|
ER Visit (level 1, minor)
|
$149.00 |
$149.00 |
$149.00 |
$245.60
|
|
ER Visit (level 2)
|
$272.00 |
$272.00 |
$272.00 |
$452.20
|
|
ER Visit (level 3)
|
$479.00 |
$479.00 |
$479.00 |
$770.04
|
|
ER Visit (level 4)
|
$787.00 |
$787.00 |
$787.00 |
$1,273.68
|
|
ER Visit (level 5, high severity)
|
$1,138.50 |
$1,138.50 |
$1,138.50 |
$1,828.80
|
|
Esophageal dilat s&i
|
$3,040.00 |
$3,040.00 |
$3,040.00 |
$581.10
|
|
Esophagosc flex trnsn biopsy
|
$1,042.50 |
$1,042.50 |
$1,042.50 |
$1,768.00
|
|
Esophagoscopy flex biopsy
|
$2,206.00 |
$2,206.00 |
$2,206.00 |
$2,132.00
|
|
Esophagoscopy/flex/diagnostic 43200
|
$1,042.50 |
$1,042.50 |
$1,042.50 |
$1,296.00
|
|
Esophagoscopy flex dx brush
|
$1,042.50 |
$1,042.50 |
$1,042.50 |
$1,872.00
|
|
Esophagus motility study
|
$719.00 |
$719.00 |
$719.00 |
$1,300.00
|
|
Established Patient Office Visit (level 1)
|
$84.00 |
$84.00 |
$84.00 |
$121.00
|
|
Established Patient Office Visit (level 2)
|
$84.00 |
$84.00 |
$84.00 |
$137.91
|
|
Estradiol total
|
$201.00 |
$201.00 |
$201.00 |
$151.20
|
|
Estrogens total-sendout
|
$18.50 |
$18.50 |
$18.50 |
$96.63
|
|
Ethylene glycol -sendout
|
$1,018.00 |
$1,018.00 |
$1,018.00 |
$86.04
|
|
Etonogestrel implant system
|
$1,242.50 |
$1,242.50 |
$1,242.50 |
$2,071.74
|
|
Euflexxa inj per dose
|
$752.00 |
$752.00 |
$752.00 |
$510.68
|
|
Euglobulin lysis
|
$66.00 |
$66.00 |
$66.00 |
$59.15
|
|
Eval aud funcj ea addl 15
|
$31.00 |
$31.00 |
$31.00 |
$82.08
|
|
Eval aud rehab status/first hr 92626
|
$125.00 |
$125.00 |
$125.00 |
$293.69
|
|
Eval/fit voice prosthesis iii, st
|
$246.00 |
$246.00 |
$246.00 |
$350.00
|
|
Evaluation heart device
|
$2,446.00 |
$2,446.00 |
$2,446.00 |
$2,368.17
|
|
Evaluation of speech fluency 92521
|
$185.00 |
$185.00 |
$185.00 |
$311.50
|
|
Evaluation psychiatric diagnostic
|
$340.00 |
$340.00 |
$340.00 |
$313.30
|
|
Evasc repair of iliac artery; endograft 34718
|
$1,970.50 |
$1,970.50 |
$1,970.50 |
$6,824.35
|
|
Evasc rpr a-ao ndgft 34701
|
$6,792.00 |
$6,792.00 |
$6,792.00 |
$5,284.62
|
|
Evasc rpr a-ao ndgft rpt 34702
|
$6,792.00 |
$6,792.00 |
$6,792.00 |
$4,537.60
|
|
Evasc rpr a-biiliac ndgft rptr
|
$6,792.00 |
$6,792.00 |
$6,792.00 |
$8,133.60
|
|
Evasc rpr a-iliac ndgft 34717
|
$2,862.50 |
$2,862.50 |
$2,862.50 |
$4,846.34
|
|
Evasc rpr a-unilac ndgft 34703
|
$6,792.00 |
$6,792.00 |
$6,792.00 |
$5,689.05
|
|
Evasc rpr a-unilac ndgft rpt
|
$6,792.00 |
$6,792.00 |
$6,792.00 |
$5,902.40
|
|
Evasc rpr ilio-iliac ndgft
|
$3,006.50 |
$3,006.50 |
$3,006.50 |
$7,150.44
|
|
Evasc rpr ilio-iliac rpt
|
$3,006.50 |
$3,006.50 |
$3,006.50 |
$8,996.13
|
|
Evasc st rpr thrc/aa acrs br
|
$2,339.50 |
$2,339.50 |
$2,339.50 |
$5,062.50
|
|
Evasc st rpr thrc/aa x crsg
|
$1,751.00 |
$1,751.00 |
$1,751.00 |
$11,524.11
|
|
Event monitor
|
$73.50 |
$73.50 |
$73.50 |
$237.60
|
|
Evoked auditory tst complete
|
$135.00 |
$135.00 |
$135.00 |
$348.80
|
|
Evoked oa emissions ltd
|
$98.50 |
$98.50 |
$98.50 |
$244.00
|
|
Evoked potentials auditory screening automated analysis
|
$244.50 |
$244.50 |
$244.50 |
$259.20
|
|
Evoked potentials upper limbs
|
$551.50 |
$551.50 |
$551.50 |
$908.54
|
|
Evoked potential visual not glaucoma
|
$407.50 |
$407.50 |
$407.50 |
$819.00
|
|
Ewhfo w/joint(s) cf
|
$1,595.00 |
$1,595.00 |
$1,595.00 |
$1,595.00
|
|
Ewho w/joint(s) cf
|
$1,079.00 |
$1,079.00 |
$1,079.00 |
$1,080.80
|
|
Exam of vagina w/scope 57420
|
$350.50 |
$350.50 |
$350.50 |
$486.03
|
|
Exam pelvic add-on
|
$15.50 |
$15.50 |
$15.50 |
$41.60
|
|
Exc arm/elbo les sc >=3cm 24071
|
$3,341.50 |
$3,341.50 |
$3,341.50 |
$4,078.80
|
|
Exc arm/elbo les sc <3cm 24075
|
$1,898.50 |
$1,898.50 |
$1,898.50 |
$2,413.45
|
|
Exc back les sbq <3 cm 21930
|
$1,898.50 |
$1,898.50 |
$1,898.50 |
$2,676.58
|
|
Exc back tum deep 5 cm/>
|
$3,341.50 |
$3,341.50 |
$3,341.50 |
$3,805.88
|
|
Exc bartholins gland/cyst
|
$3,721.00 |
$3,721.00 |
$3,721.00 |
$3,786.00
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$1,898.50 |
$1,898.50 |
$1,898.50 |
$2,271.01
|
|
Exc benign feenlm >4.0cm 11446
|
$3,339.00 |
$3,339.00 |
$3,339.00 |
$3,386.84
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$1,898.50 |
$1,898.50 |
$1,898.50 |
$2,271.01
|
|
Exc benign tal 0.5 < cm 11400
|
$814.00 |
$814.00 |
$814.00 |
$827.77
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$814.00 |
$814.00 |
$814.00 |
$969.60
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$883.50 |
$883.50 |
$883.50 |
$1,136.64
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$1,898.50 |
$1,898.50 |
$1,898.50 |
$2,061.19
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$814.00 |
$814.00 |
$814.00 |
$1,491.00
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$1,898.50 |
$1,898.50 |
$1,898.50 |
$2,271.01
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$3,339.00 |
$3,339.00 |
$3,339.00 |
$3,455.25
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$639.00 |
$639.00 |
$639.00 |
$768.00
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$822.00 |
$822.00 |
$822.00 |
$1,247.50
|
|
Exc ext ear/partial/simple repair 69110
|
$3,339.00 |
$3,339.00 |
$3,339.00 |
$3,167.89
|
|
Exc face tum deep 2cm/> 21014
|
$3,339.00 |
$3,339.00 |
$3,339.00 |
$3,386.84
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$862.50 |
$862.50 |
$862.50 |
$973.71
|
|
Exc feenl mal+mrg 2.1-3 11643
|
$2,008.50 |
$2,008.50 |
$2,008.50 |
$2,101.45
|
|
Exc foot/toe tum subq < 1.5 cm 28043
|
$1,898.50 |
$1,898.50 |
$1,898.50 |
$3,230.00
|
|
Exc hand les sc < 1.5 cm
|
$1,898.50 |
$1,898.50 |
$1,898.50 |
$1,897.50
|
|
Exc hand tum deep < 1.5 cm 26116
|
$1,898.50 |
$1,898.50 |
$1,898.50 |
$2,271.01
|
|
Exchange biliary drg cath
|
$3,426.50 |
$3,426.50 |
$3,426.50 |
$3,854.69
|
|
Exchange drainage catheter
|
$3,831.50 |
$3,831.50 |
$3,831.50 |
$2,206.00
|
|
Exchange nephrostomy cath
|
$2,853.00 |
$2,853.00 |
$2,853.00 |
$2,955.48
|
|
Exc hidradenitis ing simpl 11462
|
$3,339.00 |
$3,339.00 |
$3,339.00 |
$3,386.84
|
|
Exc hidradenitis peri/umb comp 11471
|
$3,339.00 |
$3,339.00 |
$3,339.00 |
$3,386.84
|
|
Exc hidradenitis peri/umb int 11470
|
$3,339.00 |
$3,339.00 |
$3,339.00 |
$3,386.84
|
|
Excimer lsr psriasis<250sqcm
|
$231.00 |
$231.00 |
$231.00 |
$347.88
|
|
Exc im tumor/foot/toe < 1.5 cm 28045
|
$3,341.50 |
$3,341.50 |
$3,341.50 |
$3,370.52
|
|
Excise anal ext tag/papilla
|
$1,607.00 |
$1,607.00 |
$1,607.00 |
$1,956.80
|
|
Excise lip or cheek fold
|
$1,783.50 |
$1,783.50 |
$1,783.50 |
$1,855.10
|
|
Excise pharynx lesion
|
$3,811.00 |
$3,811.00 |
$3,811.00 |
$3,837.72
|
|
Excise/repair mouth lesion
|
$1,783.50 |
$1,783.50 |
$1,783.50 |
$1,903.93
|
|
Excise subq tumor/abd wall <3 cm 22902
|
$1,898.50 |
$1,898.50 |
$1,898.50 |
$2,701.00
|
|
Excision aural polyp
|
$1,783.50 |
$1,783.50 |
$1,783.50 |
$1,981.50
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$814.00 |
$814.00 |
$814.00 |
$861.70
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$1,898.50 |
$1,898.50 |
$1,898.50 |
$2,019.16
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$814.00 |
$814.00 |
$814.00 |
$1,072.24
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$1,898.50 |
$1,898.50 |
$1,898.50 |
$2,865.00
|
|
Excision lesion mouth roof
|
$3,811.00 |
$3,811.00 |
$3,811.00 |
$3,837.72
|
|
Excision nasal polyp(s) simple 30110
|
$1,783.50 |
$1,783.50 |
$1,783.50 |
$1,752.89
|
|
Excision of anal lesion(s)
|
$3,682.00 |
$3,682.00 |
$3,682.00 |
$3,816.64
|
|
Excision of gum lesion 41825
|
$4,212.00 |
$4,212.00 |
$4,212.00 |
$4,007.22
|
|
Excision of penis lesion(s) 54060
|
$2,371.50 |
$2,371.50 |
$2,371.50 |
$2,479.33
|
|
Excision of tongue lesion
|
$3,811.00 |
$3,811.00 |
$3,811.00 |
$3,819.23
|
|
Excision olecranon bursa
|
$3,799.50 |
$3,799.50 |
$3,799.50 |
$2,889.60
|
|
Excision tongue lesion without closure 41110
|
$3,811.00 |
$3,811.00 |
$3,811.00 |
$3,811.00
|
|
Excision tumor soft tissue back/flank subcutaneous >= 3 cm
|
$1,904.00 |
$1,904.00 |
$1,904.00 |
$3,650.40
|
|
Exc les conjunctiva <1 cm
|
$2,732.50 |
$2,732.50 |
$2,732.50 |
$2,760.73
|
|
Exc les conjunctiva >1 cm
|
$2,733.00 |
$2,733.00 |
$2,733.00 |
$2,760.73
|
|
Exc les/mucos/sub/ves mouth/no rpr 40810
|
$3,811.00 |
$3,811.00 |
$3,811.00 |
$2,591.37
|
