|
Ex arm/elbow tum deep < 5 cm
|
$2,668.80 |
$2,668.80 |
$2,668.80 |
$3,386.84
|
|
Ex arm/elbow tum deep 5 cm/>
|
$3,412.80 |
$3,412.80 |
$3,412.80 |
$3,412.80
|
|
Exc abd les sc 3 cm/>
|
$1,073.60 |
$1,073.60 |
$1,073.60 |
$3,986.00
|
|
Exc abdl tum deep < 5 cm
|
$1,378.40 |
$1,378.40 |
$1,378.40 |
$3,696.00
|
|
Exc abdl tum deep 5 cm/>
|
$1,632.80 |
$1,632.80 |
$1,632.80 |
$3,386.84
|
|
Exc arm/elbo les sc >=3cm 24071
|
$1,987.20 |
$1,987.20 |
$1,987.20 |
$4,350.00
|
|
Exc arm/elbo les sc <3cm 24075
|
$2,532.80 |
$2,532.80 |
$2,532.80 |
$2,532.80
|
|
Exc aurl glomus tum trnscanl
|
$5,099.20 |
$5,099.20 |
$5,099.20 |
$7,000.36
|
|
Exc aurl glomus tum trnsmstd
|
$7,710.40 |
$7,710.40 |
$7,710.40 |
$7,000.36
|
|
Exc back les sbq <3 cm 21930
|
$1,200.80 |
$1,200.80 |
$1,200.80 |
$2,676.58
|
|
Exc back tum deep 5 cm/>
|
$1,807.20 |
$1,807.20 |
$1,807.20 |
$3,994.09
|
|
Exc bartholins gland/cyst
|
$1,534.40 |
$1,534.40 |
$1,534.40 |
$3,790.00
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$696.80 |
$696.80 |
$696.80 |
$2,315.50
|
|
Exc benign feenlm >4.0cm 11446
|
$960.80 |
$960.80 |
$960.80 |
$3,386.84
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$577.60 |
$577.60 |
$577.60 |
$2,306.25
|
|
Exc benign tal 0.5 < cm 11400
|
$307.20 |
$307.20 |
$307.20 |
$832.60
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$999.56 |
$999.56 |
$999.56 |
$972.00
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$468.00 |
$468.00 |
$468.00 |
$1,135.40
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$556.00 |
$556.00 |
$556.00 |
$2,068.80
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$392.00 |
$392.00 |
$392.00 |
$1,501.50
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$1,799.19 |
$1,799.19 |
$1,799.19 |
$2,271.01
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$826.40 |
$826.40 |
$826.40 |
$3,483.00
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$375.20 |
$375.20 |
$375.20 |
$779.35
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$479.20 |
$479.20 |
$479.20 |
$1,314.67
|
|
Exc breast duct fistula 19112
|
$2,235.20 |
$2,235.20 |
$2,235.20 |
$4,238.48
|
|
Exc carotid body tumor without exc art 60600
|
$3,356.80 |
$3,356.80 |
$3,356.80 |
$3,356.80
|
|
Exc cervix repair bowel 57556
|
$1,448.80 |
$1,448.80 |
$1,448.80 |
$5,813.46
|
|
Exc cervix/repair vagina 57555
|
$1,528.80 |
$1,528.80 |
$1,528.80 |
$5,463.96
|
|
Exc chest wall tumor w/ribs 21601
|
$2,880.00 |
$2,880.00 |
$2,880.00 |
$3,386.84
|
|
Exc ch wal tum without lymphadec
|
$3,872.00 |
$3,872.00 |
$3,872.00 |
$3,872.00
|
|
Exc ch wal tum w/lymphadec
|
$4,279.20 |
$4,279.20 |
$4,279.20 |
$4,279.20
|
|
Exc coccygl pr ulc flap clsr
|
$1,952.00 |
$1,952.00 |
$1,952.00 |
$4,311.38
|
|
Exc coccygl pr ulc prim sutr
|
$1,529.60 |
$1,529.60 |
$1,529.60 |
$2,682.40
|
|
Exc constrict ring finger w/mlt z-plasties 26596
|
$1,916.00 |
$1,916.00 |
$1,916.00 |
$3,821.05
|
|
Exc/crtg b1 cst/b9 tum rds
|
$2,617.60 |
$2,617.60 |
$2,617.60 |
$2,617.60
|
|
Exc/crtg b1 cst/tum hum agrf
|
$3,625.60 |
$3,625.60 |
$3,625.60 |
$7,807.24
|
|
Exc/crtg b1 cst/tum hum algr
|
$4,235.20 |
$4,235.20 |
$4,235.20 |
$7,807.24
|
|
Exc/crtg b1 cst/tum rds agrf
|
$3,052.80 |
$3,052.80 |
$3,052.80 |
$3,839.54
|
|
Exc/crtg b1 cst/tum rds algr
|
$3,190.40 |
$3,190.40 |
$3,190.40 |
$7,807.24
|
|
Exc/curetg cst/tum tarsal/metar w/iliac/agrf 28106
|
$1,091.20 |
$1,091.20 |
$1,091.20 |
$6,653.00
|
|
Exc/curtg b1 cst/b9 tum hum
|
$2,886.40 |
$2,886.40 |
$2,886.40 |
$3,839.54
|
|
Exc excessive skin buttock
|
$2,309.60 |
$2,309.60 |
$2,309.60 |
$3,386.84
|
|
Exc excessive skin hip
|
$4,404.80 |
$4,404.80 |
$4,404.80 |
$3,994.09
|
|
Exc excessive skin leg
|
$4,321.60 |
$4,321.60 |
$4,321.60 |
$4,321.60
|
|
Exc excessive skin thigh
|
$4,540.80 |
$4,540.80 |
$4,540.80 |
$4,540.80
|
|
Exc excsv skin forearm/hand
|
$2,130.40 |
$2,130.40 |
$2,130.40 |
$3,386.84
|
|
Exc excsv submental fat pad
|
$1,586.40 |
$1,586.40 |
$1,586.40 |
$3,386.84
|
|
Exc ext ear/partial/simple repair 69110
|
$2,259.20 |
$2,259.20 |
$2,259.20 |
$3,339.00
|
|
Exc face tum deep < 2 cm
|
$1,300.80 |
$1,300.80 |
$1,300.80 |
$2,201.16
|
|
Exc face tum deep 2cm/> 21014
|
$1,283.20 |
$1,283.20 |
$1,283.20 |
$3,386.84
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$584.80 |
$584.80 |
$584.80 |
$973.71
|
|
Exc feenl mal+mrg 2.1-3 11643
|
$2,787.08 |
$2,787.08 |
$2,787.08 |
$2,101.45
|
|
Exc foot/toe tum dep 1.5cm/>
|
$2,280.00 |
$2,280.00 |
$2,280.00 |
$4,094.05
|
|
Exc foot/toe tum subq < 1.5 cm 28043
|
$4,985.12 |
$4,985.12 |
$4,985.12 |
$3,484.00
|
|
Exc forearm les sc 3 cm/>
|
$2,078.40 |
$2,078.40 |
$2,078.40 |
$3,628.50
|
|
Exc forearm tum deep < 3 cm
|
$2,547.20 |
$2,547.20 |
$2,547.20 |
$2,271.01
|
|
Exc forearm tum deep 3 cm/>
|
$2,628.80 |
$2,628.80 |
$2,628.80 |
$3,994.09
|
|
Exc hand les sc < 1.5 cm
|
$1,302.40 |
$1,302.40 |
$1,302.40 |
$1,898.50
|
|
Exc hand tum deep 1.5 cm/>
|
$1,348.80 |
$1,348.80 |
$1,348.80 |
$2,271.01
|
|
Exc hand tum deep < 1.5 cm 26116
|
$1,294.40 |
$1,294.40 |
$1,294.40 |
$2,391.84
|
|
Exchange biliary drg cath
|
$7,362.84 |
$7,362.84 |
$7,362.84 |
$3,872.60
|
|
Exchange blood transfusion newborn 36450
|
$440.80 |
$440.80 |
$440.80 |
$566.55
|
|
Exchange drainage catheter
|
$2,018.51 |
$2,018.51 |
$2,018.51 |
$2,234.01
|
|
Exchange lens prosthesis
|
$4,504.00 |
$4,504.00 |
$4,504.00 |
$4,504.00
|
|
Exchange nephrostomy cath
|
$3,998.20 |
$3,998.20 |
$3,998.20 |
$2,958.80
|
|
Exc hidradenitis ing simpl 11462
|
$1,932.80 |
$1,932.80 |
$1,932.80 |
$3,386.84
|
|
Exc hidradenitis peri/umb comp 11471
|
$1,287.20 |
$1,287.20 |
$1,287.20 |
$3,386.84
|
|
Exc hidradenitis peri/umb int 11470
|
$1,055.20 |
$1,055.20 |
$1,055.20 |
$3,399.24
|
|
Exc hip/pelv tum deep < 5 cm
|
$2,987.20 |
$2,987.20 |
$2,987.20 |
$3,386.84
|
|
Exc hip/pelv tum deep 5 cm/>
|
$3,630.40 |
$3,630.40 |
$3,630.40 |
$3,630.40
|
|
Excimer lsr psriasis 250-500
|
$388.00 |
$388.00 |
$388.00 |
$372.84
|
|
Excimer lsr psriasis<250sqcm
|
$353.60 |
$353.60 |
$353.60 |
$341.00
|
|
Excimer lsr psriasis>500sqcm
|
$530.40 |
$530.40 |
$530.40 |
$472.79
|
|
Exc im tumor/back/flank/ < 5 cm 21932
|
$1,622.40 |
$1,622.40 |
$1,622.40 |
$3,398.50
|
|
Exc im tumor/foot/toe < 1.5 cm 28045
|
$2,444.80 |
$2,444.80 |
$2,444.80 |
$3,386.84
|
|
Exc im tumor/shoulder area 5cm/> 23073
|
$3,411.20 |
$3,411.20 |
$3,411.20 |
$3,486.52
|
|
Exc intracard tumor/resect/bypass 33120
|
$5,114.40 |
$5,114.40 |
$5,114.40 |
$5,114.40
|
|
Exc ischial pr ulcer w/ostc musc/myoq flap/skin 15946
|
$4,017.60 |
$4,017.60 |
$4,017.60 |
$4,017.60
|
|
Exc ischial pr ulc prim sutr
|
$1,720.80 |
$1,720.80 |
$1,720.80 |
$3,386.84
|
|
Exc isch pr ulc prm sut ostc
|
$2,252.80 |
$2,252.80 |
$2,252.80 |
$3,986.00
|
|
Exc isch pr ulc skn flp clsr
|
$2,241.60 |
$2,241.60 |
$2,241.60 |
$4,311.38
|
|
Exc isch pr ulc skn flp ostc
|
$2,508.80 |
$2,508.80 |
$2,508.80 |
$4,118.00
|
|
Excise anal ext tag/papilla
|
$559.20 |
$559.20 |
$559.20 |
$2,272.02
|
|
Excise epiphyseal bar
|
$4,947.20 |
$4,947.20 |
$4,947.20 |
$4,947.20
|
|
Excise foot tendon sheath
|
$2,667.20 |
$2,667.20 |
$2,667.20 |
$3,786.00
|
|
Excise foot tendon sheath
|
$2,161.60 |
$2,161.60 |
$2,161.60 |
$3,839.54
|
|
Excise ileoanal reservior
|
$4,510.40 |
$4,510.40 |
$4,510.40 |
$2,369.34
|
|
Excise inferior turbinate
|
$1,942.40 |
$1,942.40 |
$1,942.40 |
$3,592.74
|
|
Excise intestine lesion(s) 44110
|
$2,086.40 |
$2,086.40 |
$2,086.40 |
$1,600.80
|
|
Excise intraspinl lesion crv
|
$3,952.00 |
$3,952.00 |
$3,952.00 |
$5,419.00
|
|
Excise intrspinl lesion crvl
|
$4,875.20 |
$4,875.20 |
$4,875.20 |
$4,875.20
|
|
Excise intrspinl lesion lmbr
|
$3,273.60 |
$3,273.60 |
$3,273.60 |
$5,741.00
|
|
Excise intrspinl lesion lmbr
|
$4,479.20 |
$4,479.20 |
$4,479.20 |
$2,888.61
|
|
Excise intrspinl lesion scrl
|
$3,365.60 |
$3,365.60 |
$3,365.60 |
$5,741.00
|
|
Excise intrspinl lesion scrl
|
$4,381.60 |
$4,381.60 |
$4,381.60 |
$4,381.60
|
|
Excise intrspinl lesion thrc
|
$4,874.40 |
$4,874.40 |
$4,874.40 |
$4,874.40
|
|
Excise lesion testis
|
$2,715.20 |
$2,715.20 |
$2,715.20 |
$4,081.37
|
|
Excise lip or cheek fold
|
$699.20 |
$699.20 |
$699.20 |
$1,855.10
|
|
Excise lwr jaw cyst w/repair
|
$3,208.00 |
$3,208.00 |
$3,208.00 |
$6,219.35
|
|
Excise mandible lesion
|
$1,231.20 |
$1,231.20 |
$1,231.20 |
$3,589.62
|
