|
Above knee leather socket
|
$1,154.12 |
$1,154.12 |
$1,154.12 |
$697.20
|
|
Above knee manual lock
|
$567.68 |
$567.68 |
$567.68 |
$492.80
|
|
Above knee wood socket
|
$997.86 |
$997.86 |
$997.86 |
$666.40
|
|
Abrasion lesions add-on
|
$20.31 |
$20.31 |
$20.31 |
$100.00
|
|
Abrasion lesion single
|
$275.88 |
$275.88 |
$275.88 |
$340.86
|
|
Abscess drain retroperitoneal surg code
|
$2,271.01 |
$2,271.01 |
$2,271.01 |
$3,050.40
|
|
Absorpt drg >16<=48 in w/bdr
|
$5.99 |
$5.99 |
$5.99 |
$5.99
|
|
Absorpt drg >16 <=48 without bdr
|
$6.40 |
$6.40 |
$6.40 |
$6.40
|
|
Absorpt drg <=16 sq in w/bdr
|
$2.35 |
$2.35 |
$2.35 |
$13.80
|
|
Absorpt drg <=16 sq in without b
|
$3.92 |
$3.92 |
$3.92 |
$5.60
|
|
Absorpt drg > 48 sq in without b
|
$12.46 |
$12.46 |
$12.46 |
$7.76
|
|
Access & clsr pq fem art endogft dlvry w/img uni
|
$170.66 |
$170.66 |
$170.66 |
$2,314.00
|
|
Access thoracic lymph duct
|
$369.15 |
$369.15 |
$369.15 |
$828.80
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$0.08 |
$0.08 |
$0.08 |
$72.74
|
|
Acetaminophen level
|
$25.72 |
$25.72 |
$25.72 |
$116.80
|
|
Acetazolamide 500 mg solution for injection
|
$35.32 |
$35.32 |
$35.32 |
$122.55
|
|
Acetone qualitative
|
$6.24 |
$6.24 |
$6.24 |
$46.80
|
|
Acetylcholine receptor modulating antibody
|
$16.63 |
$16.63 |
$16.63 |
$67.50
|
|
Acetylcholinesterase assay
|
$16.96 |
$16.96 |
$16.96 |
$107.63
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$0.51 |
$0.51 |
$0.51 |
$218.79
|
|
Acetylcysteine non-comp unit
|
$11.67 |
$11.67 |
$11.67 |
$31.21
|
|
Acid perfusion of esophagus
|
$513.11 |
$513.11 |
$513.11 |
$587.30
|
|
Acne surgery 10040
|
$275.88 |
$275.88 |
$275.88 |
$265.20
|
|
Aco annual medicare visit (awv), initial g0438aco
|
$242.02 |
$242.02 |
$242.02 |
$243.00
|
|
Aco annual medicare visit (awv), subsq g0439aco
|
$190.67 |
$190.67 |
$190.67 |
$160.69
|
|
Aco ccm; at least 20 min 99490aco
|
$139.68 |
$139.68 |
$139.68 |
$102.47
|
|
Aco ccm; ea addl 20 min 99439aco
|
$43.72 |
$43.72 |
$43.72 |
$87.20
|
|
Aco cmplx chron care addl 20 min 99489aco
|
$62.21 |
$62.21 |
$62.21 |
$64.74
|
|
Aco cmplx chron care without pt visit, 60 min 99487aco
|
$244.07 |
$244.07 |
$244.07 |
$177.99
|
|
Aco cont gluc mnt phys/qhp eqp 95250aco
|
$204.93 |
$204.93 |
$204.93 |
$341.00
|
|
Aco depression screen annual medicare g0444aco
|
$51.52 |
$51.52 |
$51.52 |
$39.32
|
|
Aco med nutria tx/group, ea 30 min 97804aco
|
$17.19 |
$17.19 |
$17.19 |
$38.50
|
|
Acoustic immitance testing
|
$176.93 |
$176.93 |
$176.93 |
$158.50
|
|
Acoustic refl threshold tst
|
$51.36 |
$51.36 |
$51.36 |
$102.05
|
|
Acromp/acromionectomy prtl
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$3,839.54
|
|
Acth stimulation panel
|
$120.00 |
$120.00 |
$120.00 |
$218.40
|
|
Acth stimulation panel
|
$108.00 |
$108.00 |
$108.00 |
$173.60
|
|
Actigraphy testing
|
$81.12 |
$81.12 |
$81.12 |
$234.00
|
|
Actinotherapy uv light
|
$51.36 |
$51.36 |
$51.36 |
$105.60
|
|
Acup 1/> w/estim 1st 15 min
|
$47.33 |
$47.33 |
$47.33 |
$56.16
|
|
Acup 1/> w/estim ea addl 15
|
$29.78 |
$29.78 |
$29.78 |
$57.98
|
|
Acup 1/> without estim ea add 15
|
$29.31 |
$29.31 |
$29.31 |
$43.00
|
|
Acup 1/> wo estim 1st 15 min
|
$39.77 |
$39.77 |
$39.77 |
$53.50
|
|
Acute hepatitis panel
|
$65.73 |
$65.73 |
$65.73 |
$284.95
|
|
Acute venous thrombus image
|
$1,780.19 |
$1,780.19 |
$1,780.19 |
$1,426.73
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$0.16 |
$0.16 |
$0.16 |
$64.45
|
|
#acylcarnitineprfl
|
$23.28 |
$23.28 |
$23.28 |
$121.55
|
|
Acylcarnitines qual
|
$22.76 |
$22.76 |
$22.76 |
$45.60
|
|
Adapt behavior tx phys/qhp
|
$244.07 |
$244.07 |
$244.07 |
$244.07
|
|
Adaptive behavior tx by tech
|
$139.68 |
$139.68 |
$139.68 |
$139.68
|
|
Adding walker to prev cast
|
$223.45 |
$223.45 |
$223.45 |
$216.00
|
|
Additional switch, ext power
|
$699.62 |
$699.62 |
$699.62 |
$490.00
|
|
Add le poly knee custom kafo
|
$323.75 |
$323.75 |
$323.75 |
$353.76
|
|
Add ue prost a/e acrylic
|
$944.54 |
$944.54 |
$944.54 |
$616.00
|
|
Add ue prost a/e ultlite mat
|
$582.98 |
$582.98 |
$582.98 |
$380.80
|
|
Add ue prost b/e acrylic
|
$625.80 |
$625.80 |
$625.80 |
$408.80
|
|
Add ue prost be/wd, ultlite
|
$520.80 |
$520.80 |
$520.80 |
$338.80
|
|
Add ue prost s/d acrylic
|
$1,235.21 |
$1,235.21 |
$1,235.21 |
$803.60
|
|
Add ue prost s/d ultlite mat
|
$629.65 |
$629.65 |
$629.65 |
$411.60
|
|
Add up-ex prosthes lock mech
|
$840.36 |
$840.36 |
$840.36 |
$747.60
|
|
Adenosine 3 mg/250 ml bag for osm
|
$0.73 |
$0.73 |
$0.73 |
$271.98
|
|
Adenovirus ag ia
|
$16.53 |
$16.53 |
$16.53 |
$53.95
|
|
Adenovirus antibody,serum - quest
|
$17.76 |
$17.76 |
$17.76 |
$58.00
|
|
Adenovirus assay w/optic
|
$30.03 |
$30.03 |
$30.03 |
$59.80
|
|
Adhesiolysis tube ovary 58740
|
$1,219.13 |
$1,219.13 |
$1,219.13 |
$1,620.60
|
|
Adhesive, liquid or equal
|
$5.78 |
$5.78 |
$5.78 |
$14.40
|
|
Adh-sendout
|
$46.84 |
$46.84 |
$46.84 |
$118.79
|
|
Adj gastric band via subq port
|
$1,247.13 |
$1,247.13 |
$1,247.13 |
$1,666.86
|
|
Adjmt/revj ext fixj sys anes
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$8,261.40
|
|
Adj tis trans/see area/10.1-30sqcm 14041
|
$2,837.09 |
$2,837.09 |
$2,837.09 |
$3,397.11
|
|
Admin ecg contrast agent
|
$48.56 |
$48.56 |
$48.56 |
$120.78
|
|
Administration chemotherapy IV infusion each additional hour
|
$99.00 |
$99.00 |
$99.00 |
$230.35
|
|
Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr
|
$99.00 |
$99.00 |
$99.00 |
$298.98
|
|
Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug
|
$454.19 |
$454.19 |
$454.19 |
$668.98
|
|
Administration chemotherapy IV push single/initial substance/drug
|
$454.19 |
$454.19 |
$454.19 |
$439.20
|
|
Administration chemotherapy subcutaneous/im anti neoplastic hormonal
|
$99.00 |
$99.00 |
$99.00 |
$212.80
|
|
Administration chemotherapy subcutaneous/im anti neoplastic non hormonal
|
$99.00 |
$99.00 |
$99.00 |
$256.49
|
|
Administration immunization each additional component
|
$12.19 |
$12.19 |
$12.19 |
$29.20
|
|
Administration immunization each additional vaccine
|
$17.00 |
$17.00 |
$17.00 |
$47.40
|
|
Administration immunization first component each vaccine
|
$32.17 |
$32.17 |
$32.17 |
$46.40
|
|
Administration immunization intranasal/oral route 1 vaccine
|
$29.00 |
$29.00 |
$29.00 |
$48.00
|
|
Administration immunization intranasal/oral route each additional vaccine
|
$17.03 |
$17.03 |
$17.03 |
$30.24
|
|
Administration rsv monoclonal ab seasonal dose im w/counseling
|
$41.15 |
$41.15 |
$41.15 |
$44.80
|
|
Administration vaccine hepatitis b
|
$48.35 |
$48.35 |
$48.35 |
$53.00
|
|
Administration vaccine influenza virus
|
$48.35 |
$48.35 |
$48.35 |
$51.07
|
|
Administration vaccine pneumococcal
|
$64.39 |
$64.39 |
$64.39 |
$49.68
|
|
Administration vaccine rsv monoclonal ab seasonal dose im
|
$33.08 |
$33.08 |
$33.08 |
$41.45
|
|
Ado-trastuzumab emtansine 100 mg intravenous solution
|
$58.23 |
$58.23 |
$58.23 |
$11,350.31
|
|
Adrenal cortex & medulla img
|
$1,780.19 |
$1,780.19 |
$1,780.19 |
$1,987.70
|
|
Adrenalectomy expl w/exc retro tumor 60545
|
$1,759.02 |
$1,759.02 |
$1,759.02 |
$5,441.80
|
|
Advance care planning each additional 30 min 99498
|
$89.76 |
$89.76 |
$89.76 |
$110.56
|
|
Adv prim care mgmt lvl 1
|
$51.52 |
$51.52 |
$51.52 |
$51.52
|
|
Adv prim care mgmt lvl 2
|
$51.52 |
$51.52 |
$51.52 |
$51.52
|
|
Adv prim care mgmt lvl 3
|
$139.68 |
$139.68 |
$139.68 |
$139.68
|
|
Aep hearing status deter i&r
|
$296.91 |
$296.91 |
$296.91 |
$303.00
|
|
Aep neurodiagnostic i&r
|
$296.91 |
$296.91 |
$296.91 |
$583.80
|
|
Aep thrshld est mlt freq i&r
|
$296.91 |
$296.91 |
$296.91 |
$635.00
|
|
Afamelanotide implant, 1 mg
|
$4,061.92 |
$4,061.92 |
$4,061.92 |
$78,638.30
|
|
Afamitresgene autoleucel
|
$1,063,455.60 |
$1,063,455.60 |
$1,063,455.60 |
$2,125,068.14
|
|
_afb id by dna probe rflx ast
|
$27.67 |
$27.67 |
$27.67 |
$104.50
|
