|
Decompression of leg
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,855.00
|
|
Decompression of leg
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,839.54
|
|
Decompression of lower leg
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,839.54
|
|
Decompression of lower leg
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,839.54
|
|
Decompression of thigh/knee
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,839.54
|
|
Decompression of thigh/knee
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,839.54
|
|
Decompression of thigh/knee
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,217.60
|
|
Decompression of thigh/knee
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,110.00
|
|
Decompression of tibia nerve
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,625.60
|
|
Decompression unspecified nerve 64722
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,310.83
|
|
Decompress optic nerve
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,405.82
|
|
Decompres spinal cord;thoracic 63055
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$7,907.11
|
|
Decompress spinal cord lmbr
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$7,913.97
|
|
Decompress spinal cord thrc
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$6,063.98
|
|
Deep muscle biopsy 20205
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,370.52
|
|
Delayed breast prosthesis 19342
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,910.18
|
|
Delay flap arms/legs
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,164.64
|
|
Delay flap eye/nos/ear/lip
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,190.24
|
|
Delay flap fccnaxghf 15620
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,164.64
|
|
Delay flap trunk 15600
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$4,001.00
|
|
Delivery of placenta 59414
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,271.20
|
|
Denervation of hip joint
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$4,499.12
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$460.50
|
|
Dermabrasion other than face
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,170.64
|
|
Dermabrasion segmental face 15781
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,107.64
|
|
Dermabrasion suprfl any site
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$791.30
|
|
Dermabrasion total face
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
Derma-fat-fascia graft 15770
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$4,326.42
|
|
Derm autograft face/nck/hf/g
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$4,055.70
|
|
Derm autograft trnk/arm/leg
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,164.64
|
|
Design custom breast implant
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$4,242.15
|
|
Desoxycorticosterone
|
$34.08 |
$34.08 |
$34.08 |
$109.28
|
|
Dest mal lesion feenlm <0.5cm 17280
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$275.88
|
|
Dest mal lesion feenlm 0.6-1cm 17281
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$362.58
|
|
Dest mal lesion feenlm 1.1 - 2.0 cm 17282
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$394.17
|
|
Dest mal lesion snhfg <0.5cm 17270
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$273.72
|
|
Dest mal lesion snhfg 0.6-1cm 17271
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$312.00
|
|
Dest mal lesion snhfg 1.1-2cm 17272
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$278.40
|
|
Dest mal lesion tal <0.5 17260
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$238.40
|
|
Dest mal lesion tal 0.6-1.0cm 17261
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$269.60
|
|
Dest mal lesion tal 1.1-2.0cm 17262
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$332.25
|
|
Dest mal lesion tal 2.1-3.0cm 17263
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$354.00
|
|
Destroy cervthor facet jnt 64633
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,164.80
|
|
Destroy internal hemorrhoids destroy 46930
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,344.85
|
|
Destroy premlg lesns;1st lesn 17000
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$220.12
|
|
Destroy vulva lesion extensive 56515
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,837.09
|
|
Destroy vulva lesion simple 56501
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,691.50
|
|
Destruct ben lesion 15/> 17111
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$238.20
|
|
Destruct cut vasl lesions 10-50cm 17107
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,016.25
|
|
Destruct cut vasl lesions <10cm 17106
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$658.40
|
|
Destruct cut vasl lesions >50cm 17108
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,999.13
|
|
Destruction anal lesion(s)
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,772.60
|
|
Destruction anal lesion(s)
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,245.23
|
|
Destruction anal lesion(s) smpl chem 46900
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$535.46
|
|
Destruction benign lesions < 14 lesions
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$250.60
|
|
Destruction by injection tx of nerve 64630
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,589.38
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,375.00
|
|
Destruction ciliary body
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,698.92
|
|
Destruction ciliary body
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,760.73
|
|
Destruction ciliary body
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,747.43
|
|
Destruction cryosurgery anal lesion(s) simpl 46916
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$331.20
|
|
Destruction laser surgery anal lesions 46917
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,038.07
|
|
Destruction les conjunctiva
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,760.73
|
|
Destruction mal lsn s/n/h/f/g 2.1-3cm
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$513.60
|
|
Destruction mal lsn s/n/h/f/g 3.1-4cm
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$558.97
|
|
Destruction mal lsn t/a/l 3.1-4cm
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$481.50
|
|
Destruction mal lsn t/a/l >4cm
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$578.40
|
|
Destruction penis lesion(s) chem 54050
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$332.00
|
|
Destruction penis lesion(s) exten 54065
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,507.31
|
|
Destruction premal lesions 15/> 17004
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$470.51
|
|
Destruction rectal tumor 45190
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,035.44
|
|
Destruction vag lesions complex 57065
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,522.35
|
|
Destruction vag lesions simple 57061
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,762.53
|
|
Destruct penis les/smp/electrodesi 54055
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,236.85
|
|
Detect agent nos dna dir
|
$33.03 |
$33.03 |
$33.03 |
$67.15
|
|
Detect agnt mult dna direc
|
$48.04 |
$48.04 |
$48.04 |
$109.60
|
|
Device intraute mirena
|
$566.67 |
$566.67 |
$566.67 |
$2,618.91
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$115.75 |
$115.75 |
$115.75 |
$220.43
|
|
Dhea-s (dehydroepiand sulfate)
|
$24.45 |
$24.45 |
$24.45 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$10.68 |
$10.68 |
$10.68 |
$78.03
|
|
Diab manage trn ind/group
|
$56.57 |
$56.57 |
$56.57 |
$49.50
|
|
Diag bronchoscope/catheter
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,040.67
|
|
Diag laparo separate proc 49320
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,855.00
|
|
Diagnostic anoscopy
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$441.68
|
|
Diagnostic anoscopy & biopsy
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,395.28
|
|
Diagnostic anoscopy spx 46600
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$245.35
|
|
Diagnostic laryngoscopy 31505
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$385.20
|
|
Diagnostic Mammogram (both breasts)
|
$186.11 |
$186.11 |
$186.11 |
$424.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$7,145.00
|
|
Dialysis one evaluation
|
$356.78 |
$356.78 |
$356.78 |
$842.10
|
|
Diffusing capacity
|
$218.44 |
$218.44 |
$218.44 |
$360.10
|
|
Digoxin total therapeutic drug level
|
$14.61 |
$14.61 |
$14.61 |
$102.00
|
|
Dilate biliary duct/ampulla
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,304.60
|
|
Dilate esophagus
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,003.04
|
|
Dilate esophagus 1/mult pass
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,484.17
|
|
Dilate tear duct opening
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$454.40
|
|
Dilate urethra stricture
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$514.79
|
|
Dilate urethra stricture
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$185.58
|
|
Dilate urethra stricture
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,745.07
|