873	Destruction of prostate gland using ultrasound guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	168	6	
55873	Destruction of prostate gland using ultrasound guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	108	108	
55875	Insertion of needles or catheters into prostate for radiation therapy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
55875	Insertion of needles or catheters into prostate for radiation therapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
55875	Insertion of needles or catheters into prostate for radiation therapy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
55876	Insertion of radiation therapy devices in prostate gland for radiation therapy guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
55876	Insertion of radiation therapy devices in prostate gland for radiation therapy guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
55876	Insertion of radiation therapy devices in prostate gland for radiation therapy guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
55920	Insertion of needles or catheters into pelvic organs and/or genitals for radiation therapy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
55920	Insertion of needles or catheters into pelvic organs and/or genitals for radiation therapy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
56405	Incision and drainage of female genitals abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
56405	Incision and drainage of female genitals abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	22	6	
56405	Incision and drainage of female genitals abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
56420	Incision and drainage of female genital gland abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	0	
56420	Incision and drainage of female genital gland abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	6	
56420	Incision and drainage of female genital gland abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
56440	Creation of drainage tract for female genital gland or cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
56440	Creation of drainage tract for female genital gland or cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
56440	Creation of drainage tract for female genital gland or cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
56441	Removal of external female genital scar tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
56441	Removal of external female genital scar tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	6	
56441	Removal of external female genital scar tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
56442	Incision of membrane at uterine opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
56501	Destruction of external female genital growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
56501	Destruction of external female genital growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25	6	
56501	Destruction of external female genital growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
56515	Destruction of extensive growths of external female genitals	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
56515	Destruction of extensive growths of external female genitals	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	6	
56515	Destruction of extensive growths of external female genitals	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
56605	Biopsy of external female genitals	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	32	0	
56605	Biopsy of external female genitals	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
56606	Biopsy of external female genitals	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	5	0	
56620	Partial removal of external female genitals	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
56620	Partial removal of external female genitals	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
56620	Partial removal of external female genitals	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
56625	Removal of external female genitals	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
56625	Removal of external female genitals	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
56625	Removal of external female genitals	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
56630	Partial removal of external female genitals	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
56630	Partial removal of external female genitals	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
56630	Partial removal of external female genitals	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
56631	Partial removal of external female genitals and surrounding lymph nodes on one of the groin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
56631	Partial removal of external female genitals and surrounding lymph nodes on one of the groin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
56631	Partial removal of external female genitals and surrounding lymph nodes on one of the groin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
56632	Partial removal of external female genitals and surrounding lymph nodes on both sides of groin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
56632	Partial removal of external female genitals and surrounding lymph nodes on both sides of groin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
56632	Partial removal of external female genitals and surrounding lymph nodes on both sides of groin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		180	
56633	Removal of entire external female genitals	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
56633	Removal of entire external female genitals	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
56633	Removal of entire external female genitals	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
56634	Removal of entire external female genitals and surrounding lymph nodes on one of the groin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
56634	Removal of entire external female genitals and surrounding lymph nodes on one of the groin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
56634	Removal of entire external female genitals and surrounding lymph nodes on one of the groin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
56637	Removal of entire external female genitals and surrounding lymph nodes on both sides of groin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
56637	Removal of entire external female genitals and surrounding lymph nodes on both sides of groin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
56637	Removal of entire external female genitals and surrounding lymph nodes on both sides of groin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
56640	Removal of entire external female genitals and lymph nodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
56640	Removal of entire external female genitals and lymph nodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
56640	Removal of entire external female genitals and lymph nodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
56700	"Partial removal of membrane at uterine opening, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
56700	"Partial removal of membrane at uterine opening, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
56700	"Partial removal of membrane at uterine opening, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
56740	Removal of female genital gland or cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
56740	Removal of female genital gland or cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
56740	Removal of female genital gland or cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
56800	Plastic repair of uterine opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
56800	Plastic repair of uterine opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
56800	Plastic repair of uterine opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
56805	Reduction of size of the external female sexual organ (clitoris)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
56805	Reduction of size of the external female sexual organ (clitoris)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
56805	Reduction of size of the external female sexual organ (clitoris)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
56810	Nonobstetrical repair of skin from anus to genitals	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
56810	Nonobstetrical repair of skin from anus to genitals	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
56810	Nonobstetrical repair of skin from anus to genitals	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
56820	Examination of external female genitals using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	11	
56820	Examination of external female genitals using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	0	
56821	Examination and biopsy of external female genitals using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	11	
56821	Examination and biopsy of external female genitals using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
57000	Incision and exploration of vaginal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
57000	Incision and exploration of vaginal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
57000	Incision and exploration of vaginal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
57010	Incision and drainage of pelvic abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57010	Incision and drainage of pelvic abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57010	Incision and drainage of pelvic abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57020	Aspiration of abdominal cavity fluid through the vaginal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	0	
57020	Aspiration of abdominal cavity fluid through the vaginal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
57022	Incision and drainage of vaginal blood accumulation following delivery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57022	Incision and drainage of vaginal blood accumulation following delivery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
57023	Incision and drainage of vaginal blood accumulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
57023	Incision and drainage of vaginal blood accumulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57023	Incision and drainage of vaginal blood accumulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
57061	Destruction of vaginal growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
57061	Destruction of vaginal growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	6	
57061	Destruction of vaginal growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
57065	Destruction of multiple vaginal growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
57065	Destruction of multiple vaginal growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	6	
57065	Destruction of multiple vaginal growths	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
57100	Biopsy of vaginal mucous membrane	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	0	
57100	Biopsy of vaginal mucous membrane	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
57105	Biopsy of extensive area of vaginal mucous membrane	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
57105	Biopsy of extensive area of vaginal mucous membrane	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	6	
57105	Biopsy of extensive area of vaginal mucous membrane	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
57106	Partial removal of vaginal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57106	Partial removal of vaginal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57106	Partial removal of vaginal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
57107	Partial removal of vaginal wall and surrounding tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57107	Partial removal of vaginal wall and surrounding tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57107	Partial removal of vaginal wall and surrounding tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
57109	Partial removal of vaginal wall and surrounding tissue with removal of lymph nodes on both sides of pelvis and aortic lymph node biopsy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57109	Partial removal of vaginal wall and surrounding tissue with removal of lymph nodes on both sides of pelvis and aortic lymph node biopsy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57109	Partial removal of vaginal wall and surrounding tissue with removal of lymph nodes on both sides of pelvis and aortic lymph node biopsy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
57110	Removal of vaginal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57110	Removal of vaginal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57110	Removal of vaginal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57111	Removal of vaginal and surrounding tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57111	Removal of vaginal and surrounding tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57111	Removal of vaginal and surrounding tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
57112	Complete removal of vaginal wall and surrounding tissue with removal of lymph nodes on both sides of pelvis and aortic lymph node biopsy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57112	Complete removal of vaginal wall and surrounding tissue with removal of lymph nodes on both sides of pelvis and aortic lymph node biopsy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57112	Complete removal of vaginal wall and surrounding tissue with removal of lymph nodes on both sides of pelvis and aortic lymph node biopsy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
57120	Suture closure of the vagina and vaginal opening	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57120	Suture closure of the vagina and vaginal opening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57120	Suture closure of the vagina and vaginal opening	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57130	Removal of abnormal tissue dividing the vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
57130	Removal of abnormal tissue dividing the vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	34	6	
57130	Removal of abnormal tissue dividing the vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
57135	Excision of vaginal cyst or tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
57135	Excision of vaginal cyst or tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	6	
57135	Excision of vaginal cyst or tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
57150	Irrigation of vagina and/or application of drug to treat infection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	14	0	
57155	Insertion of radiation therapy devices in uterus for radiation therapy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15	18	
57155	Insertion of radiation therapy devices in uterus for radiation therapy	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	60	0	
57155	Insertion of radiation therapy devices in uterus for radiation therapy	Service  intra	L051A	RN	0.51	Service total costs	77	0	
57155	Insertion of radiation therapy devices in uterus for radiation therapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	0	
57155	Insertion of radiation therapy devices in uterus for radiation therapy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
57156	Insertion of radiation therapy devices in vagina for radiation therapy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	18	
57156	Insertion of radiation therapy devices in vagina for radiation therapy	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	30	0	
57156	Insertion of radiation therapy devices in vagina for radiation therapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	0	
57156	Insertion of radiation therapy devices in vagina for radiation therapy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
57160	Fitting and insertion of vaginal support device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	0	
57170	Fitting and insertion of pregnancy prevention device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	0	
57180	Insertion of drug agent or packing to control vaginal bleeding	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	12	
57180	Insertion of drug agent or packing to control vaginal bleeding	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
57200	Suture of non-obstetrical vaginal injury	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57200	Suture of non-obstetrical vaginal injury	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57200	Suture of non-obstetrical vaginal injury	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
57210	Suture of non-obstetrical injury of the vagina and/or skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57210	Suture of non-obstetrical injury of the vagina and/or skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57210	Suture of non-obstetrical injury of the vagina and/or skin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
57220	Plastic repair through the vagina of muscles at urinary opening (sphincter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57220	Plastic repair through the vagina of muscles at urinary opening (sphincter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57220	Plastic repair through the vagina of muscles at urinary opening (sphincter)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
57230	Plastic repair of prolapsed urinary canal (urethra) into vaginal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57230	Plastic repair of prolapsed urinary canal (urethra) into vaginal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
57230	Plastic repair of prolapsed urinary canal (urethra) into vaginal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
57240	Repair of herniated bladder into vaginal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57240	Repair of herniated bladder into vaginal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57240	Repair of herniated bladder into vaginal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
57250	Repair of herniated rectum into vaginal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57250	Repair of herniated rectum into vaginal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57250	Repair of herniated rectum into vaginal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
57260	"Plastic repair of vagina and tissue separating vagina, rectum, and bladder"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57260	"Plastic repair of vagina and tissue separating vagina, rectum, and bladder"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57260	"Plastic repair of vagina and tissue separating vagina, rectum, and bladder"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
57265	Repair of herniated rectum and bladder into vaginal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57265	Repair of herniated rectum and bladder into vaginal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57265	Repair of herniated rectum and bladder into vaginal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
57268	Repair of protrusion of intestine into rectum or vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57268	Repair of protrusion of intestine into rectum or vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57268	Repair of protrusion of intestine into rectum or vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
57270	Repair of protrusion of intestine into rectum or vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57270	Repair of protrusion of intestine into rectum or vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57270	Repair of protrusion of intestine into rectum or vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57280	Attachment of vagina to rear pelvic bone (sacrum)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57280	Attachment of vagina to rear pelvic bone (sacrum)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57280	Attachment of vagina to rear pelvic bone (sacrum)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57282	Vaginal repair of pelvic ligaments	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57282	Vaginal repair of pelvic ligaments	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57282	Vaginal repair of pelvic ligaments	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
57283	Anatomic repositioning of vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57283	Anatomic repositioning of vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57283	Anatomic repositioning of vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
57284	"Repair through abdomen of vaginal wall defect, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57284	"Repair through abdomen of vaginal wall defect, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57284	"Repair through abdomen of vaginal wall defect, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
57285	Repair through the vagina of vaginal wall defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57285	Repair through the vagina of vaginal wall defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57285	Repair through the vagina of vaginal wall defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
57287	Removal or revision of sling around bladder canal (urethra) to control leakage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57287	Removal or revision of sling around bladder canal (urethra) to control leakage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
57287	Removal or revision of sling around bladder canal (urethra) to control leakage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
57288	Creation of sling around bladder canal (urethra) to control leakage	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57288	Creation of sling around bladder canal (urethra) to control leakage	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
57288	Creation of sling around bladder canal (urethra) to control leakage	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
57289	Repair of prolapsed urinary canal (urethra) and bladder prolapse into vaginal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57289	Repair of prolapsed urinary canal (urethra) and bladder prolapse into vaginal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57289	Repair of prolapsed urinary canal (urethra) and bladder prolapse into vaginal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
57291	Creation of artificial vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57291	Creation of artificial vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57291	Creation of artificial vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57292	Creation of artificial vagina using tissue graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57292	Creation of artificial vagina using tissue graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57292	Creation of artificial vagina using tissue graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57295	Revision and removal of prosthetic vaginal graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57295	Revision and removal of prosthetic vaginal graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57295	Revision and removal of prosthetic vaginal graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
57296	"Revision and removal of prosthetic vaginal graft, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57296	"Revision and removal of prosthetic vaginal graft, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57296	"Revision and removal of prosthetic vaginal graft, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57300	Closure of abnormal drainage tract from rectum into vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57300	Closure of abnormal drainage tract from rectum into vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57300	Closure of abnormal drainage tract from rectum into vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
57305	Closure of abnormal drainage tract from rectum into vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57305	Closure of abnormal drainage tract from rectum into vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57305	Closure of abnormal drainage tract from rectum into vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
57307	"Closure of abnormal drainage tract from rectum into vagina with creation of large bowel opening, open abdominal procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57307	"Closure of abnormal drainage tract from rectum into vagina with creation of large bowel opening, open abdominal procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57307	"Closure of abnormal drainage tract from rectum into vagina with creation of large bowel opening, open abdominal procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
57308	Closure through skin of abnormal drainage tract from rectum into vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57308	Closure through skin of abnormal drainage tract from rectum into vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57308	Closure through skin of abnormal drainage tract from rectum into vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
57310	Closure of abnormal drainage tract from urinary canal (urethra) into vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57310	Closure of abnormal drainage tract from urinary canal (urethra) into vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57310	Closure of abnormal drainage tract from urinary canal (urethra) into vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57311	Closure of abnormal drainage tract from urinary canal (urethra) into vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57311	Closure of abnormal drainage tract from urinary canal (urethra) into vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57311	Closure of abnormal drainage tract from urinary canal (urethra) into vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57320	Closure of abnormal drainage tract from rectum into vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57320	Closure of abnormal drainage tract from rectum into vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57320	Closure of abnormal drainage tract from rectum into vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57330	Closure of abnormal drainage tract from rectum into vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57330	Closure of abnormal drainage tract from rectum into vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57330	Closure of abnormal drainage tract from rectum into vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57335	Plastic repair of vagina for intersex state	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57335	Plastic repair of vagina for intersex state	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57335	Plastic repair of vagina for intersex state	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
57400	Dilation of vagina under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
57410	Pelvic examination under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
57410	Pelvic examination under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
57415	Removal of impacted vaginal foreign body under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
57415	Removal of impacted vaginal foreign body under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
57415	Removal of impacted vaginal foreign body under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
57420	Examination of the vagina using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	11	
57420	Examination of the vagina using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	0	
57421	Biopsy of vagina and cervix using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	11	
57421	Biopsy of vagina and cervix using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
57423	Vaginal defect repair using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57423	Vaginal defect repair using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57423	Vaginal defect repair using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
57425	Vaginal defect repair using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57425	Vaginal defect repair using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57425	Vaginal defect repair using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57426	Revision or removal of prosthetic vaginal graft using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57426	Revision or removal of prosthetic vaginal graft using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57426	Revision or removal of prosthetic vaginal graft using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
57452	Examination of the vagina and cervix using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
57452	Examination of the vagina and cervix using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
57454	Biopsy and scraping of the cervix using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
57454	Biopsy and scraping of the cervix using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
57455	Biopsy of cervix using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	11	
57455	Biopsy of cervix using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
57456	Scraping of the cervix using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	11	
57456	Scraping of the cervix using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
57460	Biopsy of cervix using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
57460	Biopsy of cervix using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	74	0	
57461	Cone biopsy of the cervix and vagina using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	11	
57461	Cone biopsy of the cervix and vagina using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	74	0	
57500	Biopsy of cervix or excision of local growths	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
57500	Biopsy of cervix or excision of local growths	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	0	
57505	Scraping of tissue of cervix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
57505	Scraping of tissue of cervix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	19	6	
57505	Scraping of tissue of cervix	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
57510	Electro or thermal destruction of cervix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
57510	Electro or thermal destruction of cervix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	6	
57511	Freezing destruction of cervix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
57511	Freezing destruction of cervix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25	6	
57511	Freezing destruction of cervix	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
57513	Laser destruction of cervix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
57513	Laser destruction of cervix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	29	6	
57513	Laser destruction of cervix	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
57520	Removal or destruction of cervix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
57520	Removal or destruction of cervix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	6	
57520	Removal or destruction of cervix	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	41	41	
57522	Removal or destruction of cervix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
57522	Removal or destruction of cervix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	6	
57522	Removal or destruction of cervix	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
57530	Removal of cervix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57530	Removal of cervix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57530	Removal of cervix	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
57531	Removal of cervix with removal of lymph nodes on both sides of pelvis and aortic lymph node biopsy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57531	Removal of cervix with removal of lymph nodes on both sides of pelvis and aortic lymph node biopsy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57531	Removal of cervix with removal of lymph nodes on both sides of pelvis and aortic lymph node biopsy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
57540	Removal of remaining cervix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57540	Removal of remaining cervix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57540	Removal of remaining cervix	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57545	Removal of remaining cervix with plastic repair of pelvic floor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57545	Removal of remaining cervix with plastic repair of pelvic floor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57545	Removal of remaining cervix with plastic repair of pelvic floor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57550	Removal of remaining cervix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57550	Removal of remaining cervix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57550	Removal of remaining cervix	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57555	Removal of remaining cervix with repair of supporting vaginal tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57555	Removal of remaining cervix with repair of supporting vaginal tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57555	Removal of remaining cervix with repair of supporting vaginal tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57556	Removal of remaining cervix with repair of herniated bowel into vaginal wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57556	Removal of remaining cervix with repair of herniated bowel into vaginal wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57556	Removal of remaining cervix with repair of herniated bowel into vaginal wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
57558	Dilation and scraping of cervix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	16	
57558	Dilation and scraping of cervix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25	6	
57558	Dilation and scraping of cervix	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
57700	Placement of suture of cervix (nonobstetrical)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57700	Placement of suture of cervix (nonobstetrical)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57700	Placement of suture of cervix (nonobstetrical)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
57720	Plastic repair of cervix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
57720	Plastic repair of cervix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
57720	Plastic repair of cervix	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
57800	Dilation of tissue at uterine opening (cervix)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	16	
57800	Dilation of tissue at uterine opening (cervix)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	22	0	
57800	Dilation of tissue at uterine opening (cervix)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
58100	Biopsy of uterine lining	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	15	
58100	Biopsy of uterine lining	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	0	
58110	Examination of cervix using an endoscope with biopsy of uterine lining	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	6	0	
58120	D&C for diagnosis and/or therapy (non-obstetrical)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	16	
58120	D&C for diagnosis and/or therapy (non-obstetrical)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	6	
58120	D&C for diagnosis and/or therapy (non-obstetrical)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
58140	Abdominal removal of fibroid tumors (250 grams or less) of uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58140	Abdominal removal of fibroid tumors (250 grams or less) of uterus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58140	Abdominal removal of fibroid tumors (250 grams or less) of uterus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58145	Vaginal removal of fibroid tumors (250 grams or less) of uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58145	Vaginal removal of fibroid tumors (250 grams or less) of uterus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58145	Vaginal removal of fibroid tumors (250 grams or less) of uterus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58146	Abdominal removal of fibroid tumors (greater than 250 grams) of uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58146	Abdominal removal of fibroid tumors (greater than 250 grams) of uterus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58146	Abdominal removal of fibroid tumors (greater than 250 grams) of uterus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58150	Abdominal removal of uterus and cervix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58150	Abdominal removal of uterus and cervix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58150	Abdominal removal of uterus and cervix	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58152	Abdominal removal of uterus and cervix with repair of vaginal defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58152	Abdominal removal of uterus and cervix with repair of vaginal defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58152	Abdominal removal of uterus and cervix with repair of vaginal defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
58180	Abdominal removal of uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58180	Abdominal removal of uterus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58180	Abdominal removal of uterus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58200	Abdominal removal of uterus and partial removal of vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58200	Abdominal removal of uterus and partial removal of vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58200	Abdominal removal of uterus and partial removal of vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58210	"Abdominal removal of uterus, cervix, and lymph nodes on both sides of pelvis and aortic lymph node biopsy"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58210	"Abdominal removal of uterus, cervix, and lymph nodes on both sides of pelvis and aortic lymph node biopsy"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58210	"Abdominal removal of uterus, cervix, and lymph nodes on both sides of pelvis and aortic lymph node biopsy"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
58240	"Removal of malignant uterus, cervix, lymph nodes, bladder, with transplantation of urinary ducts (ureters), and bowel"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58240	"Removal of malignant uterus, cervix, lymph nodes, bladder, with transplantation of urinary ducts (ureters), and bowel"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58240	"Removal of malignant uterus, cervix, lymph nodes, bladder, with transplantation of urinary ducts (ureters), and bowel"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		224	
58260	Vaginal removal of uterus (250 grams or less)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58260	Vaginal removal of uterus (250 grams or less)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58260	Vaginal removal of uterus (250 grams or less)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		89	
58262	"Vaginal removal of uterus (250 grams or less), tubes, and/or ovaries"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58262	"Vaginal removal of uterus (250 grams or less), tubes, and/or ovaries"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58262	"Vaginal removal of uterus (250 grams or less), tubes, and/or ovaries"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		89	
58263	"Vaginal removal of uterus (250 grams or less), tubes, and/or ovaries with repair of herniated bowel"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58263	"Vaginal removal of uterus (250 grams or less), tubes, and/or ovaries with repair of herniated bowel"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58263	"Vaginal removal of uterus (250 grams or less), tubes, and/or ovaries with repair of herniated bowel"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		89	
58267	Vaginal removal of uterus (250 grams or less) with repair for stress incontinence	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58267	Vaginal removal of uterus (250 grams or less) with repair for stress incontinence	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58267	Vaginal removal of uterus (250 grams or less) with repair for stress incontinence	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
58270	Vaginal removal of uterus (250 grams or less) with repair of herniated bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58270	Vaginal removal of uterus (250 grams or less) with repair of herniated bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58270	Vaginal removal of uterus (250 grams or less) with repair of herniated bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58275	Vaginal removal of uterus and vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58275	Vaginal removal of uterus and vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58275	Vaginal removal of uterus and vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
58280	Vaginal removal of uterus and vagina with repair of herniated bowel into rectum or vagina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58280	Vaginal removal of uterus and vagina with repair of herniated bowel into rectum or vagina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58280	Vaginal removal of uterus and vagina with repair of herniated bowel into rectum or vagina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
58285	"Vaginal removal of uterus, vagina, and pelvic lymph nodes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58285	"Vaginal removal of uterus, vagina, and pelvic lymph nodes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58285	"Vaginal removal of uterus, vagina, and pelvic lymph nodes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
58290	Vaginal removal of uterus (greater than 250 grams)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58290	Vaginal removal of uterus (greater than 250 grams)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58290	Vaginal removal of uterus (greater than 250 grams)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58291	"Vaginal removal of uterus (greater than 250 grams), tubes, and/or ovaries"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58291	"Vaginal removal of uterus (greater than 250 grams), tubes, and/or ovaries"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58291	"Vaginal removal of uterus (greater than 250 grams), tubes, and/or ovaries"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58292	"Vaginal removal of uterus (greater than 250 grams), tubes, and/or ovaries with repair of herniated bowel"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58292	"Vaginal removal of uterus (greater than 250 grams), tubes, and/or ovaries with repair of herniated bowel"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58292	"Vaginal removal of uterus (greater than 250 grams), tubes, and/or ovaries with repair of herniated bowel"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58293	Vaginal removal of uterus (greater than 250 grams) with repair for stress incontinence	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58293	Vaginal removal of uterus (greater than 250 grams) with repair for stress incontinence	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58293	Vaginal removal of uterus (greater than 250 grams) with repair for stress incontinence	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58294	Vaginal removal of uterus (greater than 250 grams) with repair of herniated bowel	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58294	Vaginal removal of uterus (greater than 250 grams) with repair of herniated bowel	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58294	Vaginal removal of uterus (greater than 250 grams) with repair of herniated bowel	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58300	Placement of intra-uterine device (IUD) for pregnancy prevention	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	0	
58300	Placement of intra-uterine device (IUD) for pregnancy prevention	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	24	0	
58301	Removal of intra-uterine device (IUD) for pregnancy prevention	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	0	
58301	Removal of intra-uterine device (IUD) for pregnancy prevention	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	22	0	
58321	Injection of semen into cervix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	0	
58321	Injection of semen into cervix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	0	
58322	Injection of semen into uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	0	
58322	Injection of semen into uterus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	0	
58323	Sperm washing for artificial insemination	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	3	0	
58340	Introduction of saline or X-ray contrast material for X-ray imaging of the uterus and tubes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
58340	Introduction of saline or X-ray contrast material for X-ray imaging of the uterus and tubes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	0	
58345	Insertion of catheter through the cervix into fallopian tube	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
58345	Insertion of catheter through the cervix into fallopian tube	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58345	Insertion of catheter through the cervix into fallopian tube	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
58346	Insertion of capsules into uterus for placement of radiation therapy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58346	Insertion of capsules into uterus for placement of radiation therapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58346	Insertion of capsules into uterus for placement of radiation therapy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
58350	Injection of saline or X-ray contrast material into tubes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	15	
58350	Injection of saline or X-ray contrast material into tubes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	6	
58350	Injection of saline or X-ray contrast material into tubes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
58353	Destruction of lining of uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	27	
58353	Destruction of lining of uterus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	6	
58353	Destruction of lining of uterus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
58356	Destruction of lining of uterus using ultrasound guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	0	
58356	Destruction of lining of uterus using ultrasound guidance	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	45	0	
58356	Destruction of lining of uterus using ultrasound guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	78	0	
58356	Destruction of lining of uterus using ultrasound guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	0	
58400	Anatomic repositioning of uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58400	Anatomic repositioning of uterus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58400	Anatomic repositioning of uterus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
58410	Anatomic repositioning of uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58410	Anatomic repositioning of uterus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58410	Anatomic repositioning of uterus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58520	Repair of ruptured uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58520	Repair of ruptured uterus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58520	Repair of ruptured uterus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58540	Repair of abnormally developed uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58540	Repair of abnormally developed uterus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58540	Repair of abnormally developed uterus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58541	"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
58541	"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
58541	"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
58541	"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
58541	"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
58541	"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
58541	"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
58542	"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
58542	"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
58542	"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
58542	"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
58542	"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
58542	"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
58542	"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
58543	"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
58543	"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
58543	"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
58543	"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
58543	"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
58543	"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
58543	"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
58544	"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
58544	"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
58544	"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
58544	"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
58544	"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
58544	"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
58544	"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
58545	Removal of uterine fibroid tumors (250 grams or less) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58545	Removal of uterine fibroid tumors (250 grams or less) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58545	Removal of uterine fibroid tumors (250 grams or less) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58546	Removal of uterine fibroid tumors (greater than 250 grams) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58546	Removal of uterine fibroid tumors (greater than 250 grams) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58546	Removal of uterine fibroid tumors (greater than 250 grams) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58548	"Removal of uterus, cervix, and lymph nodes on both sides of pelvis and aortic lymph node biopsy using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58548	"Removal of uterus, cervix, and lymph nodes on both sides of pelvis and aortic lymph node biopsy using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58548	"Removal of uterus, cervix, and lymph nodes on both sides of pelvis and aortic lymph node biopsy using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
58550	Vaginal removal of uterus (250 grams or less) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58550	Vaginal removal of uterus (250 grams or less) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58550	Vaginal removal of uterus (250 grams or less) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
58552	"Vaginal removal of uterus (250 grams or less), tubes, and/or ovaries using an endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58552	"Vaginal removal of uterus (250 grams or less), tubes, and/or ovaries using an endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58552	"Vaginal removal of uterus (250 grams or less), tubes, and/or ovaries using an endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
58553	Vaginal removal of uterus (greater than 250 grams) using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58553	Vaginal removal of uterus (greater than 250 grams) using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58553	Vaginal removal of uterus (greater than 250 grams) using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58554	"Vaginal removal of uterus (greater than 250 grams), tubes, and/or ovaries with assistance of endoscope"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58554	"Vaginal removal of uterus (greater than 250 grams), tubes, and/or ovaries with assistance of endoscope"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58554	"Vaginal removal of uterus (greater than 250 grams), tubes, and/or ovaries with assistance of endoscope"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
58555	Diagnostic examination of uterus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
58555	Diagnostic examination of uterus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	0	
58555	Diagnostic examination of uterus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
58558	Biopsy and/or removal of polyp of the uterus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
58558	Biopsy and/or removal of polyp of the uterus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	0	
58558	Biopsy and/or removal of polyp of the uterus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
58559	Release of uterine adhesions using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
58559	Release of uterine adhesions using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
58560	Release of uterine adhesions and abnormal partition using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
58560	Release of uterine adhesions and abnormal partition using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
58561	Removal of uterine muscle tumor using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
58561	Removal of uterine muscle tumor using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
58562	Removal of foreign body in uterus using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
58562	Removal of foreign body in uterus using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	0	
58562	Removal of foreign body in uterus using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
58563	Examination of uterus with destruction of uterine lining using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
58563	Examination of uterus with destruction of uterine lining using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	54	0	
58563	Examination of uterus with destruction of uterine lining using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
58565	Insertion of implants to block both fallopian tubes using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
58565	Insertion of implants to block both fallopian tubes using an endoscope	Service  intra	L042A	RN/LPN	0.42	Service total costs	33	0	
58565	Insertion of implants to block both fallopian tubes using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	85	6	
58565	Insertion of implants to block both fallopian tubes using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
58570	"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
58570	"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
58570	"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
58570	"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
58570	"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
58570	"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
58570	"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
58571	"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
58571	"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
58571	"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
58571	"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
58571	"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
58571	"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
58571	"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
58572	"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
58572	"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
58572	"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
58572	"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
58572	"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
58572	"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
58572	"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
58573	"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
58573	"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
58573	"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
58573	"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
58573	"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
58573	"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		6	
58573	"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		72	
58600	Tying or incision fallopian tubes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58600	Tying or incision fallopian tubes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58600	Tying or incision fallopian tubes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
58605	Tying or incision of fallopian tubes during same hospitalization	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58605	Tying or incision of fallopian tubes during same hospitalization	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58605	Tying or incision of fallopian tubes during same hospitalization	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
58615	Vaginal or pubic tying of uterine tubes by device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
58615	Vaginal or pubic tying of uterine tubes by device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58615	Vaginal or pubic tying of uterine tubes by device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
58660	Removal of scar tissue of ovaries or uterine tubes using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58660	Removal of scar tissue of ovaries or uterine tubes using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58660	Removal of scar tissue of ovaries or uterine tubes using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
58661	Removal of ovaries and/or tubes using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
58661	Removal of ovaries and/or tubes using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58661	Removal of ovaries and/or tubes using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
58662	Destruction or removal of ovary or pelvic growths using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58662	Destruction or removal of ovary or pelvic growths using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58662	Destruction or removal of ovary or pelvic growths using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		45	
58670	Destruction of ovaries using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58670	Destruction of ovaries using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58670	Destruction of ovaries using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
58671	Blocking of uterine tubes by device using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58671	Blocking of uterine tubes by device using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58671	Blocking of uterine tubes by device using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
58672	Repair of uterine tube tissue near the ovary using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58672	Repair of uterine tube tissue near the ovary using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58672	Repair of uterine tube tissue near the ovary using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
58673	Repair of uterine tube using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58673	Repair of uterine tube using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58673	Repair of uterine tube using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
58700	Removal of the uterine tubes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58700	Removal of the uterine tubes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58700	Removal of the uterine tubes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		80	
58720	Removal of uterine tubes and ovaries	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58720	Removal of uterine tubes and ovaries	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58720	Removal of uterine tubes and ovaries	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
58740	Removal of scar tissue of ovaries or uterine tubes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58740	Removal of scar tissue of ovaries or uterine tubes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58740	Removal of scar tissue of ovaries or uterine tubes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		80	
58750	Release of blocked uterine tube	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58750	Release of blocked uterine tube	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58750	Release of blocked uterine tube	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
58752	Partial removal of blocked uterine tube	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58752	Partial removal of blocked uterine tube	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58752	Partial removal of blocked uterine tube	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
58760	Repair of blocked ovarian end of uterine tube	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58760	Repair of blocked ovarian end of uterine tube	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58760	Repair of blocked ovarian end of uterine tube	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
58770	Opening of blocked uterine tube	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58770	Opening of blocked uterine tube	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
58770	Opening of blocked uterine tube	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
58800	Vaginal drainage of ovarian cysts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
58800	Vaginal drainage of ovarian cysts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	39	6	
58800	Vaginal drainage of ovarian cysts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	41	41	
58805	Abdominal drainage of ovarian cysts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58805	Abdominal drainage of ovarian cysts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58805	Abdominal drainage of ovarian cysts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
58820	"Vaginal drainage of ovarian abscess, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58820	"Vaginal drainage of ovarian abscess, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58820	"Vaginal drainage of ovarian abscess, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
58822	Abdominal drainage of ovarian abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58822	Abdominal drainage of ovarian abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58822	Abdominal drainage of ovarian abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58825	Relocation of ovaries behind uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58825	Relocation of ovaries behind uterus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58825	Relocation of ovaries behind uterus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
58900	Vaginal or abdominal biopsy of ovaries	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58900	Vaginal or abdominal biopsy of ovaries	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58900	Vaginal or abdominal biopsy of ovaries	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
58920	Vaginal or abdominal tissue wedge removal of ovaries	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58920	Vaginal or abdominal tissue wedge removal of ovaries	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58920	Vaginal or abdominal tissue wedge removal of ovaries	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
58925	Removal of ovaries	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58925	Removal of ovaries	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58925	Removal of ovaries	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58940	Removal of ovaries	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58940	Removal of ovaries	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58940	Removal of ovaries	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58943	Removal of ovaries	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58943	Removal of ovaries	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58943	Removal of ovaries	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
58950	Removal of abdominal lining and both ovaries and fallopian tubes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58950	Removal of abdominal lining and both ovaries and fallopian tubes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58950	Removal of abdominal lining and both ovaries and fallopian tubes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
58951	"Removal of abdominal lining, uterus, both ovaries and fallopian tubes, and pelvic and aortic lymph nodes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58951	"Removal of abdominal lining, uterus, both ovaries and fallopian tubes, and pelvic and aortic lymph nodes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58951	"Removal of abdominal lining, uterus, both ovaries and fallopian tubes, and pelvic and aortic lymph nodes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		80	
58952	Removal of abdominal lining and both ovaries and fallopian tubes with tumor reduction	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58952	Removal of abdominal lining and both ovaries and fallopian tubes with tumor reduction	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58952	Removal of abdominal lining and both ovaries and fallopian tubes with tumor reduction	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		107	
58953	"Removal of abdominal lining, uterus, both ovaries and fallopian tubes with tumor reduction"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58953	"Removal of abdominal lining, uterus, both ovaries and fallopian tubes with tumor reduction"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58953	"Removal of abdominal lining, uterus, both ovaries and fallopian tubes with tumor reduction"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
58954	"Removal of abdominal lining, uterus, both ovaries and fallopian tubes, and pelvic and aortic lymph nodes with tumor reduction"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58954	"Removal of abdominal lining, uterus, both ovaries and fallopian tubes, and pelvic and aortic lymph nodes with tumor reduction"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58954	"Removal of abdominal lining, uterus, both ovaries and fallopian tubes, and pelvic and aortic lymph nodes with tumor reduction"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
58956	"Removal of abdominal lining, uterus, and both ovaries and fallopian tubes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58956	"Removal of abdominal lining, uterus, and both ovaries and fallopian tubes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58956	"Removal of abdominal lining, uterus, and both ovaries and fallopian tubes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
58957	"Removal of tubes, ovaries, uterus, and lymph nodes for uterine malignancy"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58957	"Removal of tubes, ovaries, uterus, and lymph nodes for uterine malignancy"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58957	"Removal of tubes, ovaries, uterus, and lymph nodes for uterine malignancy"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
58958	"Removal of tubes, ovaries, uterus, and lymph nodes for uterine malignancy"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58958	"Removal of tubes, ovaries, uterus, and lymph nodes for uterine malignancy"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58958	"Removal of tubes, ovaries, uterus, and lymph nodes for uterine malignancy"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
58960	Examination of abdominal cavity with removal or biopsy of abdominal lining or lymph nodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
58960	Examination of abdominal cavity with removal or biopsy of abdominal lining or lymph nodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
58960	Examination of abdominal cavity with removal or biopsy of abdominal lining or lymph nodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		80	
58970	Abdominal or endoscopic aspiration of eggs from ovaries	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
58970	Abdominal or endoscopic aspiration of eggs from ovaries	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
58970	Abdominal or endoscopic aspiration of eggs from ovaries	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
58976	Abdominal or endoscopic insertion of eggs with sperm into tubes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
58976	Abdominal or endoscopic insertion of eggs with sperm into tubes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	0	
58976	Abdominal or endoscopic insertion of eggs with sperm into tubes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
59000	Abdominal aspiration of fluid surrounding fetus for diagnosis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	15	
59000	Abdominal aspiration of fluid surrounding fetus for diagnosis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	0	
59000	Abdominal aspiration of fluid surrounding fetus for diagnosis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
59001	Abdominal aspiration to reduce amount of fluid surrounding fetus using ultrasound guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		20	
59001	Abdominal aspiration to reduce amount of fluid surrounding fetus using ultrasound guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
59012	Aspiration of blood from fetal umbilical cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
59012	Aspiration of blood from fetal umbilical cord	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
59015	Removal of tissue from placenta for diagnosis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	15	
59015	Removal of tissue from placenta for diagnosis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	0	
59015	Removal of tissue from placenta for diagnosis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
59020	Fetal contraction stress test	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16		
59020	Fetal contraction stress test	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	32		
59025	Fetal non-stress test	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8		
59025	Fetal non-stress test	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	19		
59070	Abdominal infusion of normal saline into fetal amniotic sac using ultrasound guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
59070	Abdominal infusion of normal saline into fetal amniotic sac using ultrasound guidance	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	30	0	
59070	Abdominal infusion of normal saline into fetal amniotic sac using ultrasound guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	0	
59070	Abdominal infusion of normal saline into fetal amniotic sac using ultrasound guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
59072	Fetal umbilical cord occlusion using ultrasound guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
59072	Fetal umbilical cord occlusion using ultrasound guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
59074	Aspiration of fetal fluid using ultrasound guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
59074	Aspiration of fetal fluid using ultrasound guidance	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	30	0	
59074	Aspiration of fetal fluid using ultrasound guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	0	
59074	Aspiration of fetal fluid using ultrasound guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
59076	Insertion of drainage catheter into fetal chest using ultrasound guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
59076	Insertion of drainage catheter into fetal chest using ultrasound guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
59100	Incision in uterus via abdomen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59100	Incision in uterus via abdomen	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
59100	Incision in uterus via abdomen	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		80	
59120	Removal of ovarian or tubal pregnancy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59120	Removal of ovarian or tubal pregnancy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
59120	Removal of ovarian or tubal pregnancy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		80	
59121	Removal of ovarian or tubal pregnancy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59121	Removal of ovarian or tubal pregnancy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
59121	Removal of ovarian or tubal pregnancy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
59130	Removal of pregnancy contents implanted in abdominal cavity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59130	Removal of pregnancy contents implanted in abdominal cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
59130	Removal of pregnancy contents implanted in abdominal cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
59135	Removal impregnated ovum outside the uterus and entire uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59135	Removal impregnated ovum outside the uterus and entire uterus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59135	Removal impregnated ovum outside the uterus and entire uterus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
59136	Removal of tubal pregnancy and repair of uterine wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59136	Removal of tubal pregnancy and repair of uterine wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59136	Removal of tubal pregnancy and repair of uterine wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
59140	Cervical removal impregnated ovum outside the uterus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59140	Cervical removal impregnated ovum outside the uterus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
59140	Cervical removal impregnated ovum outside the uterus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		41	
59150	Removal of ovarian or tubal pregnancy using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59150	Removal of ovarian or tubal pregnancy using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
59150	Removal of ovarian or tubal pregnancy using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
59151	Removal of ovarian or tubal pregnancy including removal of the ovary and/or tube using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59151	Removal of ovarian or tubal pregnancy including removal of the ovary and/or tube using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
59151	Removal of ovarian or tubal pregnancy including removal of the ovary and/or tube using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		56	
59160	Scraping of lining of uterus post-delivery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	6	
59160	Scraping of lining of uterus post-delivery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
59200	Insertion dilator device into cervix	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	7	0	
59200	Insertion dilator device into cervix	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	19	0	
59300	Episiotomy or vaginal repair	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	13	30	
59300	Episiotomy or vaginal repair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	0	
59320	Vaginal suture of cervix during pregnancy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
59325	Abdominal suture of cervix during pregnancy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
59400	Obstetrical pre- and postpartum care and vaginal delivery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		492	
59400	Obstetrical pre- and postpartum care and vaginal delivery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59400	Obstetrical pre- and postpartum care and vaginal delivery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		53	
59409	Vaginal delivery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59410	Vaginal delivery with post-delivery care	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59410	Vaginal delivery with post-delivery care	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
59412	Turning of fetus from breech to presenting position	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		16	
59425	Predelivery care 4-6 visits	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	206	0	
59426	Predelivery care 7 or more visits	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	386	0	
59430	Post-delivery care	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	89	0	
59510	Cesarian delivery with pre- and post-delivery care	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		492	
59510	Cesarian delivery with pre- and post-delivery care	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59510	Cesarian delivery with pre- and post-delivery care	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		89	
59514	Cesarean delivery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59515	Cesarean delivery with post-delivery care	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59515	Cesarean delivery with post-delivery care	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
59610	Vaginal delivery after prior cesarean delivery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		509	
59610	Vaginal delivery after prior cesarean delivery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59610	Vaginal delivery after prior cesarean delivery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
59614	Vaginal delivery after prior cesarean delivery with post-delivery care	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59614	Vaginal delivery after prior cesarean delivery with post-delivery care	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
59618	Routine obstetric care following attempted vaginal delivery after previous cesarean delivery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		482	
59618	Routine obstetric care following attempted vaginal delivery after previous cesarean delivery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59618	Routine obstetric care following attempted vaginal delivery after previous cesarean delivery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
59622	Cesarean delivery after vaginal delivery attempt due to prior cesarean delivery with post-delivery care	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59622	Cesarean delivery after vaginal delivery attempt due to prior cesarean delivery with post-delivery care	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
59812	Treatment of incomplete abortion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	45	
59812	Treatment of incomplete abortion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	6	
59812	Treatment of incomplete abortion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
59820	Treatment of first trimester missed abortion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
59820	Treatment of first trimester missed abortion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	6	
59820	Treatment of first trimester missed abortion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	106	106	
59821	Treatment of second trimester missed abortion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
59821	Treatment of second trimester missed abortion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	6	
59821	Treatment of second trimester missed abortion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	80	80	
59830	Treatment of septic abortion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59830	Treatment of septic abortion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
59830	Treatment of septic abortion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
59840	Induced abortion by dilation and uterine scraping	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
59840	Induced abortion by dilation and uterine scraping	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	32	6	
59840	Induced abortion by dilation and uterine scraping	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
59841	Induced abortion by dilation and removal of pregnancy contents	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
59841	Induced abortion by dilation and removal of pregnancy contents	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	6	
59841	Induced abortion by dilation and removal of pregnancy contents	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	53	53	
59850	Induced abortion by amniotic fluid injections with delivery of fetus and placenta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59850	Induced abortion by amniotic fluid injections with delivery of fetus and placenta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59850	Induced abortion by amniotic fluid injections with delivery of fetus and placenta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
59851	Induced abortion by amniotic fluid injections with delivery of fetus and placenta	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59851	Induced abortion by amniotic fluid injections with delivery of fetus and placenta	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59851	Induced abortion by amniotic fluid injections with delivery of fetus and placenta	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
59852	Induced abortion by amniotic fluid injections	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59852	Induced abortion by amniotic fluid injections	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59852	Induced abortion by amniotic fluid injections	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
59855	Induced abortion by insertion of vaginal suppositories	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59855	Induced abortion by insertion of vaginal suppositories	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59855	Induced abortion by insertion of vaginal suppositories	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
59856	Induced abortion by insertion of vaginal suppositories	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59856	Induced abortion by insertion of vaginal suppositories	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59856	Induced abortion by insertion of vaginal suppositories	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
59857	Induced abortion by insertion of vaginal suppositories	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59857	Induced abortion by insertion of vaginal suppositories	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59857	Induced abortion by insertion of vaginal suppositories	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
59866	Elimination 1 or more fetuses of a multifetal pregnancy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
59866	Elimination 1 or more fetuses of a multifetal pregnancy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
59870	Aspiration of abnormal pregnancy contents with scraping of uterine wall	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
59870	Aspiration of abnormal pregnancy contents with scraping of uterine wall	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
59870	Aspiration of abnormal pregnancy contents with scraping of uterine wall	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		134	
59871	Removal of suture of cervix under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
59871	Removal of suture of cervix under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
60000	Incision and drainage of infected thyroid duct cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	60	
60000	Incision and drainage of infected thyroid duct cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	6	
60000	Incision and drainage of infected thyroid duct cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
60100	"Needle biopsy of thyroid, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2	0	
60100	"Needle biopsy of thyroid, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	0	
60200	Incision of thyroid cyst or growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60200	Incision of thyroid cyst or growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60200	Incision of thyroid cyst or growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
60210	Partial removal of thyroid lobe on one side of the neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60210	Partial removal of thyroid lobe on one side of the neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60210	Partial removal of thyroid lobe on one side of the neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
60212	Partial removal of thyroid lobe on one side of the neck plus the same operation on the opposite side of the neck including the tissue in between	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60212	Partial removal of thyroid lobe on one side of the neck plus the same operation on the opposite side of the neck including the tissue in between	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60212	Partial removal of thyroid lobe on one side of the neck plus the same operation on the opposite side of the neck including the tissue in between	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
60220	Total removal of thyroid lobe on one side of the neck	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60220	Total removal of thyroid lobe on one side of the neck	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
60220	Total removal of thyroid lobe on one side of the neck	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
60225	Total removal of thyroid lobe on one side of the neck plus partial removal of thyroid lobe on the opposite side of the neck including the tissue in between	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60225	Total removal of thyroid lobe on one side of the neck plus partial removal of thyroid lobe on the opposite side of the neck including the tissue in between	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60225	Total removal of thyroid lobe on one side of the neck plus partial removal of thyroid lobe on the opposite side of the neck including the tissue in between	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
60240	Removal of thyroid	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60240	Removal of thyroid	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
60240	Removal of thyroid	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
60252	Removal of thyroid and surrounding lymph nodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60252	Removal of thyroid and surrounding lymph nodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60252	Removal of thyroid and surrounding lymph nodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
60254	Removal of thyroid and surrounding lymph nodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60254	Removal of thyroid and surrounding lymph nodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60254	Removal of thyroid and surrounding lymph nodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
60260	Removal of remaining thyroid tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60260	Removal of remaining thyroid tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60260	Removal of remaining thyroid tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
60270	Removal of thyroid	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60270	Removal of thyroid	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60270	Removal of thyroid	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
60271	Removal of thyroid	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60271	Removal of thyroid	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60271	Removal of thyroid	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
60280	Removal of thyroid cyst or drainage of thyroid gland duct	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60280	Removal of thyroid cyst or drainage of thyroid gland duct	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
60280	Removal of thyroid cyst or drainage of thyroid gland duct	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
60281	Removal of cyst or thyroid gland drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60281	Removal of cyst or thyroid gland drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
60281	Removal of cyst or thyroid gland drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
60300	Aspiration and/or injection of thyroid cyst	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	30	0	
60500	Removal or exploration of parathyroid glands	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60500	Removal or exploration of parathyroid glands	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
60500	Removal or exploration of parathyroid glands	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
60502	Removal or re-exploration of parathyroid glands	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60502	Removal or re-exploration of parathyroid glands	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60502	Removal or re-exploration of parathyroid glands	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
60505	Excision or exploration of parathyroid glands and breast bone tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60505	Excision or exploration of parathyroid glands and breast bone tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60505	Excision or exploration of parathyroid glands and breast bone tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
60520	Removal of thymus gland through neck incision	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60520	Removal of thymus gland through neck incision	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60520	Removal of thymus gland through neck incision	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		79	
60521	"Removal of thymus gland, sternal or chest approach"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
60521	"Removal of thymus gland, sternal or chest approach"	Service  intra	L051A	RN	0.51	Service total costs		12	
60521	"Removal of thymus gland, sternal or chest approach"	Post-service	L051A	RN	0.51	Post service total costs		68	
60522	"Removal of thymus gland surrounding lymph nodes, sternal or chest approach"	Pre-service	L051A	RN	0.51	Preservice total costs		60	
60522	"Removal of thymus gland surrounding lymph nodes, sternal or chest approach"	Service  intra	L051A	RN	0.51	Service total costs		12	
60522	"Removal of thymus gland surrounding lymph nodes, sternal or chest approach"	Post-service	L051A	RN	0.51	Post service total costs		90	
60540	Abdominal exploration or removal of adrenal gland	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60540	Abdominal exploration or removal of adrenal gland	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60540	Abdominal exploration or removal of adrenal gland	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
60545	Abdominal exploration or removal of adrenal gland with removal of abdominal growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60545	Abdominal exploration or removal of adrenal gland with removal of abdominal growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60545	Abdominal exploration or removal of adrenal gland with removal of abdominal growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
60600	Removal of carotid artery tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60600	Removal of carotid artery tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60600	Removal of carotid artery tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
60605	Removal of carotid artery and tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60605	Removal of carotid artery and tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60605	Removal of carotid artery and tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
60650	Abdominal exploration or removal of adrenal gland using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
60650	Abdominal exploration or removal of adrenal gland using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
60650	Abdominal exploration or removal of adrenal gland using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61000	Aspiration of spinal fluid from infant skull soft spot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
61001	Aspiration of spinal fluid from infant skull soft spot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
61020	"Aspiration of spinal fluid for diagnosis from skull soft spot, burr hole, or catheter in brain"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
61026	"Aspiration of spinal fluid and injection into skull soft spot, burr hole, or catheter in ventricle of brain"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
61050	Aspiration of fluid by spinal puncture in upper spine	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
61055	Spinal puncture in upper spine with injection of substance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
61070	Aspiration or injection of cerebrospinal fluid shunt tubing or reservoir	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
61105	Aspiration of fluid from brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61105	Aspiration of fluid from brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61105	Aspiration of fluid from brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
61108	Aspiration and/or drainage of blood accumulation in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61108	Aspiration and/or drainage of blood accumulation in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61108	Aspiration and/or drainage of blood accumulation in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61120	Injection into ventricle of brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61120	Injection into ventricle of brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61120	Injection into ventricle of brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
61140	Drainage or biopsy of brain or lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61140	Drainage or biopsy of brain or lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61140	Drainage or biopsy of brain or lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61150	Drainage of brain abscess or cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61150	Drainage of brain abscess or cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61150	Drainage of brain abscess or cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61151	Drainage or aspiration of brain abscess or cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61151	Drainage or aspiration of brain abscess or cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61151	Drainage or aspiration of brain abscess or cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
61154	Aspiration of blood accumulation in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61154	Aspiration of blood accumulation in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61154	Aspiration of blood accumulation in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
61156	Aspiration of blood accumulation or cyst in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61156	Aspiration of blood accumulation or cyst in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61156	Aspiration of blood accumulation or cyst in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
61215	Insertion of device beneath the skin for continuous infusion in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61215	Insertion of device beneath the skin for continuous infusion in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61215	Insertion of device beneath the skin for continuous infusion in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
61250	Burr hole exploration of the brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61250	Burr hole exploration of the brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61250	Burr hole exploration of the brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
61253	Burr hole exploration of the brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61253	Burr hole exploration of the brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61253	Burr hole exploration of the brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
61304	Exploration of the brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61304	Exploration of the brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61304	Exploration of the brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61305	Exploration of the brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61305	Exploration of the brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61305	Exploration of the brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61312	Aspiration of blood accumulation in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61312	Aspiration of blood accumulation in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61312	Aspiration of blood accumulation in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61313	Aspiration of blood accumulation in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61313	Aspiration of blood accumulation in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61313	Aspiration of blood accumulation in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
61314	Aspiration of blood accumulation in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61314	Aspiration of blood accumulation in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61314	Aspiration of blood accumulation in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61315	Aspiration of blood accumulation in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61315	Aspiration of blood accumulation in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61315	Aspiration of blood accumulation in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61320	Drainage of brain abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61320	Drainage of brain abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61320	Drainage of brain abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61321	Drainage of brain abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61321	Drainage of brain abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61321	Drainage of brain abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61322	Incision or excision of skull to reduce brain pressure	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61322	Incision or excision of skull to reduce brain pressure	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
61322	Incision or excision of skull to reduce brain pressure	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
61323	Incision or excision of skull to reduce brain pressure and excision of lobe of brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61323	Incision or excision of skull to reduce brain pressure and excision of lobe of brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
61323	Incision or excision of skull to reduce brain pressure and excision of lobe of brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
61330	Incision of eye bone to reduce pressure	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61330	Incision of eye bone to reduce pressure	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61330	Incision of eye bone to reduce pressure	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61332	Exploration and biopsy of eye bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61332	Exploration and biopsy of eye bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61332	Exploration and biopsy of eye bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61333	Exploration and removal of eye bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61333	Exploration and removal of eye bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61333	Exploration and removal of eye bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61340	Incision of skull to reduce brain pressure	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61340	Incision of skull to reduce brain pressure	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61340	Incision of skull to reduce brain pressure	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61343	Excision of skull base and upper spine to release spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61343	Excision of skull base and upper spine to release spinal cord	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61343	Excision of skull base and upper spine to release spinal cord	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61345	Excision of base of skull to reduce pressure at base of brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61345	Excision of base of skull to reduce pressure at base of brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61345	Excision of base of skull to reduce pressure at base of brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61450	Excision of skull to reduce facial nerve pressure	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61450	Excision of skull to reduce facial nerve pressure	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61450	Excision of skull to reduce facial nerve pressure	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61458	Excision of skull base for exploration or release of cranial nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61458	Excision of skull base for exploration or release of cranial nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61458	Excision of skull base for exploration or release of cranial nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61460	Excision of skull base to sever cranial nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61460	Excision of skull base to sever cranial nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61460	Excision of skull base to sever cranial nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61480	Excision of skull to sever a nerve tract to midbrain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61480	Excision of skull to sever a nerve tract to midbrain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
61480	Excision of skull to sever a nerve tract to midbrain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61500	Removal of brain tumor or other skull bone lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61500	Removal of brain tumor or other skull bone lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61500	Removal of brain tumor or other skull bone lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61501	Removal of infected skull bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61501	Removal of infected skull bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61501	Removal of infected skull bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61510	Removal of brain tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61510	Removal of brain tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61510	Removal of brain tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
61512	Removal of brain tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61512	Removal of brain tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61512	Removal of brain tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
61514	Removal of brain abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61514	Removal of brain abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61514	Removal of brain abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61516	Removal or drainage of brain cyst	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61516	Removal or drainage of brain cyst	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61516	Removal or drainage of brain cyst	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61518	Removal of brain tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61518	Removal of brain tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61518	Removal of brain tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
61519	Removal of brain tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61519	Removal of brain tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61519	Removal of brain tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
61520	Removal of eighth cranial nerve brain tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61520	Removal of eighth cranial nerve brain tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61520	Removal of eighth cranial nerve brain tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
61521	Removal of skull base tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61521	Removal of skull base tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61521	Removal of skull base tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
61522	Removal of brain abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61522	Removal of brain abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61522	Removal of brain abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61524	Removal of brain cyst or creation of drainage tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61524	Removal of brain cyst or creation of drainage tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61524	Removal of brain cyst or creation of drainage tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61526	Removal of eighth cranial nerve brain tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61526	Removal of eighth cranial nerve brain tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61526	Removal of eighth cranial nerve brain tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
61530	Removal of eighth cranial nerve brain tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61530	Removal of eighth cranial nerve brain tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61530	Removal of eighth cranial nerve brain tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61531	Implantation of brain strip electrodes for seizure monitoring	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61531	Implantation of brain strip electrodes for seizure monitoring	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61531	Implantation of brain strip electrodes for seizure monitoring	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		89	
61533	Implantation of brain electrode for seizure monitoring	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61533	Implantation of brain electrode for seizure monitoring	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61533	Implantation of brain electrode for seizure monitoring	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61534	Excision of brain tissue to halt seizure activity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61534	Excision of brain tissue to halt seizure activity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61534	Excision of brain tissue to halt seizure activity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61535	Removal of electrode from brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61535	Removal of electrode from brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61535	Removal of electrode from brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61536	Excision of brain tissue to halt seizure activity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61536	Excision of brain tissue to halt seizure activity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61536	Excision of brain tissue to halt seizure activity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61537	Excision of lobe of brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61537	Excision of lobe of brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61537	Excision of lobe of brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61538	Excision of lobe of brain with measurement of seizure activity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61538	Excision of lobe of brain with measurement of seizure activity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61538	Excision of lobe of brain with measurement of seizure activity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61539	Excision of lobe of brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61539	Excision of lobe of brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61539	Excision of lobe of brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61540	Excision of lobe of brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61540	Excision of lobe of brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61540	Excision of lobe of brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
61541	Incision of skull for incision of brain tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61541	Incision of skull for incision of brain tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61541	Incision of skull for incision of brain tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61543	Incision of skull for partial excision of brain tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61543	Incision of skull for partial excision of brain tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61543	Incision of skull for partial excision of brain tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61544	Incision of skull for excision or clotting of cerebrospinal fluid site	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61544	Incision of skull for excision or clotting of cerebrospinal fluid site	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61544	Incision of skull for excision or clotting of cerebrospinal fluid site	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61545	Incision of skull for excision of pituitary gland tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61545	Incision of skull for excision of pituitary gland tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61545	Incision of skull for excision of pituitary gland tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
61546	Incision of forehead bone for excision of pituitary gland tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61546	Incision of forehead bone for excision of pituitary gland tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61546	Incision of forehead bone for excision of pituitary gland tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61548	Excision of pituitary gland tumor	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61548	Excision of pituitary gland tumor	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61548	Excision of pituitary gland tumor	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61550	Repair of single skull suture defect present at birth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61550	Repair of single skull suture defect present at birth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
61550	Repair of single skull suture defect present at birth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
61552	Repair of multiple skull suture defects present at birth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61552	Repair of multiple skull suture defects present at birth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61552	Repair of multiple skull suture defects present at birth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61556	Incision of prematurely closed skull suture with skull bone flap	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61556	Incision of prematurely closed skull suture with skull bone flap	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61556	Incision of prematurely closed skull suture with skull bone flap	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		79	
61557	Incision of prematurely closed skull suture with bone flap from front portion of skull	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61557	Incision of prematurely closed skull suture with bone flap from front portion of skull	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61557	Incision of prematurely closed skull suture with bone flap from front portion of skull	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
61558	Removal of skull to restore shape due to multiple prematurely closed sutures	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61558	Removal of skull to restore shape due to multiple prematurely closed sutures	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
61558	Removal of skull to restore shape due to multiple prematurely closed sutures	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
61559	Removal of skull and bone grafts to restore shape due to multiple prematurely closed sutures	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61559	Removal of skull and bone grafts to restore shape due to multiple prematurely closed sutures	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
61559	Removal of skull and bone grafts to restore shape due to multiple prematurely closed sutures	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
61563	Removal of skull bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61563	Removal of skull bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61563	Removal of skull bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		79	
61564	Removal of skull bone growth with release of optic nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61564	Removal of skull bone growth with release of optic nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61564	Removal of skull bone growth with release of optic nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
61566	Removal of brain tissue to relieve seizure activity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61566	Removal of brain tissue to relieve seizure activity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61566	Removal of brain tissue to relieve seizure activity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
61567	Incision of brain tissue with seizure monitoring	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61567	Incision of brain tissue with seizure monitoring	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61567	Incision of brain tissue with seizure monitoring	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
61570	Removal of foreign body from brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61570	Removal of foreign body from brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61570	Removal of foreign body from brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61571	Treatment of penetrating brain wound	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61571	Treatment of penetrating brain wound	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61571	Treatment of penetrating brain wound	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61575	Biopsy of brain stem or upper spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61575	Biopsy of brain stem or upper spinal cord	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61575	Biopsy of brain stem or upper spinal cord	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61576	Biopsy of brain stem or upper spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61576	Biopsy of brain stem or upper spinal cord	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61576	Biopsy of brain stem or upper spinal cord	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		237	
61580	Removal of nasal sinuses to approach brain lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61580	Removal of nasal sinuses to approach brain lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61580	Removal of nasal sinuses to approach brain lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		142	
61581	Removal of nasal sinuses to approach brain lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61581	Removal of nasal sinuses to approach brain lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61581	Removal of nasal sinuses to approach brain lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		195	
61582	Removal of facial bone to approach brain lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61582	Removal of facial bone to approach brain lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61582	Removal of facial bone to approach brain lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		162	
61583	Removal of facial bone to approach brain lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61583	Removal of facial bone to approach brain lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61583	Removal of facial bone to approach brain lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		79	
61584	Removal of facial bone to approach brain lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61584	Removal of facial bone to approach brain lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61584	Removal of facial bone to approach brain lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		79	
61585	Removal of facial bone to approach brain lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61585	Removal of facial bone to approach brain lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61585	Removal of facial bone to approach brain lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61586	Removal of facial bone to approach brain lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61586	Removal of facial bone to approach brain lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61586	Removal of facial bone to approach brain lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
61590	Removal of jaw bone to approach brain lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61590	Removal of jaw bone to approach brain lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61590	Removal of jaw bone to approach brain lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		142	
61591	Removal of skull bone behind ear to approach brain lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61591	Removal of skull bone behind ear to approach brain lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61591	Removal of skull bone behind ear to approach brain lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		131	
61592	Removal of cheek bone and skull to approach brain lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61592	Removal of cheek bone and skull to approach brain lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61592	Removal of cheek bone and skull to approach brain lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
61595	Removal of skull bone behind ear to approach brain lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61595	Removal of skull bone behind ear to approach brain lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61595	Removal of skull bone behind ear to approach brain lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		142	
61596	Removal of skull bone behind ear to approach brain lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61596	Removal of skull bone behind ear to approach brain lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61596	Removal of skull bone behind ear to approach brain lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
61597	Removal of skull base to approach brain lesion	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61597	Removal of skull base to approach brain lesion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61597	Removal of skull base to approach brain lesion	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
61598	Removal of skull to approach lesion or defect at skull base with tying of sinus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61598	Removal of skull to approach lesion or defect at skull base with tying of sinus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61598	Removal of skull to approach lesion or defect at skull base with tying of sinus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
61600	Removal of lesion at skull base	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61600	Removal of lesion at skull base	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61600	Removal of lesion at skull base	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		142	
61601	Removal of lesion at skull base	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61601	Removal of lesion at skull base	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61601	Removal of lesion at skull base	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
61605	Removal of lesion at skull base	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61605	Removal of lesion at skull base	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61605	Removal of lesion at skull base	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		142	
61606	Removal of lesion at skull base	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61606	Removal of lesion at skull base	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61606	Removal of lesion at skull base	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61607	Removal of lesion at skull base	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61607	Removal of lesion at skull base	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61607	Removal of lesion at skull base	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61608	Removal of lesion at skull base	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61608	Removal of lesion at skull base	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61608	Removal of lesion at skull base	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
61613	Destruction of abnormal blood vessel at skull base	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61613	Destruction of abnormal blood vessel at skull base	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61613	Destruction of abnormal blood vessel at skull base	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
61615	Excision of abnormal blood vessel at skull base or upper spine bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61615	Excision of abnormal blood vessel at skull base or upper spine bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61615	Excision of abnormal blood vessel at skull base or upper spine bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		115	
61616	Excision of abnormal blood vessel at skull base or upper spine bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61616	Excision of abnormal blood vessel at skull base or upper spine bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61616	Excision of abnormal blood vessel at skull base or upper spine bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		115	
61618	Repair of brain covering by tissue or synthetic graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61618	Repair of brain covering by tissue or synthetic graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61618	Repair of brain covering by tissue or synthetic graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61619	Repair of brain covering by vascular or combined vascular muscle graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61619	Repair of brain covering by vascular or combined vascular muscle graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61619	Repair of brain covering by vascular or combined vascular muscle graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
61623	Balloon occlusion of head or neck artery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		15	
61630	"Balloon dilation of blood vessel in head, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61630	"Balloon dilation of blood vessel in head, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61635	Insertion of stents in blood vessel of head	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61635	Insertion of stents in blood vessel of head	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61680	Repair of abnormal artery-vein connection in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61680	Repair of abnormal artery-vein connection in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61680	Repair of abnormal artery-vein connection in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
61682	Repair of abnormal artery-vein connection in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61682	Repair of abnormal artery-vein connection in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61682	Repair of abnormal artery-vein connection in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61684	Repair of abnormal artery-vein connection in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61684	Repair of abnormal artery-vein connection in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61684	Repair of abnormal artery-vein connection in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
61686	Repair of abnormal artery-vein connection in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61686	Repair of abnormal artery-vein connection in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61686	Repair of abnormal artery-vein connection in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
61690	Repair of abnormal artery-vein connection in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61690	Repair of abnormal artery-vein connection in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61690	Repair of abnormal artery-vein connection in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
61692	Repair of abnormal artery-vein connection in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61692	Repair of abnormal artery-vein connection in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61692	Repair of abnormal artery-vein connection in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		106	
61697	Repair of bulging of blood vessel (aneurysm) in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61697	Repair of bulging of blood vessel (aneurysm) in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61697	Repair of bulging of blood vessel (aneurysm) in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
61698	Repair of bulging of blood vessel (aneurysm) in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61698	Repair of bulging of blood vessel (aneurysm) in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61698	Repair of bulging of blood vessel (aneurysm) in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
61700	Repair of bulging of blood vessel (aneurysm) in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61700	Repair of bulging of blood vessel (aneurysm) in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61700	Repair of bulging of blood vessel (aneurysm) in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
61702	Repair of bulging of blood vessel (aneurysm) in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61702	Repair of bulging of blood vessel (aneurysm) in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61702	Repair of bulging of blood vessel (aneurysm) in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		125	
61703	Repair of bulging of blood vessel (aneurysm) in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61703	Repair of bulging of blood vessel (aneurysm) in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61703	Repair of bulging of blood vessel (aneurysm) in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61705	Repair of bulging of blood vessel (aneurysm) in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61705	Repair of bulging of blood vessel (aneurysm) in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61705	Repair of bulging of blood vessel (aneurysm) in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61708	Repair of bulging of blood vessel (aneurysm) in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61708	Repair of bulging of blood vessel (aneurysm) in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61708	Repair of bulging of blood vessel (aneurysm) in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61710	Repair of bulging of blood vessel (aneurysm) in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61710	Repair of bulging of blood vessel (aneurysm) in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61710	Repair of bulging of blood vessel (aneurysm) in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61711	Connection of arteries in head	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
61711	Connection of arteries in head	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61711	Connection of arteries in head	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61720	Creation of brain lesion by stereotactic method	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61720	Creation of brain lesion by stereotactic method	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61720	Creation of brain lesion by stereotactic method	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61735	Creation of brain lesion by stereotactic method	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61735	Creation of brain lesion by stereotactic method	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61735	Creation of brain lesion by stereotactic method	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
61750	"Stereotactic biopsy, aspiration, or excision of brain lesion"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61750	"Stereotactic biopsy, aspiration, or excision of brain lesion"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61750	"Stereotactic biopsy, aspiration, or excision of brain lesion"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61751	"Stereotactic biopsy, aspiration, or excision of brain lesion using CT and/or MRI guidance"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61751	"Stereotactic biopsy, aspiration, or excision of brain lesion using CT and/or MRI guidance"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61751	"Stereotactic biopsy, aspiration, or excision of brain lesion using CT and/or MRI guidance"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
61760	Stereotactic implantation of brain electrodes for seizure monitoring	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61760	Stereotactic implantation of brain electrodes for seizure monitoring	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61760	Stereotactic implantation of brain electrodes for seizure monitoring	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		77	
61770	Stereotactic insertion of catheters or probes for radiation source	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61770	Stereotactic insertion of catheters or probes for radiation source	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61770	Stereotactic insertion of catheters or probes for radiation source	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61790	"Stereotactic creation of lesion of cranial nerve, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61790	"Stereotactic creation of lesion of cranial nerve, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
61790	"Stereotactic creation of lesion of cranial nerve, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61791	"Stereotactic creation of brainstem lesion, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61791	"Stereotactic creation of brainstem lesion, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
61791	"Stereotactic creation of brainstem lesion, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61796	Stereotactic treatment of brain growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61796	Stereotactic treatment of brain growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
61796	Stereotactic treatment of brain growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61798	Stereotactic treatment of brain growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61798	Stereotactic treatment of brain growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
61798	Stereotactic treatment of brain growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61850	Implantation of neurostimulator electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61850	Implantation of neurostimulator electrodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61850	Implantation of neurostimulator electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
61860	Implantation of neurostimulator electrodes in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61860	Implantation of neurostimulator electrodes in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61860	Implantation of neurostimulator electrodes in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61863	Implantation of neurostimulator electrodes in brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61863	Implantation of neurostimulator electrodes in brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61863	Implantation of neurostimulator electrodes in brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
61867	Implantation of brain neurostimulator electrodes microelectrode recording	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61867	Implantation of brain neurostimulator electrodes microelectrode recording	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61867	Implantation of brain neurostimulator electrodes microelectrode recording	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
61870	Implantation of brain neurostimulator electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61870	Implantation of brain neurostimulator electrodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
61870	Implantation of brain neurostimulator electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61880	Revision or removal of brain neurostimulator electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61880	Revision or removal of brain neurostimulator electrodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61880	Revision or removal of brain neurostimulator electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
61885	Insertion or replacement of brain neurostimulator generator or receiver	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61885	Insertion or replacement of brain neurostimulator generator or receiver	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
61885	Insertion or replacement of brain neurostimulator generator or receiver	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
61886	Insertion or replacement of brain neurostimulator generator or receiver	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
61886	Insertion or replacement of brain neurostimulator generator or receiver	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
61886	Insertion or replacement of brain neurostimulator generator or receiver	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
61888	Revision or removal of brain neurostimulator generator or receiver	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		28	
61888	Revision or removal of brain neurostimulator generator or receiver	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
61888	Revision or removal of brain neurostimulator generator or receiver	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
62000	Elevation of depressed skull fracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62000	Elevation of depressed skull fracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62000	Elevation of depressed skull fracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62005	Elevation of depressed skull fractures	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62005	Elevation of depressed skull fractures	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62005	Elevation of depressed skull fractures	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62010	Elevation of depressed skull fracture	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62010	Elevation of depressed skull fracture	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62010	Elevation of depressed skull fracture	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
62100	Repair of membrane covering the brain	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62100	Repair of membrane covering the brain	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62100	Repair of membrane covering the brain	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
62115	Reduction of an enlarged skull	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62115	Reduction of an enlarged skull	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62115	Reduction of an enlarged skull	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
62117	Reduction and reshaping of an enlarged skull	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62117	Reduction and reshaping of an enlarged skull	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62117	Reduction and reshaping of an enlarged skull	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
62120	Repair and reshaping of herniated brain through skull	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
62120	Repair and reshaping of herniated brain through skull	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62120	Repair and reshaping of herniated brain through skull	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		154	
62121	Repair of herniation of brain at skull base	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
62121	Repair of herniation of brain at skull base	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62121	Repair of herniation of brain at skull base	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		82	
62140	Reshaping of (up to 5 centimeter diameter) skull bone defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62140	Reshaping of (up to 5 centimeter diameter) skull bone defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62140	Reshaping of (up to 5 centimeter diameter) skull bone defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62141	Reshaping of (larger than 5 centimeter in diameter) skull bone defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62141	Reshaping of (larger than 5 centimeter in diameter) skull bone defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62141	Reshaping of (larger than 5 centimeter in diameter) skull bone defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62142	Removal of bone flap or prosthesis from skull	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62142	Removal of bone flap or prosthesis from skull	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62142	Removal of bone flap or prosthesis from skull	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62143	Replacement of bone flap or prosthesis in skull	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62143	Replacement of bone flap or prosthesis in skull	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62143	Replacement of bone flap or prosthesis in skull	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62145	Reshaping of skull bone defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62145	Reshaping of skull bone defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62145	Reshaping of skull bone defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62146	Reconstruction and (up to 5 centimeter in diameter) graft of skull bone defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62146	Reconstruction and (up to 5 centimeter in diameter) graft of skull bone defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62146	Reconstruction and (up to 5 centimeter in diameter) graft of skull bone defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62147	Reconstruction and (larger than 5 centimeter in diameter) graft of skull bone defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62147	Reconstruction and (larger than 5 centimeter in diameter) graft of skull bone defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62147	Reconstruction and (larger than 5 centimeter in diameter) graft of skull bone defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62161	Release of brain scar tissue or cyst drainage using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62161	Release of brain scar tissue or cyst drainage using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62161	Release of brain scar tissue or cyst drainage using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
62162	Drainage of brain cyst using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
62162	Drainage of brain cyst using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62162	Drainage of brain cyst using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
62163	Removal of foreign material in brain using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62163	Removal of foreign material in brain using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62163	Removal of foreign material in brain using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
62164	Removal of brain tumor using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
62164	Removal of brain tumor using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62164	Removal of brain tumor using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		131	
62165	Removal of pituitary gland tumor using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
62165	Removal of pituitary gland tumor using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62165	Removal of pituitary gland tumor using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		104	
62180	Creation of drainage tract for spinal fluid	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62180	Creation of drainage tract for spinal fluid	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62180	Creation of drainage tract for spinal fluid	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		89	
62190	Creation of brain fluid drainage shunt	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62190	Creation of brain fluid drainage shunt	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62190	Creation of brain fluid drainage shunt	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62192	Creation of brain fluid drainage shunt	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62192	Creation of brain fluid drainage shunt	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62192	Creation of brain fluid drainage shunt	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62194	Replacement or irrigation of brain catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		23	
62194	Replacement or irrigation of brain catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62194	Replacement or irrigation of brain catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62200	Creation of brain fluid drainage shunt	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62200	Creation of brain fluid drainage shunt	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62200	Creation of brain fluid drainage shunt	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62201	Stereotactic creation of spinal fluid drainage tract in the brain using an endoscope	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62201	Stereotactic creation of spinal fluid drainage tract in the brain using an endoscope	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62201	Stereotactic creation of spinal fluid drainage tract in the brain using an endoscope	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
62220	Creation of brain fluid drainage shunt	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62220	Creation of brain fluid drainage shunt	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62220	Creation of brain fluid drainage shunt	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62223	Creation of brain fluid drainage shunt	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62223	Creation of brain fluid drainage shunt	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62223	Creation of brain fluid drainage shunt	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
62225	Replacement or irrigation of brain fluid drainage shunt catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62225	Replacement or irrigation of brain fluid drainage shunt catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62225	Replacement or irrigation of brain fluid drainage shunt catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
62230	Replacement or revision of brain fluid drainage shunt valve or catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62230	Replacement or revision of brain fluid drainage shunt valve or catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62230	Replacement or revision of brain fluid drainage shunt valve or catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
62252	Reprogramming of programmable brain and spinal fluid shunt	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	22		
62252	Reprogramming of programmable brain and spinal fluid shunt	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8		
62252	Reprogramming of programmable brain and spinal fluid shunt	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	5		
62256	Removal of brain and spinal fluid shunt system	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62256	Removal of brain and spinal fluid shunt system	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62256	Removal of brain and spinal fluid shunt system	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
62258	Removal and replacement of brain and spinal fluid shunt system	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62258	Removal and replacement of brain and spinal fluid shunt system	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62258	Removal and replacement of brain and spinal fluid shunt system	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62263	"Injection or mechanical removal of spinal canal scar tissue, percutaneous procedure, accessed through the skin, multiple sessions over 2 or more days"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
62263	"Injection or mechanical removal of spinal canal scar tissue, percutaneous procedure, accessed through the skin, multiple sessions over 2 or more days"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	100	6	
62263	"Injection or mechanical removal of spinal canal scar tissue, percutaneous procedure, accessed through the skin, multiple sessions over 2 or more days"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	99	99	
62264	"Injection or mechanical removal of spinal canal scar tissue, percutaneous procedure, accessed through the skin, multiple sessions in 1 day"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	24	31	
62264	"Injection or mechanical removal of spinal canal scar tissue, percutaneous procedure, accessed through the skin, multiple sessions in 1 day"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	6	
62264	"Injection or mechanical removal of spinal canal scar tissue, percutaneous procedure, accessed through the skin, multiple sessions in 1 day"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
62267	"Diagnostic aspiration of spinal disc or tissue, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	20	
62267	"Diagnostic aspiration of spinal disc or tissue, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	0	
62267	"Diagnostic aspiration of spinal disc or tissue, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
62268	"Aspiration of spinal cord cyst or fluid-filled cavity, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
62268	"Aspiration of spinal cord cyst or fluid-filled cavity, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
62269	"Needle biopsy of spinal cord, accessed beneath the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
62269	"Needle biopsy of spinal cord, accessed beneath the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
62270	Spinal tap for diagnosis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	14	
62270	Spinal tap for diagnosis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	0	
62270	Spinal tap for diagnosis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
62272	Spinal tap with drainage of spinal fluid	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	14	
62272	Spinal tap with drainage of spinal fluid	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	0	
62272	Spinal tap with drainage of spinal fluid	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
62273	Injection of blood or blood clot into spinal canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	21	
62273	Injection of blood or blood clot into spinal canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	0	
62273	Injection of blood or blood clot into spinal canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
62280	Injection of substance into spinal canal to destroy nerve tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	25	
62280	Injection of substance into spinal canal to destroy nerve tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	6	
62280	Injection of substance into spinal canal to destroy nerve tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
62281	Injection of spinal canal to destroy nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	25	
62281	Injection of spinal canal to destroy nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58	6	
62281	Injection of spinal canal to destroy nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
62282	Injection of spinal canal to destroy nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	25	
62282	Injection of spinal canal to destroy nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49	6	
62282	Injection of spinal canal to destroy nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
62284	"Injection procedure for myelography and/or computed tomography, lumbar"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
62284	"Injection procedure for myelography and/or computed tomography, lumbar"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
62284	"Injection procedure for myelography and/or computed tomography, lumbar"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5	5	
62284	"Injection procedure for myelography and/or computed tomography, lumbar"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
62284	"Injection procedure for myelography and/or computed tomography, lumbar"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
62284	"Injection procedure for myelography and/or computed tomography, lumbar"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
62284	"Injection procedure for myelography and/or computed tomography, lumbar"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
62284	"Injection procedure for myelography and/or computed tomography, lumbar"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
62284	"Injection procedure for myelography and/or computed tomography, lumbar"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	15		
62284	"Injection procedure for myelography and/or computed tomography, lumbar"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
62284	"Injection procedure for myelography and/or computed tomography, lumbar"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
62284	"Injection procedure for myelography and/or computed tomography, lumbar"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
62284	"Injection procedure for myelography and/or computed tomography, lumbar"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains"	15		
62284	"Injection procedure for myelography and/or computed tomography, lumbar"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
62287	"Aspiration of lower spine disc, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62287	"Aspiration of lower spine disc, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62287	"Aspiration of lower spine disc, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
62290	Injection of dye for X-ray imaging of spine disc	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	25	
62290	Injection of dye for X-ray imaging of spine disc	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46	0	
62290	Injection of dye for X-ray imaging of spine disc	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
62291	Injection of dye for X-ray imaging of spine disc	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	25	
62291	Injection of dye for X-ray imaging of spine disc	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	0	
62291	Injection of dye for X-ray imaging of spine disc	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
62292	Injection of chemical enzyme into herniated spinal disc	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62292	Injection of chemical enzyme into herniated spinal disc	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62292	Injection of chemical enzyme into herniated spinal disc	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62294	Injection of drug into an artery to occlude arteriovenous malformation of spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62294	Injection of drug into an artery to occlude arteriovenous malformation of spinal cord	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62294	Injection of drug into an artery to occlude arteriovenous malformation of spinal cord	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
62302	Myelography via lumbar injection; cervical	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	0		
62302	Myelography via lumbar injection; cervical	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	0		
62302	Myelography via lumbar injection; cervical	Pre-service	L037D	RN/LPN/MTA	0.37	Availability of prior images confirmed	2		
62302	Myelography via lumbar injection; cervical	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
62302	Myelography via lumbar injection; cervical	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
62302	Myelography via lumbar injection; cervical	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	0		
62302	Myelography via lumbar injection; cervical	Pre-service	L037D	RN/LPN/MTA	0.37	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
62302	Myelography via lumbar injection; cervical	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5	5	
62302	Myelography via lumbar injection; cervical	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
62302	Myelography via lumbar injection; cervical	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
62302	Myelography via lumbar injection; cervical	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
62302	Myelography via lumbar injection; cervical	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	3		
62302	Myelography via lumbar injection; cervical	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
62302	Myelography via lumbar injection; cervical	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	0		
62302	Myelography via lumbar injection; cervical	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	26		
62302	Myelography via lumbar injection; cervical	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
62302	Myelography via lumbar injection; cervical	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
62302	Myelography via lumbar injection; cervical	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
62302	Myelography via lumbar injection; cervical	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
62302	Myelography via lumbar injection; cervical	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
62302	Myelography via lumbar injection; cervical	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
62303	Myelography via lumbar injection; thoracic	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	0		
62303	Myelography via lumbar injection; thoracic	Pre-service	L037D	RN/LPN/MTA	0.37	Availability of prior images confirmed	2		
62303	Myelography via lumbar injection; thoracic	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
62303	Myelography via lumbar injection; thoracic	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
62303	Myelography via lumbar injection; thoracic	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	0		
62303	Myelography via lumbar injection; thoracic	Pre-service	L037D	RN/LPN/MTA	0.37	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
62303	Myelography via lumbar injection; thoracic	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5	5	
62303	Myelography via lumbar injection; thoracic	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
62303	Myelography via lumbar injection; thoracic	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
62303	Myelography via lumbar injection; thoracic	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
62303	Myelography via lumbar injection; thoracic	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	3		
62303	Myelography via lumbar injection; thoracic	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
62303	Myelography via lumbar injection; thoracic	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	0		
62303	Myelography via lumbar injection; thoracic	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	25		
62303	Myelography via lumbar injection; thoracic	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
62303	Myelography via lumbar injection; thoracic	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
62303	Myelography via lumbar injection; thoracic	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
62303	Myelography via lumbar injection; thoracic	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains"	15		
62303	Myelography via lumbar injection; thoracic	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
62303	Myelography via lumbar injection; thoracic	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
62303	Myelography via lumbar injection; thoracic	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
62304	Myelography via lumbar injection; lumbosacral	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	0		
62304	Myelography via lumbar injection; lumbosacral	Pre-service	L037D	RN/LPN/MTA	0.37	Availability of prior images confirmed	2		
62304	Myelography via lumbar injection; lumbosacral	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
62304	Myelography via lumbar injection; lumbosacral	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
62304	Myelography via lumbar injection; lumbosacral	Pre-service	L037C	Orthoptist	0.37	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
62304	Myelography via lumbar injection; lumbosacral	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	0		
62304	Myelography via lumbar injection; lumbosacral	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5	5	
62304	Myelography via lumbar injection; lumbosacral	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
62304	Myelography via lumbar injection; lumbosacral	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
62304	Myelography via lumbar injection; lumbosacral	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
62304	Myelography via lumbar injection; lumbosacral	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	3		
62304	Myelography via lumbar injection; lumbosacral	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
62304	Myelography via lumbar injection; lumbosacral	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	12		
62304	Myelography via lumbar injection; lumbosacral	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	13		
62304	Myelography via lumbar injection; lumbosacral	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
62304	Myelography via lumbar injection; lumbosacral	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
62304	Myelography via lumbar injection; lumbosacral	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
62304	Myelography via lumbar injection; lumbosacral	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
62304	Myelography via lumbar injection; lumbosacral	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
62304	Myelography via lumbar injection; lumbosacral	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
62304	Myelography via lumbar injection; lumbosacral	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
62305	Myelography via lumbar injection; 2 or more regions	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
62305	Myelography via lumbar injection; 2 or more regions	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	0		
62305	Myelography via lumbar injection; 2 or more regions	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3	3	
62305	Myelography via lumbar injection; 2 or more regions	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
62305	Myelography via lumbar injection; 2 or more regions	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	0		
62305	Myelography via lumbar injection; 2 or more regions	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
62305	Myelography via lumbar injection; 2 or more regions	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	5	5	
62305	Myelography via lumbar injection; 2 or more regions	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		3	
62305	Myelography via lumbar injection; 2 or more regions	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
62305	Myelography via lumbar injection; 2 or more regions	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
62305	Myelography via lumbar injection; 2 or more regions	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	3		
62305	Myelography via lumbar injection; 2 or more regions	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
62305	Myelography via lumbar injection; 2 or more regions	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	0		
62305	Myelography via lumbar injection; 2 or more regions	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	30		
62305	Myelography via lumbar injection; 2 or more regions	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
62305	Myelography via lumbar injection; 2 or more regions	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
62305	Myelography via lumbar injection; 2 or more regions	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	2		
62305	Myelography via lumbar injection; 2 or more regions	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains"	15		
62305	Myelography via lumbar injection; 2 or more regions	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
62305	Myelography via lumbar injection; 2 or more regions	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
62305	Myelography via lumbar injection; 2 or more regions	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
62310	Injections of substances into upper or middle spine	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	21	
62310	Injections of substances into upper or middle spine	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63	0	
62310	Injections of substances into upper or middle spine	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
62311	Injections of substances into lower or sacral spine	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	21	
62311	Injections of substances into lower or sacral spine	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
62311	Injections of substances into lower or sacral spine	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
62318	Injections and continuous infusion into upper or middle spinal canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	21	
62318	Injections and continuous infusion into upper or middle spinal canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	85	0	
62318	Injections and continuous infusion into upper or middle spinal canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
62319	Injections and continuous infusion into lower or sacral spinal canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	21	
62319	Injections and continuous infusion into lower or sacral spinal canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	70	0	
62319	Injections and continuous infusion into lower or sacral spinal canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
62350	"Implantation, revision, or repositioning of spinal canal medication catheter"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62350	"Implantation, revision, or repositioning of spinal canal medication catheter"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62350	"Implantation, revision, or repositioning of spinal canal medication catheter"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
62351	"Implantation, revision, or repositioning of catheter in spinal canal for medication administration"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62351	"Implantation, revision, or repositioning of catheter in spinal canal for medication administration"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
62351	"Implantation, revision, or repositioning of catheter in spinal canal for medication administration"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
62355	Removal of implanted catheter in spinal canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62355	Removal of implanted catheter in spinal canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62355	Removal of implanted catheter in spinal canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
62360	Implantation or replacement of spinal canal drug infusion device beneath skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62360	Implantation or replacement of spinal canal drug infusion device beneath skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62360	Implantation or replacement of spinal canal drug infusion device beneath skin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
62361	Implantation or replacement of spinal canal drug infusion pump	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62361	Implantation or replacement of spinal canal drug infusion pump	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62361	Implantation or replacement of spinal canal drug infusion pump	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
62362	Implantation or replacement of programmable spinal canal drug infusion pump	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62362	Implantation or replacement of programmable spinal canal drug infusion pump	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62362	Implantation or replacement of programmable spinal canal drug infusion pump	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
62365	"Removal of spinal canal drug infusion pump or device, accessed beneath the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
62365	"Removal of spinal canal drug infusion pump or device, accessed beneath the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
62365	"Removal of spinal canal drug infusion pump or device, accessed beneath the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
62367	Electronic analysis of spinal canal drug infusion pump	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	0	
62367	Electronic analysis of spinal canal drug infusion pump	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
62368	Electronic analysis and reprogramming of spinal canal drug infusion pump	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	0	
62368	Electronic analysis and reprogramming of spinal canal drug infusion pump	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	0	
62368	Electronic analysis and reprogramming of spinal canal drug infusion pump	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
62369	Electronic analysis reprogramming and refill of spinal canal drug infusion pump	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	12	0	
62369	Electronic analysis reprogramming and refill of spinal canal drug infusion pump	Service  intra	L051A	RN	0.51	Service total costs	10	0	
62369	Electronic analysis reprogramming and refill of spinal canal drug infusion pump	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	0	
62369	Electronic analysis reprogramming and refill of spinal canal drug infusion pump	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
62370	Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	12	0	
62370	Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	0	
62370	Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
63001	Partial removal of bone and/or release of upper spinal cord or spinal nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63001	Partial removal of bone and/or release of upper spinal cord or spinal nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63001	Partial removal of bone and/or release of upper spinal cord or spinal nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
63003	Partial removal of bone and/or release of middle spinal cord or spinal nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63003	Partial removal of bone and/or release of middle spinal cord or spinal nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63003	Partial removal of bone and/or release of middle spinal cord or spinal nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
63005	Partial removal of bone and/or release of lower spinal cord or spinal nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63005	Partial removal of bone and/or release of lower spinal cord or spinal nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63005	Partial removal of bone and/or release of lower spinal cord or spinal nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63011	Partial removal of bone and/or release of sacral spinal cord or spinal nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63011	Partial removal of bone and/or release of sacral spinal cord or spinal nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63011	Partial removal of bone and/or release of sacral spinal cord or spinal nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63012	Partial removal of bone and/or release of lower spinal cord or spinal nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63012	Partial removal of bone and/or release of lower spinal cord or spinal nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63012	Partial removal of bone and/or release of lower spinal cord or spinal nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63015	Partial removal of bone with release of upper spinal cord or spinal nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63015	Partial removal of bone with release of upper spinal cord or spinal nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63015	Partial removal of bone with release of upper spinal cord or spinal nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63016	Partial removal of bone and/or release of middle spinal cord or spinal nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63016	Partial removal of bone and/or release of middle spinal cord or spinal nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63016	Partial removal of bone and/or release of middle spinal cord or spinal nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63017	Partial removal of bone and/or release of lower spinal cord or spinal nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63017	Partial removal of bone and/or release of lower spinal cord or spinal nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63017	Partial removal of bone and/or release of lower spinal cord or spinal nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63020	Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in upper spine	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63020	Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in upper spine	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63020	Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in upper spine	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63030	Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in lower spine	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63030	Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in lower spine	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63030	Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in lower spine	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63040	Re-exploration of spine repair with release of upper spinal cord or nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63040	Re-exploration of spine repair with release of upper spinal cord or nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63040	Re-exploration of spine repair with release of upper spinal cord or nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63042	Re-exploration of spine repair with release of lower spinal cord or nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63042	Re-exploration of spine repair with release of lower spinal cord or nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63042	Re-exploration of spine repair with release of lower spinal cord or nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63045	"Laminectomy, facetectomy and foraminotomy ; cervical"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
63045	"Laminectomy, facetectomy and foraminotomy ; cervical"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
63045	"Laminectomy, facetectomy and foraminotomy ; cervical"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
63045	"Laminectomy, facetectomy and foraminotomy ; cervical"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
63045	"Laminectomy, facetectomy and foraminotomy ; cervical"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
63045	"Laminectomy, facetectomy and foraminotomy ; cervical"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
63045	"Laminectomy, facetectomy and foraminotomy ; cervical"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		108	
63046	"Laminectomy, facetectomy and foraminotomy ; thoracic"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms		5	
63046	"Laminectomy, facetectomy and foraminotomy ; thoracic"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services		20	
63046	"Laminectomy, facetectomy and foraminotomy ; thoracic"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions		7	
63046	"Laminectomy, facetectomy and foraminotomy ; thoracic"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent		20	
63046	"Laminectomy, facetectomy and foraminotomy ; thoracic"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		8	
63046	"Laminectomy, facetectomy and foraminotomy ; thoracic"	Service  post	L037D	RN/LPN/MTA	0.37	Discharge day management 99238 --12 minutes		12	
63046	"Laminectomy, facetectomy and foraminotomy ; thoracic"	Post-service	L037D	RN/LPN/MTA	0.37	99213    36  minutes		108	
63047	Partial removal of middle spine bone with release of spinal cord and/or nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63047	Partial removal of middle spine bone with release of spinal cord and/or nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63047	Partial removal of middle spine bone with release of spinal cord and/or nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63050	Reconstruction of bone around spinal canal with release of spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63050	Reconstruction of bone around spinal canal with release of spinal cord	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63050	Reconstruction of bone around spinal canal with release of spinal cord	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
63051	Reconstruction of bone around spinal canal with release of spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63051	Reconstruction of bone around spinal canal with release of spinal cord	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63051	Reconstruction of bone around spinal canal with release of spinal cord	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
63055	Release of middle spinal cord and/or nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63055	Release of middle spinal cord and/or nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63055	Release of middle spinal cord and/or nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63056	Release of lower spinal cord and/or nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63056	Release of lower spinal cord and/or nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63056	Release of lower spinal cord and/or nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63064	"Release of middle spinal cord or nerves, costovertebral approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63064	"Release of middle spinal cord or nerves, costovertebral approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63064	"Release of middle spinal cord or nerves, costovertebral approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63075	Removal of upper spine disc and release of spinal cord and/or nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63075	Removal of upper spine disc and release of spinal cord and/or nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63075	Removal of upper spine disc and release of spinal cord and/or nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
63077	Removal of middle spine disc and release of spinal cord and/or nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63077	Removal of middle spine disc and release of spinal cord and/or nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63077	Removal of middle spine disc and release of spinal cord and/or nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63081	"Removal of upper spine bone with release of spinal cord and/or nerves, anterior approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63081	"Removal of upper spine bone with release of spinal cord and/or nerves, anterior approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63081	"Removal of upper spine bone with release of spinal cord and/or nerves, anterior approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63085	"Removal of middle spine bone with release of spinal cord and/or nerves, transthoracic approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63085	"Removal of middle spine bone with release of spinal cord and/or nerves, transthoracic approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63085	"Removal of middle spine bone with release of spinal cord and/or nerves, transthoracic approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63087	"Removal of middle or lower spine bone with release of spinal cord or nerves, combined thoracolumbar approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63087	"Removal of middle or lower spine bone with release of spinal cord or nerves, combined thoracolumbar approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63087	"Removal of middle or lower spine bone with release of spinal cord or nerves, combined thoracolumbar approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63090	"Removal of middle, lower, or sacral spine bone with release of spinal cord or nerves, transperitoneal or retroperitoneal approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63090	"Removal of middle, lower, or sacral spine bone with release of spinal cord or nerves, transperitoneal or retroperitoneal approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63090	"Removal of middle, lower, or sacral spine bone with release of spinal cord or nerves, transperitoneal or retroperitoneal approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63101	"Removal of middle spine bone with release of spinal cord and/or nerves, lateral extracavitary approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63101	"Removal of middle spine bone with release of spinal cord and/or nerves, lateral extracavitary approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63101	"Removal of middle spine bone with release of spinal cord and/or nerves, lateral extracavitary approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
63102	"Removal of lower spine bone with release of spinal cord and/or nerves, lateral extracavitary approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63102	"Removal of lower spine bone with release of spinal cord and/or nerves, lateral extracavitary approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63102	"Removal of lower spine bone with release of spinal cord and/or nerves, lateral extracavitary approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
63170	Removal of the spine bone around spinal canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63170	Removal of the spine bone around spinal canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63170	Removal of the spine bone around spinal canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63172	Drainage of spinal cord cyst or fluid-filled cavity into spinal canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63172	Drainage of spinal cord cyst or fluid-filled cavity into spinal canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63172	Drainage of spinal cord cyst or fluid-filled cavity into spinal canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
63173	Drainage of spinal cord cyst or fluid-filled cavity into lung or abdomen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63173	Drainage of spinal cord cyst or fluid-filled cavity into lung or abdomen	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63173	Drainage of spinal cord cyst or fluid-filled cavity into lung or abdomen	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63180	Removal of upper spine bone with removal of ligaments	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63180	Removal of upper spine bone with removal of ligaments	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63180	Removal of upper spine bone with removal of ligaments	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63182	Removal of upper spine bone with removal of ligaments	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63182	Removal of upper spine bone with removal of ligaments	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63182	Removal of upper spine bone with removal of ligaments	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63185	Removal of spine bone with severing of nerve roots	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63185	Removal of spine bone with severing of nerve roots	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
63185	Removal of spine bone with severing of nerve roots	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63190	Removal of spine bone with severing of nerve roots	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63190	Removal of spine bone with severing of nerve roots	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63190	Removal of spine bone with severing of nerve roots	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63191	Removal of spine bone with severing of spinal accessory nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63191	Removal of spine bone with severing of spinal accessory nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
63191	Removal of spine bone with severing of spinal accessory nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63194	Removal of spine bone with incision of upper spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63194	Removal of spine bone with incision of upper spinal cord	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63194	Removal of spine bone with incision of upper spinal cord	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63195	Removal of spine bone with incision of middle spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63195	Removal of spine bone with incision of middle spinal cord	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63195	Removal of spine bone with incision of middle spinal cord	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
63196	Removal of spine bone with incision of upper spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63196	Removal of spine bone with incision of upper spinal cord	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
63196	Removal of spine bone with incision of upper spinal cord	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63197	Removal of spine bone with incision of middle spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63197	Removal of spine bone with incision of middle spinal cord	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63197	Removal of spine bone with incision of middle spinal cord	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63198	"Removal of spine bone with incision of upper spinal cord, 2 stages within 14 days"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63198	"Removal of spine bone with incision of upper spinal cord, 2 stages within 14 days"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
63198	"Removal of spine bone with incision of upper spinal cord, 2 stages within 14 days"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63199	"Removal of spine bone with incision of middle spinal cord, 2 stages within 14 days"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63199	"Removal of spine bone with incision of middle spinal cord, 2 stages within 14 days"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
63199	"Removal of spine bone with incision of middle spinal cord, 2 stages within 14 days"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63200	Removal of lower spine bone with release of frayed spinal cord	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63200	Removal of lower spine bone with release of frayed spinal cord	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63200	Removal of lower spine bone with release of frayed spinal cord	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63250	Removal of upper spine bone and arteriovenous malformation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63250	Removal of upper spine bone and arteriovenous malformation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63250	Removal of upper spine bone and arteriovenous malformation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63251	Removal of upper spine bone and arteriovenous malformation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63251	Removal of upper spine bone and arteriovenous malformation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63251	Removal of upper spine bone and arteriovenous malformation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63252	Removal of upper spine bone and arteriovenous malformation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63252	Removal of upper spine bone and arteriovenous malformation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63252	Removal of upper spine bone and arteriovenous malformation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63265	Removal of upper spine bone and growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63265	Removal of upper spine bone and growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63265	Removal of upper spine bone and growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63266	Removal of middle spine bone and growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63266	Removal of middle spine bone and growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63266	Removal of middle spine bone and growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63267	Removal of lower spine bone and growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63267	Removal of lower spine bone and growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63267	Removal of lower spine bone and growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63268	Removal of sacral spine bone and growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63268	Removal of sacral spine bone and growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63268	Removal of sacral spine bone and growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63270	Removal of upper spine bone and growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63270	Removal of upper spine bone and growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63270	Removal of upper spine bone and growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63271	Removal of middle spine bone and growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63271	Removal of middle spine bone and growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63271	Removal of middle spine bone and growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63272	Removal of lower spine bone and growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63272	Removal of lower spine bone and growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63272	Removal of lower spine bone and growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63273	Removal of sacral spine bone and growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63273	Removal of sacral spine bone and growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63273	Removal of sacral spine bone and growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63275	Removal or biopsy of upper spine bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63275	Removal or biopsy of upper spine bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63275	Removal or biopsy of upper spine bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63276	Removal or biopsy of middle spine bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63276	Removal or biopsy of middle spine bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63276	Removal or biopsy of middle spine bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63277	Removal or biopsy of lower spine bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63277	Removal or biopsy of lower spine bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63277	Removal or biopsy of lower spine bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63278	Removal or biopsy of sacral spine bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63278	Removal or biopsy of sacral spine bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63278	Removal or biopsy of sacral spine bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63280	Removal or biopsy of upper spine bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63280	Removal or biopsy of upper spine bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63280	Removal or biopsy of upper spine bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63281	Removal or biopsy of middle spine bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63281	Removal or biopsy of middle spine bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63281	Removal or biopsy of middle spine bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63282	Removal or biopsy of lower spine bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63282	Removal or biopsy of lower spine bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63282	Removal or biopsy of lower spine bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63283	Removal or biopsy of sacral spine bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63283	Removal or biopsy of sacral spine bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63283	Removal or biopsy of sacral spine bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63285	Removal or biopsy of upper spine bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63285	Removal or biopsy of upper spine bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63285	Removal or biopsy of upper spine bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63286	Removal or biopsy of middle spine bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63286	Removal or biopsy of middle spine bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63286	Removal or biopsy of middle spine bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63287	Removal or biopsy of lower spine bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63287	Removal or biopsy of lower spine bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63287	Removal or biopsy of lower spine bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63290	Removal or biopsy of spine bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63290	Removal or biopsy of spine bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63290	Removal or biopsy of spine bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63300	Removal of upper spine bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63300	Removal of upper spine bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63300	Removal of upper spine bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63301	"Removal of middle spine bone growth, transthoracic approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63301	"Removal of middle spine bone growth, transthoracic approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63301	"Removal of middle spine bone growth, transthoracic approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63302	"Removal of middle spine bone growth, thoracolumbar approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63302	"Removal of middle spine bone growth, thoracolumbar approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63302	"Removal of middle spine bone growth, thoracolumbar approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63303	"Removal of lower or sacral spine bone growth, transperitoneal or retroperitoneal approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63303	"Removal of lower or sacral spine bone growth, transperitoneal or retroperitoneal approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63303	"Removal of lower or sacral spine bone growth, transperitoneal or retroperitoneal approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63304	Removal of upper spine bone growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63304	Removal of upper spine bone growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63304	Removal of upper spine bone growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63305	"Removal of middle spine bone growth, transthoracic approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63305	"Removal of middle spine bone growth, transthoracic approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63305	"Removal of middle spine bone growth, transthoracic approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63306	"Removal of middle spine bone growth, thoracolumbar approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
63306	"Removal of middle spine bone growth, thoracolumbar approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63306	"Removal of middle spine bone growth, thoracolumbar approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63307	"Removal of lower or sacral spine bone growth, transperitoneal or retroperitoneal approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63307	"Removal of lower or sacral spine bone growth, transperitoneal or retroperitoneal approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63307	"Removal of lower or sacral spine bone growth, transperitoneal or retroperitoneal approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63600	"Creation of stereotactic spinal cord lesion, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63600	"Creation of stereotactic spinal cord lesion, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
63600	"Creation of stereotactic spinal cord lesion, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
63610	Stereotactic stimulation of spinal cord through the skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
63610	Stereotactic stimulation of spinal cord through the skin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
63615	"Stereotactic biopsy, aspiration, or removal of spinal cord growth"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63615	"Stereotactic biopsy, aspiration, or removal of spinal cord growth"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63615	"Stereotactic biopsy, aspiration, or removal of spinal cord growth"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
63620	Stereotactic treatment of spine growth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63620	Stereotactic treatment of spine growth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
63620	Stereotactic treatment of spine growth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
63650	"Implantation of spinal neurostimulator electrodes, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	30	
63650	"Implantation of spinal neurostimulator electrodes, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	60	0	
63650	"Implantation of spinal neurostimulator electrodes, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	93	6	
63650	"Implantation of spinal neurostimulator electrodes, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
63655	Implantation of spinal neurostimulator electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63655	Implantation of spinal neurostimulator electrodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
63655	Implantation of spinal neurostimulator electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
63661	"Removal or revision of spinal neurostimulator electrodes, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	30	
63661	"Removal or revision of spinal neurostimulator electrodes, accessed through the skin"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	38.5	0	
63661	"Removal or revision of spinal neurostimulator electrodes, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	85	6	
63661	"Removal or revision of spinal neurostimulator electrodes, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	39	36	
63662	Removal of spinal neurostimulator electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63662	Removal of spinal neurostimulator electrodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63662	Removal of spinal neurostimulator electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
63663	Revision and replacement of spinal neurostimulator electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	30	
63663	Revision and replacement of spinal neurostimulator electrodes	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	56	0	
63663	Revision and replacement of spinal neurostimulator electrodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	125	6	
63663	Revision and replacement of spinal neurostimulator electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
63664	Revision and replacement of spinal neurostimulator electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63664	Revision and replacement of spinal neurostimulator electrodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63664	Revision and replacement of spinal neurostimulator electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
63685	Insertion of spinal neurostimulator pulse generator or receiver	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63685	Insertion of spinal neurostimulator pulse generator or receiver	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
63685	Insertion of spinal neurostimulator pulse generator or receiver	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
63688	Removal or revision of neurostimulator pulse generator or receiver	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63688	Removal or revision of neurostimulator pulse generator or receiver	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
63688	Removal or revision of neurostimulator pulse generator or receiver	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		36	
63700	Repair of (less than 5 centimeter diameter) spinal cord defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63700	Repair of (less than 5 centimeter diameter) spinal cord defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63700	Repair of (less than 5 centimeter diameter) spinal cord defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63702	Repair of (larger than 5 centimeter) spinal cord defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63702	Repair of (larger than 5 centimeter) spinal cord defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63702	Repair of (larger than 5 centimeter) spinal cord defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
63704	Repair of (less than 5 centimeter) spinal cord defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63704	Repair of (less than 5 centimeter) spinal cord defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63704	Repair of (less than 5 centimeter) spinal cord defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
63706	Repair of (larger than 5 centimeter) spinal cord defect	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63706	Repair of (larger than 5 centimeter) spinal cord defect	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63706	Repair of (larger than 5 centimeter) spinal cord defect	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
63707	Repair of spinal fluid leak	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63707	Repair of spinal fluid leak	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63707	Repair of spinal fluid leak	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63709	Repair of spinal fluid leak	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63709	Repair of spinal fluid leak	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63709	Repair of spinal fluid leak	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63710	Placement of spinal cord graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63710	Placement of spinal cord graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63710	Placement of spinal cord graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63740	Creation of spinal fluid shunt	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63740	Creation of spinal fluid shunt	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63740	Creation of spinal fluid shunt	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
63741	"Creation of spinal fluid shunt, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63741	"Creation of spinal fluid shunt, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63741	"Creation of spinal fluid shunt, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
63744	"Replacement, irrigation, or revision of lower spinal canal shunt"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63744	"Replacement, irrigation, or revision of lower spinal canal shunt"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63744	"Replacement, irrigation, or revision of lower spinal canal shunt"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
63746	Removal of lower spinal canal shunt	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
63746	Removal of lower spinal canal shunt	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
63746	Removal of lower spinal canal shunt	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
64400	"Injection of anesthetic agent, trigeminal nerve"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
64400	"Injection of anesthetic agent, trigeminal nerve"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	52	0	
64400	"Injection of anesthetic agent, trigeminal nerve"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64402	"Injection of anesthetic agent, facial nerve"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
64402	"Injection of anesthetic agent, facial nerve"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	0	
64402	"Injection of anesthetic agent, facial nerve"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64405	"Injection of anesthetic agent, greater occipital nerve"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
64405	"Injection of anesthetic agent, greater occipital nerve"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	0	
64405	"Injection of anesthetic agent, greater occipital nerve"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64408	"Injection of anesthetic agent, cranial (vagus) nerve"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	25	
64408	"Injection of anesthetic agent, cranial (vagus) nerve"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
64408	"Injection of anesthetic agent, cranial (vagus) nerve"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64410	"Injection of anesthetic agent, upper spine (phrenic) nerve"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
64410	"Injection of anesthetic agent, upper spine (phrenic) nerve"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	0	
64410	"Injection of anesthetic agent, upper spine (phrenic) nerve"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64413	"Injection of anesthetic agent, neck nerve bundle"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
64413	"Injection of anesthetic agent, neck nerve bundle"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
64413	"Injection of anesthetic agent, neck nerve bundle"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64415	"Injection of anesthetic agent, brachial (arm) nerve bundle"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	0	
64415	"Injection of anesthetic agent, brachial (arm) nerve bundle"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
64417	Injection of anesthetic agent underarm (axillary) nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
64417	Injection of anesthetic agent underarm (axillary) nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
64417	Injection of anesthetic agent underarm (axillary) nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64418	"Injection of anesthetic agent, collar bone nerve"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
64418	"Injection of anesthetic agent, collar bone nerve"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
64418	"Injection of anesthetic agent, collar bone nerve"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64420		Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
64420		Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	0	
64420		Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64421		Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
64421		Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	0	
64421		Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64425	"Injection of anesthetic agent, groin nerves"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
64425	"Injection of anesthetic agent, groin nerves"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41	0	
64425	"Injection of anesthetic agent, groin nerves"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64430	"Injection of anesthetic agent, pudendal (external genital) nerve"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
64430	"Injection of anesthetic agent, pudendal (external genital) nerve"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	0	
64430	"Injection of anesthetic agent, pudendal (external genital) nerve"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64435	"Injection of anesthetic agent, paracervical (uterine) nerve"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
64435	"Injection of anesthetic agent, paracervical (uterine) nerve"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	0	
64435	"Injection of anesthetic agent, paracervical (uterine) nerve"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64445	"Injection of anesthetic agent, sciatic nerve"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	37	0	
64445	"Injection of anesthetic agent, sciatic nerve"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
64447	"Injection of anesthetic agent, thigh nerve"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	0	
64447	"Injection of anesthetic agent, thigh nerve"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
64449		Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64450		Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	14	
64450		Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	37	0	
64450		Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64455	Injections of anesthetic and/or steroid drug into nerve of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	19	0	
64461	"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
64461	"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
64461	"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
64461	"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
64461	"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (for services under review: 67% of physician time)	10		
64461	"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
64461	"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
64461	"Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	7		
64462	"Paravertebral block (PVB) (paraspinous block), thoracic; second and any additional injection site(s), (includes imaging guidance, when performed) (List separately in addition to code for primary procedure)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (for services under review: 67% of physician time)	10		
64463	"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
64463	"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
64463	"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
64463	"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
64463	"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (for services under review: 67% of physician time)	13		
64463	"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
64463	"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
64463	"Paravertebral block (PVB) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed)"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	7		
64479	Injections of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3	0	
64479	Injections of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	21	
64479	Injections of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	17	0	
64479	Injections of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	0	
64479	Injections of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64480	Injections of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	15	0	
64480	Injections of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
64483	Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3	0	
64483	Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	21	
64483	Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	17	0	
64483	Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	0	
64483	Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64484	Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	10	0	
64484	Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	10	0	
64486	Transversus abdominis plane (tap) block unilateral	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
64486	Transversus abdominis plane (tap) block unilateral	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
64486	Transversus abdominis plane (tap) block unilateral	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
64486	Transversus abdominis plane (tap) block unilateral	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
64486	Transversus abdominis plane (tap) block unilateral	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (67%)	7		
64486	Transversus abdominis plane (tap) block unilateral	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
64486	Transversus abdominis plane (tap) block unilateral	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
64486	Transversus abdominis plane (tap) block unilateral	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	7		
64486	Transversus abdominis plane (tap) block unilateral	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
64487	Transversus abdominis plane (tap) block unilateral; by continuous infusion(s)	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
64487	Transversus abdominis plane (tap) block unilateral; by continuous infusion(s)	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
64487	Transversus abdominis plane (tap) block unilateral; by continuous infusion(s)	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
64487	Transversus abdominis plane (tap) block unilateral; by continuous infusion(s)	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
64487	Transversus abdominis plane (tap) block unilateral; by continuous infusion(s)	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (67%)	10		
64487	Transversus abdominis plane (tap) block unilateral; by continuous infusion(s)	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
64487	Transversus abdominis plane (tap) block unilateral; by continuous infusion(s)	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
64487	Transversus abdominis plane (tap) block unilateral; by continuous infusion(s)	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	7		
64487	Transversus abdominis plane (tap) block unilateral; by continuous infusion(s)	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
64488	Transversus abdominis plane (tap) block bilateral	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
64488	Transversus abdominis plane (tap) block bilateral	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
64488	Transversus abdominis plane (tap) block bilateral	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
64488	Transversus abdominis plane (tap) block bilateral	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
64488	Transversus abdominis plane (tap) block bilateral	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (67%)	10		
64488	Transversus abdominis plane (tap) block bilateral	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
64488	Transversus abdominis plane (tap) block bilateral	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
64488	Transversus abdominis plane (tap) block bilateral	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	7		
64488	Transversus abdominis plane (tap) block bilateral	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
64489	Transversus abdominis plane (tap) block bilateral by continuous infusions	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
64489	Transversus abdominis plane (tap) block bilateral by continuous infusions	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
64489	Transversus abdominis plane (tap) block bilateral by continuous infusions	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
64489	Transversus abdominis plane (tap) block bilateral by continuous infusions	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
64489	Transversus abdominis plane (tap) block bilateral by continuous infusions	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure (67%)	13		
64489	Transversus abdominis plane (tap) block bilateral by continuous infusions	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
64489	Transversus abdominis plane (tap) block bilateral by continuous infusions	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
64489	Transversus abdominis plane (tap) block bilateral by continuous infusions	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	7		
64489	Transversus abdominis plane (tap) block bilateral by continuous infusions	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
64490	Injections of upper or middle spine facet joint using imaging guidance	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3	0	
64490	Injections of upper or middle spine facet joint using imaging guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	21	
64490	Injections of upper or middle spine facet joint using imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	17	0	
64490	Injections of upper or middle spine facet joint using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
64490	Injections of upper or middle spine facet joint using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64491	Injections of upper or middle spine facet joint using imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	15	0	
64491	Injections of upper or middle spine facet joint using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
64492	Injections of upper or middle spine facet joint using imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	15	0	
64492	Injections of upper or middle spine facet joint using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
64492	Injections of upper or middle spine facet joint using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	2	2	
64493	Injections of lower or sacral spine facet joint using imaging guidance	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3	0	
64493	Injections of lower or sacral spine facet joint using imaging guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	21	
64493	Injections of lower or sacral spine facet joint using imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	17	0	
64493	Injections of lower or sacral spine facet joint using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
64493	Injections of lower or sacral spine facet joint using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64494	Injections of lower or sacral spine facet joint using imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	15	0	
64494	Injections of lower or sacral spine facet joint using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
64495	Injections of lower or sacral spine facet joint using imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	15	0	
64495	Injections of lower or sacral spine facet joint using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
64495	Injections of lower or sacral spine facet joint using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	2	2	
64505	"Injection of anesthetic agent, trigeminal nerve bundle"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	25	
64505	"Injection of anesthetic agent, trigeminal nerve bundle"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
64505	"Injection of anesthetic agent, trigeminal nerve bundle"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64508	"Injection of anesthetic agent, carotid sinus nerve"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	25	
64508	"Injection of anesthetic agent, carotid sinus nerve"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
64510	"Injection of anesthetic agent, sympathetic nerve bundle"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	21	
64510	"Injection of anesthetic agent, sympathetic nerve bundle"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	0	
64510	"Injection of anesthetic agent, sympathetic nerve bundle"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64517	"Injection of anesthetic agent, sacral nerve bundle"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
64517	"Injection of anesthetic agent, sacral nerve bundle"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	0	
64517	"Injection of anesthetic agent, sacral nerve bundle"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64520	"Injection of anesthetic agent, middle or lower spine sympathetic nerves"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	21	
64520	"Injection of anesthetic agent, middle or lower spine sympathetic nerves"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
64520	"Injection of anesthetic agent, middle or lower spine sympathetic nerves"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64530	"Injection of anesthetic agent, abdominal sympathetic nerve bundle"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	25	
64530	"Injection of anesthetic agent, abdominal sympathetic nerve bundle"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	0	
64530	"Injection of anesthetic agent, abdominal sympathetic nerve bundle"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64550	Application of skin surface neurostimulator electrodes	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	7	0	
64550	Application of skin surface neurostimulator electrodes	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	3	0	
64550	Application of skin surface neurostimulator electrodes	Post-service	L039B	Physical Therapy Assistant	0.39	Post service total costs	3	0	
64553	"Implantation of cranial nerve neurostimulator electrodes, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	23	
64553	"Implantation of cranial nerve neurostimulator electrodes, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	6	
64553	"Implantation of cranial nerve neurostimulator electrodes, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
64555	"Implantation of peripheral nerve neurostimulator electrodes, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	23	
64555	"Implantation of peripheral nerve neurostimulator electrodes, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	6	
64555	"Implantation of peripheral nerve neurostimulator electrodes, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
64561	Percutaneous implantation of neurostimulator electrode array	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
64561	Percutaneous implantation of neurostimulator electrode array	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
64561	Percutaneous implantation of neurostimulator electrode array	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
64561	Percutaneous implantation of neurostimulator electrode array	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
64561	Percutaneous implantation of neurostimulator electrode array	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2		
64561	Percutaneous implantation of neurostimulator electrode array	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
64561	Percutaneous implantation of neurostimulator electrode array	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	45		
64561	Percutaneous implantation of neurostimulator electrode array	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	2		
64561	Percutaneous implantation of neurostimulator electrode array	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
64561	Percutaneous implantation of neurostimulator electrode array	Post-service	L037D	RN/LPN/MTA	0.37	99214    53  minutes	53	53	
64561	Percutaneous implantation of neurostimulator electrode array	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
64565	"Implantation of muscular tissue neurostimulator electrodes, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	23	
64565	"Implantation of muscular tissue neurostimulator electrodes, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	52	6	
64565	"Implantation of muscular tissue neurostimulator electrodes, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
64566	"Implantation of lower leg neurostimulator electrode, accessed through the skin"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
64566	"Implantation of lower leg neurostimulator electrode, accessed through the skin"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
64566	"Implantation of lower leg neurostimulator electrode, accessed through the skin"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
64566	"Implantation of lower leg neurostimulator electrode, accessed through the skin"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
64566	"Implantation of lower leg neurostimulator electrode, accessed through the skin"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	1		
64566	"Implantation of lower leg neurostimulator electrode, accessed through the skin"	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2		
64566	"Implantation of lower leg neurostimulator electrode, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	15		
64566	"Implantation of lower leg neurostimulator electrode, accessed through the skin"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
64566	"Implantation of lower leg neurostimulator electrode, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
64568	Implantation of cranial nerve neurostimulator electrodes and generator	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64568	Implantation of cranial nerve neurostimulator electrodes and generator	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64568	Implantation of cranial nerve neurostimulator electrodes and generator	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64569	Revision of implanted cranial nerve neurostimulator electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64569	Revision of implanted cranial nerve neurostimulator electrodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64569	Revision of implanted cranial nerve neurostimulator electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64570	Removal of cranial nerve neurostimulator electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64570	Removal of cranial nerve neurostimulator electrodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64570	Removal of cranial nerve neurostimulator electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64575	Incision to implant peripheral nerve neurostimulator electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64575	Incision to implant peripheral nerve neurostimulator electrodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64575	Incision to implant peripheral nerve neurostimulator electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		41	
64580	Incision to implant muscle neurostimulator electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64580	Incision to implant muscle neurostimulator electrodes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64580	Incision to implant muscle neurostimulator electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		41	
64581	Incision to insert sacral nerve neurostimulator electrodes	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		25	
64581	Incision to insert sacral nerve neurostimulator electrodes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		53	
64585	Revision or removal of peripheral neurostimulator electrode array	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
64585	Revision or removal of peripheral neurostimulator electrode array	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	6	
64585	Revision or removal of peripheral neurostimulator electrode array	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
64590	Insertion or replacement of peripheral or gastric neurostimulator generator	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
64590	Insertion or replacement of peripheral or gastric neurostimulator generator	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	48	6	
64590	Insertion or replacement of peripheral or gastric neurostimulator generator	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
64595	Revision or removal of peripheral nerve or gastric neurostimulator generator	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
64595	Revision or removal of peripheral nerve or gastric neurostimulator generator	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	6	
64595	Revision or removal of peripheral nerve or gastric neurostimulator generator	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
64600	Destruction of trigeminal (facial) nerve branch	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	16	25	
64600	Destruction of trigeminal (facial) nerve branch	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	6	
64600	Destruction of trigeminal (facial) nerve branch	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
64605	Destruction of trigeminal (facial) nerve branch	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
64605	Destruction of trigeminal (facial) nerve branch	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	6	
64605	Destruction of trigeminal (facial) nerve branch	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
64610	Destruction of trigeminal (facial) nerve branch under X-ray monitoring	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
64610	Destruction of trigeminal (facial) nerve branch under X-ray monitoring	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	62	6	
64610	Destruction of trigeminal (facial) nerve branch under X-ray monitoring	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
64611	Injection of chemical for destruction of salivary glands on both sides of the mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	8	
64611	Injection of chemical for destruction of salivary glands on both sides of the mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	6	
64611	Injection of chemical for destruction of salivary glands on both sides of the mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
64612	Injection of chemical for destruction of nerve muscles on one side of face	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	9	
64612	Injection of chemical for destruction of nerve muscles on one side of face	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
64612	Injection of chemical for destruction of nerve muscles on one side of face	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	30	30	
64615	Injection of chemical for destruction of facial and neck nerve muscles on both sides of face	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	9	
64615	Injection of chemical for destruction of facial and neck nerve muscles on both sides of face	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
64615	Injection of chemical for destruction of facial and neck nerve muscles on both sides of face	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64616	Injection of chemical for destruction of nerve muscles on one side of neck excluding voice box accessed through the skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	9	
64616	Injection of chemical for destruction of nerve muscles on one side of neck excluding voice box accessed through the skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	24	6	
64616	Injection of chemical for destruction of nerve muscles on one side of neck excluding voice box accessed through the skin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64617	Injection of chemical for destruction of nerve muscles on one side of voice box accessed through the skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2	5	
64617	Injection of chemical for destruction of nerve muscles on one side of voice box accessed through the skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	33	6	
64620	Injection of agent to destroy rib nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
64620	Injection of agent to destroy rib nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	6	
64620	Injection of agent to destroy rib nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
64630	Destruction of pudendal (external genital) nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
64630	Destruction of pudendal (external genital) nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	6	
64630	Destruction of pudendal (external genital) nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
64632	Destruction of nerve of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	19	0	
64632	Destruction of nerve of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
64633	Destruction of upper or middle spinal facet joint nerves using imaging guidance	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3	0	
64633	Destruction of upper or middle spinal facet joint nerves using imaging guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	21	
64633	Destruction of upper or middle spinal facet joint nerves using imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	34	0	
64633	Destruction of upper or middle spinal facet joint nerves using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	0	
64633	Destruction of upper or middle spinal facet joint nerves using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
64634	Destruction of upper or middle spinal facet joint nerves with imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20	0	
64634	Destruction of upper or middle spinal facet joint nerves with imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
64635	Destruction of lower or sacral spinal facet joint nerves using imaging guidance	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3	0	
64635	Destruction of lower or sacral spinal facet joint nerves using imaging guidance	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	21	
64635	Destruction of lower or sacral spinal facet joint nerves using imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	32	0	
64635	Destruction of lower or sacral spinal facet joint nerves using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	0	
64635	Destruction of lower or sacral spinal facet joint nerves using imaging guidance	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
64636	Destruction of lower or sacral spinal facet joint nerves with imaging guidance	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	15	0	
64636	Destruction of lower or sacral spinal facet joint nerves with imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
64640	Destruction of peripheral nerve or branch	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
64640	Destruction of peripheral nerve or branch	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28	6	
64640	Destruction of peripheral nerve or branch	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
64642	"Injection of chemical for destruction of nerve muscles on arm or leg, 1-4 muscles"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	9	
64642	"Injection of chemical for destruction of nerve muscles on arm or leg, 1-4 muscles"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	0	
64642	"Injection of chemical for destruction of nerve muscles on arm or leg, 1-4 muscles"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64643	"Injection of chemical for destruction of nerve muscles on arm or leg, 1-4 muscles"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
64644	"Injection of chemical for destruction of nerve muscles on arm or leg, 5 or more muscles"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	9	
64644	"Injection of chemical for destruction of nerve muscles on arm or leg, 5 or more muscles"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	0	
64644	"Injection of chemical for destruction of nerve muscles on arm or leg, 5 or more muscles"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64645	"Injection of chemical for destruction of nerve muscles on arm or leg, 5 or more muscles"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25	0	
64646	"Injection of chemical for destruction of nerve muscles on trunk, 5 or more muscles"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	9	
64646	"Injection of chemical for destruction of nerve muscles on trunk, 5 or more muscles"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	0	
64646	"Injection of chemical for destruction of nerve muscles on trunk, 5 or more muscles"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64647	"Injection of chemical for destruction of nerve muscles on trunk, 6 or more muscles"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	9	
64647	"Injection of chemical for destruction of nerve muscles on trunk, 6 or more muscles"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43	0	
64647	"Injection of chemical for destruction of nerve muscles on trunk, 6 or more muscles"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
64650	Injection of chemical for destruction of underarm sweat glands	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	29	0	
64650	Injection of chemical for destruction of underarm sweat glands	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
64653	Injection of chemical for destruction of sweat glands	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	29	0	
64653	Injection of chemical for destruction of sweat glands	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
64680	Injection of agent to destroy abdominal sympathetic nerve bundle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
64680	Injection of agent to destroy abdominal sympathetic nerve bundle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	56	6	
64680	Injection of agent to destroy abdominal sympathetic nerve bundle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
64681	Injection of agent to destroy sacral nerve bundle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	0	
64681	Injection of agent to destroy sacral nerve bundle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	66	6	
64681	Injection of agent to destroy sacral nerve bundle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
64702	Release of nerve of finger	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64702	Release of nerve of finger	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64702	Release of nerve of finger	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
64704	Release of nerve of hand or foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64704	Release of nerve of hand or foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64704	Release of nerve of hand or foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
64708	"Release of nerve of arm or leg, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64708	"Release of nerve of arm or leg, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64708	"Release of nerve of arm or leg, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
64712	"Release of sciatic nerve, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64712	"Release of sciatic nerve, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64712	"Release of sciatic nerve, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
64713	"Release of major nerve of arm or leg, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64713	"Release of major nerve of arm or leg, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64713	"Release of major nerve of arm or leg, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
64714	"Release of nerve of upper leg, open procedure"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64714	"Release of nerve of upper leg, open procedure"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64714	"Release of nerve of upper leg, open procedure"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
64716	Release and/or relocation of cranial nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64716	Release and/or relocation of cranial nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64716	Release and/or relocation of cranial nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		99	
64718	Release and/or relocation of ulnar nerve at elbow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64718	Release and/or relocation of ulnar nerve at elbow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64718	Release and/or relocation of ulnar nerve at elbow	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
64719	Release and/or relocation ulnar nerve at wrist	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64719	Release and/or relocation ulnar nerve at wrist	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64719	Release and/or relocation ulnar nerve at wrist	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
64721	Release and/or relocation of median nerve of hand	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
64721	Release and/or relocation of median nerve of hand	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	6	
64721	Release and/or relocation of median nerve of hand	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	99	99	
64722	Release of unspecified nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64722	Release of unspecified nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64722	Release of unspecified nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
64726	Release of nerve at sole of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64726	Release of nerve at sole of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64726	Release of nerve at sole of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
64732	Incision or removal of nerve to forehead scalp and upper eyelid	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64732	Incision or removal of nerve to forehead scalp and upper eyelid	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64732	Incision or removal of nerve to forehead scalp and upper eyelid	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
64734	Incision or removal of nerve to lower eyelid upper lip and mouth	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64734	Incision or removal of nerve to lower eyelid upper lip and mouth	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64734	Incision or removal of nerve to lower eyelid upper lip and mouth	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64736	Incision or removal of nerve to chin lower lip and jaw	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64736	Incision or removal of nerve to chin lower lip and jaw	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64736	Incision or removal of nerve to chin lower lip and jaw	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64738	Incision or removal of nerve to teeth and jaw bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64738	Incision or removal of nerve to teeth and jaw bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64738	Incision or removal of nerve to teeth and jaw bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64740	Incision or removal of nerve to tongue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64740	Incision or removal of nerve to tongue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64740	Incision or removal of nerve to tongue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64742	Incision or removal of facial nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64742	Incision or removal of facial nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64742	Incision or removal of facial nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64744	Incision or removal of nerve to scalp and over ear	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64744	Incision or removal of nerve to scalp and over ear	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64744	Incision or removal of nerve to scalp and over ear	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
64746	Incision or removal of nerve to abdomen gallbladder and liver	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64746	Incision or removal of nerve to abdomen gallbladder and liver	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64746	Incision or removal of nerve to abdomen gallbladder and liver	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64755	Incision or removal of nerve to stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64755	Incision or removal of nerve to stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64755	Incision or removal of nerve to stomach	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		63	
64760	Incision or removal of nerve to abdomen	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64760	Incision or removal of nerve to abdomen	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64760	Incision or removal of nerve to abdomen	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64763	Incision or removal of nerve outside of pelvis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64763	Incision or removal of nerve outside of pelvis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64763	Incision or removal of nerve outside of pelvis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64766	Incision or removal of nerve outside of pelvis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64766	Incision or removal of nerve outside of pelvis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64766	Incision or removal of nerve outside of pelvis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64771	Incision or removal of cranial nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64771	Incision or removal of cranial nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64771	Incision or removal of cranial nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64772	Incision or removal of spinal nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64772	Incision or removal of spinal nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64772	Incision or removal of spinal nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64774	Removal of growth of skin nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64774	Removal of growth of skin nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64774	Removal of growth of skin nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64776	Removal of growth of finger or toe nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64776	Removal of growth of finger or toe nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64776	Removal of growth of finger or toe nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
64782	Removal of growth of hand or foot nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64782	Removal of growth of hand or foot nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64782	Removal of growth of hand or foot nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64784	Removal of growth of peripheral nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64784	Removal of growth of peripheral nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64784	Removal of growth of peripheral nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64786	Removal of growth of sciatic nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64786	Removal of growth of sciatic nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64786	Removal of growth of sciatic nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64788	Removal of growth of skin nerve or nerve lining	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64788	Removal of growth of skin nerve or nerve lining	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64788	Removal of growth of skin nerve or nerve lining	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64790	Removal of growth of peripheral nerve or nerve lining	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64790	Removal of growth of peripheral nerve or nerve lining	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64790	Removal of growth of peripheral nerve or nerve lining	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64792	Removal of growth of peripheral nerve or nerve lining	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64792	Removal of growth of peripheral nerve or nerve lining	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64792	Removal of growth of peripheral nerve or nerve lining	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
64795	Biopsy of nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
64795	Biopsy of nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
64802	Removal of upper spine sympathetic nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64802	Removal of upper spine sympathetic nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64802	Removal of upper spine sympathetic nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64804	Removal of upper and middle spine sympathetic nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64804	Removal of upper and middle spine sympathetic nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64804	Removal of upper and middle spine sympathetic nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64809	Removal of middle and lower spine sympathetic nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64809	Removal of middle and lower spine sympathetic nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64809	Removal of middle and lower spine sympathetic nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64818	Removal of lower spine sympathetic nerves	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64818	Removal of lower spine sympathetic nerves	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64818	Removal of lower spine sympathetic nerves	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64820	Removal of finger or toe sympathetic nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64820	Removal of finger or toe sympathetic nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64820	Removal of finger or toe sympathetic nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
64821	Removal of sympathetic radial (lower arm) artery nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64821	Removal of sympathetic radial (lower arm) artery nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64821	Removal of sympathetic radial (lower arm) artery nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
64822	Removal of sympathetic ulnar (lower arm) artery nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64822	Removal of sympathetic ulnar (lower arm) artery nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64822	Removal of sympathetic ulnar (lower arm) artery nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
64823	Removal of sympathetic palmar (hand) nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64823	Removal of sympathetic palmar (hand) nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64823	Removal of sympathetic palmar (hand) nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
64831	Suture of hand or foot digital nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64831	Suture of hand or foot digital nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64831	Suture of hand or foot digital nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
64834	Suture of hand or foot common sensory nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64834	Suture of hand or foot common sensory nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64834	Suture of hand or foot common sensory nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64835	Suture of median motor thenar nerve (hand)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64835	Suture of median motor thenar nerve (hand)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64835	Suture of median motor thenar nerve (hand)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64836	Suture of ulnar nerve (forearm or hand)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64836	Suture of ulnar nerve (forearm or hand)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64836	Suture of ulnar nerve (forearm or hand)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64840	Suture of foreleg nerve to sole of foot	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64840	Suture of foreleg nerve to sole of foot	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64840	Suture of foreleg nerve to sole of foot	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
64856	"Suture of peripheral nerve, arm or leg, with relocation to new site"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64856	"Suture of peripheral nerve, arm or leg, with relocation to new site"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64856	"Suture of peripheral nerve, arm or leg, with relocation to new site"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64857	"Suture of peripheral nerve, arm or leg"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64857	"Suture of peripheral nerve, arm or leg"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64857	"Suture of peripheral nerve, arm or leg"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64858	Suture of sciatic nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64858	Suture of sciatic nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64858	Suture of sciatic nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64861	Suture of nerve bundle to arm	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64861	Suture of nerve bundle to arm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64861	Suture of nerve bundle to arm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
64862	Suture of lower spine nerve bundle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64862	Suture of lower spine nerve bundle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64862	Suture of lower spine nerve bundle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
64864	Suture of facial nerve outside skull	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64864	Suture of facial nerve outside skull	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64864	Suture of facial nerve outside skull	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		72	
64865	Suture of facial nerve at temple	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64865	Suture of facial nerve at temple	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64865	Suture of facial nerve at temple	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		100	
64866	Connection of nerves to restore function to the face	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64866	Connection of nerves to restore function to the face	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64866	Connection of nerves to restore function to the face	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		100	
64868	Connection of nerves to restore function to the face	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64868	Connection of nerves to restore function to the face	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64868	Connection of nerves to restore function to the face	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		82	
64885	Placement of (up to 4 centimeter length) head or neck nerve graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64885	Placement of (up to 4 centimeter length) head or neck nerve graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64885	Placement of (up to 4 centimeter length) head or neck nerve graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
64886	Placement of (more than 4 centimeter length) head or neck nerve graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64886	Placement of (more than 4 centimeter length) head or neck nerve graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64886	Placement of (more than 4 centimeter length) head or neck nerve graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
64890	Placement of (up to 4 centimeter length) hand or foot nerve graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64890	Placement of (up to 4 centimeter length) hand or foot nerve graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64890	Placement of (up to 4 centimeter length) hand or foot nerve graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64891	Placement of (more than 4 centimeter length) hand or foot nerve graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64891	Placement of (more than 4 centimeter length) hand or foot nerve graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64891	Placement of (more than 4 centimeter length) hand or foot nerve graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64892	Placement of (up to 4 centimeter length) arm or leg nerve graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64892	Placement of (up to 4 centimeter length) arm or leg nerve graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64892	Placement of (up to 4 centimeter length) arm or leg nerve graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64893	Placement of (more than 4 centimeter length) arm or leg nerve graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64893	Placement of (more than 4 centimeter length) arm or leg nerve graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64893	Placement of (more than 4 centimeter length) arm or leg nerve graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64895	Placement of multiple (up to 4 centimeter length) hand or foot nerve grafts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64895	Placement of multiple (up to 4 centimeter length) hand or foot nerve grafts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64895	Placement of multiple (up to 4 centimeter length) hand or foot nerve grafts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64896	Placement of multiple (more than 4 centimeter length) hand or foot nerve grafts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64896	Placement of multiple (more than 4 centimeter length) hand or foot nerve grafts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64896	Placement of multiple (more than 4 centimeter length) hand or foot nerve grafts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
64897	Placement of multiple (up to 4 centimeter length) arm or leg nerve grafts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64897	Placement of multiple (up to 4 centimeter length) arm or leg nerve grafts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64897	Placement of multiple (up to 4 centimeter length) arm or leg nerve grafts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64898	Placement of multiple (more than 4 centimeter length) arm or leg nerve grafts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64898	Placement of multiple (more than 4 centimeter length) arm or leg nerve grafts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64898	Placement of multiple (more than 4 centimeter length) arm or leg nerve grafts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
64905	"Transfer of nerve to injured nerve, first stage"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64905	"Transfer of nerve to injured nerve, first stage"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64905	"Transfer of nerve to injured nerve, first stage"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64907	"Transfer of nerve to injured nerve, second stage"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64907	"Transfer of nerve to injured nerve, second stage"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
64907	"Transfer of nerve to injured nerve, second stage"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
64910	Repair of nerve with graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64910	Repair of nerve with graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64910	Repair of nerve with graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
64911	Repair of nerve using vein graft	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
64911	Repair of nerve using vein graft	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
64911	Repair of nerve using vein graft	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
65091	Removal of eye contents	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65091	Removal of eye contents	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65091	Removal of eye contents	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		90	
65093	Removal of eye contents with insertion of implant	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65093	Removal of eye contents with insertion of implant	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65093	Removal of eye contents with insertion of implant	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		95	
65101	Removal of eyeball	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65101	Removal of eyeball	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65101	Removal of eyeball	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
65103	Removal of eyeball with implant	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65103	Removal of eyeball with implant	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65103	Removal of eyeball with implant	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
65105	Removal of eyeball with implant attached to muscles	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65105	Removal of eyeball with implant attached to muscles	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65105	Removal of eyeball with implant attached to muscles	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		162	
65110	Removal of eye contents	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65110	Removal of eye contents	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65110	Removal of eye contents	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		198	
65112	Removal of eye contents and orbital bone	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65112	Removal of eye contents and orbital bone	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65112	Removal of eye contents and orbital bone	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		234	
65114	Removal of eye contents with muscle or flap graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65114	Removal of eye contents with muscle or flap graft	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65114	Removal of eye contents with muscle or flap graft	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		234	
65125	Modification to reshape ocular implant	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
65125	Modification to reshape ocular implant	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	59	6	
65125	Modification to reshape ocular implant	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	81	81	
65130	Insertion of permanent ocular prosthesis into orbit	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65130	Insertion of permanent ocular prosthesis into orbit	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65130	Insertion of permanent ocular prosthesis into orbit	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
65135	Insertion of permanent ocular prosthesis into orbit	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65135	Insertion of permanent ocular prosthesis into orbit	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65135	Insertion of permanent ocular prosthesis into orbit	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
65140	Insertion of permanent ocular prosthesis into orbit with muscle attachment	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65140	Insertion of permanent ocular prosthesis into orbit with muscle attachment	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65140	Insertion of permanent ocular prosthesis into orbit with muscle attachment	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		162	
65150	Reinsertion of ocular implant	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65150	Reinsertion of ocular implant	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65150	Reinsertion of ocular implant	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		95	
65155	Reinsertion of ocular implant	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65155	Reinsertion of ocular implant	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65155	Reinsertion of ocular implant	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		162	
65175	Removal of ocular implant	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65175	Removal of ocular implant	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65175	Removal of ocular implant	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		126	
65205	"Removal of foreign body in external eye, conjunctiva"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5	10	
65205	"Removal of foreign body in external eye, conjunctiva"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	17	0	
65205	"Removal of foreign body in external eye, conjunctiva"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	3	0	
65210	"Removal of foreign body in external eye, conjunctiva or sclera"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5	10	
65210	"Removal of foreign body in external eye, conjunctiva or sclera"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	22	0	
65210	"Removal of foreign body in external eye, conjunctiva or sclera"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	3	0	
65220	"Removal of foreign body, external eye, cornea"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5	10	
65220	"Removal of foreign body, external eye, cornea"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	21	0	
65220	"Removal of foreign body, external eye, cornea"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	3	0	
65222	"Removal of foreign body, external eye, cornea with slit lamp examination"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5	10	
65222	"Removal of foreign body, external eye, cornea with slit lamp examination"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	21	0	
65222	"Removal of foreign body, external eye, cornea with slit lamp examination"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	3	0	
65235	Removal of foreign body from inside the eye or lens	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65235	Removal of foreign body from inside the eye or lens	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65235	Removal of foreign body from inside the eye or lens	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		162	
65260	Removal of foreign body from inside eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65260	Removal of foreign body from inside eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65260	Removal of foreign body from inside eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		180	
65265	Removal of foreign body from inside eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65265	Removal of foreign body from inside eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65265	Removal of foreign body from inside eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		198	
65270	Repair of lacerated conjunctiva	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	15	0	
65270	Repair of lacerated conjunctiva	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	42	6	
65270	Repair of lacerated conjunctiva	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
65272	Repair of lacerated conjunctiva using flap or graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	0	
65272	Repair of lacerated conjunctiva using flap or graft	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	45	6	
65272	Repair of lacerated conjunctiva using flap or graft	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	90	90	
65273	"Repair of lacerated conjunctiva using flap or graft, requiring hospitalization"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65273	"Repair of lacerated conjunctiva using flap or graft, requiring hospitalization"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		90	
65275	Repair of lacerated cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	25	0	
65275	Repair of lacerated cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	68	6	
65275	Repair of lacerated cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	108	108	
65280	Repair of perforating laceration of cornea and/or sclera	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65280	Repair of perforating laceration of cornea and/or sclera	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		162	
65285	Repair of perforating laceration of cornea and/or sclera	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65285	Repair of perforating laceration of cornea and/or sclera	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		243	
65286	Repair of lacerated cornea and/or sclera	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	25	0	
65286	Repair of lacerated cornea and/or sclera	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	56	6	
65286	Repair of lacerated cornea and/or sclera	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	126	126	
65290	Repair of injured eye muscle or tendon	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65290	Repair of injured eye muscle or tendon	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		126	
65400	Removal of growth of cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
65400	Removal of growth of cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	70	6	
65400	Removal of growth of cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	162	162	
65410	Biopsy of cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
65410	Biopsy of cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	34	0	
65420	Removal or relocation of corneal conjunctiva	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
65420	Removal or relocation of corneal conjunctiva	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	56	6	
65420	Removal or relocation of corneal conjunctiva	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	108	108	
65426	Removal or relocation of corneal conjunctiva	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
65426	Removal or relocation of corneal conjunctiva	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	73	6	
65426	Removal or relocation of corneal conjunctiva	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	108	108	
65430	Scraping of cornea for diagnosis	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
65430	Scraping of cornea for diagnosis	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	18	0	
65435	Removal of outer layer of cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
65435	Removal of outer layer of cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	17	0	
65436	Removal of outer layer of cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	50	
65436	Removal of outer layer of cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	32	6	
65436	Removal of outer layer of cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	72	72	
65450	Destruction of lesion of cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
65450	Destruction of lesion of cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	26	6	
65450	Destruction of lesion of cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	108	108	
65600	Multiple punctures of cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	55	
65600	Multiple punctures of cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	34	6	
65600	Multiple punctures of cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	90	90	
65710	Transplantation of tissue from one cornea to other cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65710	Transplantation of tissue from one cornea to other cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65710	Transplantation of tissue from one cornea to other cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		250	
65730	Transplantation of tissue from one cornea to other cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65730	Transplantation of tissue from one cornea to other cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65730	Transplantation of tissue from one cornea to other cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		250	
65750	Transplantation of tissue from one cornea to other cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65750	Transplantation of tissue from one cornea to other cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65750	Transplantation of tissue from one cornea to other cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		216	
65755	Transplantation of tissue from one cornea to other cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65755	Transplantation of tissue from one cornea to other cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65755	Transplantation of tissue from one cornea to other cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		216	
65756	Transplant of outer layer of corneal tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
65756	Transplant of outer layer of corneal tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
65756	Transplant of outer layer of corneal tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		189	
65770	Placement of tube with optical power to cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65770	Placement of tube with optical power to cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65770	Placement of tube with optical power to cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		234	
65772	Incisions to cornea to correct astigmatism	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
65772	Incisions to cornea to correct astigmatism	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	42	6	
65772	Incisions to cornea to correct astigmatism	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	90	90	
65775	Excision of corneal tissue to correct astigmatism	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65775	Excision of corneal tissue to correct astigmatism	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65775	Excision of corneal tissue to correct astigmatism	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		126	
65778	Insertion of amniotic membrane to eye surface	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
65778	Insertion of amniotic membrane to eye surface	Service  pre	L038A	COMT/COT/RN/CST	0.38	Obtain vital signs	3		
65778	Insertion of amniotic membrane to eye surface	Service  pre	L038A	COMT/COT/RN/CST	0.38	Prepare and position pt/ monitor pt/ set up IV	2		
65778	Insertion of amniotic membrane to eye surface	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Prepare room, equipment, supplies"	2		
65778	Insertion of amniotic membrane to eye surface	Service  pre	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent	3		
65778	Insertion of amniotic membrane to eye surface	Service  intra	L038A	COMT/COT/RN/CST	0.38	Assist physician in performing procedure	5		
65778	Insertion of amniotic membrane to eye surface	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean room/equipment by physician staff	3		
65779	Insertion of amniotic membrane to eye surface with sutures	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		5	
65779	Insertion of amniotic membrane to eye surface with sutures	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
65779	Insertion of amniotic membrane to eye surface with sutures	Service  pre	L038A	COMT/COT/RN/CST	0.38	Obtain vital signs	3		
65779	Insertion of amniotic membrane to eye surface with sutures	Service  pre	L038A	COMT/COT/RN/CST	0.38	Prepare and position pt/ monitor pt/ set up IV	2		
65779	Insertion of amniotic membrane to eye surface with sutures	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Prepare room, equipment, supplies"	2		
65779	Insertion of amniotic membrane to eye surface with sutures	Service  pre	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent	3		
65779	Insertion of amniotic membrane to eye surface with sutures	Service  pre	L038A	COMT/COT/RN/CST	0.38	Setup scope (non facility setting only)	0		
65779	Insertion of amniotic membrane to eye surface with sutures	Service  intra	L038A	COMT/COT/RN/CST	0.38	Assist physician in performing procedure	30		
65779	Insertion of amniotic membrane to eye surface with sutures	Service  post	L038A	COMT/COT/RN/CST	0.38	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
65779	Insertion of amniotic membrane to eye surface with sutures	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean room/equipment by physician staff	3		
65779	Insertion of amniotic membrane to eye surface with sutures	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean surgical instrument package	10		
65779	Insertion of amniotic membrane to eye surface with sutures	Service  post	L038A	COMT/COT/RN/CST	0.38	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		0	
65779	Insertion of amniotic membrane to eye surface with sutures	Service  post	L038A	COMT/COT/RN/CST	0.38	"Monitor pt following service/check tubes, monitors, drains"	1		
65780	Transplantation of fetal sac tissue to cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
65780	Transplantation of fetal sac tissue to cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
65780	Transplantation of fetal sac tissue to cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
65780	Transplantation of fetal sac tissue to cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
65780	Transplantation of fetal sac tissue to cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
65780	Transplantation of fetal sac tissue to cornea	Service  post	L038A	COMT/COT/RN/CST	0.38	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		6	
65780	Transplantation of fetal sac tissue to cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	99212    27  minutes		135	
65780	Transplantation of fetal sac tissue to cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		72	
65781	Transplantation of stem cells to cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65781	Transplantation of stem cells to cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65781	Transplantation of stem cells to cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		270	
65782	Transplantation of stem cells from one cornea to other cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65782	Transplantation of stem cells from one cornea to other cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65782	Transplantation of stem cells from one cornea to other cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		243	
65785	Implantation of intrastromal corneal ring segments	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms	5	5	
65785	Implantation of intrastromal corneal ring segments	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
65785	Implantation of intrastromal corneal ring segments	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions	10	7	
65785	Implantation of intrastromal corneal ring segments	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent	10	20	
65785	Implantation of intrastromal corneal ring segments	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
65785	Implantation of intrastromal corneal ring segments	Service  pre	L038A	COMT/COT/RN/CST	0.38	Greet patient and provide gowning	3		
65785	Implantation of intrastromal corneal ring segments	Service  pre	L038A	COMT/COT/RN/CST	0.38	Obtain vital signs	3		
65785	Implantation of intrastromal corneal ring segments	Service  pre	L038A	COMT/COT/RN/CST	0.38	Prepare and position pt/ monitor pt/ set up IV	2		
65785	Implantation of intrastromal corneal ring segments	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Prepare room, equipment, supplies"	7		
65785	Implantation of intrastromal corneal ring segments	Service  pre	L038A	COMT/COT/RN/CST	0.38	Setup scope (non facility setting only)	0		
65785	Implantation of intrastromal corneal ring segments	Service  intra	L038A	COMT/COT/RN/CST	0.38	Assist physician in performing procedure	30		
65785	Implantation of intrastromal corneal ring segments	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean room/equipment by physician staff	3		
65785	Implantation of intrastromal corneal ring segments	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean surgical instrument package	15		
65785	Implantation of intrastromal corneal ring segments	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management  same day 99238 --6 minutes		0	
65785	Implantation of intrastromal corneal ring segments	Post-service	L038A	COMT/COT/RN/CST	0.38	99212    27  minutes	81	81	
65785	Implantation of intrastromal corneal ring segments	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes	36	36	
65800	Aspiration of eye fluid	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	32	0	
65800	Aspiration of eye fluid	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	3	0	
65810	Aspiration of eye fluid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		57	
65810	Aspiration of eye fluid	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65810	Aspiration of eye fluid	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		108	
65815	Aspiration of blood from eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
65815	Aspiration of blood from eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	61	6	
65815	Aspiration of blood from eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	108	108	
65820	Incision to improve eye fluid flow	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65820	Incision to improve eye fluid flow	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65820	Incision to improve eye fluid flow	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		153	
65850	Insertion of eye fluid drainage tube	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65850	Insertion of eye fluid drainage tube	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65850	Insertion of eye fluid drainage tube	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		135	
65855	Trabeculoplasty by laser surgery	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		3	
65855	Trabeculoplasty by laser surgery	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		3	
65855	Trabeculoplasty by laser surgery	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions	0	3	
65855	Trabeculoplasty by laser surgery	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent	0	3	
65855	Trabeculoplasty by laser surgery	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		3	
65855	Trabeculoplasty by laser surgery	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
65855	Trabeculoplasty by laser surgery	Service  pre	L038A	COMT/COT/RN/CST	0.38	Obtain vital signs	3		
65855	Trabeculoplasty by laser surgery	Service  pre	L038A	COMT/COT/RN/CST	0.38	Prepare and position pt/ monitor pt/ set up IV	2		
65855	Trabeculoplasty by laser surgery	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Prepare room, equipment, supplies"	2		
65855	Trabeculoplasty by laser surgery	Service  pre	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent	3		
65855	Trabeculoplasty by laser surgery	Service  intra	L038A	COMT/COT/RN/CST	0.38	Assist physician in performing procedure	10		
65855	Trabeculoplasty by laser surgery	Service  post	L038A	COMT/COT/RN/CST	0.38	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
65855	Trabeculoplasty by laser surgery	Service  post	L038A	COMT/COT/RN/CST	0.38	Check IOP	3		
65855	Trabeculoplasty by laser surgery	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean room/equipment by physician staff	3		
65855	Trabeculoplasty by laser surgery	Post-service	L038A	COMT/COT/RN/CST	0.38	99212    27  minutes	27	27	
65860	Laser removal of scar tissue in eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
65860	Laser removal of scar tissue in eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	54	6	
65860	Laser removal of scar tissue in eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
65865	Removal of scar tissue in eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65865	Removal of scar tissue in eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65865	Removal of scar tissue in eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		95	
65870	Removal of scar tissue in eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65870	Removal of scar tissue in eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65870	Removal of scar tissue in eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		126	
65875	Removal of scar tissue in eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65875	Removal of scar tissue in eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65875	Removal of scar tissue in eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
65880	Removal of corneal scar tissue	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65880	Removal of corneal scar tissue	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65880	Removal of corneal scar tissue	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
65900	Removal of outer lining of cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65900	Removal of outer lining of cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65900	Removal of outer lining of cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		180	
65920	Removal of implanted lens in eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65920	Removal of implanted lens in eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65920	Removal of implanted lens in eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		180	
65930	Removal of blood clot from eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
65930	Removal of blood clot from eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
65930	Removal of blood clot from eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		108	
66020	Injection of air or liquid into eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	13	18	
66020	Injection of air or liquid into eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	33	6	
66020	Injection of air or liquid into eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
66030	Injection of medication into eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	13	18	
66030	Injection of medication into eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	33	6	
66030	Injection of medication into eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
66130	Removal of growth of sclera	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
66130	Removal of growth of sclera	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	55	6	
66130	Removal of growth of sclera	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	81	81	
66150	Creation of eye fluid drainage tract with removal of iris	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66150	Creation of eye fluid drainage tract with removal of iris	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66150	Creation of eye fluid drainage tract with removal of iris	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		252	
66155	Creation of eye fluid drainage tract with removal of iris	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66155	Creation of eye fluid drainage tract with removal of iris	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66155	Creation of eye fluid drainage tract with removal of iris	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		252	
66160	Creation of eye fluid drainage tract with removal of sclera and iris	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66160	Creation of eye fluid drainage tract with removal of sclera and iris	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66160	Creation of eye fluid drainage tract with removal of sclera and iris	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		252	
66170	Creation of eye fluid drainage tract	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
66170	Creation of eye fluid drainage tract	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
66170	Creation of eye fluid drainage tract	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
66170	Creation of eye fluid drainage tract	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
66170	Creation of eye fluid drainage tract	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
66170	Creation of eye fluid drainage tract	Service  pre	L038A	COMT/COT/RN/CST	0.38	Dischrg mgmt (0.5 x 99238) (enter 6 min)		6	
66170	Creation of eye fluid drainage tract	Post-service	L038A	COMT/COT/RN/CST	0.38	99212    27  minutes		108	
66170	Creation of eye fluid drainage tract	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		180	
66172	Creation of eye fluid drainage tract	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
66172	Creation of eye fluid drainage tract	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
66172	Creation of eye fluid drainage tract	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
66172	Creation of eye fluid drainage tract	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
66172	Creation of eye fluid drainage tract	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
66172	Creation of eye fluid drainage tract	Service  post	L038A	COMT/COT/RN/CST	0.38	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		6	
66172	Creation of eye fluid drainage tract	Post-service	L038A	COMT/COT/RN/CST	0.38	99212    27  minutes		162	
66172	Creation of eye fluid drainage tract	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		180	
66174	Dilation to improve eye fluid flow	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66174	Dilation to improve eye fluid flow	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66174	Dilation to improve eye fluid flow	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		180	
66175	Dilation with insertion of device or stent to improve eye fluid flow	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66175	Dilation with insertion of device or stent to improve eye fluid flow	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66175	Dilation with insertion of device or stent to improve eye fluid flow	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		180	
66179	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
66179	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
66179	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
66179	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
66179	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
66179	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft"	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management 99238 --12 minutes		6	
66179	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft"	Post-service	L038A	COMT/COT/RN/CST	0.38	99212    27  minutes		81	
66179	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft"	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		180	
66180	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
66180	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
66180	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
66180	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
66180	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
66180	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft"	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management 99238 --12 minutes		6	
66180	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft"	Post-service	L038A	COMT/COT/RN/CST	0.38	99212    27  minutes		81	
66180	"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft"	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		180	
66183	"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66183	"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66183	"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		261	
66184	Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
66184	Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
66184	Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
66184	Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
66184	Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
66184	Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management 99238 --12 minutes		6	
66184	Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft	Post-service	L038A	COMT/COT/RN/CST	0.38	99212    27  minutes		81	
66184	Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		144	
66185	Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
66185	Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
66185	Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
66185	Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
66185	Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
66185	Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management 99238 --12 minutes		6	
66185	Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft	Post-service	L038A	COMT/COT/RN/CST	0.38	99212    27  minutes		81	
66185	Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		144	
66220	Removal of protrusion of sclera or cornea	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66220	Removal of protrusion of sclera or cornea	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66220	Removal of protrusion of sclera or cornea	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		162	
66225	Removal of protrusion sclera or cornea with graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66225	Removal of protrusion sclera or cornea with graft	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66225	Removal of protrusion sclera or cornea with graft	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		180	
66250	Revision or repair of operative wound of eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
66250	Revision or repair of operative wound of eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	69	6	
66250	Revision or repair of operative wound of eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	126	126	
66500	Incision of iris to improve eye fluid flow	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66500	Incision of iris to improve eye fluid flow	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66500	Incision of iris to improve eye fluid flow	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		68	
66505	Incision and drainage of eye fluid accumulation in iris	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66505	Incision and drainage of eye fluid accumulation in iris	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66505	Incision and drainage of eye fluid accumulation in iris	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		81	
66600	Removal of iris and growth	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66600	Removal of iris and growth	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66600	Removal of iris and growth	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		162	
66605	Removal of iris and eyelid border to improve eye fluid flow	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66605	Removal of iris and eyelid border to improve eye fluid flow	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66605	Removal of iris and eyelid border to improve eye fluid flow	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		162	
66625	Removal of iris to improve eye fluid flow	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66625	Removal of iris to improve eye fluid flow	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66625	Removal of iris to improve eye fluid flow	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		95	
66630	Removal of iris to improve eye fluid flow	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66630	Removal of iris to improve eye fluid flow	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66630	Removal of iris to improve eye fluid flow	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		126	
66635	Removal of iris and eyelid border to improve eye fluid flow	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66635	Removal of iris and eyelid border to improve eye fluid flow	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66635	Removal of iris and eyelid border to improve eye fluid flow	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		126	
66680	Repair of iris and lens tissue	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66680	Repair of iris and lens tissue	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66680	Repair of iris and lens tissue	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		108	
66682	Repair of iris and lens tissue	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66682	Repair of iris and lens tissue	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66682	Repair of iris and lens tissue	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		126	
66700	Destruction of lens tissue	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
66700	Destruction of lens tissue	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	75	6	
66700	Destruction of lens tissue	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	63	63	
66710	Destruction of lens tissue using laser	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
66710	Destruction of lens tissue using laser	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	49	6	
66710	Destruction of lens tissue using laser	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	63	63	
66711	Destruction of tissue encircling lens using en endoscope	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66711	Destruction of tissue encircling lens using en endoscope	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66711	Destruction of tissue encircling lens using en endoscope	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		171	
66720	Destruction of tissue encircling lens	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
66720	Destruction of tissue encircling lens	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	67	6	
66720	Destruction of tissue encircling lens	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	122	122	
66740	Destruction of tissue of eyelid border	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
66740	Destruction of tissue of eyelid border	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	60	6	
66740	Destruction of tissue of eyelid border	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	63	63	
66761	"Creation of eye fluid drainage tracts in iris using laser, per session"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	8	13	
66761	"Creation of eye fluid drainage tracts in iris using laser, per session"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	34	0	
66761	"Creation of eye fluid drainage tracts in iris using laser, per session"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	63	63	
66762	"Creation of openings in iris for eye fluid drainage using laser, 1 or more sessions"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
66762	"Creation of openings in iris for eye fluid drainage using laser, 1 or more sessions"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	51	6	
66762	"Creation of openings in iris for eye fluid drainage using laser, 1 or more sessions"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	90	90	
66770	Destruction of growth of iris using laser	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
66770	Destruction of growth of iris using laser	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	46	6	
66770	Destruction of growth of iris using laser	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	108	108	
66820	Removal of recurring cataract in lens capsule	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66820	Removal of recurring cataract in lens capsule	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66820	Removal of recurring cataract in lens capsule	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		68	
66821	Removal of recurring cataract in lens capsule using laser	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
66821	Removal of recurring cataract in lens capsule using laser	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	37	6	
66821	Removal of recurring cataract in lens capsule using laser	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	72	72	
66825	Repositioning of lens prosthesis	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66825	Repositioning of lens prosthesis	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66825	Repositioning of lens prosthesis	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		153	
66830	Removal of recurring cataract in lens capsule	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66830	Removal of recurring cataract in lens capsule	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66830	Removal of recurring cataract in lens capsule	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
66840	Aspiration removal of lens material	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66840	Aspiration removal of lens material	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66840	Aspiration removal of lens material	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
66850	"Fragmenting, aspiration, and removal of lens material"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66850	"Fragmenting, aspiration, and removal of lens material"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66850	"Fragmenting, aspiration, and removal of lens material"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		162	
66852	Removal of lens material	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66852	Removal of lens material	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66852	Removal of lens material	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		162	
66920	Removal of lens material and capsule	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66920	Removal of lens material and capsule	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66920	Removal of lens material and capsule	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
66930	Removal of lens material and capsule for dislocated lens	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66930	Removal of lens material and capsule for dislocated lens	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66930	Removal of lens material and capsule for dislocated lens	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		162	
66940	Removal of lens material and portion of lens capsule	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66940	Removal of lens material and portion of lens capsule	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66940	Removal of lens material and portion of lens capsule	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		162	
66982	Removal of cataract with insertion of lens	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66982	Removal of cataract with insertion of lens	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		132	
66983	Removal of cataract with insertion of lens	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66983	Removal of cataract with insertion of lens	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66983	Removal of cataract with insertion of lens	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		162	
66984	Removal of cataract with insertion of lens	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66984	Removal of cataract with insertion of lens	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		132	
66985	Insertion of lens prosthesis	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66985	Insertion of lens prosthesis	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66985	Insertion of lens prosthesis	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		180	
66986	Exchange of lens prosthesis	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
66986	Exchange of lens prosthesis	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
66986	Exchange of lens prosthesis	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		180	
67005	Partial removal of eye fluid between the lens and retina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
67005	Partial removal of eye fluid between the lens and retina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
67005	Partial removal of eye fluid between the lens and retina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
67010	Partial removal of eye fluid between the lens and retina	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
67010	Partial removal of eye fluid between the lens and retina	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
67010	Partial removal of eye fluid between the lens and retina	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
67015	Aspiration or release of eye fluid between the lens and retina	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67015	Aspiration or release of eye fluid between the lens and retina	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67015	Aspiration or release of eye fluid between the lens and retina	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		122	
67025	Injection of synthetic eye fluid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67025	Injection of synthetic eye fluid	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	49	6	
67025	Injection of synthetic eye fluid	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	144	144	
67027	Implantation of eye drug delivery system	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67027	Implantation of eye drug delivery system	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67027	Implantation of eye drug delivery system	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		153	
67028	Injection of drug into eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	8	22	
67028	Injection of drug into eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	12	0	
67028	Injection of drug into eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	0	3	
67030	Cutting of strands of eye fluid (vitreous) between the lens and retina	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67030	Cutting of strands of eye fluid (vitreous) between the lens and retina	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67030	Cutting of strands of eye fluid (vitreous) between the lens and retina	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
67031	Laser release of scar tissue between the lens and retina	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
67031	Laser release of scar tissue between the lens and retina	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	25	6	
67031	Laser release of scar tissue between the lens and retina	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	90	90	
67036	Removal of inner eye fluid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
67036	Removal of inner eye fluid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
67036	Removal of inner eye fluid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
67036	Removal of inner eye fluid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
67036	Removal of inner eye fluid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
67036	Removal of inner eye fluid	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management 99238 --12 minutes		6	
67036	Removal of inner eye fluid	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		180	
67039	Laser treatment of retina	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
67039	Laser treatment of retina	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
67039	Laser treatment of retina	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
67039	Laser treatment of retina	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
67039	Laser treatment of retina	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
67039	Laser treatment of retina	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management 99238 --12 minutes		6	
67039	Laser treatment of retina	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		180	
67040	Laser treatment of retina	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
67040	Laser treatment of retina	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
67040	Laser treatment of retina	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
67040	Laser treatment of retina	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
67040	Laser treatment of retina	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
67040	Laser treatment of retina	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management 99238 --12 minutes		6	
67040	Laser treatment of retina	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		180	
67041	Vit for macular pucker	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
67041	Vit for macular pucker	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
67041	Vit for macular pucker	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
67041	Vit for macular pucker	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
67041	Vit for macular pucker	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
67041	Vit for macular pucker	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management 99238 --12 minutes		6	
67041	Vit for macular pucker	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		180	
67042	Vit for macular hole	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
67042	Vit for macular hole	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
67042	Vit for macular hole	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
67042	Vit for macular hole	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
67042	Vit for macular hole	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
67042	Vit for macular hole	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management 99238 --12 minutes		6	
67042	Vit for macular hole	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		180	
67043	Vit for membrane dissect	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
67043	Vit for membrane dissect	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
67043	Vit for membrane dissect	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
67043	Vit for membrane dissect	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
67043	Vit for membrane dissect	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
67043	Vit for membrane dissect	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management 99238 --12 minutes		6	
67043	Vit for membrane dissect	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		180	
67101	"Repair of retinal detachment, 1 or more sessions; cryotherapy or diathermy, including drainage of subretinal fluid, when performed"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67101	"Repair of retinal detachment, 1 or more sessions; cryotherapy or diathermy, including drainage of subretinal fluid, when performed"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	157	6	
67101	"Repair of retinal detachment, 1 or more sessions; cryotherapy or diathermy, including drainage of subretinal fluid, when performed"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	144	144	
67105	"Repair of retinal detachment, 1 or more sessions; photocoagulation, including drainage of subretinal fluid, when performed"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67105	"Repair of retinal detachment, 1 or more sessions; photocoagulation, including drainage of subretinal fluid, when performed"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	97	6	
67105	"Repair of retinal detachment, 1 or more sessions; photocoagulation, including drainage of subretinal fluid, when performed"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	126	126	
67107	"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
67107	"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
67107	"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
67107	"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
67107	"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
67107	"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid"	Service  post	L038A	COMT/COT/RN/CST	0.38	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		6	
67107	"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid"	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		180	
67108	"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
67108	"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
67108	"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
67108	"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
67108	"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
67108	"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique"	Service  post	L038A	COMT/COT/RN/CST	0.38	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		6	
67108	"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique"	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		180	
67110	Repair of detached retina by injection of air or gas	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms	5	5	
67110	Repair of detached retina by injection of air or gas	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
67110	Repair of detached retina by injection of air or gas	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
67110	Repair of detached retina by injection of air or gas	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent	10	20	
67110	Repair of detached retina by injection of air or gas	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
67110	Repair of detached retina by injection of air or gas	Service  pre	L038A	COMT/COT/RN/CST	0.38	Prepare and position pt/ monitor pt/ set up IV	2		
67110	Repair of detached retina by injection of air or gas	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Prepare room, equipment, supplies"	2		
67110	Repair of detached retina by injection of air or gas	Service  intra	L038A	COMT/COT/RN/CST	0.38	Assist physician in performing procedure	30		
67110	Repair of detached retina by injection of air or gas	Service  post	L038A	COMT/COT/RN/CST	0.38	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	5		
67110	Repair of detached retina by injection of air or gas	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean room/equipment by physician staff	3		
67110	Repair of detached retina by injection of air or gas	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean surgical instrument package	10		
67110	Repair of detached retina by injection of air or gas	Service  post	L038A	COMT/COT/RN/CST	0.38	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		0	
67110	Repair of detached retina by injection of air or gas	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes	216	216	
67113	"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
67113	"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
67113	"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
67113	"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
67113	"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
67113	"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens"	Service  post	L038A	COMT/COT/RN/CST	0.38	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		6	
67113	"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens"	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		216	
67115	Release of retinal encircling material	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67115	Release of retinal encircling material	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67115	Release of retinal encircling material	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		126	
67120	Removal of implant material from outside the eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67120	Removal of implant material from outside the eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	63	6	
67120	Removal of implant material from outside the eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	126	126	
67121	Removal of implant material from inside the eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67121	Removal of implant material from inside the eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67121	Removal of implant material from inside the eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		180	
67141	"Preventive retinal detachment treatment by heat or freezing, 1 or more sessions"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67141	"Preventive retinal detachment treatment by heat or freezing, 1 or more sessions"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	53	6	
67141	"Preventive retinal detachment treatment by heat or freezing, 1 or more sessions"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	108	108	
67145	"Preventive retinal detachment treatment by heat or laser, 1 or more sessions"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67145	"Preventive retinal detachment treatment by heat or laser, 1 or more sessions"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	46	6	
67145	"Preventive retinal detachment treatment by heat or laser, 1 or more sessions"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	108	108	
67208	"Destruction of retinal growth by heat or freezing, 1 or more sessions"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67208	"Destruction of retinal growth by heat or freezing, 1 or more sessions"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	45	6	
67208	"Destruction of retinal growth by heat or freezing, 1 or more sessions"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	108	108	
67210	"Laser destruction of retinal growth, 1 or more sessions"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67210	"Laser destruction of retinal growth, 1 or more sessions"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	24	6	
67210	"Laser destruction of retinal growth, 1 or more sessions"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	108	108	
67218	"Destruction of retinal growth with implantation of radiation source, 1 or more sessions"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67218	"Destruction of retinal growth with implantation of radiation source, 1 or more sessions"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		12	
67218	"Destruction of retinal growth with implantation of radiation source, 1 or more sessions"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		117	
67220	"Destruction of vascular growth between retina and sclera, 1 or more sessions"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67220	"Destruction of vascular growth between retina and sclera, 1 or more sessions"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	31.5	6	
67220	"Destruction of vascular growth between retina and sclera, 1 or more sessions"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	108	108	
67221	Destruction of vascular growth between retina and sclera	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	8	13	
67221	Destruction of vascular growth between retina and sclera	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	36	0	
67221	Destruction of vascular growth between retina and sclera	Service  intra	L051A	RN	0.51	Service total costs	7	0	
67221	Destruction of vascular growth between retina and sclera	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	6	0	
67225	"Destruction of vascular growth between retina and sclera, at single session"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	3	0	
67227	"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms	5	5	
67227	"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services	3	10	
67227	"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions	3	3	
67227	"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent	7	7	
67227	"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility	0	5	
67227	"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy"	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
67227	"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy"	Service  pre	L038A	COMT/COT/RN/CST	0.38	Obtain vital signs	3		
67227	"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy"	Service  pre	L038A	COMT/COT/RN/CST	0.38	Prepare and position pt/ monitor pt/ set up IV	3		
67227	"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy"	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Prepare room, equipment, supplies"	3		
67227	"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Assist physician in performing procedure	30		
67227	"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy"	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean room/equipment by physician staff	3		
67227	"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy"	Service  post	L038A	COMT/COT/RN/CST	0.38	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		6	
67227	"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy"	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes	36	36	
67228	"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms	5	5	
67228	"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services	3	10	
67228	"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions	3	3	
67228	"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent	7	7	
67228	"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility	0	5	
67228	"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation"	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
67228	"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation"	Service  pre	L038A	COMT/COT/RN/CST	0.38	Obtain vital signs	3		
67228	"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation"	Service  pre	L038A	COMT/COT/RN/CST	0.38	Prepare and position pt/ monitor pt/ set up IV	3		
67228	"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation"	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Prepare room, equipment, supplies"	3		
67228	"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Assist physician in performing procedure	25		
67228	"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation"	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean room/equipment by physician staff	3		
67228	"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation"	Service  post	L038A	COMT/COT/RN/CST	0.38	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		0	
67228	"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation"	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes	36	36	
67229	"Laser destruction or freezing of extensive leaking retinal blood vessels, preterm infant, 1 or more sessions"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		30	
67229	"Laser destruction or freezing of extensive leaking retinal blood vessels, preterm infant, 1 or more sessions"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		12	
67229	"Laser destruction or freezing of extensive leaking retinal blood vessels, preterm infant, 1 or more sessions"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		216	
67250	Repair of defect in sclera	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67250	Repair of defect in sclera	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67250	Repair of defect in sclera	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		108	
67255	Scleral reinforcement (separate procedure); with graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
67255	Scleral reinforcement (separate procedure); with graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		20	
67255	Scleral reinforcement (separate procedure); with graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		7	
67255	Scleral reinforcement (separate procedure); with graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		20	
67255	Scleral reinforcement (separate procedure); with graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		8	
67255	Scleral reinforcement (separate procedure); with graft	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management 99238 --12 minutes		6	
67255	Scleral reinforcement (separate procedure); with graft	Post-service	L038A	COMT/COT/RN/CST	0.38	99212    27  minutes		81	
67255	Scleral reinforcement (separate procedure); with graft	Post-service	L038A	COMT/COT/RN/CST	0.38	99213    36  minutes		108	
67311	Realignment of the eye with repair of one horizontal eye muscle	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67311	Realignment of the eye with repair of one horizontal eye muscle	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67311	Realignment of the eye with repair of one horizontal eye muscle	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		126	
67312	Realignment of the eye with repair of two horizontal eye muscles	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67312	Realignment of the eye with repair of two horizontal eye muscles	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67312	Realignment of the eye with repair of two horizontal eye muscles	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		126	
67314	Realignment of the eye with repair of one vertical muscle	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67314	Realignment of the eye with repair of one vertical muscle	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67314	Realignment of the eye with repair of one vertical muscle	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
67316	Realignment of the eye with repair of two or more vertical muscles	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67316	Realignment of the eye with repair of two or more vertical muscles	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67316	Realignment of the eye with repair of two or more vertical muscles	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
67318	Realignment of the eye with repair of muscle	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67318	Realignment of the eye with repair of muscle	Pre-service	L037C	Orthoptist	0.37	Preservice total costs		11	
67318	Realignment of the eye with repair of muscle	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67318	Realignment of the eye with repair of muscle	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
67318	Realignment of the eye with repair of muscle	Post-service	L037C	Orthoptist	0.37	Post service total costs		11	
67343	Release of extensive eye scar tissue	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67343	Release of extensive eye scar tissue	Pre-service	L037C	Orthoptist	0.37	Preservice total costs		11	
67343	Release of extensive eye scar tissue	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67343	Release of extensive eye scar tissue	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		126	
67343	Release of extensive eye scar tissue	Post-service	L037C	Orthoptist	0.37	Post service total costs		11	
67345	Injection of chemical for destruction of eye muscle	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	13	18	
67345	Injection of chemical for destruction of eye muscle	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	23	6	
67345	Injection of chemical for destruction of eye muscle	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
67346	Biopsy of eye muscle	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		30	
67346	Biopsy of eye muscle	Pre-service	L037C	Orthoptist	0.37	Preservice total costs		11	
67400	"Exploration of cavity behind eye, frontal or transconjunctival approach"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67400	"Exploration of cavity behind eye, frontal or transconjunctival approach"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67400	"Exploration of cavity behind eye, frontal or transconjunctival approach"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		162	
67405	Incision and drainage of cavity behind eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67405	Incision and drainage of cavity behind eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67405	Incision and drainage of cavity behind eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
67412	Removal of growth in cavity behind eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67412	Removal of growth in cavity behind eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67412	Removal of growth in cavity behind eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		90	
67413	Removal of foreign body in cavity behind eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67413	Removal of foreign body in cavity behind eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67413	Removal of foreign body in cavity behind eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		135	
67414	Removal of bone from cavity behind eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67414	Removal of bone from cavity behind eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67414	Removal of bone from cavity behind eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		116	
67420	Removal of bone and growth in cavity behind eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67420	Removal of bone and growth in cavity behind eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67420	Removal of bone and growth in cavity behind eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		180	
67430	Removal of bone and foreign body in cavity behind eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67430	Removal of bone and foreign body in cavity behind eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67430	Removal of bone and foreign body in cavity behind eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		216	
67440	Removal of bone with drainage from cavity behind eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67440	Removal of bone with drainage from cavity behind eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67440	Removal of bone with drainage from cavity behind eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		198	
67445	Removal of bone from cavity behind eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67445	Removal of bone from cavity behind eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67445	Removal of bone from cavity behind eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		116	
67450	"Exploration of cavity behind eye with bone flap, lateral approach"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67450	"Exploration of cavity behind eye with bone flap, lateral approach"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67450	"Exploration of cavity behind eye with bone flap, lateral approach"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		216	
67500	Injection of medication into cavity behind eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5	10	
67500	Injection of medication into cavity behind eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	11	0	
67505	Injection of alcohol into cavity behind eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5	10	
67505	Injection of alcohol into cavity behind eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	11	0	
67515	Injection of medication or substance into membrane covering eyeball	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5	10	
67515	Injection of medication or substance into membrane covering eyeball	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	11	0	
67550	Insertion of implant outside eye muscles	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67550	Insertion of implant outside eye muscles	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67550	Insertion of implant outside eye muscles	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		180	
67560	Removal or revision of implant outside eye muscles	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67560	Removal or revision of implant outside eye muscles	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67560	Removal or revision of implant outside eye muscles	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		180	
67570	Release of optic nerve	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67570	Release of optic nerve	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67570	Release of optic nerve	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		143	
67700	Incision and drainage of eyelid abscess	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	13	18	
67700	Incision and drainage of eyelid abscess	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	37	6	
67700	Incision and drainage of eyelid abscess	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
67710	Removal of sutures between upper and lower eyelids	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	13	18	
67710	Removal of sutures between upper and lower eyelids	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	31	6	
67710	Removal of sutures between upper and lower eyelids	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
67715	Incision of corner of eye at eyelids	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	13	18	
67715	Incision of corner of eye at eyelids	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	31	6	
67715	Incision of corner of eye at eyelids	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
67800	Removal of eyelid growth	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5	10	
67800	Removal of eyelid growth	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	36	6	
67800	Removal of eyelid growth	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	14	14	
67801	Removal of multiple growths of same eyelid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5	10	
67801	Removal of multiple growths of same eyelid	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	42	6	
67801	Removal of multiple growths of same eyelid	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	14	14	
67805	Removal of multiple growths of different eyelids	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5	10	
67805	Removal of multiple growths of different eyelids	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	54	6	
67805	Removal of multiple growths of different eyelids	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
67808	Removal of eyelid growth under general anesthesia and/or requiring hospitalization	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		50	
67808	Removal of eyelid growth under general anesthesia and/or requiring hospitalization	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		90	
67810	Biopsy of eyelid	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	32	0	
67810	Biopsy of eyelid	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
67820	Removal of eyelashes by forceps	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	8	25	
67820	Removal of eyelashes by forceps	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	6	0	
67825	Removal of eyelashes	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	11	25	
67825	Removal of eyelashes	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	6	6	
67825	Removal of eyelashes	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
67830	Incisional removal of eyelashes	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	13	18	
67830	Incisional removal of eyelashes	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	42	6	
67830	Incisional removal of eyelashes	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
67835	Incisional removal of eyelashes with graft	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67835	Incisional removal of eyelashes with graft	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67835	Incisional removal of eyelashes with graft	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		81	
67840	Removal of eyelid growth	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	13	18	
67840	Removal of eyelid growth	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	38	6	
67840	Removal of eyelid growth	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
67850	Destruction of (up to 1 centimeter) growth of eyelid margin	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	13	18	
67850	Destruction of (up to 1 centimeter) growth of eyelid margin	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	35	6	
67850	Destruction of (up to 1 centimeter) growth of eyelid margin	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
67875	Temporary closure of eyelids by suture	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
67875	Temporary closure of eyelids by suture	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	32	0	
67880	Creation of permanent eyelid margin scarring	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	50	
67880	Creation of permanent eyelid margin scarring	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	39	0	
67880	Creation of permanent eyelid margin scarring	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	90	90	
67882	Creation of permanent eyelid margin scarring with relocation of eyelid tissue	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67882	Creation of permanent eyelid margin scarring with relocation of eyelid tissue	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	49	0	
67882	Creation of permanent eyelid margin scarring with relocation of eyelid tissue	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	108	108	
67900	Repair of brow paralysis	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	50	
67900	Repair of brow paralysis	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	94	0	
67900	Repair of brow paralysis	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	99	99	
67901	Repair of upper eyelid muscle to correct drooping or paralysis	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67901	Repair of upper eyelid muscle to correct drooping or paralysis	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	94	6	
67901	Repair of upper eyelid muscle to correct drooping or paralysis	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	108	108	
67902	Repair of upper eyelid muscle to correct drooping or paralysis	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67902	Repair of upper eyelid muscle to correct drooping or paralysis	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
67902	Repair of upper eyelid muscle to correct drooping or paralysis	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		117	
67903	Shortening or advancement of upper eyelid muscle to correct drooping or paralysis	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67903	Shortening or advancement of upper eyelid muscle to correct drooping or paralysis	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	66	0	
67903	Shortening or advancement of upper eyelid muscle to correct drooping or paralysis	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	81	81	
67904	Repair of tendon of upper eyelid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67904	Repair of tendon of upper eyelid	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	69	0	
67904	Repair of tendon of upper eyelid	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	117	117	
67906	Suspension of upper eyelid muscle to correct drooping or paralysis	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67906	Suspension of upper eyelid muscle to correct drooping or paralysis	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		81	
67908	"Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67908	"Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	49	0	
67908	"Removal of tissue, muscle, and membrane to correct eyelid drooping or paralysis"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	95	95	
67909	Procedure to reduce overcorrection of drooping or paralyzed upper eyelid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67909	Procedure to reduce overcorrection of drooping or paralyzed upper eyelid	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	49	0	
67909	Procedure to reduce overcorrection of drooping or paralyzed upper eyelid	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	95	95	
67911	Correction of widely-opened upper eyelid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67911	Correction of widely-opened upper eyelid	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		108	
67912	Restoration of eyelid blinking function	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67912	Restoration of eyelid blinking function	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	65	6	
67912	Restoration of eyelid blinking function	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	99	99	
67914	Suture repair of a turning-outward defect of upper or lower eyelid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67914	Suture repair of a turning-outward defect of upper or lower eyelid	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	41	6	
67914	Suture repair of a turning-outward defect of upper or lower eyelid	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	90	90	
67915	Repair of a turning-outward defect of upper or lower eyelid using heat	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67915	Repair of a turning-outward defect of upper or lower eyelid using heat	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	21	6	
67915	Repair of a turning-outward defect of upper or lower eyelid using heat	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	54	54	
67916	Repair of turning-outward eyelid defect	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67916	Repair of turning-outward eyelid defect	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	46	6	
67916	Repair of turning-outward eyelid defect	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	90	90	
67917	Extensive repair of turning-outward eyelid defect	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67917	Extensive repair of turning-outward eyelid defect	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	54	6	
67917	Extensive repair of turning-outward eyelid defect	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	90	90	
67921	Suture repair of turning-inward eyelid defect	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67921	Suture repair of turning-inward eyelid defect	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	36	6	
67921	Suture repair of turning-inward eyelid defect	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	90	90	
67922	Corrective repair of turning-inward eyelid defect using heat	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67922	Corrective repair of turning-inward eyelid defect using heat	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	31	6	
67922	Corrective repair of turning-inward eyelid defect using heat	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	54	54	
67923	Repair of turning-inward eyelid defect	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67923	Repair of turning-inward eyelid defect	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	46	6	
67923	Repair of turning-inward eyelid defect	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	90	90	
67924	Repair of turning-inward eyelid defect	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67924	Repair of turning-inward eyelid defect	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	61	6	
67924	Repair of turning-inward eyelid defect	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	90	90	
67930	Suture of recent wound of the eyelid involving lid margin	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	0	
67930	Suture of recent wound of the eyelid involving lid margin	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	59	6	
67930	Suture of recent wound of the eyelid involving lid margin	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
67935	Repair of wound of eyelid margin	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	0	
67935	Repair of wound of eyelid margin	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	78	0	
67935	Repair of wound of eyelid margin	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	81	81	
67938	Removal of embedded foreign body in eyelid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
67938	Removal of embedded foreign body in eyelid	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	30	6	
67938	Removal of embedded foreign body in eyelid	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
67950	Enlargement of eyelid margin	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67950	Enlargement of eyelid margin	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	64	0	
67950	Enlargement of eyelid margin	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	95	95	
67961	Removal of up to one-fourth of the eyelid involving lid margin	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67961	Removal of up to one-fourth of the eyelid involving lid margin	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	80	0	
67961	Removal of up to one-fourth of the eyelid involving lid margin	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	95	95	
67966	Removal of over one-fourth of the eyelid involving lid margin	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
67966	Removal of over one-fourth of the eyelid involving lid margin	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	84	0	
67966	Removal of over one-fourth of the eyelid involving lid margin	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	95	117	
67971	Reconstruction of up to two-thirds of the eyelid by transfer of opposite eyelid tissue	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67971	Reconstruction of up to two-thirds of the eyelid by transfer of opposite eyelid tissue	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		122	
67973	Reconstruction of lower eyelid by transfer of eyelid tissue from opposite eyelid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67973	Reconstruction of lower eyelid by transfer of eyelid tissue from opposite eyelid	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		149	
67974	Reconstruction of upper eyelid by transfer of eyelid tissue from opposite eyelid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67974	Reconstruction of upper eyelid by transfer of eyelid tissue from opposite eyelid	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		149	
67975	Reconstruction of an eyelid by transfer of eyelid tissue from opposite eyelid	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
67975	Reconstruction of an eyelid by transfer of eyelid tissue from opposite eyelid	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		122	
68020	Incision and drainage of eye cyst	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	8	8	
68020	Incision and drainage of eye cyst	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	15	6	
68020	Incision and drainage of eye cyst	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
68040	Removal of scarring of lining of eyelid due to infection	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5	5	
68040	Removal of scarring of lining of eyelid due to infection	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	15	0	
68100	Biopsy of sclera	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	15	30	
68100	Biopsy of sclera	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	29	0	
68110	Removal of (up to 1 centimeter) growth of sclera	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
68110	Removal of (up to 1 centimeter) growth of sclera	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	37	6	
68110	Removal of (up to 1 centimeter) growth of sclera	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
68115	Removal of (over 1 centimeter) growth of sclera	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
68115	Removal of (over 1 centimeter) growth of sclera	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	51	6	
68115	Removal of (over 1 centimeter) growth of sclera	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
68130	Removal of growth of sclera	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
68130	Removal of growth of sclera	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	55	6	
68130	Removal of growth of sclera	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	95	95	
68135	Destruction of growth of sclera	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	15	27	
68135	Destruction of growth of sclera	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	19	6	
68135	Destruction of growth of sclera	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
68200	Injection into conjunctiva	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5	10	
68200	Injection into conjunctiva	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	9	0	
68320	Repair of conjunctiva	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
68320	Repair of conjunctiva	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	91	6	
68320	Repair of conjunctiva	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	144	144	
68325	Repair of conjunctiva	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
68325	Repair of conjunctiva	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
68325	Repair of conjunctiva	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
68326	Reconstruction of conjunctiva	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
68326	Reconstruction of conjunctiva	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
68326	Reconstruction of conjunctiva	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
68328	Reconstruction of conjunctiva	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
68328	Reconstruction of conjunctiva	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
68328	Reconstruction of conjunctiva	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
68330	Release of scar tissue from conjunctiva	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
68330	Release of scar tissue from conjunctiva	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	64	6	
68330	Release of scar tissue from conjunctiva	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	108	108	
68335	Release of scar tissue from eyelids	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
68335	Release of scar tissue from eyelids	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
68335	Release of scar tissue from eyelids	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
68340	Release of scar tissue from eyelids	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
68340	Release of scar tissue from eyelids	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	48	6	
68340	Release of scar tissue from eyelids	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	90	90	
68360	Relocation of conjunctival flap	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	35	60	
68360	Relocation of conjunctival flap	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	52	6	
68360	Relocation of conjunctival flap	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	90	90	
68362	Relocation of conjunctival flap	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
68362	Relocation of conjunctival flap	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
68362	Relocation of conjunctival flap	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
68371	Harvest of donor conjunctiva	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		30	
68371	Harvest of donor conjunctiva	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
68371	Harvest of donor conjunctiva	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		108	
68400	Drainage of tear-producing gland	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	11	15	
68400	Drainage of tear-producing gland	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	53	6	
68400	Drainage of tear-producing gland	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
68420	Snip incision of tear duct opening	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	11	15	
68420	Snip incision of tear duct opening	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	53	6	
68420	Snip incision of tear duct opening	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
68440	Snip incision of tear-drainage opening at inner corner of the eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
68440	Snip incision of tear-drainage opening at inner corner of the eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	16	6	
68440	Snip incision of tear-drainage opening at inner corner of the eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
68500	Removal of tear-producing gland	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
68500	Removal of tear-producing gland	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
68500	Removal of tear-producing gland	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		198	
68505	Partial removal of tear-producing gland	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
68505	Partial removal of tear-producing gland	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
68505	Partial removal of tear-producing gland	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		198	
68510	Biopsy of tear-producing gland	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
68510	Biopsy of tear-producing gland	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	60	3	
68520	Removal of tear sac of the eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
68520	Removal of tear sac of the eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
68520	Removal of tear sac of the eye	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
68530	Removal of foreign body or stone from tear passages	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
68530	Removal of foreign body or stone from tear passages	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	71	6	
68530	Removal of foreign body or stone from tear passages	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
68540	Removal of growth of tear-producing gland	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
68540	Removal of growth of tear-producing gland	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
68540	Removal of growth of tear-producing gland	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		180	
68550	Removal of growth in tear-producing gland	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
68550	Removal of growth in tear-producing gland	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
68550	Removal of growth in tear-producing gland	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		216	
68700	Plastic repair of tear ducts	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		50	
68700	Plastic repair of tear ducts	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
68705	Release of tissue at tear duct opening	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
68705	Release of tissue at tear duct opening	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	19	6	
68705	Release of tissue at tear duct opening	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
68720	Creation of drainage tract from tear sac to the nasal cavity	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
68720	Creation of drainage tract from tear sac to the nasal cavity	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
68720	Creation of drainage tract from tear sac to the nasal cavity	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		135	
68745	Creation of a tear drainage tract to the nasal cavity	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
68745	Creation of a tear drainage tract to the nasal cavity	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
68745	Creation of a tear drainage tract to the nasal cavity	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
68750	Creation of a tear drainage tract to the nasal cavity with insertion of tube or stent	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		60	
68750	Creation of a tear drainage tract to the nasal cavity with insertion of tube or stent	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs		6	
68750	Creation of a tear drainage tract to the nasal cavity with insertion of tube or stent	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		162	
68760	Repair duct opening	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
68760	Repair duct opening	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	9	6	
68760	Repair duct opening	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
68761	Closure of tear duct opening using plug	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
68761	Closure of tear duct opening using plug	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	9	6	
68761	Closure of tear duct opening using plug	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
68770	Closure of abnormal tear-drainage tract	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs		50	
68770	Closure of abnormal tear-drainage tract	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs		144	
68801	Dilation of tear-drainage opening	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms	3	5	
68801	Dilation of tear-drainage opening	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		10	
68801	Dilation of tear-drainage opening	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		3	
68801	Dilation of tear-drainage opening	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent	7	7	
68801	Dilation of tear-drainage opening	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		5	
68801	Dilation of tear-drainage opening	Service  intra	L038A	COMT/COT/RN/CST	0.38	Assist physician in performing procedure	5		
68801	Dilation of tear-drainage opening	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean surgical instrument package	10		
68801	Dilation of tear-drainage opening	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management  same day 99238 --6 minutes		0	
68801	Dilation of tear-drainage opening	Post-service	L038A	COMT/COT/RN/CST	0.38	99212    27  minutes	27	27	
68810	Insertion of probe into the tear duct	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms	3	5	
68810	Insertion of probe into the tear duct	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		10	
68810	Insertion of probe into the tear duct	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		3	
68810	Insertion of probe into the tear duct	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent	7	7	
68810	Insertion of probe into the tear duct	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		5	
68810	Insertion of probe into the tear duct	Service  intra	L038A	COMT/COT/RN/CST	0.38	Assist physician in performing procedure	10		
68810	Insertion of probe into the tear duct	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean surgical instrument package	10		
68810	Insertion of probe into the tear duct	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management  same day 99238 --6 minutes		0	
68810	Insertion of probe into the tear duct	Post-service	L038A	COMT/COT/RN/CST	0.38	99212    27  minutes	27	27	
68811	Insertion of probe into the tear duct under anesthesia	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms		5	
68811	Insertion of probe into the tear duct under anesthesia	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		10	
68811	Insertion of probe into the tear duct under anesthesia	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions		3	
68811	Insertion of probe into the tear duct under anesthesia	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent		7	
68811	Insertion of probe into the tear duct under anesthesia	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		5	
68811	Insertion of probe into the tear duct under anesthesia	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management  same day 99238 --6 minutes		6	
68811	Insertion of probe into the tear duct under anesthesia	Post-service	L038A	COMT/COT/RN/CST	0.38	99211     16 minutes		16	
68815	Probing of nasal-tear duct with insertion of tube or stent	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms	5	5	
68815	Probing of nasal-tear duct with insertion of tube or stent	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		10	
68815	Probing of nasal-tear duct with insertion of tube or stent	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions	3	3	
68815	Probing of nasal-tear duct with insertion of tube or stent	Pre-service	L038A	COMT/COT/RN/CST	0.38	Obtain vital signs	3		
68815	Probing of nasal-tear duct with insertion of tube or stent	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent	7	7	
68815	Probing of nasal-tear duct with insertion of tube or stent	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		5	
68815	Probing of nasal-tear duct with insertion of tube or stent	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
68815	Probing of nasal-tear duct with insertion of tube or stent	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Prepare room, equipment, supplies"	2		
68815	Probing of nasal-tear duct with insertion of tube or stent	Service  intra	L038A	COMT/COT/RN/CST	0.38	Assist physician in performing procedure	20		
68815	Probing of nasal-tear duct with insertion of tube or stent	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean room/equipment by physician staff	3		
68815	Probing of nasal-tear duct with insertion of tube or stent	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean surgical instrument package	10		
68815	Probing of nasal-tear duct with insertion of tube or stent	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management  same day 99238 --6 minutes		6	
68815	Probing of nasal-tear duct with insertion of tube or stent	Post-service	L038A	COMT/COT/RN/CST	0.38	99212    27  minutes	54	54	
68816	Probing of nasal-tear duct with balloon catheter dilation	Pre-service	L038A	COMT/COT/RN/CST	0.38	Complete pre-service diagnostic and referral forms	5	5	
68816	Probing of nasal-tear duct with balloon catheter dilation	Pre-service	L038A	COMT/COT/RN/CST	0.38	Coordinate pre-surgery services		10	
68816	Probing of nasal-tear duct with balloon catheter dilation	Pre-service	L038A	COMT/COT/RN/CST	0.38	Follow-up phone calls and prescriptions	3	3	
68816	Probing of nasal-tear duct with balloon catheter dilation	Pre-service	L038A	COMT/COT/RN/CST	0.38	Provide pre-service education/obtain consent	7	7	
68816	Probing of nasal-tear duct with balloon catheter dilation	Pre-service	L038A	COMT/COT/RN/CST	0.38	Schedule space and equipment in facility		5	
68816	Probing of nasal-tear duct with balloon catheter dilation	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
68816	Probing of nasal-tear duct with balloon catheter dilation	Service  pre	L038A	COMT/COT/RN/CST	0.38	Obtain vital signs	3		
68816	Probing of nasal-tear duct with balloon catheter dilation	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Prepare room, equipment, supplies"	2		
68816	Probing of nasal-tear duct with balloon catheter dilation	Service  intra	L038A	COMT/COT/RN/CST	0.38	Assist physician in performing procedure	20		
68816	Probing of nasal-tear duct with balloon catheter dilation	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean room/equipment by physician staff	3		
68816	Probing of nasal-tear duct with balloon catheter dilation	Service  post	L038A	COMT/COT/RN/CST	0.38	Clean surgical instrument package	10		
68816	Probing of nasal-tear duct with balloon catheter dilation	Service  post	L038A	COMT/COT/RN/CST	0.38	Discharge day management  same day 99238 --6 minutes		6	
68816	Probing of nasal-tear duct with balloon catheter dilation	Post-service	L038A	COMT/COT/RN/CST	0.38	99211     16 minutes	16	16	
68840	Probing of nasal-tear duct	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
68840	Probing of nasal-tear duct	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	14	6	
68840	Probing of nasal-tear duct	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	27	27	
68850	Injection of contrast for X-ray imaging of tear sac	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	18	30	
68850	Injection of contrast for X-ray imaging of tear sac	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	9	0	
69000	Incision and drainage of external ear abscess or blood accumulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
69000	Incision and drainage of external ear abscess or blood accumulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	6	
69000	Incision and drainage of external ear abscess or blood accumulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
69005	Incision and drainage of external ear abscess or blood accumulation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
69005	Incision and drainage of external ear abscess or blood accumulation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	6	
69005	Incision and drainage of external ear abscess or blood accumulation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
69020	Incision and drainage of ear canal abscess	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
69020	Incision and drainage of ear canal abscess	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	6	
69020	Incision and drainage of ear canal abscess	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
69100	Biopsy of ear	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	19	0	
69105	Biopsy of ear canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	30	
69105	Biopsy of ear canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
69105	Biopsy of ear canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
69110	Removal of portion of external ear	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
69110	Removal of portion of external ear	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	80	6	
69110	Removal of portion of external ear	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54	54	
69120	Removal of entire ear	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69120	Removal of entire ear	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69120	Removal of entire ear	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		54	
69140	Removal of bony growths of ear canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69140	Removal of bony growths of ear canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69140	Removal of bony growths of ear canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		165	
69145	Removal of soft tissue growth of ear canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35	60	
69145	Removal of soft tissue growth of ear canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	72	6	
69145	Removal of soft tissue growth of ear canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	41	41	
69150	Removal of growth of ear canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69150	Removal of growth of ear canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69150	Removal of growth of ear canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
69155	Removal of growth of ear canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
69155	Removal of growth of ear canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69155	Removal of growth of ear canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		205	
69200	Removal foreign body from external auditory canal; without general anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	0	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	0	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	0	7	
69200	Removal foreign body from external auditory canal; without general anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0	5	
69200	Removal foreign body from external auditory canal; without general anesthesia	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	0	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	0	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	0	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	10	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Service  post	L037D	RN/LPN/MTA	0.37	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Clean scope	0	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Clean Surgical Instrument Package	10	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab & X-ray requisitions"	0	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	0	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	"Monitor pt. following service/check tubes, monitors, drains (not related to moderate sedation)"	3	0	
69200	Removal foreign body from external auditory canal; without general anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	"Review/read X-ray, lab, and pathology reports"	0	0	
69205	Removal of foreign body from ear canal under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
69205	Removal of foreign body from ear canal under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
69205	Removal of foreign body from ear canal under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		8	
69209	"Removal impacted cerumen using irrigation/lavage, unilateral"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
69209	"Removal impacted cerumen using irrigation/lavage, unilateral"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
69209	"Removal impacted cerumen using irrigation/lavage, unilateral"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
69209	"Removal impacted cerumen using irrigation/lavage, unilateral"	Service  intra	L037D	RN/LPN/MTA	0.37	Perform procedure	7		
69209	"Removal impacted cerumen using irrigation/lavage, unilateral"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
69210	"Removal of impact ear wax, one ear"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	0	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	0	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Pre-service	L037D	RN/LPN/MTA	0.37	Obtain vital signs	0	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	0	7	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0	5	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	0	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	0	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	0	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	10	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  post	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	3	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean scope	0	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean surgical instrument package	10	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	0	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  post	L037D	RN/LPN/MTA	0.37	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains"	3	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Service  post	L037D	RN/LPN/MTA	0.37	"Review/read X-ray, lab, and pathology reports"	0	0	
69220	"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	0	0	
69222	Removal of skin debris and drainage of mastoid cavity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
69222	Removal of skin debris and drainage of mastoid cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	6	
69222	Removal of skin debris and drainage of mastoid cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
69300	Repair of protruding ear	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	28	60	
69300	Repair of protruding ear	Service  intra	L051A	RN	0.51	Service total costs	137	0	
69300	Repair of protruding ear	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	106	6	
69300	Repair of protruding ear	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	122	122	
69310	Reconstruction of ear canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69310	Reconstruction of ear canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69310	Reconstruction of ear canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		188	
69320	Creation of an ear canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69320	Creation of an ear canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69320	Creation of an ear canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		235	
69420	"Incision, aspiration, and/or inflation of eardrum"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
69420	"Incision, aspiration, and/or inflation of eardrum"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	6	
69420	"Incision, aspiration, and/or inflation of eardrum"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
69421	"Incision, aspiration, and inflation of eardrum under anesthesia"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
69421	"Incision, aspiration, and inflation of eardrum under anesthesia"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
69421	"Incision, aspiration, and inflation of eardrum under anesthesia"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
69424	Removal of implanted eardrum tube under anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
69424	Removal of implanted eardrum tube under anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	31	0	
69424	Removal of implanted eardrum tube under anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
69433	Incision of eardrum with insertion of eardrum tube under local or topical anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
69433	Incision of eardrum with insertion of eardrum tube under local or topical anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	1	
69433	Incision of eardrum with insertion of eardrum tube under local or topical anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	36	36	
69436	Incision of eardrum with insertion of eardrum tube under general anesthesia	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
69436	Incision of eardrum with insertion of eardrum tube under general anesthesia	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
69436	Incision of eardrum with insertion of eardrum tube under general anesthesia	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		27	
69440	Middle ear exploration	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69440	Middle ear exploration	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69440	Middle ear exploration	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		111	
69450	Incision of ear canal with release of scar tissue	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69450	Incision of ear canal with release of scar tissue	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69450	Incision of ear canal with release of scar tissue	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		93	
69501	Incision of mastoid bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69501	Incision of mastoid bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69501	Incision of mastoid bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
69502	Removal of mastoid bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69502	Removal of mastoid bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69502	Removal of mastoid bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
69505	Removal of mastoid bone including removal of growth of middle ear	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69505	Removal of mastoid bone including removal of growth of middle ear	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69505	Removal of mastoid bone including removal of growth of middle ear	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		188	
69511	Removal of mastoid bone including removal of growth and bone of middle ear	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69511	Removal of mastoid bone including removal of growth and bone of middle ear	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69511	Removal of mastoid bone including removal of growth and bone of middle ear	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		188	
69530	Removal of portion of temporal bone including removal of mastoid bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69530	Removal of portion of temporal bone including removal of mastoid bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69530	Removal of portion of temporal bone including removal of mastoid bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		212	
69535	Removal of temporal bone of ear	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
69535	Removal of temporal bone of ear	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69535	Removal of temporal bone of ear	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		235	
69540	Removal of polyp of external ear	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
69540	Removal of polyp of external ear	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	6	
69540	Removal of polyp of external ear	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
69550	Removal of growth of external ear through ear canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69550	Removal of growth of external ear through ear canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69550	Removal of growth of external ear through ear canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		165	
69552	Removal of growth of external ear through mastoid bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69552	Removal of growth of external ear through mastoid bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69552	Removal of growth of external ear through mastoid bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		188	
69554	Removal of growth of external ear	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
69554	Removal of growth of external ear	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69554	Removal of growth of external ear	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		258	
69601	Revision of previous mastoid surgery with removal of remaining mastoid bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69601	Revision of previous mastoid surgery with removal of remaining mastoid bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69601	Revision of previous mastoid surgery with removal of remaining mastoid bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		122	
69602	Revision of previous mastoid surgery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69602	Revision of previous mastoid surgery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69602	Revision of previous mastoid surgery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		148	
69603	Revision of previous mastoid surgery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69603	Revision of previous mastoid surgery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69603	Revision of previous mastoid surgery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		188	
69604	Revision of previous mastoid surgery and ear drum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69604	Revision of previous mastoid surgery and ear drum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69604	Revision of previous mastoid surgery and ear drum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		148	
69605	Revision of previous mastoid surgery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69605	Revision of previous mastoid surgery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69605	Revision of previous mastoid surgery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		212	
69610	Repair of eardrum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	30	
69610	Repair of eardrum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	69	6	
69610	Repair of eardrum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27	27	
69620	Repair of defect or perforation of eardrum	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	30	60	
69620	Repair of defect or perforation of eardrum	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	121	6	
69620	Repair of defect or perforation of eardrum	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	91	91	
69631	Repair of eardrum and ear canal with opening to ear bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69631	Repair of eardrum and ear canal with opening to ear bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69631	Repair of eardrum and ear canal with opening to ear bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		148	
69632	"Repair of eardrum, ear canal, and bones"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69632	"Repair of eardrum, ear canal, and bones"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69632	"Repair of eardrum, ear canal, and bones"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		167	
69633	"Repair of eardrum, ear canal, and bones with insertion of prosthesis"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69633	"Repair of eardrum, ear canal, and bones with insertion of prosthesis"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69633	"Repair of eardrum, ear canal, and bones with insertion of prosthesis"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		167	
69635	Repair of eardrum and ear canal with incision of mastoid bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69635	Repair of eardrum and ear canal with incision of mastoid bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69635	Repair of eardrum and ear canal with incision of mastoid bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		188	
69636	"Repair of eardrum, ear canal, and bones with incision of mastoid bone"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69636	"Repair of eardrum, ear canal, and bones with incision of mastoid bone"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69636	"Repair of eardrum, ear canal, and bones with incision of mastoid bone"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		212	
69637	"Repair of eardrum, ear canal, and bones with insertion of prosthesis"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69637	"Repair of eardrum, ear canal, and bones with insertion of prosthesis"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69637	"Repair of eardrum, ear canal, and bones with insertion of prosthesis"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		212	
69641	Repair of eardrum and ear canal with removal of mastoid bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69641	Repair of eardrum and ear canal with removal of mastoid bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69641	Repair of eardrum and ear canal with removal of mastoid bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		148	
69642	"Repair of eardrum, ear canal and bones with removal of mastoid bone"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69642	"Repair of eardrum, ear canal and bones with removal of mastoid bone"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69642	"Repair of eardrum, ear canal and bones with removal of mastoid bone"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		185	
69643	Repair of eardrum and ear canal with removal of mastoid bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69643	Repair of eardrum and ear canal with removal of mastoid bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69643	Repair of eardrum and ear canal with removal of mastoid bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		167	
69644	"Repair of eardrum, ear canal and bones with removal of mastoid bone"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69644	"Repair of eardrum, ear canal and bones with removal of mastoid bone"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69644	"Repair of eardrum, ear canal and bones with removal of mastoid bone"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		212	
69645	Repair of eardrum and ear canal with removal of mastoid bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69645	Repair of eardrum and ear canal with removal of mastoid bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69645	Repair of eardrum and ear canal with removal of mastoid bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		212	
69646	"Repair of eardrum, ear canal and bones with removal of mastoid bone"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69646	"Repair of eardrum, ear canal and bones with removal of mastoid bone"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69646	"Repair of eardrum, ear canal and bones with removal of mastoid bone"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		212	
69650	Release of ear bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69650	Release of ear bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69650	Release of ear bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		111	
69660	Incision or removal of ear bone with insertion of prosthesis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69660	Incision or removal of ear bone with insertion of prosthesis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69660	Incision or removal of ear bone with insertion of prosthesis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		111	
69661	Incision or removal with drilling of ear bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69661	Incision or removal with drilling of ear bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69661	Incision or removal with drilling of ear bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		148	
69662	Revision of previous ear bone surgery	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69662	Revision of previous ear bone surgery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69662	Revision of previous ear bone surgery	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		130	
69666	Repair of membrane opening of middle to inner ear	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69666	Repair of membrane opening of middle to inner ear	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69666	Repair of membrane opening of middle to inner ear	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		111	
69667	Repair of opening into cochlea	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69667	Repair of opening into cochlea	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69667	Repair of opening into cochlea	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		111	
69670	Creation of flap to close mastoid cavity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69670	Creation of flap to close mastoid cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69670	Creation of flap to close mastoid cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		130	
69676	Removal of eardrum nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69676	Removal of eardrum nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69676	Removal of eardrum nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		130	
69700	Closure of drainage tract in mastoid cavity	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69700	Closure of drainage tract in mastoid cavity	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69700	Closure of drainage tract in mastoid cavity	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		81	
69711	Removal or repair of temporal bone conduction hearing device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69711	Removal or repair of temporal bone conduction hearing device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69711	Removal or repair of temporal bone conduction hearing device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
69714	"Temporal bone implantation of cochlear stimulating system, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69714	"Temporal bone implantation of cochlear stimulating system, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
69714	"Temporal bone implantation of cochlear stimulating system, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
69715	"Removal of mastoid bone with implantation of cochlear stimulating system, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69715	"Removal of mastoid bone with implantation of cochlear stimulating system, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
69715	"Removal of mastoid bone with implantation of cochlear stimulating system, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
69717	"Temporal bone implantation of cochlear stimulating system, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69717	"Temporal bone implantation of cochlear stimulating system, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
69717	"Temporal bone implantation of cochlear stimulating system, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		117	
69718	Removal of mastoid bone with removal and replacement (accessed through the skin) of cochlear stimulating system	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69718	Removal of mastoid bone with removal and replacement (accessed through the skin) of cochlear stimulating system	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
69718	Removal of mastoid bone with removal and replacement (accessed through the skin) of cochlear stimulating system	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		126	
69720	Release of facial nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69720	Release of facial nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69720	Release of facial nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		167	
69725	Release of facial nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
69725	Release of facial nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69725	Release of facial nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		184	
69740	Repair of facial nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
69740	Repair of facial nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69740	Repair of facial nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		111	
69745	Repair of facial nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
69745	Repair of facial nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69745	Repair of facial nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		130	
69801	"Incision of fluid canals of inner ear with infusion of drugs, transcanal approach"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	22	
69801	"Incision of fluid canals of inner ear with infusion of drugs, transcanal approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	64	0	
69801	"Incision of fluid canals of inner ear with infusion of drugs, transcanal approach"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
69805	Inner ear operation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69805	Inner ear operation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69805	Inner ear operation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		116	
69806	Inner ear operation with insertion of shunt	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69806	Inner ear operation with insertion of shunt	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69806	Inner ear operation with insertion of shunt	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
69820	Opening of inner ear canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69820	Opening of inner ear canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69820	Opening of inner ear canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
69840	Revision of opening of inner ear canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69840	Revision of opening of inner ear canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69840	Revision of opening of inner ear canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		148	
69905	Removal of inner ear canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69905	Removal of inner ear canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69905	Removal of inner ear canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		130	
69910	Removal of inner ear canal and removal of mastoid bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69910	Removal of inner ear canal and removal of mastoid bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69910	Removal of inner ear canal and removal of mastoid bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		95	
69915	Severing of ear canal nerve through mastoid and skull bones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
69915	Severing of ear canal nerve through mastoid and skull bones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69915	Severing of ear canal nerve through mastoid and skull bones	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		108	
69930	Implantation of cochlear device	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
69930	Implantation of cochlear device	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		6	
69930	Implantation of cochlear device	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		89	
69950	Severing of ear canal nerve through skull bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
69950	Severing of ear canal nerve through skull bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69950	Severing of ear canal nerve through skull bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		133	
69955	Release of facial nerve	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
69955	Release of facial nerve	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69955	Release of facial nerve	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		184	
69960	Release ear canal	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
69960	Release ear canal	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69960	Release ear canal	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		144	
69970	Removal of growth of temporal bone	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		75	
69970	Removal of growth of temporal bone	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
69970	Removal of growth of temporal bone	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		184	
70015	Radiological supervision and interpretation X-ray of brain and spinal cord with contrast	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	47		
70030	"X-ray of mandible, less than 4 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	16		
70100	"X-ray of mandible, less than 4 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	19		
70110	"X-ray of mandible, minimum of 4 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	22		
70120	"X-ray of mastoid, less than 3 views per side"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
70130	"X-ray of mastoid, minimum of 3 views per side"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	32		
70134	X-ray of internal ear canal	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	24		
70140	"X-ray of bones of face, less than 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	16		
70150	"X-ray of bones of face, minimum of 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	24		
70160	"X-ray of bones of nose, minimum of 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
70190	X-ray of skull	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
70200	"X-ray of eye bones, minimum of 4 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	24		
70210	"X-ray of paranasal sinus, less than 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	16		
70220	"X-ray of paranasal sinus, complete, minimum of 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
70240	X-ray of bone at base of skull	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	16		
70250	"X-ray of skull, less than 4 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
70260	"X-ray of skull, complete, minimum of 4 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	24		
70300	"X-ray of teeth, single view"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	10		
70310	"X-ray of teeth, less than full mouth"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
70320	"X-ray of teeth, full mouth"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	28		
70328	X-ray of jaw joint on one side of the face	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	18		
70330	X-ray of jaw joints on both sides of the face	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	28		
70332	Radiological supervision and interpretation X-ray of jaw joint	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
70336	MRI scan of jaw joints	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
70336	MRI scan of jaw joints	Service  intra	L047A	MRI Technologist	0.47	Service total costs	58		
70350	Imaging of jaws and skull for orthodontic purposes	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	11		
70355	X-ray imaging of teeth	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	11		
70360	X-ray of soft tissue of neck	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	16		
70370	X-ray of voice box or throat	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	26		
70371	Imaging of voice box with speech evaluation	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
70380	X-ray of salivary gland	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
70390	Radiological supervision and interpretation X-ray of salivary structure	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	34		
70450	CT scan head or brain	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	6		
70450	CT scan head or brain	Service  intra	L046A	CT Technologist	0.46	Service total costs	25		
70460	CT scan head or brain with contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
70460	CT scan head or brain with contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	32		
70470	CT scan head or brain before and after contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
70470	CT scan head or brain before and after contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	38		
70480	CT scan of cranial cavity	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	6		
70480	CT scan of cranial cavity	Service  intra	L046A	CT Technologist	0.46	Service total costs	45		
70481	CT scan of cranial cavity with contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
70481	CT scan of cranial cavity with contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	53		
70482	CT scan of cranial cavity before and after contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
70482	CT scan of cranial cavity before and after contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	61		
70486	"Computed tomography, maxillofacial area; without contrast material"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
70486	"Computed tomography, maxillofacial area; without contrast material"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
70486	"Computed tomography, maxillofacial area; without contrast material"	Service  pre	L046A	CT Technologist	0.46	Greet patient and provide gowning	3		
70486	"Computed tomography, maxillofacial area; without contrast material"	Service  pre	L046A	CT Technologist	0.46	Prepare and position pt/ monitor pt/ set up IV	2		
70486	"Computed tomography, maxillofacial area; without contrast material"	Service  pre	L046A	CT Technologist	0.46	"Prepare room, equipment, supplies"	3		
70486	"Computed tomography, maxillofacial area; without contrast material"	Service  pre	L046A	CT Technologist	0.46	SVC Provide pre-service education/obtain consent	2		
70486	"Computed tomography, maxillofacial area; without contrast material"	Service  intra	L046A	CT Technologist	0.46	Acquire images	15		
70486	"Computed tomography, maxillofacial area; without contrast material"	Service  post	L046A	CT Technologist	0.46	Clean room/equipment by physician staff	3		
70486	"Computed tomography, maxillofacial area; without contrast material"	Service  post	L046A	CT Technologist	0.46	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
70486	"Computed tomography, maxillofacial area; without contrast material"	Service  post	L046A	CT Technologist	0.46	Review examination with interpreting MD	2		
70486	"Computed tomography, maxillofacial area; without contrast material"	Service  post	L046A	CT Technologist	0.46	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
70487	"Computed tomography, maxillofacial area; with contrast material(s)"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
70487	"Computed tomography, maxillofacial area; with contrast material(s)"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
70487	"Computed tomography, maxillofacial area; with contrast material(s)"	Service  pre	L046A	CT Technologist	0.46	Greet patient and provide gowning	3		
70487	"Computed tomography, maxillofacial area; with contrast material(s)"	Service  pre	L046A	CT Technologist	0.46	Prepare and position pt/ monitor pt/ set up IV	4		
70487	"Computed tomography, maxillofacial area; with contrast material(s)"	Service  pre	L046A	CT Technologist	0.46	"Prepare room, equipment, supplies"	2		
70487	"Computed tomography, maxillofacial area; with contrast material(s)"	Service  pre	L046A	CT Technologist	0.46	SVC Provide pre-service education/obtain consent	3		
70487	"Computed tomography, maxillofacial area; with contrast material(s)"	Service  intra	L046A	CT Technologist	0.46	Acquire images	17		
70487	"Computed tomography, maxillofacial area; with contrast material(s)"	Service  post	L046A	CT Technologist	0.46	Clean room/equipment by physician staff	3		
70487	"Computed tomography, maxillofacial area; with contrast material(s)"	Service  post	L046A	CT Technologist	0.46	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
70487	"Computed tomography, maxillofacial area; with contrast material(s)"	Service  post	L046A	CT Technologist	0.46	Review examination with interpreting MD	2		
70487	"Computed tomography, maxillofacial area; with contrast material(s)"	Service  post	L046A	CT Technologist	0.46	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
70488	"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
70488	"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
70488	"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections"	Service  pre	L046A	CT Technologist	0.46	Greet patient and provide gowning	3		
70488	"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections"	Service  pre	L046A	CT Technologist	0.46	Prepare and position pt/ monitor pt/ set up IV	4		
70488	"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections"	Service  pre	L046A	CT Technologist	0.46	"Prepare room, equipment, supplies"	2		
70488	"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections"	Service  pre	L046A	CT Technologist	0.46	SVC Provide pre-service education/obtain consent	3		
70488	"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections"	Service  intra	L046A	CT Technologist	0.46	Acquire images	26		
70488	"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections"	Service  post	L046A	CT Technologist	0.46	Clean room/equipment by physician staff	3		
70488	"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections"	Service  post	L046A	CT Technologist	0.46	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
70488	"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections"	Service  post	L046A	CT Technologist	0.46	Review examination with interpreting MD	2		
70488	"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections"	Service  post	L046A	CT Technologist	0.46	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
70490	CT scan of neck	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	6		
70490	CT scan of neck	Service  intra	L046A	CT Technologist	0.46	Service total costs	34		
70491	CT scan of neck with contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
70491	CT scan of neck with contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	42		
70492	CT scan of neck before and after contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
70492	CT scan of neck before and after contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	54		
70496	"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Pre-service	L046A	CT Technologist	0.46	Availability of prior images confirmed	2		
70496	"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	0		
70496	"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Pre-service	L046A	CT Technologist	0.46	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
70496	"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	0		
70496	"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
70496	"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  pre	L046A	CT Technologist	0.46	Prepare and position pt/ monitor pt/ set up IV	5		
70496	"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  pre	L046A	CT Technologist	0.46	"Prepare room, equipment, supplies"	2		
70496	"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  pre	L046A	CT Technologist	0.46	SVC Provide pre-service education/obtain consent	2		
70496	"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  intra	L046A	CT Technologist	0.46	Acquire images	28		
70496	"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  intra	L046A	CT Technologist	0.46	Computer post processing	33		
70496	"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
70496	"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  post	L046A	CT Technologist	0.46	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
70496	"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  post	L046A	CT Technologist	0.46	Review examination with interpreting MD	2		
70496	"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  post	L046A	CT Technologist	0.46	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
70498	"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Pre-service	L046A	CT Technologist	0.46	Availability of prior images confirmed	2		
70498	"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	0		
70498	"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Pre-service	L046A	CT Technologist	0.46	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
70498	"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	0		
70498	"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
70498	"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  pre	L046A	CT Technologist	0.46	Prepare and position pt/ monitor pt/ set up IV	5		
70498	"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  pre	L046A	CT Technologist	0.46	"Prepare room, equipment, supplies"	2		
70498	"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  pre	L046A	CT Technologist	0.46	SVC Provide pre-service education/obtain consent	2		
70498	"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  intra	L046A	CT Technologist	0.46	Acquire images	28		
70498	"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  intra	L046A	CT Technologist	0.46	Computer post processing	33		
70498	"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
70498	"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  post	L046A	CT Technologist	0.46	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
70498	"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  post	L046A	CT Technologist	0.46	Review examination with interpreting MD	2		
70498	"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing"	Service  post	L046A	CT Technologist	0.46	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
70540	"MRI scan bones of the eye, face, and/or neck"	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
70540	"MRI scan bones of the eye, face, and/or neck"	Service  intra	L047A	MRI Technologist	0.47	Service total costs	68		
70542	"MRI scan bones of the eye, face, and/or neck with contrast"	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
70542	"MRI scan bones of the eye, face, and/or neck with contrast"	Service  intra	L047A	MRI Technologist	0.47	Service total costs	70		
70543	"MRI scan bones of the eye, face, and/or neck before and after contrast"	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
70543	"MRI scan bones of the eye, face, and/or neck before and after contrast"	Service  intra	L047A	MRI Technologist	0.47	Service total costs	87		
70544	MRA scan of head blood vessels	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	5		
70544	MRA scan of head blood vessels	Service  intra	L041A	Angio Technician	0.41	Service total costs	74		
70544	MRA scan of head blood vessels	Post-service	L026A	Medical/Technical Assistant	0.26	Post service total costs	10		
70545	MRA scan of head blood vessels with contrast	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	5		
70545	MRA scan of head blood vessels with contrast	Service  intra	L041A	Angio Technician	0.41	Service total costs	72		
70545	MRA scan of head blood vessels with contrast	Post-service	L026A	Medical/Technical Assistant	0.26	Post service total costs	10		
70546	MRA scan of head blood vessels before and after contrast	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	5		
70546	MRA scan of head blood vessels before and after contrast	Service  intra	L041A	Angio Technician	0.41	Service total costs	113		
70546	MRA scan of head blood vessels before and after contrast	Post-service	L026A	Medical/Technical Assistant	0.26	Post service total costs	10		
70547	MRA scan of neck blood vessels	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	5		
70547	MRA scan of neck blood vessels	Service  intra	L041A	Angio Technician	0.41	Service total costs	74		
70547	MRA scan of neck blood vessels	Post-service	L026A	Medical/Technical Assistant	0.26	Post service total costs	10		
70548	MRA scan of neck blood vessels with contrast	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	5		
70548	MRA scan of neck blood vessels with contrast	Service  intra	L041A	Angio Technician	0.41	Service total costs	76		
70548	MRA scan of neck blood vessels with contrast	Post-service	L026A	Medical/Technical Assistant	0.26	Post service total costs	10		
70549	MRA scan of neck blood vessels before and after contrast	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	5		
70549	MRA scan of neck blood vessels before and after contrast	Service  intra	L041A	Angio Technician	0.41	Service total costs	113		
70549	MRA scan of neck blood vessels before and after contrast	Post-service	L026A	Medical/Technical Assistant	0.26	Post service total costs	10		
70551	MRI scan brain	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	3		
70551	MRI scan brain	Service  intra	L047A	MRI Technologist	0.47	Service total costs	56		
70552	MRI scan of brain with contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	5		
70552	MRI scan of brain with contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	71		
70553	MRI scan of brain before and after contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	5		
70553	MRI scan of brain before and after contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	81		
70554	Functional MRI scan of brain	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	3		
70554	Functional MRI scan of brain	Service  intra	L047A	MRI Technologist	0.47	Service total costs	106		
71010	"X-ray of chest, 1 view, front"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	11		
71015	"X-ray of chest, stereo, front"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	14		
71020	"X-ray of chest, 2 views, front and side"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	14		
71021	"X-ray of chest, 2 views, front and side"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	17		
71022	"X-ray of chest, 2 views, front and side"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	22		
71023	"X-ray of chest, 2 views, front and side with fluoroscopy"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	21		
71030	"X-ray of chest, minimum of 4 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	22		
71034	"X-ray of chest, complete, minimum of 4 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	27		
71035	"X-ray of chest, special views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
71100	"Radiologic examination, ribs, unilateral; 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
71100	"Radiologic examination, ribs, unilateral; 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
71100	"Radiologic examination, ribs, unilateral; 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
71100	"Radiologic examination, ribs, unilateral; 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician - acquire images	6		
71100	"Radiologic examination, ribs, unilateral; 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
71100	"Radiologic examination, ribs, unilateral; 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
71100	"Radiologic examination, ribs, unilateral; 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
71100	"Radiologic examination, ribs, unilateral; 2 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
71101	"X-ray of ribs on one side of body including the chest, minimum of 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	19		
71110	"X-ray of both sides of the ribs, 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
71111	"X-ray of both sides of the ribs including the chest, minimum of 4 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	27		
71120	"X-ray of breast bone, minimum of 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	16		
71130	"X-ray of junction of breast and collar bones, minimum of 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
71250	CT scan chest	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	6		
71250	CT scan chest	Service  intra	L046A	CT Technologist	0.46	Service total costs	34		
71260	CT scan chest with contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
71260	CT scan chest with contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	42		
71270	CT scan chest before and after contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
71270	CT scan chest before and after contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	54		
71275	"Computed tomographic angiography, chest"	Pre-service	L046A	CT Technologist	0.46	Availability of prior images confirmed	2		
71275	"Computed tomographic angiography, chest"	Pre-service	L046A	CT Technologist	0.46	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
71275	"Computed tomographic angiography, chest"	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
71275	"Computed tomographic angiography, chest"	Service  pre	L046A	CT Technologist	0.46	Prepare and position pt/ monitor pt/ set up IV	5		
71275	"Computed tomographic angiography, chest"	Service  pre	L046A	CT Technologist	0.46	"Prepare room, equipment, supplies"	2		
71275	"Computed tomographic angiography, chest"	Service  pre	L046A	CT Technologist	0.46	SVC Provide pre-service education/obtain consent	2		
71275	"Computed tomographic angiography, chest"	Service  intra	L046A	CT Technologist	0.46	Acquire images	28		
71275	"Computed tomographic angiography, chest"	Service  intra	L046A	CT Technologist	0.46	Computer post processing	33		
71275	"Computed tomographic angiography, chest"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
71275	"Computed tomographic angiography, chest"	Service  post	L046A	CT Technologist	0.46	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
71275	"Computed tomographic angiography, chest"	Service  post	L046A	CT Technologist	0.46	Review examination with interpreting MD	2		
71275	"Computed tomographic angiography, chest"	Service  post	L046A	CT Technologist	0.46	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
71550	MRI scan of chest	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
71550	MRI scan of chest	Service  intra	L047A	MRI Technologist	0.47	Service total costs	78		
71551	MRI scan of chest with contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
71551	MRI scan of chest with contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	82		
71552	MRI scan of chest before and after contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
71552	MRI scan of chest before and after contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	104		
71555	MRI scan of blood vessels of chest	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
71555	MRI scan of blood vessels of chest	Service  intra	L047A	MRI Technologist	0.47	Service total costs	95		
72020	"X-ray of spine, 1 view"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	12		
72040	"X-ray of spine of neck, 2 or 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
72050	"X-ray of upper spine, 4 or 5 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	28		
72052	"X-ray of upper spine, 6 or more views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	36		
72070	"Radiologic examination, spine; thoracic, 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
72070	"Radiologic examination, spine; thoracic, 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
72070	"Radiologic examination, spine; thoracic, 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
72070	"Radiologic examination, spine; thoracic, 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician - acquire images	6		
72070	"Radiologic examination, spine; thoracic, 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
72070	"Radiologic examination, spine; thoracic, 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
72070	"Radiologic examination, spine; thoracic, 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
72070	"Radiologic examination, spine; thoracic, 2 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
72072	"X-ray of middle spine, 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
72074	"X-ray of middle spine, minimum of 4 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	24		
72080	"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	16		
72081	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
72081	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
72081	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view"	Service  pre	L041B	Radiologic Technologist	0.41	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
72081	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
72081	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
72081	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images	6		
72081	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
72081	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view"	Post-service	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
72081	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view"	Post-service	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACs. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
72081	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view"	Post-service	L041B	Radiologic Technologist	0.41	Review examination with interpreting physician	2		
72082	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
72082	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
72082	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
72082	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
72082	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
72082	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images	21		
72082	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
72082	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
72082	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
72082	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
72083	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
72083	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
72083	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
72083	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
72083	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
72083	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images	29		
72083	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
72083	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
72083	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
72083	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
72084	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
72084	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
72084	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
72084	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
72084	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
72084	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images	38		
72084	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
72084	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
72084	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
72084	"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
72100	"X-ray of lower and sacral spine, 2 or 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
72110	"X-ray of lower and sacral spine, minimum of 4 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	28		
72114	X-ray lower and sacral spine including bending views minimum 6 views	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	36		
72120	X-ray lower and sacral spine including bending views 2 or 3 views	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	23		
72125	CT scan of upper spine	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	6		
72125	CT scan of upper spine	Service  intra	L046A	CT Technologist	0.46	Service total costs	34		
72126	CT scan of upper spine with contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
72126	CT scan of upper spine with contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	42		
72127	CT scan of upper spine before and after contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
72127	CT scan of upper spine before and after contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	54		
72128	CT scan of middle spine	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	6		
72128	CT scan of middle spine	Service  intra	L046A	CT Technologist	0.46	Service total costs	34		
72129	CT scan of middle spine with contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
72129	CT scan of middle spine with contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	42		
72130	CT scan of middle spine before and after contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
72130	CT scan of middle spine before and after contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	54		
72131	CT scan of lower spine	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	6		
72131	CT scan of lower spine	Service  intra	L046A	CT Technologist	0.46	Service total costs	34		
72132	CT scan of lower spine with contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
72132	CT scan of lower spine with contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	42		
72133	CT scan of lower spine before and after contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
72133	CT scan of lower spine before and after contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	54		
72141	MRI scan of upper spinal canal	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	3		
72141	MRI scan of upper spinal canal	Service  intra	L047A	MRI Technologist	0.47	Service total costs	49		
72142	MRI scan of upper spinal canal with contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	5		
72142	MRI scan of upper spinal canal with contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	64		
72146	MRI scan of middle spinal canal	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	3		
72146	MRI scan of middle spinal canal	Service  intra	L047A	MRI Technologist	0.47	Service total costs	49		
72147	MRI scan of middle spinal canal with contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	5		
72147	MRI scan of middle spinal canal with contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	64		
72148	MRI scan of lower spinal canal	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	3		
72148	MRI scan of lower spinal canal	Service  intra	L047A	MRI Technologist	0.47	Service total costs	47		
72149	MRI scan of lower spinal canal with contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	5		
72149	MRI scan of lower spinal canal with contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	64		
72156	MRI scan of upper spinal canal before and after contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	5		
72156	MRI scan of upper spinal canal before and after contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	72		
72157	MRI scan of middle spinal canal before and after contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	5		
72157	MRI scan of middle spinal canal before and after contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	72		
72158	MRI scan of lower spinal canal before and after contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	5		
72158	MRI scan of lower spinal canal before and after contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	72		
72159	MRA scan of spinal canal blood vessels	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
72159	MRA scan of spinal canal blood vessels	Service  intra	L047A	MRI Technologist	0.47	Service total costs	95		
72170	"X-ray of pelvis, 1 or 2 views"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
72170	"X-ray of pelvis, 1 or 2 views"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
72170	"X-ray of pelvis, 1 or 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
72170	"X-ray of pelvis, 1 or 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
72170	"X-ray of pelvis, 1 or 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
72170	"X-ray of pelvis, 1 or 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images	3		
72170	"X-ray of pelvis, 1 or 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
72170	"X-ray of pelvis, 1 or 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
72170	"X-ray of pelvis, 1 or 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
72170	"X-ray of pelvis, 1 or 2 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
72190		Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
72191	Ct angiograph pelv w/o&w/dye	Pre-service	L046A	CT Technologist	0.46	Availability of prior images confirmed	2		
72191	Ct angiograph pelv w/o&w/dye	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
72191	Ct angiograph pelv w/o&w/dye	Service  pre	L046A	CT Technologist	0.46	Prepare and position pt/ monitor pt/ set up IV	5		
72191	Ct angiograph pelv w/o&w/dye	Service  pre	L046A	CT Technologist	0.46	"Prepare room, equipment, supplies"	2		
72191	Ct angiograph pelv w/o&w/dye	Service  pre	L046A	CT Technologist	0.46	SVC Provide pre-service education/obtain consent	2		
72191	Ct angiograph pelv w/o&w/dye	Service  intra	L046A	CT Technologist	0.46	Acquire images	28		
72191	Ct angiograph pelv w/o&w/dye	Service  intra	L046A	CT Technologist	0.46	Assist physician in performing procedure/Computer post processing	33		
72191	Ct angiograph pelv w/o&w/dye	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
72191	Ct angiograph pelv w/o&w/dye	Service  post	L046A	CT Technologist	0.46	Post processing: Technical QC	2		
72191	Ct angiograph pelv w/o&w/dye	Service  post	L046A	CT Technologist	0.46	Review documents w/ physician	2		
72191	Ct angiograph pelv w/o&w/dye	Service  post	L046A	CT Technologist	0.46	Scanning other documents into PACs	1		
72192	CT scan pelvis	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	4		
72192	CT scan pelvis	Service  intra	L046A	CT Technologist	0.46	Service total costs	32		
72193	CT scan pelvis with contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	4		
72193	CT scan pelvis with contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	43		
72194	"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections"	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	4		
72194	"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections"	Service  intra	L046A	CT Technologist	0.46	Service total costs	52		
72195	MRI scan of pelvis	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
72195	MRI scan of pelvis	Service  intra	L047A	MRI Technologist	0.47	Service total costs	68		
72196	MRI scan of pelvis with contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
72196	MRI scan of pelvis with contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	70		
72197	MRI scan of pelvis before and after contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
72197	MRI scan of pelvis before and after contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	87		
72198	MRA scan of pelvic blood vessels	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
72198	MRA scan of pelvic blood vessels	Service  intra	L047A	MRI Technologist	0.47	Service total costs	95		
72200	"X-ray of sacroiliac joints, less than 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	16		
72202	"X-ray of sacroiliac joints, 3 or more views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
72220	"X-ray of pelvis, minimum of 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	16		
72240	"Myelography, cervical, radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
72240	"Myelography, cervical, radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
72240	"Myelography, cervical, radiological supervision and interpretation"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	1		
72240	"Myelography, cervical, radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	16		
72240	"Myelography, cervical, radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
72240	"Myelography, cervical, radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
72240	"Myelography, cervical, radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
72240	"Myelography, cervical, radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
72255	"Myelography, thoracic, radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
72255	"Myelography, thoracic, radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
72255	"Myelography, thoracic, radiological supervision and interpretation"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	1		
72255	"Myelography, thoracic, radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	15		
72255	"Myelography, thoracic, radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
72255	"Myelography, thoracic, radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
72255	"Myelography, thoracic, radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
72255	"Myelography, thoracic, radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
72265	"Myelography, lumbosacral, radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
72265	"Myelography, lumbosacral, radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
72265	"Myelography, lumbosacral, radiological supervision and interpretation"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	1		
72265	"Myelography, lumbosacral, radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	15		
72265	"Myelography, lumbosacral, radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
72265	"Myelography, lumbosacral, radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
72265	"Myelography, lumbosacral, radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
72265	"Myelography, lumbosacral, radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
72270	"Myelography, 2 or more regions radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
72270	"Myelography, 2 or more regions radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
72270	"Myelography, 2 or more regions radiological supervision and interpretation"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	1		
72270	"Myelography, 2 or more regions radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	20		
72270	"Myelography, 2 or more regions radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
72270	"Myelography, 2 or more regions radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
72270	"Myelography, 2 or more regions radiological supervision and interpretation"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
72275	Radiological supervision and interpretation X-ray of covering of spinal cord	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	33		
72285	"Radiological supervision and interpretation X-ray of disc of vertebra, upper or middle spine"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	26		
72295	"Radiological supervision and interpretation X-ray of disc of vertebra, lower spine"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	26		
73000	X-ray of collar bone	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	14		
73010	X-ray of shoulder blade	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	14		
73020	"X-ray of shoulder, 1 view"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	11		
73030	"X-ray of shoulder, minimum of 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	17		
73040	Radiological supervision and interpretation X-ray of shoulder joint	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	32		
73050	X-ray of both collar bones	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	16		
73060	"Radiologic examination; humerus, minimum of 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
73060	"Radiologic examination; humerus, minimum of 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
73060	"Radiologic examination; humerus, minimum of 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
73060	"Radiologic examination; humerus, minimum of 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician - acquire images	4		
73060	"Radiologic examination; humerus, minimum of 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
73060	"Radiologic examination; humerus, minimum of 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
73060	"Radiologic examination; humerus, minimum of 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
73060	"Radiologic examination; humerus, minimum of 2 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
73070	"X-ray of elbow, 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	14		
73080	"X-ray of elbow, minimum of 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	15		
73085	Radiological supervision and interpretation X-ray of elbow	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	26		
73090	"X-ray of forearm, 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	14		
73092	X-ray of arm in infant minimum of 2 views	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	16		
73100	"X-ray of wrist, 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	14		
73110	"X-ray of wrist, minimum of 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
73115	Radiological supervision and interpretation X-ray of wrist joint	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	32		
73120	"X-ray of hand, 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	14		
73130	"X-ray of hand, minimum of 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	17		
73140	"X-ray of fingers, minimum of 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	17		
73200	CT scan of arm	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	6		
73200	CT scan of arm	Service  intra	L046A	CT Technologist	0.46	Service total costs	34		
73201	CT scan of arm with contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
73201	CT scan of arm with contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	42		
73202	CT scan of arm before and after contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
73202	CT scan of arm before and after contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	57		
73206	CT scan of arm blood vessels with contrast	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	5		
73206	CT scan of arm blood vessels with contrast	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	103		
73206	CT scan of arm blood vessels with contrast	Post-service	L041B	Radiologic Technologist	0.41	Post service total costs	5		
73218	MRI scan of arm	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
73218	MRI scan of arm	Service  intra	L047A	MRI Technologist	0.47	Service total costs	68		
73219	MRI scan of arm with contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
73219	MRI scan of arm with contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	70		
73220	MRI scan of arm before and after contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
73220	MRI scan of arm before and after contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	87		
73221	MRI scan of arm joint	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
73221	MRI scan of arm joint	Service  intra	L047A	MRI Technologist	0.47	Service total costs	58		
73222	MRI scan of arm joint with contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
73222	MRI scan of arm joint with contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	65		
73223	MRI scan of arm joint before and after contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
73223	MRI scan of arm joint before and after contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	80		
73225	MRA scan of arm blood vessels	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
73225	MRA scan of arm blood vessels	Service  intra	L047A	MRI Technologist	0.47	Service total costs	95		
73501	"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
73501	"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
73501	"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view"	Service  pre	L041B	Radiologic Technologist	0.41	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
73501	"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	1		
73501	"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	1		
73501	"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images	3		
73501	"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
73501	"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
73501	"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
73501	"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
73502	"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
73502	"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
73502	"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
73502	"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
73502	"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
73502	"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images	9		
73502	"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
73502	"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
73502	"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
73502	"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
73503	"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
73503	"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
73503	"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
73503	"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
73503	"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
73503	"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images	15		
73503	"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
73503	"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
73503	"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
73503	"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
73521	"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
73521	"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
73521	"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
73521	"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
73521	"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
73521	"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images	6		
73521	"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
73521	"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
73521	"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
73521	"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
73522	"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
73522	"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
73522	"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
73522	"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
73522	"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
73522	"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images	12		
73522	"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
73522	"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
73522	"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
73522	"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
73523	"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
73523	"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
73523	"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
73523	"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
73523	"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
73523	"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images	18		
73523	"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
73523	"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
73523	"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
73523	"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
73525	Radiological supervision and interpretation X-ray of hip joint	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	26		
73551	"Radiologic examination, femur; 1 view"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
73551	"Radiologic examination, femur; 1 view"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
73551	"Radiologic examination, femur; 1 view"	Service  pre	L041B	Radiologic Technologist	0.41	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
73551	"Radiologic examination, femur; 1 view"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	1		
73551	"Radiologic examination, femur; 1 view"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	1		
73551	"Radiologic examination, femur; 1 view"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images	3		
73551	"Radiologic examination, femur; 1 view"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
73551	"Radiologic examination, femur; 1 view"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
73551	"Radiologic examination, femur; 1 view"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
73551	"Radiologic examination, femur; 1 view"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
73552	"Radiologic examination, femur; minimum 2 views"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
73552	"Radiologic examination, femur; minimum 2 views"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
73552	"Radiologic examination, femur; minimum 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
73552	"Radiologic examination, femur; minimum 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
73552	"Radiologic examination, femur; minimum 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
73552	"Radiologic examination, femur; minimum 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images	4		
73552	"Radiologic examination, femur; minimum 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
73552	"Radiologic examination, femur; minimum 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
73552	"Radiologic examination, femur; minimum 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
73552	"Radiologic examination, femur; minimum 2 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
73560	"Radiologic examination, knee; 1 or 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
73560	"Radiologic examination, knee; 1 or 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
73560	"Radiologic examination, knee; 1 or 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
73560	"Radiologic examination, knee; 1 or 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician - acquire images	4		
73560	"Radiologic examination, knee; 1 or 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
73560	"Radiologic examination, knee; 1 or 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
73560	"Radiologic examination, knee; 1 or 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
73560	"Radiologic examination, knee; 1 or 2 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
73562	"Radiologic examination, knee; 3 views"	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
73562	"Radiologic examination, knee; 3 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
73562	"Radiologic examination, knee; 3 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
73562	"Radiologic examination, knee; 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician - acquire images	6		
73562	"Radiologic examination, knee; 3 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
73562	"Radiologic examination, knee; 3 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
73562	"Radiologic examination, knee; 3 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
73562	"Radiologic examination, knee; 3 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
73564	"Radiologic examination, knee; complete, 4 or more views"	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
73564	"Radiologic examination, knee; complete, 4 or more views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
73564	"Radiologic examination, knee; complete, 4 or more views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
73564	"Radiologic examination, knee; complete, 4 or more views"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician - acquire images	8		
73564	"Radiologic examination, knee; complete, 4 or more views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
73564	"Radiologic examination, knee; complete, 4 or more views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
73564	"Radiologic examination, knee; complete, 4 or more views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
73564	"Radiologic examination, knee; complete, 4 or more views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
73565	"Radiologic examination, knee; both knees, standing, anteroposterior"	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
73565	"Radiologic examination, knee; both knees, standing, anteroposterior"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
73565	"Radiologic examination, knee; both knees, standing, anteroposterior"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
73565	"Radiologic examination, knee; both knees, standing, anteroposterior"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician - acquire images	4		
73565	"Radiologic examination, knee; both knees, standing, anteroposterior"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
73565	"Radiologic examination, knee; both knees, standing, anteroposterior"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
73565	"Radiologic examination, knee; both knees, standing, anteroposterior"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
73565	"Radiologic examination, knee; both knees, standing, anteroposterior"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
73580	Radiological supervision and interpretation X-ray of knee joint	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	32		
73590	"Radiologic examination; tibia and fibula, 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
73590	"Radiologic examination; tibia and fibula, 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
73590	"Radiologic examination; tibia and fibula, 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
73590	"Radiologic examination; tibia and fibula, 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician - acquire images	4		
73590	"Radiologic examination; tibia and fibula, 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
73590	"Radiologic examination; tibia and fibula, 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
73590	"Radiologic examination; tibia and fibula, 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
73590	"Radiologic examination; tibia and fibula, 2 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
73592	X-ray of leg in infant minimum of 2 views	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	16		
73600	"Radiologic examination, ankle; 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
73600	"Radiologic examination, ankle; 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	2		
73600	"Radiologic examination, ankle; 2 views"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
73600	"Radiologic examination, ankle; 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician - acquire images	4		
73600	"Radiologic examination, ankle; 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
73600	"Radiologic examination, ankle; 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
73600	"Radiologic examination, ankle; 2 views"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
73600	"Radiologic examination, ankle; 2 views"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
73610	"X-ray of ankle, minimum of 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	17		
73615	Radiological supervision and interpretation X-ray of ankle joint	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	26		
73620	"X-ray of foot, 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	17		
73630	"X-ray of foot, minimum of 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	15		
73650	"X-ray of heel, minimum of 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	14		
73660	"X-ray of toes, minimum of 2 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	17		
73700	CT scan leg	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	6		
73700	CT scan leg	Service  intra	L046A	CT Technologist	0.46	Service total costs	34		
73701	CT scan leg with contrast injection	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
73701	CT scan leg with contrast injection	Service  intra	L046A	CT Technologist	0.46	Service total costs	42		
73702	CT scan of leg before and after contrast injection	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	7		
73702	CT scan of leg before and after contrast injection	Service  intra	L046A	CT Technologist	0.46	Service total costs	57		
73706	CT scan of lower leg blood vessels with contrast	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	5		
73706	CT scan of lower leg blood vessels with contrast	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	118		
73706	CT scan of lower leg blood vessels with contrast	Post-service	L041B	Radiologic Technologist	0.41	Post service total costs	5		
73718	MRI scan of leg	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
73718	MRI scan of leg	Service  intra	L047A	MRI Technologist	0.47	Service total costs	68		
73719	MRI scan of leg with contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
73719	MRI scan of leg with contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	70		
73720	MRI scan of leg before and after contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
73720	MRI scan of leg before and after contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	87		
73721	MRI scan of leg joint	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
73721	MRI scan of leg joint	Service  intra	L047A	MRI Technologist	0.47	Service total costs	58		
73722	MRI scan of leg joint with contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
73722	MRI scan of leg joint with contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	65		
73723	MRI scan of leg joint before and after contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
73723	MRI scan of leg joint before and after contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	80		
73725	MRA scan of leg blood vessels	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
73725	MRA scan of leg blood vessels	Service  intra	L047A	MRI Technologist	0.47	Service total costs	95		
74000	"X-ray of abdomen, single view"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	12		
74010	Imaging of abdomen	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
74020	Imaging of abdomen	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
74022	Imaging of abdomen and chest	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	24		
74150	CT scan abdomen	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	4		
74150	CT scan abdomen	Service  intra	L046A	CT Technologist	0.46	Service total costs	32		
74160	"Computed tomography, abdomen; with contrast material(s)"	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	4		
74160	"Computed tomography, abdomen; with contrast material(s)"	Service  intra	L046A	CT Technologist	0.46	Service total costs	43		
74170	CT scan abdomen before and after contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	4		
74170	CT scan abdomen before and after contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	52		
74174	Ct angio abd&pelv w/o&w/dye	Pre-service	L046A	CT Technologist	0.46	Availability of prior images confirmed	2		
74174	Ct angio abd&pelv w/o&w/dye	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
74174	Ct angio abd&pelv w/o&w/dye	Service  pre	L046A	CT Technologist	0.46	Prepare and position pt/ monitor pt/ set up IV	5		
74174	Ct angio abd&pelv w/o&w/dye	Service  pre	L046A	CT Technologist	0.46	"Prepare room, equipment, supplies"	2		
74174	Ct angio abd&pelv w/o&w/dye	Service  pre	L046A	CT Technologist	0.46	SVC Provide pre-service education/obtain consent	2		
74174	Ct angio abd&pelv w/o&w/dye	Service  intra	L046A	CT Technologist	0.46	Acquire images	45		
74174	Ct angio abd&pelv w/o&w/dye	Service  intra	L046A	CT Technologist	0.46	Assist physician in performing procedure/Computer post processing	33		
74174	Ct angio abd&pelv w/o&w/dye	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
74174	Ct angio abd&pelv w/o&w/dye	Service  post	L046A	CT Technologist	0.46	Post processing: Technical QC	2		
74174	Ct angio abd&pelv w/o&w/dye	Service  post	L046A	CT Technologist	0.46	Review documents w/ physician	2		
74174	Ct angio abd&pelv w/o&w/dye	Service  post	L046A	CT Technologist	0.46	Scanning other documents into PACs	1		
74175	Ct angio abdom w/o & w/dye	Pre-service	L046A	CT Technologist	0.46	Availability of prior images confirmed	2		
74175	Ct angio abdom w/o & w/dye	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
74175	Ct angio abdom w/o & w/dye	Service  pre	L046A	CT Technologist	0.46	Prepare and position pt/ monitor pt/ set up IV	5		
74175	Ct angio abdom w/o & w/dye	Service  pre	L046A	CT Technologist	0.46	"Prepare room, equipment, supplies"	2		
74175	Ct angio abdom w/o & w/dye	Service  pre	L046A	CT Technologist	0.46	SVC Provide pre-service education/obtain consent	2		
74175	Ct angio abdom w/o & w/dye	Service  intra	L046A	CT Technologist	0.46	Acquire images	28		
74175	Ct angio abdom w/o & w/dye	Service  intra	L046A	CT Technologist	0.46	Assist physician in performing procedure/Computer post processing	33		
74175	Ct angio abdom w/o & w/dye	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
74175	Ct angio abdom w/o & w/dye	Service  post	L046A	CT Technologist	0.46	Post processing: Technical QC	2		
74175	Ct angio abdom w/o & w/dye	Service  post	L046A	CT Technologist	0.46	Review documents w/ physician	2		
74175	Ct angio abdom w/o & w/dye	Service  post	L046A	CT Technologist	0.46	Scanning other documents into PACs	1		
74176	CT scan of abdomen and pelvis	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	6		
74176	CT scan of abdomen and pelvis	Service  intra	L046A	CT Technologist	0.46	Service total costs	39		
74177	"Computed tomography, abdomen and pelvis; with contrast material(s)"	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	6		
74177	"Computed tomography, abdomen and pelvis; with contrast material(s)"	Service  intra	L046A	CT Technologist	0.46	Service total costs	52		
74178	CT scan of abdomen and pelvis before and after contrast	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	6		
74178	CT scan of abdomen and pelvis before and after contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	64		
74181	MRI scan of abdomen	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
74181	MRI scan of abdomen	Service  intra	L047A	MRI Technologist	0.47	Service total costs	58		
74182	MRI scan of abdomen with contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
74182	MRI scan of abdomen with contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	80		
74183	MRI scan of abdomen before and after contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
74183	MRI scan of abdomen before and after contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	87		
74185	MRI scan of blood vessels of abdomen	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
74185	MRI scan of blood vessels of abdomen	Service  intra	L047A	MRI Technologist	0.47	Service total costs	95		
74210	X-ray of voice box and/or esophagus	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	27		
74220	X-ray of esophagus	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	27		
74230	"Swallowing function, with cineradiography/videoradiography"	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
74230	"Swallowing function, with cineradiography/videoradiography"	Service  pre	L041B	Radiologic Technologist	0.41	Prepare and position pt/ monitor pt/ set up IV	6		
74230	"Swallowing function, with cineradiography/videoradiography"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
74230	"Swallowing function, with cineradiography/videoradiography"	Service  intra	L041B	Radiologic Technologist	0.41	Acquire images	15		
74230	"Swallowing function, with cineradiography/videoradiography"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
74230	"Swallowing function, with cineradiography/videoradiography"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
74230	"Swallowing function, with cineradiography/videoradiography"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
74240	"Radiologic examination, gastrointestinal tract, upper; with or without delayed images, without KUB"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	34		
74241	"Radiologic examination, gastrointestinal tract, upper; with or without delayed images, with KUB"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	38		
74245	"Radiologic examination, gastrointestinal tract, upper; with small intestine, includes multiple serial images"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	58		
74246	"Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; with or without delayed images, without KUB"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	39		
74247	"Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; with or without delayed images, with KUB"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	46		
74249	X-ray of upper digestive tract with contrast followed by x-ray of small bowel at later point	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	63		
74250	"Radiologic examination, small intestine, includes multiple serial images; "	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	35		
74251	"Radiologic examination, small intestine, includes multiple serial images; via enteroclysis tube"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	64		
74260	Imaging of small intestine	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	36		
74261	Diagnostic CT scan of large bowel	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	91		
74262	Diagnostic CT scan of large bowel with contrast dye	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	101		
74263	Screening CT scan of large bowel	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	91		
74270	X-ray of large bowel with contrast	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	48		
74280	X-ray of large bowel with contrast	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	58		
74283	Imaging of colon using enema	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	43		
74290	Imaging of gallbladder with contrast	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	24		
74400	Imaging of urinary tract with injection of contrast into a vein	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	55		
74410	Imaging of urinary tract using infusion technique	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	55		
74415	Imaging of urinary tract using infusion technique with kidney section filming	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	55		
74430	"Radiological supervision and interpretation X-ray of urinary bladder, minimum of 3 views"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	22		
74440	Radiological supervision and interpretation X-ray of male internal genitals	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3		
74440	Radiological supervision and interpretation X-ray of male internal genitals	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	24		
74455	Radiological supervision and interpretation X-ray of urinary bladder and urethra	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	28		
74485		Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	5		
74485		Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	16		
74710	Imaging of pelvis	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	16		
74712	"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation"	Pre-service	L047A	MRI Technologist	0.47	Availability of prior images confirmed	2		
74712	"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation"	Pre-service	L047A	MRI Technologist	0.47	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
74712	"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation"	Service  pre	L047A	MRI Technologist	0.47	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
74712	"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation"	Service  pre	L047A	MRI Technologist	0.47	Prepare and position pt/ monitor pt/ set up IV	3		
74712	"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation"	Service  pre	L047A	MRI Technologist	0.47	"Prepare room, equipment, supplies"	5		
74712	"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation"	Service  pre	L047A	MRI Technologist	0.47	Provide pre-service education/obtain consent	7		
74712	"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation"	Service  intra	L047A	MRI Technologist	0.47	Acquire images	60		
74712	"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation"	Service  post	L047A	MRI Technologist	0.47	Clean room/equipment by physician staff	3		
74712	"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation"	Service  post	L047A	MRI Technologist	0.47	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
74712	"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation"	Service  post	L047A	MRI Technologist	0.47	Review examination with interpreting MD	2		
74712	"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation"	Service  post	L047A	MRI Technologist	0.47	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
74713	"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure)"	Service  intra	L047A	MRI Technologist	0.47	Acquire images	30		
74713	"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure)"	Service  post	L047A	MRI Technologist	0.47	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
74713	"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure)"	Service  post	L047A	MRI Technologist	0.47	Review examination with interpreting MD	2		
74713	"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (List separately in addition to code for primary procedure)"	Service  post	L047A	MRI Technologist	0.47	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
74740	Radiological supervision and interpretation X-ray of uterine tubes and ovaries	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	13		
75557	MRI of heart	Service  intra	L047A	MRI Technologist	0.47	Service total costs	46		
75559	MRI of heart with stress imaging	Service  intra	L047A	MRI Technologist	0.47	Service total costs	65		
75561	MRI of heart before and after contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	67		
75563	MRI of heart before and after contrast with stress imaging	Service  intra	L047A	MRI Technologist	0.47	Service total costs	78		
75565	MRI of blood flow of heart	Service  intra	L047A	MRI Technologist	0.47	Service total costs	10		
75571	CT scan of heart with evaluation of blood vessel calcium	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
75571	CT scan of heart with evaluation of blood vessel calcium	Service  intra	L046A	CT Technologist	0.46	Service total costs	27		
75571	CT scan of heart with evaluation of blood vessel calcium	Service  intra	L051A	RN	0.51	Service total costs	4		
75571	CT scan of heart with evaluation of blood vessel calcium	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8		
75572	CT scan of heart structure with contrast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
75572	CT scan of heart structure with contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	47		
75572	CT scan of heart structure with contrast	Service  intra	L051A	RN	0.51	Service total costs	27		
75572	CT scan of heart structure with contrast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	10		
75573	CT scan of congenital heart structure defect with contrast	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
75573	CT scan of congenital heart structure defect with contrast	Service  intra	L046A	CT Technologist	0.46	Service total costs	54		
75573	CT scan of congenital heart structure defect with contrast	Service  intra	L051A	RN	0.51	Service total costs	32		
75573	CT scan of congenital heart structure defect with contrast	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	16		
75574	CT scan of heart blood vessels and grafts with contrast dye	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
75574	CT scan of heart blood vessels and grafts with contrast dye	Service  intra	L046A	CT Technologist	0.46	Service total costs	62		
75574	CT scan of heart blood vessels and grafts with contrast dye	Service  intra	L051A	RN	0.51	Service total costs	34		
75574	CT scan of heart blood vessels and grafts with contrast dye	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	16		
75600	Radiological supervision and interpretation X-ray of chest aorta	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75600	Radiological supervision and interpretation X-ray of chest aorta	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	53		
75605	Radiological supervision and interpretation X-ray of chest aorta	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75605	Radiological supervision and interpretation X-ray of chest aorta	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	53		
75625	Radiological supervision and interpretation X-ray of abdominal aorta	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75625	Radiological supervision and interpretation X-ray of abdominal aorta	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	53		
75630	Radiological supervision and interpretation X-ray of abdominal aorta and both leg arteries	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75630	Radiological supervision and interpretation X-ray of abdominal aorta and both leg arteries	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	53		
75635	CT scan of abdominal aorta and both leg arteries with contrast	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	5		
75635	CT scan of abdominal aorta and both leg arteries with contrast	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	133		
75635	CT scan of abdominal aorta and both leg arteries with contrast	Post-service	L041B	Radiologic Technologist	0.41	Post service total costs	5		
75658	Radiological supervision and interpretation of imaging of arm artery	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75658	Radiological supervision and interpretation of imaging of arm artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	86		
75705	Radiological supervision and interpretation of imaging of spinal artery	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75705	Radiological supervision and interpretation of imaging of spinal artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	86		
75710	Radiological supervision and interpretation of imaging of artery of one arm or leg	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75710	Radiological supervision and interpretation of imaging of artery of one arm or leg	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	89		
75716	Radiological supervision and interpretation of imaging of arteries of both arms or legs	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75716	Radiological supervision and interpretation of imaging of arteries of both arms or legs	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	132		
75726	Radiological supervision and interpretation of imaging of abdominal artery	Pre-service	L041A	Angio Technician	0.41	Preservice total costs	6		
75726	Radiological supervision and interpretation of imaging of abdominal artery	Service  intra	L041A	Angio Technician	0.41	Service total costs	60		
75731	Radiological supervision and interpretation of imaging of artery of one adrenal gland	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75731	Radiological supervision and interpretation of imaging of artery of one adrenal gland	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	89		
75733	Radiological supervision and interpretation of imaging of arteries of both adrenal glands	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75733	Radiological supervision and interpretation of imaging of arteries of both adrenal glands	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	132		
75736	Radiological supervision and interpretation of imaging of artery of pelvis	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75736	Radiological supervision and interpretation of imaging of artery of pelvis	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	88		
75741	Radiological supervision and interpretation of imaging of artery of one lung	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75741	Radiological supervision and interpretation of imaging of artery of one lung	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	48		
75743	Radiological supervision and interpretation of imaging of arteries of both lungs	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75743	Radiological supervision and interpretation of imaging of arteries of both lungs	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	52		
75746	"Radiological supervision and interpretation of imaging of lung artery, contrast inserted by catheter or injection into vein"	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75746	"Radiological supervision and interpretation of imaging of lung artery, contrast inserted by catheter or injection into vein"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	69		
75756	Radiological supervision and interpretation of imaging of artery of breast	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75756	Radiological supervision and interpretation of imaging of artery of breast	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	89		
75774	Radiological supervision and interpretation of imaging of artery	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75774	Radiological supervision and interpretation of imaging of artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	30		
75791	Radiological supervision and interpretation of imaging of artery-vein dialysis shunt	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75791	Radiological supervision and interpretation of imaging of artery-vein dialysis shunt	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	60		
75809	Radiological supervision and interpretation of imaging of previous placed shunt	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3		
75809	Radiological supervision and interpretation of imaging of previous placed shunt	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	26		
75820	Radiological supervision and interpretation of imaging of vein of one arm or leg	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75820	Radiological supervision and interpretation of imaging of vein of one arm or leg	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	40		
75822	Radiological supervision and interpretation of imaging of veins of both arms or legs	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75822	Radiological supervision and interpretation of imaging of veins of both arms or legs	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	44		
75825	Radiological supervision and interpretation of imaging of major abdominal vein	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75825	Radiological supervision and interpretation of imaging of major abdominal vein	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	40		
75827	Radiological supervision and interpretation of imaging of major chest vein	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75827	Radiological supervision and interpretation of imaging of major chest vein	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	40		
75831	Radiological supervision and interpretation of imaging of vein of one kidney	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75831	Radiological supervision and interpretation of imaging of vein of one kidney	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	49		
75833	Radiological supervision and interpretation of imaging of vein of both kidneys	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75833	Radiological supervision and interpretation of imaging of vein of both kidneys	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	71		
75840	Radiological supervision and interpretation of imaging of vein of one adrenal gland	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75840	Radiological supervision and interpretation of imaging of vein of one adrenal gland	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	49		
75842	Radiological supervision and interpretation of imaging of veins of both adrenal glands	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75842	Radiological supervision and interpretation of imaging of veins of both adrenal glands	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	71		
75860	Radiological supervision and interpretation of imaging of vein system in head or neck vein	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75860	Radiological supervision and interpretation of imaging of vein system in head or neck vein	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	49		
75870	Radiological supervision and interpretation of imaging of vein system of head	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75870	Radiological supervision and interpretation of imaging of vein system of head	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	49		
75872	Radiological supervision and interpretation X-ray of spinal canal vein	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75872	Radiological supervision and interpretation X-ray of spinal canal vein	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	49		
75880	Radiological supervision and interpretation X-ray of vein of eye socket	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75880	Radiological supervision and interpretation X-ray of vein of eye socket	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	49		
75885	"Radiological supervision and interpretation of imaging of liver vein with assessment of blood flow, injection of contrast (accessed through the skin)"	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75885	"Radiological supervision and interpretation of imaging of liver vein with assessment of blood flow, injection of contrast (accessed through the skin)"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	49		
75887	"Radiological supervision and interpretation of imaging of liver vein, injection of contrast (accessed through the skin)"	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75887	"Radiological supervision and interpretation of imaging of liver vein, injection of contrast (accessed through the skin)"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	49		
75889	Radiological supervision and interpretation of imaging of liver vein with assessment of blood flow	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75889	Radiological supervision and interpretation of imaging of liver vein with assessment of blood flow	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	49		
75891	Radiological supervision and interpretation of imaging of liver vein	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75891	Radiological supervision and interpretation of imaging of liver vein	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	49		
75893	Radiological supervision and interpretation of drawing blood via catheter procedure	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75893	Radiological supervision and interpretation of drawing blood via catheter procedure	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	49		
75901	Radiological supervision and interpretation of removal of obstructive material in catheter procedure	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	68		
75902	Radiological supervision and interpretation of removal of obstructive material from large vein catheter procedure	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	24		
75962	Radiological supervision and interpretation of balloon dilation of narrowed artery	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75962	Radiological supervision and interpretation of balloon dilation of narrowed artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	89		
75964	Radiological supervision and interpretation of balloon dilation of narrowed artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	36		
75964	Radiological supervision and interpretation of balloon dilation of narrowed artery	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	5		
75966	Radiological supervision and interpretation of balloon dilation of narrowed renal or abdominal organ artery	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75966	Radiological supervision and interpretation of balloon dilation of narrowed renal or abdominal organ artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	99		
75968	Radiological supervision and interpretation of balloon dilation of narrowed renal or abdominal organ artery	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	36		
75978	"Transluminal balloon angioplasty, venous (eg, subclavian stenosis), radiological supervision and interpretation"	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	6		
75978	"Transluminal balloon angioplasty, venous (eg, subclavian stenosis), radiological supervision and interpretation"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	84		
75984		Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3		
75984		Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	28		
75989	Radiological supervision and interpretation of placement of catheter with drainage (accessed through the skin) procedure	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	5		
75989	Radiological supervision and interpretation of placement of catheter with drainage (accessed through the skin) procedure	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	16		
76000		Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3		
76000		Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	37		
76010	"Imaging from nose to rectum, single view, child"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	14		
76080		Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3		
76080		Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	22		
76098	Imaging of surgical specimen	Service  intra	L043A	Mammography Technologist	0.43	Service total costs	12		
76100	Single plane imaging procedure	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	48		
76101	Complex motion imaging procedure on one side of body	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	72		
76102	Complex motion imaging procedure on both sides of body	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	104		
76120	Imaging of organ	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	27		
76376	3D radiographic procedure	Service  intra	L046A	CT Technologist	0.46	Service total costs	20		
76377	3D radiographic procedure with computerized image postprocessing	Service  intra	L046A	CT Technologist	0.46	Service total costs	38		
76380	CT scan limited or follow-up study	Pre-service	L046A	CT Technologist	0.46	Preservice total costs	6		
76380	CT scan limited or follow-up study	Service  intra	L046A	CT Technologist	0.46	Service total costs	25		
76390	MRI study	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
76390	MRI study	Service  intra	L047A	MRI Technologist	0.47	Service total costs	45		
76506	Ultrasound of brain	Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Preservice total costs	3		
76506	Ultrasound of brain	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	35		
76510	Ultrasound of eye tissue and structures	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5		
76510	Ultrasound of eye tissue and structures	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	38		
76511	Ultrasound of eye disease or growth	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5		
76511	Ultrasound of eye disease or growth	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	27		
76512	"Ultrasound of eye disease, growth, or structure"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5		
76512	"Ultrasound of eye disease, growth, or structure"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	18		
76513	Ultrasound of eye using water bath method	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5		
76513	Ultrasound of eye using water bath method	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	39		
76513	Ultrasound of eye using water bath method	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	3		
76514	Ultrasound of corneal structure and measurement	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	1		
76514	Ultrasound of corneal structure and measurement	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	4		
76516	Ultrasound to determine length from cornea to retina	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5		
76516	Ultrasound to determine length from cornea to retina	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	26		
76519	Ultrasound of eye for determination of lens power	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5		
76519	Ultrasound of eye for determination of lens power	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	32		
76529	Ultrasound of eye foreign body localization	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5		
76529	Ultrasound of eye foreign body localization	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	21		
76529	Ultrasound of eye foreign body localization	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	3		
76536	Ultrasound of head and neck	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	3		
76536	Ultrasound of head and neck	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	37		
76604	Ultrasound of chest	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	5		
76604	Ultrasound of chest	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	24		
76641	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete"	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Availability of prior images confirmed	2		
76641	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete"	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
76641	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete"	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	Greet patient and provide gowning	3		
76641	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete"	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	Prepare and position pt/ monitor pt/ set up IV	3		
76641	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete"	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	"Prepare room, equipment, supplies"	2		
76641	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete"	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	SVC Provide pre-service education/obtain consent	2		
76641	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete"	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Acquire images	15		
76641	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete"	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Clean room/equipment by physician staff	3		
76641	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete"	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
76641	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete"	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Review examination with interpreting MD	2		
76641	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete"	Service  post	L050B	Diagnostic Medical Sonographer	0.5	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
76642	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited"	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Availability of prior images confirmed	2		
76642	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited"	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
76642	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited"	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	Greet patient and provide gowning	3		
76642	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited"	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	Prepare and position pt/ monitor pt/ set up IV	2		
76642	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited"	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	"Prepare room, equipment, supplies"	2		
76642	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited"	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	SVC Provide pre-service education/obtain consent	2		
76642	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited"	Service  intra	L046A	CT Technologist	0.46	Acquire images	10		
76642	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited"	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Clean room/equipment by physician staff	3		
76642	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited"	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
76642	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited"	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Review examination with interpreting MD	2		
76642	"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited"	Service  post	L050B	Diagnostic Medical Sonographer	0.5	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	1		
76700	Us exam abdom complete	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Availability of prior images confirmed	2		
76700	Us exam abdom complete	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	"Review patient electronic clinical information and questionnaire reviewed, order from physician confirmed, and exam protocoled"	2		
76700	Us exam abdom complete	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
76700	Us exam abdom complete	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	Prepare and position pt/ monitor pt/ set up IV	3		
76700	Us exam abdom complete	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	"Prepare room, equipment, supplies"	2		
76700	Us exam abdom complete	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Assist physician - acquire images	23		
76700	Us exam abdom complete	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Clean room/equipment by physician staff	3		
76700	Us exam abdom complete	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Post processing: Technical QC	2		
76700	Us exam abdom complete	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Review documents w/ physician	2		
76700	Us exam abdom complete	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Scanning other documents into PACs	1		
76705	Echo exam of abdomen	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Availability of prior images confirmed	2		
76705	Echo exam of abdomen	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	"Review patient electronic clinical information and questionnaire reviewed, order from physician confirmed, and exam protocoled"	2		
76705	Echo exam of abdomen	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
76705	Echo exam of abdomen	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	Prepare and position patient	2		
76705	Echo exam of abdomen	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	"Prepare room, equipment, supplies"	2		
76705	Echo exam of abdomen	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Assist physician - acquire images	15		
76705	Echo exam of abdomen	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Clean room/equipment by physician staff	3		
76705	Echo exam of abdomen	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Post processing: Technical QC	1		
76705	Echo exam of abdomen	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Review charts	2		
76705	Echo exam of abdomen	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Scanning other documents into PACs	1		
76770	Us exam abdo back wall comp	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Availability of prior images confirmed	2		
76770	Us exam abdo back wall comp	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	"Review patient electronic clinical information and questionnaire reviewed, order from physician confirmed, and exam protocoled"	2		
76770	Us exam abdo back wall comp	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	Greet patient and provide gowning	3		
76770	Us exam abdo back wall comp	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	Prepare and position pt/ monitor pt/ set up IV	3		
76770	Us exam abdo back wall comp	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	"Prepare room, equipment, supplies"	2		
76770	Us exam abdo back wall comp	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Acquire images	20		
76770	Us exam abdo back wall comp	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Clean room/equipment by physician staff	3		
76770	Us exam abdo back wall comp	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Post processing: Technical QC	2		
76770	Us exam abdo back wall comp	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Review documents w/ physician	2		
76770	Us exam abdo back wall comp	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Scanning other documents into PACs	1		
76775	Us exam abdo back wall lim	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Availability of prior images confirmed	2		
76775	Us exam abdo back wall lim	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	"Review patient electronic clinical information and questionnaire reviewed, order from physician confirmed, and exam protocoled"	2		
76775	Us exam abdo back wall lim	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	Greet patient and provide gowning	3		
76775	Us exam abdo back wall lim	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	Prepare and position pt/ monitor pt/ set up IV	2		
76775	Us exam abdo back wall lim	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	"Prepare room, equipment, supplies"	2		
76775	Us exam abdo back wall lim	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Acquire images	15		
76775	Us exam abdo back wall lim	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Clean room/equipment by physician staff	3		
76775	Us exam abdo back wall lim	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Post processing: Technical QC	1		
76775	Us exam abdo back wall lim	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Review documents w/ physician	2		
76775	Us exam abdo back wall lim	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Scanning other documents into PACs	1		
76776	Ultrasound of transplanted kidney	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	3		
76776	Ultrasound of transplanted kidney	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	50		
76800	Ultrasound of spinal canal	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	5		
76800	Ultrasound of spinal canal	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	31		
76801	Abdominal ultrasound of pregnant uterus (less than 14 weeks 0 days) single or first fetus	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	3		
76801	Abdominal ultrasound of pregnant uterus (less than 14 weeks 0 days) single or first fetus	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	35		
76802	Abdominal ultrasound of pregnant uterus (less than 14 weeks 0 days)	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	10		
76805	Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	3		
76805	Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	44		
76810	Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days)	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	20		
76811	Abdominal ultrasound of pregnant uterus single or first fetus	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	3		
76811	Abdominal ultrasound of pregnant uterus single or first fetus	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	76		
76812	Abdominal ultrasound of pregnant uterus	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	53		
76813	Ultrasound of pregnant uterus (first trimester) single or first fetus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
76813	Ultrasound of pregnant uterus (first trimester) single or first fetus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28		
76814	"Ultrasound of pregnant uterus (first trimester), abdominal or vaginal approach"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
76815	"Ultrasound of pregnant uterus, 1 or more fetus(es)"	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	3		
76815	"Ultrasound of pregnant uterus, 1 or more fetus(es)"	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	25		
76816	"Ultrasound re-evaluation of pregnant uterus, per fetus"	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	3		
76816	"Ultrasound re-evaluation of pregnant uterus, per fetus"	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	35		
76817	Vaginal ultrasound of pregnant uterus	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	3		
76817	Vaginal ultrasound of pregnant uterus	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	29		
76818	Ultrasound and monitoring of heart of fetus	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	5		
76818	Ultrasound and monitoring of heart of fetus	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	30		
76818	Ultrasound and monitoring of heart of fetus	Service  intra	L051A	RN	0.51	Service total costs	25		
76818	Ultrasound and monitoring of heart of fetus	Post-service	L050B	Diagnostic Medical Sonographer	0.5	Post service total costs	7		
76819	Ultrasound of fetus	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	5		
76819	Ultrasound of fetus	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	30		
76819	Ultrasound of fetus	Post-service	L050B	Diagnostic Medical Sonographer	0.5	Post service total costs	7		
76820	Ultrasound of fetal umbilical artery flow rate	Service  intra	L050A	Cardiac Sonographer	0.5	Service total costs	10		
76821	Ultrasound of fetal brain artery	Pre-service	L050A	Cardiac Sonographer	0.5	Preservice total costs	5		
76821	Ultrasound of fetal brain artery	Service  intra	L050A	Cardiac Sonographer	0.5	Service total costs	28		
76825	Ultrasound of fetal heart blood flow	Pre-service	L050A	Cardiac Sonographer	0.5	Preservice total costs	5		
76825	Ultrasound of fetal heart blood flow	Service  intra	L050A	Cardiac Sonographer	0.5	Service total costs	72		
76825	Ultrasound of fetal heart blood flow	Post-service	L050A	Cardiac Sonographer	0.5	Post service total costs	6		
76826	Follow-up or repeat ultrasound of fetal heart blood flow	Pre-service	L050A	Cardiac Sonographer	0.5	Preservice total costs	5		
76826	Follow-up or repeat ultrasound of fetal heart blood flow	Service  intra	L050A	Cardiac Sonographer	0.5	Service total costs	44		
76826	Follow-up or repeat ultrasound of fetal heart blood flow	Post-service	L050A	Cardiac Sonographer	0.5	Post service total costs	6		
76827	Ultrasound of fetal heart	Service  intra	L050A	Cardiac Sonographer	0.5	Service total costs	19		
76828	Follow-up or repeat ultrasound of fetal heart	Service  intra	L050A	Cardiac Sonographer	0.5	Service total costs	10		
76830	Ultrasound pelvis through vagina	Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Preservice total costs	3		
76830	Ultrasound pelvis through vagina	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	39		
76831	Ultrasound of uterus	Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Preservice total costs	3		
76831	Ultrasound of uterus	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	36		
76856	Us exam pelvic complete	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Availability of prior images confirmed	2		
76856	Us exam pelvic complete	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	"Review patient electronic clinical information and questionnaire reviewed, order from physician confirmed, and exam protocoled"	2		
76856	Us exam pelvic complete	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	Greet patient and provide gowning	3		
76856	Us exam pelvic complete	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	Prepare and position pt/ monitor pt/ set up IV	3		
76856	Us exam pelvic complete	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	"Prepare room, equipment, supplies"	2		
76856	Us exam pelvic complete	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Acquire images	20		
76856	Us exam pelvic complete	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Clean room/equipment by physician staff	3		
76856	Us exam pelvic complete	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Post processing: Technical QC	2		
76856	Us exam pelvic complete	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Review documents w/ physician	2		
76856	Us exam pelvic complete	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Scanning other documents into PACs	1		
76857	Us exam pelvic limited	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	"Review patient electronic clinical information and questionnaire reviewed, order from physician confirmed, and exam protocoled"	2		
76857	Us exam pelvic limited	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	Prepare and position pt/ monitor pt/ set up IV	2		
76857	Us exam pelvic limited	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	"Prepare room, equipment, supplies"	2		
76857	Us exam pelvic limited	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Acquire images	12		
76857	Us exam pelvic limited	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Clean room/equipment by physician staff	3		
76857	Us exam pelvic limited	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Post processing: Technical QC	1		
76857	Us exam pelvic limited	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Review documents w/ physician	2		
76857	Us exam pelvic limited	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Scanning other documents into PACs	1		
76870	Ultrasound of scrotum	Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Preservice total costs	3		
76870	Ultrasound of scrotum	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	37		
76872	Ultrasound of rectum	Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Preservice total costs	3		
76872	Ultrasound of rectum	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	45		
76873	Ultrasound of prostate	Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Preservice total costs	3		
76873	Ultrasound of prostate	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	42		
76881	Ultrasound of leg or arm	Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Preservice total costs	3		
76881	Ultrasound of leg or arm	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	32		
76882	Ultrasound of arm or leg	Pre-service	L026A	Medical/Technical Assistant	0.26	Preservice total costs	3		
76882	Ultrasound of arm or leg	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	16		
76885	"Ultrasound of hips with manipulation, infant"	Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Preservice total costs	3		
76885	"Ultrasound of hips with manipulation, infant"	Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Service total costs	45		
76886	"Ultrasound of hips, infant"	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	5		
76886	"Ultrasound of hips, infant"	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	30		
76936	Ultrasound guidance for repair of blood vessel	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	3		
76936	Ultrasound guidance for repair of blood vessel	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	82		
76937	Ultrasound guidance for accessing into blood vessel	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	15		
76942		Pre-service	L051B	RN/Diagnostic Medical Sonographer	0.51	Availability of prior images confirmed	2		
76942		Service  pre	L051B	RN/Diagnostic Medical Sonographer	0.51	Prepare and position pt/ monitor pt/ set up IV	2		
76942		Service  pre	L051B	RN/Diagnostic Medical Sonographer	0.51	"Prepare room, equipment, supplies"	2		
76942		Service  intra	L051B	RN/Diagnostic Medical Sonographer	0.51	Moderate sedation	15		
76942		Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	Clean room/equipment by physician staff	2		
76942		Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
76942		Service  post	L051B	RN/Diagnostic Medical Sonographer	0.51	Review examination with interpreting MD	2		
76946	Ultrasonic guidance imaging supervision and interpretation for amniocentesis	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	15		
76948	"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation"	Service  pre	L050B	Diagnostic Medical Sonographer	0.5	"Prepare room, equipment, supplies"	2		
76948	"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation"	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Acquire images	25		
76948	"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation"	Service  post	L050B	Diagnostic Medical Sonographer	0.5	Clean room/equipment by physician staff	3		
76965	Ultrasonic guidance for interstitial radioelement application	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35		
76970	Ultrasound follow-up study	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	5		
76970	Ultrasound follow-up study	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	29		
76977	Ultrasound of bone density measurement	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	7		
77001	"Fluoroscopic guidance for insertion, replacement or removal of central venous access device"	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3		
77001	"Fluoroscopic guidance for insertion, replacement or removal of central venous access device"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	18		
77002	Fluoroscopic guidance for insertion of needle	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3		
77002	Fluoroscopic guidance for insertion of needle	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	24		
77003	Fluoroscopic guidance for spine or spinal canal injection	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3		
77003	Fluoroscopic guidance for spine or spinal canal injection	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
77011	CT scan guidance for stereotactic localization	Service  intra	L046A	CT Technologist	0.46	Service total costs	26		
77012	Radiological supervision and interpretation of CT guidance for needle insertion	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	3		
77012	Radiological supervision and interpretation of CT guidance for needle insertion	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	26		
77012	Radiological supervision and interpretation of CT guidance for needle insertion	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	1		
77014	CT scan guidance for insertion of radiation therapy fields	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	18		
77021	Radiological supervision and interpretation of MRI guidance for insertion of needle	Service  intra	L047A	MRI Technologist	0.47	Service total costs	45		
77051	Computer analysis of diagnostic mammogram	Service  intra	L043A	Mammography Technologist	0.43	Service total costs	5		
77052	Computer analysis of screening mammogram to assist detection of cancer	Service  intra	L043A	Mammography Technologist	0.43	Service total costs	5		
77053	Radiological supervision and interpretation of imaging of breast duct	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	2		
77053	Radiological supervision and interpretation of imaging of breast duct	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	30		
77054	Radiological supervision and interpretation of imaging of breast ducts	Pre-service	L041B	Radiologic Technologist	0.41	Preservice total costs	2		
77054	Radiological supervision and interpretation of imaging of breast ducts	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	40		
77055	Mammography of one breast	Pre-service	L043A	Mammography Technologist	0.43	Preservice total costs	7		
77055	Mammography of one breast	Service  intra	L043A	Mammography Technologist	0.43	Service total costs	28		
77055	Mammography of one breast	Post-service	L043A	Mammography Technologist	0.43	Post service total costs	7		
77056		Pre-service	L043A	Mammography Technologist	0.43	Preservice total costs	7		
77056		Service  intra	L043A	Mammography Technologist	0.43	Service total costs	37		
77056		Post-service	L043A	Mammography Technologist	0.43	Post service total costs	7		
77057	"Screening mammography, bilateral (2-view study of each breast)"	Pre-service	L043A	Mammography Technologist	0.43	Preservice total costs	2		
77057	"Screening mammography, bilateral (2-view study of each breast)"	Service  intra	L043A	Mammography Technologist	0.43	Service total costs	23		
77057	"Screening mammography, bilateral (2-view study of each breast)"	Post-service	L043A	Mammography Technologist	0.43	Post service total costs	7		
77058	MRI scan of one breast with contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
77058	MRI scan of one breast with contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	102		
77059	MRI scan of both breasts with contrast	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
77059	MRI scan of both breasts with contrast	Service  intra	L047A	MRI Technologist	0.47	Service total costs	102		
77063	"Screening digital breast tomosynthesis, bilateral"	Service  pre	L043A	Mammography Technologist	0.43	Prepare and position pt/ monitor pt/ set up IV	2		
77063	"Screening digital breast tomosynthesis, bilateral"	Service  pre	L043A	Mammography Technologist	0.43	SVC Provide pre-service education/obtain consent	2		
77063	"Screening digital breast tomosynthesis, bilateral"	Service  intra	L043A	Mammography Technologist	0.43	Acquire images	6		
77063	"Screening digital breast tomosynthesis, bilateral"	Service  post	L043A	Mammography Technologist	0.43	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
77063	"Screening digital breast tomosynthesis, bilateral"	Post-service	L043A	Mammography Technologist	0.43	Federally Mandated MQSA Activities Allocated To Each Mammogram	0		
77071	Imaging of joint with stressing by physician	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	15	0	
77072	Imaging for bone age assessment	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	11		
77073	Imaging for bone length assessment	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	15		
77074	X-ray of bones	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	36		
77075	X-ray survey of forearm or wrist bone density	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	53		
77076	"X-ray survey of bones, infant"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	53		
77077	"Imaging of 2 or more joints, single view"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	14		
77078	CT scan bone mineral density study 1 or more sites	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	29		
77080	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
77080	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
77080	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)"	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
77080	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)"	Service  pre	L041B	Radiologic Technologist	0.41	Obtain vital signs	3		
77080	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
77080	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)"	Service  pre	L041B	Radiologic Technologist	0.41	SVC Provide pre-service education/obtain consent	2		
77080	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	15		
77080	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
77080	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
77080	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
77080	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
77081	Bone density measurement using dedicated X-ray machine	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	22		
77084	MRI scan of bone marrow	Pre-service	L047A	MRI Technologist	0.47	Preservice total costs	8		
77084	MRI scan of bone marrow	Service  intra	L047A	MRI Technologist	0.47	Service total costs	68		
77085	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment"	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
77085	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment"	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
77085	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment"	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
77085	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment"	Service  pre	L041B	Radiologic Technologist	0.41	Obtain vital signs	3		
77085	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment"	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
77085	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment"	Service  pre	L041B	Radiologic Technologist	0.41	SVC Provide pre-service education/obtain consent	2		
77085	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment"	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	25		
77085	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment"	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
77085	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment"	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
77085	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment"	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
77085	"Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment"	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
77086	Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA)	Pre-service	L041B	Radiologic Technologist	0.41	Availability of prior images confirmed	2		
77086	Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA)	Pre-service	L041B	Radiologic Technologist	0.41	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
77086	Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA)	Service  pre	L041B	Radiologic Technologist	0.41	Greet patient and provide gowning	3		
77086	Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA)	Service  pre	L041B	Radiologic Technologist	0.41	Obtain vital signs	3		
77086	Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA)	Service  pre	L041B	Radiologic Technologist	0.41	"Prepare room, equipment, supplies"	2		
77086	Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA)	Service  pre	L041B	Radiologic Technologist	0.41	SVC Provide pre-service education/obtain consent	2		
77086	Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA)	Service  intra	L041B	Radiologic Technologist	0.41	Assist physician in performing procedure	10		
77086	Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA)	Service  post	L041B	Radiologic Technologist	0.41	Clean room/equipment by physician staff	3		
77086	Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA)	Service  post	L041B	Radiologic Technologist	0.41	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
77086	Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA)	Service  post	L041B	Radiologic Technologist	0.41	Review examination with interpreting MD	2		
77086	Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA)	Service  post	L041B	Radiologic Technologist	0.41	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
77280	"Management of radiation therapy simulation, simple"	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	34		
77285	"Management of radiation therapy, simulation, intermediate"	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	52		
77290	"Management of radiation therapy, simulation, complex"	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	61		
77293	Respiratory motion management simulation	Service  intra	L152A	Medical Physicist	1.523	Service total costs	23		
77293	Respiratory motion management simulation	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	17		
77295	"Management of radiation therapy, 3D"	Service  intra	L063A	Medical Dosimetrist	0.63	Service total costs	165		
77300	Basic radiation dosimetry calculation	Service  pre	L107A	Medical Dosimetrist/Medical Physicist	1.075	Perform Procedure - Dose Calculations	14		
77301	Management of modulation radiotherapy planning	Pre-service	L152A	Medical Physicist	1.523	Preservice total costs	10		
77301	Management of modulation radiotherapy planning	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
77301	Management of modulation radiotherapy planning	Service  intra	L107A	Medical Dosimetrist/Medical Physicist	1.075	Service total costs	65		
77301	Management of modulation radiotherapy planning	Service  intra	L152A	Medical Physicist	1.523	Service total costs	255		
77301	Management of modulation radiotherapy planning	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	48		
77301	Management of modulation radiotherapy planning	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	6		
77301	Management of modulation radiotherapy planning	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	2		
77306	Teletherapy isodose plan; simple	Service  pre	L107A	Medical Dosimetrist/Medical Physicist	1.075	Perform Procedure - Dose Calculations	23		
77306	Teletherapy isodose plan; simple	Service  pre	L063A	Medical Dosimetrist	0.63	Perform Procedure - Isodose Planning	14		
77307	Teletherapy isodose plan; complex	Service  pre	L107A	Medical Dosimetrist/Medical Physicist	1.075	Perform Procedure - Dose Calculations	42		
77307	Teletherapy isodose plan; complex	Service  pre	L063A	Medical Dosimetrist	0.63	Perform Procedure - Isodose Planning	26		
77316	Brachytherapy isodose plan; simple	Service  pre	L107A	Medical Dosimetrist/Medical Physicist	1.075	Perform Procedure - Dose Calculations	11		
77316	Brachytherapy isodose plan; simple	Service  pre	L063A	Medical Dosimetrist	0.63	Perform Procedure - Isodose Planning	72		
77316	Brachytherapy isodose plan; simple	Service  pre	L152A	Medical Physicist	1.523	Perform Procedure - Isodose Planning	8		
77317	Brachytherapy isodose plan; intermediate	Service  pre	L107A	Medical Dosimetrist/Medical Physicist	1.075	Perform Procedure - Dose Calculations	11		
77317	Brachytherapy isodose plan; intermediate	Service  pre	L063A	Medical Dosimetrist	0.63	Perform Procedure - Isodose Planning	104		
77317	Brachytherapy isodose plan; intermediate	Service  pre	L152A	Medical Physicist	1.523	Perform Procedure - Isodose Planning	8		
77318	Brachytherapy isodose plan; complex	Service  pre	L107A	Medical Dosimetrist/Medical Physicist	1.075	Perform Procedure - Dose Calculations	23		
77318	Brachytherapy isodose plan; complex	Service  pre	L063A	Medical Dosimetrist	0.63	Perform Procedure - Isodose Planning	134		
77318	Brachytherapy isodose plan; complex	Service  pre	L152A	Medical Physicist	1.523	Perform Procedure - Isodose Planning	8		
77321	Radiation therapy total body port plan	Service  intra	L063A	Medical Dosimetrist	0.63	Service total costs	14		
77321	Radiation therapy total body port plan	Service  intra	L152A	Medical Physicist	1.523	Service total costs	6		
77331	Special radiation therapy planning	Service  intra	L063A	Medical Dosimetrist	0.63	Service total costs	5		
77331	Special radiation therapy planning	Service  intra	L152A	Medical Physicist	1.523	Service total costs	2		
77331	Special radiation therapy planning	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	2		
77332	"Radiation treatment devices, design and construction, simple"	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	3		
77333	"Radiation treatment devices, design and construction, intermediate"	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	11		
77334	"Radiation treatment devices, design and construction, complex"	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	37		
77336	Radiation therapy consultation per week	Pre-service	L152A	Medical Physicist	1.523	Preservice total costs	6		
77336	Radiation therapy consultation per week	Service  intra	L152A	Medical Physicist	1.523	Service total costs	30		
77338	Design and construction of device for radiation therapy	Service  intra	L063A	Medical Dosimetrist	0.63	Service total costs	18		
77338	Design and construction of device for radiation therapy	Service  intra	L107A	Medical Dosimetrist/Medical Physicist	1.075	Service total costs	90		
77338	Design and construction of device for radiation therapy	Service  intra	L152A	Medical Physicist	1.523	Service total costs	10		
77370	Radiation therapy consultation	Service  intra	L152A	Medical Physicist	1.523	Service total costs	65		
77372	"Radiation therapy delivery, stereotactic radiosurgery (SRS) for cranial growths, per session"	Pre-service	L152A	Medical Physicist	1.523	Preservice total costs	20		
77372	"Radiation therapy delivery, stereotactic radiosurgery (SRS) for cranial growths, per session"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
77372	"Radiation therapy delivery, stereotactic radiosurgery (SRS) for cranial growths, per session"	Service  intra	L152A	Medical Physicist	1.523	Service total costs	40		
77372	"Radiation therapy delivery, stereotactic radiosurgery (SRS) for cranial growths, per session"	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	51		
77372	"Radiation therapy delivery, stereotactic radiosurgery (SRS) for cranial growths, per session"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28		
77372	"Radiation therapy delivery, stereotactic radiosurgery (SRS) for cranial growths, per session"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
77373	Stereotactic body radiation therapy 1 or more lesions using imaging guidance	Service  intra	L152A	Medical Physicist	1.523	Service total costs	78		
77373	Stereotactic body radiation therapy 1 or more lesions using imaging guidance	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	82		
77373	Stereotactic body radiation therapy 1 or more lesions using imaging guidance	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	22		
77401	"Radiation treatment delivery, superficial"	Pre-service	L050C	Radiation Therapist	0.5	Preservice total costs	5		
77401	"Radiation treatment delivery, superficial"	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	9		
77417	Therapeutic radiology port image(s)	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	16		
77422	"Radiation treatment delivery, high energy, single treatment area"	Pre-service	L152A	Medical Physicist	1.523	Preservice total costs	5		
77422	"Radiation treatment delivery, high energy, single treatment area"	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	38		
77422	"Radiation treatment delivery, high energy, single treatment area"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	3		
77423	"Radiation treatment delivery, high energy"	Pre-service	L152A	Medical Physicist	1.523	Preservice total costs	5		
77423	"Radiation treatment delivery, high energy"	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	68		
77423	"Radiation treatment delivery, high energy"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	3		
77427	"Radiation treatment management, 5 treatments"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	20.9	0	
77431	"Radiation treatment management, 1 or 2 treatments"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	16	0	
77435	"Stereotactic radiation treatment management of 1 or more lesions using imaging guidance, per treatment course"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	12	
77435	"Stereotactic radiation treatment management of 1 or more lesions using imaging guidance, per treatment course"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
77469	Intraoperative radiation treatment management	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		25	
77469	Intraoperative radiation treatment management	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
77470	Special radiation treatment procedure	Service  intra	L051A	RN	0.51	Service total costs	80		
77600	External hyperthermia treatment depth 4 cm or less	Service  intra	L152A	Medical Physicist	1.523	Service total costs	18		
77600	External hyperthermia treatment depth 4 cm or less	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	77		
77600	External hyperthermia treatment depth 4 cm or less	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47		
77600	External hyperthermia treatment depth 4 cm or less	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
77605	External hyperthermia treatment depth greater than 4 cm	Service  intra	L152A	Medical Physicist	1.523	Service total costs	18		
77605	External hyperthermia treatment depth greater than 4 cm	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	77		
77605	External hyperthermia treatment depth greater than 4 cm	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57		
77605	External hyperthermia treatment depth greater than 4 cm	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
77610	"Hyperthermia treatment, 5 or fewer probe applications"	Service  intra	L152A	Medical Physicist	1.523	Service total costs	18		
77610	"Hyperthermia treatment, 5 or fewer probe applications"	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	77		
77610	"Hyperthermia treatment, 5 or fewer probe applications"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57		
77610	"Hyperthermia treatment, 5 or fewer probe applications"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
77615	"Hyperthermia treatment, 5 or more probe applications"	Service  intra	L152A	Medical Physicist	1.523	Service total costs	83		
77615	"Hyperthermia treatment, 5 or more probe applications"	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	87		
77615	"Hyperthermia treatment, 5 or more probe applications"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60		
77615	"Hyperthermia treatment, 5 or more probe applications"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
77620	Hyperthermia treatment by organ cavity probes	Service  intra	L152A	Medical Physicist	1.523	Service total costs	18		
77620	Hyperthermia treatment by organ cavity probes	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	79		
77620	Hyperthermia treatment by organ cavity probes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57		
77620	Hyperthermia treatment by organ cavity probes	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
77750	"Infusion or instillation of radioelement solution, includes 3-month follow-up care"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	2		
77750	"Infusion or instillation of radioelement solution, includes 3-month follow-up care"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	72		
77750	"Infusion or instillation of radioelement solution, includes 3-month follow-up care"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	58		
77761	"Application of organ cavity radiation source, simple"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35		
77761	"Application of organ cavity radiation source, simple"	Service  intra	L152A	Medical Physicist	1.523	Service total costs	45		
77761	"Application of organ cavity radiation source, simple"	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	8		
77761	"Application of organ cavity radiation source, simple"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25		
77761	"Application of organ cavity radiation source, simple"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27		
77762	"Application of organ cavity radiation source, intermediate"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35		
77762	"Application of organ cavity radiation source, intermediate"	Service  intra	L152A	Medical Physicist	1.523	Service total costs	60		
77762	"Application of organ cavity radiation source, intermediate"	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	8		
77762	"Application of organ cavity radiation source, intermediate"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25		
77762	"Application of organ cavity radiation source, intermediate"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	27		
77763	"Application of organ cavity radiation source, complex"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	35		
77763	"Application of organ cavity radiation source, complex"	Service  intra	L152A	Medical Physicist	1.523	Service total costs	80		
77763	"Application of organ cavity radiation source, complex"	Service  intra	L050C	Radiation Therapist	0.5	Service total costs	8		
77763	"Application of organ cavity radiation source, complex"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65		
77763	"Application of organ cavity radiation source, complex"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	54		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	1		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	1		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Pre-service	L107A	Medical Dosimetrist/Medical Physicist	1.075	Prepare afterloader unit for treatment	3		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	1		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  pre	L050C	Radiation Therapist	0.5	Set Up REMOTE RADIATION MONITORING	2		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  intra	L152A	Medical Physicist	1.523	Assist physician: treatment	7		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  intra	L050C	Radiation Therapist	0.5	Assist physician: treatment	7		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  intra	L152A	Medical Physicist	1.523	Complete treatment documentation	2		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  intra	L050C	Radiation Therapist	0.5	Complete treatment documentation	1		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  intra	L050C	Radiation Therapist	0.5	Detach equipment from patient/implant removal	1		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  intra	L037D	RN/LPN/MTA	0.37	Detach equipment from patient/implant removal	1		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  intra	L107A	Medical Dosimetrist/Medical Physicist	1.075	Dose calculation	14		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  intra	L152A	Medical Physicist	1.523	"Patient, unit, and room surveys"	5		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  intra	L152A	Medical Physicist	1.523	"Prepare patient for treatment (attach cables, additional positioning, verification, etc)"	2		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  intra	L152A	Medical Physicist	1.523	"Prepare system for treatment (enter treatment plans, source coordinates, etc)"	5		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  intra	L050C	Radiation Therapist	0.5	"Prepare system for treatment (enter treatment plans, source coordinates, etc)"	2		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  post	L050C	Radiation Therapist	0.5	Clean room/equipment by physician staff	2		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  post	L050C	Radiation Therapist	0.5	Clean scope - transfer tube(s) & connection devices	2		
77767	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	2		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	1		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	1		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Pre-service	L107A	Medical Dosimetrist/Medical Physicist	1.075	Prepare afterloader unit for treatment	3		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	1		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  pre	L050C	Radiation Therapist	0.5	Set Up REMOTE RADIATION MONITORING	2		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  pre	L050C	Radiation Therapist	0.5	Setup scope (non facility setting only)	0		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  intra	L152A	Medical Physicist	1.523	Assist physician: treatment	15		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  intra	L050C	Radiation Therapist	0.5	Assist physician: treatment	15		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  intra	L152A	Medical Physicist	1.523	Complete treatment documentation	2		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  intra	L050C	Radiation Therapist	0.5	Complete treatment documentation	1		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  intra	L050C	Radiation Therapist	0.5	Detach equipment from patient/implant removal	1		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  intra	L051A	RN	0.51	Detach equipment from patient/implant removal	0		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  intra	L037D	RN/LPN/MTA	0.37	Detach equipment from patient/implant removal	1		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  intra	L107A	Medical Dosimetrist/Medical Physicist	1.075	Dose calculation	14		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  intra	L152A	Medical Physicist	1.523	"Patient, unit, and room surveys"	5		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  intra	L152A	Medical Physicist	1.523	"Prepare patient for treatment (attach cables, additional positioning, verification, etc)"	5		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  intra	L050C	Radiation Therapist	0.5	"Prepare patient for treatment (attach cables, additional positioning, verification, etc)"	2		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  intra	L152A	Medical Physicist	1.523	"Prepare system for treatment (enter treatment plans, source coordinates, etc)"	14		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  intra	L050C	Radiation Therapist	0.5	"Prepare system for treatment (enter treatment plans, source coordinates, etc)"	7		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  post	L050C	Radiation Therapist	0.5	Clean room/equipment by physician staff	2		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  post	L050C	Radiation Therapist	0.5	Clean scope - transfer tube(s) & connection devices	3		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	0		
77768	"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	2		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	2		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	2		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Pre-service	L107A	Medical Dosimetrist/Medical Physicist	1.075	Prepare afterloader unit for treatment	3		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  pre	L050C	Radiation Therapist	0.5	Set Up REMOTE RADIATION MONITORING	2		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  intra	L152A	Medical Physicist	1.523	Assist physician: treatment	10		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  intra	L050C	Radiation Therapist	0.5	Assist physician: treatment	10		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  intra	L152A	Medical Physicist	1.523	Complete treatment documentation	2		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  intra	L050C	Radiation Therapist	0.5	Complete treatment documentation	1		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  intra	L050C	Radiation Therapist	0.5	Detach equipment from patient/implant removal	1		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  intra	L051A	RN	0.51	Detach equipment from patient/implant removal	1		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  intra	L107A	Medical Dosimetrist/Medical Physicist	1.075	Dose calculation	14		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  intra	L152A	Medical Physicist	1.523	"Patient, unit, and room surveys"	5		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  intra	L152A	Medical Physicist	1.523	"Prepare patient for treatment (attach cables, additional positioning, verification, etc)"	2		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  intra	L152A	Medical Physicist	1.523	"Prepare system for treatment (enter treatment plans, source coordinates, etc)"	9		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  intra	L050C	Radiation Therapist	0.5	"Prepare system for treatment (enter treatment plans, source coordinates, etc)"	4		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  post	L050C	Radiation Therapist	0.5	Clean room/equipment by physician staff	2		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  post	L050C	Radiation Therapist	0.5	Clean scope - transfer tube(s) & connection devices	2		
77770	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	2		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Pre-service	L107A	Medical Dosimetrist/Medical Physicist	1.075	Prepare afterloader unit for treatment	3		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  pre	L050C	Radiation Therapist	0.5	Set Up REMOTE RADIATION MONITORING	5		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  pre	L050C	Radiation Therapist	0.5	Setup scope (non facility setting only)	5		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  intra	L152A	Medical Physicist	1.523	Assist physician: treatment	20		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  intra	L050C	Radiation Therapist	0.5	Assist physician: treatment	20		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  intra	L051A	RN	0.51	Assist physician: treatment	5		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  intra	L152A	Medical Physicist	1.523	Complete treatment documentation	4		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  intra	L050C	Radiation Therapist	0.5	Complete treatment documentation	3		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  intra	L050C	Radiation Therapist	0.5	Detach equipment from patient/implant removal	3		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  intra	L051A	RN	0.51	Detach equipment from patient/implant removal	5		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  intra	L107A	Medical Dosimetrist/Medical Physicist	1.075	Dose calculation	14		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  intra	L152A	Medical Physicist	1.523	"Patient, unit, and room surveys"	6		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  intra	L152A	Medical Physicist	1.523	"Prepare patient for treatment (attach cables, additional positioning, verification, etc)"	7		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  intra	L050C	Radiation Therapist	0.5	"Prepare patient for treatment (attach cables, additional positioning, verification, etc)"	4		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  intra	L152A	Medical Physicist	1.523	"Prepare system for treatment (enter treatment plans, source coordinates, etc)"	17		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  intra	L050C	Radiation Therapist	0.5	"Prepare system for treatment (enter treatment plans, source coordinates, etc)"	10		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  post	L050C	Radiation Therapist	0.5	Clean room/equipment by physician staff	3		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  post	L050C	Radiation Therapist	0.5	Clean scope - transfer tube(s) & connection devices	5		
77771	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	7		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	3		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Pre-service	L107A	Medical Dosimetrist/Medical Physicist	1.075	Prepare afterloader unit for treatment	3		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	3		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  pre	L050C	Radiation Therapist	0.5	Set Up REMOTE RADIATION MONITORING	5		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  pre	L050C	Radiation Therapist	0.5	Setup scope (non facility setting only)	0		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  intra	L152A	Medical Physicist	1.523	Assist physician: treatment	40		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  intra	L050C	Radiation Therapist	0.5	Assist physician: treatment	40		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  intra	L051A	RN	0.51	Assist physician: treatment	40		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  intra	L152A	Medical Physicist	1.523	Complete treatment documentation	6		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  intra	L050C	Radiation Therapist	0.5	Complete treatment documentation	4		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  intra	L050C	Radiation Therapist	0.5	Detach equipment from patient/implant removal	4		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  intra	L051A	RN	0.51	Detach equipment from patient/implant removal	10		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  intra	L107A	Medical Dosimetrist/Medical Physicist	1.075	Dose calculation	14		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  intra	L152A	Medical Physicist	1.523	"Patient, unit, and room surveys"	6		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  intra	L152A	Medical Physicist	1.523	"Prepare patient for treatment (attach cables, additional positioning, verification, etc)"	15		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  intra	L050C	Radiation Therapist	0.5	"Prepare patient for treatment (attach cables, additional positioning, verification, etc)"	8		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  intra	L152A	Medical Physicist	1.523	"Prepare system for treatment (enter treatment plans, source coordinates, etc)"	24		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  intra	L050C	Radiation Therapist	0.5	"Prepare system for treatment (enter treatment plans, source coordinates, etc)"	17		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  post	L050C	Radiation Therapist	0.5	Clean room/equipment by physician staff	3		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  post	L050C	Radiation Therapist	0.5	Clean scope - transfer tube(s) & connection devices	10		
77772	"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	10		
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Pre-service	L152A	Medical Physicist	1.523	Check invoice/receipt and log radioactive material in accordance with NRC regulations	3		
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	3	10	
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	3	3	
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Pre-service	L152A	Medical Physicist	1.523	"Order radioactive materials, verify source counts, survey sources, calibrate sources, prepare individual patient log, load cartridges"	20		
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	7	7	
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility		5	
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Pre-service	L152A	Medical Physicist	1.523	Secure radioactive material until needed	3		
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	5		
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Service  pre	L050C	Radiation Therapist	0.5	Prepare and position pt/ monitor pt/ set up IV	4		
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Service  pre	L050C	Radiation Therapist	0.5	"Prepare room, equipment, supplies"	4		
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Service  intra	L152A	Medical Physicist	1.523	Assist physician in performing procedure	90		
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	5		
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	7		
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Service  post	L037D	RN/LPN/MTA	0.37	"Monitor pt following service/check tubes, monitors, drains (not related to moderate sedation)"	30		
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Service  post	L152A	Medical Physicist	1.523	"Removal, storage, and disposal of unused isotope"	20		
77778	"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3	3	
77789	Surface application of low dose rate radionuclide source	Service  intra	L152A	Medical Physicist	1.523	Service total costs	6		
77789	Surface application of low dose rate radionuclide source	Service  intra	L051A	RN	0.51	Service total costs	34		
77790	"Supervision, handling, loading of radiation"	Pre-service	L041B	Radiologic Technologist	0.41	Check invoice/receipt and log radioactive material in accordance with NRC regulations	3		
77790	"Supervision, handling, loading of radiation"	Pre-service	L152A	Medical Physicist	1.523	"Order radioactive materials, verify source counts, survey sources, calibrate sources, prepare individual patient log, load cartridges"	5		
77790	"Supervision, handling, loading of radiation"	Pre-service	L041B	Radiologic Technologist	0.41	"Order radioactive materials, verify source counts, survey sources, calibrate sources, prepare individual patient log, load cartridges"	5		
77790	"Supervision, handling, loading of radiation"	Pre-service	L041B	Radiologic Technologist	0.41	Secure radioactive material until needed	3		
78012	Nuclear medicine imaging for thyroid uptake measurements	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	20		
78012	Nuclear medicine imaging for thyroid uptake measurements	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	60		
78013	Nuclear medicine imaging of thyroid	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	20		
78013	Nuclear medicine imaging of thyroid	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	68		
78014	Nuclear medicine imaging for thyroid uptake measurements	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	20		
78014	Nuclear medicine imaging for thyroid uptake measurements	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	85		
78015	Nuclear medicine limited study for thyroid cancer	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78015	Nuclear medicine limited study for thyroid cancer	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	68		
78015	Nuclear medicine limited study for thyroid cancer	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78016	Nuclear medicine additional studies for thyroid cancer	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78016	Nuclear medicine additional studies for thyroid cancer	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	104		
78016	Nuclear medicine additional studies for thyroid cancer	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78018	Nuclear medicine whole body study for thyroid cancer	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78018	Nuclear medicine whole body study for thyroid cancer	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	93		
78018	Nuclear medicine whole body study for thyroid cancer	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78020	Nuclear medicine study for thyroid cancer	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	40		
78020	Nuclear medicine study for thyroid cancer	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	19		
78070	Imaging of parathyroid	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	20		
78070	Imaging of parathyroid	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	93		
78071	Imaging of parathyroid with nuclear medicine study	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78071	Imaging of parathyroid with nuclear medicine study	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	103		
78072	Imaging of parathyroid with CT and nuclear medicine study	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78072	Imaging of parathyroid with CT and nuclear medicine study	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	113		
78075	Imaging of blood vessel of gland of kidney	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78075	Imaging of blood vessel of gland of kidney	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	137		
78075	Imaging of blood vessel of gland of kidney	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78102	Imaging of bone marrow limited area	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78102	Imaging of bone marrow limited area	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	55		
78102	Imaging of bone marrow limited area	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78103	Imaging of bone marrow multiple areas	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78103	Imaging of bone marrow multiple areas	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	68		
78103	Imaging of bone marrow multiple areas	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78104	Imaging of bone marrow whole body	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78104	Imaging of bone marrow whole body	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	75		
78104	Imaging of bone marrow whole body	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78110	Nuclear medicine study of plasma	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	28		
78110	Nuclear medicine study of plasma	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	23		
78110	Nuclear medicine study of plasma	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	38		
78111	Nuclear medicine study of plasma	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	28		
78111	Nuclear medicine study of plasma	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	26		
78111	Nuclear medicine study of plasma	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	38		
78120	Nuclear medicine study of red blood cell	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	28		
78120	Nuclear medicine study of red blood cell	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	23		
78120	Nuclear medicine study of red blood cell	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	38		
78121	Nuclear medicine study of red blood cell	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	28		
78121	Nuclear medicine study of red blood cell	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	26		
78121	Nuclear medicine study of red blood cell	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	38		
78122	Nuclear medicine study of blood	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	28		
78122	Nuclear medicine study of blood	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	26		
78122	Nuclear medicine study of blood	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	38		
78130	Nuclear medicine study of red blood cell	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	28		
78130	Nuclear medicine study of red blood cell	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	38		
78130	Nuclear medicine study of red blood cell	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	78		
78135	Nuclear medicine study of red blood cell	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78135	Nuclear medicine study of red blood cell	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	104		
78135	Nuclear medicine study of red blood cell	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78140	Nuclear medicine study of red blood cell	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78140	Nuclear medicine study of red blood cell	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	77		
78140	Nuclear medicine study of red blood cell	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78185	Imaging of spleen	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78185	Imaging of spleen	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	67		
78185	Imaging of spleen	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78190	Nuclear medicine study of survival of blood cell	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78190	Nuclear medicine study of survival of blood cell	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	104		
78190	Nuclear medicine study of survival of blood cell	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78191	Nuclear medicine study of platelet	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	28		
78191	Nuclear medicine study of platelet	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	38		
78191	Nuclear medicine study of platelet	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	78		
78195	Imaging of lymphatic tissue and lymph node	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78195	Imaging of lymphatic tissue and lymph node	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	99		
78195	Imaging of lymphatic tissue and lymph node	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78201	Imaging of liver	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78201	Imaging of liver	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	62		
78201	Imaging of liver	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78202	Imaging of liver blood flow	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78202	Imaging of liver blood flow	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	68		
78202	Imaging of liver blood flow	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78205	Nuclear medicine study of liver	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	26		
78205	Nuclear medicine study of liver	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	66		
78205	Nuclear medicine study of liver	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	16		
78206	Nuclear medicine study of liver with blood flow	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	28		
78206	Nuclear medicine study of liver with blood flow	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	91		
78206	Nuclear medicine study of liver with blood flow	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	18		
78215	Imaging of liver and spleen	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78215	Imaging of liver and spleen	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	62		
78215	Imaging of liver and spleen	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78216	Imaging of liver and spleen with blood flow	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78216	Imaging of liver and spleen with blood flow	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	75		
78216	Imaging of liver and spleen with blood flow	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78226	Imaging of liver and bile duct system	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	20		
78226	Imaging of liver and bile duct system	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	109		
78227	Imaging of liver and bile duct system with use of drugs	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	20		
78227	Imaging of liver and bile duct system with use of drugs	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	148		
78230	Imaging of salivary gland	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78230	Imaging of salivary gland	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	55		
78230	Imaging of salivary gland	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78231	Imaging of salivary gland	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78231	Imaging of salivary gland	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	75		
78231	Imaging of salivary gland	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78232	Nuclear medicine study of salivary gland	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78232	Nuclear medicine study of salivary gland	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	75		
78232	Nuclear medicine study of salivary gland	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78258	Imaging of esophagus using radioisotopes	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78258	Imaging of esophagus using radioisotopes	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	69		
78258	Imaging of esophagus using radioisotopes	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78261	Imaging of stomach lining	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78261	Imaging of stomach lining	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	75		
78261	Imaging of stomach lining	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78262	Stomach and esophagus regurgitation study	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78262	Stomach and esophagus regurgitation study	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	75		
78262	Stomach and esophagus regurgitation study	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Availability of prior images confirmed	2		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	"Prepare radiopharmaceutical(s) delivered by central pharmacy with NRC and DOT required check-in of RP, survey package, wipe test of package and all recordings for required documentation by federal or state regulators.  Verify ordered dosages with received"	13		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	QC Equipment Planar to be used in imaging	4		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Service  pre	L049A	Nuclear Medicine Technologist	0.615	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Service  pre	L049A	Nuclear Medicine Technologist	0.615	Prepare and position pt/ monitor pt/ set up IV	2		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Service  pre	L049A	Nuclear Medicine Technologist	0.615	"Prepare room, equipment, supplies"	2		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Service  pre	L049A	Nuclear Medicine Technologist	0.615	Provide pre-service education/obtain consent/mandatory radiation protection education	3		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Acquire images	50		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Monitor patient while eating radioactive meal	8		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	"Obtain RP from Storage, verify patient, recheck dose, record, ressay, prepare meal following guideline"	20		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Service  post	L049A	Nuclear Medicine Technologist	0.615	Clean room/equipment by physician staff	3		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Service  post	L049A	Nuclear Medicine Technologist	0.615	Complete diagnostic forms and lab requisitions	2		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Service  post	L049A	Nuclear Medicine Technologist	0.615	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Service  post	L049A	Nuclear Medicine Technologist	0.615	"Post processing of raw data, including ROI and analysis"	15		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Service  post	L049A	Nuclear Medicine Technologist	0.615	Regulatory compliance - NRC required wipe tests and survey areas used including regulatory documentation	3		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Service  post	L049A	Nuclear Medicine Technologist	0.615	Review examination with interpreting MD	2		
78264	"Gastric emptying imaging study (eg, solid, liquid, or both);"	Service  post	L049A	Nuclear Medicine Technologist	0.615	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Availability of prior images confirmed	2		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	"Prepare radiopharmaceutical(s) delivered by central pharmacy with NRC and DOT required check-in of RP, survey package, wipe test of package and all recordings for required documentation by federal or state regulators.  Verify ordered dosages with received"	13		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	QC Equipment Planar to be used in imaging	4		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Service  pre	L049A	Nuclear Medicine Technologist	0.615	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Service  pre	L049A	Nuclear Medicine Technologist	0.615	Prepare and position pt/ monitor pt/ set up IV	2		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Service  pre	L049A	Nuclear Medicine Technologist	0.615	"Prepare room, equipment, supplies"	2		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Service  pre	L049A	Nuclear Medicine Technologist	0.615	Provide pre-service education/obtain consent/mandatory radiation protection education	3		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Acquire images	60		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Monitor patient while eating radioactive meal	10		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	"Obtain RP from Storage, verify patient, recheck dose, record, ressay, prepare meal following guideline"	25		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Service  post	L049A	Nuclear Medicine Technologist	0.615	Clean room/equipment by physician staff	3		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Service  post	L049A	Nuclear Medicine Technologist	0.615	Complete diagnostic forms and lab requisitions	2		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Service  post	L049A	Nuclear Medicine Technologist	0.615	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Service  post	L049A	Nuclear Medicine Technologist	0.615	"Post processing of raw data, including ROI and analysis"	19		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Service  post	L049A	Nuclear Medicine Technologist	0.615	Regulatory compliance - State and NRC required surveys of areas used and documentation	3		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Service  post	L049A	Nuclear Medicine Technologist	0.615	Review examination with interpreting MD	2		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Service  post	L049A	Nuclear Medicine Technologist	0.615	"Review/read X-ray, lab, and pathology reports"	0		
78265	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit, up to 24 hours"	Service  post	L049A	Nuclear Medicine Technologist	0.615	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Availability of prior images confirmed	2		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	"Prepare radiopharmaceutical(s) delivered by central pharmacy with NRC and DOT required check-in of RP, survey package, wipe test of package and all recordings for required documentation by federal or state regulators.  Verify ordered dosages with received"	13		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	QC Equipment Planar to be used in imaging	4		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Service  pre	L049A	Nuclear Medicine Technologist	0.615	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Service  pre	L049A	Nuclear Medicine Technologist	0.615	Prepare and position pt/ monitor pt/ set up IV	2		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Service  pre	L049A	Nuclear Medicine Technologist	0.615	"Prepare room, equipment, supplies"	2		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Service  pre	L049A	Nuclear Medicine Technologist	0.615	Provide pre-service education/obtain consent/mandatory radiation protection education	3		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Acquire images	75		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Monitor patient while eating radioactive meal	10		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	"Obtain RP from Storage, verify patient, recheck dose, record, ressay, prepare meal following guideline"	25		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Service  post	L049A	Nuclear Medicine Technologist	0.615	Clean room/equipment by physician staff	3		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Service  post	L049A	Nuclear Medicine Technologist	0.615	"Complete diagnostic forms, lab, X-ray requisitions"	2		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Service  post	L049A	Nuclear Medicine Technologist	0.615	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Service  post	L049A	Nuclear Medicine Technologist	0.615	"Post processing of raw data, including ROI and analysis"	25		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Service  post	L049A	Nuclear Medicine Technologist	0.615	Regulatory compliance - NRC required wipe tests and survey areas used including regulatory documentation	3		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Service  post	L049A	Nuclear Medicine Technologist	0.615	Review examination with interpreting MD	2		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Service  post	L049A	Nuclear Medicine Technologist	0.615	"Review/read X-ray, lab, and pathology reports"	0		
78266	"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days"	Service  post	L049A	Nuclear Medicine Technologist	0.615	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
78270	Vitamin B-12 absorption study	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78270	Vitamin B-12 absorption study	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	23		
78270	Vitamin B-12 absorption study	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	38		
78271	Vitamin B-12 absorption study with factor necessary for absorption	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78271	Vitamin B-12 absorption study with factor necessary for absorption	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	23		
78271	Vitamin B-12 absorption study with factor necessary for absorption	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	38		
78272	Vitamin B-12 absorption study without then with factor necessary for absorption	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	28		
78272	Vitamin B-12 absorption study without then with factor necessary for absorption	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	23		
78272	Vitamin B-12 absorption study without then with factor necessary for absorption	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	38		
78278	Acute digestive tract blood loss imaging	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78278	Acute digestive tract blood loss imaging	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	99		
78278	Acute digestive tract blood loss imaging	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78290	Intestine imaging	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78290	Intestine imaging	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	99		
78290	Intestine imaging	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78291	Peritoneal-venous shunt patency test	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78291	Peritoneal-venous shunt patency test	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	75		
78291	Peritoneal-venous shunt patency test	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78300	Bone and/or joint imaging	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78300	Bone and/or joint imaging	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	55		
78300	Bone and/or joint imaging	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78305	"Bone and/or joint imaging, multiple areas"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78305	"Bone and/or joint imaging, multiple areas"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	68		
78305	"Bone and/or joint imaging, multiple areas"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78306	"Bone and/or joint imaging, whole body"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78306	"Bone and/or joint imaging, whole body"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	75		
78306	"Bone and/or joint imaging, whole body"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78315	"Bone and/or joint imaging, 3 phase study"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78315	"Bone and/or joint imaging, 3 phase study"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	99		
78315	"Bone and/or joint imaging, 3 phase study"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78320	Nuclear medicine study of bone and/or joint	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	26		
78320	Nuclear medicine study of bone and/or joint	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	66		
78320	Nuclear medicine study of bone and/or joint	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	16		
78350	Bone density (bone mineral content) study	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	21		
78428	Cardiac shunt detection	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78428	Cardiac shunt detection	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	58		
78428	Cardiac shunt detection	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78445	Non-cardiac vascular flow imaging	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78445	Non-cardiac vascular flow imaging	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	58		
78445	Non-cardiac vascular flow imaging	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78451	Nuclear medicine study of vessels of heart using drugs or exercise single study	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78451	Nuclear medicine study of vessels of heart using drugs or exercise single study	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	99		
78451	Nuclear medicine study of vessels of heart using drugs or exercise single study	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	11		
78452	Nuclear medicine study of vessels of heart using drugs or exercise multiple studies	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78452	Nuclear medicine study of vessels of heart using drugs or exercise multiple studies	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	150		
78452	Nuclear medicine study of vessels of heart using drugs or exercise multiple studies	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78453	Nuclear medicine single study of vessels of heart using drugs or exercise	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	20		
78453	Nuclear medicine single study of vessels of heart using drugs or exercise	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	90		
78453	Nuclear medicine single study of vessels of heart using drugs or exercise	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	11		
78454	"Nuclear medicine multiple studies of vessels of heart at rest, using drugs, or exercise"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	20		
78454	"Nuclear medicine multiple studies of vessels of heart at rest, using drugs, or exercise"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	134		
78454	"Nuclear medicine multiple studies of vessels of heart at rest, using drugs, or exercise"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78456	Diagnostic nuclear imaging of platelet proteins for blood clot assessment in vein	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78456	Diagnostic nuclear imaging of platelet proteins for blood clot assessment in vein	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	99		
78456	Diagnostic nuclear imaging of platelet proteins for blood clot assessment in vein	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78457	"Venography for blood clot in vein, one leg or arm"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78457	"Venography for blood clot in vein, one leg or arm"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	58		
78457	"Venography for blood clot in vein, one leg or arm"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78458	"Venography for blood clot in veins, both legs or arms"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78458	"Venography for blood clot in veins, both legs or arms"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	58		
78458	"Venography for blood clot in veins, both legs or arms"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78466	Nuclear medicine study of heart muscle following heart attack	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78466	Nuclear medicine study of heart muscle following heart attack	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	55		
78466	Nuclear medicine study of heart muscle following heart attack	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78468	Nuclear medicine study of heart muscle following heart attack with evaluation of blood ejection from heart	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78468	Nuclear medicine study of heart muscle following heart attack with evaluation of blood ejection from heart	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	64		
78468	Nuclear medicine study of heart muscle following heart attack with evaluation of blood ejection from heart	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78469	Nuclear medicine study of heart muscle following heart attack	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	26		
78469	Nuclear medicine study of heart muscle following heart attack	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	66		
78469	Nuclear medicine study of heart muscle following heart attack	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	16		
78472	"Nuclear medicine study of heart wall motion at rest or stress with evaluation of blood ejection from heart, single study"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78472	"Nuclear medicine study of heart wall motion at rest or stress with evaluation of blood ejection from heart, single study"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	59		
78472	"Nuclear medicine study of heart wall motion at rest or stress with evaluation of blood ejection from heart, single study"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78473	"Nuclear medicine study of heart function wall motion at rest and stress with evaluation of blood ejection from heart, multiple studies"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78473	"Nuclear medicine study of heart function wall motion at rest and stress with evaluation of blood ejection from heart, multiple studies"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	80		
78473	"Nuclear medicine study of heart function wall motion at rest and stress with evaluation of blood ejection from heart, multiple studies"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78481	"Nuclear medicine study of heart wall motion at rest or stress with evaluation of blood ejection from heart, single study"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78481	"Nuclear medicine study of heart wall motion at rest or stress with evaluation of blood ejection from heart, single study"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	42		
78481	"Nuclear medicine study of heart wall motion at rest or stress with evaluation of blood ejection from heart, single study"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78483	"Nuclear medicine study of heart wall motion at rest and stress with evaluation of blood ejection from heart, multiple studies"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78483	"Nuclear medicine study of heart wall motion at rest and stress with evaluation of blood ejection from heart, multiple studies"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	50		
78483	"Nuclear medicine study of heart wall motion at rest and stress with evaluation of blood ejection from heart, multiple studies"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78494	Nuclear medicine study of heart wall motion at rest with evaluation of blood ejection from heart	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	26		
78494	Nuclear medicine study of heart wall motion at rest with evaluation of blood ejection from heart	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	67		
78494	Nuclear medicine study of heart wall motion at rest with evaluation of blood ejection from heart	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	16		
78496	Nuclear medicine study of heart function at rest or stress with evaluation of blood ejection from heart	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	12		
78496	Nuclear medicine study of heart function at rest or stress with evaluation of blood ejection from heart	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	11		
78579	Nuclear medicine study of lung ventilation	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	20		
78579	Nuclear medicine study of lung ventilation	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	63		
78580	Nuclear medicine study of blood circulation in the lungs	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	20		
78580	Nuclear medicine study of blood circulation in the lungs	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	73		
78582	Nuclear medicine study of lung ventilation and blood circulation in the lungs	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	20		
78582	Nuclear medicine study of lung ventilation and blood circulation in the lungs	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	103		
78597	Nuclear medicine study with measurement of blood circulation in the lungs	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	20		
78597	Nuclear medicine study with measurement of blood circulation in the lungs	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	63		
78598	Nuclear medicine study with measurement of blood circulation in the lungs and ventilation	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	20		
78598	Nuclear medicine study with measurement of blood circulation in the lungs and ventilation	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	100		
78600	"Imaging of brain, less than 4 static views"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78600	"Imaging of brain, less than 4 static views"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	62		
78600	"Imaging of brain, less than 4 static views"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78601	"Imaging of brain with blood flow, less than 4 static views"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78601	"Imaging of brain with blood flow, less than 4 static views"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	68		
78601	"Imaging of brain with blood flow, less than 4 static views"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78605	"Imaging of brain with blood flow, minimum of 4 static views"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78605	"Imaging of brain with blood flow, minimum of 4 static views"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	62		
78605	"Imaging of brain with blood flow, minimum of 4 static views"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78606	"Imaging of brain with blood flow, minimum of 4 static views"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78606	"Imaging of brain with blood flow, minimum of 4 static views"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	99		
78606	"Imaging of brain with blood flow, minimum of 4 static views"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78607	Nuclear medicine study of brain	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	28		
78607	Nuclear medicine study of brain	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	91		
78607	Nuclear medicine study of brain	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	18		
78610	"Imaging of brain, blood flow"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78610	"Imaging of brain, blood flow"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	58		
78610	"Imaging of brain, blood flow"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78630	Imaging of brain and spinal cord fluid flow at base of brain	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78630	Imaging of brain and spinal cord fluid flow at base of brain	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	103		
78630	Imaging of brain and spinal cord fluid flow at base of brain	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78635	Imaging of brain and spinal cord fluid flow in brain compartments (ventricles)	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78635	Imaging of brain and spinal cord fluid flow in brain compartments (ventricles)	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	102		
78635	Imaging of brain and spinal cord fluid flow in brain compartments (ventricles)	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78645	Imaging of brain and spinal cord fluid flow shunt evaluation	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78645	Imaging of brain and spinal cord fluid flow shunt evaluation	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	102		
78645	Imaging of brain and spinal cord fluid flow shunt evaluation	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78647	Nuclear medicine study of brain and spinal cord fluid flow	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	28		
78647	Nuclear medicine study of brain and spinal cord fluid flow	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	91		
78647	Nuclear medicine study of brain and spinal cord fluid flow	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	18		
78650	Imaging of brain and spinal cord fluid leakage detection and localization	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78650	Imaging of brain and spinal cord fluid leakage detection and localization	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	103		
78650	Imaging of brain and spinal cord fluid leakage detection and localization	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78660	Nuclear medicine study of tear drainage structure of eye	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78660	Nuclear medicine study of tear drainage structure of eye	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	55		
78660	Nuclear medicine study of tear drainage structure of eye	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78700	Imaging of kidney	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78700	Imaging of kidney	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	55		
78700	Imaging of kidney	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78701	Nuclear medicine study of kidney with assessment of blood flow	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78701	Nuclear medicine study of kidney with assessment of blood flow	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	68		
78701	Nuclear medicine study of kidney with assessment of blood flow	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78707	Nuclear medicine study of kidney with assessment of blood flow and function	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78707	Nuclear medicine study of kidney with assessment of blood flow and function	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	68		
78707	Nuclear medicine study of kidney with assessment of blood flow and function	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78708	Nuclear medicine study of kidney with assessment of blood flow and function	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78708	Nuclear medicine study of kidney with assessment of blood flow and function	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	93		
78708	Nuclear medicine study of kidney with assessment of blood flow and function	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78709	Nuclear medicine study of kidney with assessment of blood flow and function	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78709	Nuclear medicine study of kidney with assessment of blood flow and function	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	104		
78709	Nuclear medicine study of kidney with assessment of blood flow and function	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78710	Nuclear medicine study of kidney	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	26		
78710	Nuclear medicine study of kidney	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	66		
78710	Nuclear medicine study of kidney	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	16		
78725	Nuclear medicine kidney function study	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	28		
78725	Nuclear medicine kidney function study	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	29		
78725	Nuclear medicine kidney function study	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	38		
78730	Nuclear medicine study of remaining urine in bladder	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	20		
78740	Nuclear medicine backwash of urine into kidney	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78740	Nuclear medicine backwash of urine into kidney	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	68		
78740	Nuclear medicine backwash of urine into kidney	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78761	Nuclear medicine study of testicles and blood vessel flow	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78761	Nuclear medicine study of testicles and blood vessel flow	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	63		
78761	Nuclear medicine study of testicles and blood vessel flow	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78800	Nuclear medicine study of radioactive material distribution at tumor location	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78800	Nuclear medicine study of radioactive material distribution at tumor location	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	55		
78800	Nuclear medicine study of radioactive material distribution at tumor location	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78801	Nuclear medicine study of radioactive material distribution at multiple tumor locations	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78801	Nuclear medicine study of radioactive material distribution at multiple tumor locations	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	75		
78801	Nuclear medicine study of radioactive material distribution at multiple tumor locations	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78802	"Nuclear medicine study of radioactive material distribution at tumor locations in whole body, single day imaging"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78802	"Nuclear medicine study of radioactive material distribution at tumor locations in whole body, single day imaging"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	98		
78802	"Nuclear medicine study of radioactive material distribution at tumor locations in whole body, single day imaging"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	17		
78803	Nuclear medicine study of radioactive material distribution	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	28		
78803	Nuclear medicine study of radioactive material distribution	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	91		
78803	Nuclear medicine study of radioactive material distribution	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	18		
78804	"Nuclear medicine study of radioactive material distribution of whole body, requiring 2 or more days imaging"	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	27		
78804	"Nuclear medicine study of radioactive material distribution of whole body, requiring 2 or more days imaging"	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	174		
78804	"Nuclear medicine study of radioactive material distribution of whole body, requiring 2 or more days imaging"	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	25		
78805	Nuclear medicine study of radioactive material distribution at site of inflammation	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78805	Nuclear medicine study of radioactive material distribution at site of inflammation	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	55		
78805	Nuclear medicine study of radioactive material distribution at site of inflammation	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	13		
78806	Nuclear medicine study of radioactive material distribution at sites of inflammation in whole body	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	23		
78806	Nuclear medicine study of radioactive material distribution at sites of inflammation in whole body	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	101		
78806	Nuclear medicine study of radioactive material distribution at sites of inflammation in whole body	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	14		
78807	Nuclear medicine study of radioactive material distribution at site of inflammation	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	28		
78807	Nuclear medicine study of radioactive material distribution at site of inflammation	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	91		
78807	Nuclear medicine study of radioactive material distribution at site of inflammation	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	18		
78808	Injection of radioactive contrast material into a vein for non-imaging gamma probe	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	6		
78808	Injection of radioactive contrast material into a vein for non-imaging gamma probe	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	37		
78808	Injection of radioactive contrast material into a vein for non-imaging gamma probe	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	3		
79005	Oral administration of radioactive material therapy agent	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	19		
79005	Oral administration of radioactive material therapy agent	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	31		
79005	Oral administration of radioactive material therapy agent	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	3		
79101	Radioactive material therapy into vein	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	19		
79101	Radioactive material therapy into vein	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	27		
79101	Radioactive material therapy into vein	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	3		
79200	Radioactive material therapy into body space or cavity	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	19		
79200	Radioactive material therapy into body space or cavity	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	41		
79200	Radioactive material therapy into body space or cavity	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	3		
79403	Radioactive material therapy into vein	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	36		
79403	Radioactive material therapy into vein	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	55		
79403	Radioactive material therapy into vein	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	4		
79440	Radioactive material therapy into bone joint	Pre-service	L049A	Nuclear Medicine Technologist	0.615	Preservice total costs	19		
79440	Radioactive material therapy into bone joint	Service  intra	L049A	Nuclear Medicine Technologist	0.615	Service total costs	26		
79440	Radioactive material therapy into bone joint	Post-service	L049A	Nuclear Medicine Technologist	0.615	Post service total costs	3		
80500	Clinical pathology consultation	Service  intra	L035A	Lab Tech/Histotechnologist	0.35	Service total costs	8	0	
80502	"Comprehensive, clinical pathology consultation"	Service  intra	L035A	Lab Tech/Histotechnologist	0.35	Service total costs	8	0	
85097	"Bone marrow, smear interpretation"	Service  intra	L030A	Lab Tech/MTA	0.3	Service total costs	89	0	
86077	Blood bank physician services for cross match and/or evaluation and written report	Service  intra	L035A	Lab Tech/Histotechnologist	0.35	Service total costs	8	0	
86078	Blood bank physician services for investigation of transfusion reaction with written report	Service  intra	L035A	Lab Tech/Histotechnologist	0.35	Service total costs	8	0	
86079	Blood bank physician services with written report	Service  intra	L035A	Lab Tech/Histotechnologist	0.35	Service total costs	8	0	
86486	Skin test for infectious organism	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8		
86490	Skin test for coccidioidomycosis (fungal infection)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8		
86510	Skin test histoplasmosis (parasite infection)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8		
86580	Skin test for tuberculosis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8		
88104	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Accession specimen in laboratory information system including the following:Unwrap and/or remove specimen/ bottle and requisition slip from plastic bag.  Check demographics to ensure they are correct and to ensure proper billing….	4		
88104	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation"	Pre-service	L045A	Cytotechnologist	0.45	"Confirm patient ID, organize work, verify and review history"	1		
88104	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Describe and document gross specimen in laboratory information system	2		
88104	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation"	Pre-service	L045A	Cytotechnologist	0.45	"Enter screening diagnosis in laboratory information system, complete workload recording logs, manage any relevant utilization review/quality assurance activities and regulatory compliance documentation."	0.5		
88104	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Order, restock, and distribute specimen containers with requisition forms."	0		
88104	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation"	Pre-service	L045A	Cytotechnologist	0.45	Perform screening function: The cytotechnologist meticulously reviews all cells on slide(s) for any abnormalities prior to sending out cases to pathologists	32		
88104	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare automated stainer with solutions and load microscopic slides. Set and confirm stainer program. Prepare automated coverslipper, remove slides from stainer and place on coverslipper or manually coverslip."	4		
88104	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare specimen air dried and alcohol fixed slides (includes preparing wet smears, millipore filter preparation, cytospin preparation, stain quality evaluation, specimen tracking logs, labeling)"	5		
88104	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Prepare specimen containers/preload fixative/label containers/distribute requisition form(s) to physician	0.5		
88104	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Stain air dried slides with modified Wright stain and coverslip.  Review slides for malignancy/high cellularity (cross contamination)	2		
88104	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation"	Service  pre	L035A	Lab Tech/Histotechnologist	0.35	Assemble and deliver slides with paperwork to pathologists	0.5		
88104	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation"	Service  post	L035A	Lab Tech/Histotechnologist	0.35	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88104	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation"	Service  post	L035A	Lab Tech/Histotechnologist	0.35	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88104	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation"	Service  post	L035A	Lab Tech/Histotechnologist	0.35	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88104	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation"	Post-service	L033A	Lab Technician	0.33	Recycle xylene from stainer	0		
88106	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Accession specimen in laboratory information system including the following:Unwrap and/or remove specimen/ bottle and requisition slip from plastic bag.  Check demographics to ensure they are correct and to ensure proper billing….	4		
88106	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation"	Pre-service	L045A	Cytotechnologist	0.45	"Confirm patient ID, organize work, verify and review history"	1		
88106	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Describe and document gross specimen in laboratory information system	2		
88106	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation"	Pre-service	L045A	Cytotechnologist	0.45	"Enter screening diagnosis in laboratory information system, complete workload recording logs, manage any relevant utilization review/quality assurance activities and regulatory compliance documentation."	0.5		
88106	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Order, restock, and distribute specimen containers with requisition forms."	0		
88106	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation"	Pre-service	L045A	Cytotechnologist	0.45	Perform screening function: The cytotechnologist meticulously reviews all cells on slide(s) for any abnormalities prior to sending out cases to pathologists	16		
88106	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare automated stainer with solutions and load microscopic slides. Set and confirm stainer program. Prepare automated coverslipper, remove slides from stainer and place on coverslipper or manually coverslip."	4		
88106	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare specimen air dried and alcohol fixed slides (includes preparing wet smears, millipore filter preparation, cytospin preparation, stain quality evaluation, specimen tracking logs, labeling)"	15		
88106	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Prepare specimen containers/preload fixative/label containers/distribute requisition form(s) to physician	0.5		
88106	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Stain air dried slides with modified Wright stain and coverslip.  Review slides for malignancy/high cellularity (cross contamination)	2		
88106	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation"	Service  pre	L035A	Lab Tech/Histotechnologist	0.35	Assemble and deliver slides with paperwork to pathologists	0.5		
88106	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation"	Post-service	L035A	Lab Tech/Histotechnologist	0.35	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88106	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation"	Post-service	L035A	Lab Tech/Histotechnologist	0.35	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88106	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation"	Post-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88106	"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation"	Post-service	L033A	Lab Technician	0.33	Recycle xylene from stainer	0		
88108	"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Accession specimen in laboratory information system including the following:Unwrap and/or remove specimen/ bottle and requisition slip from plastic bag.  Check demographics to ensure they are correct and to ensure proper billing….	4		
88108	"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)"	Pre-service	L045A	Cytotechnologist	0.45	"Confirm patient ID, organize work, verify and review history"	1		
88108	"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Describe and document gross specimen in laboratory information system	2		
88108	"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)"	Pre-service	L045A	Cytotechnologist	0.45	"Enter screening diagnosis in laboratory information system, complete workload recording logs, manage any relevant utilization review/quality assurance activities and regulatory compliance documentation."	0.5		
88108	"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Order, restock, and distribute specimen containers with requisition forms."	0		
88108	"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)"	Pre-service	L045A	Cytotechnologist	0.45	Perform screening function: The cytotechnologist meticulously reviews all cells on slide(s) for any abnormalities prior to sending out cases to pathologists	16		
88108	"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare automated stainer with solutions and load microscopic slides. Set and confirm stainer program. Prepare automated coverslipper, remove slides from stainer and place on coverslipper or manually coverslip."	4		
88108	"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare specimen air dried and alcohol fixed slides (includes preparing wet smears, millipore filter preparation, cytospin preparation, stain quality evaluation, specimen tracking logs, labeling)"	7		
88108	"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Prepare specimen containers/preload fixative/label containers/distribute requisition form(s) to physician	0.5		
88108	"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)"	Service  pre	L035A	Lab Tech/Histotechnologist	0.35	Assemble and deliver slides with paperwork to pathologists	0.5		
88108	"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)"	Post-service	L035A	Lab Tech/Histotechnologist	0.35	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88108	"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)"	Post-service	L035A	Lab Tech/Histotechnologist	0.35	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88108	"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)"	Post-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88108	"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)"	Post-service	L033A	Lab Technician	0.33	Recycle xylene from stainer	0		
88112	Cell examination of specimen	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Accession specimen in laboratory information system including the following:Unwrap and/or remove specimen/ bottle and requisition slip from plastic bag.  Check demographics to ensure they are correct and to ensure proper billing….	4		
88112	Cell examination of specimen	Pre-service	L045A	Cytotechnologist	0.45	"Confirm patient ID, organize work, verify and review history"	1		
88112	Cell examination of specimen	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Describe and document gross specimen in laboratory information system	2		
88112	Cell examination of specimen	Pre-service	L045A	Cytotechnologist	0.45	"Enter screening diagnosis in laboratory information system, complete workload recording logs, manage any relevant utilization review/quality assurance activities and regulatory compliance documentation."	0.5		
88112	Cell examination of specimen	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Order, restock, and distribute specimen containers with requisition forms."	0		
88112	Cell examination of specimen	Pre-service	L045A	Cytotechnologist	0.45	Perform screening function: The cytotechnologist meticulously reviews all cells on slide(s) for any abnormalities prior to sending out cases to pathologists	8		
88112	Cell examination of specimen	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare automated stainer with solutions and load microscopic slides. Set and confirm stainer program. Prepare automated coverslipper, remove slides from stainer and place on coverslipper or manually coverslip."	4		
88112	Cell examination of specimen	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare specimen air dried and alcohol fixed slides (includes preparing wet smears, millipore filter preparation, cytospin preparation, stain quality evaluation, specimen tracking logs, labeling)"	12		
88112	Cell examination of specimen	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Prepare specimen containers/preload fixative/label containers/distribute requisition form(s) to physician	0.5		
88112	Cell examination of specimen	Service  pre	L035A	Lab Tech/Histotechnologist	0.35	Assemble and deliver slides with paperwork to pathologists	0.5		
88112	Cell examination of specimen	Post-service	L035A	Lab Tech/Histotechnologist	0.35	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88112	Cell examination of specimen	Post-service	L035A	Lab Tech/Histotechnologist	0.35	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88112	Cell examination of specimen	Post-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88112	Cell examination of specimen	Post-service	L033A	Lab Technician	0.33	Recycle xylene from stainer	0		
88120	Cell examination of urine	Pre-service	L033A	Lab Technician	0.33	Preservice total costs	32.33		
88120	Cell examination of urine	Pre-service	L026A	Medical/Technical Assistant	0.26	Preservice total costs	11.49		
88120	Cell examination of urine	Service  intra	L045A	Cytotechnologist	0.45	Service total costs	49		
88120	Cell examination of urine	Post-service	L033A	Lab Technician	0.33	Post service total costs	9.33		
88121	Cell examination of urine	Pre-service	L033A	Lab Technician	0.33	Preservice total costs	20.7		
88121	Cell examination of urine	Pre-service	L026A	Medical/Technical Assistant	0.26	Preservice total costs	9.51		
88121	Cell examination of urine	Service  intra	L045A	Cytotechnologist	0.45	Service total costs	17.83		
88121	Cell examination of urine	Post-service	L033A	Lab Technician	0.33	Post service total costs	4.7		
88125	Forensic (investigation) examination of specimen	Service  intra	L035A	Lab Tech/Histotechnologist	0.35	Service total costs	17		
88141	Pap test (Pap smear)	Pre-service	L045A	Cytotechnologist	0.45	Preservice total costs	7	0	
88141	Pap test (Pap smear)	Pre-service	L033A	Lab Technician	0.33	Preservice total costs	2	0	
88141	Pap test (Pap smear)	Service  intra	L045A	Cytotechnologist	0.45	Service total costs	2	0	
88141	Pap test (Pap smear)	Post-service	L045A	Cytotechnologist	0.45	Post service total costs	9	0	
88141	Pap test (Pap smear)	Post-service	L033A	Lab Technician	0.33	Post service total costs	9	0	
88160	"Cytopathology, smears, any other source; screening and interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Accession specimen in laboratory information system including the following:Unwrap and/or remove specimen/ bottle and requisition slip from plastic bag.  Check demographics to ensure they are correct and to ensure proper billing….	4		
88160	"Cytopathology, smears, any other source; screening and interpretation"	Pre-service	L045A	Cytotechnologist	0.45	"Confirm patient ID, organize work, verify and review history"	1		
88160	"Cytopathology, smears, any other source; screening and interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Describe and document gross specimen in laboratory information system	2		
88160	"Cytopathology, smears, any other source; screening and interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Order, restock, and distribute specimen containers with requisition forms."	0		
88160	"Cytopathology, smears, any other source; screening and interpretation"	Pre-service	L045A	Cytotechnologist	0.45	Perform screening function: The cytotechnologist meticulously reviews all cells on slide(s) for any abnormalities prior to sending out cases to pathologists	32		
88160	"Cytopathology, smears, any other source; screening and interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare automated stainer with solutions and load microscopic slides. Set and confirm stainer program. Prepare automated coverslipper, remove slides from stainer and place on coverslipper or manually coverslip."	4		
88160	"Cytopathology, smears, any other source; screening and interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Prepare specimen containers/preload fixative/label containers/distribute requisition form(s) to physician	0.5		
88160	"Cytopathology, smears, any other source; screening and interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Stain air dried slides with modified Wright stain and coverslip.  Review slides for malignancy/high cellularity (cross contamination)	2		
88160	"Cytopathology, smears, any other source; screening and interpretation"	Service  pre	L035A	Lab Tech/Histotechnologist	0.35	Assemble and deliver slides with paperwork to pathologists	0.5		
88160	"Cytopathology, smears, any other source; screening and interpretation"	Service  pre	L045A	Cytotechnologist	0.45	Enter screening diagnosis in laboratory information system.	0.5		
88160	"Cytopathology, smears, any other source; screening and interpretation"	Service  post	L035A	Lab Tech/Histotechnologist	0.35	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88160	"Cytopathology, smears, any other source; screening and interpretation"	Service  post	L035A	Lab Tech/Histotechnologist	0.35	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88160	"Cytopathology, smears, any other source; screening and interpretation"	Service  post	L035A	Lab Tech/Histotechnologist	0.35	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88160	"Cytopathology, smears, any other source; screening and interpretation"	Post-service	L033A	Lab Technician	0.33	Recycle xylene from stainer	0		
88161	"Cytopathology, smears, any other source; preparation, screening and interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Accession specimen in laboratory information system including the following:Unwrap and/or remove specimen/ bottle and requisition slip from plastic bag.  Check demographics to ensure they are correct and to ensure proper billing….	4		
88161	"Cytopathology, smears, any other source; preparation, screening and interpretation"	Pre-service	L045A	Cytotechnologist	0.45	"Confirm patient ID, organize work, verify and review history"	1		
88161	"Cytopathology, smears, any other source; preparation, screening and interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Describe and document gross specimen in laboratory information system	2		
88161	"Cytopathology, smears, any other source; preparation, screening and interpretation"	Pre-service	L045A	Cytotechnologist	0.45	"Enter screening diagnosis in laboratory information system, complete workload recording logs, manage any relevant utilization review/quality assurance activities and regulatory compliance documentation."	0.5		
88161	"Cytopathology, smears, any other source; preparation, screening and interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Order, restock, and distribute specimen containers with requisition forms."	0		
88161	"Cytopathology, smears, any other source; preparation, screening and interpretation"	Pre-service	L045A	Cytotechnologist	0.45	Perform screening function: The cytotechnologist meticulously reviews all cells on slide(s) for any abnormalities prior to sending out cases to pathologists	32		
88161	"Cytopathology, smears, any other source; preparation, screening and interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare automated stainer with solutions and load microscopic slides. Set and confirm stainer program. Prepare automated coverslipper, remove slides from stainer and place on coverslipper or manually coverslip."	4		
88161	"Cytopathology, smears, any other source; preparation, screening and interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare specimen air dried and alcohol fixed slides (includes preparing wet smears, millipore filter preparation, cytospin preparation, stain quality evaluation, specimen tracking logs, labeling)"	6		
88161	"Cytopathology, smears, any other source; preparation, screening and interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Prepare specimen containers/preload fixative/label containers/distribute requisition form(s) to physician	0.5		
88161	"Cytopathology, smears, any other source; preparation, screening and interpretation"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Stain air dried slides with modified Wright stain and coverslip.  Review slides for malignancy/high cellularity (cross contamination)	2		
88161	"Cytopathology, smears, any other source; preparation, screening and interpretation"	Service  pre	L035A	Lab Tech/Histotechnologist	0.35	Assemble and deliver slides with paperwork to pathologists	0.5		
88161	"Cytopathology, smears, any other source; preparation, screening and interpretation"	Post-service	L035A	Lab Tech/Histotechnologist	0.35	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88161	"Cytopathology, smears, any other source; preparation, screening and interpretation"	Post-service	L035A	Lab Tech/Histotechnologist	0.35	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88161	"Cytopathology, smears, any other source; preparation, screening and interpretation"	Post-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88161	"Cytopathology, smears, any other source; preparation, screening and interpretation"	Post-service	L033A	Lab Technician	0.33	Recycle xylene from stainer	0		
88162	"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Accession specimen in laboratory information system including the following:Unwrap and/or remove specimen/ bottle and requisition slip from plastic bag.  Check demographics to ensure they are correct and to ensure proper billing….	4		
88162	"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains"	Pre-service	L045A	Cytotechnologist	0.45	"Confirm patient ID, organize work, verify and review history"	1		
88162	"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Describe and document gross specimen in laboratory information system	2		
88162	"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains"	Pre-service	L045A	Cytotechnologist	0.45	"Enter screening diagnosis in laboratory information system, complete workload recording logs, manage any relevant utilization review/quality assurance activities and regulatory compliance documentation."	0.5		
88162	"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Order, restock, and distribute specimen containers with requisition forms."	0		
88162	"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains"	Pre-service	L045A	Cytotechnologist	0.45	Perform screening function: The cytotechnologist meticulously reviews all cells on slide(s) for any abnormalities prior to sending out cases to pathologists	56		
88162	"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare automated stainer with solutions and load microscopic slides. Set and confirm stainer program. Prepare automated coverslipper, remove slides from stainer and place on coverslipper or manually coverslip."	4		
88162	"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Prepare specimen containers/preload fixative/label containers/distribute requisition form(s) to physician	0.5		
88162	"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Stain air dried slides with modified Wright stain and coverslip.  Review slides for malignancy/high cellularity (cross contamination)	2		
88162	"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains"	Service  pre	L035A	Lab Tech/Histotechnologist	0.35	Assemble and deliver slides with paperwork to pathologists	0.5		
88162	"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains"	Post-service	L035A	Lab Tech/Histotechnologist	0.35	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88162	"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains"	Post-service	L035A	Lab Tech/Histotechnologist	0.35	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88162	"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains"	Post-service	L035A	Lab Tech/Histotechnologist	0.35	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88162	"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains"	Post-service	L033A	Lab Technician	0.33	Recycle xylene from stainer	0		
88172	Evaluation of fine needle aspirate	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	Preservice total costs	1		
88172	Evaluation of fine needle aspirate	Service  intra	L035A	Lab Tech/Histotechnologist	0.35	Service total costs	19		
88172	Evaluation of fine needle aspirate	Post-service	L035A	Lab Tech/Histotechnologist	0.35	Post service total costs	3		
88173	Evaluation of fine needle aspirate with interpretation and report	Service  intra	L045A	Cytotechnologist	0.45	Service total costs	54		
88173	Evaluation of fine needle aspirate with interpretation and report	Service  intra	L035A	Lab Tech/Histotechnologist	0.35	Service total costs	42		
88177	Pap test	Service  intra	L035A	Lab Tech/Histotechnologist	0.35	Service total costs	11		
88182	"Flow cytometry, cell cycle or dna analysis"	Pre-service	L033A	Lab Technician	0.33	Accession specimen/prepare for examination	4		
88182	"Flow cytometry, cell cycle or dna analysis"	Service  pre	L045A	Cytotechnologist	0.45	Data acquisition and modeling	18		
88182	"Flow cytometry, cell cycle or dna analysis"	Service  pre	L045A	Cytotechnologist	0.45	"Instrument start-up, quality control functions, calibration, centrifugation,  maintaining specimen tracking, logs and labeling"	13		
88182	"Flow cytometry, cell cycle or dna analysis"	Service  pre	L033A	Lab Technician	0.33	"Load specimen into flow cytometer, run specimen, monitor data acquisition, and unload flow cytometer"	0		
88182	"Flow cytometry, cell cycle or dna analysis"	Service  pre	L045A	Cytotechnologist	0.45	"Load specimen into flow cytometer, run specimen, monitor, analyze, resulting output and functions , and unload flow cytometer"	7		
88182	"Flow cytometry, cell cycle or dna analysis"	Service  pre	L037B	Histotechnologist	0.37	Prepare specimen for manual/automated processing. (Remove frozen tissue material out of cryostate and placing in cassette)	0		
88182	"Flow cytometry, cell cycle or dna analysis"	Service  pre	L037B	Histotechnologist	0.37	Prepare specimen through block resectioning of thick 50 micron sections	12		
88182	"Flow cytometry, cell cycle or dna analysis"	Service  pre	L045A	Cytotechnologist	0.45	"Print out histograms, assemble materials with paperwork to pathologists Review histograms and gating with pathologist."	2		
88182	"Flow cytometry, cell cycle or dna analysis"	Service  pre	L033A	Lab Technician	0.33	Process paraffin-embedded tissue for analysis	0		
88182	"Flow cytometry, cell cycle or dna analysis"	Service  pre	L045A	Cytotechnologist	0.45	"Process paraffinized thick tissue sections: deparaffinize sections, disaggregate tissue with enzymatic digestion, isolate nuclei, stain DNA."	60		
88182	"Flow cytometry, cell cycle or dna analysis"	Post-service	L045A	Cytotechnologist	0.45	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88182	"Flow cytometry, cell cycle or dna analysis"	Post-service	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	0		
88182	"Flow cytometry, cell cycle or dna analysis"	Post-service	L033A	Lab Technician	0.33	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88182	"Flow cytometry, cell cycle or dna analysis"	Post-service	L045A	Cytotechnologist	0.45	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88182	"Flow cytometry, cell cycle or dna analysis"	Post-service	L037B	Histotechnologist	0.37	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	0		
88182	"Flow cytometry, cell cycle or dna analysis"	Post-service	L033A	Lab Technician	0.33	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88182	"Flow cytometry, cell cycle or dna analysis"	Post-service	L045A	Cytotechnologist	0.45	"Enter data into laboratory information system, multiparameter analyses and field data entry, complete quality assurance documentation"	0		
88182	"Flow cytometry, cell cycle or dna analysis"	Post-service	L033A	Lab Technician	0.33	"Enter data into laboratory information system, multiparameter analyses and field data entry, complete quality assurance documentation"	0		
88182	"Flow cytometry, cell cycle or dna analysis"	Post-service	L033A	Lab Technician	0.33	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88184	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker"	Pre-service	L033A	Lab Technician	0.33	Accession specimen/prepare for examination	4		
88184	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker"	Service  pre	L045A	Cytotechnologist	0.45	Data acquisition and modeling	0		
88184	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker"	Service  pre	L045A	Cytotechnologist	0.45	"Instrument start-up, quality control functions, calibration, centrifugation,  maintaining specimen tracking, logs and labeling"	13		
88184	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker"	Service  pre	L045A	Cytotechnologist	0.45	"Load specimen into flow cytometer, run specimen, monitor data acquisition, and data modeling, and unload flow cytometer"	7		
88184	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker"	Service  pre	L045A	Cytotechnologist	0.45	"Prepare cytospin or smear, stain, cover slip, examine under microscope for quality."	8		
88184	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker"	Service  pre	L045A	Cytotechnologist	0.45	"Prepare specimen, including cell enrichment free of debris, cell separation, add reagents, for manual/automated processing."	15		
88184	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker"	Service  pre	L045A	Cytotechnologist	0.45	"Print out histograms, assemble materials with paperwork to pathologists"	0		
88184	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker"	Service  pre	L045A	Cytotechnologist	0.45	"Print out histograms, assemble materials with paperwork to pathologists Review histograms and gating with pathologist."	2		
88184	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker"	Service  pre	L045A	Cytotechnologist	0.45	Review histograms and gating with pathologist	0		
88184	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker"	Post-service	L033A	Lab Technician	0.33	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88184	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker"	Post-service	L033A	Lab Technician	0.33	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88184	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker"	Post-service	L033A	Lab Technician	0.33	"Enter data into laboratory information system, multiparameter analyses and field data entry, complete quality assurance documentation"	0		
88184	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker"	Post-service	L033A	Lab Technician	0.33	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88185	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (list separately in addition to code for first marker)"	Service  pre	L045A	Cytotechnologist	0.45	Data acquisition and modeling	0		
88185	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (list separately in addition to code for first marker)"	Service  pre	L045A	Cytotechnologist	0.45	"Load specimen into flow cytometer, run specimen, monitor data acquisition, and data modeling, and unload flow cytometer"	3		
88185	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (list separately in addition to code for first marker)"	Service  pre	L045A	Cytotechnologist	0.45	"Prepare specimen, including cell enrichment free of debris, cell separation, add reagents, for manual/automated processing."	3		
88185	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (list separately in addition to code for first marker)"	Service  pre	L045A	Cytotechnologist	0.45	"Print out histograms, assemble materials with paperwork to pathologists Review histograms and gating with pathologist."	1		
88185	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (list separately in addition to code for first marker)"	Service  pre	L045A	Cytotechnologist	0.45	Review histograms and gating with pathologist	0		
88185	"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (list separately in addition to code for first marker)"	Post-service	L033A	Lab Technician	0.33	"Enter data into laboratory information system, multiparameter analyses and field data entry, complete quality assurance documentation"	0		
88291	Interpretation and report of genetic testing	Pre-service	L045A	Cytotechnologist	0.45	Preservice total costs	15	0	
88291	Interpretation and report of genetic testing	Post-service	L045A	Cytotechnologist	0.45	Post service total costs	5	0	
88300	"Pathology examination of tissue using a microscope, limited examination"	Service  intra	L037B	Histotechnologist	0.37	Service total costs	5		
88300	"Pathology examination of tissue using a microscope, limited examination"	Service  intra	L033A	Lab Technician	0.33	Service total costs	7		
88300	"Pathology examination of tissue using a microscope, limited examination"	Post-service	L033A	Lab Technician	0.33	Post service total costs	1		
88302	Pathology examination of tissue using a microscope	Pre-service	L033A	Lab Technician	0.33	Preservice total costs	0.5		
88302	Pathology examination of tissue using a microscope	Service  intra	L037B	Histotechnologist	0.37	Service total costs	10		
88302	Pathology examination of tissue using a microscope	Service  intra	L033A	Lab Technician	0.33	Service total costs	9		
88302	Pathology examination of tissue using a microscope	Post-service	L033A	Lab Technician	0.33	Post service total costs	4		
88304	"Pathology examination of tissue using a microscope, moderately low complexity"	Pre-service	L033A	Lab Technician	0.33	Preservice total costs	0.5		
88304	"Pathology examination of tissue using a microscope, moderately low complexity"	Service  intra	L037B	Histotechnologist	0.37	Service total costs	14		
88304	"Pathology examination of tissue using a microscope, moderately low complexity"	Service  intra	L033A	Lab Technician	0.33	Service total costs	10		
88304	"Pathology examination of tissue using a microscope, moderately low complexity"	Post-service	L033A	Lab Technician	0.33	Post service total costs	5		
88305		Pre-service	L033A	Lab Technician	0.33	Preservice total costs	0.5		
88305		Service  intra	L037B	Histotechnologist	0.37	Service total costs	16		
88305		Service  intra	L033A	Lab Technician	0.33	Service total costs	9		
88305		Post-service	L033A	Lab Technician	0.33	Post service total costs	4		
88307	"Pathology examination of tissue using a microscope, moderately high complexity"	Pre-service	L033A	Lab Technician	0.33	Preservice total costs	1		
88307	"Pathology examination of tissue using a microscope, moderately high complexity"	Service  intra	L037B	Histotechnologist	0.37	Service total costs	82		
88307	"Pathology examination of tissue using a microscope, moderately high complexity"	Service  intra	L033A	Lab Technician	0.33	Service total costs	28		
88307	"Pathology examination of tissue using a microscope, moderately high complexity"	Post-service	L033A	Lab Technician	0.33	Post service total costs	13		
88309	"Pathology examination of tissue using a microscope, high complexity"	Pre-service	L033A	Lab Technician	0.33	Preservice total costs	1		
88309	"Pathology examination of tissue using a microscope, high complexity"	Service  intra	L037B	Histotechnologist	0.37	Service total costs	111		
88309	"Pathology examination of tissue using a microscope, high complexity"	Service  intra	L033A	Lab Technician	0.33	Service total costs	27		
88309	"Pathology examination of tissue using a microscope, high complexity"	Post-service	L033A	Lab Technician	0.33	Post service total costs	13		
88311	Preparation of tissue for examination by removing any calcium present	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	15		
88312	Special stained specimen slides to identify organisms including interpretation and report	Pre-service	L037B	Histotechnologist	0.37	Preservice total costs	42		
88312	Special stained specimen slides to identify organisms including interpretation and report	Pre-service	L033A	Lab Technician	0.33	Preservice total costs	1		
88312	Special stained specimen slides to identify organisms including interpretation and report	Post-service	L033A	Lab Technician	0.33	Post service total costs	7		
88313	Special stained specimen slides to examine tissue including interpretation and report	Pre-service	L037B	Histotechnologist	0.37	Preservice total costs	38		
88313	Special stained specimen slides to examine tissue including interpretation and report	Pre-service	L033A	Lab Technician	0.33	Preservice total costs	1		
88313	Special stained specimen slides to examine tissue including interpretation and report	Post-service	L033A	Lab Technician	0.33	Post service total costs	7		
88314	Special stained specimen slides to examine tissue and frozen preparation of specimen including interpretation and report	Pre-service	L037B	Histotechnologist	0.37	Preservice total costs	41		
88314	Special stained specimen slides to examine tissue and frozen preparation of specimen including interpretation and report	Pre-service	L033A	Lab Technician	0.33	Preservice total costs	1		
88314	Special stained specimen slides to examine tissue and frozen preparation of specimen including interpretation and report	Post-service	L033A	Lab Technician	0.33	Post service total costs	11		
88319	Evaluation of specimen enzymes	Pre-service	L037B	Histotechnologist	0.37	Preservice total costs	57		
88319	Evaluation of specimen enzymes	Pre-service	L033A	Lab Technician	0.33	Preservice total costs	1		
88319	Evaluation of specimen enzymes	Post-service	L033A	Lab Technician	0.33	Post service total costs	12		
88321	Consultation and report on referred slides prepared elsewhere	Pre-service	L033A	Lab Technician	0.33	Accession specimen/prepare for examination	0		
88321	Consultation and report on referred slides prepared elsewhere	Pre-service	L033A	Lab Technician	0.33	"Open shipping package, remove and sort slides based on outside number, and hand label outside paperwork"	3		
88321	Consultation and report on referred slides prepared elsewhere	Pre-service	L033A	Lab Technician	0.33	"Register the patient in the information system, including all demographic and billing information.  In addition to standard accessioning, enter contributing physician name and address, number of slides and the outside case number, etc, into the laboratoy"	5		
88321	Consultation and report on referred slides prepared elsewhere	Service  intra	L037B	Histotechnologist	0.37	Phone calls for clarifications and/or additional materials	3		
88321	Consultation and report on referred slides prepared elsewhere	Post-service	L033A	Lab Technician	0.33	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88321	Consultation and report on referred slides prepared elsewhere	Post-service	L033A	Lab Technician	0.33	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	0		
88321	Consultation and report on referred slides prepared elsewhere	Post-service	L033A	Lab Technician	0.33	Securely package and return outside material.	5		
88323	Consultation and report on referred material requiring preparation of slides	Pre-service	L033A	Lab Technician	0.33	Accession specimen/prepare for examination	4		
88323	Consultation and report on referred material requiring preparation of slides	Pre-service	L033A	Lab Technician	0.33	"Open shipping package, remove and sort slides based on outside number, and hand label outside paperwork"	3		
88323	Consultation and report on referred material requiring preparation of slides	Pre-service	L033A	Lab Technician	0.33	"Register the patient in the information system, including all demographic and billing information.  In addition to standard accessioning, enter contributing physician name and address, number of slides and the outside case number, etc, into the laboratoy"	5		
88323	Consultation and report on referred material requiring preparation of slides	Service  intra	L037B	Histotechnologist	0.37	Assemble and deliver slides with paperwork to pathologists	0		
88323	Consultation and report on referred material requiring preparation of slides	Service  intra	L037B	Histotechnologist	0.37	Clean equipment while performing service	0		
88323	Consultation and report on referred material requiring preparation of slides	Service  intra	L037B	Histotechnologist	0.37	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist	1		
88323	Consultation and report on referred material requiring preparation of slides	Service  intra	L037B	Histotechnologist	0.37	Phone calls for clarifications and/or additional materials	3		
88323	Consultation and report on referred material requiring preparation of slides	Service  intra	L037B	Histotechnologist	0.37	"Prepare automated coverslipper, remove slides from stainer and place on coverslipper."	1		
88323	Consultation and report on referred material requiring preparation of slides	Service  intra	L037B	Histotechnologist	0.37	Prepare automated stainer with solutions and load microscopic slides. Set and confirm stainer program.	1		
88323	Consultation and report on referred material requiring preparation of slides	Service  intra	L037B	Histotechnologist	0.37	"Process specimen for slide preparation (includes processing, embedding, sectioning and recuts, centrifugation, routine and special staining, coverslipping, quality control function, maintaining specimen tracking, logs and labeling."	0		
88323	Consultation and report on referred material requiring preparation of slides	Service  intra	L037B	Histotechnologist	0.37	"Slide preparation sectioning and recuts, quality control function, maintaining specimen tracking, logs and labeling"	4		
88323	Consultation and report on referred material requiring preparation of slides	Post-service	L033A	Lab Technician	0.33	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88323	Consultation and report on referred material requiring preparation of slides	Post-service	L033A	Lab Technician	0.33	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88323	Consultation and report on referred material requiring preparation of slides	Post-service	L033A	Lab Technician	0.33	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	2		
88323	Consultation and report on referred material requiring preparation of slides	Post-service	L033A	Lab Technician	0.33	Securely package and return outside material.	5		
88325	"Consultation, comprehensive, with review of records and specimens, with report on referred material"	Pre-service	L033A	Lab Technician	0.33	Accession specimen/prepare for examination	0		
88325	"Consultation, comprehensive, with review of records and specimens, with report on referred material"	Pre-service	L033A	Lab Technician	0.33	"Open shipping package, remove and sort slides based on outside number, and hand label outside paperwork"	3		
88325	"Consultation, comprehensive, with review of records and specimens, with report on referred material"	Pre-service	L033A	Lab Technician	0.33	"Register the patient in the information system, including all demographic and billing information.  In addition to standard accessioning, enter contributing physician name and address, number of slides and the outside case number, etc, into the laboratoy"	5		
88325	"Consultation, comprehensive, with review of records and specimens, with report on referred material"	Service  intra	L037B	Histotechnologist	0.37	Assemble and deliver slides with paperwork to pathologists	1		
88325	"Consultation, comprehensive, with review of records and specimens, with report on referred material"	Service  intra	L037B	Histotechnologist	0.37	Clean equipment while performing service	0		
88325	"Consultation, comprehensive, with review of records and specimens, with report on referred material"	Service  intra	L037B	Histotechnologist	0.37	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist	0		
88325	"Consultation, comprehensive, with review of records and specimens, with report on referred material"	Service  intra	L037B	Histotechnologist	0.37	Phone calls for clarifications and/or additional materials	3		
88325	"Consultation, comprehensive, with review of records and specimens, with report on referred material"	Service  intra	L037B	Histotechnologist	0.37	"Prepare automated coverslipper, remove slides from stainer and place on coverslipper."	0		
88325	"Consultation, comprehensive, with review of records and specimens, with report on referred material"	Service  intra	L037B	Histotechnologist	0.37	Prepare automated stainer with solutions and load microscopic slides. Set and confirm stainer program.	0		
88325	"Consultation, comprehensive, with review of records and specimens, with report on referred material"	Service  intra	L037B	Histotechnologist	0.37	"Process specimen for slide preparation (includes processing, embedding, sectioning and recuts, centrifugation, routine and special staining, coverslipping, quality control function, maintaining specimen tracking, logs and labeling."	0		
88325	"Consultation, comprehensive, with review of records and specimens, with report on referred material"	Service  intra	L037B	Histotechnologist	0.37	"Slide preparation sectioning and recuts, quality control function, maintaining specimen tracking, logs and labeling"	0		
88325	"Consultation, comprehensive, with review of records and specimens, with report on referred material"	Post-service	L033A	Lab Technician	0.33	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88325	"Consultation, comprehensive, with review of records and specimens, with report on referred material"	Post-service	L033A	Lab Technician	0.33	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	0		
88325	"Consultation, comprehensive, with review of records and specimens, with report on referred material"	Post-service	L033A	Lab Technician	0.33	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	0		
88325	"Consultation, comprehensive, with review of records and specimens, with report on referred material"	Post-service	L033A	Lab Technician	0.33	Securely package and return outside material.	5		
88329	Pathology consultation during surgery;	Pre-service	L037B	Histotechnologist	0.37	Transport specimen from OR to frozen section suite	0		
88329	Pathology consultation during surgery;	Service  pre	L038B	Cardiovascular Technician	0.38	Assist pathologist with gross specimen examination	3		
88329	Pathology consultation during surgery;	Post-service	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88331	"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen"	Pre-service	L037B	Histotechnologist	0.37	Accession specimen/prepare for examination	4		
88331	"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen"	Pre-service	L033A	Lab Technician	0.33	"Prepare room. Filter and replenish stains and supplies. (including OCT blocks, set up grossing station with colored stains)"	0		
88331	"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen"	Pre-service	L037B	Histotechnologist	0.37	Transport specimen from OR to frozen section suite	0		
88331	"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen"	Service  pre	L037B	Histotechnologist	0.37	Assemble and deliver slides with paperwork to pathologists	0.5		
88331	"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen"	Service  pre	L037B	Histotechnologist	0.37	Assist pathologist with gross specimen examination	3		
88331	"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen"	Service  pre	L037B	Histotechnologist	0.37	Prepare specimen for manual/automated processing. (Remove frozen tissue material out of cryostate and placing in cassette)	0		
88331	"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen"	Service  pre	L037B	Histotechnologist	0.37	"Process specimen for slide preparation (includes processing, embedding, sectioning and recuts, centrifugation, routine and special staining, coverslipping, quality control function, maintaining specimen tracking, logs and labeling"	12		
88331	"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen"	Post-service	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88332	Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)	Pre-service	L033A	Lab Technician	0.33	"Prepare room. Filter and replenish stains and supplies. (including OCT blocks, set up grossing station with colored stains)"	0		
88332	Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)	Service  pre	L037B	Histotechnologist	0.37	Assemble and deliver slides with paperwork to pathologists	0.5		
88332	Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)	Service  pre	L037B	Histotechnologist	0.37	Assist pathologist with gross specimen examination	3		
88332	Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)	Service  pre	L037B	Histotechnologist	0.37	Prepare specimen for manual/automated processing. (Remove frozen tissue material out of cryostate and placing in cassette)	0		
88332	Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)	Service  pre	L037B	Histotechnologist	0.37	"Process specimen for slide preparation (includes processing, embedding, sectioning and recuts, centrifugation, routine and special staining, coverslipping, quality control function, maintaining specimen tracking, logs and labeling"	12		
88332	Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)	Service  post	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88333	"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site"	Pre-service	L037B	Histotechnologist	0.37	Accession specimen/prepare for examination	4		
88333	"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site"	Pre-service	L033A	Lab Technician	0.33	"Prepare room. Filter and replenish stains and supplies. (including OCT blocks, set up grossing station with colored stains)"	0		
88333	"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site"	Service  pre	L037B	Histotechnologist	0.37	Assemble and deliver slides with paperwork to pathologists	0.5		
88333	"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site"	Service  pre	L037B	Histotechnologist	0.37	Assist pathologist with gross specimen examination (including performance of intraoperative frozen sections)	3		
88333	"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site"	Service  pre	L037B	Histotechnologist	0.37	"Process specimen for slide preparation (includes staining, coverslipping, quality control function, maintaining specimen tracking, logs and labeling)"	6		
88333	"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site"	Service  post	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88334	"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)"	Service  pre	L037B	Histotechnologist	0.37	Assemble and deliver slides with paperwork to pathologists	0.5		
88334	"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)"	Service  pre	L037B	Histotechnologist	0.37	Assist pathologist with gross specimen examination (including performance of intraoperative frozen sections)	3		
88334	"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)"	Service  pre	L037B	Histotechnologist	0.37	"Process specimen for slide preparation (includes staining, coverslipping, quality control function, maintaining specimen tracking, logs and labeling)"	6		
88334	"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)"	Post-service	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88341	Immunohistochemistry or immunocytochemistry per specimen;each multiplex antibody stain procedure	Pre-service	L033A	Lab Technician	0.33	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist.	0.5		
88341	Immunohistochemistry or immunocytochemistry per specimen;each multiplex antibody stain procedure	Pre-service	L037B	Histotechnologist	0.37	"Cut patient tissue and place on slide to include the following:
 - Section paraffin block in microtome, place section in water bath…"	1		
88341	Immunohistochemistry or immunocytochemistry per specimen;each multiplex antibody stain procedure	Pre-service	L037B	Histotechnologist	0.37	Cut positive control tissue and place on slide	3		
88341	Immunohistochemistry or immunocytochemistry per specimen;each multiplex antibody stain procedure	Pre-service	L033A	Lab Technician	0.33	"Dehydrate to xylene through progressive alcohols, clear and coverslip by hand with permanent mounting media"	1		
88341	Immunohistochemistry or immunocytochemistry per specimen;each multiplex antibody stain procedure	Pre-service	L037B	Histotechnologist	0.37	"Enter patient data, computational prep for antibody testing, generate and apply bar codes to slides, and enter data for automated slide stainer"	0.5		
88341	Immunohistochemistry or immunocytochemistry per specimen;each multiplex antibody stain procedure	Pre-service	L037B	Histotechnologist	0.37	"Load the primary antibody (load secondary if applicable), detection kit dispensers and required reagents onto the reagent tray and place the tray on the automated slide stainer.  Load the slides onto the automated slide stainer…"	2		
88341	Immunohistochemistry or immunocytochemistry per specimen;each multiplex antibody stain procedure	Pre-service	L033A	Lab Technician	0.33	"Place slides in oven and incubate for 60 minutes, remove from oven, set timer"	1		
88341	Immunohistochemistry or immunocytochemistry per specimen;each multiplex antibody stain procedure	Pre-service	L037B	Histotechnologist	0.37	"Prepare positive control block to include the following: Confirm control tissue ID. Embed tissue in paraffin. Take cassette out of embedding chamber, open cassette, put paraffin in bottom of embedding mold, embed tissue…"	0.15		
88341	Immunohistochemistry or immunocytochemistry per specimen;each multiplex antibody stain procedure	Pre-service	L037B	Histotechnologist	0.37	Pull and verify tissue block and control block	0.5		
88341	Immunohistochemistry or immunocytochemistry per specimen;each multiplex antibody stain procedure	Pre-service	L033A	Lab Technician	0.33	Remove slides from automated slide stainer. Rinse slides in soapy water to remove the coverslip material.  Load slides on to cover rack.	1		
88341	Immunohistochemistry or immunocytochemistry per specimen;each multiplex antibody stain procedure	Pre-service	L037B	Histotechnologist	0.37	Review positive and negative control slides	1		
88341	Immunohistochemistry or immunocytochemistry per specimen;each multiplex antibody stain procedure	Post-service	L033A	Lab Technician	0.33	Clean equipment and work station in histology lab	0.5		
88341	Immunohistochemistry or immunocytochemistry per specimen;each multiplex antibody stain procedure	Post-service	L033A	Lab Technician	0.33	Hazardous waste disposal	1		
88341	Immunohistochemistry or immunocytochemistry per specimen;each multiplex antibody stain procedure	Post-service	L033A	Lab Technician	0.33	Recycle xylene from tissue processor and stainer	1		
88341	Immunohistochemistry or immunocytochemistry per specimen;each multiplex antibody stain procedure	Post-service	L037B	Histotechnologist	0.37	"Refile block, unload and store antibody, detection kit and reagents"	1		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Pre-service	L033A	Lab Technician	0.33	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist.	1		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Pre-service	L037B	Histotechnologist	0.37	Cut patient tissue and place on negative control slide	1		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Pre-service	L037B	Histotechnologist	0.37	"Cut patient tissue and place on slide to include the following:
 - Section paraffin block in microtome, place section in water bath…"	3		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Pre-service	L037B	Histotechnologist	0.37	Cut positive control tissue and place on slide	3		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Pre-service	L033A	Lab Technician	0.33	"Dehydrate to xylene through progressive alcohols, clear and coverslip by hand with permanent mounting media"	1		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Pre-service	L037B	Histotechnologist	0.37	"Enter patient data, computational prep for antibody testing, generate and apply bar codes to slides, and enter data for automated slide stainer"	5		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Pre-service	L037B	Histotechnologist	0.37	"Load the primary antibody (load secondary if applicable), detection kit dispensers and required reagents onto the reagent tray and place the tray on the automated slide stainer.  Load the slides onto the automated slide stainer…"	3		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Pre-service	L033A	Lab Technician	0.33	"Place slides in oven and incubate for 60 minutes, remove from oven, set timer"	1		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Pre-service	L037B	Histotechnologist	0.37	"Prepare positive control block to include the following: Confirm control tissue ID. Embed tissue in paraffin. Take cassette out of embedding chamber, open cassette, put paraffin in bottom of embedding mold, embed tissue…"	0.15		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Pre-service	L037B	Histotechnologist	0.37	Pull and verify tissue block and control block	1		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Pre-service	L033A	Lab Technician	0.33	Remove slides from automated slide stainer. Rinse slides in soapy water to remove the coverslip material.  Load slides on to cover rack.	1		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Pre-service	L037B	Histotechnologist	0.37	Review positive and negative control slides	1		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Pre-service	L033A	Lab Technician	0.33	Verify order and accession immunohistochemical stain order in laboratory information system	1		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Post-service	L033A	Lab Technician	0.33	Clean equipment and work station in histology lab	4		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Post-service	L033A	Lab Technician	0.33	Hazardous waste disposal	1		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Post-service	L033A	Lab Technician	0.33	Recycle xylene from tissue processor and stainer	1		
88342	Immunohistochemistry or immunocytochemistry per specimen;each additional single antibody stain procedure	Post-service	L037B	Histotechnologist	0.37	"Refile block, unload and store antibody, detection kit and reagents"	2		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Pre-service	L033A	Lab Technician	0.33	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist.	1		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Cut patient tissue and place on negative control slide	1		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Cut patient tissue and place on slide to include the following:
 - Section paraffin block in microtome, place section in water bath…"	3		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Cut positive control tissue and place on slide	3		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Pre-service	L033A	Lab Technician	0.33	"Dehydrate to xylene through progressive alcohols, clear and coverslip by hand with permanent mounting media"	1		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Enter patient data, computational prep for antibody testing, generate and apply bar codes to slides, and enter data for automated slide stainer"	5		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Load the primary antibody (load secondary if applicable), detection kit dispensers and required reagents onto the reagent tray and place the tray on the automated slide stainer.  Load the slides onto the automated slide stainer…"	5		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Pre-service	L033A	Lab Technician	0.33	"Place slides in oven and incubate for 60 minutes, remove from oven, set timer"	1		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Prepare positive control block to include the following: Confirm control tissue ID. Embed tissue in paraffin. Take cassette out of embedding chamber, open cassette, put paraffin in bottom of embedding mold, embed tissue…"	0.15		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Pull and verify tissue block and control block	1		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Pre-service	L033A	Lab Technician	0.33	Remove slides from automated slide stainer. Rinse slides in soapy water to remove the coverslip material.  Load slides on to cover rack.	1		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Review positive and negative control slides	1		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Pre-service	L033A	Lab Technician	0.33	Verify order and accession immunohistochemical stain order in laboratory information system	1		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Post-service	L033A	Lab Technician	0.33	Clean equipment and work station in histology lab	4		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Post-service	L033A	Lab Technician	0.33	Hazardous waste disposal	1		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Post-service	L033A	Lab Technician	0.33	Recycle xylene from tissue processor and stainer	1		
88344	"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure"	Post-service	L037B	Histotechnologist	0.37	"Refile block, unload and store antibody, detection kit and reagents"	3		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Pre-service	L033A	Lab Technician	0.33	"Accession specimen verify order, prepare for examination"	1		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Assist pathologist with gross specimen examination	1		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Freeze specimen, section block, label slides, perform H&E slide staining, coverslipping, quality control function, maintaining specimen tracking, logs, and labeling."	12		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Wash specimen, received in Zeus transport media, with 20 ml of Zeus washing solution for 30 minutes with gentle agitation. Includes preparation of magnetic stirrer, beaker for washing."	5		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Service  intra	L037B	Histotechnologist	0.37	"Allow the tissues to incubate for 30 minutes at room temperature.  Remove the slides from the folder, allow the excess antibody to run off onto a paper towel and tap the long edge of the slide to remove remaining droplets…"	6		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Service  intra	L037B	Histotechnologist	0.37	Assemble and deliver paperwork and  H&E and fluourescent stained slides with paperwork to pathologist	2		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Service  intra	L037B	Histotechnologist	0.37	Cut negative control tissue and place on slide	1		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Service  intra	L037B	Histotechnologist	0.37	Cut positive control tissue and place on slide	1		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Service  intra	L037B	Histotechnologist	0.37	"Immediately prior to staining, slides are fixed in acetone for 10 minutes.  Allow slides to dry for 5 minutes.  Draw a circle around each section with a PAP Pen to keep the antibodies on the tissue.  Allow the PAP Pen to dry for 5 minutes before con…"	10		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Service  intra	L037B	Histotechnologist	0.37	"Mix reagent solutions for dilution of antibodies and check pH, prepare and dispense PBS buffer"	1		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Service  intra	L037B	Histotechnologist	0.37	Place the slides in the plastic slide folder on a level counter so the antibody will stay on the tissue when applied.  Pipette each antibody onto the appropriate section of the slides including the controls.  Be sure each tissue is covered with antibod…	6		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Service  intra	L037B	Histotechnologist	0.37	Prepare positive control block by freezing control tissue on frozen tissue block and store at -70C.	0.15		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Service  intra	L037B	Histotechnologist	0.37	"Remove frozen block from cyostat, place in freezer at -70, Record place location in freezer in log book. (patient tissue block/sample)"	1		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Service  post	L033A	Lab Technician	0.33	Clean equipment and work station in histology lab and crytostat.	4		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Service  post	L033A	Lab Technician	0.33	Hazardous waste disposal	1		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Service  post	L037B	Histotechnologist	0.37	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88346	"Immunofluorescence, per specimen; initial single antibody stain procedure"	Service  post	L033A	Lab Technician	0.33	Recycle xylene from stainer	1		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Accession specimen in electron microscopy laboratory computer system.	2		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Affix labels to toluidine blue slides and examine under light microscopy access for adequacy.  Recut and/or retain slides as necessary.  Collate stained slides and paperwork and place in labeled case folder.	3		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	"Collate printed images, plastic sections, and place in labeled file folder."	3		
88348	Electron microscopy	Pre-service	L033A	Lab Technician	0.33	Collect electron micrographs from photographic laboratory and transport back to electron microscopy laboratory.	5		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Cut resin blocks on microtome to make one micron sections and place on labeled microscopic slides.	20		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Cut thin sections on diamond knife from block selected by pathologist.	20		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Deliver case folder including plastic sections and paperwork to pathologist and review plastic sections with pathologist.	10		
88348	Electron microscopy	Pre-service	L033A	Lab Technician	0.33	Deliver prints and slides to pathologist.	1		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Dilute 25% concentrated glutaraldehyde solution into working 3.75% buffered solution. Fill and label specimen containers with glutaraldehyde and distribute to surgical pathology grossing station.	3		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Embed tissue in resin molds.Place blocks in oven for partial resin polymerization.	3		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Examine blocks under light microscope to identify glomeruli.	4		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	"Examine tissue specimen under dissecting microscope and section into appropriately sized pieces for processing, wrap specimens in lens tissue and place into processor baskets with identification numbers.  Place baskets into processor vial."	10		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Face off tissue blocks on milling machine. Trim excess polymerized resin from sides of faced block to form pyramidal blocks that can be cut using microtome.	8		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Insert grid into staining rings.	1		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Load tissue processor with specimens and start processor.	2		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	"Perform measurements on glomerular basement membranes (30 separate foci), enter into excel spread sheet, average measurements, and print for inclusions in file folder."	20		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Place thin sections on labeled electron microscopic grids.  Place grids into appropriately labeled petri dishes.	3		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Prepare and load solutions onto tissue processor.	10		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Prepare and mix resin for EM tissue blocks.	10		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Prepare glass knifes for thick sectioning.	2		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	"Prepare instrument for carbon coating procedure.  Prepare carbon rod, insert into carbon evaporator, arrange petri dishes so that grids will receive ample carbon coating. Lower bell jar and prepump and pump system…"	22		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	"Prepare specimen labels for tissue block storage, EM grid identification, toluidine blue slide labels, and EM print file folder.  Prepare and label patient specimen boxes for storage of blocks."	5		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Prepare toluidine blue staining solution for staining thick sections.	5		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Prepare uranyl acetate and lead citrate staining solutions.	5		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Print electron microscopic images from digital files.	5		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Program tissue processor and perform quality control functions.	5		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	"Put resin into block molds, and add patient identifying number into resin mold."	1		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Remove completely polymerized tissue blocks from oven and trim blocks.	8		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Remove partially polymerized tissue blocks from oven and reposition tissue to center of embedding mold.  Return tissue blocks to oven.	3		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Remove tissue from processor.	2		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Retrieve liquid nitrogen from storage dewar (-70C solution) and place in electron microscope cooling chamber.	5		
88348	Electron microscopy	Pre-service	L033A	Lab Technician	0.33	Retrieve specimen from surgical pathology laboratory and transport to electron microscopy laboratory.	1		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Stain microscopic slides while applying heat to achieve proper metachromatic staining effect.	8		
88348	Electron microscopy	Pre-service	L045B	Electron Microscopy Technologist	0.45	Stain thin sections with uranyl acetate and lead citrate  Place petri dishes in oven.	10		
88348	Electron microscopy	Post-service	L033A	Lab Technician	0.33	Clean room/equipment by physician staff	3		
88348	Electron microscopy	Post-service	L033A	Lab Technician	0.33	Dispose of tissue trimmings. Dispose of used chemicals	1		
88348	Electron microscopy	Post-service	L033A	Lab Technician	0.33	File glass slides from plastic sections.  File electron microscopic prints.	2		
88350	"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)"	Pre-service	L037B	Histotechnologist	0.37	"Freeze specimen, section block, label slides, perform H&E slide staining, coverslipping, quality control function, maintaining specimen tracking, logs, and labeling."	1		
88350	"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)"	Service  intra	L037B	Histotechnologist	0.37	"Allow the tissues to incubate for 30 minutes at room temperature.  Remove the slides from the folder, allow the excess antibody to run off onto a paper towel and tap the long edge of the slide to remove remaining droplets…"	6		
88350	"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)"	Service  intra	L037B	Histotechnologist	0.37	Cut positive control tissue and place on slide	1		
88350	"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)"	Service  intra	L037B	Histotechnologist	0.37	"Immediately prior to staining, slides are fixed in acetone for 10 minutes.  Allow slides to dry for 5 minutes.  Draw a circle around each section with a PAP Pen to keep the antibodies on the tissue.  Allow the PAP Pen to dry for 5 minutes before con…"	10		
88350	"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)"	Service  intra	L037B	Histotechnologist	0.37	"Mix reagent solutions for dilution of antibodies and check pH, prepare and dispense PBS buffer"	1		
88350	"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)"	Service  intra	L037B	Histotechnologist	0.37	Place the slides in the plastic slide folder on a level counter so the antibody will stay on the tissue when applied.  Pipette each antibody onto the appropriate section of the slides including the controls.  Be sure each tissue is covered with antibod…	6		
88350	"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)"	Service  intra	L037B	Histotechnologist	0.37	Prepare positive control block by freezing control tissue on frozen tissue block and store at -70C.	0.15		
88350	"Immunofluorescence, per specimen; each additional single antibody stain procedure (List separately in addition to code for primary procedure)"	Service  post	L033A	Lab Technician	0.33	Hazardous waste disposal	1		
88355	Morphometric analysis; skeletal muscle	Pre-service	L033A	Lab Technician	0.33	Accession specimen/prepare for examination	4		
88355	Morphometric analysis; skeletal muscle	Pre-service	L033A	Lab Technician	0.33	Prepare specimen containers/preload fixative/label containers/distribute requisition form(s) to physician	5		
88355	Morphometric analysis; skeletal muscle	Pre-service	L033A	Lab Technician	0.33	"Receive phone call from referring laboratory/facility with scheduled procedure to arrange special delivery of specimen procurement kit, including muscle biopsy clamp as needed."	5		
88355	Morphometric analysis; skeletal muscle	Service  pre	L033A	Lab Technician	0.33	Assemble and deliver slides with paperwork to pathologists	0.5		
88355	Morphometric analysis; skeletal muscle	Service  pre	L037B	Histotechnologist	0.37	Assist pathologist with gross examination.	3		
88355	Morphometric analysis; skeletal muscle	Service  pre	L037B	Histotechnologist	0.37	Measure and snap freeze fresh saline specimen for histochemistry.	10		
88355	Morphometric analysis; skeletal muscle	Service  pre	L033A	Lab Technician	0.33	"Measure specimen and fix on muscle/nerve clamp in Karnovskys fixative for 8-12 hours.  After fixation, cut cross and longitudinal sections for histologic sections and retain portion for possible additional EM or nerve teasing studies."	5		
88355	Morphometric analysis; skeletal muscle	Service  pre	L037B	Histotechnologist	0.37	Prepare specimen for manual/automated processing. (Remove frozen tissue material out of cryostate and placing in cassette)	0		
88355	Morphometric analysis; skeletal muscle	Service  pre	L037B	Histotechnologist	0.37	"Process specimen for slide preparation (includes processing, embedding, sectioning and recuts, centrifugation, routine and special staining, coverslipping, quality control function, maintaining specimen tracking, logs and labeling"	24		
88355	Morphometric analysis; skeletal muscle	Service  post	L033A	Lab Technician	0.33	"Clean room, equipment following procedure including any equipment maintenance that must be done after the procedure."	1		
88355	Morphometric analysis; skeletal muscle	Service  post	L033A	Lab Technician	0.33	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88355	Morphometric analysis; skeletal muscle	Service  post	L033A	Lab Technician	0.33	"Prepare specimen for -70 degree storage, log specimen and place in freezer for retrieval and performance of quantitative enzyme/protein studies if needed.  Store minimum of 1 year."	0		
88355	Morphometric analysis; skeletal muscle	Service  post	L033A	Lab Technician	0.33	"Prepare, pack and transport specimens and records for storage."	3		
88356	Morphometric analysis; nerve	Pre-service	L033A	Lab Technician	0.33	Accession specimen/prepare for examination	3		
88356	Morphometric analysis; nerve	Pre-service	L045B	Electron Microscopy Technologist	0.45	"EM - lab prepares containers  by mixing solutions, labeling and prefilling with fixative."	10		
88356	Morphometric analysis; nerve	Pre-service	L045B	Electron Microscopy Technologist	0.45	"EM-lab prepares labels, requisitions, billing forms.  Verifies order worksheet."	5		
88356	Morphometric analysis; nerve	Pre-service	L045B	Electron Microscopy Technologist	0.45	EM-retrieves specimen from receiving workstation or storage area.  Accession specimen and evaluate specimen quality.	1		
88356	Morphometric analysis; nerve	Pre-service	L033A	Lab Technician	0.33	Prepare specimen containers/preload fixative/label containers/distribute requisition form(s) to physician	6.5		
88356	Morphometric analysis; nerve	Service  pre	L033A	Lab Technician	0.33	Assemble and deliver slides with paperwork to pathologists	2		
88356	Morphometric analysis; nerve	Service  pre	L037B	Histotechnologist	0.37	Assist pathologist with gross specimen examination	10		
88356	Morphometric analysis; nerve	Service  pre	L045B	Electron Microscopy Technologist	0.45	"Fixes specimen in glutaraldehyde, washes 3 times, dehydrates, mixes resin and infiltrates specimen with resin.
Labels blocks (types labels, prints, cuts, puts into capsules/molds, logs into book). Places specimen into capsules/molds, orients and trims…"	96		
88356	Morphometric analysis; nerve	Service  pre	L033A	Lab Technician	0.33	"Under dissecting microscope, after fixation, cut cross and longitudinal sections for histologic sections and retain portion for possible additional EM or nerve teasing studies."	5		
88356	Morphometric analysis; nerve	Post-service	L033A	Lab Technician	0.33	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	3		
88356	Morphometric analysis; nerve	Post-service	L033A	Lab Technician	0.33	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88356	Morphometric analysis; nerve	Post-service	L033A	Lab Technician	0.33	File glass slides from plastic sections.  File electron microscopic prints.	2		
88356	Morphometric analysis; nerve	Post-service	L033A	Lab Technician	0.33	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	3		
88358	Microscopic genetic analysis of tumor	Pre-service	L033A	Lab Technician	0.33	Preservice total costs	1		
88358	Microscopic genetic analysis of tumor	Service  intra	L037B	Histotechnologist	0.37	Service total costs	29		
88358	Microscopic genetic analysis of tumor	Post-service	L033A	Lab Technician	0.33	Post service total costs	4		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Pre-service	L037B	Histotechnologist	0.37	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist.	1		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Pre-service	L037B	Histotechnologist	0.37	Cut patient tissue and place on negative control slide	1		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Pre-service	L037B	Histotechnologist	0.37	"Cut patient tissue and place on slide to include the following:
 - Section paraffin block in microtome, place section in water bath; label and place on microscopic slide from waterbath includes change and insert knife, rough-cut block."	3		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Pre-service	L037B	Histotechnologist	0.37	Cut positive control tissue and place on slide	3		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Pre-service	L033A	Lab Technician	0.33	"Dehydrate to xylene through progressive alcohols, clear and coverslip by hand with permanent mounting media"	1		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Pre-service	L037B	Histotechnologist	0.37	"Enter patient data, computational prep for antibody testing, generate and apply bar codes to slides, and enter data for automated slide stainer"	1		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Pre-service	L037B	Histotechnologist	0.37	Load slides on automatic image analyzer. Cardona to check all steps here. - sop to us.	1		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Pre-service	L037B	Histotechnologist	0.37	"Load the primary antibody (load secondary if applicable), detection kit dispensers and required reagents onto the reagent tray and place the tray on the automated slide stainer.  Load the slides onto the automated slide stainer…"	3		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Pre-service	L033A	Lab Technician	0.33	"Place slides in oven and incubate for 60 minutes, remove from oven, set timer"	1		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Pre-service	L037B	Histotechnologist	0.37	"Prepare positive control block to include the following: Confirm control tissue ID. Embed tissue in paraffin. Take cassette out of embedding chamber, open cassette, put paraffin in bottom of embedding mold, embed tissue…"	0.15		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Pre-service	L037B	Histotechnologist	0.37	Pull and verify tissue block and control block	1		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Pre-service	L033A	Lab Technician	0.33	Remove slides from automated slide stainer. Rinse slides in soapy water to remove the coverslip material.  Load slides on to cover rack.	1		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Pre-service	L033A	Lab Technician	0.33	Retrieves the blocks and slides for review and selection of the appropriate block for slide preparation for morphometric analysis.	0		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Pre-service	L037B	Histotechnologist	0.37	Review positive and negative control slides	1		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Pre-service	L033A	Lab Technician	0.33	Verify order and accession immunohistochemical stain order in laboratory information system	1		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Service  pre	L037B	Histotechnologist	0.37	Assemble and deliver slides with paperwork to pathologists	0		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Service  post	L037B	Histotechnologist	0.37	Clean equipment and work station in histology lab and crytostat.	4		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Service  post	L033A	Lab Technician	0.33	Hazardous waste disposal	1		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Service  post	L037B	Histotechnologist	0.37	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Service  post	L037B	Histotechnologist	0.37	"Refile block, unload and store antibody, detection kit, and reagents"	2		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Service  post	L037B	Histotechnologist	0.37	Verify results and complete work load recording logs	0		
88360	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; manual"	Post-service	L033A	Lab Technician	0.33	Recycle xylene from tissue processor and stainer	0		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Pre-service	L037B	Histotechnologist	0.37	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist.	1		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Pre-service	L037B	Histotechnologist	0.37	Cut patient tissue and place on negative control slide	1		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Pre-service	L037B	Histotechnologist	0.37	"Cut patient tissue and place on slide to include the following:
 - Section paraffin block in microtome, place section in water bath; label and place on microscopic slide from waterbath includes change and insert knife, rough-cut block."	3		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Pre-service	L037B	Histotechnologist	0.37	Cut positive control tissue and place on slide	3		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Pre-service	L033A	Lab Technician	0.33	"Dehydrate to xylene through progressive alcohols, clear and coverslip by hand with permanent mounting media"	1		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Pre-service	L037B	Histotechnologist	0.37	"Enter patient data, computational prep for antibody testing, generate and apply bar codes to slides, and enter data for automated slide stainer"	1		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Pre-service	L037B	Histotechnologist	0.37	Load slides on automatic image analyzer. Cardona to check all steps here. - sop to us.	1		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Pre-service	L037B	Histotechnologist	0.37	"Load the primary antibody (load secondary if applicable), detection kit dispensers and required reagents onto the reagent tray and place the tray on the automated slide stainer.  Load the slides onto the automated slide stainer…"	3		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Pre-service	L033A	Lab Technician	0.33	"Place slides in oven and incubate for 60 minutes, remove from oven, set timer"	1		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Pre-service	L037B	Histotechnologist	0.37	"Prepare positive control block to include the following: Confirm control tissue ID. Embed tissue in paraffin. Take cassette out of embedding chamber, open cassette, put paraffin in bottom of embedding mold, embed tissue…"	0.15		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Pre-service	L037B	Histotechnologist	0.37	Pull and verify tissue block and control block	1		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Pre-service	L033A	Lab Technician	0.33	Remove slides from automated slide stainer. Rinse slides in soapy water to remove the coverslip material.  Load slides on to cover rack.	1		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Pre-service	L033A	Lab Technician	0.33	Retrieves the blocks and slides for review and selection of the appropriate block for slide preparation for morphometric analysis.	0		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Pre-service	L037B	Histotechnologist	0.37	Review positive and negative control slides	1		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Pre-service	L033A	Lab Technician	0.33	Verify order and accession immunohistochemical stain order in laboratory information system	1		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Service  pre	L037B	Histotechnologist	0.37	Assemble and deliver slides with paperwork to pathologists	0		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Service  post	L037B	Histotechnologist	0.37	"Refile block, unload and store antibody, detection kit, and reagents"	2		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Post-service	L033A	Lab Technician	0.33	Clean equipment and work station in histology lab	4		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Post-service	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Post-service	L033A	Lab Technician	0.33	Hazardous waste disposal	1		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Post-service	L037B	Histotechnologist	0.37	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Post-service	L033A	Lab Technician	0.33	Recycle xylene from tissue processor and stainer	0		
88361	"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, each antibody; using computer-assisted technology"	Post-service	L037B	Histotechnologist	0.37	Verify results and complete work load recording logs	0		
88362	Nerve teasing preparations	Pre-service	L037B	Histotechnologist	0.37	Accession specimen and prepare for examination	4		
88362	Nerve teasing preparations	Pre-service	L037B	Histotechnologist	0.37	Collect specimen from OR or coordinate delivery of fresh specimen.	5		
88362	Nerve teasing preparations	Pre-service	L037B	Histotechnologist	0.37	"Consult with pathologist regarding representation needed, block selection and appropriate technique."	0		
88362	Nerve teasing preparations	Pre-service	L037B	Histotechnologist	0.37	Prepare specimen containers/preload fixative/label containers/distribute requisition form(s) to physician	5		
88362	Nerve teasing preparations	Service  pre	L033A	Lab Technician	0.33	Assemble and deliver cedar mounted slides with paperwork to pathologists	0.5		
88362	Nerve teasing preparations	Service  pre	L037B	Histotechnologist	0.37	Assemble and deliver slides with paperwork to pathologists	0		
88362	Nerve teasing preparations	Service  pre	L037B	Histotechnologist	0.37	"Assemble images, light microscopy interpretations, and other materials, discribe and prsent to pathologist for review."	0		
88362	Nerve teasing preparations	Service  pre	L033A	Lab Technician	0.33	"Assemble other light microscopy slides, epon nerve biopsy slides, and clinical history, and present to pathologist to prepare clinical pathologic interpretation."	0.5		
88362	Nerve teasing preparations	Service  pre	L037B	Histotechnologist	0.37	"Assist pathologist with gross specimen examination including the following; 
A ; Selection of fresh unfixed tissue sample; 
B; selection of tissue for formulant fixation for parrifn blocking and epon blocking."	5		
88362	Nerve teasing preparations	Service  pre	L045B	Electron Microscopy Technologist	0.45	Clean room/equipment while performing service	0		
88362	Nerve teasing preparations	Service  pre	L037B	Histotechnologist	0.37	Clean room/equipment while performing service	0		
88362	Nerve teasing preparations	Service  pre	L033A	Lab Technician	0.33	Preparation: labeling of blocks and containers and document location and processor used.	0.5		
88362	Nerve teasing preparations	Service  pre	L037B	Histotechnologist	0.37	"Prepare nerve for teasing: A: Strip epineurium from nerve B: Osmicate the nerve C; under a disection microscope, tease individual axons from nerve fascicle; D: Place axon onto cedar oil prepared glass slide, repeat 40-50 times. E: Coverslip"	70		
88362	Nerve teasing preparations	Service  pre	L045B	Electron Microscopy Technologist	0.45	"Process specimen for slide preparation (includes processing, embedding, sectioning and recuts, centrifugation, routine and special staining, coverslipping, quality control function, maintaining specimen tracking, logs and labeling"	0		
88362	Nerve teasing preparations	Service  pre	L037B	Histotechnologist	0.37	"Process specimen for slide review, includes coverslipping, quality control function, maintaining specimen tracking logs and labeling"	5		
88362	Nerve teasing preparations	Post-service	L045B	Electron Microscopy Technologist	0.45	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	0		
88362	Nerve teasing preparations	Post-service	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	0		
88362	Nerve teasing preparations	Post-service	L033A	Lab Technician	0.33	Clean room/equipment following procedure (including dissecting microscope and dissection work area. Cedar oil specific clean up including and all tools.	1		
88362	Nerve teasing preparations	Post-service	L045B	Electron Microscopy Technologist	0.45	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	0		
88362	Nerve teasing preparations	Post-service	L037B	Histotechnologist	0.37	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88362	Nerve teasing preparations	Post-service	L045B	Electron Microscopy Technologist	0.45	Manage any relevant utilization review/quality assurance activities and regulatory compliance documentation.	0		
88362	Nerve teasing preparations	Post-service	L037B	Histotechnologist	0.37	Manage any relevant utilization review/quality assurance activities and regulatory compliance documentation.	0		
88362	Nerve teasing preparations	Post-service	L037B	Histotechnologist	0.37	"Prepare, pack and transport cedar oiled glass slides and records for in-house special storage (need to be stored flat)"	0		
88362	Nerve teasing preparations	Post-service	L037B	Histotechnologist	0.37	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88362	Nerve teasing preparations	Post-service	L037B	Histotechnologist	0.37	"Storage remaining specimen. (Osmicated nerve strands, potential for additional teased specimens)"	0		
88362	Nerve teasing preparations	Post-service	L037B	Histotechnologist	0.37	Submit/receive material for consultation (where applicable)	0		
88363	Microscopic genetic analysis of tissue	Pre-service	L033A	Lab Technician	0.33	Preservice total costs	6	0	
88363	Microscopic genetic analysis of tissue	Post-service	L033A	Lab Technician	0.33	Post service total costs	2	0	
88364	"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Pre-service	L037B	Histotechnologist	0.37	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist.	0.5		
88364	"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Pre-service	L037B	Histotechnologist	0.37	Examine signals in each cell and generate data for the pathologist to interpret	10		
88364	"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Pre-service	L037B	Histotechnologist	0.37	Photograph and print samples	5		
88364	"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Pre-service	L037B	Histotechnologist	0.37	"Prepare reagents and equipment.  Re-cut paraffin blocks and bake slides. Deparaffinize, treat with HCL, wash. Treat with enzyme, wash and rehydrate.  Apply DNA probe mixture to positive, negative control and patient’s slide…"	14		
88364	"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Pre-service	L037B	Histotechnologist	0.37	Signal Enumeration: Verify and QC controls and slide adequacy.	3		
88364	"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Post-service	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	0		
88364	"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Post-service	L037B	Histotechnologist	0.37	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	0.5		
88364	"In situ hybridization (eg, FISH), per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Post-service	L037B	Histotechnologist	0.37	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88365	"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist.	1		
88365	"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Examine signals in each cell and generate data for the pathologist to interpret	10		
88365	"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Gather all the relevant slides, prior report, and history on the patient for the pathologist to review to choose the region of interest on the slide"	4		
88365	"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Photograph and print samples	7		
88365	"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Prepare reagents and equipment.  Re-cut paraffin blocks and bake slides. Deparaffinize, treat with HCL, wash. Treat with enzyme, wash and rehydrate.  Apply DNA probe mixture to positive, negative control and patient’s slide…"	43		
88365	"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Retrieve and accession specimen	1.5		
88365	"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Signal Enumeration: Verify and QC controls and slide adequacy.	3		
88365	"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88365	"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88365	"In situ hybridization (eg, FISH), per specimen; initial single probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	2		
88366	"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist.	1		
88366	"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Examine signals in each cell and generate data for the pathologist to interpret	15		
88366	"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Gather all the relevant slides, prior report, and history on the patient for the pathologist to review to choose the region of interest on the slide"	4		
88366	"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Photograph and print samples	7		
88366	"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Prepare reagents and equipment.  Re-cut paraffin blocks and bake slides. Deparaffinize, treat with HCL, wash. Treat with enzyme, wash and rehydrate.  Apply DNA probe mixture to positive, negative control and patient’s slide…"	43		
88366	"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Retrieve and accession specimen	1.5		
88366	"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Signal Enumeration: Verify and QC controls and slide adequacy.	4.5		
88366	"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88366	"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88366	"In situ hybridization (eg, FISH), per specimen; each multiplex probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	2		
88367	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen: initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist.	1		
88367	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen: initial single probe stain procedure"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Gather all the relevant slides, prior report, and history on the patient for the pathologist to review to choose the region of interest on the slide"	4		
88367	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen: initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Load slides on Auto Vysis Scanner, and enter slide IDs.    After pathologist has verified fields of interest, select the fields to be scanned."	4		
88367	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen: initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Photograph and print samples	1		
88367	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen: initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Prepare reagents and equipment.  Re-cut paraffin blocks and bake slides. Deparaffinize, treat with HCL, wash. Treat with enzyme, wash and rehydrate.  Apply DNA probe mixture to positive, negative control and patient’s slide…"	32		
88367	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen: initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Retrieve and accession specimen	1.5		
88367	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen: initial single probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88367	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen: initial single probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88367	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen: initial single probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	2		
88368	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist.	1		
88368	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; initial single probe stain procedure"	Pre-service	L035A	Lab Tech/Histotechnologist	0.35	"Gather all the relevant slides, prior report, and history on the patient for the pathologist to review to choose the region of interest on the slide"	4		
88368	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Photograph and print samples	7		
88368	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Prepare reagents and equipment.  Re-cut paraffin blocks and bake slides. Deparaffinize, treat with HCL, wash. Treat with enzyme, wash and rehydrate.  Apply DNA probe mixture to positive, negative control and patient’s slide…"	43		
88368	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Retrieve and accession specimen	1.5		
88368	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Signal Enumeration: Count signals in malignant cells and generate data for pathologist to interpret	12		
88368	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; initial single probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Signal Enumeration: Verify and QC controls and slide adequacy.	4		
88368	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; initial single probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88368	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; initial single probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88368	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; initial single probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	2		
88369	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Pre-service	L037B	Histotechnologist	0.37	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist.	0.5		
88369	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Pre-service	L037B	Histotechnologist	0.37	Photograph and print samples	5		
88369	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Pre-service	L037B	Histotechnologist	0.37	"Prepare reagents and equipment.  Re-cut paraffin blocks and bake slides. Deparaffinize, treat with HCL, wash. Treat with enzyme, wash and rehydrate.  Apply DNA probe mixture to positive, negative control and patient’s slide…"	14		
88369	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Pre-service	L037B	Histotechnologist	0.37	Signal Enumeration: Count signals in malignant cells and generate data for pathologist to interpret	12		
88369	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Pre-service	L037B	Histotechnologist	0.37	Signal Enumeration: Verify and QC controls and slide adequacy.	4		
88369	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Post-service	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	0		
88369	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Post-service	L037B	Histotechnologist	0.37	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	0.5		
88369	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) manual, per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Post-service	L037B	Histotechnologist	0.37	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88373	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Pre-service	L037B	Histotechnologist	0.37	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist.	0.5		
88373	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Pre-service	L037B	Histotechnologist	0.37	"Load slides on Auto Vysis Scanner, and enter slide IDs.    After pathologist has verified fields of interest, select the fields to be scanned."	4		
88373	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Pre-service	L037B	Histotechnologist	0.37	Photograph and print samples	1		
88373	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Pre-service	L037B	Histotechnologist	0.37	"Prepare reagents and equipment.  Re-cut paraffin blocks and bake slides. Deparaffinize, treat with HCL, wash. Treat with enzyme, wash and rehydrate.  Apply DNA probe mixture to positive, negative control and patient’s slide…"	10		
88373	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Post-service	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	0.5		
88373	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Post-service	L037B	Histotechnologist	0.37	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	0.5		
88373	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each additional single probe stain procedure (List separately in addition to code for primary procedure)"	Post-service	L037B	Histotechnologist	0.37	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	1		
88374	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist.	1		
88374	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Gather all the relevant slides, prior report, and history on the patient for the pathologist to review to choose the region of interest on the slide"	4		
88374	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Load slides on Auto Vysis Scanner, and enter slide IDs.    After pathologist has verified fields of interest, select the fields to be scanned."	4		
88374	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Photograph and print samples	1		
88374	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Prepare reagents and equipment.  Re-cut paraffin blocks and bake slides. Deparaffinize, treat with HCL, wash. Treat with enzyme, wash and rehydrate.  Apply DNA probe mixture to positive, negative control and patient’s slide…"	32		
88374	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Retrieve and accession specimen	1.5		
88374	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each multiplex probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88374	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each multiplex probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88374	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology,  per specimen; each multiplex probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	2		
88377	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist.	1		
88377	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Gather all the relevant slides, prior report, and history on the patient for the pathologist to review to choose the region of interest on the slide"	4		
88377	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Photograph and print samples	7		
88377	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	"Prepare reagents and equipment.  Re-cut paraffin blocks and bake slides. Deparaffinize, treat with HCL, wash. Treat with enzyme, wash and rehydrate.  Apply DNA probe mixture to positive, negative control and patient’s slide…"	43		
88377	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Retrieve and accession specimen	1.5		
88377	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Signal Enumeration: Count signals in malignant cells and generate data for pathologist to interpret	18		
88377	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure"	Pre-service	L037B	Histotechnologist	0.37	Signal Enumeration: Verify and QC controls and slide adequacy.	6		
88377	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88377	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88377	"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure"	Post-service	L037B	Histotechnologist	0.37	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	2		
88380	Microdissection; laser capture	Pre-service	L033A	Lab Technician	0.33	"Accession specimen/prepare for examination, assemble slides"	1.5		
88380	Microdissection; laser capture	Pre-service	L037B	Histotechnologist	0.37	"Process specimen for H&E slide preparation (includes refacing block and preparing for cutting, step sectioning and recuts,  routine  staining, coverslipping, quality control function, maintaining specimen tracking logs and labeling.)"	14.5		
88380	Microdissection; laser capture	Pre-service	L033A	Lab Technician	0.33	Retrieve block	1		
88380	Microdissection; laser capture	Service  pre	L033A	Lab Technician	0.33	Assemble and deliver slides with paperwork to pathologists for H&E examination and target selection	1		
88380	Microdissection; laser capture	Service  pre	L045A	Cytotechnologist	0.45	Collect and label tubes for target	1		
88380	Microdissection; laser capture	Service  pre	L045A	Cytotechnologist	0.45	Deparaffination of unstained slides	15		
88380	Microdissection; laser capture	Service  pre	L045A	Cytotechnologist	0.45	"Dispose of razor blade, Cap tube and vortex specimens. Visually inspect tube to make sure microdissected material are at the bottom of tube."	3		
88380	Microdissection; laser capture	Service  pre	L045A	Cytotechnologist	0.45	Document procedure in logs and place tubes in storage until extraction	4		
88380	Microdissection; laser capture	Service  pre	L045A	Cytotechnologist	0.45	Etch slide with diamond tipped marker	3		
88380	Microdissection; laser capture	Service  pre	L045A	Cytotechnologist	0.45	Examination of stained slides to verify and visualize targets	8		
88380	Microdissection; laser capture	Service  pre	L045A	Cytotechnologist	0.45	Methylene blue staining of 10 (laser) and 8 (manual) slides	8		
88380	Microdissection; laser capture	Service  pre	L045A	Cytotechnologist	0.45	"Place tape on tube, place parafilm over tube lid.  Add to 55 degree waterbath overnight, after which tube will be transported to atuomated DNA extractor"	3		
88380	Microdissection; laser capture	Service  pre	L045A	Cytotechnologist	0.45	"Prepare Incubation buffer: Thaw proteinase K and DDT.  Add 100 uL of proteinase K and 100 uL of DTT to 800 uL of incubation buffer (can use for 10 cases).  Add 60uL of incubation buffer into cap of tube and 40uL of incubation buffer to tube.
"	6		
88380	Microdissection; laser capture	Service  pre	L045A	Cytotechnologist	0.45	"Prepare laser instrument, quality control and maintenance functions"	3		
88380	Microdissection; laser capture	Service  pre	L033A	Lab Technician	0.33	Slides and paperwork delivered to the laboratory after target selection	1		
88380	Microdissection; laser capture	Service  pre	L045A	Cytotechnologist	0.45	"Turn on dissecting microscope, place slide on scope, remove razor blade from box.  Microdissect tissue within etched area, while viewing slide under dissecting scope, place tissue into cap of collection tube with blade.  Repeat"	0		
88380	Microdissection; laser capture	Post-service	L033A	Lab Technician	0.33	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88380	Microdissection; laser capture	Post-service	L033A	Lab Technician	0.33	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88380	Microdissection; laser capture	Post-service	L033A	Lab Technician	0.33	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	2		
88381	Microdissection; manual	Pre-service	L033A	Lab Technician	0.33	"Accession specimen/prepare for examination, assemble slides"	1.5		
88381	Microdissection; manual	Pre-service	L037B	Histotechnologist	0.37	"Process specimen for H&E slide preparation (includes refacing block and preparing for cutting, step sectioning and recuts,  routine  staining, coverslipping, quality control function, maintaining specimen tracking logs and labeling.)"	14.5		
88381	Microdissection; manual	Pre-service	L033A	Lab Technician	0.33	Retrieve block	1		
88381	Microdissection; manual	Service  pre	L033A	Lab Technician	0.33	Assemble and deliver slides with paperwork to pathologists for H&E examination and target selection	1		
88381	Microdissection; manual	Service  pre	L045A	Cytotechnologist	0.45	Collect and label tubes for target	1		
88381	Microdissection; manual	Service  pre	L045A	Cytotechnologist	0.45	decontamination of workspace and dissecting scope	3		
88381	Microdissection; manual	Service  pre	L045A	Cytotechnologist	0.45	Deparaffination of unstained slides	15		
88381	Microdissection; manual	Service  pre	L045A	Cytotechnologist	0.45	"Dispose of razor blade, Cap tube and vortex specimens. Visually inspect tube to make sure microdissected material are at the bottom of tube."	3		
88381	Microdissection; manual	Service  pre	L045A	Cytotechnologist	0.45	Document procedure in logs and place tubes in storage until extraction	4		
88381	Microdissection; manual	Service  pre	L045A	Cytotechnologist	0.45	Etch slide with diamond tipped marker	3		
88381	Microdissection; manual	Service  pre	L045A	Cytotechnologist	0.45	Examination of stained slides to verify and visualize targets	8		
88381	Microdissection; manual	Service  pre	L045A	Cytotechnologist	0.45	Methylene blue staining of 10 (laser) and 8 (manual) slides	8		
88381	Microdissection; manual	Service  pre	L045A	Cytotechnologist	0.45	"Place tape on tube, place parafilm over tube lid.  Add to 55 degree waterbath overnight, after which tube will be transported to atuomated DNA extractor"	3		
88381	Microdissection; manual	Service  pre	L045A	Cytotechnologist	0.45	"Prepare Incubation buffer: Thaw proteinase K and DDT.  Add 100 uL of proteinase K and 100 uL of DTT to 800 uL of incubation buffer (can use for 10 cases).  Add 60uL of incubation buffer into cap of tube and 40uL of incubation buffer to tube.
"	6		
88381	Microdissection; manual	Service  pre	L033A	Lab Technician	0.33	Slides and paperwork delivered to the laboratory after target selection	1		
88381	Microdissection; manual	Service  pre	L045A	Cytotechnologist	0.45	"Turn on dissecting microscope, place slide on scope, remove razor blade from box.  Microdissect tissue within etched area, while viewing slide under dissecting scope, place tissue into cap of collection tube with blade.  Repeat"	30		
88381	Microdissection; manual	Post-service	L033A	Lab Technician	0.33	Clean room/equipment following procedure (including any equipment maintenance that must be done after the procedure)	1		
88381	Microdissection; manual	Post-service	L033A	Lab Technician	0.33	"Dispose of remaining specimens, spent chemicals/other consumables, and hazardous waste"	1		
88381	Microdissection; manual	Post-service	L033A	Lab Technician	0.33	"Prepare, pack and transport specimens and records for in-house storage and external storage (where applicable)"	2		
88387	"Pathologist examination, dissection, and preparation of tissue"	Pre-service	L033A	Lab Technician	0.33	Preservice total costs	3		
88387	"Pathologist examination, dissection, and preparation of tissue"	Post-service	L033A	Lab Technician	0.33	Post service total costs	1		
88388	"Pathologist examination, dissection, and preparation of tissue during surgery"	Pre-service	L033A	Lab Technician	0.33	Preservice total costs	3		
88388	"Pathologist examination, dissection, and preparation of tissue during surgery"	Post-service	L033A	Lab Technician	0.33	Post service total costs	1		
89049	Test for malignant hyperthermia susceptibility (genetic disorder)	Service  intra	L035A	Lab Tech/Histotechnologist	0.35	Service total costs	274	0	
89220	Sputum specimen collection	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25		
89230	Sweat collection	Service  intra	L035A	Lab Tech/Histotechnologist	0.35	Service total costs	8		
90460	Administration of first vaccine or toxoid component through 18 years of age with counseling	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	1		
90460	Administration of first vaccine or toxoid component through 18 years of age with counseling	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	16		
90460	Administration of first vaccine or toxoid component through 18 years of age with counseling	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	1		
90471	Administration of 1 vaccine	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	17		
90472	Administration of vaccine	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8		
90474	Administration of nasal or oral vaccine	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8		
90849	Multiple-family group psychotherapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	12	6	
90849	Multiple-family group psychotherapy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	1	0	
90865	Injection of hypnotic drug for psychiatric diagnosis or therapy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	0	
90865	Injection of hypnotic drug for psychiatric diagnosis or therapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35	6	
90865	Injection of hypnotic drug for psychiatric diagnosis or therapy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	0	
90870	Shock treatment and monitoring	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	0	
90870	Shock treatment and monitoring	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	0	
90870	Shock treatment and monitoring	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	3	
90876	"Individual psychophysiological therapy incorporating biofeedback training with psychotherapy, 45 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	1	0	
90876	"Individual psychophysiological therapy incorporating biofeedback training with psychotherapy, 45 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
90876	"Individual psychophysiological therapy incorporating biofeedback training with psychotherapy, 45 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
90880	Hypnotherapy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	1	0	
90880	Hypnotherapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	7	0	
90880	Hypnotherapy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
90887	"Explanation of psychiatric, medical examinations, procedures, and data to other than patient"	Service  intra	L051A	RN	0.51	Service total costs	20	0	
90901	Biofeedback training	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	10	0	
90901	Biofeedback training	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	9	0	
90901	Biofeedback training	Post-service	L039B	Physical Therapy Assistant	0.39	Post service total costs	3	0	
90911	"Biofeedback training, perineal muscles, anorectal or urethral sphincter"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	12	0	
90911	"Biofeedback training, perineal muscles, anorectal or urethral sphincter"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	36	0	
90911	"Biofeedback training, perineal muscles, anorectal or urethral sphincter"	Post-service	L039B	Physical Therapy Assistant	0.39	Post service total costs	3	0	
90945	Dialysis procedure including one evaluation	Pre-service	L051A	RN	0.51	Preservice total costs		6	
90945	Dialysis procedure including one evaluation	Post-service	L051A	RN	0.51	Post service total costs		8	
90951	"Dialysis services (4 or more physician visits per month), patient younger than 2 years of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	60	60	
90954	"Dialysis services (4 or more physician visits per month), patient 2-11 years of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	60	60	
90955	"Dialysis services (2-3 physician visits per month), patient 2-11 years of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	60	60	
90956	"Dialysis services (1 physician visit per month), patient 2-11 years of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	60	60	
90957	"Dialysis services (4 or more physician visits per month), patient 12-19 years of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	60	60	
90958	"Dialysis services (2-3 physician visits per month), patient 12-19 years of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	60	60	
90959	"Dialysis services (1 physician visit per month), patient 12-19 years of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	60	60	
90960	"Dialysis services (4 or more physician visits per month), patient 20 years of age and older"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	60	60	
90961	"Dialysis services (2-3 physician visits per month), patient 20 years of age and older"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	60	60	
90962	"Dialysis services (1 physician visit per month), patient 20 years of age and older"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	60	60	
90963	"Home dialysis services per month, patient younger than 2 years of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	60	60	
90964	"Home dialysis services per month, patient 2-11 years of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	60	60	
90965	"Home dialysis services per month, patient 12-19 years of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	60	60	
90966	"Home dialysis services per month, patient 20 years of age or older"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	60	60	
90967	"Dialysis services, per day (less than full month service), patient younger than 2 years of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2	2	
90968	"Dialysis services, per day (less than full month service), patient 2-11 years of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2	2	
90969	"Dialysis services, per day (less than full month service), patient 12-19 years of age"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2	2	
90970	"Dialysis services, per day (less than full month service), patient 20 years of age or older"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2	2	
91010	Measurement of esophageal swallowing movement	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
91010	Measurement of esophageal swallowing movement	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	63		
91010	Measurement of esophageal swallowing movement	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
91013	Measurement of esophageal swallowing movement	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	9		
91020	Studies of the spontaneous stomach movement function	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
91020	Studies of the spontaneous stomach movement function	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	87		
91022	Study of movement of the upper small bowel (duodenum)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
91022	Study of movement of the upper small bowel (duodenum)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60		
91022	Study of movement of the upper small bowel (duodenum)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	13		
91030	Test for esophageal reflux disease	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
91030	Test for esophageal reflux disease	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	60		
91034	Monitoring and recording of gastroesophageal reflux through nose including analysis and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
91034	Monitoring and recording of gastroesophageal reflux through nose including analysis and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46		
91034	Monitoring and recording of gastroesophageal reflux through nose including analysis and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	5		
91035	Monitoring and recording of gastroesophageal reflux with pH electrode insertion including analysis and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
91035	Monitoring and recording of gastroesophageal reflux with pH electrode insertion including analysis and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44		
91035	Monitoring and recording of gastroesophageal reflux with pH electrode insertion including analysis and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	5		
91037	Monitoring of gastroesophageal reflux including analysis and interpretation	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
91037	Monitoring of gastroesophageal reflux including analysis and interpretation	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46		
91037	Monitoring of gastroesophageal reflux including analysis and interpretation	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	5		
91038	"Monitoring of gastroesophageal reflux including analysis and interpretation, prolonged (greater than 1 hour, up to 24 hours)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
91038	"Monitoring of gastroesophageal reflux including analysis and interpretation, prolonged (greater than 1 hour, up to 24 hours)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51		
91038	"Monitoring of gastroesophageal reflux including analysis and interpretation, prolonged (greater than 1 hour, up to 24 hours)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	5		
91040	"Esophageal balloon distension study, diagnostic, with provocation when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
91040	"Esophageal balloon distension study, diagnostic, with provocation when performed"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36		
91040	"Esophageal balloon distension study, diagnostic, with provocation when performed"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	5		
91065	Measurement of hydrogen in breath to test for GI symptoms	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
91065	Measurement of hydrogen in breath to test for GI symptoms	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36		
91065	Measurement of hydrogen in breath to test for GI symptoms	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
91110	Imaging of digestive tract done from the inside of the digestive tract	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	5		
91110	Imaging of digestive tract done from the inside of the digestive tract	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65		
91110	Imaging of digestive tract done from the inside of the digestive tract	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
91111	Imaging of esophagus done from the inside of the esophagus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	5		
91111	Imaging of esophagus done from the inside of the esophagus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	62		
91111	Imaging of esophagus done from the inside of the esophagus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
91112	Transit and pressure measurement of stomach through colon with wireless capsule	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15		
91112	Transit and pressure measurement of stomach through colon with wireless capsule	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41		
91112	Transit and pressure measurement of stomach through colon with wireless capsule	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	5		
91117	"Measurement of colon movement, minimum 6 hours continuous recording"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		19	
91120	Testing of tone and sensation of rectum and anus	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
91120	Testing of tone and sensation of rectum and anus	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36		
91120	Testing of tone and sensation of rectum and anus	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	5		
91122	Study of anorectal pressure generated by muscles surrounding anus (sphincter)	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
91122	Study of anorectal pressure generated by muscles surrounding anus (sphincter)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	87		
91132	Recording of gastrointestinal electrical activity of stomach	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
91132	Recording of gastrointestinal electrical activity of stomach	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	35		
91133	Recording of electrical activity of stomach with administration of drug	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
91133	Recording of electrical activity of stomach with administration of drug	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43		
91200	"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report"	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	0		
91200	"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	0		
91200	"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
91200	"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
91200	"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
91200	"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report"	Service  intra	L037D	RN/LPN/MTA	0.37	Perform procedure	7		
91200	"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	1		
91200	"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report"	Service  post	L037D	RN/LPN/MTA	0.37	Post processing: Technical QC	0		
91200	"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report"	Service  post	L037D	RN/LPN/MTA	0.37	Review documents w/ physician	2		
92002	"Eye and medical examination for diagnosis and treatment, new patient"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	2	0	
92002	"Eye and medical examination for diagnosis and treatment, new patient"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	38	0	
92002	"Eye and medical examination for diagnosis and treatment, new patient"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	4	0	
92004	"Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	2	0	
92004	"Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	62	0	
92004	"Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	4	0	
92012	"Eye and medical examination for diagnosis and treatment, established patient"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	2	0	
92012	"Eye and medical examination for diagnosis and treatment, established patient"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	36	0	
92012	"Eye and medical examination for diagnosis and treatment, established patient"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	4	0	
92014	"Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	2	0	
92014	"Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	53	0	
92014	"Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits"	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	4	0	
92015	Assessment for prescriptive eye wear using a range of lens powers	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	1	0	
92020	Examination of cornea and iris using lens device and slit lamp	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	2	0	
92025	Computerized mapping of corneal curvature	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	17		
92060	Measurement of eye muscles to detect deviation of eyeball	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5		
92060	Measurement of eye muscles to detect deviation of eyeball	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	26		
92065	Exercises to correct eyeball muscle imbalances	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	46		
92065	Exercises to correct eyeball muscle imbalances	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	2		
92071	Fitting of contact lens for treatment of ocular surface disease	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	5	0	
92072	Fitting of contact lens for management of corneal degeneration	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	42	0	
92072	Fitting of contact lens for management of corneal degeneration	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	6	0	
92081	Measurement of field of vision during daylight conditions	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	17		
92082	Measurement of field of vision during daylight conditions	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	27		
92083	Measurement of field of vision during daylight conditions	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	37		
92100	"Multiple measurements of eye fluid pressure over an extended time period, same day"	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5	0	
92100	"Multiple measurements of eye fluid pressure over an extended time period, same day"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	55	0	
92132	Diagnostic imaging of eyes	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	2		
92132	Diagnostic imaging of eyes	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	13		
92133	Diagnostic imaging of optic nerve of eye	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	2		
92133	Diagnostic imaging of optic nerve of eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	13		
92134	Diagnostic imaging of retina	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	2		
92134	Diagnostic imaging of retina	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	13		
92136	Measurement of corneal curvature and depth of eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	41		
92140	Glaucoma testing of eye fluid pressure	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	5	0	
92140	Glaucoma testing of eye fluid pressure	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	47	0	
92140	Glaucoma testing of eye fluid pressure	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	3	0	
92145	Corneal hysteresis determination	Service  pre	L038A	COMT/COT/RN/CST	0.38	Prepare and position pt/ monitor pt/ set up IV	2		
92145	Corneal hysteresis determination	Service  pre	L038A	COMT/COT/RN/CST	0.38	"Prepare room, equipment, supplies"	2		
92145	Corneal hysteresis determination	Service  pre	L038A	COMT/COT/RN/CST	0.38	SVC Provide pre-service education/obtain consent	1		
92145	Corneal hysteresis determination	Service  intra	L038A	COMT/COT/RN/CST	0.38	Assist physician in performing procedure	5		
92225	Examination of eye by ophthalmoscope with retinal drawing	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	4	0	
92226	Examination of eye by ophthalmoscope with retinal drawing	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	4	0	
92227	Diagnostic imaging of retina	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	12		
92227	Diagnostic imaging of retina	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	2		
92228	Diagnostic imaging of retina	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	12		
92230	Examination of retinal blood vessels by ophthalmoscope	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	8	0	
92230	Examination of retinal blood vessels by ophthalmoscope	Service  intra	L051A	RN	0.51	Service total costs	7	0	
92235	Examination of retinal blood vessels by ophthalmoscope	Pre-service	L039A	Certified Retinal Angio	0.39	Preservice total costs	2		
92235	Examination of retinal blood vessels by ophthalmoscope	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	2		
92235	Examination of retinal blood vessels by ophthalmoscope	Service  intra	L039A	Certified Retinal Angio	0.39	Service total costs	35		
92235	Examination of retinal blood vessels by ophthalmoscope	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	2		
92240	Examination of eye using an endoscope	Service  intra	L039A	Certified Retinal Angio	0.39	Service total costs	52		
92240	Examination of eye using an endoscope	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	15		
92250	Photography of the retina	Service  intra	L039A	Certified Retinal Angio	0.39	Service total costs	29		
92250	Photography of the retina	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	8		
92260	Determination of retinal arterial pressure	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	4	0	
92265	Application of needle electrodes to eye muscles with recording of muscle movement	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	13		
92265	Application of needle electrodes to eye muscles with recording of muscle movement	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	23		
92270	Evaluation of retinal response to light	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	65		
92275	Recording of retinal electrical responses to external stimuli	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	115		
92283	Extended color vision examination	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	55		
92284	Evaluation of eye adaptation to light and dark (rods and cones)	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	8		
92284	Evaluation of eye adaptation to light and dark (rods and cones)	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	61		
92285	Photography of content of eyes	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	18		
92286	Microscopic evaluation of deep cells of the eye	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	17		
92287	Imaging and evaluation of deep cells of the eye	Pre-service	L039A	Certified Retinal Angio	0.39	Preservice total costs	5		
92287	Imaging and evaluation of deep cells of the eye	Service  intra	L039A	Certified Retinal Angio	0.39	Service total costs	69		
92287	Imaging and evaluation of deep cells of the eye	Service  intra	L051A	RN	0.51	Service total costs	7		
92310	Measurement of curvature of both corneas with contact lens fitting	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	34	0	
92310	Measurement of curvature of both corneas with contact lens fitting	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	10	0	
92311	Measurement of curvature of cornea with contact lens fitting	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	44	0	
92311	Measurement of curvature of cornea with contact lens fitting	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	8	0	
92312	Measurement of curvature of both corneas with contact lens fitting	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	54	0	
92312	Measurement of curvature of both corneas with contact lens fitting	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	10	0	
92313	Measurement of curvature of cornea with contact lens fitting to cornea and sclera	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	49	0	
92313	Measurement of curvature of cornea with contact lens fitting to cornea and sclera	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	8	0	
92314	Measurement of curvature of both corneas with contact lens fitting	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	47	0	
92314	Measurement of curvature of both corneas with contact lens fitting	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	10	0	
92315	Measurement of curvature of the cornea with contact lens fitting	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	57	0	
92315	Measurement of curvature of the cornea with contact lens fitting	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	8	0	
92316	Measurement of curvature of both corneas with contact lens fitting	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	67	0	
92316	Measurement of curvature of both corneas with contact lens fitting	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	10	0	
92317	Measurement of curvature of cornea with contact lens fitting to cornea and sclera	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	62	0	
92317	Measurement of curvature of cornea with contact lens fitting to cornea and sclera	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	8	0	
92325	Modification of contact lens and medical supervision of adaptation	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	32		
92325	Modification of contact lens and medical supervision of adaptation	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	3		
92326	Replacement of contact lens	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	28		
92340	Fitting of monofocal spectacles	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	23	0	
92340	Fitting of monofocal spectacles	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	10	0	
92341	Fitting of bifocal spectacles	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	23	0	
92341	Fitting of bifocal spectacles	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	10	0	
92342	Fitting of multifocal spectacles	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	23	0	
92342	Fitting of multifocal spectacles	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	10	0	
92352	Fitting of monofocal spectacles	Service  intra	L033B	Optician/COMT	0.33	Service total costs	29	0	
92353	Fitting of multifocal spectacles	Service  intra	L033B	Optician/COMT	0.33	Service total costs	29	0	
92354	Fitting of spectacle mounted low vision aid	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	23		
92355	"Fitting of spectacle mounted, telescopic, or compound lens low vision aid"	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	36		
92358	Fitting and provision of temporary contact lens for patient absent a natural lens	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	20		
92370	Repair and refitting of spectacles	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	19	0	
92370	Repair and refitting of spectacles	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	2	0	
92371	Repair and refitting of spectacle prosthesis for patient absent a natural lens	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	20		
92502	"Examination of head, neck, including ears, nose and throat under general anesthesia"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
92502	"Examination of head, neck, including ears, nose and throat under general anesthesia"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
92504	Diagnostic examination of ear and nose	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Pre-service	L037D	RN/LPN/MTA	0.37	Complete pre-service diagnostic and referral forms	0	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Pre-service	L037D	RN/LPN/MTA	0.37	Coordinate pre-surgery services	0	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	0	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Pre-service	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	0	7	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Pre-service	L037D	RN/LPN/MTA	0.37	Schedule space and equipment in facility	0	5	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Service  pre	L037D	RN/LPN/MTA	0.37	"Assist physician in cleaning area, relaxing patient.  Take notes from physician"	0	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	0	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	0	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Service  pre	L037D	RN/LPN/MTA	0.37	Sedate/Apply anesthesia	2	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Service  pre	L037D	RN/LPN/MTA	0.37	Setup scope (non facility setting only)	5	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	5	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Post-service	L037D	RN/LPN/MTA	0.37	Check dressings & wound/home care instructions / coordinate office visits / prescriptions	0	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Post-service	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Post-service	L037D	RN/LPN/MTA	0.37	Clean scope	30	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Post-service	L037D	RN/LPN/MTA	0.37	Clean Surgical Instrument Package	0	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Post-service	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab & X-ray requisitions"	0	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	0	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Post-service	L037D	RN/LPN/MTA	0.37	Dischrg mgmt same day (0.5 x 99238) (enter 6 min)		0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Post-service	L037D	RN/LPN/MTA	0.37	"Monitor pt. following service/check tubes, monitors, drains (not related to moderate sedation)"	5	0	
92511	Nasopharyngoscopy with endoscope (separate procedure)	Post-service	L037D	RN/LPN/MTA	0.37	"Review/read X-ray, lab, and pathology reports"	0	0	
92512	Analysis of nasal resistance during breathing	Service  intra	L052A	Audiologist	0.52	Service total costs	42	0	
92516	Tests for facial paralysis disorders	Service  intra	L052A	Audiologist	0.52	Service total costs	38	0	
92520	Functional assessment of the voice box	Pre-service	L055A	Speech Pathologist	0.55	Preservice total costs	3	0	
92520	Functional assessment of the voice box	Service  intra	L055A	Speech Pathologist	0.55	Service total costs	29	0	
92520	Functional assessment of the voice box	Post-service	L055A	Speech Pathologist	0.55	Post service total costs	3	0	
92546	Assessment and recording of abnormal eye movement with patient in a rotating chair	Pre-service	L052A	Audiologist	0.52	Preservice total costs	3		
92546	Assessment and recording of abnormal eye movement with patient in a rotating chair	Service  intra	L052A	Audiologist	0.52	Service total costs	50		
92546	Assessment and recording of abnormal eye movement with patient in a rotating chair	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	6		
92546	Assessment and recording of abnormal eye movement with patient in a rotating chair	Post-service	L052A	Audiologist	0.52	Post service total costs	3		
92547	Use of vertical electrodes during eye or balance evaluation	Service  intra	L052A	Audiologist	0.52	Service total costs	1		
92548	Assessment of balance and postural instability	Service  intra	L052A	Audiologist	0.52	Service total costs	58		
92551	Air tone conduction hearing assessment screening	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	19		
92552	Pure tone air conduction threshold hearing assessment	Service  intra	L052A	Audiologist	0.52	Service total costs	26		
92553	Pure tone air and bone conduction hearing assessment	Service  intra	L052A	Audiologist	0.52	Service total costs	31		
92555	Assessment of speech hearing loss	Service  intra	L052A	Audiologist	0.52	Service total costs	16		
92556	Assessment of hearing loss and speech recognition	Service  intra	L052A	Audiologist	0.52	Service total costs	26		
92561	Diagnostic hearing loss test	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
92561	Diagnostic hearing loss test	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50		
92562	Comparison assessment of hearing tones in one or both ears	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
92562	Comparison assessment of hearing tones in one or both ears	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	41		
92563	Hearing test using earphones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
92563	Hearing test using earphones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	31		
92564	Hearing test using earphones	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
92564	Hearing test using earphones	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	31		
92565	Assessment of simultaneous but different hearing tones in same ear	Service  intra	L052A	Audiologist	0.52	Service total costs	13		
92571	Assessment of hearing using speech test with tone filtering	Service  intra	L052A	Audiologist	0.52	Service total costs	18		
92572	Assessment of hearing using speech test with tone filtering	Service  intra	L052A	Audiologist	0.52	Service total costs	33		
92575	Assessment of hearing using different tone pitches	Service  intra	L052A	Audiologist	0.52	Service total costs	42		
92576	Assessment of hearing loss using grammatically incorrect sentences	Service  intra	L052A	Audiologist	0.52	Service total costs	24		
92577	Assessment of two simultaneous words at different tones in same ear	Service  intra	L052A	Audiologist	0.52	Service total costs	13		
92582	Hearing tests for children	Service  intra	L052A	Audiologist	0.52	Service total costs	49		
92583	Hearing test in a booth	Service  intra	L052A	Audiologist	0.52	Service total costs	34		
92584	Testing of nerve from ear to brain (cochlear)	Service  intra	L052A	Audiologist	0.52	Service total costs	47		
92585	Placement of scalp electrodes for assessment and recording of responses from several areas of the nerve-brain hearing system	Service  intra	L052A	Audiologist	0.52	Service total costs	66		
92586	"Placement of scalp electrodes for assessment and recording of responses from several areas of the nerve-brain hearing system, infant"	Service  intra	L052A	Audiologist	0.52	Service total costs	51		
92596	Hearing test in soundproof booth	Service  intra	L052A	Audiologist	0.52	Service total costs	43		
92612	Evaluation and recording of swallowing using an endoscope	Pre-service	L053A	RN/Speech Pathologist	0.53	Preservice total costs	5	0	
92612	Evaluation and recording of swallowing using an endoscope	Service  intra	L053A	RN/Speech Pathologist	0.53	Service total costs	54	0	
92614	Evaluation and recording of voice box sensory function using an endoscope	Pre-service	L053A	RN/Speech Pathologist	0.53	Preservice total costs	5	0	
92614	Evaluation and recording of voice box sensory function using an endoscope	Service  intra	L053A	RN/Speech Pathologist	0.53	Service total costs	51	0	
92616	Evaluation and recording of swallowing and voice box sensory function using an endoscope	Pre-service	L053A	RN/Speech Pathologist	0.53	Preservice total costs	5	0	
92616	Evaluation and recording of swallowing and voice box sensory function using an endoscope	Service  intra	L053A	RN/Speech Pathologist	0.53	Service total costs	72	0	
92950	Attempt to restart heart and lungs	Service  intra	L051A	RN	0.51	Service total costs	37	0	
92960	External shock to heart to regulate heart beat	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	27	
92960	External shock to heart to regulate heart beat	Service  intra	L051A	RN	0.51	Service total costs	32	0	
92960	External shock to heart to regulate heart beat	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	0	
92961	Internal shock to heart to regulate heart beat	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		27	
92971	Placement of external devices to assist circulation	Pre-service	L042A	RN/LPN	0.42	Preservice total costs		12	
92977	Infusion of drug into vein to dissolve coronary blood clot	Service  intra	L051A	RN	0.51	Service total costs	60		
92986	"Catheter based repair of left lower heart (aortic) valve, accessed through the skin"	Pre-service	L051A	RN	0.51	Preservice total costs		75	
92986	"Catheter based repair of left lower heart (aortic) valve, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs		12	
92986	"Catheter based repair of left lower heart (aortic) valve, accessed through the skin"	Post-service	L051A	RN	0.51	Post service total costs		108	
92987	"Catheter based repair of heart valve (mitral) between left upper and lower chambers, accessed through the skin"	Pre-service	L051A	RN	0.51	Preservice total costs		75	
92987	"Catheter based repair of heart valve (mitral) between left upper and lower chambers, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs		12	
92987	"Catheter based repair of heart valve (mitral) between left upper and lower chambers, accessed through the skin"	Post-service	L051A	RN	0.51	Post service total costs		108	
92990	"Catheter based repair of heart valve (pulmonary) to lungs, accessed through the skin"	Pre-service	L051A	RN	0.51	Preservice total costs		75	
92990	"Catheter based repair of heart valve (pulmonary) to lungs, accessed through the skin"	Service  intra	L051A	RN	0.51	Service total costs		12	
92990	"Catheter based repair of heart valve (pulmonary) to lungs, accessed through the skin"	Post-service	L051A	RN	0.51	Post service total costs		108	
92997	"Balloon catheter opening of major lung artery (pulmonary), accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		16	
92997	"Balloon catheter opening of major lung artery (pulmonary), accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
93000	Routine EKG using at least 12 leads including interpretation and report	Service  intra	L051A	RN	0.51	Service total costs	10		
93005	Routine electrocardiogram (EKG) with tracing using at least 12 leads	Service  intra	L051A	RN	0.51	Service total costs	10		
93015	"Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report"	Pre-service	L051A	RN	0.51	Preservice total costs	5		
93015	"Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician supervision, interpretation, and report"	Service  intra	L051A	RN	0.51	Service total costs	46		
93017	Exercise or drug-induced heart and blood vessel stress test with EKG tracing and monitoring	Pre-service	L051A	RN	0.51	Preservice total costs	15		
93017	Exercise or drug-induced heart and blood vessel stress test with EKG tracing and monitoring	Service  intra	L051A	RN	0.51	Service total costs	42		
93024	Infusion of drug with evaluation of coronary artery spasm response	Service  intra	L051A	RN	0.51	Service total costs	80		
93025	Measurement of height of heart beats on EKG	Service  intra	L051A	RN	0.51	Service total costs	53		
93040	Tracing of electrical activity of heart using 1-3 leads with interpretation and report	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8		
93041	Tracing of electrical activity of the heart using 1-3 leads	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8		
93050	"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity artery, non-invasive"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	1		
93050	"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity artery, non-invasive"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	1		
93050	"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity artery, non-invasive"	Service  pre	L037D	RN/LPN/MTA	0.37	Provide pre-service education/obtain consent	2		
93050	"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity artery, non-invasive"	Service  intra	L037D	RN/LPN/MTA	0.37	Acquire images	8		
93050	"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity artery, non-invasive"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	1		
93224	"Heart rhythm tracing, analysis, and interpretation of 48-hour EKG"	Pre-service	L037A	Electrodiagnostic Technologist	0.37	Preservice total costs	5		
93224	"Heart rhythm tracing, analysis, and interpretation of 48-hour EKG"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	94		
93224	"Heart rhythm tracing, analysis, and interpretation of 48-hour EKG"	Post-service	L037A	Electrodiagnostic Technologist	0.37	Post service total costs	3		
93225	Heart rhythm tracing of 48-hour EKG	Pre-service	L037A	Electrodiagnostic Technologist	0.37	Preservice total costs	5		
93225	Heart rhythm tracing of 48-hour EKG	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	42		
93225	Heart rhythm tracing of 48-hour EKG	Post-service	L037A	Electrodiagnostic Technologist	0.37	Post service total costs	3		
93226	"Heart rhythm analysis, interpretation and report of 48-hour EKG"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	52		
93229	"Heart rhythm tracing, computer analysis, physician prescribed transmission of patient-triggered events greater than 24-hour EKG up to 30 days"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	214		
93229	"Heart rhythm tracing, computer analysis, physician prescribed transmission of patient-triggered events greater than 24-hour EKG up to 30 days"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	111		
93260	"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care;"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
93260	"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care;"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
93260	"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care;"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
93260	"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care;"	Service  pre	L037D	RN/LPN/MTA	0.37	Review charts	2		
93260	"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care;"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
93260	"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care;"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	15		
93260	"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care;"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
93260	"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care;"	Service  post	L037D	RN/LPN/MTA	0.37	Print PaceArt Report & Send	3		
93260	"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care;"	Service  post	L037D	RN/LPN/MTA	0.37	Scan & File	2		
93261	"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
93261	"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
93261	"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
93261	"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system"	Service  pre	L037D	RN/LPN/MTA	0.37	Review charts	2		
93261	"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
93261	"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	15		
93261	"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
93261	"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system"	Service  post	L037D	RN/LPN/MTA	0.37	Print PaceArt Report & Send	3		
93261	"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system"	Service  post	L037D	RN/LPN/MTA	0.37	Scan & File	2		
93268	Heart rhythm symptom-related tracing and interpretation of 24-hour EKG monitoring up to 30 days	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	143		
93268	Heart rhythm symptom-related tracing and interpretation of 24-hour EKG monitoring up to 30 days	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	22		
93270	Heart rhythm symptom-related tracing of 24-hour EKG monitoring up to 30 days	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	22		
93271	Heart rhythm symptom-related transmission and analysis of 24-hour EKG monitoring up to 30 days	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	121		
93271	Heart rhythm symptom-related transmission and analysis of 24-hour EKG monitoring up to 30 days	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	22		
93278	Recording to evaluate height and duration of heart beats through damaged heart tissue	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	31		
93279	"Evaluation, testing, and programming adjustment of permanent single lead pacemaker system with physician analysis, review, and report"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
93279	"Evaluation, testing, and programming adjustment of permanent single lead pacemaker system with physician analysis, review, and report"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	10		
93279	"Evaluation, testing, and programming adjustment of permanent single lead pacemaker system with physician analysis, review, and report"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21		
93280	"Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
93280	"Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	10		
93280	"Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25		
93281	"Evaluation, testing, and programming adjustment of permanent multiple lead pacemaker system with physician analysis, review, and report"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
93281	"Evaluation, testing, and programming adjustment of permanent multiple lead pacemaker system with physician analysis, review, and report"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	10		
93281	"Evaluation, testing, and programming adjustment of permanent multiple lead pacemaker system with physician analysis, review, and report"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	31		
93282	"Evaluation, testing and programming adjustment of defibrillator with analysis, review and report"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
93282	"Evaluation, testing and programming adjustment of defibrillator with analysis, review and report"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	10		
93282	"Evaluation, testing and programming adjustment of defibrillator with analysis, review and report"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26		
93283	"Evaluation, testing and programming adjustment of defibrillator with analysis, review and report"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
93283	"Evaluation, testing and programming adjustment of defibrillator with analysis, review and report"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	10		
93283	"Evaluation, testing and programming adjustment of defibrillator with analysis, review and report"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	32		
93284	"Evaluation, testing and programming adjustment of defibrillator with analysis, review and report"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
93284	"Evaluation, testing and programming adjustment of defibrillator with analysis, review and report"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	10		
93284	"Evaluation, testing and programming adjustment of defibrillator with analysis, review and report"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38		
93285	"Evaluation, testing, and programming adjustment of implantable, patient activated heart recorder system including physician analysis, review, and report"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	1		
93285	"Evaluation, testing, and programming adjustment of implantable, patient activated heart recorder system including physician analysis, review, and report"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	7		
93285	"Evaluation, testing, and programming adjustment of implantable, patient activated heart recorder system including physician analysis, review, and report"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20		
93286	"Evaluation, physician analysis, review, report, and programming adjustment of single, dual, or multiple lead pacemaker system"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	1		
93286	"Evaluation, physician analysis, review, report, and programming adjustment of single, dual, or multiple lead pacemaker system"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	5		
93286	"Evaluation, physician analysis, review, report, and programming adjustment of single, dual, or multiple lead pacemaker system"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	13		
93287	"Evaluation and programming adjustment of defibrillator with analysis, review and report"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	1		
93287	"Evaluation and programming adjustment of defibrillator with analysis, review and report"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	5		
93287	"Evaluation and programming adjustment of defibrillator with analysis, review and report"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
93288	"Evaluation of parameters of single, dual, or multiple lead pacemaker including device connection, recording, and disconnection"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
93288	"Evaluation of parameters of single, dual, or multiple lead pacemaker including device connection, recording, and disconnection"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	10		
93288	"Evaluation of parameters of single, dual, or multiple lead pacemaker including device connection, recording, and disconnection"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18		
93289	"Evaluation of defibrillator including connection, recording and disconnection"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
93289	"Evaluation of defibrillator including connection, recording and disconnection"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	10		
93289	"Evaluation of defibrillator including connection, recording and disconnection"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26		
93290	"Evaluation of parameters of single, dual, or multiple lead cardioverter-defibrillator including connection, recording, disconnection, and analysis"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	1		
93290	"Evaluation of parameters of single, dual, or multiple lead cardioverter-defibrillator including connection, recording, disconnection, and analysis"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	8		
93290	"Evaluation of parameters of single, dual, or multiple lead cardioverter-defibrillator including connection, recording, disconnection, and analysis"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8		
93291	"Evaluation of implantable heart recorder system including physician analysis, review, and report"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	1		
93291	"Evaluation of implantable heart recorder system including physician analysis, review, and report"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	7		
93291	"Evaluation of implantable heart recorder system including physician analysis, review, and report"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18		
93292	"Evaluation of wearable defibrillator system including connection, disconnection, recording, physician analysis, review, and report"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	1		
93292	"Evaluation of wearable defibrillator system including connection, disconnection, recording, physician analysis, review, and report"	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	8		
93292	"Evaluation of wearable defibrillator system including connection, disconnection, recording, physician analysis, review, and report"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	11		
93293	"Telephonic evaluation of single, dual, or multiple lead pacemaker heart rhythm strips up to 90 days"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	39		
93293	"Telephonic evaluation of single, dual, or multiple lead pacemaker heart rhythm strips up to 90 days"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	9		
93296	"Remote evaluations of defibrillator transmissions, technician review, support and distribution of results up to 90 days"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	27		
93296	"Remote evaluations of defibrillator transmissions, technician review, support and distribution of results up to 90 days"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	1		
93303	Ultrasound examination of congenital heart defect	Pre-service	L050A	Cardiac Sonographer	0.5	Preservice total costs	5		
93303	Ultrasound examination of congenital heart defect	Service  intra	L050A	Cardiac Sonographer	0.5	Service total costs	65		
93303	Ultrasound examination of congenital heart defect	Post-service	L050A	Cardiac Sonographer	0.5	Post service total costs	6		
93304	Follow-up or limited ultrasound examination of congenital heart defect	Pre-service	L050A	Cardiac Sonographer	0.5	Preservice total costs	5		
93304	Follow-up or limited ultrasound examination of congenital heart defect	Service  intra	L050A	Cardiac Sonographer	0.5	Service total costs	44		
93304	Follow-up or limited ultrasound examination of congenital heart defect	Post-service	L050A	Cardiac Sonographer	0.5	Post service total costs	6		
93306	"Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function"	Pre-service	L050A	Cardiac Sonographer	0.5	Preservice total costs	3		
93306	"Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	5		
93306	"Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function"	Service  intra	L050A	Cardiac Sonographer	0.5	Service total costs	63		
93306	"Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	7		
93306	"Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function"	Post-service	L050A	Cardiac Sonographer	0.5	Post service total costs	4		
93307	Chest ultrasound examination of heart	Pre-service	L050A	Cardiac Sonographer	0.5	Preservice total costs	3		
93307	Chest ultrasound examination of heart	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	5		
93307	Chest ultrasound examination of heart	Service  intra	L050A	Cardiac Sonographer	0.5	Service total costs	42		
93307	Chest ultrasound examination of heart	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	7		
93308	Follow-up or limited ultrasound examination of heart	Pre-service	L050A	Cardiac Sonographer	0.5	Preservice total costs	3		
93308	Follow-up or limited ultrasound examination of heart	Service  intra	L050A	Cardiac Sonographer	0.5	Service total costs	37		
93308	Follow-up or limited ultrasound examination of heart	Post-service	L050A	Cardiac Sonographer	0.5	Post service total costs	6		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Pre-service	L037D	RN/LPN/MTA	0.37	Availability of prior images confirmed	2		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	2		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Pre-service	L037D	RN/LPN/MTA	0.37	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Service  pre	L051A	RN	0.51	Prepare and position pt/ monitor pt/ set up IV	2		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Service  intra	L050A	Cardiac Sonographer	0.5	Assist physician in performing procedure (acquire ultrasound data)	30		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	30		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Service  intra	L051A	RN	0.51	Sedate/apply anesthesia	2		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Service  post	L050A	Cardiac Sonographer	0.5	Clean surgical instrument package	0		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	5		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Service  post	L037D	RN/LPN/MTA	0.37	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Service  post	L050A	Cardiac Sonographer	0.5	"Process data: measure, record, preliminary findings"	0		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Service  post	L050A	Cardiac Sonographer	0.5	Review images with MD	2		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Service  post	L050A	Cardiac Sonographer	0.5	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Post-service	L051A	RN	0.51	Check dressings & wound/home care instructions / coordinate office visits / prescriptions	3		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Post-service	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
93312	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report"	Post-service	L050A	Cardiac Sonographer	0.5	Clean scope	10		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Pre-service	L037D	RN/LPN/MTA	0.37	Availability of prior images confirmed	2		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Pre-service	L037D	RN/LPN/MTA	0.37	Follow-up phone calls and prescriptions	2		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Pre-service	L037D	RN/LPN/MTA	0.37	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Service  pre	L051A	RN	0.51	Prepare and position pt/ monitor pt/ set up IV	2		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	3		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Service  intra	L050A	Cardiac Sonographer	0.5	Assist physician in performing procedure (acquire ultrasound data)	30		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	30		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Service  intra	L051A	RN	0.51	Sedate/apply anesthesia	2		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Service  post	L050A	Cardiac Sonographer	0.5	Clean surgical instrument package	0		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	5		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Service  post	L037D	RN/LPN/MTA	0.37	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Service  post	L050A	Cardiac Sonographer	0.5	"Process data: measure, record, preliminary findings"	0		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Service  post	L050A	Cardiac Sonographer	0.5	Review images with MD	2		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Service  post	L050A	Cardiac Sonographer	0.5	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Post-service	L051A	RN	0.51	Check dressings & wound/home care instructions / coordinate office visits / prescriptions	3		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Post-service	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
93314	"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only"	Post-service	L050A	Cardiac Sonographer	0.5	Clean scope	10		
93320	Doppler echocardiography; complete	Service  intra	L050A	Cardiac Sonographer	0.5	Acquire images	19		
93321	Doppler echocardiography; follow-up or limited study	Service  intra	L050A	Cardiac Sonographer	0.5	Acquire images	10		
93325	Doppler echocardiography color flow velocity mapping	Service  intra	L050A	Cardiac Sonographer	0.5	Acquire images	11		
93350	"Ultrasound examination of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report"	Pre-service	L050A	Cardiac Sonographer	0.5	Preservice total costs	3		
93350	"Ultrasound examination of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report"	Service  intra	L050A	Cardiac Sonographer	0.5	Service total costs	67		
93350	"Ultrasound examination of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report"	Post-service	L050A	Cardiac Sonographer	0.5	Post service total costs	4		
93351	"Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3		
93351	"Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report"	Service  intra	L050A	Cardiac Sonographer	0.5	Service total costs	64		
93351	"Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report"	Service  intra	L051A	RN	0.51	Service total costs	28		
93351	"Ultrasound examination and continuous monitoring of the heart performed during rest, exercise, and/or drug-induced stress with interpretation and report"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	16		
93352	Injection of X-ray contrast material for ultrasound examination of the heart	Service  intra	L050A	Cardiac Sonographer	0.5	Service total costs	9		
93352	Injection of X-ray contrast material for ultrasound examination of the heart	Service  intra	L051A	RN	0.51	Service total costs	21		
93451	Insertion of catheter for diagnostic evaluation of right heart structures	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15		
93451	Insertion of catheter for diagnostic evaluation of right heart structures	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	35		
93451	Insertion of catheter for diagnostic evaluation of right heart structures	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	32		
93451	Insertion of catheter for diagnostic evaluation of right heart structures	Service  intra	L051A	RN	0.51	Service total costs	62		
93451	Insertion of catheter for diagnostic evaluation of right heart structures	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
93451	Insertion of catheter for diagnostic evaluation of right heart structures	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
93452	Insertion of catheter into left heart for diagnosis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15		
93452	Insertion of catheter into left heart for diagnosis	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	35		
93452	Insertion of catheter into left heart for diagnosis	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	32		
93452	Insertion of catheter into left heart for diagnosis	Service  intra	L051A	RN	0.51	Service total costs	92		
93452	Insertion of catheter into left heart for diagnosis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
93452	Insertion of catheter into left heart for diagnosis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
93453	Insertion of catheter into right and left heart for diagnosis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15		
93453	Insertion of catheter into right and left heart for diagnosis	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	50		
93453	Insertion of catheter into right and left heart for diagnosis	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	47		
93453	Insertion of catheter into right and left heart for diagnosis	Service  intra	L051A	RN	0.51	Service total costs	107		
93453	Insertion of catheter into right and left heart for diagnosis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
93453	Insertion of catheter into right and left heart for diagnosis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
93454	Insertion of catheter for imaging of heart blood vessels or grafts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15		
93454	Insertion of catheter for imaging of heart blood vessels or grafts	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	35		
93454	Insertion of catheter for imaging of heart blood vessels or grafts	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	32		
93454	Insertion of catheter for imaging of heart blood vessels or grafts	Service  intra	L051A	RN	0.51	Service total costs	92		
93454	Insertion of catheter for imaging of heart blood vessels or grafts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
93454	Insertion of catheter for imaging of heart blood vessels or grafts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
93455	Insertion of catheter for imaging of heart blood vessels or grafts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15		
93455	Insertion of catheter for imaging of heart blood vessels or grafts	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	45		
93455	Insertion of catheter for imaging of heart blood vessels or grafts	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	42		
93455	Insertion of catheter for imaging of heart blood vessels or grafts	Service  intra	L051A	RN	0.51	Service total costs	102		
93455	Insertion of catheter for imaging of heart blood vessels or grafts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
93455	Insertion of catheter for imaging of heart blood vessels or grafts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
93456	Insertion of catheter in right heart for X-ray imaging of blood vessels or grafts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15		
93456	Insertion of catheter in right heart for X-ray imaging of blood vessels or grafts	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	45		
93456	Insertion of catheter in right heart for X-ray imaging of blood vessels or grafts	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	42		
93456	Insertion of catheter in right heart for X-ray imaging of blood vessels or grafts	Service  intra	L051A	RN	0.51	Service total costs	102		
93456	Insertion of catheter in right heart for X-ray imaging of blood vessels or grafts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
93456	Insertion of catheter in right heart for X-ray imaging of blood vessels or grafts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
93457	Insertion of catheter in right heart for imaging of blood vessels or grafts	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15		
93457	Insertion of catheter in right heart for imaging of blood vessels or grafts	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	55		
93457	Insertion of catheter in right heart for imaging of blood vessels or grafts	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	52		
93457	Insertion of catheter in right heart for imaging of blood vessels or grafts	Service  intra	L051A	RN	0.51	Service total costs	112		
93457	Insertion of catheter in right heart for imaging of blood vessels or grafts	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
93457	Insertion of catheter in right heart for imaging of blood vessels or grafts	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
93458	Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15		
93458	Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	50		
93458	Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	47		
93458	Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L051A	RN	0.51	Service total costs	107		
93458	Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
93458	Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
93459	Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15		
93459	Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	55		
93459	Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	52		
93459	Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L051A	RN	0.51	Service total costs	112		
93459	Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
93459	Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
93460	Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15		
93460	Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	55		
93460	Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	52		
93460	Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L051A	RN	0.51	Service total costs	112		
93460	Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
93460	Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
93461	Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15		
93461	Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	70		
93461	Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	67		
93461	Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L051A	RN	0.51	Service total costs	127		
93461	Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
93461	Insertion of catheter in right and left heart for imaging of blood vessels or grafts and left lower heart	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
93464	Drug infusion or exercise for heart stimulation during diagnostic study	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	29		
93464	Drug infusion or exercise for heart stimulation during diagnostic study	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	20		
93464	Drug infusion or exercise for heart stimulation during diagnostic study	Service  intra	L051A	RN	0.51	Service total costs	30		
93505	Biopsy of the wall dividing the left and right heart	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9		
93505	Biopsy of the wall dividing the left and right heart	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	25		
93505	Biopsy of the wall dividing the left and right heart	Service  intra	L051A	RN	0.51	Service total costs	70		
93505	Biopsy of the wall dividing the left and right heart	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27		
93505	Biopsy of the wall dividing the left and right heart	Post-service	L051A	RN	0.51	Post service total costs	3		
93505	Biopsy of the wall dividing the left and right heart	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
93566	Injection for X-ray imaging of right upper or lower heart	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	15	0	
93566	Injection for X-ray imaging of right upper or lower heart	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	17	0	
93566	Injection for X-ray imaging of right upper or lower heart	Service  intra	L051A	RN	0.51	Service total costs	20	0	
93567	Injection for X-ray imaging of aorta above heart valve	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	10	0	
93567	Injection for X-ray imaging of aorta above heart valve	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	12	0	
93567	Injection for X-ray imaging of aorta above heart valve	Service  intra	L051A	RN	0.51	Service total costs	10	0	
93568	Injection for X-ray imaging of pulmonary (lung) artery from heart	Service  intra	L038B	Cardiovascular Technician	0.38	Service total costs	15	0	
93568	Injection for X-ray imaging of pulmonary (lung) artery from heart	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	17	0	
93568	Injection for X-ray imaging of pulmonary (lung) artery from heart	Service  intra	L051A	RN	0.51	Service total costs	20	0	
93580	"Catheter based closure of congenital heart defect with implant, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
93580	"Catheter based closure of congenital heart defect with implant, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
93581	"Catheter based closure of congenital heart defect with implant, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		30	
93581	"Catheter based closure of congenital heart defect with implant, accessed through the skin"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
93642	Evaluation of single or dual chamber pacing cardioverter-defibrillator with programming or reprogramming	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11		
93642	Evaluation of single or dual chamber pacing cardioverter-defibrillator with programming or reprogramming	Service  intra	L051A	RN	0.51	Service total costs	77		
93642	Evaluation of single or dual chamber pacing cardioverter-defibrillator with programming or reprogramming	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	86		
93642	Evaluation of single or dual chamber pacing cardioverter-defibrillator with programming or reprogramming	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
93644	Electrophysiologic evaluation of subcutaneous implantable defibrillator	Service  pre	L037D	RN/LPN/MTA	0.37	Assemble lab/x-ray/path reports	2		
93644	Electrophysiologic evaluation of subcutaneous implantable defibrillator	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
93644	Electrophysiologic evaluation of subcutaneous implantable defibrillator	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
93644	Electrophysiologic evaluation of subcutaneous implantable defibrillator	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position patient / apply electrodes	2		
93644	Electrophysiologic evaluation of subcutaneous implantable defibrillator	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
93644	Electrophysiologic evaluation of subcutaneous implantable defibrillator	Service  pre	L037D	RN/LPN/MTA	0.37	"Review history, system, medications"	5		
93644	Electrophysiologic evaluation of subcutaneous implantable defibrillator	Service  pre	L051A	RN	0.51	Sedate/Apply anesthesia	2		
93644	Electrophysiologic evaluation of subcutaneous implantable defibrillator	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	7		
93644	Electrophysiologic evaluation of subcutaneous implantable defibrillator	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	14		
93644	Electrophysiologic evaluation of subcutaneous implantable defibrillator	Service  intra	L051A	RN	0.51	Assist physician/moderate sedation (% of physician time)	20		
93644	Electrophysiologic evaluation of subcutaneous implantable defibrillator	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
93644	Electrophysiologic evaluation of subcutaneous implantable defibrillator	Service  post	L037D	RN/LPN/MTA	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	3		
93644	Electrophysiologic evaluation of subcutaneous implantable defibrillator	Service  post	L051A	RN	0.51	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	15		
93644	Electrophysiologic evaluation of subcutaneous implantable defibrillator	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
93650	Insertion of catheters for creation of complete heart block	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		27	
93660	Evaluation of heart function using tilt table	Pre-service	L051A	RN	0.51	Preservice total costs	9		
93660	Evaluation of heart function using tilt table	Service  intra	L051A	RN	0.51	Service total costs	76		
93668	Peripheral arterial disease (PAD) rehabilitation per session	Pre-service	L051A	RN	0.51	Preservice total costs	5		
93668	Peripheral arterial disease (PAD) rehabilitation per session	Service  intra	L051A	RN	0.51	Service total costs	15		
93701	Measurement of heart blood flow and respiration	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20		
93702	"Bioimpedance spectroscopy (BIS), extracellular fluid analysis for lymphedema assessment(s)"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	3		
93702	"Bioimpedance spectroscopy (BIS), extracellular fluid analysis for lymphedema assessment(s)"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
93702	"Bioimpedance spectroscopy (BIS), extracellular fluid analysis for lymphedema assessment(s)"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
93702	"Bioimpedance spectroscopy (BIS), extracellular fluid analysis for lymphedema assessment(s)"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	2		
93702	"Bioimpedance spectroscopy (BIS), extracellular fluid analysis for lymphedema assessment(s)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	2		
93702	"Bioimpedance spectroscopy (BIS), extracellular fluid analysis for lymphedema assessment(s)"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
93702	"Bioimpedance spectroscopy (BIS), extracellular fluid analysis for lymphedema assessment(s)"	Service  post	L037D	RN/LPN/MTA	0.37	Results are uploaded from the device into the analysis software and a report is generated and printed for physician review.	0		
93724	Electronic analysis of pacemaker to correct rapid heart rate	Service  intra	L051A	RN	0.51	Service total costs	27		
93724	Electronic analysis of pacemaker to correct rapid heart rate	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	14		
93750	Evaluation of lower heart chamber assist device with physician analysis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	17	0	
93784	"Ambulatory blood pressure monitoring, recording, scanning analysis, interpretation, and report 24 hours or longer"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4		
93784	"Ambulatory blood pressure monitoring, recording, scanning analysis, interpretation, and report 24 hours or longer"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18		
93784	"Ambulatory blood pressure monitoring, recording, scanning analysis, interpretation, and report 24 hours or longer"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	25		
93786	Ambulatory blood pressure monitoring and recording 24 hours or longer	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4		
93786	Ambulatory blood pressure monitoring and recording 24 hours or longer	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18		
93786	Ambulatory blood pressure monitoring and recording 24 hours or longer	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	15		
93788	"Ambulatory blood pressure monitoring, scanning analysis, and report 24 hours or longer"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	10		
93797	Physician services for outpatient heart cardiac rehabilitation per session	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
93798	Physician services for outpatient heart rehabilitation with continuous EKG monitoring per session	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
93880	Duplex scan of extracranial arteries; complete bilateral study	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	1		
93880	Duplex scan of extracranial arteries; complete bilateral study	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93880	Duplex scan of extracranial arteries; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	Greet patient and provide gowning	3		
93880	Duplex scan of extracranial arteries; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	Obtain vital signs	3		
93880	Duplex scan of extracranial arteries; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	Prepare and position pt/ monitor pt/ set up IV	2		
93880	Duplex scan of extracranial arteries; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	"Prepare room, equipment, supplies"	2		
93880	Duplex scan of extracranial arteries; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	Set up US Equipment	2		
93880	Duplex scan of extracranial arteries; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	SVC Provide pre-service education/obtain consent	3		
93880	Duplex scan of extracranial arteries; complete bilateral study	Service  intra	L054A	Vascular Technologist	0.54	Acquire images	42		
93880	Duplex scan of extracranial arteries; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Clean room/equipment by physician staff	3		
93880	Duplex scan of extracranial arteries; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93880	Duplex scan of extracranial arteries; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	1		
93880	Duplex scan of extracranial arteries; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Technologist reviews & optimizes all duplex images; reviews & optimizes spectrum analysis measuring velocities & assuring proper angle acquisition. Compiles findings with sufficient data for physician review & diagnosis.	2		
93880	Duplex scan of extracranial arteries; complete bilateral study	Post-service	L054A	Vascular Technologist	0.54	QA Documentation	0		
93882	Duplex scan of extracranial arteries; unilateral or limited study	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	1		
93882	Duplex scan of extracranial arteries; unilateral or limited study	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93882	Duplex scan of extracranial arteries; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	Greet patient and provide gowning	3		
93882	Duplex scan of extracranial arteries; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	Obtain vital signs	3		
93882	Duplex scan of extracranial arteries; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	Prepare and position pt/ monitor pt/ set up IV	2		
93882	Duplex scan of extracranial arteries; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	"Prepare room, equipment, supplies"	2		
93882	Duplex scan of extracranial arteries; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	Set up US Equipment	2		
93882	Duplex scan of extracranial arteries; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	SVC Provide pre-service education/obtain consent	3		
93882	Duplex scan of extracranial arteries; unilateral or limited study	Service  intra	L054A	Vascular Technologist	0.54	Acquire images	21		
93882	Duplex scan of extracranial arteries; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	Clean room/equipment by physician staff	3		
93882	Duplex scan of extracranial arteries; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93882	Duplex scan of extracranial arteries; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	1		
93882	Duplex scan of extracranial arteries; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
93882	Duplex scan of extracranial arteries; unilateral or limited study	Post-service	L054A	Vascular Technologist	0.54	QA Documentation	0		
93886	Transcranial doppler study of the intracranial arteries; complete study	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	1		
93886	Transcranial doppler study of the intracranial arteries; complete study	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93886	Transcranial doppler study of the intracranial arteries; complete study	Service  pre	L054A	Vascular Technologist	0.54	Greet patient and provide gowning	3		
93886	Transcranial doppler study of the intracranial arteries; complete study	Service  pre	L054A	Vascular Technologist	0.54	Obtain vital signs	3		
93886	Transcranial doppler study of the intracranial arteries; complete study	Service  pre	L054A	Vascular Technologist	0.54	Prepare and position pt/ monitor pt/ set up IV	2		
93886	Transcranial doppler study of the intracranial arteries; complete study	Service  pre	L054A	Vascular Technologist	0.54	"Prepare room, equipment, supplies"	2		
93886	Transcranial doppler study of the intracranial arteries; complete study	Service  pre	L054A	Vascular Technologist	0.54	Set up US Equipment	2		
93886	Transcranial doppler study of the intracranial arteries; complete study	Service  pre	L054A	Vascular Technologist	0.54	SVC Provide pre-service education/obtain consent	3		
93886	Transcranial doppler study of the intracranial arteries; complete study	Service  intra	L054A	Vascular Technologist	0.54	Acquire images	48		
93886	Transcranial doppler study of the intracranial arteries; complete study	Service  post	L054A	Vascular Technologist	0.54	Clean room/equipment by physician staff	3		
93886	Transcranial doppler study of the intracranial arteries; complete study	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93886	Transcranial doppler study of the intracranial arteries; complete study	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	1		
93886	Transcranial doppler study of the intracranial arteries; complete study	Service  post	L054A	Vascular Technologist	0.54	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
93886	Transcranial doppler study of the intracranial arteries; complete study	Post-service	L054A	Vascular Technologist	0.54	QA Documentation	0		
93888	Transcranial doppler study of the intracranial arteries; limited study	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	1		
93888	Transcranial doppler study of the intracranial arteries; limited study	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93888	Transcranial doppler study of the intracranial arteries; limited study	Service  pre	L054A	Vascular Technologist	0.54	Greet patient and provide gowning	3		
93888	Transcranial doppler study of the intracranial arteries; limited study	Service  pre	L054A	Vascular Technologist	0.54	Obtain vital signs	3		
93888	Transcranial doppler study of the intracranial arteries; limited study	Service  pre	L054A	Vascular Technologist	0.54	Prepare and position pt/ monitor pt/ set up IV	2		
93888	Transcranial doppler study of the intracranial arteries; limited study	Service  pre	L054A	Vascular Technologist	0.54	"Prepare room, equipment, supplies"	2		
93888	Transcranial doppler study of the intracranial arteries; limited study	Service  pre	L054A	Vascular Technologist	0.54	Set up US Equipment	2		
93888	Transcranial doppler study of the intracranial arteries; limited study	Service  pre	L054A	Vascular Technologist	0.54	SVC Provide pre-service education/obtain consent	3		
93888	Transcranial doppler study of the intracranial arteries; limited study	Service  intra	L054A	Vascular Technologist	0.54	Acquire images	24		
93888	Transcranial doppler study of the intracranial arteries; limited study	Service  post	L054A	Vascular Technologist	0.54	Clean room/equipment by physician staff	3		
93888	Transcranial doppler study of the intracranial arteries; limited study	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93888	Transcranial doppler study of the intracranial arteries; limited study	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	1		
93888	Transcranial doppler study of the intracranial arteries; limited study	Service  post	L054A	Vascular Technologist	0.54	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
93888	Transcranial doppler study of the intracranial arteries; limited study	Post-service	L054A	Vascular Technologist	0.54	QA Documentation	0		
93890	Ultrasound scanning for medication response in head and neck vessel blood flow (inside the brain)	Pre-service	L054A	Vascular Technologist	0.54	Preservice total costs	3		
93890	Ultrasound scanning for medication response in head and neck vessel blood flow (inside the brain)	Service  intra	L054A	Vascular Technologist	0.54	Service total costs	70		
93890	Ultrasound scanning for medication response in head and neck vessel blood flow (inside the brain)	Post-service	L054A	Vascular Technologist	0.54	Post service total costs	5		
93892	Ultrasound scanning for blood clot detection in head and neck vessel blood flow (inside the brain)	Pre-service	L054A	Vascular Technologist	0.54	Preservice total costs	3		
93892	Ultrasound scanning for blood clot detection in head and neck vessel blood flow (inside the brain)	Service  intra	L054A	Vascular Technologist	0.54	Service total costs	80		
93892	Ultrasound scanning for blood clot detection in head and neck vessel blood flow (inside the brain)	Post-service	L054A	Vascular Technologist	0.54	Post service total costs	5		
93893	Ultrasound scanning for blood clot detection with microbubble injection in head and neck vessel blood flow (inside the brain)	Pre-service	L054A	Vascular Technologist	0.54	Preservice total costs	3		
93893	Ultrasound scanning for blood clot detection with microbubble injection in head and neck vessel blood flow (inside the brain)	Service  intra	L054A	Vascular Technologist	0.54	Service total costs	73		
93893	Ultrasound scanning for blood clot detection with microbubble injection in head and neck vessel blood flow (inside the brain)	Post-service	L054A	Vascular Technologist	0.54	Post service total costs	5		
93922	Ultrasound study of arteries of both arms and legs	Pre-service	L054A	Vascular Technologist	0.54	Preservice total costs	3		
93922	Ultrasound study of arteries of both arms and legs	Service  intra	L054A	Vascular Technologist	0.54	Service total costs	36		
93922	Ultrasound study of arteries of both arms and legs	Post-service	L054A	Vascular Technologist	0.54	Post service total costs	3		
93923	Ultrasound study of arteries of both arms and legs	Pre-service	L054A	Vascular Technologist	0.54	Preservice total costs	3		
93923	Ultrasound study of arteries of both arms and legs	Service  intra	L054A	Vascular Technologist	0.54	Service total costs	56		
93923	Ultrasound study of arteries of both arms and legs	Post-service	L054A	Vascular Technologist	0.54	Post service total costs	3		
93924	Ultrasound study of arteries of both legs at rest and exercise	Pre-service	L054A	Vascular Technologist	0.54	Preservice total costs	3		
93924	Ultrasound study of arteries of both legs at rest and exercise	Service  intra	L054A	Vascular Technologist	0.54	Service total costs	70		
93924	Ultrasound study of arteries of both legs at rest and exercise	Post-service	L054A	Vascular Technologist	0.54	Post service total costs	3		
93925	Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	1		
93925	Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93925	Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	Greet patient and provide gowning	3		
93925	Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	Obtain vital signs	3		
93925	Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	Prepare and position pt/ monitor pt/ set up IV	2		
93925	Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	"Prepare room, equipment, supplies"	2		
93925	Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	Set up US Equipment	2		
93925	Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	SVC Provide pre-service education/obtain consent	3		
93925	Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	Service  intra	L054A	Vascular Technologist	0.54	Acquire images	69		
93925	Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Clean room/equipment by physician staff	3		
93925	Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93925	Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	1		
93925	Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Technologist reviews & optimizes all duplex images; reviews & optimizes spectrum analysis measuring velocities & assuring proper angle acquisition. Compiles findings with sufficient data for physician review & diagnosis.	2		
93925	Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study	Post-service	L054A	Vascular Technologist	0.54	QA Documentation	0		
93926	Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	1		
93926	Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93926	Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	Greet patient and provide gowning	3		
93926	Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	Obtain vital signs	3		
93926	Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	Prepare and position pt/ monitor pt/ set up IV	2		
93926	Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	"Prepare room, equipment, supplies"	2		
93926	Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	Set up US Equipment	2		
93926	Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	SVC Provide pre-service education/obtain consent	3		
93926	Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study	Service  intra	L054A	Vascular Technologist	0.54	Acquire images	35		
93926	Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	Clean room/equipment by physician staff	3		
93926	Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93926	Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	1		
93926	Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	Technologist reviews & optimizes all duplex images; reviews & optimizes spectrum analysis measuring velocities & assuring proper angle acquisition. Compiles findings with sufficient data for physician review & diagnosis.	2		
93926	Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study	Post-service	L054A	Vascular Technologist	0.54	QA Documentation	0		
93930	Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	1		
93930	Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93930	Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	Greet patient and provide gowning	3		
93930	Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	Obtain vital signs	3		
93930	Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	Prepare and position pt/ monitor pt/ set up IV	2		
93930	Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	"Prepare room, equipment, supplies"	2		
93930	Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	Set up US Equipment	2		
93930	Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	SVC Provide pre-service education/obtain consent	3		
93930	Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study	Service  intra	L054A	Vascular Technologist	0.54	Acquire images	45		
93930	Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Clean room/equipment by physician staff	3		
93930	Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93930	Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	1		
93930	Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Technologist reviews & optimizes all duplex images; reviews & optimizes spectrum analysis measuring velocities & assuring proper angle acquisition. Compiles findings with sufficient data for physician review & diagnosis.	8		
93930	Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study	Post-service	L054A	Vascular Technologist	0.54	QA Documentation	0		
93931	Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	1		
93931	Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93931	Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	Greet patient and provide gowning	3		
93931	Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	Obtain vital signs	3		
93931	Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	Prepare and position pt/ monitor pt/ set up IV	2		
93931	Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	"Prepare room, equipment, supplies"	2		
93931	Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	Set up US Equipment	2		
93931	Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	SVC Provide pre-service education/obtain consent	3		
93931	Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study	Service  intra	L054A	Vascular Technologist	0.54	Acquire images	23		
93931	Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	Clean room/equipment by physician staff	3		
93931	Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93931	Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	1		
93931	Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	Technologist reviews & optimizes all duplex images; reviews & optimizes spectrum analysis measuring velocities & assuring proper angle acquisition. Compiles findings with sufficient data for physician review & diagnosis.	5		
93931	Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study	Post-service	L054A	Vascular Technologist	0.54	QA Documentation	0		
93965	Ultrasound study of veins of both arms or legs including assessment of functional maneuvers	Service  intra	L054A	Vascular Technologist	0.54	Service total costs	38		
93965	Ultrasound study of veins of both arms or legs including assessment of functional maneuvers	Post-service	L054A	Vascular Technologist	0.54	Post service total costs	6		
93970	Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	1		
93970	Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93970	Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	Greet patient and provide gowning	3		
93970	Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	Prepare and position pt/ monitor pt/ set up IV	2		
93970	Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	"Prepare room, equipment, supplies"	2		
93970	Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	Set up US Equipment	2		
93970	Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	Service  pre	L054A	Vascular Technologist	0.54	SVC Provide pre-service education/obtain consent	3		
93970	Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	Service  intra	L054A	Vascular Technologist	0.54	Acquire images	45		
93970	Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Clean room/equipment by physician staff	3		
93970	Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93970	Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	1		
93970	Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	Service  post	L054A	Vascular Technologist	0.54	Technologist reviews & optimizes all duplex images; reviews & optimizes spectrum analysis measuring velocities & assuring proper angle acquisition. Compiles findings with sufficient data for physician review & diagnosis.	5		
93970	Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study	Post-service	L054A	Vascular Technologist	0.54	QA Documentation	0		
93971	Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	1		
93971	Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93971	Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
93971	Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	Prepare and position pt/ monitor pt/ set up IV	2		
93971	Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	"Prepare room, equipment, supplies"	2		
93971	Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	Provide pre-service education/obtain consent	3		
93971	Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	Service  pre	L054A	Vascular Technologist	0.54	Set up US Equipment	2		
93971	Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	Service  intra	L054A	Vascular Technologist	0.54	Acquire images	23		
93971	Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	Clean room/equipment by physician staff	3		
93971	Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93971	Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	1		
93971	Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	Service  post	L054A	Vascular Technologist	0.54	Technologist reviews & optimizes all duplex images; reviews & optimizes spectrum analysis measuring velocities & assuring proper angle acquisition. Compiles findings with sufficient data for physician review & diagnosis.	2		
93971	Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study	Post-service	L054A	Vascular Technologist	0.54	QA Documentation	0		
93975	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study"	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	1		
93975	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study"	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93975	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study"	Service  pre	L054A	Vascular Technologist	0.54	Greet patient and provide gowning	3		
93975	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study"	Service  pre	L054A	Vascular Technologist	0.54	Obtain vital signs	3		
93975	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study"	Service  pre	L054A	Vascular Technologist	0.54	Prepare and position pt/ monitor pt/ set up IV	2		
93975	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study"	Service  pre	L054A	Vascular Technologist	0.54	"Prepare room, equipment, supplies"	2		
93975	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study"	Service  pre	L054A	Vascular Technologist	0.54	Set up US Equipment	2		
93975	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study"	Service  pre	L054A	Vascular Technologist	0.54	SVC Provide pre-service education/obtain consent	3		
93975	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study"	Service  intra	L054A	Vascular Technologist	0.54	Acquire images	67		
93975	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study"	Service  post	L054A	Vascular Technologist	0.54	Clean room/equipment by physician staff	3		
93975	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study"	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93975	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study"	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	1		
93975	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study"	Service  post	L054A	Vascular Technologist	0.54	Technologist reviews & optimizes all duplex images; reviews & optimizes spectrum analysis measuring velocities & assuring proper angle acquisition. Compiles findings with sufficient data for physician review & diagnosis.	2		
93975	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study"	Post-service	L054A	Vascular Technologist	0.54	QA Documentation	0		
93976	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study"	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	1		
93976	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study"	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93976	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study"	Service  pre	L054A	Vascular Technologist	0.54	Greet patient and provide gowning	3		
93976	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study"	Service  pre	L054A	Vascular Technologist	0.54	Obtain vital signs	3		
93976	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study"	Service  pre	L054A	Vascular Technologist	0.54	Prepare and position pt/ monitor pt/ set up IV	2		
93976	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study"	Service  pre	L054A	Vascular Technologist	0.54	"Prepare room, equipment, supplies"	2		
93976	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study"	Service  pre	L054A	Vascular Technologist	0.54	Set up US Equipment	2		
93976	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study"	Service  pre	L054A	Vascular Technologist	0.54	SVC Provide pre-service education/obtain consent	3		
93976	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study"	Service  intra	L054A	Vascular Technologist	0.54	Acquire images	28		
93976	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study"	Service  post	L054A	Vascular Technologist	0.54	Clean room/equipment by physician staff	3		
93976	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study"	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93976	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study"	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	1		
93976	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study"	Service  post	L054A	Vascular Technologist	0.54	Technologist reviews & optimizes all duplex images; reviews & optimizes spectrum analysis measuring velocities & assuring proper angle acquisition. Compiles findings with sufficient data for physician review & diagnosis.	2		
93976	"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study"	Post-service	L054A	Vascular Technologist	0.54	QA Documentation	0		
93978	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study"	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	1		
93978	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study"	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93978	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study"	Service  pre	L054A	Vascular Technologist	0.54	Greet patient and provide gowning	3		
93978	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study"	Service  pre	L054A	Vascular Technologist	0.54	Obtain vital signs	3		
93978	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study"	Service  pre	L054A	Vascular Technologist	0.54	Prepare and position pt/ monitor pt/ set up IV	2		
93978	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study"	Service  pre	L054A	Vascular Technologist	0.54	"Prepare room, equipment, supplies"	2		
93978	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study"	Service  pre	L054A	Vascular Technologist	0.54	Set up US Equipment	2		
93978	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study"	Service  pre	L054A	Vascular Technologist	0.54	SVC Provide pre-service education/obtain consent	3		
93978	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study"	Service  intra	L054A	Vascular Technologist	0.54	Acquire images	40		
93978	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study"	Service  post	L054A	Vascular Technologist	0.54	Clean room/equipment by physician staff	3		
93978	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study"	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93978	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study"	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	1		
93978	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study"	Service  post	L054A	Vascular Technologist	0.54	Technologist reviews & optimizes all duplex images; reviews & optimizes spectrum analysis measuring velocities & assuring proper angle acquisition. Compiles findings with sufficient data for physician review & diagnosis.	8		
93978	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study"	Post-service	L054A	Vascular Technologist	0.54	QA Documentation	0		
93979	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study"	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	1		
93979	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study"	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93979	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study"	Service  pre	L054A	Vascular Technologist	0.54	Greet patient and provide gowning	3		
93979	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study"	Service  pre	L054A	Vascular Technologist	0.54	Obtain vital signs	3		
93979	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study"	Service  pre	L054A	Vascular Technologist	0.54	Prepare and position pt/ monitor pt/ set up IV	2		
93979	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study"	Service  pre	L054A	Vascular Technologist	0.54	"Prepare room, equipment, supplies"	2		
93979	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study"	Service  pre	L054A	Vascular Technologist	0.54	Set up US Equipment	2		
93979	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study"	Service  pre	L054A	Vascular Technologist	0.54	SVC Provide pre-service education/obtain consent	3		
93979	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study"	Service  intra	L054A	Vascular Technologist	0.54	Acquire images	20		
93979	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study"	Service  post	L054A	Vascular Technologist	0.54	Clean room/equipment by physician staff	3		
93979	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study"	Service  post	L054A	Vascular Technologist	0.54	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
93979	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study"	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	1		
93979	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study"	Service  post	L054A	Vascular Technologist	0.54	Technologist reviews & optimizes all duplex images; reviews & optimizes spectrum analysis measuring velocities & assuring proper angle acquisition. Compiles findings with sufficient data for physician review & diagnosis.	5		
93979	"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study"	Post-service	L054A	Vascular Technologist	0.54	QA Documentation	0		
93980	Ultrasound scan of penile arterial inflow and venous outflow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
93980	Ultrasound scan of penile arterial inflow and venous outflow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47		
93981	Ultrasound limited scan of penile arterial inflow and venous outflow	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
93981	Ultrasound limited scan of penile arterial inflow and venous outflow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	39		
93982	Implanted pressure sensor study of bulging blood vessel sac (aneurysm) after endovascular repair	Service  intra	L054A	Vascular Technologist	0.54	Service total costs	34		
93982	Implanted pressure sensor study of bulging blood vessel sac (aneurysm) after endovascular repair	Post-service	L054A	Vascular Technologist	0.54	Post service total costs	5		
93990	"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)"	Pre-service	L054A	Vascular Technologist	0.54	Availability of prior images confirmed	1		
93990	"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)"	Pre-service	L054A	Vascular Technologist	0.54	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
93990	"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)"	Service  pre	L054A	Vascular Technologist	0.54	Greet patient and provide gowning	3		
93990	"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)"	Service  pre	L054A	Vascular Technologist	0.54	Obtain vital signs	3		
93990	"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)"	Service  pre	L054A	Vascular Technologist	0.54	Prepare and position pt/ monitor pt/ set up IV	2		
93990	"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)"	Service  pre	L054A	Vascular Technologist	0.54	"Prepare room, equipment, supplies"	2		
93990	"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)"	Service  pre	L054A	Vascular Technologist	0.54	Set up US Equipment	2		
93990	"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)"	Service  pre	L054A	Vascular Technologist	0.54	SVC Provide pre-service education/obtain consent	2		
93990	"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)"	Service  intra	L054A	Vascular Technologist	0.54	Acquire images	38		
93990	"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)"	Service  post	L054A	Vascular Technologist	0.54	Clean room/equipment by physician staff	3		
93990	"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)"	Service  post	L054A	Vascular Technologist	0.54	Review examination with interpreting MD	1		
93990	"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)"	Post-service	L054A	Vascular Technologist	0.54	QA Documentation	0		
94005	"Evaluation of home ventilator management care plan, 30 minutes or more"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18		
94005	"Evaluation of home ventilator management care plan, 30 minutes or more"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18		
94010	Measurement and graphic recording of total and timed exhaled air capacity	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	31		
94014	"Measurement and graphic recording of amount and speed of breathed air including transmission of tracing, analysis, recalibration of device, physician review and interpretation over 30 days"	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	35		
94015	Measurement and graphic recording of amount and speed of breathed air over 30-day period	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	35		
94060	"Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration"	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs	5		
94060	"Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration"	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	51		
94060	"Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration"	Post-service	L047C	RN/Respiratory Therapist	0.47	Post service total costs	5		
94070	"Multiple measurements and graphic recordings of the amount and speed of breathed air, before and following medication administration"	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	45		
94150	Measurement of largest amount of air exhaled from lungs	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26		
94200	Measurement of largest amount of air breathed in an out of lungs over one minute	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	24		
94250	Single measurement of remaining air or lung capacity after exhalation	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	29		
94375	Diagnostic testing in a pulmonary function lab	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	28		
94400	Diagnostic testing in a pulmonary function lab	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	55		
94450	Lung function response to low oxygen	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	65		
94452	Testing of lung function at high altitude	Service  intra	L042B	Respiratory Therapist	0.42	Service total costs	43		
94453	Testing of lung function at high altitude with supplemental oxygen delivery	Service  intra	L042B	Respiratory Therapist	0.42	Service total costs	53		
94620	Pulmonary exercise testing	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	37		
94621	Pulmonary exercise testing	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs	20		
94621	Pulmonary exercise testing	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	79		
94621	Pulmonary exercise testing	Post-service	L047C	RN/Respiratory Therapist	0.47	Post service total costs	5		
94640	"Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (IPPB) device"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28		
94644	"Respiratory inhaled aerosol treatment to relieve airway obstruction, first hour"	Pre-service	L047C	RN/Respiratory Therapist	0.47	Preservice total costs	5		
94644	"Respiratory inhaled aerosol treatment to relieve airway obstruction, first hour"	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	22		
94645	Respiratory inhaled aerosol treatment to relieve airway obstruction	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	19		
94645	Respiratory inhaled aerosol treatment to relieve airway obstruction	Post-service	L047C	RN/Respiratory Therapist	0.47	Post service total costs	3		
94660	Initiation and management of continued pressured respiratory assistance by mask or breathing tube	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	42	0	
94664	"Demonstration and/or evaluation of patient use of aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (IPPB) device"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	1		
94664	"Demonstration and/or evaluation of patient use of aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (IPPB) device"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	28		
94667	Demonstration and/or evaluation of manual maneuvers to chest wall to assist movement of lung secretions	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	35		
94668	Manual maneuvers to chest wall to assist movement of lung secretions	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	33		
94669	Mechanical chest wall manipulation for improvement in lung function	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	45		
94680	Collection and analysis of exhaled air for evaluation of lung function during rest and exercise	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	44		
94681	Collection and analysis of exhaled air and carbon dioxide for evaluation of lung function	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	44		
94690	Collection and analysis of exhaled air for evaluation of lung function at rest	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	35		
94726	Determination of lung volumes using plethysmography	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	47		
94726	Determination of lung volumes using plethysmography	Post-service	L047C	RN/Respiratory Therapist	0.47	Post service total costs	3		
94727	Determination of lung volumes using gas dilution or washout	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	32		
94727	Determination of lung volumes using gas dilution or washout	Post-service	L047C	RN/Respiratory Therapist	0.47	Post service total costs	3		
94728	Measurement of airway resistance by impulse oscillometry	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	31		
94728	Measurement of airway resistance by impulse oscillometry	Post-service	L047C	RN/Respiratory Therapist	0.47	Post service total costs	3		
94729	Measurement of lung diffusing capacity	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	30		
94750	Measurement of lung stretching capacity	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	44		
94760	Measurement of oxygen saturation in blood using ear or finger device	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	4		
94761	Multiple measurements of oxygen saturation in blood using ear or finger device	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	7		
94762	Overnight measurement of oxygen saturation in blood using ear or finger device	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	22		
94780	"Car seat or bed airway testing of neonate, 60 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	5	0	
94780	"Car seat or bed airway testing of neonate, 60 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	65	0	
94781	Car seat or bed airway testing of neonate	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	30	0	
95004	"Injection of allergenic extracts into skin, accessed through the skin"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0.125		
95004	"Injection of allergenic extracts into skin, accessed through the skin"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	0.85		
95012	Measurement of inhaled nitric oxide gas	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	19		
95017	"Allergy testing with venoms into or within skin, immediate type reaction, including test interpretation and report"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	4.2	0	
95018	"Allergy testing with drugs or biologicals into or within the skin, immediate type reaction, including test interpretation and report"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	5.195	0	
95024	Injection of allergenic extracts into skin for immediate reaction analysis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0.5	0	
95024	Injection of allergenic extracts into skin for immediate reaction analysis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	1.349	0	
95027	Injection into skin of airborne allergen extracts for immediate reaction analysis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0.533		
95027	Injection into skin of airborne allergen extracts for immediate reaction analysis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	1.437		
95027	Injection into skin of airborne allergen extracts for immediate reaction analysis	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0.067		
95028	Injection of allergenic extracts into skin with delayed reaction analysis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	13		
95044	Application of allergenic extract skin patch with reaction analysis	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0.14		
95044	Application of allergenic extract skin patch with reaction analysis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	2.22		
95052	"Application of allergenic extract skin patch, exposure to ultraviolet light, and reaction analysis"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0.14		
95052	"Application of allergenic extract skin patch, exposure to ultraviolet light, and reaction analysis"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	3		
95056	Ultraviolet light tests of skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	5		
95056	Ultraviolet light tests of skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47		
95060	Application of allergenic extract onto mucous membrane of eye with reaction analysis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40		
95065	Application of allergenic extract onto mucous membrane of nose with reaction analysis	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40		
95070	Inhalation of medications with allergic reaction analysis	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	36		
95071	Inhalation of allergic substances with reaction analysis	Service  intra	L047C	RN/Respiratory Therapist	0.47	Service total costs	41		
95076	"Ingestion of test items for allergies, 120 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	108	0	
95079	Ingestion of test items for allergies	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	40	0	
95115	Injection of incremental dosages of allergen	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
95117	"Injection of incremental dosages of allergen, 2 or more injections"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	17		
95144	Preparation and provision of single-dose vials of allergen antigens for allergy immunotherapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	3.3	0	
95145	Preparation and provision of single stinging insect venom for allergen immunotherapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	2.3	0	
95146	Preparation and provision of 2 single stinging insect venom for allergen immunotherapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	3.3	0	
95147	Preparation and provision of 3 single stinging insect venom for allergen immunotherapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	2.3	0	
95148	Preparation and provision of 4 single stinging insect venom for allergen immunotherapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	3.3	0	
95149	Preparation and provision of 5 single stinging insect venom for allergen immunotherapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	4.3	0	
95165	Preparation and provision of single or multiple antigens for allergen immunotherapy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	2.3	0	
95170	Preparation and provision of whole body extract of biting insect or arthropod antigens	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	2.3	0	
95180	"Rapid desensitization procedure, each hour"	Pre-service	L051A	RN	0.51	Preservice total costs	14	0	
95180	"Rapid desensitization procedure, each hour"	Service  intra	L051A	RN	0.51	Service total costs	37	0	
95180	"Rapid desensitization procedure, each hour"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	3	0	
95180	"Rapid desensitization procedure, each hour"	Post-service	L051A	RN	0.51	Post service total costs	3	6	
95250	"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; sensor placement, hook-up, calibration of monitor, patient training, removal of sensor, and printout of recording"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	5		
95250	"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; sensor placement, hook-up, calibration of monitor, patient training, removal of sensor, and printout of recording"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	77		
95250	"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; sensor placement, hook-up, calibration of monitor, patient training, removal of sensor, and printout of recording"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	25		
95782	Sleep monitoring of patient (younger than 6 years) in sleep lab	Pre-service	L047B	REEGT	0.47	Preservice total costs	6		
95782	Sleep monitoring of patient (younger than 6 years) in sleep lab	Service  intra	L047B	REEGT	0.47	Service total costs	642		
95782	Sleep monitoring of patient (younger than 6 years) in sleep lab	Post-service	L047B	REEGT	0.47	Post service total costs	99		
95783	Sleep monitoring of patient (younger than 6 years) in sleep lab with continued pressured respiratory assistance by mask or breathing tube	Pre-service	L047B	REEGT	0.47	Preservice total costs	6		
95783	Sleep monitoring of patient (younger than 6 years) in sleep lab with continued pressured respiratory assistance by mask or breathing tube	Service  intra	L047B	REEGT	0.47	Service total costs	687		
95783	Sleep monitoring of patient (younger than 6 years) in sleep lab with continued pressured respiratory assistance by mask or breathing tube	Post-service	L047B	REEGT	0.47	Post service total costs	99		
95800	Study of sleep patterns	Pre-service	L047B	REEGT	0.47	Preservice total costs	6		
95800	Study of sleep patterns	Service  intra	L047B	REEGT	0.47	Service total costs	26		
95800	Study of sleep patterns	Post-service	L047B	REEGT	0.47	Post service total costs	17		
95801	Study of sleep patterns	Pre-service	L047B	REEGT	0.47	Preservice total costs	6		
95801	Study of sleep patterns	Service  intra	L047B	REEGT	0.47	Service total costs	23		
95801	Study of sleep patterns	Post-service	L047B	REEGT	0.47	Post service total costs	17		
95803	"Study of sleep and wake patterns including interpretation and report, minimum of 72 hours to 14 consecutive days of recording"	Pre-service	L047B	REEGT	0.47	Preservice total costs	6		
95803	"Study of sleep and wake patterns including interpretation and report, minimum of 72 hours to 14 consecutive days of recording"	Service  intra	L047B	REEGT	0.47	Service total costs	12		
95803	"Study of sleep and wake patterns including interpretation and report, minimum of 72 hours to 14 consecutive days of recording"	Post-service	L047B	REEGT	0.47	Post service total costs	17		
95805	Diagnostic test for sleep disorder	Pre-service	L047B	REEGT	0.47	Preservice total costs	6		
95805	Diagnostic test for sleep disorder	Service  intra	L047B	REEGT	0.47	Service total costs	307		
95805	Diagnostic test for sleep disorder	Post-service	L047B	REEGT	0.47	Post service total costs	2		
95806	"Unattended sleep study with recording of heart rate, oxygen, respiratory airflow and effort"	Pre-service	L047B	REEGT	0.47	Preservice total costs	6		
95806	"Unattended sleep study with recording of heart rate, oxygen, respiratory airflow and effort"	Service  intra	L047B	REEGT	0.47	Service total costs	28		
95806	"Unattended sleep study with recording of heart rate, oxygen, respiratory airflow and effort"	Post-service	L047B	REEGT	0.47	Post service total costs	17		
95807	Sleep study attended by a technician	Pre-service	L047B	REEGT	0.47	Preservice total costs	6		
95807	Sleep study attended by a technician	Service  intra	L047B	REEGT	0.47	Service total costs	271		
95807	Sleep study attended by a technician	Post-service	L047B	REEGT	0.47	Post service total costs	22		
95808	Sleep monitoring of patient in sleep lab	Pre-service	L047B	REEGT	0.47	Preservice total costs	6		
95808	Sleep monitoring of patient in sleep lab	Service  intra	L047B	REEGT	0.47	Service total costs	299		
95808	Sleep monitoring of patient in sleep lab	Post-service	L047B	REEGT	0.47	Post service total costs	52		
95810	Sleep monitoring of patient (6 years or older) in sleep lab	Pre-service	L047B	REEGT	0.47	Preservice total costs	6		
95810	Sleep monitoring of patient (6 years or older) in sleep lab	Service  intra	L047B	REEGT	0.47	Service total costs	317		
95810	Sleep monitoring of patient (6 years or older) in sleep lab	Post-service	L047B	REEGT	0.47	Post service total costs	88		
95811	Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube	Pre-service	L047B	REEGT	0.47	Preservice total costs	6		
95811	Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube	Service  intra	L047B	REEGT	0.47	Service total costs	352		
95811	Sleep monitoring of patient (6 years or older) in sleep lab with continued pressured respiratory assistance by mask or breathing tube	Post-service	L047B	REEGT	0.47	Post service total costs	88		
95812	Electroencephalogram (eeg) extended monitoring; 41-60 minutes	Pre-service	L047B	REEGT	0.47	Coordinate pre-surgery services	3		
95812	Electroencephalogram (eeg) extended monitoring; 41-60 minutes	Pre-service	L047B	REEGT	0.47	Provide pre-service education/obtain consent	3		
95812	Electroencephalogram (eeg) extended monitoring; 41-60 minutes	Service  pre	L047B	REEGT	0.47	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
95812	Electroencephalogram (eeg) extended monitoring; 41-60 minutes	Service  pre	L047B	REEGT	0.47	"Measure and mark head. Apply and secure electrodes to head and chest. Check impedances, reapply electrodes as needed."	20		
95812	Electroencephalogram (eeg) extended monitoring; 41-60 minutes	Service  pre	L047B	REEGT	0.47	Obtain vital signs	3		
95812	Electroencephalogram (eeg) extended monitoring; 41-60 minutes	Service  pre	L047B	REEGT	0.47	Provide pre-service education/obtain consent	0		
95812	Electroencephalogram (eeg) extended monitoring; 41-60 minutes	Service  pre	L047B	REEGT	0.47	Review charts	0		
95812	Electroencephalogram (eeg) extended monitoring; 41-60 minutes	Service  intra	L047B	REEGT	0.47	Assist physician in performing procedure	50		
95812	Electroencephalogram (eeg) extended monitoring; 41-60 minutes	Service  post	L047B	REEGT	0.47	"Clean patient, remove electrodes"	20		
95812	Electroencephalogram (eeg) extended monitoring; 41-60 minutes	Service  post	L047B	REEGT	0.47	Clean room/equipment by physician staff	3		
95812	Electroencephalogram (eeg) extended monitoring; 41-60 minutes	Service  post	L047B	REEGT	0.47	"Complete diagnostic forms, lab, X-ray requisitions"	3		
95812	Electroencephalogram (eeg) extended monitoring; 41-60 minutes	Post-service	L047B	REEGT	0.47	Enter patient information into laboratory log book	0		
95812	Electroencephalogram (eeg) extended monitoring; 41-60 minutes	Post-service	L047B	REEGT	0.47	Prepare technician report in EEG file	3		
95812	Electroencephalogram (eeg) extended monitoring; 41-60 minutes	Post-service	L047B	REEGT	0.47	Score record	0		
95812	Electroencephalogram (eeg) extended monitoring; 41-60 minutes	Post-service	L047B	REEGT	0.47	Transfer data to reading station & archive data	2		
95813	Electroencephalogram (eeg) extended monitoring; greater than 1 hour	Pre-service	L047B	REEGT	0.47	Coordinate pre-surgery services	3		
95813	Electroencephalogram (eeg) extended monitoring; greater than 1 hour	Pre-service	L047B	REEGT	0.47	Provide pre-service education/obtain consent	3		
95813	Electroencephalogram (eeg) extended monitoring; greater than 1 hour	Service  pre	L047B	REEGT	0.47	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
95813	Electroencephalogram (eeg) extended monitoring; greater than 1 hour	Service  pre	L047B	REEGT	0.47	"Measure and mark head. Apply and secure electrodes to head and chest. Check impedances, reapply electrodes as needed."	20		
95813	Electroencephalogram (eeg) extended monitoring; greater than 1 hour	Service  pre	L047B	REEGT	0.47	Obtain vital signs	3		
95813	Electroencephalogram (eeg) extended monitoring; greater than 1 hour	Service  pre	L047B	REEGT	0.47	Provide pre-service education/obtain consent	0		
95813	Electroencephalogram (eeg) extended monitoring; greater than 1 hour	Service  pre	L047B	REEGT	0.47	Review charts	0		
95813	Electroencephalogram (eeg) extended monitoring; greater than 1 hour	Service  intra	L047B	REEGT	0.47	Assist physician in performing procedure	80		
95813	Electroencephalogram (eeg) extended monitoring; greater than 1 hour	Service  post	L047B	REEGT	0.47	"Clean patient, remove electrodes"	20		
95813	Electroencephalogram (eeg) extended monitoring; greater than 1 hour	Service  post	L047B	REEGT	0.47	Clean room/equipment by physician staff	3		
95813	Electroencephalogram (eeg) extended monitoring; greater than 1 hour	Service  post	L047B	REEGT	0.47	"Complete diagnostic forms, lab, X-ray requisitions"	3		
95813	Electroencephalogram (eeg) extended monitoring; greater than 1 hour	Post-service	L047B	REEGT	0.47	Enter patient information into laboratory log book	0		
95813	Electroencephalogram (eeg) extended monitoring; greater than 1 hour	Post-service	L047B	REEGT	0.47	Prepare technician report in EEG file	3		
95813	Electroencephalogram (eeg) extended monitoring; greater than 1 hour	Post-service	L047B	REEGT	0.47	Score record	0		
95813	Electroencephalogram (eeg) extended monitoring; greater than 1 hour	Post-service	L047B	REEGT	0.47	Transfer data to reading station & archive data	2		
95816	"Measurement and recording of brain wave (EEG) activity, awake and drowsy"	Pre-service	L047B	REEGT	0.47	Preservice total costs	6		
95816	"Measurement and recording of brain wave (EEG) activity, awake and drowsy"	Service  intra	L047B	REEGT	0.47	Service total costs	107		
95816	"Measurement and recording of brain wave (EEG) activity, awake and drowsy"	Post-service	L047B	REEGT	0.47	Post service total costs	9		
95819	"Measurement and recording of brain wave (EEG) activity, awake and asleep"	Pre-service	L047B	REEGT	0.47	Preservice total costs	6		
95819	"Measurement and recording of brain wave (EEG) activity, awake and asleep"	Service  intra	L047B	REEGT	0.47	Service total costs	139		
95819	"Measurement and recording of brain wave (EEG) activity, awake and asleep"	Post-service	L047B	REEGT	0.47	Post service total costs	9		
95822	"Measurement and recording of brain wave (EEG) activity, in coma or asleep"	Pre-service	L047B	REEGT	0.47	Preservice total costs	6		
95822	"Measurement and recording of brain wave (EEG) activity, in coma or asleep"	Service  intra	L047B	REEGT	0.47	Service total costs	114		
95822	"Measurement and recording of brain wave (EEG) activity, in coma or asleep"	Post-service	L047B	REEGT	0.47	Post service total costs	9		
95827	"Measurement and recording of brain wave (EEG) activity, overnight"	Pre-service	L047B	REEGT	0.47	Preservice total costs	16		
95827	"Measurement and recording of brain wave (EEG) activity, overnight"	Service  intra	L047B	REEGT	0.47	Service total costs	447		
95829	Measurement of brain activity (EEG) during surgery	Pre-service	L047B	REEGT	0.47	Preservice total costs	50		
95829	Measurement of brain activity (EEG) during surgery	Service  intra	L047B	REEGT	0.47	Service total costs	178		
95829	Measurement of brain activity (EEG) during surgery	Post-service	L047B	REEGT	0.47	Post service total costs	35		
95830	Insertion of electrodes in bone for measurement and recording of brain wave activity (EEG)	Pre-service	L047B	REEGT	0.47	Preservice total costs	8	0	
95830	Insertion of electrodes in bone for measurement and recording of brain wave activity (EEG)	Service  intra	L047B	REEGT	0.47	Service total costs	32	0	
95830	Insertion of electrodes in bone for measurement and recording of brain wave activity (EEG)	Post-service	L047B	REEGT	0.47	Post service total costs	5	0	
95831	"Manual muscle testing of arm, leg or trunk"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	8	0	
95831	"Manual muscle testing of arm, leg or trunk"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	10	0	
95832	Manual muscle testing of hand	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	8	0	
95832	Manual muscle testing of hand	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	8	0	
95833	Manual muscle testing of whole body	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	8	0	
95833	Manual muscle testing of whole body	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	13	0	
95834	Manual muscle testing of whole body including hands	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	8	0	
95834	Manual muscle testing of whole body including hands	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	14	0	
95851	"Range of motion testing of arm, leg or each spine section"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	8	0	
95851	"Range of motion testing of arm, leg or each spine section"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	10	0	
95852	Range of motion testing of hand	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	8	0	
95852	Range of motion testing of hand	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	8	0	
95857	Injection to test for myasthenia gravis	Service  intra	L032B	EEG Technician	0.32	Service total costs	30	0	
95860	Needle measurement and recording of electrical activity of muscles of arm or leg	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	32		
95861	Needle measurement and recording of electrical activity of muscles of arms or legs	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	41		
95863	Needle electromyography; 3 extremities with or without related paraspinal areas	Service  pre	L037A	Electrodiagnostic Technologist	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
95863	Needle electromyography; 3 extremities with or without related paraspinal areas	Service  pre	L037A	Electrodiagnostic Technologist	0.37	Obtain vital signs	3		
95863	Needle electromyography; 3 extremities with or without related paraspinal areas	Service  pre	L037A	Electrodiagnostic Technologist	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
95863	Needle electromyography; 3 extremities with or without related paraspinal areas	Service  pre	L037A	Electrodiagnostic Technologist	0.37	"Prepare room, equipment, supplies"	2		
95863	Needle electromyography; 3 extremities with or without related paraspinal areas	Service  pre	L037A	Electrodiagnostic Technologist	0.37	Provide pre-service education/obtain consent	2		
95863	Needle electromyography; 3 extremities with or without related paraspinal areas	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Assist physician in performing procedure	40		
95863	Needle electromyography; 3 extremities with or without related paraspinal areas	Service  post	L037A	Electrodiagnostic Technologist	0.37	Clean room/equipment by physician staff	3		
95864	Needle electromyography; 4 extremities with or without related paraspinal areas	Service  pre	L037A	Electrodiagnostic Technologist	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
95864	Needle electromyography; 4 extremities with or without related paraspinal areas	Service  pre	L037A	Electrodiagnostic Technologist	0.37	Obtain vital signs	3		
95864	Needle electromyography; 4 extremities with or without related paraspinal areas	Service  pre	L037A	Electrodiagnostic Technologist	0.37	Prepare and position patient/ monitor patient	2		
95864	Needle electromyography; 4 extremities with or without related paraspinal areas	Service  pre	L037A	Electrodiagnostic Technologist	0.37	"Prepare room, equipment, supplies"	2		
95864	Needle electromyography; 4 extremities with or without related paraspinal areas	Service  pre	L037A	Electrodiagnostic Technologist	0.37	Provide pre-service education/obtain consent	2		
95864	Needle electromyography; 4 extremities with or without related paraspinal areas	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Assist physician in performing procedure	50		
95864	Needle electromyography; 4 extremities with or without related paraspinal areas	Service  post	L037A	Electrodiagnostic Technologist	0.37	Clean room/equipment by physician staff	3		
95864	Needle electromyography; 4 extremities with or without related paraspinal areas	Service  post	L037A	Electrodiagnostic Technologist	0.37	"Prepare technician report, summarize clinical and electrodiagnostic data, and interpretation. Provide maximum assistance with dressing and transferring the patient"	0		
95865	Needle measurement and recording of electrical activity of muscles of voice box	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	27		
95866	Needle measurement and recording of electrical activity of muscles between chest and abdominal cavity	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	27		
95867	Needle measurement and recording of electrical activity of cranial nerve-supplied muscles on one side of body	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	27		
95868	Needle measurement and recording of electrical activity of cranial nerve-supplied muscles on both sides of body	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	32		
95869	Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)	Service  pre	L037A	Electrodiagnostic Technologist	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
95869	Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)	Service  pre	L037A	Electrodiagnostic Technologist	0.37	Obtain vital signs	3		
95869	Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)	Service  pre	L037A	Electrodiagnostic Technologist	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
95869	Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)	Service  pre	L037A	Electrodiagnostic Technologist	0.37	"Prepare room, equipment, supplies"	2		
95869	Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)	Service  pre	L037A	Electrodiagnostic Technologist	0.37	Provide pre-service education/obtain consent	2		
95869	Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Assist physician in performing procedure	15		
95869	Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)	Service  post	L037A	Electrodiagnostic Technologist	0.37	Clean room/equipment by physician staff	3		
95870	"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters"	Service  pre	L037A	Electrodiagnostic Technologist	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
95870	"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters"	Service  pre	L037A	Electrodiagnostic Technologist	0.37	Obtain vital signs	3		
95870	"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters"	Service  pre	L037A	Electrodiagnostic Technologist	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
95870	"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters"	Service  pre	L037A	Electrodiagnostic Technologist	0.37	"Prepare room, equipment, supplies"	2		
95870	"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters"	Service  pre	L037A	Electrodiagnostic Technologist	0.37	Provide pre-service education/obtain consent	2		
95870	"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Assist physician in performing procedure	15		
95870	"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters"	Service  post	L037A	Electrodiagnostic Technologist	0.37	Clean room/equipment by physician staff	3		
95872	Needle measurement and recording electrical activity of muscles including jitter blocking and/or fiber density using single electrode	Pre-service	L037A	Electrodiagnostic Technologist	0.37	Preservice total costs	8		
95872	Needle measurement and recording electrical activity of muscles including jitter blocking and/or fiber density using single electrode	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	26		
95872	Needle measurement and recording electrical activity of muscles including jitter blocking and/or fiber density using single electrode	Post-service	L037A	Electrodiagnostic Technologist	0.37	Post service total costs	3		
95873	Electrical stimulation for guidance with injection of chemical for destruction of muscles	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	5		
95874	Needle measurement and recording of electrical activity of muscles for guidance with injection of chemical for destruction of muscles	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	5		
95875	Needle measurement and recording of electrical activity of muscles having lost blood flow	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43		
95885	Needle measurement and recording of electrical activity of muscles of arm or leg limited study	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	8		
95886	Needle measurement and recording of electrical activity of muscles of arm or leg complete study	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	18		
95887	Needle measurement and recording of electrical activity of head or trunk muscles	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	13		
95905	Needle measurement and recording of movement and/or feeling of arm or leg with interpretation and report	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	8		
95907	"Nerve transmission studies, 1-2 studies"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	27		
95908	"Nerve transmission studies, 3-4 studies"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	34		
95909	"Nerve transmission studies, 5-6 studies"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	42		
95910	"Nerve transmission studies, 7-8 studies"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	52		
95911	"Nerve transmission studies, 9-10 studies"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	62		
95912	"Nerve transmission studies, 11-12 studies"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	72		
95913	"Nerve transmission studies, 13 or more studies"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	82		
95921	Testing of autonomic (sympathetic) nervous system function	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	55		
95922	Testing of autonomic (sympathetic) nervous system function at least 5 minutes of tilt	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	70		
95923	"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential"	Pre-service	L037A	Electrodiagnostic Technologist	0.37	Check to make sure patient is not wearing compression garments; remove compression garments	0		
95923	"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential"	Pre-service	L037A	Electrodiagnostic Technologist	0.37	Complete pre-service diagnostic and referral forms	2		
95923	"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential"	Service  pre	L037A	Electrodiagnostic Technologist	0.37	"Prepare room, equipment, supplies"	2		
95923	"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Assist physician in performing procedure	41		
95923	"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential"	Service  post	L037A	Electrodiagnostic Technologist	0.37	Clean room/equipment by physician staff	0		
95923	"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential"	Service  post	L037A	Electrodiagnostic Technologist	0.37	"Complete diagnostic forms, lab, X-ray requisitions"	0		
95924	"Testing of autonomic (sympathetic) nervous system function, at least 5 minutes of tilt"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	76		
95925	Insertion of needles and skin electrodes for measurement and recording of stimulated sites in the arms	Pre-service	L047B	REEGT	0.47	Preservice total costs	8		
95925	Insertion of needles and skin electrodes for measurement and recording of stimulated sites in the arms	Service  intra	L047B	REEGT	0.47	Service total costs	76		
95926	Insertion of needles and skin electrodes for measurement and recording of stimulated sites in the legs	Pre-service	L047B	REEGT	0.47	Preservice total costs	8		
95926	Insertion of needles and skin electrodes for measurement and recording of stimulated sites in the legs	Service  intra	L047B	REEGT	0.47	Service total costs	76		
95927	Insertion of needles and skin electrodes for measurement and recording of stimulated sites on the trunk or head	Pre-service	L047B	REEGT	0.47	Preservice total costs	14		
95927	Insertion of needles and skin electrodes for measurement and recording of stimulated sites on the trunk or head	Service  intra	L047B	REEGT	0.47	Service total costs	92		
95927	Insertion of needles and skin electrodes for measurement and recording of stimulated sites on the trunk or head	Post-service	L047B	REEGT	0.47	Post service total costs	3		
95928	Central motor evoked potential study (transcranial motor stimulation); upper limbs	Pre-service	L047B	REEGT	0.47	Complete pre-service diagnostic and referral forms	2		
95928	Central motor evoked potential study (transcranial motor stimulation); upper limbs	Pre-service	L047B	REEGT	0.47	Provide pre-service education/obtain consent	3		
95928	Central motor evoked potential study (transcranial motor stimulation); upper limbs	Pre-service	L047B	REEGT	0.47	"Review requisition. Assess for special needs. Give patient instructions for test preparation (eg, hair, lotion) and what to expect on the day of testing"	0		
95928	Central motor evoked potential study (transcranial motor stimulation); upper limbs	Service  pre	L047B	REEGT	0.47	"Greet patient, provide gowning, ensure appropriate medical records are available"	0		
95928	Central motor evoked potential study (transcranial motor stimulation); upper limbs	Service  pre	L047B	REEGT	0.47	"Prepare room, equipment, supplies"	2		
95928	Central motor evoked potential study (transcranial motor stimulation); upper limbs	Service  intra	L047B	REEGT	0.47	Assist physician in performing procedure	40		
95928	Central motor evoked potential study (transcranial motor stimulation); upper limbs	Service  post	L047B	REEGT	0.47	Clean room/equipment by physician staff	3		
95928	Central motor evoked potential study (transcranial motor stimulation); upper limbs	Service  post	L047B	REEGT	0.47	"Complete diagnostic forms, lab, X-ray requisitions"	0		
95929	Central motor evoked potential study (transcranial motor stimulation); lower limbs	Pre-service	L047B	REEGT	0.47	Complete pre-service diagnostic and referral forms	2		
95929	Central motor evoked potential study (transcranial motor stimulation); lower limbs	Pre-service	L047B	REEGT	0.47	Provide pre-service education/obtain consent	3		
95929	Central motor evoked potential study (transcranial motor stimulation); lower limbs	Pre-service	L047B	REEGT	0.47	"Review requisition. Assess for special needs. Give patient instructions for test preparation (eg, hair, lotion) and what to expect on the day of testing"	0		
95929	Central motor evoked potential study (transcranial motor stimulation); lower limbs	Service  pre	L047B	REEGT	0.47	Assist physician in performing procedure	40		
95929	Central motor evoked potential study (transcranial motor stimulation); lower limbs	Service  pre	L047B	REEGT	0.47	"Greet patient, provide gowning, ensure appropriate medical records are available"	0		
95929	Central motor evoked potential study (transcranial motor stimulation); lower limbs	Service  pre	L047B	REEGT	0.47	"Prepare room, equipment, supplies"	2		
95929	Central motor evoked potential study (transcranial motor stimulation); lower limbs	Service  post	L047B	REEGT	0.47	Clean room/equipment by physician staff	3		
95929	Central motor evoked potential study (transcranial motor stimulation); lower limbs	Service  post	L047B	REEGT	0.47	"Complete diagnostic forms, lab, X-ray requisitions"	0		
95930	Measurement and recording of nerve conduction patterns using visually-evoked stimulation	Pre-service	L047B	REEGT	0.47	Preservice total costs	14		
95930	Measurement and recording of nerve conduction patterns using visually-evoked stimulation	Service  intra	L047B	REEGT	0.47	Service total costs	67		
95930	Measurement and recording of nerve conduction patterns using visually-evoked stimulation	Post-service	L047B	REEGT	0.47	Post service total costs	3		
95933	"Orbicularis oculi (blink) reflex, by electrodiagnostic testing"	Service  pre	L037A	Electrodiagnostic Technologist	0.37	"Assist physician in cleaning area, relaxing patient.  Take notes from physician"	25		
95933	"Orbicularis oculi (blink) reflex, by electrodiagnostic testing"	Service  pre	L037A	Electrodiagnostic Technologist	0.37	"Prepare room, equipment, supplies"	2		
95933	"Orbicularis oculi (blink) reflex, by electrodiagnostic testing"	Service  post	L037A	Electrodiagnostic Technologist	0.37	Clean room/equipment by physician staff	3		
95937	Testing with stimulation for assessment of function at muscle-nerve junction	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	22		
95938	Insertion of needles and skin electrodes for measurement and recording of stimulated sites in the arms and legs	Pre-service	L047B	REEGT	0.47	Preservice total costs	8		
95938	Insertion of needles and skin electrodes for measurement and recording of stimulated sites in the arms and legs	Service  intra	L047B	REEGT	0.47	Service total costs	132		
95939	Insertion of needles and skin electrodes for measurement and recording of stimulated sites in the arms and legs	Pre-service	L047B	REEGT	0.47	Preservice total costs	8		
95939	Insertion of needles and skin electrodes for measurement and recording of stimulated sites in the arms and legs	Service  intra	L047B	REEGT	0.47	Service total costs	153		
95950	Monitoring and localization of seizure activity over 24-hour period using electroencephalograph (EEG)	Pre-service	L047B	REEGT	0.47	Preservice total costs	9		
95950	Monitoring and localization of seizure activity over 24-hour period using electroencephalograph (EEG)	Service  intra	L047B	REEGT	0.47	Service total costs	67		
95950	Monitoring and localization of seizure activity over 24-hour period using electroencephalograph (EEG)	Post-service	L047B	REEGT	0.47	Post service total costs	44		
95953	Monitoring and localization of seizure activity over 24-hour period using portable 16-channel electroencephalograph (EEG)	Pre-service	L047B	REEGT	0.47	Preservice total costs	9		
95953	Monitoring and localization of seizure activity over 24-hour period using portable 16-channel electroencephalograph (EEG)	Service  intra	L047B	REEGT	0.47	Service total costs	67		
95953	Monitoring and localization of seizure activity over 24-hour period using portable 16-channel electroencephalograph (EEG)	Post-service	L047B	REEGT	0.47	Post service total costs	44		
95954	Measurement and recording of electrical activity (EEG) of the brain including stimulation by medication or physical activity	Pre-service	L047B	REEGT	0.47	Preservice total costs	8		
95954	Measurement and recording of electrical activity (EEG) of the brain including stimulation by medication or physical activity	Service  intra	L047B	REEGT	0.47	Service total costs	177		
95954	Measurement and recording of electrical activity (EEG) of the brain including stimulation by medication or physical activity	Post-service	L047B	REEGT	0.47	Post service total costs	33		
95956	"Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (eeg) recording and interpretation, each 24 hours, attended by a technologist or nurse"	Pre-service	L047B	REEGT	0.47	Coordinate pre-surgery services	3		
95956	"Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (eeg) recording and interpretation, each 24 hours, attended by a technologist or nurse"	Pre-service	L047B	REEGT	0.47	Coordinate pretesting services/ review test/exam results	0		
95956	"Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (eeg) recording and interpretation, each 24 hours, attended by a technologist or nurse"	Pre-service	L047B	REEGT	0.47	Provide pre-service education/obtain consent	3		
95956	"Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (eeg) recording and interpretation, each 24 hours, attended by a technologist or nurse"	Service  pre	L047B	REEGT	0.47	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
95956	"Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (eeg) recording and interpretation, each 24 hours, attended by a technologist or nurse"	Service  pre	L047B	REEGT	0.47	"Measure and mark head. Apply and secure electrodes to head and chest. Check impedances, reapply electrodes as needed."	20		
95956	"Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (eeg) recording and interpretation, each 24 hours, attended by a technologist or nurse"	Service  pre	L047B	REEGT	0.47	Obtain vital signs	3		
95956	"Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (eeg) recording and interpretation, each 24 hours, attended by a technologist or nurse"	Service  pre	L047B	REEGT	0.47	Provide pre-service education/obtain consent	0		
95956	"Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (eeg) recording and interpretation, each 24 hours, attended by a technologist or nurse"	Service  intra	L047B	REEGT	0.47	Assist physician in performing procedure	720		
95956	"Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (eeg) recording and interpretation, each 24 hours, attended by a technologist or nurse"	Service  post	L047B	REEGT	0.47	Clean room/equipment by physician staff	3		
95956	"Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (eeg) recording and interpretation, each 24 hours, attended by a technologist or nurse"	Service  post	L047B	REEGT	0.47	"Complete diagnostic forms, lab, X-ray requisitions"	1		
95956	"Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (eeg) recording and interpretation, each 24 hours, attended by a technologist or nurse"	Service  post	L047B	REEGT	0.47	Remove electrodes and recording devices; clean up patient	20		
95956	"Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (eeg) recording and interpretation, each 24 hours, attended by a technologist or nurse"	Post-service	L047B	REEGT	0.47	Prepare tech report	4		
95956	"Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (eeg) recording and interpretation, each 24 hours, attended by a technologist or nurse"	Post-service	L047B	REEGT	0.47	Review and edit recording	40		
95957	Digital analysis of electrical brain wave activity (EEG)	Service  intra	L047B	REEGT	0.47	Service total costs	105		
95958	Measurement and recording of electrical brain wave activity (EEG) in a specific area of the brain	Pre-service	L047B	REEGT	0.47	Preservice total costs	17		
95958	Measurement and recording of electrical brain wave activity (EEG) in a specific area of the brain	Service  intra	L047B	REEGT	0.47	Service total costs	223		
95961	"Mapping of electrical brain wave activity (EEG) using electrodes on brain surface to provoke seizure activity or assess brain function, first hour"	Service  intra	L047B	REEGT	0.47	Service total costs	60		
95962	Mapping of electrical brain wave activity (EEG) to provoke seizure activity or assess brain function	Service  intra	L047B	REEGT	0.47	Service total costs	60		
95970	Electronic analysis of implanted brain spinal cord or peripheral neurostimulator generator system	Service  intra	L051A	RN	0.51	Service total costs	44	0	
95971	Electronic analysis of implanted neurostimulator ; simple spinal cord with intraoperative or subsequent programming	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
95971	Electronic analysis of implanted neurostimulator ; simple spinal cord with intraoperative or subsequent programming	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
95971	Electronic analysis of implanted neurostimulator ; simple spinal cord with intraoperative or subsequent programming	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	13		
95971	Electronic analysis of implanted neurostimulator ; simple spinal cord with intraoperative or subsequent programming	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	1		
95972	"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex spinal cord, or peripheral (ie, peripheral nerve, sacral nerve, neuromuscular) (except cranial nerve) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming"	Service  pre	L037D	RN/LPN/MTA	0.37	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
95972	"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex spinal cord, or peripheral (ie, peripheral nerve, sacral nerve, neuromuscular) (except cranial nerve) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	3		
95972	"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex spinal cord, or peripheral (ie, peripheral nerve, sacral nerve, neuromuscular) (except cranial nerve) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming"	Service  pre	L037D	RN/LPN/MTA	0.37	Prepare and position pt/ monitor pt/ set up IV	2		
95972	"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex spinal cord, or peripheral (ie, peripheral nerve, sacral nerve, neuromuscular) (except cranial nerve) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
95972	"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex spinal cord, or peripheral (ie, peripheral nerve, sacral nerve, neuromuscular) (except cranial nerve) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	15		
95972	"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex spinal cord, or peripheral (ie, peripheral nerve, sacral nerve, neuromuscular) (except cranial nerve) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	3		
95972	"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude, pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); complex spinal cord, or peripheral (ie, peripheral nerve, sacral nerve, neuromuscular) (except cranial nerve) neurostimulator pulse generator/transmitter, with intraoperative or subsequent programming"	Post-service	L037D	RN/LPN/MTA	0.37	Conduct phone calls/call in prescriptions	3		
95974	"Electronic analysis and programming of implanted complex cranial neurostimulator generator system during or after surgery, first hour"	Service  intra	L051A	RN	0.51	Service total costs	34	0	
95975	Electronic analysis and programming of implanted complex cranial neurostimulator generator system during or after surgery	Service  intra	L051A	RN	0.51	Service total costs	15	0	
95978	"Electronic analysis and programming of implanted complex deep brain neurostimulator generator system, first hour"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	0	
95978	"Electronic analysis and programming of implanted complex deep brain neurostimulator generator system, first hour"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
95979	Electronic analysis and programming of implanted complex deep brain neurostimulator generator system	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
95980	Electronic analysis and programming during surgery of implanted gastric neurostimulator generator	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		3	
95981	Electronic analysis of implanted gastric neurostimulator generator or transmitter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	3	
95981	Electronic analysis of implanted gastric neurostimulator generator or transmitter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	23	0	
95981	Electronic analysis of implanted gastric neurostimulator generator or transmitter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
95982	Electronic analysis and programming of implanted gastric neurostimulator generator or transmitter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	3	
95982	Electronic analysis and programming of implanted gastric neurostimulator generator or transmitter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
95982	Electronic analysis and programming of implanted gastric neurostimulator generator or transmitter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
95990	Refilling and maintenance of implantable spinal or brain drug delivery pump or reservoir	Pre-service	L051A	RN	0.51	Preservice total costs	15		
95990	Refilling and maintenance of implantable spinal or brain drug delivery pump or reservoir	Service  intra	L051A	RN	0.51	Service total costs	32		
95990	Refilling and maintenance of implantable spinal or brain drug delivery pump or reservoir	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	3		
95991	Refilling and maintenance by physician of implantable spinal or brain drug delivery pump or reservoir	Pre-service	L051A	RN	0.51	Preservice total costs	15	0	
95991	Refilling and maintenance by physician of implantable spinal or brain drug delivery pump or reservoir	Service  intra	L051A	RN	0.51	Service total costs	32	0	
95991	Refilling and maintenance by physician of implantable spinal or brain drug delivery pump or reservoir	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	3	0	
95992	"Repositioning maneuvers for treatment of vertigo, per day"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	4	0	
96040	Medical genetic patient or family counseling services each 30 minutes	Pre-service	L057A	Genetics Counselor	0.567	Preservice total costs	5		
96040	Medical genetic patient or family counseling services each 30 minutes	Service  intra	L057A	Genetics Counselor	0.567	Service total costs	30		
96040	Medical genetic patient or family counseling services each 30 minutes	Post-service	L057A	Genetics Counselor	0.567	Post service total costs	20		
96102	Psychological testing with interpretation and report by technician per hour	Service  intra	L039C	Psychometrist	0.394	Service total costs	60	0	
96111	Developmental testing	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	3	0	
96119	Neuropsychological testing by technician with interpretation and report by a qualified healthcare professional per hour	Service  intra	L039C	Psychometrist	0.394	Service total costs	60	0	
96120	Neuropsychological testing by a computer with interpretation and report by a qualified healthcare professional	Service  intra	L039C	Psychometrist	0.394	Service total costs	20	0	
96127	Brief emotional/behavioral assessment	Service  intra	L026A	Medical/Technical Assistant	0.26	Scoring completed behavior assessment tool	7		
96360	Hydration infusion into a vein 31 minutes to 1 hour	Pre-service	L056A	RN/OCN	0.79	Preservice total costs	3		
96360	Hydration infusion into a vein 31 minutes to 1 hour	Service  intra	L056A	RN/OCN	0.79	Service total costs	34		
96360	Hydration infusion into a vein 31 minutes to 1 hour	Post-service	L056A	RN/OCN	0.79	Post service total costs	3		
96361	Hydration infusion into a vein	Service  intra	L056A	RN/OCN	0.79	Service total costs	10		
96365	"Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour"	Pre-service	L056A	RN/OCN	0.79	Preservice total costs	2		
96365	"Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour"	Service  intra	L056A	RN/OCN	0.79	Service total costs	42		
96365	"Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour"	Post-service	L056A	RN/OCN	0.79	Post service total costs	3		
96366	"Infusion into a vein for therapy, prevention, or diagnosis"	Service  intra	L056A	RN/OCN	0.79	Service total costs	9		
96367	Infusion into a vein for therapy prevention or diagnosis additional sequential infusion up to 1 hour	Service  intra	L056A	RN/OCN	0.79	Service total costs	19		
96368	"Infusion into a vein for therapy, prevention, or diagnosis, concurrent with another infusion"	Service  intra	L056A	RN/OCN	0.79	Service total costs	11		
96369	Infusion into tissue for therapy or prevention up to 1 hour	Pre-service	L051A	RN	0.51	Preservice total costs	6		
96369	Infusion into tissue for therapy or prevention up to 1 hour	Service  intra	L051A	RN	0.51	Service total costs	41		
96369	Infusion into tissue for therapy or prevention up to 1 hour	Post-service	L051A	RN	0.51	Post service total costs	1		
96370	"Infusion into tissue for therapy or prevention, beneath the skin"	Service  intra	L051A	RN	0.51	Service total costs	10		
96371	"Infusion for therapy or prevention, beneath the skin"	Service  intra	L051A	RN	0.51	Service total costs	7		
96372	"Injection beneath the skin or into muscle for therapy, diagnosis, or prevention"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3		
96372	"Injection beneath the skin or into muscle for therapy, diagnosis, or prevention"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26		
96372	"Injection beneath the skin or into muscle for therapy, diagnosis, or prevention"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
96373	"Injection into artery for therapy, diagnosis, or prevention"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	19		
96374	"Injection of drug or substance into a vein for therapy, diagnosis, or prevention"	Pre-service	L056A	RN/OCN	0.79	Preservice total costs	6		
96374	"Injection of drug or substance into a vein for therapy, diagnosis, or prevention"	Service  intra	L056A	RN/OCN	0.79	Service total costs	32		
96374	"Injection of drug or substance into a vein for therapy, diagnosis, or prevention"	Post-service	L056A	RN/OCN	0.79	Post service total costs	3		
96375	"Injection of different drug or substance into a vein for therapy, diagnosis, or prevention"	Service  intra	L056A	RN/OCN	0.79	Service total costs	16		
96401	Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle	Pre-service	L056A	RN/OCN	0.79	Preservice total costs	6		
96401	Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle	Service  intra	L056A	RN/OCN	0.79	Service total costs	50		
96401	Non-hormonal anti-neoplastic chemotherapy beneath the skin or into muscle	Post-service	L056A	RN/OCN	0.79	Post service total costs	3		
96402	Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
96402	Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36		
96402	Hormonal anti-neoplastic chemotherapy administration beneath the skin or into muscle	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3		
96405	"Chemotherapy into a lesion, up to and including 7 lesions"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	0	
96406	"Chemotherapy into a lesion, more than 7 lesions"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
96409	Infusion of chemotherapy into a vein using push technique	Pre-service	L056A	RN/OCN	0.79	Preservice total costs	6		
96409	Infusion of chemotherapy into a vein using push technique	Service  intra	L056A	RN/OCN	0.79	Service total costs	73		
96409	Infusion of chemotherapy into a vein using push technique	Post-service	L056A	RN/OCN	0.79	Post service total costs	6		
96411	Infusion of different chemotherapy drug or substance into a vein	Service  intra	L056A	RN/OCN	0.79	Service total costs	46		
96413	Infusion of chemotherapy into a vein up to 1 hour	Pre-service	L056A	RN/OCN	0.79	Preservice total costs	2		
96413	Infusion of chemotherapy into a vein up to 1 hour	Service  intra	L056A	RN/OCN	0.79	Service total costs	88		
96413	Infusion of chemotherapy into a vein up to 1 hour	Post-service	L056A	RN/OCN	0.79	Post service total costs	6		
96415	Infusion of chemotherapy into a vein	Service  intra	L056A	RN/OCN	0.79	Service total costs	19		
96416	Prolonged chemotherapy infusion into a vein by portable or implanted pump more than 8 hours	Pre-service	L056A	RN/OCN	0.79	Preservice total costs	5		
96416	Prolonged chemotherapy infusion into a vein by portable or implanted pump more than 8 hours	Service  intra	L056A	RN/OCN	0.79	Service total costs	83		
96416	Prolonged chemotherapy infusion into a vein by portable or implanted pump more than 8 hours	Post-service	L056A	RN/OCN	0.79	Post service total costs	6		
96417	Infusion of different chemotherapy drug or substance into a vein up to 1 hour	Service  intra	L056A	RN/OCN	0.79	Service total costs	44		
96420	Injection of chemotherapy using push technique into an artery	Service  intra	L056A	RN/OCN	0.79	Service total costs	76		
96420	Injection of chemotherapy using push technique into an artery	Post-service	L056A	RN/OCN	0.79	Post service total costs	6		
96422	Infusion of chemotherapy into an artery up to 1 hour	Service  intra	L056A	RN/OCN	0.79	Service total costs	121		
96422	Infusion of chemotherapy into an artery up to 1 hour	Post-service	L056A	RN/OCN	0.79	Post service total costs	6		
96423	Infusion of chemotherapy into artery	Service  intra	L056A	RN/OCN	0.79	Service total costs	65		
96425	"Prolonged chemotherapy infusion into artery by portable or implanted pump, more than 8 hours"	Service  intra	L056A	RN/OCN	0.79	Service total costs	140		
96425	"Prolonged chemotherapy infusion into artery by portable or implanted pump, more than 8 hours"	Post-service	L056A	RN/OCN	0.79	Post service total costs	6		
96440	Chemotherapy administration into chest cavity requiring insertion of catheter	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	23	
96440	Chemotherapy administration into chest cavity requiring insertion of catheter	Service  intra	L051A	RN	0.51	Service total costs	67	0	
96440	Chemotherapy administration into chest cavity requiring insertion of catheter	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	12	0	
96440	Chemotherapy administration into chest cavity requiring insertion of catheter	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
96446	Chemotherapy infusion into abdominal cavity	Pre-service	L056A	RN/OCN	0.79	Preservice total costs	6	0	
96446	Chemotherapy infusion into abdominal cavity	Service  intra	L056A	RN/OCN	0.79	Service total costs	121	0	
96446	Chemotherapy infusion into abdominal cavity	Post-service	L056A	RN/OCN	0.79	Post service total costs	6	0	
96450	Chemotherapy administration into spinal canal requiring spinal tap	Pre-service	L056A	RN/OCN	0.79	Preservice total costs	6	0	
96450	Chemotherapy administration into spinal canal requiring spinal tap	Service  intra	L056A	RN/OCN	0.79	Service total costs	72	0	
96450	Chemotherapy administration into spinal canal requiring spinal tap	Post-service	L056A	RN/OCN	0.79	Post service total costs	3	0	
96521	Refilling and maintenance of portable pump	Pre-service	L056A	RN/OCN	0.79	Preservice total costs	6		
96521	Refilling and maintenance of portable pump	Service  intra	L056A	RN/OCN	0.79	Service total costs	70		
96521	Refilling and maintenance of portable pump	Post-service	L056A	RN/OCN	0.79	Post service total costs	6		
96522	Refilling and maintenance of implantable pump or reservoir for drug delivery	Pre-service	L056A	RN/OCN	0.79	Preservice total costs	6		
96522	Refilling and maintenance of implantable pump or reservoir for drug delivery	Service  intra	L056A	RN/OCN	0.79	Service total costs	73		
96522	Refilling and maintenance of implantable pump or reservoir for drug delivery	Post-service	L056A	RN/OCN	0.79	Post service total costs	6		
96523	Irrigation of implanted venous access drug delivery device	Service  intra	L056A	RN/OCN	0.79	Service total costs	16		
96542	Chemotherapy injection into brain through reservoir beneath the skin	Pre-service	L056A	RN/OCN	0.79	Preservice total costs	6	0	
96542	Chemotherapy injection into brain through reservoir beneath the skin	Service  intra	L056A	RN/OCN	0.79	Service total costs	59	0	
96542	Chemotherapy injection into brain through reservoir beneath the skin	Post-service	L056A	RN/OCN	0.79	Post service total costs	3	0	
96567	"Application of light to aid destruction of premalignant and/or malignant skin growths, each session"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
96567	"Application of light to aid destruction of premalignant and/or malignant skin growths, each session"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	58		
96567	"Application of light to aid destruction of premalignant and/or malignant skin growths, each session"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	4		
96900	Application of ultraviolet light to skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21		
96900	Application of ultraviolet light to skin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	1		
96904	Whole body skin photography	Service  intra	L038C	Medical Photographer	0.383	Service total costs	28		
96904	Whole body skin photography	Service  intra	L026A	Medical/Technical Assistant	0.26	Service total costs	29		
96910	Skin application of tar and ultraviolet B or petrolatum and ultraviolet B	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
96910	Skin application of tar and ultraviolet B or petrolatum and ultraviolet B	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	43		
96910	Skin application of tar and ultraviolet B or petrolatum and ultraviolet B	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	1		
96912	Application of chemical agents activated by ultraviolet light to skin	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
96912	Application of chemical agents activated by ultraviolet light to skin	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	46		
96912	Application of chemical agents activated by ultraviolet light to skin	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	1		
96913	Application of chemical agents activated by ultraviolet light to skin at least 4-8 hours	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2		
96913	Application of chemical agents activated by ultraviolet light to skin at least 4-8 hours	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	83		
96920	Laser treatment (total area less than 250 sq centimeters) for inflammatory skin disease	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	42	0	
96921	Laser treatment (250 to 500 sq centimeters) for inflammatory skin disease	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	45	0	
96922	Laser treatment (over 500 sq centimeters) for inflammatory skin disease	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	55	0	
97001	Physical therapy evaluation	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	13		
97001	Physical therapy evaluation	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	21		
97002	Physical therapy re-evaluation	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	13		
97002	Physical therapy re-evaluation	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	14		
97003	Occupational therapy evaluation	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	13		
97003	Occupational therapy evaluation	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	21		
97004	Occupational therapy re-evaluation	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	12		
97004	Occupational therapy re-evaluation	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	15		
97010	Application of hot or cold packs to 1 or more areas	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	3		
97010	Application of hot or cold packs to 1 or more areas	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	4		
97012	Application of mechanical traction to 1 or more areas	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	3		
97012	Application of mechanical traction to 1 or more areas	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	6		
97014	"Application of electrical stimulation to 1 or more areas, unattended by physical therapist"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	3		
97014	"Application of electrical stimulation to 1 or more areas, unattended by physical therapist"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	4		
97016	Application of blood vessel compression or decompression device to 1 or more areas	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	4		
97016	Application of blood vessel compression or decompression device to 1 or more areas	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	17		
97018	Application of hot wax bath to 1 or more areas	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	9		
97018	Application of hot wax bath to 1 or more areas	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	6		
97022	Application of whirlpool therapy to 1 or more areas	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	18		
97022	Application of whirlpool therapy to 1 or more areas	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	6		
97024	Application of heat wave therapy to 1 or more areas	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	2		
97024	Application of heat wave therapy to 1 or more areas	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	4		
97026	Application of low energy heat (infrared) to 1 or more areas	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	2		
97026	Application of low energy heat (infrared) to 1 or more areas	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	4		
97028	Application of ultraviolet light to 1 or more areas	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	2		
97028	Application of ultraviolet light to 1 or more areas	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	4		
97032	"Application of electrical stimulation to 1 or more areas, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	3		
97032	"Application of electrical stimulation to 1 or more areas, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	4		
97033	"Application of medication through skin using electrical current, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	8		
97033	"Application of medication through skin using electrical current, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	2		
97034	"Therapeutic hot and cold baths to 1 or more areas, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	10		
97034	"Therapeutic hot and cold baths to 1 or more areas, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	6		
97035	"Application of ultrasound to 1 or more areas, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	2		
97035	"Application of ultrasound to 1 or more areas, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	4		
97036	"Physical therapy treatment to 1 or more areas, Hubbard tank, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	24		
97036	"Physical therapy treatment to 1 or more areas, Hubbard tank, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	16		
97110	"Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	5		
97110	"Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	15		
97112	"Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	5		
97112	"Therapeutic procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	15		
97113	"Water pool therapy with therapeutic exercises to 1 or more areas, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	8		
97113	"Water pool therapy with therapeutic exercises to 1 or more areas, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	15		
97116	"Walking training to 1 or more areas, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	5		
97116	"Walking training to 1 or more areas, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	15		
97124	"Therapeutic massage to 1 or more areas, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	5		
97124	"Therapeutic massage to 1 or more areas, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	15		
97140	"Manual (physical) therapy techniques to 1 or more regions, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	5		
97140	"Manual (physical) therapy techniques to 1 or more regions, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	15		
97150	Therapeutic procedures in a group setting	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	5		
97530	"Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	7		
97530	"Therapeutic activities to improve function, with one-on-one contact between patient and provider, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	13		
97532	"Development of cognitive skills to improve attention, memory, or problem solving, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	12		
97533	"Sensory technique to enhance processing and adaptation to environmental demands, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	20		
97535	"Self-care or home management training, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	7		
97535	"Self-care or home management training, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	13		
97537	"Community or work reintegration training, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	7		
97537	"Community or work reintegration training, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	13		
97542	"Wheelchair management, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	7		
97542	"Wheelchair management, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	13		
97597	Removal of tissue from wounds per session	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	0	
97597	Removal of tissue from wounds per session	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
97598	Removal of tissue from wounds per session	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	14	0	
97605	"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less th"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
97605	"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less th"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	20		
97605	"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less th"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	2		
97605	"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less th"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	1		
97606	"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	2		
97606	"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist physician in performing procedure	30		
97606	"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater"	Service  post	L037D	RN/LPN/MTA	0.37	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	2		
97606	"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	1		
97610	"Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day"	Service  pre	L023A	Physical Therapy Aide	0.23	Greet patient and provide gowning	3		
97610	"Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day"	Service  pre	L023A	Physical Therapy Aide	0.23	Obtain vital signs	3		
97610	"Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day"	Service  pre	L023A	Physical Therapy Aide	0.23	Prepare and position pt/ monitor pt/ set up IV	2		
97610	"Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day"	Service  pre	L023A	Physical Therapy Aide	0.23	"Prepare room, equipment, supplies"	2		
97610	"Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day"	Service  pre	L023A	Physical Therapy Aide	0.23	SVC Provide pre-service education/obtain consent	3		
97610	"Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day"	Service  intra	L023A	Physical Therapy Aide	0.23	Assist physician in performing procedure	12		
97610	"Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day"	Service  post	L023A	Physical Therapy Aide	0.23	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	3		
97610	"Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day"	Service  post	L023A	Physical Therapy Aide	0.23	Clean room/equipment by physician staff	3		
97750	"Physical performance test or measurement with report, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	8		
97750	"Physical performance test or measurement with report, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	14		
97755	"Assistive technology assessment to enhance functional performance, each 15 minutes"	Pre-service	L023A	Physical Therapy Aide	0.23	Preservice total costs	0.8		
97755	"Assistive technology assessment to enhance functional performance, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	0.7		
97755	"Assistive technology assessment to enhance functional performance, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	9.6		
97755	"Assistive technology assessment to enhance functional performance, each 15 minutes"	Post-service	L023A	Physical Therapy Aide	0.23	Post service total costs	0.8		
97755	"Assistive technology assessment to enhance functional performance, each 15 minutes"	Post-service	L039B	Physical Therapy Assistant	0.39	Post service total costs	0.6		
97760	"Training in use of orthotics (supports, braces, or splints) for arms, legs and/or trunk each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	7		
97760	"Training in use of orthotics (supports, braces, or splints) for arms, legs and/or trunk each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	12		
97761	Training in use of prosthesis for arms and/or legs each 15 minutes	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	5		
97761	Training in use of prosthesis for arms and/or legs each 15 minutes	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	15		
97762	"Evaluation of orthotic or prosthetic use, each 15 minutes"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	7		
97762	"Evaluation of orthotic or prosthetic use, each 15 minutes"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	13		
97802	"Medical nutrition therapy, assessment and intervention, each 15 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	2	0	
97803	"Medical nutrition therapy re-assessment and intervention, each 15 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	2	0	
97810	"Acupuncture 1 or more needles, first 15 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
97810	"Acupuncture 1 or more needles, first 15 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
97813	"Acupuncture 1 or more needles with electrical stimulation, first 15 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
97813	"Acupuncture 1 or more needles with electrical stimulation, first 15 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
98925	Osteopathic manipulative treatment to 1-2 body regions	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	14	0	
98926	Osteopathic manipulative treatment to 3-4 body regions	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	17	0	
98927	Osteopathic manipulative treatment to 5-6 body regions	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	0	
98928	Osteopathic manipulative treatment to 7-8 body regions	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	22	0	
98929	Osteopathic manipulative treatment to 9-10 body regions	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	24	0	
98940	"Chiropractic manipulative treatment, 1-2 spinal regions"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	10	0	
98941	"Chiropractic manipulative treatment, 3 to 4 spinal regions"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	11	0	
98942	"Chiropractic manipulative treatment, 5 spinal regions"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	11	0	
98943	Chiropractic manipulative treatment to 1 or more regions other than spine	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	10	0	
98960	"Education and training for patient self-management, each 30 minutes"	Pre-service	L047D	RN/Registered Dietician	0.47	Preservice total costs	3		
98960	"Education and training for patient self-management, each 30 minutes"	Service  intra	L047D	RN/Registered Dietician	0.47	Service total costs	30		
98960	"Education and training for patient self-management, each 30 minutes"	Post-service	L047D	RN/Registered Dietician	0.47	Post service total costs	5		
98961	"Education and training for patient self-management, 2-4 patients, each 30 minutes"	Pre-service	L047D	RN/Registered Dietician	0.47	Preservice total costs	3		
98961	"Education and training for patient self-management, 2-4 patients, each 30 minutes"	Service  intra	L047D	RN/Registered Dietician	0.47	Service total costs	10		
98961	"Education and training for patient self-management, 2-4 patients, each 30 minutes"	Post-service	L047D	RN/Registered Dietician	0.47	Post service total costs	5		
98962	"Education and training for patient self-management, 5-8 patients, each 30 minutes"	Pre-service	L047D	RN/Registered Dietician	0.47	Preservice total costs	3		
98962	"Education and training for patient self-management, 5-8 patients, each 30 minutes"	Service  intra	L047D	RN/Registered Dietician	0.47	Service total costs	5		
98962	"Education and training for patient self-management, 5-8 patients, each 30 minutes"	Post-service	L047D	RN/Registered Dietician	0.47	Post service total costs	5		
98966	"Telephone assessment and management service, 5-10 minutes of medical discussion"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
98967	"Telephone assessment and management service, 11-20 minutes of medical discussion"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
98968	"Telephone assessment and management service, 21-30 minutes of medical discussion"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
99170	"Examination of genital and anal region of child using an endoscope, suspected trauma"	Pre-service	L051A	RN	0.51	Preservice total costs	3	0	
99170	"Examination of genital and anal region of child using an endoscope, suspected trauma"	Service  intra	L037E	Child Life Specialist	0.37	Service total costs	60	0	
99170	"Examination of genital and anal region of child using an endoscope, suspected trauma"	Service  intra	L051A	RN	0.51	Service total costs	70	0	
99170	"Examination of genital and anal region of child using an endoscope, suspected trauma"	Post-service	L051A	RN	0.51	Post service total costs	3	0	
99173	Eye chart testing of visual acuity of both eyes	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	5		
99175	Administration of medication to induce vomiting	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	16		
99195	Therapeutic removal of whole blood to correct blood level imbalance	Service  intra	L056A	RN/OCN	0.79	Service total costs	77		
99201	"New patient office or other outpatient visit, typically 10 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	24	0	
99202	"New patient office or other outpatient visit, typically 20 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	0	
99203	"New patient office or other outpatient visit, typically 30 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
99204	"New patient office or other outpatient visit, typically 45 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99204	"New patient office or other outpatient visit, typically 45 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
99204	"New patient office or other outpatient visit, typically 45 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	0	
99205	"New patient office or other outpatient visit, typically 60 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	71	0	
99211	"Established patient office or other outpatient visit, typically 5 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	16	0	
99212	"Established patient office or other outpatient visit, typically 10 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	0	
99213	"Established patient office or other outpatient visit, typically 15 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	0	
99214	"Established patient office or other outpatient, visit typically 25 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99214	"Established patient office or other outpatient, visit typically 25 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	0	
99214	"Established patient office or other outpatient, visit typically 25 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	0	
99215	"Established patient office or other outpatient, visit typically 40 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	0	
99215	"Established patient office or other outpatient, visit typically 40 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
99215	"Established patient office or other outpatient, visit typically 40 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	0	
99217	Hospital observation care discharge	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
99238	"Hospital discharge day management, 30 minutes or less"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
99239	"Hospital discharge day management, more than 30 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		15	
99241	"Patient office consultation, typically 15 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	1	0	
99241	"Patient office consultation, typically 15 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	25	0	
99241	"Patient office consultation, typically 15 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	1	0	
99242	"Patient office consultation, typically 30 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2	0	
99242	"Patient office consultation, typically 30 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	0	
99242	"Patient office consultation, typically 30 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	2	0	
99243	"Patient office consultation, typically 40 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99243	"Patient office consultation, typically 40 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	0	
99243	"Patient office consultation, typically 40 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	5	0	
99244	"Patient office consultation, typically 60 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	0	
99244	"Patient office consultation, typically 60 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	53	0	
99244	"Patient office consultation, typically 60 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	0	
99245	"Patient office consultation, typically 80 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	0	
99245	"Patient office consultation, typically 80 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61	0	
99245	"Patient office consultation, typically 80 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	0	
99291	"Critical care delivery critically ill or injured patient, first 30-74 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	0	
99291	"Critical care delivery critically ill or injured patient, first 30-74 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
99291	"Critical care delivery critically ill or injured patient, first 30-74 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	0	
99292	Critical care delivery critically ill or injured patient	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
99304	"Initial nursing facility visit, typically 25 minutes per day"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	3	
99304	"Initial nursing facility visit, typically 25 minutes per day"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	11	11	
99305	"Initial nursing facility visit, typically 35 minutes per day"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	3	
99305	"Initial nursing facility visit, typically 35 minutes per day"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	11	11	
99306	"Initial nursing facility visit, typically 45 minutes per day"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	3	
99306	"Initial nursing facility visit, typically 45 minutes per day"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	11	11	
99307	"Subsequent nursing facility visit, typically 10 minutes per day"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	3	
99307	"Subsequent nursing facility visit, typically 10 minutes per day"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	8	
99308	"Subsequent nursing facility visit, typically 15 minutes per day"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	6	
99308	"Subsequent nursing facility visit, typically 15 minutes per day"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	11	11	
99309	"Subsequent nursing facility visit, typically 25 minutes per day"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6	6	
99309	"Subsequent nursing facility visit, typically 25 minutes per day"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	15	15	
99310	"Subsequent nursing facility visit, typically 35 minutes per day"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	9	
99310	"Subsequent nursing facility visit, typically 35 minutes per day"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	18	18	
99315	"Nursing facility discharge day management, 30 minutes or less"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	3	
99315	"Nursing facility discharge day management, 30 minutes or less"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	9	9	
99316	"Nursing facility discharge management, more than 30 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	3	
99316	"Nursing facility discharge management, more than 30 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	9	9	
99318	"Nursing facility annual assessment, typically 30 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	3	
99318	"Nursing facility annual assessment, typically 30 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	11	11	
99324	"New patient assisted living visit, typically 20 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99324	"New patient assisted living visit, typically 20 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99325	"New patient assisted living visit, typically 30 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99325	"New patient assisted living visit, typically 30 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99326	"New patient assisted living visit, typically 45 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99326	"New patient assisted living visit, typically 45 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99327	"New patient assisted living visit, typically 60 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99327	"New patient assisted living visit, typically 60 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99328	"New patient assisted living visit, typically 75 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99328	"New patient assisted living visit, typically 75 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99334	"Established patient assisted living visit, typically 15 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99334	"Established patient assisted living visit, typically 15 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99335	"Established patient assisted living visit, typically 25 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99335	"Established patient assisted living visit, typically 25 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99336	"Established patient assisted living visit, typically 40 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99336	"Established patient assisted living visit, typically 40 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99337	"Established patient assisted living visit, typically 60 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99337	"Established patient assisted living visit, typically 60 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99339	"Physician supervision of patient care at home or assisted living facility, 15-29 minutes in one month"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15		
99339	"Physician supervision of patient care at home or assisted living facility, 15-29 minutes in one month"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
99340	"Physician supervision of patient care at home or assisted living facility, 30 minutes or more in one month"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18		
99340	"Physician supervision of patient care at home or assisted living facility, 30 minutes or more in one month"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18		
99341	"New patient home visit, typically 20 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99341	"New patient home visit, typically 20 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99342	"New patient home visit, typically 30 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99342	"New patient home visit, typically 30 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99343	"New patient home visit, typically 45 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99343	"New patient home visit, typically 45 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99344	"New patient home visit, typically 60 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99344	"New patient home visit, typically 60 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99345	"New patient home visit, typically 75 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99345	"New patient home visit, typically 75 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99347	"Established patient home visit, typically 15 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99347	"Established patient home visit, typically 15 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99348	"Established patient home visit, typically 25 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99348	"Established patient home visit, typically 25 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99349	"Established patient home visit, typically 40 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99349	"Established patient home visit, typically 40 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99350	"Established patient home visit, typically 60 minutes"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
99350	"Established patient home visit, typically 60 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
99354	Prolonged evaluation and management or pscyhotherapy service(s) (beyond the typical service time of the primary procedure) in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour (List separately in addition to code for office or other outpatient Evaluation and Management or psychotherapy service)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	10	0	
99354	Prolonged evaluation and management or pscyhotherapy service(s) (beyond the typical service time of the primary procedure) in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour (List separately in addition to code for office or other outpatient Evaluation and Management or psychotherapy service)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
99355	Prolonged evaluation and management or pscyhotherapy service(s) (beyond the typical service time of the primary procedure) in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (List separately in addition to code for prolonged service)	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	10	0	
99355	Prolonged evaluation and management or pscyhotherapy service(s) (beyond the typical service time of the primary procedure) in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (List separately in addition to code for prolonged service)	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
99356	Prolonged inpatient or observation hospital service first hour	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
99357	Prolonged inpatient or observation hospital service each 30 minutes beyond first hour	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		3	
99358	Prolonged patient service without direct patient contact first hour	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
99359	Prolonged patient service without direct patient contact each 30 minutes beyond first hour	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
99363	"Anti-clotting management for patient taking blood thinner, first 90 day therapy"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	90	0	
99364	Anti-clotting management for patient taking blood thinner	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	24	0	
99366	"Medical team conference with patient and/or family, and nonphysician health care professionals, 30 minutes or more"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	0.33	0	
99374	"Physician supervision of patient home health agency services, 15-29 minutes per month"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15	0	
99374	"Physician supervision of patient home health agency services, 15-29 minutes per month"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
99375	"Physician supervision of patient home health agency services, 30 minutes or more per month"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	0	
99375	"Physician supervision of patient home health agency services, 30 minutes or more per month"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
99377	"Physician supervision of patient hospice services, 15-29 minutes per month"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15	0	
99377	"Physician supervision of patient hospice services, 15-29 minutes per month"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
99378	"Physician supervision of patient hospice services, 30 minutes or more per month"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	0	
99378	"Physician supervision of patient hospice services, 30 minutes or more per month"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
99379	"Supervision of nursing facility patient services, 15-29 minutes per month"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	15	0	
99379	"Supervision of nursing facility patient services, 15-29 minutes per month"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
99380	"Supervision of nursing facility patient services, 30 minutes or more per month"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18	0	
99380	"Supervision of nursing facility patient services, 30 minutes or more per month"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18	0	
99381	Initial new patient preventive medicine evaluation infant younger than 1 year	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99381	Initial new patient preventive medicine evaluation infant younger than 1 year	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
99381	Initial new patient preventive medicine evaluation infant younger than 1 year	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	0	
99382	"Initial new patient preventive medicine evaluation, age 1 through 4 years"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99382	"Initial new patient preventive medicine evaluation, age 1 through 4 years"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
99382	"Initial new patient preventive medicine evaluation, age 1 through 4 years"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	0	
99383	"Initial new patient preventive medicine evaluation, age 5 through 11 years"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99383	"Initial new patient preventive medicine evaluation, age 5 through 11 years"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
99383	"Initial new patient preventive medicine evaluation, age 5 through 11 years"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	0	
99384	"Initial new patient preventive medicine evaluation, age 12 through 17 years"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99384	"Initial new patient preventive medicine evaluation, age 12 through 17 years"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
99384	"Initial new patient preventive medicine evaluation, age 12 through 17 years"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	0	
99385	Initial new patient preventive medicine evaluation age 18-39 years	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99385	Initial new patient preventive medicine evaluation age 18-39 years	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
99385	Initial new patient preventive medicine evaluation age 18-39 years	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	0	
99386	Initial new patient preventive medicine evaluation age 40-64 years	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99386	Initial new patient preventive medicine evaluation age 40-64 years	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
99386	Initial new patient preventive medicine evaluation age 40-64 years	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	0	
99387	"Initial new patient preventive medicine evaluation, age 65 years and older"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	0	
99387	"Initial new patient preventive medicine evaluation, age 65 years and older"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	59	0	
99387	"Initial new patient preventive medicine evaluation, age 65 years and older"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	0	
99391	Established patient periodic preventive medicine examination infant younger than 1 year	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99391	Established patient periodic preventive medicine examination infant younger than 1 year	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	0	
99391	Established patient periodic preventive medicine examination infant younger than 1 year	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	0	
99392	"Established patient periodic preventive medicine examination, age 1 through 4 years"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99392	"Established patient periodic preventive medicine examination, age 1 through 4 years"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	0	
99392	"Established patient periodic preventive medicine examination, age 1 through 4 years"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	0	
99393	"Established patient periodic preventive medicine examination, age 5 through 11 years"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99393	"Established patient periodic preventive medicine examination, age 5 through 11 years"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	0	
99393	"Established patient periodic preventive medicine examination, age 5 through 11 years"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	0	
99394	"Established patient periodic preventive medicine examination, age 12 through 17 years"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99394	"Established patient periodic preventive medicine examination, age 12 through 17 years"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	0	
99394	"Established patient periodic preventive medicine examination, age 12 through 17 years"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	0	
99395	Established patient periodic preventive medicine examination age 18-39 years	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99395	Established patient periodic preventive medicine examination age 18-39 years	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	0	
99395	Established patient periodic preventive medicine examination age 18-39 years	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	0	
99396	Established patient periodic preventive medicine examination age 40-64 years	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99396	Established patient periodic preventive medicine examination age 40-64 years	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	0	
99396	Established patient periodic preventive medicine examination age 40-64 years	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6	0	
99397	"Established patient periodic preventive medicine examination, age 65 years and older"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	0	
99397	"Established patient periodic preventive medicine examination, age 65 years and older"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
99397	"Established patient periodic preventive medicine examination, age 65 years and older"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	0	
99401	"Preventive medicine counseling, approximately 15 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
99401	"Preventive medicine counseling, approximately 15 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	1	0	
99402	"Preventive medicine counseling, approximately 30 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
99402	"Preventive medicine counseling, approximately 30 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	1	0	
99403	"Preventive medicine counseling, approximately 45 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
99403	"Preventive medicine counseling, approximately 45 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	1	0	
99404	"Preventive medicine counseling, approximately 60 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
99404	"Preventive medicine counseling, approximately 60 minutes"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	1	0	
99411	"Group preventive medicine counseling, approximately 30 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	6	0	
99412	"Group preventive medicine counseling, approximately 60 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	6	0	
99415	"Prolonged clinical staff service (the service beyond the typical service time) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; first hour (List separately in addition to code for outpatient Evaluation and Management service)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist in performing procedure (Outpatient Observation based on 4/1 ratio for clinical staff.)	15		
99416	"Prolonged clinical staff service (the service beyond the typical service time) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; each additional 30 minutes (List separately in addition to code for prolonged service)"	Service  intra	L037D	RN/LPN/MTA	0.37	Assist in performing procedure (Outpatient Observation based on 4/1 ratio for clinical staff.)	8	0	
99420	Administration and interpretation of health risk assessment instrument	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
99420	Administration and interpretation of health risk assessment instrument	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	1		
99441	"Physician telephone patient service, 5-10 minutes of medical discussion"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
99442	"Physician telephone patient service, 11-20 minutes of medical discussion"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
99443	"Physician telephone patient service, 21-30 minutes of medical discussion"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
99461	Initial newborn infant evaluation and management per day	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	0	
99461	Initial newborn infant evaluation and management per day	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	50	0	
99461	Initial newborn infant evaluation and management per day	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	0	
99463	Initial inpatient hospital or birthing center same date care and discharge of newborn	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		12	
99490	"Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month"	Pre-service	L051A	RN	0.51	Care management activities performed by clinical staff	0		
99490	"Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month"	Pre-service	L037D	RN/LPN/MTA	0.37	Care management activities performed by clinical staff	20		
99495	"Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
99495	"Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	44	0	
99495	"Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge"	Post-service	L042A	RN/LPN	0.42	Post service total costs	45	0	
99496	"Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	4	0	
99496	"Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
99496	"Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge"	Post-service	L042A	RN/LPN	0.42	Post service total costs	70	0	
99497	"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified healthcare professional; first 30 minutes, face-to-face with t"	Service  pre	L037D	RN/LPN/MTA	0.37	SVC Provide pre-service education/obtain consent	2		
99497	"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified healthcare professional; first 30 minutes, face-to-face with t"	Service  post	L037D	RN/LPN/MTA	0.37	Provide post visit education to patient	5		
G0101	Cervical or vaginal cancer screening; pelvic and clinical breast examination	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	0	10	
G0101	Cervical or vaginal cancer screening; pelvic and clinical breast examination	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	0	
G0104	Colorectal cancer screening; flexible sigmoidoscopy	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	10	18	
G0104	Colorectal cancer screening; flexible sigmoidoscopy	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	67	0	
G0104	Colorectal cancer screening; flexible sigmoidoscopy	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
G0105	Colorectal cancer screening; colonoscopy on individual at high risk	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	9	19	
G0105	Colorectal cancer screening; colonoscopy on individual at high risk	Service  intra	L051A	RN	0.51	Service total costs	56	0	
G0105	Colorectal cancer screening; colonoscopy on individual at high risk	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	76	0	
G0105	Colorectal cancer screening; colonoscopy on individual at high risk	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
G0106	"Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enema"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	75		
G0108	"Diabetes outpatient self-management training services, individual, per 30 minutes"	Service  intra	L051A	RN	0.51	Service total costs	2		
G0117	Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	2		
G0117	Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	36		
G0117	Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	4		
G0118	Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalomologist	Pre-service	L038A	COMT/COT/RN/CST	0.38	Preservice total costs	2		
G0118	Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalomologist	Service  intra	L038A	COMT/COT/RN/CST	0.38	Service total costs	36		
G0118	Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalomologist	Post-service	L038A	COMT/COT/RN/CST	0.38	Post service total costs	4		
G0120	"Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema."	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	75		
G0121	Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	Service  intra	L051A	RN	0.51	Service total costs	219	0	
G0122	Colorectal cancer screening; barium enema	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	75		
G0124	"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician"	Service  intra	L045A	Cytotechnologist	0.45	Service total costs	32	0	
G0124	"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician"	Service  intra	L035A	Lab Tech/Histotechnologist	0.35	Service total costs	22	0	
G0127	"Trimming of dystrophic nails, any number"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	17	0	
G0128	"Direct (face-to-face with patient) skilled nursing services of a registered nurse provided in a comprehensive outpatient rehabilitation facility, each 10 minutes beyond the first 5 minutes"	Service  intra	L051C	RN/CORF	0.51	Service total costs	10		
G0130	"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)"	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	26		
G0166	"External counterpulsation, per treatment session"	Service  intra	L051A	RN	0.51	Service total costs	73		
G0168	Wound closure utilizing tissue adhesive(s) only	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	20	6	
G0179	"Physician re-certification for medicare-covered home health  services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial i"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18		
G0179	"Physician re-certification for medicare-covered home health  services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial i"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18		
G0180	"Physician certification for medicare-covered home health  services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial impl"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18		
G0180	"Physician certification for medicare-covered home health  services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial impl"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18		
G0181	Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of 	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18		
G0181	Physician supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of 	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18		
G0182	"Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patie"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	18		
G0182	"Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patie"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	18		
G0237	"Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)"	Service  intra	L042B	Respiratory Therapist	0.42	Service total costs	15		
G0238	"Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)"	Service  intra	L042B	Respiratory Therapist	0.42	Service total costs	15		
G0239	"Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)"	Service  intra	L042B	Respiratory Therapist	0.42	Service total costs	20		
G0245	"Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that con"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	38	0	
G0246	"Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	27	0	
G0247	"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following "	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	47	0	
G0247	"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following "	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	0	
G0248	"Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-t"	Pre-service	L051A	RN	0.51	Preservice total costs	5		
G0248	"Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-t"	Service  intra	L051A	RN	0.51	Service total costs	50		
G0248	"Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-t"	Post-service	L051A	RN	0.51	Post service total costs	20		
G0249	"Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in th"	Service  intra	L037A	Electrodiagnostic Technologist	0.37	Service total costs	32		
G0268	Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	26	0	
G0277	"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval"	Service  pre	L037D	RN/LPN/MTA	0.37	"Blood glucose, food/H2O, blood glucose recheck"	0.25		
G0277	"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval"	Service  pre	L037D	RN/LPN/MTA	0.37	Greet patient and provide gowning	1		
G0277	"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval"	Service  pre	L037D	RN/LPN/MTA	0.37	Obtain vital signs	1		
G0277	"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval"	Service  pre	L047C	RN/Respiratory Therapist	0.47	Prepare and position pt/ monitor pt/ set up IV	1		
G0277	"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval"	Service  pre	L037D	RN/LPN/MTA	0.37	"Prepare room, equipment, supplies"	0.5		
G0277	"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval"	Service  pre	L047C	RN/Respiratory Therapist	0.47	SVC Provide pre-service education/obtain consent	1		
G0277	"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval"	Service  pre	L047C	RN/Respiratory Therapist	0.47	"Turn on chamber operating panel, check communications with patient and adjust volumes, prepare chamber operating settings per physician order"	1		
G0277	"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval"	Service  intra	L047C	RN/Respiratory Therapist	0.47	Assist physician in performing procedure	15		
G0277	"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval"	Service  post	L047C	RN/Respiratory Therapist	0.47	Check dressings & wound/ home care instructions /coordinate office visits /prescriptions	1		
G0277	"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval"	Service  post	L037D	RN/LPN/MTA	0.37	"Clean air mask and tubes, clean inside of chamber"	2		
G0277	"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval"	Service  post	L037D	RN/LPN/MTA	0.37	Clean room/equipment by physician staff	1		
G0277	"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval"	Service  post	L047C	RN/Respiratory Therapist	0.47	"Monitor pt following service/check tubes, monitors, drains (moderate sedation)"	1		
G0277	"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval"	Service  post	L037D	RN/LPN/MTA	0.37	"Post-service blood glucose, food/H2O, blood glucose recheck"	0.25		
G0281	"Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous statsis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, a"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	3		
G0283	"Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	3		
G0288	"Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery"	Service  intra	L046A	CT Technologist	0.46	Service total costs	60		
G0296		Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	2	0	
G0297		Pre-service	L046A	CT Technologist	0.46	Availability of prior images confirmed	2		
G0297		Pre-service	L046A	CT Technologist	0.46	"Patient clinical information and questionnaire reviewed by technologist, order from physician confirmed and exam protocoled by radiologist"	2		
G0297		Service  pre	L046A	CT Technologist	0.46	"Greet patient, provide gowning, ensure appropriate medical records are available"	3		
G0297		Service  pre	L046A	CT Technologist	0.46	Prepare and position pt/ monitor pt/ set up IV	2		
G0297		Service  pre	L046A	CT Technologist	0.46	"Prepare room, equipment, supplies"	2		
G0297		Service  pre	L046A	CT Technologist	0.46	Provide pre-service education/obtain consent	2		
G0297		Service  intra	L046A	CT Technologist	0.46	Acquire images	15		
G0297		Service  post	L046A	CT Technologist	0.46	Clean room/equipment by physician staff	3		
G0297		Service  post	L046A	CT Technologist	0.46	Exam documents scanned into PACS. Exam completed in RIS system to generate billing process and to populate images into Radiologist work queue	1		
G0297		Service  post	L046A	CT Technologist	0.46	Review examination with interpreting MD	2		
G0297		Service  post	L046A	CT Technologist	0.46	"Technologist QCs images in PACS, checking all images, reformats, and dose page"	2		
G0297		Post-service	L046A	CT Technologist	0.46	Federally Mandated MQSA Activities Allocated To Each Mammogram	4		
G0329	"Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a thera"	Service  intra	L023A	Physical Therapy Aide	0.23	Service total costs	2		
G0329	"Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a thera"	Service  intra	L039B	Physical Therapy Assistant	0.39	Service total costs	4		
G0341	"Percutaneous islet cell transplant, includes portal vein catheterization and infusion"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	8	10	
G0341	"Percutaneous islet cell transplant, includes portal vein catheterization and infusion"	Service  intra	L041A	Angio Technician	0.41	Service total costs	84	0	
G0341	"Percutaneous islet cell transplant, includes portal vein catheterization and infusion"	Service  intra	L051A	RN	0.51	Service total costs	137	0	
G0341	"Percutaneous islet cell transplant, includes portal vein catheterization and infusion"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	21	0	
G0341	"Percutaneous islet cell transplant, includes portal vein catheterization and infusion"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	3	3	
G0342	"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
G0342	"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
G0342	"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		68	
G0343	"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		60	
G0343	"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
G0343	"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
G0364	Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service	Service  intra	L033A	Lab Technician	0.33	Service total costs	2	0	
G0364	Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service	Service  intra	L051A	RN	0.51	Service total costs	5	0	
G0365	"Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)"	Pre-service	L054A	Vascular Technologist	0.54	Preservice total costs	3		
G0365	"Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)"	Service  intra	L054A	Vascular Technologist	0.54	Service total costs	65		
G0365	"Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)"	Post-service	L054A	Vascular Technologist	0.54	Post service total costs	8		
G0389	Ultrasound b-scan and/or real time with image documentation; for abdominal aortic aneurysm (aaa) screening	Pre-service	L050B	Diagnostic Medical Sonographer	0.5	Preservice total costs	5		
G0389	Ultrasound b-scan and/or real time with image documentation; for abdominal aortic aneurysm (aaa) screening	Service  intra	L050B	Diagnostic Medical Sonographer	0.5	Service total costs	31		
G0402	"Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3	0	
G0402	"Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	51	0	
G0402	"Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8	0	
G0403	"Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report"	Service  intra	L051A	RN	0.51	Service total costs	12		
G0409	"Social work and psychological services, directly relating to and/or furthering the patient's rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf)"	Service  intra	L045C	CORF socialworker/psychologist	0.45	Service total costs	15		
G0412	"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		33	
G0412	"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
G0412	"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		90	
G0413	"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		33	
G0413	"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
G0413	"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
G0414	"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		33	
G0414	"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
G0414	"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
G0415	"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs		33	
G0415	"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs		12	
G0415	"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs		135	
G0416	"Surgical pathology, gross and microscopic examinations, for prostate needle  biopsy, any method"	Pre-service	L033A	Lab Technician	0.33	"Order, fill, lable, restock, and distribute specimen containers"	4		
G0416	"Surgical pathology, gross and microscopic examinations, for prostate needle  biopsy, any method"	Service  pre	L033A	Lab Technician	0.33	Accession specimen in lab computer system including the following:  Unwrap and/or remove specimen bottle and requisition slip from plastic bag. Check demographics to ensure they are correct and to ensure proper billing.  Check requisition slip against bot	17		
G0416	"Surgical pathology, gross and microscopic examinations, for prostate needle  biopsy, any method"	Service  pre	L037B	Histotechnologist	0.37	Assist pathologist with gross examination.	18		
G0416	"Surgical pathology, gross and microscopic examinations, for prostate needle  biopsy, any method"	Service  pre	L033A	Lab Technician	0.33	"Clean grossing station includes; Load dirty cutting board, knives, forceps, etc. (instrument pack) in dishwasher, clean counter, clean sink, dispose of and package trash, restocks, set up gross area for next day"	3		
G0416	"Surgical pathology, gross and microscopic examinations, for prostate needle  biopsy, any method"	Service  pre	L033A	Lab Technician	0.33	Complete workload recording logs. Collate slides and paperwork. Deliver to pathologist.	6.5		
G0416	"Surgical pathology, gross and microscopic examinations, for prostate needle  biopsy, any method"	Service  pre	L037B	Histotechnologist	0.37	"Confirm specimen ID.  Embed tissue in paraffin includes: Review applicable gross information (number of fragments, orientation, size) Take cassette out of embeding chamber, open cassette, put paraffin in bottom of embedding mold, embed tissue, put cassett"	24		
G0416	"Surgical pathology, gross and microscopic examinations, for prostate needle  biopsy, any method"	Service  pre	L037B	Histotechnologist	0.37	"Load solutions into tissue processor.  Load and sort cassettes into tissues processor include drain cassette basket, place basket in processor, put lid on basket, close lid, set processor.  Confirm settings.  Take requisitions to secretary."	2		
G0416	"Surgical pathology, gross and microscopic examinations, for prostate needle  biopsy, any method"	Service  pre	L037B	Histotechnologist	0.37	"Prepare automated coverslipper, remove slides from stainer and place on coverslipper"	6.5		
G0416	"Surgical pathology, gross and microscopic examinations, for prostate needle  biopsy, any method"	Service  pre	L037B	Histotechnologist	0.37	Prepare automated stainer with solutions and load microscopic slides. Set and confirm stainer program.	6.5		
G0416	"Surgical pathology, gross and microscopic examinations, for prostate needle  biopsy, any method"	Service  pre	L037B	Histotechnologist	0.37	Prepare tissue cassettes	6.5		
G0416	"Surgical pathology, gross and microscopic examinations, for prostate needle  biopsy, any method"	Service  pre	L037B	Histotechnologist	0.37	Retrieve paraffin block from freezer and place on ice tray at microtome.  Place paraffin block in microtome.  Change and insert knife.  Rough-cut block.  Place block on ice.  Retrieve block and section.  Place section on water bath.  Confirm specimen ID.	60		
G0416	"Surgical pathology, gross and microscopic examinations, for prostate needle  biopsy, any method"	Post-service	L033A	Lab Technician	0.33	"Clean tissue processor, embedding and staining area"	1		
G0416	"Surgical pathology, gross and microscopic examinations, for prostate needle  biopsy, any method"	Post-service	L033A	Lab Technician	0.33	Dispose of remaining chemicals	1		
G0416	"Surgical pathology, gross and microscopic examinations, for prostate needle  biopsy, any method"	Post-service	L033A	Lab Technician	0.33	"File blocks, requisitions and slides"	1		
G0416	"Surgical pathology, gross and microscopic examinations, for prostate needle  biopsy, any method"	Post-service	L033A	Lab Technician	0.33	Recycle xylene from tissue processor and stainer	1		
G0420	"Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	2		
G0424	"Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day"	Service  intra	L042B	Respiratory Therapist	0.42	Service total costs	30	0	
G0429	"Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	11	0	
G0429	"Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	36	0	
G0429	"Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	0	3	
G0438	"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3		
G0438	"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	61		
G0438	"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	8		
G0439	"Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	3		
G0439	"Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	49		
G0439	"Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
G0442	"Annual alcohol misuse screening, 15 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
G0443	"Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	2	0	
G0444	"Annual depression screening, 15 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15	0	
G0445	"High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	2	0	
G0446	"Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	2	0	
G0447	"Face-to-face behavioral counseling for obesity, 15 minutes"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	2	0	
G0451	"Development testing, with interpretation and report, per standardized instrument form"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	15		
G0455	"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	2	0	
G0455	"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	77	0	
G0473	"Group obesity csl, small grp"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	1	0	
G6001		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	22		
G6002		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	24		
G6003		Pre-service	L050C	Radiation Therapist	0.5	Preservice total costs	1		
G6003		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	13		
G6004		Pre-service	L050C	Radiation Therapist	0.5	Preservice total costs	1		
G6004		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	13		
G6005		Pre-service	L050C	Radiation Therapist	0.5	Preservice total costs	1		
G6005		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	13		
G6006		Pre-service	L050C	Radiation Therapist	0.5	Preservice total costs	1		
G6006		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	13		
G6007		Pre-service	L050C	Radiation Therapist	0.5	Preservice total costs	1		
G6007		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	18		
G6008		Pre-service	L050C	Radiation Therapist	0.5	Preservice total costs	1		
G6008		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	18		
G6009		Pre-service	L050C	Radiation Therapist	0.5	Preservice total costs	1		
G6009		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	18		
G6010		Pre-service	L050C	Radiation Therapist	0.5	Preservice total costs	1		
G6010		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	18		
G6011		Pre-service	L050C	Radiation Therapist	0.5	Preservice total costs	1		
G6011		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	24		
G6012		Pre-service	L050C	Radiation Therapist	0.5	Preservice total costs	1		
G6012		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	24		
G6013		Pre-service	L050C	Radiation Therapist	0.5	Preservice total costs	1		
G6013		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	24		
G6014		Pre-service	L050C	Radiation Therapist	0.5	Preservice total costs	1		
G6014		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	24		
G6015		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	30		
G6015		Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	3		
G6015		Service  intra	L050D	Second Radiation Therapist for IMRT	0.5	Service total costs	30		
G6015		Post-service	L050C	Radiation Therapist	0.5	Post service total costs	5		
G6016		Service  intra	L050C	Radiation Therapist	0.5	Service total costs	30		
G6016		Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	3		
G6016		Service  intra	L050D	Second Radiation Therapist for IMRT	0.5	Service total costs	30		
G6016		Post-service	L050C	Radiation Therapist	0.5	Post service total costs	5		
G9187	"Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, flui"	Pre-service	L037D	RN/LPN/MTA	0.37	Preservice total costs	6		
G9187	"Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, flui"	Service  intra	L051A	RN	0.51	Service total costs	45		
G9187	"Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, flui"	Post-service	L037D	RN/LPN/MTA	0.37	Post service total costs	6		
P3001	"Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician"	Service  intra	L045A	Cytotechnologist	0.45	Service total costs	32	0	
P3001	"Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician"	Service  intra	L035A	Lab Tech/Histotechnologist	0.35	Service total costs	22	0	
Q0035	Cardiokymography	Service  intra	L051A	RN	0.51	Service total costs	12		
Q0091	"Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory"	Service  intra	L037D	RN/LPN/MTA	0.37	Service total costs	57	0	
Q0092	Set-up portable x-ray equipment	Service  intra	L041B	Radiologic Technologist	0.41	Service total costs	45	0	
