|
Destruct cut vasl lesions 10-50cm 17107
|
$920.40 |
$1,100.00 |
$1,100.00 |
|
|
Destruct cut vasl lesions <10cm 17106
|
$150.36 |
$843.20 |
$843.20 |
|
|
Destruct cut vasl lesions >50cm 17108
|
$1,525.20 |
$1,572.80 |
$20,778.75 |
|
|
Destruction 2-14 lesions 17003
|
$15.20 |
$15.20 |
$603.00 |
|
|
Destruction anal lesion(s)
|
$452.40 |
$633.60 |
$4,427.80 |
|
|
Destruction anal lesion(s)
|
$661.00 |
$1,316.80 |
$1,316.80 |
|
|
Destruction anal lesion(s) smpl chem 46900
|
$429.00 |
$581.60 |
$581.60 |
|
|
Destruction benign lesions < 14 lesions
|
$92.16 |
$272.80 |
$13,781.80 |
|
|
Destruction by injection tx of nerve 64630
|
$423.60 |
$600.00 |
$600.00 |
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$849.60 |
$3,302.69 |
$27,136.69 |
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$1,332.00 |
$5,693.27 |
$26,986.06 |
|
|
Destruction ciliary body
|
$2,240.00 |
$2,240.00 |
$2,240.00 |
|
|
Destruction ciliary body
|
$2,283.20 |
$2,283.20 |
$2,283.20 |
|
|
Destruction ciliary body
|
$2,177.60 |
$2,177.60 |
$2,177.60 |
|
|
Destruction cryosurgery anal lesion(s) simpl 46916
|
$421.20 |
$605.60 |
$605.60 |
|
|
Destruction laser surgery anal lesions 46917
|
$831.00 |
$1,024.80 |
$1,024.80 |
|
|
Destruction les conjunctiva
|
$782.40 |
$782.40 |
$782.40 |
|
|
Destruction mal lsn s/n/h/f/g 2.1-3cm
|
$411.00 |
$513.60 |
$513.60 |
|
|
Destruction mal lsn s/n/h/f/g 3.1-4cm
|
$376.20 |
$605.60 |
$605.60 |
|
|
Destruction mal lsn t/a/l 3.1-4cm
|
$284.70 |
$507.20 |
$507.20 |
|
|
Destruction mal lsn t/a/l >4cm
|
$475.20 |
$578.40 |
$578.40 |
|
|
Destruction penis lesion(s) chem 54050
|
$239.40 |
$332.00 |
$332.00 |
|
|
Destruction penis lesion(s) exten 54065
|
$403.80 |
$544.80 |
$544.80 |
|
|
Destruction premal lesions 15/> 17004
|
$204.48 |
$388.80 |
$559.00 |
|
|
Destruction rectal tumor 45190
|
$1,041.60 |
$1,743.20 |
$2,556.00 |
|
|
Destruction vag lesions complex 57065
|
$434.40 |
$547.20 |
$547.20 |
|
|
Destruction vag lesions simple 57061
|
$210.00 |
$347.20 |
$6,449.30 |
|
|
Destruct penis les/smp/electrodesi 54055
|
$311.20 |
$311.20 |
$397.80 |
|
|
Detect agent nos dna dir
|
$49.20 |
$67.15 |
$80.64 |
|
|
Detect agnt mult dna direc
|
$76.20 |
$109.60 |
$109.60 |
|
|
Determination venous press
|
$18.40 |
$18.40 |
$18.40 |
|
|
Developmental screen/score/document 96110
|
$24.00 |
$56.80 |
$122.00 |
|
|
Devel tst phys/qhp 1st hr
|
$15.60 |
$307.20 |
$635.10 |
|
|
Device ablt adv novasure
|
$231.43 |
$6,237.48 |
$20,652.62 |
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$1,902.00 |
$2,599.67 |
$7,555.36 |
|
|
Device intraute mirena
|
$1,544.80 |
$2,105.82 |
$6,362.20 |
|
|
Device sut capio slim opn
|
$623.91 |
$1,534.26 |
$6,063.04 |
|
|
Device tiss remov myosure reach
|
$1,044.75 |
$3,961.70 |
$40,161.37 |
|
|
Dev interrog remote 1/2/mlt
|
$115.20 |
$115.20 |
$209.30 |
|
|
Devise bowel pouch
|
$3,464.00 |
$3,464.00 |
$3,464.00 |
|
|
Devlopment test interpt&rep
|
$49.60 |
$49.60 |
$703.61 |
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$137.60 |
$137.60 |
$317.55 |
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$57.96 |
$180.70 |
$654.00 |
|
|
Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr
|
$21.00 |
$21.00 |
$28,888.08 |
|
|
Dexamethasone 4 mg tablet
|
$0.40 |
$2.23 |
$130,837.85 |
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$14.89 |
$20.76 |
$28,355.31 |
|
|
Dexamethasone panel
|
$324.00 |
$324.00 |
$324.00 |
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$235.99 |
$853.51 |
$2,752.60 |
|
|
Dextran 40 infusion
|
$28.53 |
$86.84 |
$1,820.00 |
|
|
Dextroamphetamine
|
$0.44 |
$0.44 |
$0.44 |
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$2.80 |
$20.00 |
$101.31 |
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$6.40 |
$40.00 |
$101.31 |
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$5.60 |
$35.00 |
$144.00 |
|
|
Dextrose 5 % IV bolus
|
$4.80 |
$37.55 |
$7,405.29 |
|
|
Dhea-s (dehydroepiand sulfate)
|
$56.00 |
$133.20 |
$564.20 |
|
|
Diabetes (HbA1c) Test
|
$33.57 |
$67.62 |
$2,104.00 |
|
|
Diabetes training group per 30 min g0109
|
$16.80 |
$36.00 |
$49.00 |
|
|
Diab manage trn ind/group
|
$15.84 |
$54.99 |
$122.00 |
|
|
Diab shoe for density insert
|
$178.40 |
$178.40 |
$178.40 |
|
|
Diag bronchoscope/catheter
|
$448.00 |
$448.00 |
$1,889.16 |
|
|
Diag laparo separate proc 49320
|
$427.20 |
$807.20 |
$58,543.15 |
|
|
Diagnostic anoscopy
|
$355.20 |
$355.20 |
$355.20 |
|
|
Diagnostic anoscopy & biopsy
|
$496.80 |
$496.80 |
$496.80 |
|
|
Diagnostic anoscopy spx 46600
|
$96.85 |
$252.00 |
$617.50 |
|
|
Diagnostic digital breast tomosynthesis bil
|
$23.40 |
$382.40 |
$382.40 |
|
|
Diagnostic digital breast tomosynthesis unil
|
$23.40 |
$382.40 |
$2,302.00 |
|
|
Diagnostic laryngoscopy 31505
|
$96.18 |
$212.80 |
$509.85 |
|
|
Diagnostic laryngoscopy 31575
|
$130.00 |
$300.80 |
$908.96 |
|
|
Diagnostic Mammogram (both breasts)
|
$128.10 |
$413.31 |
$686.00 |
|
|
Diagnostic Mammogram (one breast)
|
$100.38 |
$295.10 |
$508.00 |
|
|
Diagnostic radio unlisted proc
|
$39.00 |
$45.36 |
$879.00 |
|
|
Dialysis circuit perm vascular embolization 36909
|
$347.40 |
$8,242.80 |
$14,977.66 |
|
|
Dialysis one evaluation
|
$192.00 |
$1,124.50 |
$2,673.25 |
|
|
Dialysis repeated eval
|
$280.00 |
$280.00 |
$3,749.20 |
|
|
Dialysis training complete
|
$789.60 |
$789.60 |
$789.60 |
|
|
Dialysis training incompl
|
$172.00 |
$172.00 |
$172.00 |
|
|
Diathermy eg microwave
|
$13.60 |
$13.60 |
$65.65 |
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.11 |
$41.79 |
$103.50 |
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$68.15 |
$96.96 |
$939.09 |
|
|
Dicyclomine injection
|
$131.33 |
$132.40 |
$198.04 |
|
|
Diffusing capacity
|
$18.00 |
$253.52 |
$548.00 |
|
|
Digital analysis of eeg
|
$134.40 |
$605.60 |
$625.95 |
|
|
Digit nerve surgery add-on
|
$450.40 |
$450.40 |
$450.40 |
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$11.50 |
$137.60 |
$1,171.84 |
|
|
Digoxin immune fab 40 mg intravenous solution
|
$7,687.80 |
$13,725.30 |
$13,725.30 |
|
|
Digoxin total therapeutic drug level
|
$41.60 |
$76.80 |
$316.00 |
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$92.00 |
$245.07 |
$2,743.80 |
|
|
Dilate biliary duct/ampulla
|
$975.36 |
$1,273.60 |
$4,826.09 |
|
|
Dilate esophagus
|
$387.84 |
$2,142.40 |
$2,577.60 |
|
|
Dilate esophagus 1/mult pass
|
$289.20 |
$420.80 |
$9,526.30 |
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$7,378.56 |
$7,378.56 |
$7,378.56 |
|
|
Dilate ic vasospasm ea add vsl same territory
|
$5,903.10 |
$5,903.10 |
$5,903.10 |
|
|
Dilate ic vasospasm init
|
$14,759.22 |
$14,759.22 |
$14,759.22 |
|
|
Dilate tear duct opening
|
$454.40 |
$454.40 |
$454.40 |
|
|
Dilate urethra stricture
|
$191.94 |
$212.00 |
$778.05 |
|
|
Dilate urethra stricture
|
$158.40 |
$200.80 |
$231.00 |
|
|
Dilate urethra stricture
|
$164.00 |
$164.00 |
$164.00 |
|
|
Dilate urethra stricture
|
$344.80 |
$344.80 |
$565.77 |
|
|
Dilation/female urethra/initial 53660
|
$132.00 |
$174.40 |
$174.40 |
|
|
Dilation of anal sphincter
|
$336.00 |
$416.80 |
$3,086.65 |
|
