|
Established Patient Office Visit (level 1)
|
$84.00 |
$84.00 |
$84.00 |
$122.20
|
|
Established Patient Office Visit (level 2)
|
$110.40 |
$110.40 |
$110.40 |
$139.20
|
|
Established Patient Office Visit (level 3)
|
$183.00 |
$183.00 |
$183.00 |
$186.94
|
|
Established Patient Office Visit (level 4)
|
$273.00 |
$273.00 |
$273.00 |
$239.25
|
|
Established Patient Office Visit (level 5)
|
$367.80 |
$367.80 |
$367.80 |
$290.68
|
|
Estim aid bone healg invasiv
|
$311.40 |
$311.40 |
$311.40 |
$2,620.80
|
|
Estradiol total
|
$193.80 |
$193.80 |
$193.80 |
$152.10
|
|
Estrogens total-sendout
|
$204.60 |
$204.60 |
$204.60 |
$97.50
|
|
Etonogestrel implant system
|
$967.20 |
$967.20 |
$967.20 |
$2,081.30
|
|
Etoposide 20 mg/ml intravenous solution
|
$2.40 |
$2.40 |
$2.40 |
$235.20
|
|
Euflexxa inj per dose
|
$451.80 |
$451.80 |
$451.80 |
$510.68
|
|
Eval/fit voice prosthesis iii, st
|
$324.00 |
$324.00 |
$324.00 |
$359.50
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$292.20 |
$292.20 |
$292.20 |
$213.15
|
|
Evaluation of speech fluency 92521
|
$354.60 |
$354.60 |
$354.60 |
$302.50
|
|
Event monitor
|
$207.00 |
$207.00 |
$207.00 |
$231.00
|
|
Exam plvc w/anes othr thn lcl
|
$200.40 |
$200.40 |
$200.40 |
$3,816.40
|
|
Ex arm/elbow tum deep 5 cm/>
|
$979.20 |
$979.20 |
$979.20 |
$3,412.80
|
|
Exc abd les sc 3 cm/>
|
$696.00 |
$696.00 |
$696.00 |
$3,994.09
|
|
Exc abdl tum deep < 5 cm
|
$727.20 |
$727.20 |
$727.20 |
$3,786.00
|
|
Exc arm/elbo les sc >=3cm 24071
|
$742.20 |
$742.20 |
$742.20 |
$4,529.20
|
|
Exc arm/elbo les sc <3cm 24075
|
$860.40 |
$860.40 |
$860.40 |
$2,532.80
|
|
Exc back les sbq <3 cm 21930
|
$672.60 |
$672.60 |
$672.60 |
$2,711.00
|
|
Exc back tum deep 5 cm/>
|
$1,420.20 |
$1,420.20 |
$1,420.20 |
$3,994.09
|
|
Exc bartholins gland/cyst
|
$551.40 |
$551.40 |
$551.40 |
$3,902.88
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$279.60 |
$279.60 |
$279.60 |
$2,443.20
|
|
Exc benign feenlm >4.0cm 11446
|
$555.60 |
$555.60 |
$555.60 |
$3,386.84
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$317.40 |
$317.40 |
$317.40 |
$2,306.25
|
|
Exc benign tal 0.5 < cm 11400
|
$94.20 |
$94.20 |
$94.20 |
$832.60
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$123.00 |
$123.00 |
$123.00 |
$969.60
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$1,266.00 |
$1,266.00 |
$1,266.00 |
$1,152.96
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$308.40 |
$308.40 |
$308.40 |
$2,069.20
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$1,266.00 |
$1,266.00 |
$1,266.00 |
$1,501.50
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$265.80 |
$265.80 |
$265.80 |
$2,271.01
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$465.00 |
$465.00 |
$465.00 |
$3,483.00
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$1,266.00 |
$1,266.00 |
$1,266.00 |
$779.35
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$1,266.00 |
$1,266.00 |
$1,266.00 |
$1,314.67
|
|
Exc breast duct fistula 19112
|
$465.00 |
$465.00 |
$465.00 |
$4,238.48
|
|
Exc ext ear/partial/simple repair 69110
|
$576.00 |
$576.00 |
$576.00 |
$3,339.00
|
|
Exc face tum deep < 2 cm
|
$740.40 |
$740.40 |
$740.40 |
$2,206.43
|
|
Exc face tum deep 2cm/> 21014
|
$969.60 |
$969.60 |
$969.60 |
$3,421.60
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$1,371.60 |
$1,371.60 |
$1,371.60 |
$999.50
|
|
Exc feenl mal+mrg 2.1-3 11643
|
$396.60 |
$396.60 |
$396.60 |
$2,101.45
|
|
Exc foot/toe tum dep 1.5cm/>
|
$838.80 |
$838.80 |
$838.80 |
$4,094.05
|
|
Exc foot/toe tum subq < 1.5 cm 28043
|
$501.00 |
$501.00 |
$501.00 |
$3,484.00
|
|
Exc forearm les sc 3 cm/>
|
$735.60 |
$735.60 |
$735.60 |
$3,628.50
|
|
Exc hand les sc < 1.5 cm
|
$678.00 |
$678.00 |
$678.00 |
$1,908.09
|
|
Exc hand tum deep < 1.5 cm 26116
|
$977.40 |
$977.40 |
$977.40 |
$2,391.84
|
|
Exchange nephrostomy cath
|
$120.00 |
$120.00 |
$120.00 |
$2,958.80
|
|
Exc im tumor/back/flank/ < 5 cm 21932
|
$1,174.80 |
$1,174.80 |
$1,174.80 |
$3,398.50
|
|
Exc im tumor/shoulder area 5cm/> 23073
|
$1,202.40 |
$1,202.40 |
$1,202.40 |
$3,486.52
|
|
Excise inferior turbinate
|
$650.40 |
$650.40 |
$650.40 |
$3,819.23
|
|
Excise lip or cheek fold
|
$390.60 |
$390.60 |
$390.60 |
$1,855.10
|
|
Excise oral mucosa for graft 40818
|
$511.20 |
$511.20 |
$511.20 |
$904.80
|
|
Excise parotid gland/lesion
|
$1,119.60 |
$1,119.60 |
$1,119.60 |
$6,831.82
|
|
Excise parotid gland/lesion
|
$2,053.20 |
$2,053.20 |
$2,053.20 |
$7,000.36
|
|
Excise parotid gland/lesion
|
$2,452.20 |
$2,452.20 |
$2,452.20 |
$6,839.00
|
|
Excise pharynx lesion
|
$307.80 |
$307.80 |
$307.80 |
$3,837.72
|
|
Excise/repair mouth lesion
|
$351.00 |
$351.00 |
$351.00 |
$1,915.20
|
|
Excise submaxillary gland
|
$845.40 |
$845.40 |
$845.40 |
$6,465.11
|
|
Excise subq tumor/abd wall <3 cm 22902
|
$626.40 |
$626.40 |
$626.40 |
$3,322.80
|
|
Excise tendon forearm/wrist
|
$966.00 |
$966.00 |
$966.00 |
$3,839.54
|
|
Excision addl breast lesion 19126
|
$297.00 |
$297.00 |
$297.00 |
$761.80
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$225.00 |
$225.00 |
$225.00 |
$914.34
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$233.40 |
$233.40 |
$233.40 |
$2,064.75
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$157.80 |
$157.80 |
$157.80 |
$1,072.24
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$249.00 |
$249.00 |
$249.00 |
$2,865.00
|
|
Excision breast lesion
|
$666.60 |
$666.60 |
$666.60 |
$4,064.45
|
|
Excision floor mouth lesion 41116
|
$385.20 |
$385.20 |
$385.20 |
$3,892.91
|
|
Excision lesion mouth roof
|
$334.80 |
$334.80 |
$334.80 |
$3,837.72
|
|
Excision nasal polyp(s) simple 30110
|
$3,777.60 |
$3,777.60 |
$3,777.60 |
$1,752.89
|
|
Excision of anal lesion(s)
|
$226.80 |
$226.80 |
$226.80 |
$3,823.00
|
|
Excision of gum lesion 41825
|
$207.60 |
$207.60 |
$207.60 |
$4,007.22
|
|
Excision of neck cyst
|
$951.00 |
$951.00 |
$951.00 |
$6,150.92
|
|
Excision of penis lesion(s) 54060
|
$381.60 |
$381.60 |
$381.60 |
$2,837.09
|
|
Excision of tongue lesion
|
$310.20 |
$310.20 |
$310.20 |
$3,837.72
|
|
Excision of uvula
|
$273.00 |
$273.00 |
$273.00 |
$3,837.72
|
|
Excision olecranon bursa
|
$633.00 |
$633.00 |
$633.00 |
$3,591.33
|
|
Excision radial head
|
$888.60 |
$888.60 |
$888.60 |
$3,986.00
|
|
Excision tumor soft tissue back/flank subcutaneous >= 3 cm
|
$904.80 |
$904.80 |
$904.80 |
$4,420.32
|
|
Excis partial tal calc
|
$786.00 |
$786.00 |
$786.00 |
$3,594.44
|
|
Exc leg/ankle tum subfasc<5cm 27619
|
$1,153.80 |
$1,153.80 |
$1,153.80 |
$3,127.88
|
|
Exc malig feenl <0.5cm 11640
|
$166.80 |
$166.80 |
$166.80 |
$1,186.00
|
|
Exc malig feenl 1.1-2 11642
|
$225.00 |
$225.00 |
$225.00 |
$1,082.00
|
|
Exc malig feenl 3.1-4.0 11644
|
$519.60 |
$519.60 |
$519.60 |
$2,070.30
|
|
Exc malig feenl >4cm 11646
|
$714.00 |
$714.00 |
$714.00 |
$3,253.05
|
|
Exc malig snhfg 0.5cm or less 11620
|
$175.80 |
$175.80 |
$175.80 |
$1,377.57
|
|
Exc malig snhfg 0.6-1.0 cm 11621
|
$187.20 |
$187.20 |
$187.20 |
$1,064.70
|
|
Exc malig snhfg 2.1-3 cm 11623
|
$352.20 |
$352.20 |
$352.20 |
$1,954.00
|
|
Exc malig tal <0.5cm 11600
|
$138.00 |
$138.00 |
$138.00 |
$973.71
|
|
Exc malig tal 0.6-1.0cm 11601
|
$172.80 |
$172.80 |
$172.80 |
$832.60
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$199.20 |
$199.20 |
$199.20 |
$889.20
|
|
Exc mal+marg tal 2.1-3 cm 11603
|
$969.60 |
$969.60 |
$969.60 |
$1,207.80
|
|
Exc mal+marg tal 3.1-4 cm 11604
|
$343.80 |
$343.80 |
$343.80 |
$1,294.80
|
|
Exc mandible 21025
|
$1,345.20 |
$1,345.20 |
$1,345.20 |
$6,289.53
|
|
Exc neck tum deep < 5 cm
|
$910.80 |
$910.80 |
$910.80 |
$3,813.50
|
|
Exc neck tum deep 5 cm/>
|
$1,053.60 |
$1,053.60 |
$1,053.60 |
$3,386.84
|
|
Exc prtl bn phlnx toe
|
$1,527.60 |
$1,527.60 |
$1,527.60 |
$3,839.54
|
|
Exc rect tum transanal part
|
$1,128.00 |
$1,128.00 |
$1,128.00 |
$3,786.00
|
|
Exc shoulder tum deep < 5 cm
|
$1,015.20 |
$1,015.20 |
$1,015.20 |
$3,849.30
|
|
Exc skn hdrdnt ax smpl/ntrm
|
$321.60 |
$321.60 |
$321.60 |
$3,386.84
|
