|
Cystostomy cystotomy w/drainage 51040
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,465.00
|
|
Cystotomy/cystostomy fulg+/insj radact matrl 51020
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,986.00
|
|
Cystotomy excise/incise/repair 51535
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,940.80
|
|
Cystouretero & or pyeloscope
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,315.98
|
|
Cysto/uretero stricture tx
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,024.52
|
|
Cystouretero w/biopsy
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,881.00
|
|
Cystouretero w/excise tumor
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,627.00
|
|
Cysto/uretero w/lithotripsy
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,855.00
|
|
Cystouretero w/lithotripsy
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$6,015.75
|
|
Cystouretero w/renal strict
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,627.00
|
|
Cystouretero w/stone remove
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,724.46
|
|
Cysto/uretero w/up stricture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,820.84
|
|
Cystourethro cut ejacul duct
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,817.53
|
|
Cystourethroscop/calib/dilat stric 52281
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,845.50
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,970.98
|
|
Cysto w/renal stricture tx
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,817.53
|
|
Cysto w/up stricture tx
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,891.34
|
|
Cysto w/ureter stricture tx
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,081.37
|
|
Cytogenetics 25-99
|
$46.62 |
$46.62 |
$46.62 |
$180.00
|
|
Cytogenetics 3-5
|
$44.77 |
$44.77 |
$44.77 |
$127.64
|
|
Cytogenomic neo microra alys
|
$1,276.00 |
$1,276.00 |
$1,276.00 |
$1,742.40
|
|
Cytogenom microarray copy nmbr var
|
$990.00 |
$990.00 |
$990.00 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$15.83 |
$15.83 |
$15.83 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$18.54 |
$18.54 |
$18.54 |
$101.94
|
|
Cytomegalovirus dfa
|
$14.76 |
$14.76 |
$14.76 |
$51.20
|
|
Cytopath c/v auto in fluid
|
$27.91 |
$27.91 |
$27.91 |
$35.01
|
|
Cytopath c/v index add-on
|
$16.12 |
$16.12 |
$16.12 |
$29.60
|
|
Cytopath fl nongyn filter
|
$46.28 |
$46.28 |
$46.28 |
$66.61
|
|
Cytopathology cellular enhancement technique non-gyn
|
$58.65 |
$58.65 |
$58.65 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$29.27 |
$29.27 |
$29.27 |
$91.53
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$22.29 |
$22.29 |
$22.29 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$66.54 |
$66.54 |
$66.54 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$47.56 |
$47.56 |
$47.56 |
$122.40
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$15.78 |
$15.78 |
$15.78 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$62.07 |
$62.07 |
$62.07 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$83.61 |
$83.61 |
$83.61 |
$203.08
|
|
Cytopath smear other source
|
$27.30 |
$27.30 |
$27.30 |
$85.80
|
|
Cytopath smear other source
|
$80.20 |
$80.20 |
$80.20 |
$135.27
|
|
Cytopath smear oth prep screen & interp
|
$57.59 |
$57.59 |
$57.59 |
$95.00
|
|
Cytopath tbs c/v manual
|
$19.54 |
$19.54 |
$19.54 |
$57.94
|
|
Cytotoxic antibody screening
|
$86.52 |
$86.52 |
$86.52 |
$157.60
|
|
Cytotoxic antibody screening
|
$32.65 |
$32.65 |
$32.65 |
$75.20
|
|
Cytp urine 3-5 probes cmptr
|
$289.87 |
$289.87 |
$289.87 |
$690.00
|
|
D&c after delivery 59160
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,474.84
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,762.53
|
|
Dch glucoscan
|
$5.54 |
$5.54 |
$5.54 |
$23.25
|
|
Dch pulmonary stress test
|
$539.43 |
$539.43 |
$539.43 |
$964.41
|
|
Dch validity tests
|
$3.83 |
$3.83 |
$3.83 |
$25.00
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,021.68
|
|
Dcmprn orbit only transcrnl
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,558.89
|
|
Dcmprn plantar digital nerve
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,310.83
|
|
D&c of cervical stump
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,522.35
|
|
Deamidated gliadin antibody iga
|
$13.26 |
$13.26 |
$13.26 |
$44.20
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$677.54
|
|
Debridement (>20 cm) charge pt
|
$124.35 |
$124.35 |
$124.35 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,553.60
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$798.23
|
|
Debride nail1-5 11720
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$173.25
|
|
Debride nail6 or more 11721
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$200.21
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,280.79
|
|
Debride skin bone at fx site
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,167.89
|
|
Debrid mastoidectomy cavity simple 69220
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$252.43
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,129.45
|
|
Debr musc/fascia 20sq cm/< 11043
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,193.40
|
|
Decalcification
|
$24.10 |
$24.10 |
$24.10 |
$75.38
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$497.14
|
|
Decomp fasct leg ant+/lat+pst cmprt 27602
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,881.00
|
|
Decomp forearm 1 space 25020
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,985.84
|
|
Decomp forearm 2 spaces w/debrid 25025
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,627.00
|
|
Decompress fasciotomyhand 26037
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,545.97
|
|
Decompress fingers/hand
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,594.44
|
|
Decompress forearm 1 space
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,957.20
|
|
Decompress forearm 2 spaces
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,851.20
|
|
Decompression fasct forearm
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,855.00
|
|
Decompression of leg
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,839.54
|
|
Decompression of leg
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,855.00
|
|
Decompression of leg
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,839.54
|
|
Decompression of lower leg
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,594.44
|
|
Decompression of lower leg
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,839.54
|
|
Decompression of thigh/knee
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,594.44
|
|
Decompression of thigh/knee
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,839.54
|
|
Decompression of thigh/knee
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,217.60
|
|
Decompression of thigh/knee
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,110.00
|
|
Decompression of tibia nerve
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,625.60
|
|
Decompression unspecified nerve 64722
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,310.83
|
|
Decompress optic nerve
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,405.82
|
|
Decompres spinal cord;thoracic 63055
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$7,907.11
|
|
Decompress spinal cord lmbr
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$7,913.97
|
|
Decompress spinal cord thrc
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$6,063.98
|
|
Deep muscle biopsy 20205
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,170.64
|
|
Delayed breast prosthesis 19342
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,910.18
|
|
Delay flap arms/legs
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,164.64
|
|
Delay flap eye/nos/ear/lip
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,190.24
|
|
Delay flap fccnaxghf 15620
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,164.64
|
|
Delay flap trunk 15600
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,001.00
|
|
Delivery of placenta 59414
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,135.14
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$85.74 |
$85.74 |
$85.74 |
$182.40
|
|
Denervation of hip joint
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,499.12
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$448.50
|
|
Dermabrasion other than face
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,170.64
|
