|
Debridement bone <= 20 sq cm
|
$2,325.60 |
$2,325.60 |
$2,325.60 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$759.60 |
$759.60 |
$759.60 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,518.60 |
$1,518.60 |
$1,518.60 |
$1,412.40
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$793.20 |
$793.20 |
$793.20 |
$810.50
|
|
Debride nail1-5 11720
|
$501.60 |
$501.60 |
$501.60 |
$149.04
|
|
Debride nail6 or more 11721
|
$524.40 |
$524.40 |
$524.40 |
$169.80
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$1,287.00 |
$1,287.00 |
$1,287.00 |
$1,149.50
|
|
Debride skin bone at fx site
|
$1,803.00 |
$1,803.00 |
$1,803.00 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$603.00 |
$603.00 |
$603.00 |
$639.60
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,128.60 |
$1,128.60 |
$1,128.60 |
$1,129.45
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,018.20 |
$1,018.20 |
$1,018.20 |
$1,160.00
|
|
Decalcification
|
$126.00 |
$126.00 |
$126.00 |
$67.60
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$1,105.80 |
$1,105.80 |
$1,105.80 |
$557.00
|
|
Decomp fasct leg ant+/lat+pst cmprt 27602
|
$2,767.80 |
$2,767.80 |
$2,767.80 |
$4,914.00
|
|
Decomp forearm 1 space 25020
|
$1,849.80 |
$1,849.80 |
$1,849.80 |
$3,137.60
|
|
Decomp forearm 2 spaces w/debrid 25025
|
$2,516.40 |
$2,516.40 |
$2,516.40 |
$4,664.40
|
|
Decompress fasciotomyhand 26037
|
$1,266.60 |
$1,266.60 |
$1,266.60 |
$3,839.54
|
|
Decompress forearm 1 space
|
$1,738.80 |
$1,738.80 |
$1,738.80 |
$3,957.20
|
|
Decompress forearm 2 spaces
|
$1,247.40 |
$1,247.40 |
$1,247.40 |
$3,851.20
|
|
Decompression of leg
|
$5,013.00 |
$5,013.00 |
$5,013.00 |
$3,839.54
|
|
Decompression of leg
|
$5,013.00 |
$5,013.00 |
$5,013.00 |
$7,907.11
|
|
Decompression of leg
|
$5,013.00 |
$5,013.00 |
$5,013.00 |
$3,839.54
|
|
Decompression of lower leg
|
$864.00 |
$864.00 |
$864.00 |
$3,839.54
|
|
Decompression of lower leg
|
$1,051.80 |
$1,051.80 |
$1,051.80 |
$3,839.54
|
|
Decompression of thigh/knee
|
$1,135.80 |
$1,135.80 |
$1,135.80 |
$4,108.00
|
|
Decompression of thigh/knee
|
$1,174.20 |
$1,174.20 |
$1,174.20 |
$3,839.54
|
|
Decompression of thigh/knee
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$3,217.60
|
|
Decompression of thigh/knee
|
$1,437.00 |
$1,437.00 |
$1,437.00 |
$7,807.24
|
|
Decompression of tibia nerve
|
$822.60 |
$822.60 |
$822.60 |
$2,625.60
|
|
Decompression unspecified nerve 64722
|
$534.60 |
$534.60 |
$534.60 |
$2,163.32
|
|
Delivery of placenta 59414
|
$4,222.20 |
$4,222.20 |
$4,222.20 |
$2,763.36
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$120.00 |
$120.00 |
$120.00 |
$184.20
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$451.80 |
$451.80 |
$451.80 |
$401.60
|
|
Descend thora aorta rpr/lt sub art 33880
|
$2,697.60 |
$2,697.60 |
$2,697.60 |
$5,958.60
|
|
Design mlc device for imrt
|
$1,811.40 |
$1,811.40 |
$1,811.40 |
$1,677.86
|
|
Desoxycorticosterone
|
$366.60 |
$366.60 |
$366.60 |
$109.28
|
|
Des thora aorta rpr without left sub art 33881
|
$2,314.80 |
$2,314.80 |
$2,314.80 |
$5,698.68
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$1,674.00 |
$1,674.00 |
$1,674.00 |
$2,727.20
|
|
Destroy cervthor facet jnt 64633
|
$3,412.80 |
$3,412.80 |
$3,412.80 |
$3,018.00
|
|
Destroy cth facet jnt addl 64634
|
$1,527.60 |
$1,527.60 |
$1,527.60 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$239.40 |
$239.40 |
$239.40 |
$203.04
|
|
Destruct ben lesion 15/> 17111
|
$268.80 |
$268.80 |
$268.80 |
$235.13
|
|
Destruction 2-14 lesions 17003
|
$150.60 |
$150.60 |
$150.60 |
$78.61
|
|
Destruction benign lesions < 14 lesions
|
$210.00 |
$210.00 |
$210.00 |
$239.22
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$2,638.80 |
$2,638.80 |
$2,638.80 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,412.80 |
$3,412.80 |
$3,412.80 |
$3,205.20
|
|
Developmental screen/score/document 96110
|
$164.40 |
$164.40 |
$164.40 |
$136.64
|
|
Devel tst phys/qhp 1st hr
|
$331.80 |
$331.80 |
$331.80 |
$331.80
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$186.00 |
$186.00 |
$186.00 |
$196.30
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$484.20 |
$484.20 |
$484.20 |
$227.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$311.40 |
$311.40 |
$311.40 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$82.20 |
$82.20 |
$82.20 |
$79.30
|
|
Diab manage trn ind/group
|
$94.20 |
$94.20 |
$94.20 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$253.20 |
$253.20 |
$253.20 |
$187.00
|
|
Diagnostic laryngoscopy 31505
|
$207.00 |
$207.00 |
$207.00 |
$235.00
|
|
Diagnostic laryngoscopy 31575
|
$607.20 |
$607.20 |
$607.20 |
$321.00
|
|
Diagnostic Mammogram (both breasts)
|
$727.80 |
$727.80 |
$727.80 |
$415.80
|
|
Diagnostic Mammogram (one breast)
|
$544.20 |
$544.20 |
$544.20 |
$311.04
|
|
Dialysis circuit perm vascular embolization 36909
|
$11,656.80 |
$11,656.80 |
$11,656.80 |
$5,770.50
|
|
Dialysis one evaluation
|
$790.20 |
$790.20 |
$790.20 |
$925.74
|
|
Diatrizoate meglumine 18 % urethral solution
|
$5.40 |
$5.40 |
$5.40 |
$115.15
|
|
Diffusing capacity
|
$405.00 |
$405.00 |
$405.00 |
$337.60
|
|
Digital analysis of eeg
|
$487.80 |
$487.80 |
$487.80 |
$605.60
|
|
Digoxin total therapeutic drug level
|
$176.40 |
$176.40 |
$176.40 |
$102.00
|
|
Dilate biliary duct/ampulla
|
$4,834.20 |
$4,834.20 |
$4,834.20 |
$1,866.73
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$2,824.80 |
$2,824.80 |
$2,824.80 |
$3,183.60
|
|
Dilate ic vasospasm ea add vsl same territory
|
$2,824.80 |
$2,824.80 |
$2,824.80 |
$1,931.80
|
|
Dilate ic vasospasm init
|
$2,824.80 |
$2,824.80 |
$2,824.80 |
$5,741.00
|
|
Dilation of cervical canal 57800
|
$4,662.60 |
$4,662.60 |
$4,662.60 |
$4,376.00
|
|
Dilat xst trc ndurlgc px
|
$3,586.80 |
$3,586.80 |
$3,586.80 |
$4,081.37
|
|
Dilat xst trc new access rcs
|
$3,586.80 |
$3,586.80 |
$3,586.80 |
$4,258.20
|
|
Disability dlco
|
$406.80 |
$406.80 |
$406.80 |
$294.55
|
|
Disaccharidases
|
$1,348.80 |
$1,348.80 |
$1,348.80 |
$224.31
|
|
Discography cerv/thor spine
|
$4,150.20 |
$4,150.20 |
$4,150.20 |
$2,595.00
|
|
Dlyd plmt xtn prosth ea addl
|
$4,360.20 |
$4,360.20 |
$4,360.20 |
$1,631.87
|
|
Dna antibody native/double stranded
|
$351.00 |
$351.00 |
$351.00 |
$100.00
|
|
Dna gardnerella
|
$118.80 |
$118.80 |
$118.80 |
$61.80
|
|
Dna trichomonas
|
$123.60 |
$123.60 |
$123.60 |
$66.05
|
|
Doppler echo complete
|
$684.60 |
$684.60 |
$684.60 |
$548.00
|
|
Doppler intravascular pressure flow initial vessel
|
$2,451.00 |
$2,451.00 |
$2,451.00 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,002.00 |
$1,002.00 |
$1,002.00 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$703.80 |
$703.80 |
$703.80 |
$481.65
|
|
Dpyd gene common variants
|
$1,596.60 |
$1,596.60 |
$1,596.60 |
$386.12
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$443.40 |
$443.40 |
$443.40 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$1,123.20 |
$1,123.20 |
$1,123.20 |
$901.80
|
|
Drainage external ear simple 69000
|
$443.40 |
$443.40 |
$443.40 |
$779.45
|
|
Drainage mouth roof lesion
|
$288.60 |
$288.60 |
$288.60 |
$401.50
|
|
Drainage of arm bursa 23931
|
$2,218.80 |
$2,218.80 |
$2,218.80 |
$2,209.90
|
|
Drainage of bone lesion
|
$2,417.40 |
$2,417.40 |
$2,417.40 |
$2,854.40
|
|
Drainage of bone lesion
|
$1,122.60 |
$1,122.60 |
$1,122.60 |
$3,153.60
|
|
Drainage of eye
|
$2,418.00 |
$2,418.00 |
$2,418.00 |
$2,360.00
|
|
Drainage of eye
|
$3,244.20 |
$3,244.20 |
$3,244.20 |
$3,170.00
|
|
Drainage of forearm bursa
|
$823.80 |
$823.80 |
$823.80 |
$2,054.00
|
|
Drainage of kidney lesion
|
$3,105.00 |
$3,105.00 |
$3,105.00 |
$1,546.28
|
|
Drainage of mouth lesion
|
$4,650.00 |
$4,650.00 |
$4,650.00 |
$3,837.72
|
|
Drainage of mouth lesion
|
$299.40 |
$299.40 |
$299.40 |
$1,752.89
|
|
Drainage of pelvis lesion 26990
|
$3,473.40 |
$3,473.40 |
$3,473.40 |
$3,863.70
|
|
Drain blood from under nail 11740
|
$182.40 |
$182.40 |
$182.40 |
$173.21
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$4,021.20 |
$4,021.20 |
$4,021.20 |
$2,556.00
|
|
Drain cath image guided visceral pq
|
$3,001.20 |
$3,001.20 |
$3,001.20 |
$2,885.30
|
