|
Ercp biliary & pancreas
|
$373.33 |
$373.33 |
$373.33 |
$943.50
|
|
Ercp bil/panc duct; each stent plcmt 43274
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,339.00
|
|
Ercp ea duct/ampulla dilate
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,211.08
|
|
Ercp lesion ablate w/dilate 43278
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,301.42
|
|
Ercp lithotripsy calculi
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,378.40
|
|
Ercp remove duct calculi 43264
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,214.73
|
|
Ercp remove forgn body duct 43275
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,859.02
|
|
Ercp sphincter pressure meas
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.82
|
|
Ercp stent exchange w/dilate
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,718.03
|
|
Ercp w/specimen collection
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,440.54
|
|
ER Visit (level 1, minor)
|
$197.46 |
$197.46 |
$197.46 |
$276.70
|
|
ER Visit (level 2)
|
$267.84 |
$267.84 |
$267.84 |
$487.50
|
|
ER Visit (level 3)
|
$424.38 |
$424.38 |
$424.38 |
$850.50
|
|
ER Visit (level 4)
|
$581.68 |
$581.68 |
$581.68 |
$1,359.15
|
|
ER Visit (level 5, high severity)
|
$817.80 |
$817.80 |
$817.80 |
$2,007.00
|
|
Esophageal dilat s&i
|
$144.34 |
$144.34 |
$144.34 |
$525.00
|
|
Esophageal motility
|
$323.59 |
$323.59 |
$323.59 |
$573.20
|
|
Esophagosc dilate balloon 30
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,234.01
|
|
Esophagosc flex trnsn biopsy
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,739.25
|
|
Esophagoscop mucosal resect
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,806.70
|
|
Esophagoscop stent placement
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,505.71
|
|
Esophagoscop ultrasound exam
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,440.80
|
|
Esophagoscopy balloon <30mm
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,460.00
|
|
Esophagoscopy control bleed
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.82
|
|
Esophagoscopy flex biopsy
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.82
|
|
Esophagoscopy/flex/diagnostic 43200
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,109.47
|
|
Esophagoscopy flex dx brush
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,785.00
|
|
Esophagoscopy flex remove fb
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,109.53
|
|
Esophagoscopy lesion ablate
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,211.08
|
|
Esophagoscopy lesion removal
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.82
|
|
Esophagoscopy retro balloon
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.82
|
|
Esophagoscopy rigid balloon
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,502.13
|
|
Esophagoscopy/rigid/diagnostic 43191
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.82
|
|
Esophagoscopy rigid trnso 43180
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,311.00
|
|
Esophagoscopy snare les remv
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.82
|
|
Esophagoscopy w/us needle bx
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.82
|
|
Esophagoscp guide wire dilat 43196
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.82
|
|
Esophagoscp rig trnso biopsy
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.82
|
|
Esophagoscp rig trnso inject
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.82
|
|
Esophagoscp rig trnso rem fb
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.82
|
|
Esophagus endoscopy/ligation
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,293.85
|
|
Esophagus motility study
|
$558.59 |
$558.59 |
$558.59 |
$1,289.20
|
|
Esoph balloon distension tst
|
$380.84 |
$380.84 |
$380.84 |
$780.00
|
|
Esoph egd dilation <30 mm
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,656.80
|
|
Esoph endoscopy dilation
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,221.83
|
|
Esophgl motil w/stim/perfus
|
$27.59 |
$27.59 |
$27.59 |
$1,075.06
|
|
Esoph imped function test
|
$237.62 |
$237.62 |
$237.62 |
$597.03
|
|
Esoph imped funct test > 1hr
|
$426.64 |
$426.64 |
$426.64 |
$986.40
|
|
Esoph optical endomicroscopy
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.82
|
|
Esoph scope w/sclerosis inj
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,234.01
|
|
Esoph scope w/submucous inj
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.82
|
|
Essure 58565
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,463.96
|
|
Established Patient Office Visit (level 1)
|
$57.24 |
$57.24 |
$57.24 |
$121.00
|
|
Established Patient Office Visit (level 2)
|
$87.28 |
$87.28 |
$87.28 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$96.29 |
$96.29 |
$96.29 |
$187.00
|
|
Established Patient Office Visit (level 4)
|
$105.86 |
$105.86 |
$105.86 |
$233.60
|
|
Established Patient Office Visit (level 5)
|
$124.82 |
$124.82 |
$124.82 |
$287.10
|
|
Estradiol total
|
$30.73 |
$30.73 |
$30.73 |
$153.00
|
|
Estrogens total-sendout
|
$23.87 |
$23.87 |
$23.87 |
$89.25
|
|
Ethmoidectomy extranasal total 31205
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,837.72
|
|
Ethylene glycol -sendout
|
$16.39 |
$16.39 |
$16.39 |
$75.00
|
|
Euglobulin lysis
|
$9.25 |
$9.25 |
$9.25 |
$39.75
|
|
Evacuate mole of uterus
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,522.35
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$107.92 |
$107.92 |
$107.92 |
$219.60
|
|
Evaluation psychiatric diagnostic
|
$161.04 |
$161.04 |
$161.04 |
$320.00
|
|
Event monitor
|
$103.61 |
$103.61 |
$103.61 |
$242.12
|
|
Evoked potentials auditory screening automated analysis
|
$48.42 |
$48.42 |
$48.42 |
$283.62
|
|
Exam of vagina w/scope 57420
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$535.00
|
|
Exam plvc w/anes othr thn lcl
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,649.80
|
|
Ex arm/elbow tum deep < 5 cm
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,386.84
|
|
Ex arm/elbow tum deep 5 cm/>
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,412.80
|
|
Exc abd les sc 3 cm/>
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,386.84
|
|
Exc abdl tum deep < 5 cm
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,386.84
|
|
Exc abdl tum deep 5 cm/>
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,386.84
|
|
Exc arm/elbo les sc >=3cm 24071
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,386.84
|
|
Exc arm/elbo les sc <3cm 24075
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,917.33
|
|
Exc aurl glomus tum trnscanl
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,547.81
|
|
Exc aurl glomus tum trnsmstd
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,969.40
|
|
Exc back les sbq <3 cm 21930
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,271.01
|
|
Exc back tum deep 5 cm/>
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,370.52
|
|
Exc bartholins gland/cyst
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,744.41
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,184.60
|
|
Exc benign feenlm >4.0cm 11446
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,386.84
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.06
|
|
Exc benign tal 0.5 < cm 11400
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$837.48
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$914.34
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,045.20
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,112.60
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,372.15
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,112.60
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,483.00
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$818.53
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,301.30
|
|
Exc breast duct fistula 19112
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,847.45
|
|
Exc cervix repair bowel 57556
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,394.95
|
|
Exc cervix/repair vagina 57555
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,627.00
|
|
Exc chest wall tumor w/ribs 21601
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,386.84
|
|
Exc coccygl pr ulc flap clsr
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,052.18
|
|
Exc coccygl pr ulc prim sutr
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,167.89
|
|
Exc constrict ring finger w/mlt z-plasties 26596
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,591.33
|
