|
Debridement bone <= 20 sq cm
|
$2,281.60 |
$2,281.60 |
$2,281.60 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$510.40 |
$510.40 |
$510.40 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,369.60 |
$1,369.60 |
$1,369.60 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$539.20 |
$539.20 |
$539.20 |
$810.50
|
|
Debride nail1-5 11720
|
$83.20 |
$83.20 |
$83.20 |
$148.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$146.40 |
$146.40 |
$146.40 |
$639.60
|
|
Debr musc/fascia 20sq cm/< 11043
|
$850.40 |
$850.40 |
$850.40 |
$1,160.00
|
|
Decalcification
|
$81.60 |
$81.60 |
$81.60 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$516.00 |
$516.00 |
$516.00 |
$543.00
|
|
Delivery of placenta 59414
|
$2,671.20 |
$2,671.20 |
$2,671.20 |
$3,070.56
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$116.00 |
$116.00 |
$116.00 |
$185.17
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$172.00 |
$172.00 |
$172.00 |
$408.10
|
|
Desoxycorticosterone
|
$273.60 |
$273.60 |
$273.60 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$3,918.40 |
$3,918.40 |
$3,918.40 |
$3,011.50
|
|
Destroy cth facet jnt addl 64634
|
$1,307.20 |
$1,307.20 |
$1,307.20 |
$1,441.44
|
|
Destruction benign lesions < 14 lesions
|
$223.20 |
$223.20 |
$223.20 |
$235.13
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,307.20 |
$1,307.20 |
$1,307.20 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,918.40 |
$3,918.40 |
$3,918.40 |
$3,202.98
|
|
Developmental screen/score/document 96110
|
$219.20 |
$219.20 |
$219.20 |
$130.65
|
|
Devel tst phys/qhp 1st hr
|
$442.40 |
$442.40 |
$442.40 |
$337.50
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$248.00 |
$248.00 |
$248.00 |
$200.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$162.40 |
$162.40 |
$162.40 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$79.20 |
$79.20 |
$79.20 |
$79.20
|
|
Diagnostic Mammogram (both breasts)
|
$577.60 |
$577.60 |
$577.60 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$458.40 |
$458.40 |
$458.40 |
$301.55
|
|
Diffusing capacity
|
$335.20 |
$335.20 |
$335.20 |
$332.00
|
|
Digoxin total therapeutic drug level
|
$171.20 |
$171.20 |
$171.20 |
$102.00
|
|
Disaccharidases
|
$776.00 |
$776.00 |
$776.00 |
$216.00
|
|
Dna antibody native/double stranded
|
$43.20 |
$43.20 |
$43.20 |
$97.50
|
|
Dna gardnerella
|
$102.40 |
$102.40 |
$102.40 |
$62.50
|
|
Dna trichomonas
|
$106.40 |
$106.40 |
$106.40 |
$67.80
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$789.60 |
$789.60 |
$789.60 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$538.40 |
$538.40 |
$538.40 |
$471.17
|
|
Dpyd gene common variants
|
$1,864.80 |
$1,864.80 |
$1,864.80 |
$380.50
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$591.20 |
$591.20 |
$591.20 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$1,004.80 |
$1,004.80 |
$1,004.80 |
$914.34
|
|
Drainage external ear simple 69000
|
$591.20 |
$591.20 |
$591.20 |
$789.60
|
|
Drainage mouth roof lesion
|
$308.80 |
$308.80 |
$308.80 |
$390.39
|
|
Drainage of arm bursa 23931
|
$2,063.20 |
$2,063.20 |
$2,063.20 |
$2,197.48
|
|
Drainage of mouth lesion
|
$4,420.80 |
$4,420.80 |
$4,420.80 |
$3,900.60
|
|
Drain finger abscess;simple 26010
|
$534.40 |
$534.40 |
$534.40 |
$419.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$372.00 |
$372.00 |
$372.00 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$555.20 |
$555.20 |
$555.20 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$493.60 |
$493.60 |
$493.60 |
$523.00
|
|
Drng of eyelid abscess 67700
|
$422.40 |
$422.40 |
$422.40 |
$648.00
|
|
Drng of finger abscess comp 26011
|
$1,360.80 |
$1,360.80 |
$1,360.80 |
$1,943.50
|
|
Drng of scrotum abscess 55100
|
$1,977.60 |
$1,977.60 |
$1,977.60 |
$1,917.33
|
|
Drug assay posaconazole
|
$190.40 |
$190.40 |
$190.40 |
$96.75
|
|
Drug assay voriconazole
|
$140.00 |
$140.00 |
$140.00 |
$96.75
|
|
Drug of abuse screen urine
|
$354.40 |
$354.40 |
$354.40 |
$63.75
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$870.40 |
$870.40 |
$870.40 |
$278.85
|
|
Drvvt confirm - quest
|
$196.80 |
$196.80 |
$196.80 |
$109.20
|
|
Ductogram sgl duct
|
$753.60 |
$753.60 |
$753.60 |
$463.10
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$898.40 |
$898.40 |
$898.40 |
$745.00
|
|
Dxa bone density axl vrt fx
|
$297.60 |
$297.60 |
$297.60 |
$392.60
|
|
Ear irrigation 69209
|
$271.20 |
$271.20 |
$271.20 |
$149.76
|
|
Ecg 12 lead tracing only
|
$327.20 |
$327.20 |
$327.20 |
$226.50
|
|
Ecg < 30 days transmission & analysis
|
$613.60 |
$613.60 |
$613.60 |
$487.60
|
|
Ecg external < 48 hours recording
|
$613.60 |
$613.60 |
$613.60 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$613.60 |
$613.60 |
$613.60 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$216.80 |
$216.80 |
$216.80 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$360.80 |
$360.80 |
$360.80 |
$161.85
|
|
Echocardiogram (Heart Ultrasound)
|
$2,319.20 |
$2,319.20 |
$2,319.20 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$572.00 |
$572.00 |
$572.00 |
$469.95
|
|
Echocardiography transthoracic 2d followup/limited
|
$1,100.80 |
$1,100.80 |
$1,100.80 |
$703.25
|
|
Echocardiograpy doppler follow up/limited study
|
$384.00 |
$384.00 |
$384.00 |
$362.50
|
|
Echo stress
|
$1,602.40 |
$1,602.40 |
$1,602.40 |
$1,592.05
|
|
Edu/train/pt/nonmd/in person/30 min98960
|
$114.40 |
$114.40 |
$114.40 |
$87.84
|
|
Eeg recording awake and asleep
|
$966.40 |
$966.40 |
$966.40 |
$931.20
|
|
Ehrlicha chaffeensis amp prb
|
$49.60 |
$49.60 |
$49.60 |
$93.00
|
|
Electrical stimulation/unattended 97014
|
$70.40 |
$70.40 |
$70.40 |
$79.20
|
|
Electrolyte panel
|
$140.00 |
$140.00 |
$140.00 |
$84.24
|
|
Endo cath bile duct s&i
|
$1,032.00 |
$1,032.00 |
$1,032.00 |
$694.06
|
|
Endoscopy swallow (fees) vid
|
$500.80 |
$500.80 |
$500.80 |
$402.35
|
|
Endoven ther chem adhes 1st 36482
|
$5,180.00 |
$5,180.00 |
$5,180.00 |
$5,988.54
|
|
Enzyme histochemistry
|
$700.80 |
$700.80 |
$700.80 |
$471.60
|
|
Ep & ablate supravent arrhyt
|
$20,607.20 |
$20,607.20 |
$20,607.20 |
$27,075.00
|
|
Ep & ablate ventric tachy
|
$20,607.20 |
$20,607.20 |
$20,607.20 |
$28,199.40
|
|
Epidural/lumbar/sacral/ea add level64484
|
$1,169.60 |
$1,169.60 |
$1,169.60 |
$1,141.80
|
|
Epstein barr early antigen antibody
|
$67.20 |
$67.20 |
$67.20 |
$60.48
|
|
Epstein barr nuclear antigen antibody
|
$50.40 |
$50.40 |
$50.40 |
$78.65
|
|
Epstein barr viral capsid antigen antibody igm
|
$50.40 |
$50.40 |
$50.40 |
$91.00
|
|
Ercp biliary & pancreas
|
$1,136.80 |
$1,136.80 |
$1,136.80 |
$967.04
|
|
ER Visit (level 1, minor)
|
$183.20 |
$183.20 |
$183.20 |
$246.24
|
|
ER Visit (level 2)
|
$380.00 |
$380.00 |
$380.00 |
$452.20
|
|
ER Visit (level 3)
|
$648.00 |
$648.00 |
$648.00 |
$770.04
|
|
ER Visit (level 4)
|
$1,026.40 |
$1,026.40 |
$1,026.40 |
$1,273.68
|
|
ER Visit (level 5, high severity)
|
$1,707.20 |
$1,707.20 |
$1,707.20 |
$1,820.02
|
|
Established Patient Office Visit (level 1)
|
$110.40 |
$110.40 |
$110.40 |
$120.25
|
|
Established Patient Office Visit (level 2)
|
$118.40 |
$118.40 |
$118.40 |
$132.72
|
|
Established Patient Office Visit (level 3)
|
$199.20 |
$199.20 |
$199.20 |
$183.00
|
|
Established Patient Office Visit (level 4)
|
$301.60 |
$301.60 |
$301.60 |
$231.75
|
|
Established Patient Office Visit (level 5)
|
$427.20 |
$427.20 |
$427.20 |
$280.33
|
|
Estradiol total
|
$212.80 |
$212.80 |
$212.80 |
$146.50
|
|
Evaluation of speech fluency 92521
|
$483.20 |
$483.20 |
$483.20 |
$311.50
|
|
Evaluation psychiatric diagnostic
|
$244.00 |
$244.00 |
$244.00 |
$312.00
|
|
Event monitor
|
$216.80 |
$216.80 |
$216.80 |
$242.65
|
|
Evoked oa emissions ltd
|
$261.60 |
$261.60 |
$261.60 |
$234.32
|
|
Exchange biliary drg cath
|
$2,929.60 |
$2,929.60 |
$2,929.60 |
$3,909.56
|
|
Exchange nephrostomy cath
|
$1,564.80 |
$1,564.80 |
$1,564.80 |
$2,958.80
|
