|
Destruction mal lsn s/n/h/f/g 3.1-4cm
|
$519.50 |
$519.50 |
$519.50 |
$558.97
|
|
Destruction mal lsn t/a/l 3.1-4cm
|
$482.00 |
$482.00 |
$482.00 |
$482.00
|
|
Destruction mal lsn t/a/l >4cm
|
$594.00 |
$594.00 |
$594.00 |
$569.80
|
|
Destruction penis lesion(s) chem 54050
|
$270.50 |
$270.50 |
$270.50 |
$332.00
|
|
Destruction penis lesion(s) exten 54065
|
$3,170.00 |
$3,170.00 |
$3,170.00 |
$2,507.31
|
|
Destruction premal lesions 15/> 17004
|
$298.50 |
$298.50 |
$298.50 |
$442.61
|
|
Destruction vag lesions simple 57061
|
$2,548.50 |
$2,548.50 |
$2,548.50 |
$3,815.20
|
|
Determine refractive state
|
$30.00 |
$30.00 |
$30.00 |
$21.50
|
|
Device ablt adv novasure
|
$4,842.50 |
$4,842.50 |
$4,842.50 |
$6,237.48
|
|
Device tiss remov myosure reach
|
$3,868.50 |
$3,868.50 |
$3,868.50 |
$2,466.14
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$50.50 |
$50.50 |
$50.50 |
$227.15
|
|
Dhea-s (dehydroepiand sulfate)
|
$97.50 |
$97.50 |
$97.50 |
$111.60
|
|
Diabetes (HbA1c) Test
|
$76.50 |
$76.50 |
$76.50 |
$79.20
|
|
Diab manage trn ind/group
|
$42.00 |
$42.00 |
$42.00 |
$54.99
|
|
Diagnostic anoscopy
|
$173.00 |
$173.00 |
$173.00 |
$392.70
|
|
Diagnostic anoscopy spx 46600
|
$173.00 |
$173.00 |
$173.00 |
$190.68
|
|
Diagnostic digital breast tomosynthesis bil
|
$468.50 |
$468.50 |
$468.50 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$414.00 |
$414.00 |
$414.00 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$269.00 |
$269.00 |
$269.00 |
$334.95
|
|
Diagnostic Mammogram (both breasts)
|
$414.00 |
$414.00 |
$414.00 |
$413.50
|
|
Diagnostic Mammogram (one breast)
|
$358.50 |
$358.50 |
$358.50 |
$312.72
|
|
Diagnostic radio unlisted proc
|
$574.50 |
$574.50 |
$574.50 |
$243.60
|
|
Dialysis circuit perm vascular embolization 36909
|
$5,728.50 |
$5,728.50 |
$5,728.50 |
$5,663.50
|
|
Dialysis one evaluation
|
$335.00 |
$335.00 |
$335.00 |
$936.00
|
|
Diffusing capacity
|
$227.00 |
$227.00 |
$227.00 |
$335.20
|
|
Digital analysis of eeg
|
$1,058.50 |
$1,058.50 |
$1,058.50 |
$551.20
|
|
Digoxin total therapeutic drug level
|
$80.00 |
$80.00 |
$80.00 |
$102.07
|
|
Dilate biliary duct/ampulla
|
$1,396.00 |
$1,396.00 |
$1,396.00 |
$1,729.70
|
|
Dilate esophagus 1/mult pass
|
$853.50 |
$853.50 |
$853.50 |
$1,490.36
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$2,455.50 |
$2,455.50 |
$2,455.50 |
$3,026.10
|
|
Dilate ic vasospasm ea add vsl same territory
|
$2,241.00 |
$2,241.00 |
$2,241.00 |
$1,895.00
|
|
Dilate ic vasospasm init
|
$3,920.00 |
$3,920.00 |
$3,920.00 |
$4,627.52
|
|
Dilate tear duct opening
|
$266.50 |
$266.50 |
$266.50 |
$454.40
|
|
Dilate urethra stricture
|
$377.50 |
$377.50 |
$377.50 |
$496.00
|
|
Dilate urethra stricture
|
$196.50 |
$196.50 |
$196.50 |
$200.80
|
|
Dilate urethra stricture
|
$234.50 |
$234.50 |
$234.50 |
$343.55
|
|
Dilation/female urethra/initial 53660
|
$256.50 |
$256.50 |
$256.50 |
$235.61
|
|
Dilation of anal sphincter
|
$5,901.50 |
$5,901.50 |
$5,901.50 |
$1,995.20
|
|
Dilation of cervical canal 57800
|
$1,997.00 |
$1,997.00 |
$1,997.00 |
$4,376.00
|
|
Dilation of rectal stricture 45910
|
$3,947.00 |
$3,947.00 |
$3,947.00 |
$2,263.80
|
|
Dilation of salivary duct
|
$511.50 |
$511.50 |
$511.50 |
$750.00
|
|
Dilation of urethra
|
$243.00 |
$243.00 |
$243.00 |
$172.00
|
|
Dilation/urethral strict/male/ini 53620
|
$3,166.00 |
$3,166.00 |
$3,166.00 |
$1,372.80
|
|
Dilator fascial 10fx20cm
|
$237.50 |
$237.50 |
$237.50 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$1,985.00 |
$1,985.00 |
$1,985.00 |
$3,883.16
|
|
Dilat xst trc new access rcs
|
$3,339.00 |
$3,339.00 |
$3,339.00 |
$4,258.20
|
|
Disability dlco
|
$213.00 |
$213.00 |
$213.00 |
$292.03
|
|
Disaccharidases
|
$177.50 |
$177.50 |
$177.50 |
$224.31
|
|
Discography cerv/thor spine
|
$1,244.50 |
$1,244.50 |
$1,244.50 |
$2,481.50
|
|
Dise eval slp do brth flx dx
|
$1,600.50 |
$1,600.50 |
$1,600.50 |
$1,120.00
|
|
Dissolve clot heart vessel
|
$1,560.00 |
$1,560.00 |
$1,560.00 |
$1,560.00
|
|
Dlyd plmt xtn prosth ea addl
|
$299.50 |
$299.50 |
$299.50 |
$1,875.00
|
|
Dna antibody native/double stranded
|
$109.00 |
$109.00 |
$109.00 |
$100.00
|
|
Doppler echo complete
|
$475.00 |
$475.00 |
$475.00 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$5,221.50 |
$5,221.50 |
$5,221.50 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$649.50 |
$649.50 |
$649.50 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$473.50 |
$473.50 |
$473.50 |
$473.76
|
|
Dornhoffer fixed part w/window
|
$41,761.50 |
$41,761.50 |
$41,761.50 |
$34,278.00
|
|
Dorsi & plantar flex ass/res
|
$162.50 |
$162.50 |
$162.50 |
$163.50
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$494.00 |
$494.00 |
$494.00 |
$794.82
|
|
Drainage ext aud canal abscess 69020
|
$494.00 |
$494.00 |
$494.00 |
$914.34
|
|
Drainage external ear complex 69005
|
$1,539.50 |
$1,539.50 |
$1,539.50 |
$2,888.03
|
|
Drainage external ear simple 69000
|
$494.00 |
$494.00 |
$494.00 |
$779.45
|
|
Drainage mouth roof lesion
|
$895.00 |
$895.00 |
$895.00 |
$405.60
|
|
Drainage of arm bursa 23931
|
$3,389.50 |
$3,389.50 |
$3,389.50 |
$2,271.01
|
|
Drainage of eye
|
$2,302.50 |
$2,302.50 |
$2,302.50 |
$2,415.65
|
|
Drainage of eye
|
$2,756.50 |
$2,756.50 |
$2,756.50 |
$3,170.00
|
|
Drainage of kidney lesion
|
$1,110.50 |
$1,110.50 |
$1,110.50 |
$1,506.00
|
|
Drainage of mouth lesion
|
$2,823.00 |
$2,823.00 |
$2,823.00 |
$3,837.72
|
|
Drainage of mouth lesion
|
$827.50 |
$827.50 |
$827.50 |
$905.30
|
|
Drainage of nose lesion int 30000
|
$312.00 |
$312.00 |
$312.00 |
$548.00
|
|
Drainage of nose lesion sept 30020
|
$604.00 |
$604.00 |
$604.00 |
$781.44
|
|
Drainage of urethra abscess 53060
|
$2,882.50 |
$2,882.50 |
$2,882.50 |
$2,424.12
|
|
Drain bladder by trocar/cath
|
$775.00 |
$775.00 |
$775.00 |
$1,198.14
|
|
Drain blood from under nail 11740
|
$95.00 |
$95.00 |
$95.00 |
$177.04
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$1,698.00 |
$1,698.00 |
$1,698.00 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$2,741.00 |
$2,741.00 |
$2,741.00 |
$2,885.30
|
|
Drain cerebro spinal fluid 62272
|
$718.00 |
$718.00 |
$718.00 |
$1,025.00
|
|
Drain chst dry seal exp thorastat
|
$100.00 |
$100.00 |
$100.00 |
$119.43
|
|
Drain finger abscess;simple 26010
|
$284.00 |
$284.00 |
$284.00 |
$428.40
|
|
Drain lower leg lesion 27603
|
$2,737.50 |
$2,737.50 |
$2,737.50 |
$3,858.40
|
|
Drain neck/chest lesion 21501
|
$2,012.00 |
$2,012.00 |
$2,012.00 |
$3,301.20
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$437.50 |
$437.50 |
$437.50 |
$394.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$362.00 |
$362.00 |
$362.00 |
$352.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$734.00 |
$734.00 |
$734.00 |
$540.80
|
|
Dressing change not for burn w/anes 15852
|
$412.00 |
$412.00 |
$412.00 |
$724.37
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$3,878.50 |
$3,878.50 |
$3,878.50 |
$5,857.52
|
|
Drill hole implt ventricular cath/device 61107
|
$651.00 |
$651.00 |
$651.00 |
$1,485.75
|
|
Drng of eyelid abscess 67700
|
$645.00 |
$645.00 |
$645.00 |
$655.72
|
|
Drng of finger abscess comp 26011
|
$2,079.50 |
$2,079.50 |
$2,079.50 |
$2,029.60
|
|
Drng of hydrocele 55000
|
$812.00 |
$812.00 |
$812.00 |
$832.60
|
|
Drng of mouth lesion 40801
|
$1,404.00 |
$1,404.00 |
$1,404.00 |
$1,350.97
|
|
Drng of ovarian cyst(s) 58800
|
$3,478.50 |
$3,478.50 |
$3,478.50 |
$3,474.84
|
|
Drng of salivary cyst 42409
|
$4,001.00 |
$4,001.00 |
$4,001.00 |
$3,819.23
|
|
Drng of scrotum abscess 55100
|
$1,819.50 |
$1,819.50 |
$1,819.50 |
$1,997.89
|
|
Drng peritoneal abscess open 49020
|
$1,601.00 |
$1,601.00 |
$1,601.00 |
$2,520.00
|
|
Drng salivary gland simple 42300
|
$1,404.00 |
$1,404.00 |
$1,404.00 |
$2,039.50
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$7,319.00 |
$7,319.00 |
$7,319.00 |
$1,818.32
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$76.50 |
$76.50 |
$76.50 |
$1,575.70
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$25.50 |
$25.50 |
$25.50 |
$58.20
|
