|
Destruction anal lesion(s)
|
$113.30 |
$113.30 |
$113.30 |
$3,363.79
|
|
Destruction anal lesion(s) smpl chem 46900
|
$85.58 |
$85.58 |
$85.58 |
$535.46
|
|
Destruction benign lesions < 14 lesions
|
$464.88 |
$464.88 |
$464.88 |
$248.25
|
|
Destruction by injection tx of nerve 64630
|
$119.24 |
$119.24 |
$119.24 |
$1,646.40
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$36.30 |
$36.30 |
$36.30 |
$1,673.10
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$118.58 |
$118.58 |
$118.58 |
$3,296.80
|
|
Destruction ciliary body
|
$236.94 |
$236.94 |
$236.94 |
$2,698.92
|
|
Destruction ciliary body
|
$248.82 |
$248.82 |
$248.82 |
$3,228.83
|
|
Destruction ciliary body
|
$236.94 |
$236.94 |
$236.94 |
$2,760.73
|
|
Destruction cryosurgery anal lesion(s) simpl 46916
|
$87.56 |
$87.56 |
$87.56 |
$364.50
|
|
Destruction laser surgery anal lesions 46917
|
$80.08 |
$80.08 |
$80.08 |
$3,640.00
|
|
Destruction les conjunctiva
|
$91.08 |
$91.08 |
$91.08 |
$2,760.73
|
|
Destruction mal lsn s/n/h/f/g 2.1-3cm
|
$84.70 |
$84.70 |
$84.70 |
$513.60
|
|
Destruction mal lsn s/n/h/f/g 3.1-4cm
|
$103.84 |
$103.84 |
$103.84 |
$558.97
|
|
Destruction mal lsn t/a/l 3.1-4cm
|
$80.96 |
$80.96 |
$80.96 |
$481.50
|
|
Destruction mal lsn t/a/l >4cm
|
$94.82 |
$94.82 |
$94.82 |
$569.80
|
|
Destruction penis lesion(s) chem 54050
|
$66.44 |
$66.44 |
$66.44 |
$332.00
|
|
Destruction penis lesion(s) exten 54065
|
$107.58 |
$107.58 |
$107.58 |
$2,507.31
|
|
Destruction premal lesions 15/> 17004
|
$60.72 |
$60.72 |
$60.72 |
$451.50
|
|
Destruction rectal tumor 45190
|
$430.54 |
$430.54 |
$430.54 |
$3,245.23
|
|
Destruction vag lesions complex 57065
|
$114.40 |
$114.40 |
$114.40 |
$3,986.00
|
|
Destruction vag lesions simple 57061
|
$70.84 |
$70.84 |
$70.84 |
$4,006.38
|
|
Destruct penis les/smp/electrodesi 54055
|
$60.06 |
$60.06 |
$60.06 |
$2,837.09
|
|
Detect agent nos dna dir
|
$19.80 |
$19.80 |
$19.80 |
$115.20
|
|
Detect agnt mult dna direc
|
$29.04 |
$29.04 |
$29.04 |
$157.25
|
|
Determination venous press
|
$5.06 |
$5.06 |
$5.06 |
$166.56
|
|
Determine refractive state
|
$12.10 |
$12.10 |
$12.10 |
$20.50
|
|
Devel tst phys/qhp 1st hr
|
$75.02 |
$75.02 |
$75.02 |
$345.50
|
|
Device intraute mirena
|
$632.50 |
$632.50 |
$632.50 |
$2,143.02
|
|
Dev interrog remote 1/2/mlt
|
$22.22 |
$22.22 |
$22.22 |
$115.20
|
|
Devise bowel pouch
|
$875.16 |
$875.16 |
$875.16 |
$3,464.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$31.02 |
$31.02 |
$31.02 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$283.14 |
$283.14 |
$283.14 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$0.77 |
$0.77 |
$0.77 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$5.77 |
$5.77 |
$5.77 |
$20.52
|
|
Dexamethasone panel
|
$106.92 |
$106.92 |
$106.92 |
$223.39
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$4.62 |
$4.62 |
$4.62 |
$36.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$4.62 |
$4.62 |
$4.62 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$13.09 |
$13.09 |
$13.09 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$4.62 |
$4.62 |
$4.62 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$117.00 |
$117.00 |
$117.00 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$50.70 |
$50.70 |
$50.70 |
$79.20
|
|
Diab manage trn ind/group
|
$31.98 |
$31.98 |
$31.98 |
$54.99
|
|
Diag bronchoscope/catheter
|
$103.18 |
$103.18 |
$103.18 |
$2,379.00
|
|
Diag laparo separate proc 49320
|
$205.04 |
$205.04 |
$205.04 |
$7,104.72
|
|
Diagnostic anoscopy
|
$57.64 |
$57.64 |
$57.64 |
$363.30
|
|
Diagnostic anoscopy & biopsy
|
$76.34 |
$76.34 |
$76.34 |
$2,288.00
|
|
Diagnostic anoscopy spx 46600
|
$301.86 |
$301.86 |
$301.86 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$531.96 |
$531.96 |
$531.96 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$265.98 |
$265.98 |
$265.98 |
$76.37
|
|
Diagnostic laryngoscopy 31505
|
$454.74 |
$454.74 |
$454.74 |
$258.30
|
|
Diagnostic laryngoscopy 31575
|
$454.74 |
$454.74 |
$454.74 |
$338.25
|
|
Diagnostic Mammogram (both breasts)
|
$357.24 |
$357.24 |
$357.24 |
$421.20
|
|
Diagnostic Mammogram (one breast)
|
$287.04 |
$287.04 |
$287.04 |
$314.16
|
|
Diagnostic radio unlisted proc
|
$283.14 |
$283.14 |
$283.14 |
$259.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$10,006.62 |
$10,006.62 |
$10,006.62 |
$6,185.00
|
|
Dialysis one evaluation
|
$52.80 |
$52.80 |
$52.80 |
$936.00
|
|
Dialysis repeated eval
|
$75.02 |
$75.02 |
$75.02 |
$1,267.50
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$25.92 |
$25.92 |
$25.92 |
$79.71
|
|
Dicyclomine injection
|
$64.73 |
$64.73 |
$64.73 |
$154.14
|
|
Diffusing capacity
|
$5.50 |
$5.50 |
$5.50 |
$337.60
|
|
Digital analysis of eeg
|
$61.60 |
$61.60 |
$61.60 |
$576.69
|
|
Digit nerve surgery add-on
|
$110.44 |
$110.44 |
$110.44 |
$1,832.59
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$4.60 |
$4.60 |
$4.60 |
$65.84
|
|
Digoxin total therapeutic drug level
|
$70.20 |
$70.20 |
$70.20 |
$102.07
|
|
Dilate biliary duct/ampulla
|
$82.06 |
$82.06 |
$82.06 |
$1,866.73
|
|
Dilate esophagus
|
$53.02 |
$53.02 |
$53.02 |
$2,142.40
|
|
Dilate esophagus 1/mult pass
|
$48.84 |
$48.84 |
$48.84 |
$1,548.00
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$7,934.16 |
$7,934.16 |
$7,934.16 |
$3,183.60
|
|
Dilate ic vasospasm ea add vsl same territory
|
$7,934.16 |
$7,934.16 |
$7,934.16 |
$1,931.80
|
|
Dilate ic vasospasm init
|
$226.16 |
$226.16 |
$226.16 |
$5,250.40
|
|
Dilate tear duct opening
|
$47.96 |
$47.96 |
$47.96 |
$454.40
|
|
Dilate urethra stricture
|
$39.38 |
$39.38 |
$39.38 |
$513.00
|
|
Dilate urethra stricture
|
$33.00 |
$33.00 |
$33.00 |
$200.80
|
|
Dilate urethra stricture
|
$39.16 |
$39.16 |
$39.16 |
$3,863.60
|
|
Dilate urethra stricture
|
$44.00 |
$44.00 |
$44.00 |
$343.55
|
|
Dilation/female urethra/initial 53660
|
$25.52 |
$25.52 |
$25.52 |
$235.61
|
|
Dilation of anal sphincter
|
$105.60 |
$105.60 |
$105.60 |
$2,166.04
|
|
Dilation of cervical canal 57800
|
$29.70 |
$29.70 |
$29.70 |
$4,446.00
|
|
Dilation of rectal stricture 45910
|
$119.90 |
$119.90 |
$119.90 |
$2,263.80
|
|
Dilation of salivary duct
|
$48.84 |
$48.84 |
$48.84 |
$750.00
|
|
Dilation of urethra
|
$24.64 |
$24.64 |
$24.64 |
$172.00
|
|
Dilation of urethra
|
$22.88 |
$22.88 |
$22.88 |
$2,424.12
|
|
Dilation of vagina
|
$80.52 |
$80.52 |
$80.52 |
$4,446.00
|
|
Dilation salivary duct 42650
|
$36.74 |
$36.74 |
$36.74 |
$2,498.32
|
|
Dilation/urethral strict/male/ini 53620
|
$1,562.34 |
$1,562.34 |
$1,562.34 |
$1,372.80
|
|
Dilat xst trc ndurlgc px
|
$8,070.66 |
$8,070.66 |
$8,070.66 |
$3,903.54
|
|
Dilat xst trc new access rcs
|
$8,070.66 |
$8,070.66 |
$8,070.66 |
$4,258.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$8.79 |
$8.79 |
$8.79 |
$45.06
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$2.32 |
$2.32 |
$2.32 |
$18.00
|
|
Disability dlco
|
$7.26 |
$7.26 |
$7.26 |
$294.55
|
|
Disaccharidases
|
$14.52 |
$14.52 |
$14.52 |
$224.58
|
|
Disarticulation sho sec clsr
|
$295.90 |
$295.90 |
$295.90 |
$2,300.80
|
|
Disarticulation shoulder
|
$698.28 |
$698.28 |
$698.28 |
$13,116.76
|
|
Discectomy ant dcmprn cord thoracic 1 ntrspc 63077
|
$905.30 |
$905.30 |
$905.30 |
$3,636.00
|
|
Discectomy ant dcmprn cord thoracic ea ntrsp 63078
|
$127.60 |
$127.60 |
$127.60 |
$316.10
|
|
Discography cerv/thor spine
|
$6,282.90 |
$6,282.90 |
$6,282.90 |
$2,565.00
|
|
Dise eval slp do brth flx dx
|
$59.84 |
$59.84 |
$59.84 |
$1,120.00
|
|
Dissect brain w/scope
|
$952.38 |
$952.38 |
$952.38 |
$2,321.68
|
|
Dis site tele svcs rhc/fqhc
|
$63.36 |
$63.36 |
$63.36 |
$94.80
|
