|
Injection of sinus tract
|
$1,526.40 |
$1,526.40 |
$1,526.40 |
$1,627.60
|
|
Injection radioactive tracer sentinel node (both sides)
|
$568.80 |
$568.80 |
$568.80 |
$670.64
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,220.40 |
$1,220.40 |
$1,220.40 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,453.20 |
$1,453.20 |
$1,453.20 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,803.80 |
$2,803.80 |
$2,803.80 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,255.80 |
$1,255.80 |
$1,255.80 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$3,517.20 |
$3,517.20 |
$3,517.20 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,091.40 |
$1,091.40 |
$1,091.40 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$3,058.80 |
$3,058.80 |
$3,058.80 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$5,189.40 |
$5,189.40 |
$5,189.40 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$4,966.20 |
$4,966.20 |
$4,966.20 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$672.00 |
$672.00 |
$672.00 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$628.80 |
$628.80 |
$628.80 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$912.60 |
$912.60 |
$912.60 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$273.00 |
$273.00 |
$273.00 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$273.00 |
$273.00 |
$273.00 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$273.00 |
$273.00 |
$273.00 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$406.20 |
$406.20 |
$406.20 |
$135.60
|
|
Injection treatment of nerve
|
$3,690.00 |
$3,690.00 |
$3,690.00 |
$2,025.45
|
|
Inject sacroiliac joint
|
$2,338.80 |
$2,338.80 |
$2,338.80 |
$1,028.95
|
|
Inj epidural sgl cerv-thor without img
|
$3,734.40 |
$3,734.40 |
$3,734.40 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$3,106.80 |
$3,106.80 |
$3,106.80 |
$1,415.50
|
|
Inj for ext venography
|
$1,074.60 |
$1,074.60 |
$1,074.60 |
$649.95
|
|
Inj for mammo ductogram
|
$787.80 |
$787.80 |
$787.80 |
$399.60
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$2,214.00 |
$2,214.00 |
$2,214.00 |
$1,439.90
|
|
Inj hrt cath w/s&i sel left vent
|
$1,782.00 |
$1,782.00 |
$1,782.00 |
$1,239.00
|
|
Inj hrt cath w/s&i sel right vent
|
$2,262.60 |
$2,262.60 |
$2,262.60 |
$965.33
|
|
Inj intralesional <= 7 lsn(s)
|
$386.40 |
$386.40 |
$386.40 |
$235.13
|
|
Inj multihance
|
$13.80 |
$13.80 |
$13.80 |
$73.49
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,461.60 |
$1,461.60 |
$1,461.60 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$2,640.00 |
$2,640.00 |
$2,640.00 |
$2,837.09
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$2,640.00 |
$2,640.00 |
$2,640.00 |
$2,609.38
|
|
Inj proc ankle arthr
|
$754.20 |
$754.20 |
$754.20 |
$405.31
|
|
Inj proc elbow arthro
|
$754.20 |
$754.20 |
$754.20 |
$419.60
|
|
Inj proc lumbr disk ea lvl
|
$2,425.20 |
$2,425.20 |
$2,425.20 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$1,041.60 |
$1,041.60 |
$1,041.60 |
$830.50
|
|
Inj proc sialogram
|
$790.80 |
$790.80 |
$790.80 |
$373.00
|
|
Inj prohance multipack
|
$10.80 |
$10.80 |
$10.80 |
$9.59
|
|
Inj retro urethrocysto
|
$1,345.20 |
$1,345.20 |
$1,345.20 |
$443.50
|
|
Inj scleros sol mult veins
|
$1,107.60 |
$1,107.60 |
$1,107.60 |
$675.00
|
|
Inj scleros sol sgl vein
|
$1,107.60 |
$1,107.60 |
$1,107.60 |
$558.97
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$3,027.60 |
$3,027.60 |
$3,027.60 |
$436.80
|
|
Inj w/fluor eval cv device
|
$807.00 |
$807.00 |
$807.00 |
$503.92
|
|
Ins cath ren art 1st bi
|
$6,442.80 |
$6,442.80 |
$6,442.80 |
$5,753.10
|
|
Ins cath ren art 1st uni
|
$4,294.80 |
$4,294.80 |
$4,294.80 |
$4,660.00
|
|
Ins cath ren art 2nd+ bi
|
$6,808.80 |
$6,808.80 |
$6,808.80 |
$5,500.86
|
|
Ins cath ren art 2nd+ uni
|
$4,539.60 |
$4,539.60 |
$4,539.60 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$502.80 |
$502.80 |
$502.80 |
$480.28
|
|
Insert and remove bone pin
|
$5,050.80 |
$5,050.80 |
$5,050.80 |
$4,410.60
|
|
Insert cath pleura with image
|
$2,952.00 |
$2,952.00 |
$2,952.00 |
$2,194.40
|
|
Insert cath pleura without image
|
$1,195.20 |
$1,195.20 |
$1,195.20 |
$2,073.18
|
|
Insert cv cath inf & sup app
|
$14,899.20 |
$14,899.20 |
$14,899.20 |
$9,763.31
|
|
Insert drug delivery implant
|
$172.20 |
$172.20 |
$172.20 |
$280.00
|
|
Insert epicard eltrd endo 33203
|
$2,326.20 |
$2,326.20 |
$2,326.20 |
$3,053.00
|
|
Insert epicardial lead open 33202
|
$1,576.80 |
$1,576.80 |
$1,576.80 |
$3,775.20
|
|
Insertion catheter bladder non indwelling
|
$321.00 |
$321.00 |
$321.00 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$386.40 |
$386.40 |
$386.40 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$7,851.00 |
$7,851.00 |
$7,851.00 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,482.00 |
$1,482.00 |
$1,482.00 |
$2,529.45
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$8,157.60 |
$8,157.60 |
$8,157.60 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,574.00 |
$2,574.00 |
$2,574.00 |
$2,505.60
|
|
Insertion of catheter vein
|
$1,356.00 |
$1,356.00 |
$1,356.00 |
$836.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$15,233.40 |
$15,233.40 |
$15,233.40 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$14,245.20 |
$14,245.20 |
$14,245.20 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$30,926.40 |
$30,926.40 |
$30,926.40 |
$10,100.35
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$3,625.80 |
$3,625.80 |
$3,625.80 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$4,309.80 |
$4,309.80 |
$4,309.80 |
$2,419.65
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$26,808.00 |
$26,808.00 |
$26,808.00 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$8,109.00 |
$8,109.00 |
$8,109.00 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$8,336.40 |
$8,336.40 |
$8,336.40 |
$7,312.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$9,283.20 |
$9,283.20 |
$9,283.20 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$6,894.60 |
$6,894.60 |
$6,894.60 |
$5,223.20
|
|
Insertion ureth cath
|
$1,290.60 |
$1,290.60 |
$1,290.60 |
$2,412.45
|
|
Insert major vessel graft
|
$2,147.40 |
$2,147.40 |
$2,147.40 |
$2,051.87
|
|
Insert major vessel graft with bypass 33335
|
$2,664.00 |
$2,664.00 |
$2,664.00 |
$3,669.00
|
|
Insert pessary/other device
|
$327.60 |
$327.60 |
$327.60 |
$278.50
|
|
Insert pm/icd lead dual
|
$8,336.40 |
$8,336.40 |
$8,336.40 |
$7,115.20
|
|
Insert/repl sq defib w/eltrd
|
$30,926.40 |
$30,926.40 |
$30,926.40 |
$32,800.04
|
|
Insert sq defib electrode
|
$30,926.40 |
$30,926.40 |
$30,926.40 |
$8,167.68
|
|
Insert swan-ganz cath
|
$1,792.80 |
$1,792.80 |
$1,792.80 |
$2,210.50
|
|
Insert tissue expander(s)
|
$2,266.20 |
$2,266.20 |
$2,266.20 |
$4,332.25
|
|
Insert tunneled cv cath
|
$5,863.80 |
$5,863.80 |
$5,863.80 |
$4,520.00
|
|
Insert vad art access left hrt arterial access
|
$3,863.40 |
$3,863.40 |
$3,863.40 |
$4,270.75
|
|
Insert vad art access left hrt art & vein access
|
$4,825.20 |
$4,825.20 |
$4,825.20 |
$3,677.40
|
|
Ins icd gen exist mlt leads
|
$23,861.40 |
$23,861.40 |
$23,861.40 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$26,051.40 |
$26,051.40 |
$26,051.40 |
$23,230.50
|
|
Insitu hybridization auto
|
$557.40 |
$557.40 |
$557.40 |
$377.37
|
|
Insitu hybridization (fish)
|
$879.60 |
$879.60 |
$879.60 |
$481.60
|
|
Insitu hybridization manual
|
$843.60 |
$843.60 |
$843.60 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$666.00 |
$666.00 |
$666.00 |
$241.15
|
|
In situ hybridization per specimen initial single probe stain
|
$560.40 |
$560.40 |
$560.40 |
$331.69
|
|
Insj biomechanical device 22853
|
$395.40 |
$395.40 |
$395.40 |
$622.40
|
|
Insj perq vad r hrt venous
|
$5,634.60 |
$5,634.60 |
$5,634.60 |
$3,796.00
|
|
Ins lv lead exist pm/icd
|
$30,926.40 |
$30,926.40 |
$30,926.40 |
$12,384.25
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$6,540.00 |
$6,540.00 |
$6,540.00 |
$1,690.00
|
|
Ins pm gen exist dual lead
|
$26,051.40 |
$26,051.40 |
$26,051.40 |
$23,665.85
|
|
Ins pm gen w/exist mlt leads
|
$19,576.20 |
$19,576.20 |
$19,576.20 |
$14,804.40
|
|
Ins pq tunnld ip cath w/img
|
$9,099.00 |
$9,099.00 |
$9,099.00 |
$5,377.00
|
|
Ins/rpl ldless pm right vent w img & eval
|
$19,228.80 |
$19,228.80 |
$19,228.80 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$13,824.00 |
$13,824.00 |
$13,824.00 |
$11,005.50
|
