|
Dest mal lesion snhfg 1.1-2cm 17272
|
$121.55 |
$121.55 |
$121.55 |
|
|
Dest mal lesion tal <0.5 17260
|
$165.10 |
$165.10 |
$165.10 |
|
|
Dest mal lesion tal 0.6-1.0cm 17261
|
$180.05 |
$180.05 |
$255.45 |
|
|
Dest mal lesion tal 1.1-2.0cm 17262
|
$107.25 |
$107.25 |
$292.50 |
|
|
Dest mal lesion tal 2.1-3.0cm 17263
|
$125.45 |
$125.45 |
$125.45 |
|
|
Destroy cervthor facet jnt 64633
|
$3,316.31 |
$3,736.01 |
$5,446.67 |
|
|
Destroy cth facet jnt addl 64634
|
$3,316.31 |
$3,736.01 |
$5,585.68 |
|
|
Destroy premlg lesns;1st lesn 17000
|
$43.55 |
$117.00 |
$261.30 |
|
|
Destroy vulva lesion extensive 56515
|
$612.30 |
$612.30 |
$612.30 |
|
|
Destroy vulva lesion simple 56501
|
$14,872.62 |
$14,872.62 |
$14,872.62 |
|
|
Destruct ben lesion 15/> 17111
|
$66.30 |
$83.25 |
$306.15 |
|
|
Destruction 2-14 lesions 17003
|
$9.10 |
$10.50 |
$29.25 |
|
|
Destruction anal lesion(s)
|
$11,823.58 |
$11,823.58 |
$11,823.58 |
|
|
Destruction anal lesion(s)
|
$9,237.64 |
$10,103.06 |
$16,816.12 |
|
|
Destruction anal lesion(s) smpl chem 46900
|
$278.25 |
$278.25 |
$278.25 |
|
|
Destruction benign lesions < 14 lesions
|
$54.60 |
$150.15 |
$204.10 |
|
|
Destruction by injection tx of nerve 64630
|
$646.75 |
$646.75 |
$646.75 |
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$3,486.30 |
$3,803.33 |
$7,255.19 |
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,481.32 |
$4,408.17 |
$31,824.53 |
|
|
Destruction ciliary body
|
$14,327.25 |
$14,327.25 |
$14,327.25 |
|
|
Destruction laser surgery anal lesions 46917
|
$10,355.25 |
$10,355.25 |
$10,355.25 |
|
|
Destruction les conjunctiva
|
$9,917.02 |
$9,917.02 |
$9,917.02 |
|
|
Destruction mal lsn s/n/h/f/g 2.1-3cm
|
$108.55 |
$108.55 |
$310.70 |
|
|
Destruction mal lsn s/n/h/f/g 3.1-4cm
|
$130.65 |
$130.65 |
$130.65 |
|
|
Destruction mal lsn t/a/l 3.1-4cm
|
$358.80 |
$358.80 |
$358.80 |
|
|
Destruction mal lsn t/a/l >4cm
|
$121.55 |
$121.55 |
$121.55 |
|
|
Destruction penis lesion(s) chem 54050
|
$85.15 |
$85.15 |
$423.75 |
|
|
Destruction penis lesion(s) exten 54065
|
$1,639.95 |
$1,639.95 |
$15,221.73 |
|
|
Destruction premal lesions 15/> 17004
|
$78.00 |
$78.00 |
$341.25 |
|
|
Destruction vag lesions simple 57061
|
$15,005.71 |
$15,005.71 |
$15,005.71 |
|
|
Destruct penis les/smp/electrodesi 54055
|
$2,651.35 |
$2,651.35 |
$2,651.35 |
|
|
Developmental screen/score/document 96110
|
$21.75 |
$330.85 |
$341.90 |
|
|
Devel tst phys/qhp 1st hr
|
$294.45 |
$294.45 |
$294.45 |
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$193.05 |
$193.05 |
$193.05 |
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$86.25 |
$181.35 |
$310.05 |
|
|
Dexamethasone 4 mg tablet
|
$4.87 |
$6.12 |
$33.49 |
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$7.15 |
$12.67 |
$174.10 |
|
|
Dexamethasone intra implant
|
$2,739.10 |
$2,739.10 |
$2,739.10 |
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$604.50 |
$842.89 |
$1,296.75 |
|
|
Dextran 40 infusion
|
$34.12 |
$34.12 |
$34.12 |
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$25.35 |
$68.25 |
$130.00 |
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$23.40 |
$68.25 |
$130.00 |
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$23.40 |
$68.25 |
$130.00 |
|
|
Dextrose 5 % IV bolus
|
$25.35 |
$27.30 |
$130.00 |
|
|
Dhea-s (dehydroepiand sulfate)
|
$69.75 |
$169.65 |
$219.70 |
|
|
Diabetes (HbA1c) Test
|
$31.50 |
$87.10 |
$124.80 |
|
|
Diabetes training group per 30 min g0109
|
$34.50 |
$34.50 |
$34.50 |
|
|
Diab manage trn ind/group
|
$44.85 |
$58.50 |
$91.65 |
|
|
Diag laparo separate proc 49320
|
$1,045.20 |
$13,814.31 |
$20,192.52 |
|
|
Diagnostic anoscopy spx 46600
|
$57.00 |
$166.40 |
$3,793.47 |
|
|
Diagnostic laryngoscopy 31505
|
$102.75 |
$102.75 |
$154.05 |
|
|
Diagnostic laryngoscopy 31575
|
$286.65 |
$286.65 |
$445.90 |
|
|
Diagnostic Mammogram (both breasts)
|
$165.10 |
$226.20 |
$521.30 |
|
|
Diagnostic Mammogram (one breast)
|
$108.55 |
$246.35 |
$431.60 |
|
|
Dialysis circuit perm vascular embolization 36909
|
$12,563.83 |
$12,563.83 |
$12,563.83 |
|
|
Dialysis one evaluation
|
$123.50 |
$123.50 |
$1,275.30 |
|
|
Diathermy eg microwave
|
$39.00 |
$39.00 |
$39.00 |
|
|
Diatrizoate meglumine 18 % urethral solution
|
$29.90 |
$29.90 |
$97.93 |
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$4.50 |
$13.34 |
$69.55 |
|
|
Dicyclomine injection
|
$39.39 |
$51.97 |
$126.87 |
|
|
Diffusing capacity
|
$123.75 |
$219.05 |
$357.50 |
|
|
Digital analysis of eeg
|
$778.70 |
$778.70 |
$778.70 |
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$7.15 |
$7.15 |
$432.91 |
|
|
Digoxin total therapeutic drug level
|
$42.75 |
$111.15 |
$159.90 |
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$126.75 |
$170.62 |
$177.90 |
|
|
Dilate biliary duct/ampulla
|
$2,900.95 |
$2,900.95 |
$2,900.95 |
|
|
Dilate esophagus
|
$1,645.15 |
$1,645.15 |
$1,645.15 |
|
|
Dilate esophagus 1/mult pass
|
$4,577.23 |
$4,577.23 |
$4,577.23 |
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$2,557.10 |
$2,557.10 |
$2,557.10 |
|
|
Dilate ic vasospasm ea add vsl same territory
|
$2,449.85 |
$2,449.85 |
$2,449.85 |
|
|
Dilate ic vasospasm init
|
$7,783.10 |
$7,783.10 |
$7,783.10 |
|
|
Dilate tear duct opening
|
$605.80 |
$605.80 |
$605.80 |
|
|
Dilate urethra stricture
|
$3,565.69 |
$3,565.69 |
$3,565.69 |
|
|
Dilate urethra stricture
|
$3,355.74 |
$3,355.74 |
$3,355.74 |
|
|
Dilate urethra stricture
|
$1,535.74 |
$1,535.74 |
$1,535.74 |
|
|
Dilation/female urethra/initial 53660
|
$5,002.84 |
$5,002.84 |
$5,002.84 |
|
|
Dilation of anal sphincter
|
$8,598.67 |
$8,598.67 |
$8,598.67 |
|
|
Dilation of rectal stricture 45910
|
$6,471.40 |
$6,471.40 |
$6,471.40 |
|
|
Dilation of salivary duct
|
$8,925.34 |
$8,925.34 |
$8,925.34 |
|
|
Dilation of urethra
|
$653.69 |
$653.69 |
$653.69 |
|
|
Dilation of urethra
|
$915.20 |
$915.20 |
$915.20 |
|
|
Dilation/urethral strict/male/ini 53620
|
$306.15 |
$306.15 |
$306.15 |
|
|
Dilat xst trc ndurlgc px
|
$3,153.80 |
$3,153.80 |
$3,153.80 |
|
|
Dilat xst trc new access rcs
|
$28,746.67 |
$28,746.67 |
$28,746.67 |
|
|
Diltiazem 5 mg/ml intravenous solution
|
$7.15 |
$44.96 |
$48.75 |
|
|
Dimethyl sulfoxide 50% 50 ml
|
$2,205.67 |
$2,205.67 |
$2,371.69 |
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$2.21 |
$7.15 |
$9.10 |
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$23.25 |
$23.25 |
$23.25 |
|
|
Disability dlco
|
$225.55 |
$312.00 |
$339.95 |
|
|
Disaccharidases
|
$15.60 |
$22.10 |
$312.00 |
|
|
Discography cerv/thor spine
|
$4,724.20 |
$4,724.20 |
$4,724.20 |
|
|
Dise eval slp do brth flx dx
|
$5,763.34 |
$5,763.34 |
$5,763.34 |
|
|
Dist revas ligation hemo
|
$28,378.10 |
$28,378.10 |
$28,378.10 |
|
|
Diverticulectomy/hypophar/esoph 43130
|
$24,903.10 |
$24,903.10 |
$24,903.10 |
|
|
Dlyd plmt xtn prosth ea addl
|
$4,963.40 |
$4,963.40 |
$4,963.40 |
|
|
Dna antibody native/double stranded
|
$20.25 |
$113.75 |
$145.60 |
|
|
Dna gardnerella
|
$55.25 |
$59.80 |
$91.00 |
|
|
Dna probe chlamydia
|
$97.50 |
$97.50 |
$146.90 |
|
|
Dna probe gc
|
$102.70 |
$102.70 |
$126.10 |
|
|
Dna trichomonas
|
$55.25 |
$59.80 |
$91.00 |
|