|
ER Visit (level 1, minor)
|
$247.00 |
$247.00 |
$247.00 |
$246.24
|
|
ER Visit (level 2)
|
$446.00 |
$446.00 |
$446.00 |
$452.20
|
|
ER Visit (level 3)
|
$671.50 |
$671.50 |
$671.50 |
$770.04
|
|
ER Visit (level 4)
|
$1,091.00 |
$1,091.00 |
$1,091.00 |
$1,273.68
|
|
ER Visit (level 5, high severity)
|
$1,933.50 |
$1,933.50 |
$1,933.50 |
$1,820.02
|
|
Esophageal dilat s&i
|
$719.00 |
$719.00 |
$719.00 |
$581.10
|
|
Esophagoscopy balloon <30mm
|
$3,462.50 |
$3,462.50 |
$3,462.50 |
$2,460.00
|
|
Esophagoscopy flex biopsy
|
$1,856.00 |
$1,856.00 |
$1,856.00 |
$2,132.00
|
|
Esophagoscopy/flex/diagnostic 43200
|
$706.00 |
$706.00 |
$706.00 |
$1,296.00
|
|
Esophagoscopy flex remove fb
|
$2,140.00 |
$2,140.00 |
$2,140.00 |
$2,099.70
|
|
Esophagoscopy/rigid/diagnostic 43191
|
$1,869.50 |
$1,869.50 |
$1,869.50 |
$2,660.00
|
|
Esoph egd dilation <30 mm
|
$2,811.00 |
$2,811.00 |
$2,811.00 |
$2,656.80
|
|
Established Patient Office Visit (level 1)
|
$63.00 |
$63.00 |
$63.00 |
$120.25
|
|
Established Patient Office Visit (level 2)
|
$63.00 |
$63.00 |
$63.00 |
$132.72
|
|
Established Patient Office Visit (level 3)
|
$70.50 |
$70.50 |
$70.50 |
$183.00
|
|
Established Patient Office Visit (level 4)
|
$104.00 |
$104.00 |
$104.00 |
$231.75
|
|
Established Patient Office Visit (level 5)
|
$154.00 |
$154.00 |
$154.00 |
$280.33
|
|
Estradiol total
|
$144.00 |
$144.00 |
$144.00 |
$146.50
|
|
Estrogens total-sendout
|
$113.00 |
$113.00 |
$113.00 |
$96.20
|
|
Ethylene glycol -sendout
|
$77.50 |
$77.50 |
$77.50 |
$89.40
|
|
Etonogestrel implant system
|
$1,242.50 |
$1,242.50 |
$1,242.50 |
$2,081.30
|
|
Etoposide 20 mg/ml intravenous solution
|
$50.06 |
$50.06 |
$50.06 |
$235.20
|
|
Euflexxa inj per dose
|
$752.00 |
$752.00 |
$752.00 |
$587.51
|
|
Euglobulin lysis
|
$66.00 |
$66.00 |
$66.00 |
$56.70
|
|
Eval aud funcj ea addl 15
|
$97.00 |
$97.00 |
$97.00 |
$85.80
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$325.50 |
$325.50 |
$325.50 |
$219.60
|
|
Evaluation of speech fluency 92521
|
$363.00 |
$363.00 |
$363.00 |
$311.50
|
|
Evaluation psychiatric diagnostic
|
$102.50 |
$102.50 |
$102.50 |
$312.00
|
|
Event monitor
|
$43.00 |
$43.00 |
$43.00 |
$242.65
|
|
Evoked oa emissions ltd
|
$182.50 |
$182.50 |
$182.50 |
$234.32
|
|
Evoked potentials auditory screening automated analysis
|
$218.00 |
$218.00 |
$218.00 |
$249.71
|
|
Exam of vagina w/scope 57420
|
$1,290.08 |
$1,290.08 |
$1,290.08 |
$486.03
|
|
Exam pelvic add-on
|
$17.50 |
$17.50 |
$17.50 |
$41.60
|
|
Exam plvc w/anes othr thn lcl
|
$2,066.00 |
$2,066.00 |
$2,066.00 |
$3,762.53
|
|
Ex arm/elbow tum deep < 5 cm
|
$1,945.50 |
$1,945.50 |
$1,945.50 |
$3,386.84
|
|
Exc abd les sc 3 cm/>
|
$4,499.00 |
$4,499.00 |
$4,499.00 |
$3,796.00
|
|
Exc arm/elbo les sc >=3cm 24071
|
$3,876.50 |
$3,876.50 |
$3,876.50 |
$4,078.80
|
|
Exc arm/elbo les sc <3cm 24075
|
$3,359.00 |
$3,359.00 |
$3,359.00 |
$2,413.45
|
|
Exc back les sbq <3 cm 21930
|
$3,739.00 |
$3,739.00 |
$3,739.00 |
$2,676.58
|
|
Exc bartholins gland/cyst
|
$7,004.50 |
$7,004.50 |
$7,004.50 |
$3,762.53
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$1,898.50 |
$1,898.50 |
$1,898.50 |
$2,244.20
|
|
Exc benign feenlm >4.0cm 11446
|
$2,628.25 |
$2,628.25 |
$2,628.25 |
$3,386.84
|
|
Exc benign tal 0.5 < cm 11400
|
$1,846.75 |
$1,846.75 |
$1,846.75 |
$827.40
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$9,819.00 |
$9,819.00 |
$9,819.00 |
$914.34
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$4,195.00 |
$4,195.00 |
$4,195.00 |
$1,135.40
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$5,992.50 |
$5,992.50 |
$5,992.50 |
$2,061.19
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$4,043.00 |
$4,043.00 |
$4,043.00 |
$1,372.15
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$3,085.50 |
$3,085.50 |
$3,085.50 |
$2,166.78
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$1,846.67 |
$1,846.67 |
$1,846.67 |
$765.50
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$2,285.00 |
$2,285.00 |
$2,285.00 |
$1,247.50
|
|
Exc ext ear/partial/simple repair 69110
|
$2,492.67 |
$2,492.67 |
$2,492.67 |
$3,127.88
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$4,651.00 |
$4,651.00 |
$4,651.00 |
$973.71
|
|
Exc foot/toe tum subq < 1.5 cm 28043
|
$3,967.00 |
$3,967.00 |
$3,967.00 |
$3,230.00
|
|
Exc forearm les sc 3 cm/>
|
$2,599.00 |
$2,599.00 |
$2,599.00 |
$3,628.50
|
|
Exc forearm tum deep 3 cm/>
|
$2,057.88 |
$2,057.88 |
$2,057.88 |
$3,994.09
|
|
Exc hand les sc < 1.5 cm
|
$4,955.00 |
$4,955.00 |
$4,955.00 |
$1,897.50
|
|
Exc hand tum deep < 1.5 cm 26116
|
$4,119.00 |
$4,119.00 |
$4,119.00 |
$2,271.01
|
|
Exchange nephrostomy cath
|
$7,257.00 |
$7,257.00 |
$7,257.00 |
$2,958.80
|
|
Exc im tumor/shoulder area 5cm/> 23073
|
$6,703.00 |
$6,703.00 |
$6,703.00 |
$3,486.52
|
|
Excise anal ext tag/papilla
|
$2,976.00 |
$2,976.00 |
$2,976.00 |
$1,710.00
|
|
Excise inferior turbinate
|
$2,582.25 |
$2,582.25 |
$2,582.25 |
$3,589.62
|
|
Excise lip or cheek fold
|
$3,391.00 |
$3,391.00 |
$3,391.00 |
$1,855.10
|
|
Excise parotid gland/lesion
|
$9,211.00 |
$9,211.00 |
$9,211.00 |
$6,553.49
|
|
Excise parotid gland/lesion
|
$18,214.00 |
$18,214.00 |
$18,214.00 |
$7,000.36
|
|
Excise parotid gland/lesion
|
$17,884.00 |
$17,884.00 |
$17,884.00 |
$6,839.00
|
|
Excise/repair mouth lesion
|
$1,666.50 |
$1,666.50 |
$1,666.50 |
$1,903.93
|
|
Excise submaxillary gland
|
$7,645.50 |
$7,645.50 |
$7,645.50 |
$6,547.81
|
|
Excise subq tumor/abd wall <3 cm 22902
|
$3,435.00 |
$3,435.00 |
$3,435.00 |
$2,623.00
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$2,847.34 |
$2,847.34 |
$2,847.34 |
$832.60
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$6,268.50 |
$6,268.50 |
$6,268.50 |
$1,973.12
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$3,131.00 |
$3,131.00 |
$3,131.00 |
$1,012.86
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$2,363.50 |
$2,363.50 |
$2,363.50 |
$2,865.00
|
|
Excision breast lesion
|
$9,856.50 |
$9,856.50 |
$9,856.50 |
$3,749.85
|
|
Excision floor mouth lesion 41116
|
$3,055.00 |
$3,055.00 |
$3,055.00 |
$3,892.91
|
|
Excision lesion mouth roof
|
$3,283.00 |
$3,283.00 |
$3,283.00 |
$3,837.72
|
|
Excision of anal lesion(s)
|
$5,715.00 |
$5,715.00 |
$5,715.00 |
$3,786.00
|
|
Excision of gum lesion
|
$2,523.00 |
$2,523.00 |
$2,523.00 |
$6,547.81
|
|
Excision of tongue lesion
|
$4,358.50 |
$4,358.50 |
$4,358.50 |
$3,811.00
|
|
Excision of uvula
|
$2,107.67 |
$2,107.67 |
$2,107.67 |
$3,811.00
|
|
Excision of vaginal septum 57130
|
$1,829.00 |
$1,829.00 |
$1,829.00 |
$3,762.53
|
|
Excision olecranon bursa
|
$8,223.00 |
$8,223.00 |
$8,223.00 |
$2,889.60
|
|
Excision tongue lesion without closure 41110
|
$2,138.00 |
$2,138.00 |
$2,138.00 |
$3,786.00
|
|
Excision tumor soft tissue back/flank subcutaneous >= 3 cm
|
$6,095.00 |
$6,095.00 |
$6,095.00 |
$3,650.40
|
|
Exc leg/ankle tum dep 5 cm/ > 27634
|
$6,019.00 |
$6,019.00 |
$6,019.00 |
$3,386.84
|
|
Exc les conjunctiva >1 cm
|
$2,733.00 |
$2,733.00 |
$2,733.00 |
$2,760.73
|
|
Exc malig feenl >4cm 11646
|
$4,106.50 |
$4,106.50 |
$4,106.50 |
$3,083.21
|
|
Exc malig tal <0.5cm 11600
|
$7,083.00 |
$7,083.00 |
$7,083.00 |
$973.20
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$5,791.00 |
$5,791.00 |
$5,791.00 |
$889.20
|
|
Exc mal+marg tal 2.1-3 cm 11603
|
$3,815.00 |
$3,815.00 |
$3,815.00 |
$1,131.50
|
|
Exc mal+marg tal 3.1-4 cm 11604
|
$1,986.00 |
$1,986.00 |
$1,986.00 |
$1,294.80
|
|
Exc neck tum deep < 5 cm
|
$6,095.00 |
$6,095.00 |
$6,095.00 |
$3,501.81
|
|
Exc neck tum deep 5 cm/>
|
$5,164.50 |
$5,164.50 |
$5,164.50 |
$3,386.84
|
|
Exc/pilonidal cyst/sinus/simple 11770
|
$5,411.00 |
$5,411.00 |
$5,411.00 |
$3,386.84
|
|
Exc prtl bn phlnx toe
|
$4,704.50 |
$4,704.50 |
$4,704.50 |
$3,752.25
|
|
Exc rect tum transanal full
|
$4,119.00 |
$4,119.00 |
$4,119.00 |
$3,245.23
|
|
Exc rect tum transanal part
|
$3,055.00 |
$3,055.00 |
$3,055.00 |
$3,245.23
|
|
Exc shoulder tum deep < 5 cm
|
$2,083.83 |
$2,083.83 |
$2,083.83 |
$3,786.00
|
|
Exc skn hdrdnt ax smpl/ntrm
|
$10,316.50 |
$10,316.50 |
$10,316.50 |
$3,386.84
|
|
Exc snhfg mal+mrg 3.1-4 11624
|
$2,515.50 |
$2,515.50 |
$2,515.50 |
$2,014.93
|
|
Exc sq tum/leg or ankle area <3 cm 27618
|
$3,967.00 |
$3,967.00 |
$3,967.00 |
$2,310.40
|
