|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,112.60
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,372.15
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,112.60
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,483.00
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$818.53
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,301.30
|
|
Exc breast duct fistula 19112
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,847.45
|
|
Exc cervix repair bowel 57556
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,394.95
|
|
Exc cervix/repair vagina 57555
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,627.00
|
|
Exc chest wall tumor w/ribs 21601
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,386.84
|
|
Exc coccygl pr ulc flap clsr
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,052.18
|
|
Exc coccygl pr ulc prim sutr
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,167.89
|
|
Exc constrict ring finger w/mlt z-plasties 26596
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,591.33
|
|
Exc/crtg b1 cst/b9 tum rds
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,591.33
|
|
Exc/crtg b1 cst/tum hum agrf
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,886.74
|
|
Exc/crtg b1 cst/tum hum algr
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,886.74
|
|
Exc/crtg b1 cst/tum rds agrf
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,839.54
|
|
Exc/crtg b1 cst/tum rds algr
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,855.00
|
|
Exc/curetg cst/tum tarsal/metar w/iliac/agrf 28106
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,741.00
|
|
Exc/curtg b1 cst/b9 tum hum
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,839.54
|
|
Exc excessive skin buttock
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,377.40
|
|
Exc excessive skin hip
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,386.84
|
|
Exc excessive skin leg
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,321.60
|
|
Exc excessive skin thigh
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,074.75
|
|
Exc excsv skin forearm/hand
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,167.89
|
|
Exc excsv submental fat pad
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,170.64
|
|
Exc ext ear/partial/simple repair 69110
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,386.84
|
|
Exc face tum deep < 2 cm
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,917.33
|
|
Exc face tum deep 2cm/> 21014
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,386.84
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,061.40
|
|
Exc feenl mal+mrg 2.1-3 11643
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,101.45
|
|
Exc foot/toe tum dep 1.5cm/>
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,786.00
|
|
Exc foot/toe tum subq < 1.5 cm 28043
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,424.00
|
|
Exc forearm les sc 3 cm/>
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,078.40
|
|
Exc forearm tum deep < 3 cm
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,547.20
|
|
Exc forearm tum deep 3 cm/>
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,386.84
|
|
Exc hand les sc < 1.5 cm
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,897.50
|
|
Exc hand tum deep 1.5 cm/>
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,271.01
|
|
Exc hand tum deep < 1.5 cm 26116
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,271.01
|
|
Exchange biliary drg cath
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,176.15
|
|
Exchange blood transfusion newborn 36450
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$517.34
|
|
Exchange drainage catheter
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,256.80
|
|
Exchange lens prosthesis
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,504.00
|
|
Exchange nephrostomy cath
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,097.16
|
|
Exc hidradenitis ing simpl 11462
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,170.64
|
|
Exc hidradenitis peri/umb comp 11471
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,386.84
|
|
Exc hidradenitis peri/umb int 11470
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,386.84
|
|
Exc hip/pelv tum deep < 5 cm
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,386.84
|
|
Exc hip/pelv tum deep 5 cm/>
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,630.40
|
|
Exc im tumor/back/flank/ < 5 cm 21932
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,386.84
|
|
Exc im tumor/foot/toe < 1.5 cm 28045
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,170.64
|
|
Exc im tumor/shoulder area 5cm/> 23073
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,411.20
|
|
Exc ischial pr ulcer w/ostc musc/myoq flap/skin 15946
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,696.64
|
|
Exc ischial pr ulc prim sutr
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,386.84
|
|
Exc isch pr ulc prm sut ostc
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,386.84
|
|
Exc isch pr ulc skn flp clsr
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,052.18
|
|
Exc isch pr ulc skn flp ostc
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,508.80
|
|
Excise anal ext tag/papilla
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,395.28
|
|
Excise epiphyseal bar
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,947.20
|
|
Excise foot tendon sheath
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,594.44
|
|
Excise foot tendon sheath
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,594.44
|
|
Excise inferior turbinate
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,589.62
|
|
Excise intraspinl lesion crv
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$6,193.20
|
|
Excise intrspinl lesion lmbr
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,741.00
|
|
Excise intrspinl lesion scrl
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,855.00
|
|
Excise lesion testis
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,986.00
|
|
Excise lip or cheek fold
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,752.89
|
|
Excise lwr jaw cyst w/repair
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$6,219.35
|
|
Excise mandible lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,592.74
|
|
Excise max/zygoma b9 tumor
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,741.00
|
|
Excise max/zygoma mal tumor
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$6,517.80
|
|
Excise oral mucosa for graft 40818
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$788.48
|
|
Excise parotid gland/lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$6,465.11
|
|
Excise parotid gland/lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$6,311.00
|
|
Excise parotid gland/lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$6,465.11
|
|
Excise parotid gland/lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$6,547.81
|
|
Excise pharynx lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,592.74
|
|
Excise/repair mouth lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,133.48
|
|
Excise sublingual gland
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,885.66
|
|
Excise submaxillary gland
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,314.01
|
|
Excise subq tumor/abd wall <3 cm 22902
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,974.40
|
|
Excise tendon forearm/wrist
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,591.33
|
|
Excise wrist tendon sheath
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,893.86
|
|
Excision aural polyp
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,752.89
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$832.60
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,981.25
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,064.30
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,916.96
|
|
Excision breast lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,694.96
|
|
Excision floor mouth lesion 41116
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,819.23
|
|
Excision graft extremity
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,982.97
|
|
Excision gum each quadrant
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,837.72
|
|
Excision hand/finger tendon
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,594.44
|
|
Excision lesion mouth roof
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,600.75
|
|
Excision lesion mouth roof
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,413.19
|
|
Excision nasal polyp(s) simple 30110
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,639.57
|
|
Excision of anal lesion(s)
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,245.23
|
|
Excision of gum flap
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,752.89
|
|
Excision of gum lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,752.89
|
|
Excision of gum lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,339.00
|
