|
Ex arm/elbow tum deep < 5 cm
|
$1,267.20 |
$1,267.20 |
$1,267.20 |
$3,386.84
|
|
Ex arm/elbow tum deep 5 cm/>
|
$1,580.70 |
$1,580.70 |
$1,580.70 |
$3,412.80
|
|
Exc abd les sc 3 cm/>
|
$999.90 |
$999.90 |
$999.90 |
$3,786.00
|
|
Exc abdl tum deep < 5 cm
|
$1,287.66 |
$1,287.66 |
$1,287.66 |
$3,386.84
|
|
Exc abdl tum deep 5 cm/>
|
$1,503.48 |
$1,503.48 |
$1,503.48 |
$3,370.52
|
|
Exc arm/elbo les sc >=3cm 24071
|
$929.94 |
$929.94 |
$929.94 |
$4,168.59
|
|
Exc arm/elbo les sc <3cm 24075
|
$1,237.50 |
$1,237.50 |
$1,237.50 |
$2,532.80
|
|
Exc back les sbq <3 cm 21930
|
$1,168.20 |
$1,168.20 |
$1,168.20 |
$2,676.58
|
|
Exc back tum deep 5 cm/>
|
$1,663.86 |
$1,663.86 |
$1,663.86 |
$3,986.00
|
|
Exc bartholins gland/cyst
|
$712.14 |
$712.14 |
$712.14 |
$3,781.65
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$661.98 |
$661.98 |
$661.98 |
$2,271.01
|
|
Exc benign feenlm >4.0cm 11446
|
$894.96 |
$894.96 |
$894.96 |
$3,386.84
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$557.70 |
$557.70 |
$557.70 |
$2,271.01
|
|
Exc benign tal 0.5 < cm 11400
|
$302.94 |
$302.94 |
$302.94 |
$827.40
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$337.92 |
$337.92 |
$337.92 |
$923.06
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$454.74 |
$454.74 |
$454.74 |
$1,051.40
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$534.60 |
$534.60 |
$534.60 |
$2,061.19
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$375.54 |
$375.54 |
$375.54 |
$1,467.00
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$483.78 |
$483.78 |
$483.78 |
$2,121.60
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$762.96 |
$762.96 |
$762.96 |
$3,483.00
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$367.62 |
$367.62 |
$367.62 |
$770.70
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$465.30 |
$465.30 |
$465.30 |
$1,244.03
|
|
Exc breast duct fistula 19112
|
$748.44 |
$748.44 |
$748.44 |
$4,238.48
|
|
Exc chest wall tumor w/ribs 21601
|
$2,536.38 |
$2,536.38 |
$2,536.38 |
$3,386.84
|
|
Exc coccygl pr ulc flap clsr
|
$1,842.72 |
$1,842.72 |
$1,842.72 |
$4,332.25
|
|
Exc coccygl pr ulc prim sutr
|
$1,446.72 |
$1,446.72 |
$1,446.72 |
$2,682.40
|
|
Exc/crtg b1 cst/b9 tum rds
|
$1,254.66 |
$1,254.66 |
$1,254.66 |
$2,617.60
|
|
Exc/curtg b1 cst/b9 tum hum
|
$1,383.36 |
$1,383.36 |
$1,383.36 |
$3,839.54
|
|
Exc ext ear/partial/simple repair 69110
|
$1,101.54 |
$1,101.54 |
$1,101.54 |
$3,170.00
|
|
Exc face tum deep < 2 cm
|
$1,243.44 |
$1,243.44 |
$1,243.44 |
$1,917.33
|
|
Exc face tum deep 2cm/> 21014
|
$1,202.52 |
$1,202.52 |
$1,202.52 |
$3,386.84
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$557.04 |
$557.04 |
$557.04 |
$973.71
|
|
Exc feenl mal+mrg 2.1-3 11643
|
$735.90 |
$735.90 |
$735.90 |
$2,101.45
|
|
Exc foot/toe tum dep 1.5cm/>
|
$1,044.12 |
$1,044.12 |
$1,044.12 |
$3,994.09
|
|
Exc foot/toe tum subq < 1.5 cm 28043
|
$892.32 |
$892.32 |
$892.32 |
$3,230.00
|
|
Exc forearm les sc 3 cm/>
|
$978.12 |
$978.12 |
$978.12 |
$3,628.50
|
|
Exc forearm tum deep < 3 cm
|
$1,215.72 |
$1,215.72 |
$1,215.72 |
$2,149.50
|
|
Exc forearm tum deep 3 cm/>
|
$1,247.40 |
$1,247.40 |
$1,247.40 |
$3,994.09
|
|
Exc hand les sc < 1.5 cm
|
$1,298.88 |
$1,298.88 |
$1,298.88 |
$1,897.50
|
|
Exc hand tum deep 1.5 cm/>
|
$1,285.68 |
$1,285.68 |
$1,285.68 |
$2,271.01
|
|
Exc hand tum deep < 1.5 cm 26116
|
$1,236.84 |
$1,236.84 |
$1,236.84 |
$2,271.01
|
|
Exchange biliary drg cath
|
$290.40 |
$290.40 |
$290.40 |
$3,797.76
|
|
Exchange drainage catheter
|
$153.78 |
$153.78 |
$153.78 |
$2,191.20
|
|
Exchange lens prosthesis
|
$2,072.40 |
$2,072.40 |
$2,072.40 |
$4,504.00
|
|
Exchange nephrostomy cath
|
$2,369.40 |
$2,369.40 |
$2,369.40 |
$2,958.80
|
|
Exc hidradenitis ing simpl 11462
|
$584.10 |
$584.10 |
$584.10 |
$3,386.84
|
|
Exc hidradenitis peri/umb comp 11471
|
$807.84 |
$807.84 |
$807.84 |
$3,386.84
|
|
Exc hidradenitis peri/umb int 11470
|
$1,059.30 |
$1,059.30 |
$1,059.30 |
$3,386.84
|
|
Exc hip/pelv tum deep < 5 cm
|
$1,403.16 |
$1,403.16 |
$1,403.16 |
$3,386.84
|
|
Exc hip/pelv tum deep 5 cm/>
|
$1,664.52 |
$1,664.52 |
$1,664.52 |
$3,630.40
|
|
Exc im tumor/back/flank/ < 5 cm 21932
|
$1,508.10 |
$1,508.10 |
$1,508.10 |
$3,398.50
|
|
Exc im tumor/foot/toe < 1.5 cm 28045
|
$816.42 |
$816.42 |
$816.42 |
$3,370.52
|
|
Exc im tumor/shoulder area 5cm/> 23073
|
$1,587.96 |
$1,587.96 |
$1,587.96 |
$3,486.52
|
|
Exc ischial pr ulcer w/ostc musc/myoq flap/skin 15946
|
$3,621.42 |
$3,621.42 |
$3,621.42 |
$4,017.60
|
|
Exc ischial pr ulc prim sutr
|
$1,614.36 |
$1,614.36 |
$1,614.36 |
$3,386.84
|
|
Excise anal ext tag/papilla
|
$588.72 |
$588.72 |
$588.72 |
$2,172.09
|
|
Excise foot tendon sheath
|
$813.12 |
$813.12 |
$813.12 |
$3,821.05
|
|
Excise ileoanal reservior
|
$3,993.00 |
$3,993.00 |
$3,993.00 |
$4,510.40
|
|
Excise inferior turbinate
|
$982.08 |
$982.08 |
$982.08 |
$3,589.62
|
|
Excise intestine lesion(s) 44110
|
$1,888.26 |
$1,888.26 |
$1,888.26 |
$1,524.60
|
|
Excise intraspinl lesion crv
|
$3,663.00 |
$3,663.00 |
$3,663.00 |
$5,741.00
|
|
Excise intrspinl lesion lmbr
|
$3,047.22 |
$3,047.22 |
$3,047.22 |
$6,311.00
|
|
Excise intrspinl lesion lmbr
|
$663.30 |
$663.30 |
$663.30 |
$4,479.20
|
|
Excise lesion testis
|
$1,227.60 |
$1,227.60 |
$1,227.60 |
$4,081.37
|
|
Excise lip or cheek fold
|
$645.48 |
$645.48 |
$645.48 |
$1,855.10
|
|
Excise mandible lesion
|
$854.70 |
$854.70 |
$854.70 |
$3,589.62
|
|
Excise max/zygoma b9 tumor
|
$851.40 |
$851.40 |
$851.40 |
$6,547.81
|
|
Excise parotid gland/lesion
|
$1,442.10 |
$1,442.10 |
$1,442.10 |
$6,583.24
|
|
Excise parotid gland/lesion
|
$2,410.32 |
$2,410.32 |
$2,410.32 |
$7,000.36
|
|
Excise parotid gland/lesion
|
$2,694.12 |
$2,694.12 |
$2,694.12 |
$6,839.00
|
|
Excise parotid gland/lesion
|
$1,917.30 |
$1,917.30 |
$1,917.30 |
$6,839.00
|
|
Excise pharynx lesion
|
$386.10 |
$386.10 |
$386.10 |
$3,837.72
|
|
Excise/repair mouth lesion
|
$652.08 |
$652.08 |
$652.08 |
$1,903.93
|
|
Excise sublingual gland
|
$851.40 |
$851.40 |
$851.40 |
$5,678.40
|
|
Excise submaxillary gland
|
$960.30 |
$960.30 |
$960.30 |
$6,553.49
|
|
Excise subq tumor/abd wall <3 cm 22902
|
$1,094.94 |
$1,094.94 |
$1,094.94 |
$3,307.66
|
|
Excise tendon forearm/wrist
|
$1,263.90 |
$1,263.90 |
$1,263.90 |
$3,821.05
|
|
Excise wrist tendon sheath
|
$914.76 |
$914.76 |
$914.76 |
$1,893.86
|
|
Excision addl breast lesion 19126
|
$344.52 |
$344.52 |
$344.52 |
$546.17
|
|
Excision aural polyp
|
$304.92 |
$304.92 |
$304.92 |
$2,133.48
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$408.54 |
$408.54 |
$408.54 |
$863.10
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$421.74 |
$421.74 |
$421.74 |
$1,999.20
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$405.90 |
$405.90 |
$405.90 |
$1,064.30
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$741.18 |
$741.18 |
$741.18 |
$2,641.65
|
|
Excision breast lesion
|
$1,045.44 |
$1,045.44 |
$1,045.44 |
$4,042.99
|
|
Excision floor mouth lesion 41116
|
$508.86 |
$508.86 |
$508.86 |
$3,892.91
|
|
Excision graft extremity
|
$1,206.48 |
$1,206.48 |
$1,206.48 |
$4,881.00
|
|
Excision hand/finger tendon
|
$1,981.32 |
$1,981.32 |
$1,981.32 |
$3,839.54
|
|
Excision lesion mouth roof
|
$595.98 |
$595.98 |
$595.98 |
$3,837.72
|
|
Excision lesion mouth roof
|
$760.32 |
$760.32 |
$760.32 |
$6,465.11
|
|
Excision nasal polyp(s) simple 30110
|
$584.76 |
$584.76 |
$584.76 |
$1,752.89
|
|
Excision of anal lesion(s)
|
$733.92 |
$733.92 |
$733.92 |
$3,823.00
|
|
Excision of gum lesion 41825
|
$287.76 |
$287.76 |
$287.76 |
$4,007.22
|
|
Excision of lesion of mesentery 44820
|
$1,886.28 |
$1,886.28 |
$1,886.28 |
$1,621.80
|
|
Excision of lingual tonsil
|
$1,381.38 |
$1,381.38 |
$1,381.38 |
$6,465.11
|
|
Excision of meckels diverticulum 44800
|
$1,732.50 |
$1,732.50 |
$1,732.50 |
$1,373.40
|
|
Excision of mouth lesion complex 40816
|
$712.14 |
$712.14 |
$712.14 |
$3,986.00
|
|
Excision of neck cyst
|
$1,242.78 |
$1,242.78 |
$1,242.78 |
$6,150.92
|
|
Excision of neck cyst confined 42810
|
$664.62 |
$664.62 |
$664.62 |
$4,558.89
|
|
Excision of penis lesion(s) 54060
|
$461.34 |
$461.34 |
$461.34 |
$2,479.33
|