|
Debridement (>20 cm) charge pt
|
$148.80 |
$148.80 |
$148.80 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$456.00 |
$456.00 |
$456.00 |
$2,578.95
|
|
Debridement/bone/20 sq cm or less 11046
|
$108.80 |
$108.80 |
$108.80 |
$681.60
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$180.80 |
$180.80 |
$180.80 |
$1,407.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$192.00 |
$192.00 |
$192.00 |
$810.50
|
|
Debride nail1-5 11720
|
$49.60 |
$49.60 |
$49.60 |
$173.25
|
|
Debride nail6 or more 11721
|
$93.60 |
$93.60 |
$93.60 |
$200.21
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$740.80 |
$740.80 |
$740.80 |
$1,288.00
|
|
Debride skin bone at fx site
|
$3,936.80 |
$3,936.80 |
$3,936.80 |
$3,035.00
|
|
Debride skn/sq/musc/abd wall 11004
|
$832.80 |
$832.80 |
$832.80 |
$1,117.20
|
|
Debride skn/sq t/m/f necro infctj abdl wall 11005
|
$1,138.40 |
$1,138.40 |
$1,138.40 |
$2,328.50
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$60.80 |
$60.80 |
$60.80 |
$663.30
|
|
Debrid mastoidectomy cavity simple 69220
|
$113.60 |
$113.60 |
$113.60 |
$252.43
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$673.60 |
$673.60 |
$673.60 |
$1,160.00
|
|
Debr inf skin add-on 11001
|
$40.80 |
$40.80 |
$40.80 |
$78.00
|
|
Debr musc/fascia 20sq cm/< 11043
|
$344.00 |
$344.00 |
$344.00 |
$1,193.40
|
|
Decalcification
|
$66.40 |
$66.40 |
$66.40 |
$75.38
|
|
Decitabine 50 mg intravenous solution
|
$2,258.52 |
$2,258.52 |
$2,258.52 |
$1,026.60
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$153.60 |
$153.60 |
$153.60 |
$510.95
|
|
Decomp fasct leg ant+/lat+pst cmprt 27602
|
$708.00 |
$708.00 |
$708.00 |
$5,339.00
|
|
Decompress fasciotomyhand 26037
|
$860.80 |
$860.80 |
$860.80 |
$2,788.80
|
|
Decompression fasct forearm
|
$1,374.40 |
$1,374.40 |
$1,374.40 |
$5,339.00
|
|
Decompression of lower leg
|
$604.80 |
$604.80 |
$604.80 |
$3,591.33
|
|
Decompression of tibia nerve
|
$793.60 |
$793.60 |
$793.60 |
$2,625.60
|
|
Deep muscle biopsy 20205
|
$456.80 |
$456.80 |
$456.80 |
$3,167.89
|
|
Degarelix 120 mg subcutaneous solution
|
$2,151.47 |
$2,151.47 |
$2,151.47 |
$1,963.06
|
|
Delivery of placenta 59414
|
$132.00 |
$132.00 |
$132.00 |
$3,135.14
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$27.20 |
$27.20 |
$27.20 |
$180.00
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$8,516.62 |
$8,516.62 |
$8,516.62 |
$7,737.00
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$435.20 |
$435.20 |
$435.20 |
$460.50
|
|
Dermabrasion other than face
|
$727.20 |
$727.20 |
$727.20 |
$3,167.89
|
|
Dermabrasion segmental face 15781
|
$783.20 |
$783.20 |
$783.20 |
$1,290.07
|
|
Dermabrasion suprfl any site
|
$676.80 |
$676.80 |
$676.80 |
$1,144.80
|
|
Dermabrasion total face
|
$1,264.00 |
$1,264.00 |
$1,264.00 |
$3,370.52
|
|
Desmopressin 4 mcg/ml injection solution
|
$78.02 |
$78.02 |
$78.02 |
$172.46
|
|
Dest mal lesion feenlm <0.5cm 17280
|
$205.60 |
$205.60 |
$205.60 |
$275.88
|
|
Dest mal lesion feenlm 0.6-1cm 17281
|
$264.80 |
$264.80 |
$264.80 |
$440.00
|
|
Dest mal lesion feenlm 1.1 - 2.0 cm 17282
|
$302.40 |
$302.40 |
$302.40 |
$408.50
|
|
Dest mal lesion snhfg <0.5cm 17270
|
$224.80 |
$224.80 |
$224.80 |
$275.88
|
|
Dest mal lesion snhfg 0.6-1cm 17271
|
$244.00 |
$244.00 |
$244.00 |
$312.00
|
|
Dest mal lesion snhfg 1.1-2cm 17272
|
$278.40 |
$278.40 |
$278.40 |
$339.00
|
|
Dest mal lesion tal <0.5 17260
|
$147.20 |
$147.20 |
$147.20 |
$238.40
|
|
Dest mal lesion tal 0.6-1.0cm 17261
|
$217.60 |
$217.60 |
$217.60 |
$274.80
|
|
Dest mal lesion tal 1.1-2.0cm 17262
|
$263.20 |
$263.20 |
$263.20 |
$332.25
|
|
Dest mal lesion tal 2.1-3.0cm 17263
|
$288.00 |
$288.00 |
$288.00 |
$354.00
|
|
Destroy internal hemorrhoids destroy 46930
|
$330.40 |
$330.40 |
$330.40 |
$1,305.08
|
|
Destroy premlg lesns;1st lesn 17000
|
$99.20 |
$99.20 |
$99.20 |
$199.50
|
|
Destroy vulva lesion extensive 56515
|
$415.20 |
$415.20 |
$415.20 |
$2,837.09
|
|
Destroy vulva lesion simple 56501
|
$289.60 |
$289.60 |
$289.60 |
$3,691.50
|
|
Destruct ben lesion 15/> 17111
|
$196.00 |
$196.00 |
$196.00 |
$250.20
|
|
Destruct cut vasl lesions 10-50cm 17107
|
$673.60 |
$673.60 |
$673.60 |
$1,066.45
|
|
Destruct cut vasl lesions <10cm 17106
|
$518.40 |
$518.40 |
$518.40 |
$666.75
|
|
Destruct cut vasl lesions >50cm 17108
|
$955.20 |
$955.20 |
$955.20 |
$1,602.40
|
|
Destruction 2-14 lesions 17003
|
$10.40 |
$10.40 |
$10.40 |
$78.61
|
|
Destruction anal lesion(s)
|
$828.00 |
$828.00 |
$828.00 |
$3,219.15
|
|
Destruction anal lesion(s) smpl chem 46900
|
$362.40 |
$362.40 |
$362.40 |
$535.46
|
|
Destruction benign lesions < 14 lesions
|
$167.20 |
$167.20 |
$167.20 |
$233.20
|
|
Destruction cryosurgery anal lesion(s) simpl 46916
|
$388.00 |
$388.00 |
$388.00 |
$355.29
|
|
Destruction mal lsn s/n/h/f/g 2.1-3cm
|
$312.00 |
$312.00 |
$312.00 |
$513.60
|
|
Destruction mal lsn s/n/h/f/g 3.1-4cm
|
$365.60 |
$365.60 |
$365.60 |
$558.97
|
|
Destruction mal lsn t/a/l 3.1-4cm
|
$304.80 |
$304.80 |
$304.80 |
$495.72
|
|
Destruction mal lsn t/a/l >4cm
|
$346.40 |
$346.40 |
$346.40 |
$578.40
|
|
Destruction penis lesion(s) chem 54050
|
$218.40 |
$218.40 |
$218.40 |
$326.34
|
|
Destruction penis lesion(s) exten 54065
|
$336.80 |
$336.80 |
$336.80 |
$2,507.31
|
|
Destruction premal lesions 15/> 17004
|
$248.00 |
$248.00 |
$248.00 |
$442.61
|
|
Destruction vag lesions simple 57061
|
$3,815.20 |
$3,815.20 |
$3,815.20 |
$3,504.00
|
|
Developmental screen/score/document 96110
|
$17.60 |
$17.60 |
$17.60 |
$136.64
|
|
Device intraute mirena
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$2,289.60
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$95.20 |
$95.20 |
$95.20 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$12.39 |
$12.39 |
$12.39 |
$5.17
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$67.11 |
$67.11 |
$67.11 |
$23.27
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$432.49 |
$432.49 |
$432.49 |
$537.74
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$70.84 |
$70.84 |
$70.84 |
$43.65
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$70.84 |
$70.84 |
$70.84 |
$68.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$77.92 |
$77.92 |
$77.92 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$70.84 |
$70.84 |
$70.84 |
$68.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$102.40 |
$102.40 |
$102.40 |
$108.00
|
|
Diabetes (HbA1c) Test
|
$63.20 |
$63.20 |
$63.20 |
$79.30
|
|
Diabetes training group per 30 min g0109
|
$28.80 |
$28.80 |
$28.80 |
$32.56
|
|
Diab manage trn ind/group
|
$24.00 |
$24.00 |
$24.00 |
$52.07
|
|
Diag laparo separate proc 49320
|
$485.60 |
$485.60 |
$485.60 |
$5,649.52
|
|
Diagnostic anoscopy
|
$240.00 |
$240.00 |
$240.00 |
$469.93
|
|
Diagnostic anoscopy spx 46600
|
$181.60 |
$181.60 |
$181.60 |
$245.35
|
|
Diagnostic digital breast tomosynthesis bil
|
$62.40 |
$62.40 |
$62.40 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$62.40 |
$62.40 |
$62.40 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$276.00 |
$276.00 |
$276.00 |
$403.24
|
|
Diagnostic Mammogram (both breasts)
|
$314.40 |
$314.40 |
$314.40 |
$421.20
|
|
Diagnostic Mammogram (one breast)
|
$246.40 |
$246.40 |
$246.40 |
$289.85
|
|
Dialysis one evaluation
|
$1,357.60 |
$1,357.60 |
$1,357.60 |
$827.97
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$77.25 |
$77.25 |
$77.25 |
$67.89
|
|
Diffusing capacity
|
$113.60 |
$113.60 |
$113.60 |
$357.50
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$66.86 |
$66.86 |
$66.86 |
$53.00
|
|
Digoxin total therapeutic drug level
|
$158.40 |
$158.40 |
$158.40 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$387.52 |
$387.52 |
$387.52 |
$308.90
|
|
Dilate esophagus 1/mult pass
|
$284.00 |
$284.00 |
$284.00 |
$1,484.17
|
|
Dilate urethra stricture
|
$132.80 |
$132.80 |
$132.80 |
$514.79
|
|
Dilate urethra stricture
|
$128.80 |
$128.80 |
$128.80 |
$187.33
|
|
Dilation of cervical canal 57800
|
$115.20 |
$115.20 |
$115.20 |
$4,340.80
|
|
Dilation of urethra
|
$111.20 |
$111.20 |
$111.20 |
$182.95
|
|
Dilation of urethra
|
$55.20 |
$55.20 |
$55.20 |
$2,507.31
|
