|
Dermabrasion other than face
|
$390.00 |
$390.00 |
$390.00 |
$3,214.40
|
|
Dermabrasion segmental face 15781
|
$1,305.20 |
$1,305.20 |
$1,305.20 |
$1,290.07
|
|
Dermabrasion suprfl any site
|
$325.00 |
$325.00 |
$325.00 |
$1,144.80
|
|
Derma-fat-fascia graft 15770
|
$2,562.30 |
$2,562.30 |
$2,562.30 |
$4,402.30
|
|
Dermapure 1 square cm
|
$1,592.50 |
$1,592.50 |
$1,592.50 |
$3,300.73
|
|
Descend thora aorta rpr/lt sub art 33880
|
$8,990.80 |
$8,990.80 |
$8,990.80 |
$6,288.45
|
|
Design mlc device for imrt
|
$2,869.10 |
$2,869.10 |
$2,869.10 |
$1,753.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$185.38 |
$185.38 |
$185.38 |
$91.84
|
|
Desoxycorticosterone
|
$139.10 |
$139.10 |
$139.10 |
$109.28
|
|
Des thora aorta rpr without left sub art 33881
|
$8,184.15 |
$8,184.15 |
$8,184.15 |
$5,267.20
|
|
Dest mal lesion feenlm <0.5cm 17280
|
$317.20 |
$317.20 |
$317.20 |
$275.88
|
|
Dest mal lesion feenlm 0.6-1cm 17281
|
$460.20 |
$460.20 |
$460.20 |
$362.58
|
|
Dest mal lesion feenlm 1.1 - 2.0 cm 17282
|
$543.40 |
$543.40 |
$543.40 |
$408.50
|
|
Dest mal lesion snhfg <0.5cm 17270
|
$356.20 |
$356.20 |
$356.20 |
$273.72
|
|
Dest mal lesion snhfg 0.6-1cm 17271
|
$400.40 |
$400.40 |
$400.40 |
$312.00
|
|
Dest mal lesion snhfg 1.1-2cm 17272
|
$473.20 |
$473.20 |
$473.20 |
$311.20
|
|
Dest mal lesion tal <0.5 17260
|
$274.30 |
$274.30 |
$274.30 |
$238.40
|
|
Dest mal lesion tal 0.6-1.0cm 17261
|
$349.05 |
$349.05 |
$349.05 |
$274.80
|
|
Dest mal lesion tal 1.1-2.0cm 17262
|
$466.05 |
$466.05 |
$466.05 |
$332.25
|
|
Dest mal lesion tal 2.1-3.0cm 17263
|
$526.50 |
$526.50 |
$526.50 |
$364.50
|
|
Destroy cervthor facet jnt 64633
|
$8,758.10 |
$8,758.10 |
$8,758.10 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$594.10 |
$594.10 |
$594.10 |
$1,441.44
|
|
Destroy internal hemorrhoids destroy 46930
|
$418.60 |
$418.60 |
$418.60 |
$1,395.28
|
|
Destroy premlg lesns;1st lesn 17000
|
$387.40 |
$387.40 |
$387.40 |
$202.40
|
|
Destroy vulva lesion extensive 56515
|
$880.75 |
$880.75 |
$880.75 |
$3,058.98
|
|
Destroy vulva lesion simple 56501
|
$410.80 |
$410.80 |
$410.80 |
$3,562.00
|
|
Destruct ben lesion 15/> 17111
|
$387.40 |
$387.40 |
$387.40 |
$235.13
|
|
Destruct cut vasl lesions 10-50cm 17107
|
$1,370.20 |
$1,370.20 |
$1,370.20 |
$966.60
|
|
Destruct cut vasl lesions <10cm 17106
|
$1,055.60 |
$1,055.60 |
$1,055.60 |
$666.75
|
|
Destruct cut vasl lesions >50cm 17108
|
$2,142.40 |
$2,142.40 |
$2,142.40 |
$2,142.40
|
|
Destruction 2-14 lesions 17003
|
$217.10 |
$217.10 |
$217.10 |
$78.61
|
|
Destruction anal lesion(s)
|
$496.60 |
$496.60 |
$496.60 |
$3,711.00
|
|
Destruction anal lesion(s)
|
$730.60 |
$730.60 |
$730.60 |
$3,363.79
|
|
Destruction anal lesion(s) smpl chem 46900
|
$496.60 |
$496.60 |
$496.60 |
$557.90
|
|
Destruction benign lesions < 14 lesions
|
$387.40 |
$387.40 |
$387.40 |
$240.24
|
|
Destruction by injection tx of nerve 64630
|
$3,992.95 |
$3,992.95 |
$3,992.95 |
$1,646.40
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$2,123.55 |
$2,123.55 |
$2,123.55 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$8,758.10 |
$8,758.10 |
$8,758.10 |
$3,296.80
|
|
Destruction laser surgery anal lesions 46917
|
$496.60 |
$496.60 |
$496.60 |
$3,640.00
|
|
Destruction mal lsn s/n/h/f/g 2.1-3cm
|
$546.00 |
$546.00 |
$546.00 |
$513.60
|
|
Destruction mal lsn s/n/h/f/g 3.1-4cm
|
$686.40 |
$686.40 |
$686.40 |
$558.97
|
|
Destruction mal lsn t/a/l 3.1-4cm
|
$569.40 |
$569.40 |
$569.40 |
$482.00
|
|
Destruction mal lsn t/a/l >4cm
|
$683.80 |
$683.80 |
$683.80 |
$569.80
|
|
Destruction penis lesion(s) chem 54050
|
$369.20 |
$369.20 |
$369.20 |
$332.00
|
|
Destruction penis lesion(s) exten 54065
|
$642.20 |
$642.20 |
$642.20 |
$2,507.31
|
|
Destruction premal lesions 15/> 17004
|
$779.35 |
$779.35 |
$779.35 |
$442.61
|
|
Destruction rectal tumor 45190
|
$2,709.20 |
$2,709.20 |
$2,709.20 |
$3,245.23
|
|
Destruction vag lesions complex 57065
|
$760.50 |
$760.50 |
$760.50 |
$3,986.00
|
|
Destruction vag lesions simple 57061
|
$371.80 |
$371.80 |
$371.80 |
$4,006.38
|
|
Destruct penis les/smp/electrodesi 54055
|
$5,469.10 |
$5,469.10 |
$5,469.10 |
$2,837.09
|
|
Developmental screen/score/document 96110
|
$205.40 |
$205.40 |
$205.40 |
$142.38
|
|
Devel tst phys/qhp 1st hr
|
$702.00 |
$702.00 |
$702.00 |
$350.40
|
|
Device intraute mirena
|
$1,894.83 |
$1,894.83 |
$1,894.83 |
$2,125.00
|
|
Dev interrog remote 1/2/mlt
|
$211.90 |
$211.90 |
$211.90 |
$115.20
|
|
Devlopment test interpt&rep
|
$276.25 |
$276.25 |
$276.25 |
$109.46
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$301.60 |
$301.60 |
$301.60 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$452.40 |
$452.40 |
$452.40 |
$227.25
|
|
Dexametha opth insert 0.1 mg
|
$998.40 |
$998.40 |
$998.40 |
$888.47
|
|
Dexamethasone 4 mg tablet
|
$2.47 |
$2.47 |
$2.47 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$17.55 |
$17.55 |
$17.55 |
$20.76
|
|
Dexamethasone intra implant
|
$3,119.22 |
$3,119.22 |
$3,119.22 |
$2,356.90
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$641.76 |
$641.76 |
$641.76 |
$884.80
|
|
Dextran 40 infusion
|
$1.54 |
$1.54 |
$1.54 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$0.02 |
$0.02 |
$0.02 |
$36.05
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$4.88 |
$4.88 |
$4.88 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$17.55 |
$17.55 |
$17.55 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$99.45 |
$99.45 |
$99.45 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$43.55 |
$43.55 |
$43.55 |
$79.30
|
|
Diabetes training group per 30 min g0109
|
$51.35 |
$51.35 |
$51.35 |
$35.43
|
|
Diab manage trn ind/group
|
$78.65 |
$78.65 |
$78.65 |
$54.99
|
|
Diag laparo separate proc 49320
|
$1,470.30 |
$1,470.30 |
$1,470.30 |
$7,104.72
|
|
Diagnostic anoscopy
|
$416.00 |
$416.00 |
$416.00 |
$392.70
|
|
Diagnostic anoscopy & biopsy
|
$629.20 |
$629.20 |
$629.20 |
$2,288.00
|
|
Diagnostic anoscopy spx 46600
|
$385.45 |
$385.45 |
$385.45 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$87.10 |
$87.10 |
$87.10 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$111.15 |
$111.15 |
$111.15 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$580.45 |
$580.45 |
$580.45 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$580.45 |
$580.45 |
$580.45 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$458.90 |
$458.90 |
$458.90 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$576.55 |
$576.55 |
$576.55 |
$314.00
|
|
Diagnostic radio unlisted proc
|
$14,137.50 |
$14,137.50 |
$14,137.50 |
$259.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$14,800.50 |
$14,800.50 |
$14,800.50 |
$5,741.00
|
|
Dialysis one evaluation
|
$1,909.70 |
$1,909.70 |
$1,909.70 |
$936.00
|
|
Dialysis repeated eval
|
$655.20 |
$655.20 |
$655.20 |
$1,332.80
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.98 |
$0.98 |
$0.98 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$46.80 |
$46.80 |
$46.80 |
$79.71
|
|
Dicyclomine injection
|
$45.63 |
$45.63 |
$45.63 |
$154.33
|
|
Diffusing capacity
|
$442.65 |
$442.65 |
$442.65 |
$336.80
|
|
Digital analysis of eeg
|
$514.80 |
$514.80 |
$514.80 |
$593.40
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$335.15 |
$335.15 |
$335.15 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$11,639.16 |
$11,639.16 |
$11,639.16 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$59.80 |
$59.80 |
$59.80 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$245.70 |
$245.70 |
$245.70 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$2,683.85 |
$2,683.85 |
$2,683.85 |
$1,866.73
|
|
Dilate esophagus
|
$366.60 |
$366.60 |
$366.60 |
$2,142.40
|
|
Dilate esophagus 1/mult pass
|
$365.95 |
$365.95 |
$365.95 |
$1,548.00
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$11,098.75 |
$11,098.75 |
$11,098.75 |
$3,169.00
|
|
Dilate ic vasospasm ea add vsl same territory
|
$5,428.80 |
$5,428.80 |
$5,428.80 |
$1,931.80
|
|
Dilate ic vasospasm init
|
$17,110.60 |
$17,110.60 |
$17,110.60 |
$5,151.95
|
|
Dilate urethra stricture
|
$727.35 |
$727.35 |
$727.35 |
$513.00
|
