|
Debride nail6 or more 11721
|
$72.91 |
$161.60 |
$251.76 |
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$2,492.00 |
$2,492.00 |
$2,492.00 |
|
|
Debride skin bone at fx site
|
$2,921.60 |
$2,921.60 |
$2,921.60 |
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$640.00 |
$741.41 |
$844.00 |
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,826.40 |
$2,094.40 |
$3,204.00 |
|
|
Debr musc/fascia 20sq cm/< 11043
|
$884.80 |
$893.66 |
$1,560.80 |
|
|
Decalcification
|
$28.00 |
$36.67 |
$96.80 |
|
|
Decitabine 50 mg intravenous solution
|
$1,537.37 |
$3,036.68 |
$4,363.94 |
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$207.20 |
$315.45 |
$822.00 |
|
|
Decomp fasct leg ant+/lat+pst cmprt 27602
|
$9,976.94 |
$9,976.94 |
$9,976.94 |
|
|
Decompression unspecified nerve 64722
|
$3,170.40 |
$3,170.40 |
$3,170.40 |
|
|
Decompress small bowel
|
$1,019.20 |
$1,019.20 |
$1,019.20 |
|
|
Deferoxamine 500 mg solution for injection
|
$41.00 |
$110.37 |
$209.28 |
|
|
Degarelix 120 mg subcutaneous solution
|
$653.68 |
$2,072.15 |
$2,791.18 |
|
|
Delivery of placenta 59414
|
$1,012.26 |
$1,094.54 |
$3,486.40 |
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$15,705.94 |
$15,705.94 |
$15,705.94 |
|
|
Demonstrate use home inr mon
|
$246.40 |
$278.40 |
$278.40 |
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$83.05 |
$137.42 |
$204.80 |
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$1,735.76 |
$5,159.32 |
$6,452.20 |
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$351.20 |
$437.60 |
$498.40 |
|
|
Depo-estradiol cypionate inj
|
$65.48 |
$493.37 |
$493.37 |
|
|
Descend thora aorta rpr/lt sub art 33880
|
$1,872.72 |
$1,872.72 |
$1,872.72 |
|
|
Design mlc device for imrt
|
$977.87 |
$977.87 |
$4,421.14 |
|
|
Desmopressin 4 mcg/ml injection solution
|
$42.02 |
$57.92 |
$102.60 |
|
|
Des thora aorta rpr without left sub art 33881
|
$2,706.77 |
$2,706.77 |
$2,706.77 |
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$1,199.86 |
$1,199.86 |
$1,199.86 |
|
|
Destroy cervthor facet jnt 64633
|
$1,520.51 |
$1,521.07 |
$3,404.00 |
|
|
Destroy cth facet jnt addl 64634
|
$141.62 |
$141.62 |
$2,440.42 |
|
|
Destroy premlg lesns;1st lesn 17000
|
$219.20 |
$219.20 |
$219.20 |
|
|
Destruct cut vasl lesions 10-50cm 17107
|
$1,380.00 |
$1,380.00 |
$1,380.00 |
|
|
Destruction 2-14 lesions 17003
|
$36.00 |
$36.00 |
$36.00 |
|
|
Destruction benign lesions < 14 lesions
|
$243.20 |
$248.80 |
$297.60 |
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$140.17 |
$141.62 |
$1,734.40 |
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$1,520.51 |
$1,521.07 |
$3,480.00 |
|
|
Determination venous press
|
$192.91 |
$192.91 |
$192.91 |
|
|
Devel tst phys/qhp 1st hr
|
$192.92 |
$240.35 |
$240.35 |
|
|
Device ablt adv novasure
|
$760.80 |
$24,069.12 |
$28,080.64 |
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$1,225.54 |
$1,429.79 |
$1,429.79 |
|
|
Device intraute mirena
|
$752.95 |
$1,983.72 |
$2,314.33 |
|
|
Device sut capio slim opn
|
$1,390.40 |
$1,390.76 |
$1,622.40 |
|
|
Device tiss remov myosure reach
|
$1,383.79 |
$1,614.42 |
$2,060.80 |
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$96.49 |
$120.23 |
$120.23 |
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$92.50 |
$92.85 |
$425.60 |
|
|
Dexamethasone 4 mg tablet
|
$2.86 |
$36.80 |
$57.82 |
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$24.68 |
$50.24 |
$77.12 |
|
|
Dexamethasone intra implant
|
$2,262.34 |
$2,262.34 |
$2,262.34 |
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$119.37 |
$401.58 |
$1,249.87 |
|
|
Dextran 40 infusion
|
$146.81 |
$146.81 |
$146.81 |
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$13.00 |
$34.27 |
$86.40 |
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$25.09 |
$32.20 |
$80.00 |
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$13.51 |
$29.09 |
$86.40 |
|
|
Dextrose 5 % IV bolus
|
$14.00 |
$29.38 |
$86.40 |
|
|
Dhea-s (dehydroepiand sulfate)
|
$36.14 |
$42.17 |
$254.40 |
|
|
Diabetes (HbA1c) Test
|
$28.50 |
$31.20 |
$117.60 |
|
|
Diab manage trn ind/group
|
$20.78 |
$40.43 |
$72.00 |
|
|
Diab shoe for density insert
|
$116.70 |
$159.43 |
$159.43 |
|
|
Diagnostic anoscopy spx 46600
|
$88.98 |
$98.74 |
$295.20 |
|
|
Diagnostic digital breast tomosynthesis bil
|
$190.40 |
$436.80 |
$436.80 |
|
|
Diagnostic digital breast tomosynthesis unil
|
$166.40 |
$172.00 |
$356.00 |
|
|
Diagnostic laryngoscopy 31505
|
$350.40 |
$350.40 |
$350.40 |
|
|
Diagnostic laryngoscopy 31575
|
$143.70 |
$143.70 |
$878.40 |
|
|
Diagnostic Mammogram (both breasts)
|
$358.57 |
$487.20 |
$588.00 |
|
|
Diagnostic Mammogram (one breast)
|
$272.80 |
$386.40 |
$466.32 |
|
|
Diagnostic radio unlisted proc
|
$223.20 |
$417.54 |
$1,618.08 |
|
|
Dialysis circuit perm vascular embolization 36909
|
$6,576.38 |
$6,576.38 |
$11,752.00 |
|
|
Dialysis one evaluation
|
$755.14 |
$755.14 |
$920.00 |
|
|
Diathermy eg microwave
|
$77.47 |
$81.48 |
$89.60 |
|
|
Diatrizoate meglumine 18 % urethral solution
|
$1.44 |
$1.68 |
$21.00 |
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$32.03 |
$68.84 |
$83.67 |
|
|
Dicyclomine injection
|
$37.84 |
$49.60 |
$74.94 |
|
|
Diffusing capacity
|
$234.40 |
$336.80 |
$370.40 |
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$23.26 |
$62.28 |
$65.84 |
|
|
Digoxin immune fab 40 mg intravenous solution
|
$3,449.75 |
$7,158.74 |
$7,840.46 |
|
|
Digoxin total therapeutic drug level
|
$38.02 |
$44.35 |
$134.40 |
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$96.63 |
$236.47 |
$275.88 |
|
|
Dilate biliary duct/ampulla
|
$1,035.60 |
$1,035.60 |
$1,035.60 |
|
|
Dilate esophagus
|
$2,458.08 |
$2,458.08 |
$3,694.40 |
|
|
Dilate esophagus 1/mult pass
|
$2,041.60 |
$2,041.60 |
$2,041.60 |
|
|
Dilate ic vasospasm init
|
$12,459.41 |
$12,459.41 |
$12,459.41 |
|
|
Dilate urethra stricture
|
$767.20 |
$1,996.42 |
$1,996.42 |
|
|
Dilate urethra stricture
|
$5,869.60 |
$5,869.60 |
$5,869.60 |
|
|
Dilation/female urethra/initial 53660
|
$1,305.79 |
$1,305.79 |
$1,305.79 |
|
|
Dilation of cervical canal 57800
|
$3,492.10 |
$3,492.10 |
$3,492.10 |
|
|
Dilation of salivary duct
|
$1,273.63 |
$1,273.63 |
$1,273.63 |
|
|
Dilation of urethra
|
$1,284.00 |
$1,284.00 |
$1,284.00 |
|
|
Dilation/urethral strict/male/ini 53620
|
$2,644.80 |
$2,644.80 |
$2,644.80 |
|
|
Dilator fascial 10fx20cm
|
$161.52 |
$188.44 |
$636.80 |
|
|
Dilat xst trc ndurlgc px
|
$6,254.40 |
$6,254.40 |
$6,254.40 |
|
|
Dilat xst trc new access rcs
|
$6,254.40 |
$6,254.40 |
$6,254.40 |
|
|
Diltiazem 5 mg/ml intravenous solution
|
$25.32 |
$56.74 |
$385.78 |
|
|
Dimecaprol injection
|
$293.38 |
$293.38 |
$293.38 |
|
|
Dimenhydrinate injection
|
$31.08 |
$36.27 |
$36.27 |
|
|
Dimethyl sulfoxide 50% 50 ml
|
$51.83 |
$54.64 |
$1,204.25 |
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$1.20 |
$4.90 |
$10.68 |
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$23.23 |
$30.92 |
$62.48 |
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$84.45 |
$157.68 |
$157.68 |
|
|
Dipyridamole injection
|
$51.74 |
$51.74 |
$51.74 |
|
|
Disability dlco
|
$280.00 |
$438.54 |
$526.40 |
|
|
Disaccharidases
|
$176.40 |
$197.12 |
$260.74 |
|
|
Discography cerv/thor spine
|
$546.96 |
$546.96 |
$2,961.60 |
|
