|
Excise wrist tendon sheath
|
$1,172.60 |
$1,172.60 |
$1,172.60 |
$2,211.05
|
|
Excision addl breast lesion 19126
|
$761.80 |
$761.80 |
$761.80 |
$761.80
|
|
Excision aural polyp
|
$3,851.25 |
$3,851.25 |
$3,851.25 |
$2,133.48
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$1,372.15 |
$1,372.15 |
$1,372.15 |
$895.20
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$3,159.65 |
$3,159.65 |
$3,159.65 |
$2,064.75
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$1,372.15 |
$1,372.15 |
$1,372.15 |
$1,074.00
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$3,159.65 |
$3,159.65 |
$3,159.65 |
$2,865.00
|
|
Excision breast lesion
|
$1,913.60 |
$1,913.60 |
$1,913.60 |
$4,064.45
|
|
Excision coa w/graft
|
$5,961.80 |
$5,961.80 |
$5,961.80 |
$1,923.76
|
|
Excision floor mouth lesion 41116
|
$9,696.70 |
$9,696.70 |
$9,696.70 |
$3,892.91
|
|
Excision graft abdomen
|
$9,690.20 |
$9,690.20 |
$9,690.20 |
$4,638.40
|
|
Excision graft extremity
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$4,706.99
|
|
Excision graft neck
|
$2,178.80 |
$2,178.80 |
$2,178.80 |
$1,148.00
|
|
Excision graft thorax 35905
|
$8,715.20 |
$8,715.20 |
$8,715.20 |
$2,362.96
|
|
Excision gum each quadrant
|
$891.80 |
$891.80 |
$891.80 |
$4,560.40
|
|
Excision hand/finger tendon
|
$2,212.60 |
$2,212.60 |
$2,212.60 |
$3,821.05
|
|
Excision lesion mouth roof
|
$9,696.70 |
$9,696.70 |
$9,696.70 |
$3,837.72
|
|
Excision lesion mouth roof
|
$1,185.60 |
$1,185.60 |
$1,185.60 |
$6,465.11
|
|
Excision nasal polyp(s) simple 30110
|
$4,429.10 |
$4,429.10 |
$4,429.10 |
$1,752.89
|
|
Excision of anal lesion(s)
|
$8,199.75 |
$8,199.75 |
$8,199.75 |
$3,823.00
|
|
Excision of bile duct cyst
|
$5,953.35 |
$5,953.35 |
$5,953.35 |
$3,263.20
|
|
Excision of bile duct tumor
|
$6,734.00 |
$6,734.00 |
$6,734.00 |
$3,825.60
|
|
Excision of bile duct tumor
|
$8,767.20 |
$8,767.20 |
$8,767.20 |
$2,813.24
|
|
Excision of bowel lesion(s)
|
$4,295.20 |
$4,295.20 |
$4,295.20 |
$2,420.80
|
|
Excision of brain tumor
|
$12,071.80 |
$12,071.80 |
$12,071.80 |
$4,794.16
|
|
Excision of esophagus lesion
|
$2,511.60 |
$2,511.60 |
$2,511.60 |
$803.66
|
|
Excision of esophagus lesion
|
$4,438.20 |
$4,438.20 |
$4,438.20 |
$3,908.80
|
|
Excision of gum flap
|
$183.30 |
$183.30 |
$183.30 |
$2,000.80
|
|
Excision of gum lesion
|
$626.60 |
$626.60 |
$626.60 |
$1,944.80
|
|
Excision of gum lesion
|
$17,687.80 |
$17,687.80 |
$17,687.80 |
$7,000.36
|
|
Excision of gum lesion
|
$9,696.70 |
$9,696.70 |
$9,696.70 |
$4,560.40
|
|
Excision of gum lesion
|
$1,095.25 |
$1,095.25 |
$1,095.25 |
$6,547.81
|
|
Excision of gum lesion
|
$4,429.10 |
$4,429.10 |
$4,429.10 |
$3,710.62
|
|
Excision of gum lesion 41825
|
$366.60 |
$366.60 |
$366.60 |
$4,007.22
|
|
Excision of lesion of mesentery 44820
|
$3,569.80 |
$3,569.80 |
$3,569.80 |
$1,517.60
|
|
Excision of lingual tonsil
|
$1,435.20 |
$1,435.20 |
$1,435.20 |
$5,855.00
|
|
Excision of meckels diverticulum 44800
|
$3,133.00 |
$3,133.00 |
$3,133.00 |
$1,361.16
|
|
Excision of mouth lesion complex 40816
|
$980.20 |
$980.20 |
$980.20 |
$4,558.89
|
|
Excision of neck cyst
|
$1,900.60 |
$1,900.60 |
$1,900.60 |
$6,150.92
|
|
Excision of neck cyst confined 42810
|
$878.80 |
$878.80 |
$878.80 |
$4,560.40
|
|
Excision of penis lesion(s) 54060
|
$5,469.10 |
$5,469.10 |
$5,469.10 |
$2,837.09
|
|
Excision of rectal lesion
|
$4,245.80 |
$4,245.80 |
$4,245.80 |
$3,816.64
|
|
Excision of rectal stricture
|
$1,521.00 |
$1,521.00 |
$1,521.00 |
$1,395.28
|
|
Excision of salivary cyst
|
$1,211.60 |
$1,211.60 |
$1,211.60 |
$3,986.00
|
|
Excision of skull/sutures
|
$6,890.00 |
$6,890.00 |
$6,890.00 |
$2,867.45
|
|
Excision of skull/sutures
|
$8,845.20 |
$8,845.20 |
$8,845.20 |
$3,639.94
|
|
Excision of skull tumor
|
$7,394.40 |
$7,394.40 |
$7,394.40 |
$3,003.39
|
|
Excision of stomach lesion
|
$4,248.40 |
$4,248.40 |
$4,248.40 |
$1,385.93
|
|
Excision of stomach lesion
|
$5,298.80 |
$5,298.80 |
$5,298.80 |
$2,708.64
|
|
Excision of tongue lesion
|
$9,696.70 |
$9,696.70 |
$9,696.70 |
$3,837.72
|
|
Excision of tongue lesion
|
$2,293.20 |
$2,293.20 |
$2,293.20 |
$4,558.89
|
|
Excision of tongue lesion w/closure 41113
|
$9,696.70 |
$9,696.70 |
$9,696.70 |
$3,837.72
|
|
Excision of tonsil tags
|
$598.00 |
$598.00 |
$598.00 |
$4,350.00
|
|
Excision of umbilicus 49250
|
$2,342.60 |
$2,342.60 |
$2,342.60 |
$3,909.56
|
|
Excision of uvula
|
$9,696.70 |
$9,696.70 |
$9,696.70 |
$3,837.72
|
|
Excision of vaginal septum 57130
|
$639.60 |
$9,506.90 |
$9,506.90 |
$3,762.53
|
|
Excision olecranon bursa
|
$982.80 |
$982.80 |
$982.80 |
$3,545.97
|
|
Excision perinephric cyst
|
$4,199.00 |
$4,199.00 |
$4,199.00 |
$1,171.18
|
|
Excision radial head
|
$1,669.20 |
$1,669.20 |
$1,669.20 |
$3,839.54
|
|
Excision tongue lesion without closure 41110
|
$9,696.70 |
$9,696.70 |
$9,696.70 |
$3,819.23
|
|
Excision tumor soft tissue back/flank subcutaneous >= 3 cm
|
$4,844.45 |
$4,844.45 |
$4,844.45 |
$4,350.00
|
|
Excis partial tal calc
|
$1,900.60 |
$1,900.60 |
$1,900.60 |
$3,594.44
|
|
Excis uppr jaw cyst w/repair
|
$5,023.20 |
$5,023.20 |
$5,023.20 |
$6,553.49
|
|
Exc leg/ankle tum dep 5 cm/ > 27634
|
$2,633.80 |
$2,633.80 |
$2,633.80 |
$3,386.84
|
|
Exc leg/ankle tum subfasc<5cm 27619
|
$8,557.25 |
$8,557.25 |
$8,557.25 |
$3,127.88
|
|
Exc les conjunctiva <1 cm
|
$6,975.80 |
$6,975.80 |
$6,975.80 |
$2,760.73
|
|
Exc les conjunctiva >1 cm
|
$6,975.80 |
$6,975.80 |
$6,975.80 |
$2,760.73
|
|
Exc les conjunctiva adj scl
|
$1,326.00 |
$1,326.00 |
$1,326.00 |
$2,760.73
|
|
Exc les/mucos/sub/ves mouth/no rpr 40810
|
$9,696.70 |
$9,696.70 |
$9,696.70 |
$3,104.42
|
|
Excl laa open any method 33267
|
$4,810.00 |
$4,810.00 |
$4,810.00 |
$2,592.00
|
|
Excl laa opn oth px any meth 33268
|
$650.00 |
$650.00 |
$650.00 |
$277.76
|
|
Excl laa thrscp any method
|
$3,720.60 |
$3,720.60 |
$3,720.60 |
$3,720.60
|
|
Exc malig feenl <0.5cm 11640
|
$1,372.15 |
$1,372.15 |
$1,372.15 |
$1,168.92
|
|
Exc malig feenl 1.1-2 11642
|
$1,372.15 |
$1,372.15 |
$1,372.15 |
$1,082.00
|
|
Exc malig feenl 3.1-4.0 11644
|
$3,159.65 |
$3,159.65 |
$3,159.65 |
$2,070.30
|
|
Exc malig feenl >4cm 11646
|
$5,580.90 |
$5,580.90 |
$5,580.90 |
$3,170.64
|
|
Exc malig snhfg 0.5cm or less 11620
|
$3,159.65 |
$3,159.65 |
$3,159.65 |
$1,377.57
|
|
Exc malig snhfg 0.6-1.0 cm 11621
|
$1,372.15 |
$1,372.15 |
$1,372.15 |
$1,064.70
|
|
Exc malig snhfg 2.1-3 cm 11623
|
$3,159.65 |
$3,159.65 |
$3,159.65 |
$1,954.00
|
|
Exc malig tal <0.5cm 11600
|
$1,372.15 |
$1,372.15 |
$1,372.15 |
$924.50
|
|
Exc malig tal 0.6-1.0cm 11601
|
$1,372.15 |
$1,372.15 |
$1,372.15 |
$832.60
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$779.35 |
$779.35 |
$779.35 |
$889.20
|
|
Exc mal+marg tal 2.1-3 cm 11603
|
$1,372.15 |
$1,372.15 |
$1,372.15 |
$1,186.50
|
|
Exc mal+marg tal 3.1-4 cm 11604
|
$1,372.15 |
$1,372.15 |
$1,372.15 |
$1,294.80
|
|
Exc mandible 21025
|
$17,687.80 |
$17,687.80 |
$17,687.80 |
$6,289.53
|
|
Exc neck tum deep < 5 cm
|
$8,557.25 |
$8,557.25 |
$8,557.25 |
$3,677.10
|
|
Exc neck tum deep 5 cm/>
|
$2,893.80 |
$2,893.80 |
$2,893.80 |
$3,386.84
|
|
Exc of facial bones/osteomy/abcess 21026
|
$1,482.00 |
$1,482.00 |
$1,482.00 |
$5,753.00
|
|
Exc of rectal prlpse 45130
|
$4,810.00 |
$4,810.00 |
$4,810.00 |
$1,659.60
|
|
Exc of residual cervix via aginal approach 57550
|
$1,648.40 |
$1,648.40 |
$1,648.40 |
$5,394.95
|
|
Exc/pilonidal cyst/sinus/simple 11770
|
$5,580.90 |
$5,580.90 |
$5,580.90 |
$3,386.84
|
|
Exc prtl bn phlnx toe
|
$1,300.00 |
$1,300.00 |
$1,300.00 |
$3,839.54
|
|
Exc rect tum transanal full
|
$3,153.80 |
$3,153.80 |
$3,153.80 |
$3,816.64
|
|
Exc rect tum transanal part
|
$2,113.80 |
$2,113.80 |
$2,113.80 |
$3,245.23
|
|
Exc sac pr ulc prim str ostc
|
$3,060.20 |
$3,060.20 |
$3,060.20 |
$3,786.00
|
|
Exc sac pr ulc skn flp ostc
|
$4,102.80 |
$4,102.80 |
$4,102.80 |
$4,332.25
|
|
Exc sacral pr ulc prim sutr
|
$2,618.20 |
$2,618.20 |
$2,618.20 |
$3,386.84
|
|
Exc sacral pr ulc skn flap
|
$3,556.80 |
$3,556.80 |
$3,556.80 |
$4,332.25
|
|
Exc shoulder tum deep < 5 cm
|
$8,557.25 |
$8,557.25 |
$8,557.25 |
$3,849.30
|
|
Exc skn hdrdnt ax complex
|
$1,151.80 |
$1,151.80 |
$1,151.80 |
$3,386.84
|
