|
Cystouretero w/stone remove
|
$361.50 |
$2,530.50 |
$10,832.67 |
|
|
Cystourethroscop/calib/dilat stric 52281
|
$157.00 |
$2,537.67 |
$6,372.00 |
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$146.50 |
$2,403.00 |
$8,478.67 |
|
|
Cystourethro w/addl implant 52442
|
$51.50 |
$53.00 |
$4,166.67 |
|
|
Cystourethro w/implant
|
$213.00 |
$218.50 |
$2,602.67 |
|
|
Cysto w/renal stricture tx
|
$350.50 |
$350.50 |
$560.80 |
|
|
Cysto w/ureter stricture tx
|
$289.50 |
$294.50 |
$4,612.83 |
|
|
Cytarabine 20 mg/ml injection solution
|
$0.28 |
$2.75 |
$68.55 |
|
|
Cytogenetics 25-99
|
$68.50 |
$165.50 |
$627.00 |
|
|
Cytogenetics 3-5
|
$35.00 |
$55.00 |
$88.00 |
|
|
Cytogenomic neo microra alys
|
$1,882.75 |
$1,882.75 |
$1,882.75 |
|
|
Cytogenom microarray copy nmbr var
|
$1,159.00 |
$2,298.00 |
$2,807.00 |
|
|
Cytomegalovirus (cmv) antibody igg
|
$32.00 |
$72.50 |
$218.50 |
|
|
Cytomegalovirus (cmv) antibody igm
|
$10.00 |
$80.00 |
$218.50 |
|
|
Cytomegalovirus dfa
|
$65.50 |
$65.50 |
$112.50 |
|
|
Cyto/molecular report
|
$34.00 |
$36.00 |
$567.50 |
|
|
Cytopath fl nongyn filter
|
$19.00 |
$19.50 |
$107.50 |
|
|
Cytopathology cellular enhancement technique non-gyn
|
$29.00 |
$90.00 |
$510.00 |
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$32.50 |
$86.50 |
$212.00 |
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$50.00 |
$80.50 |
$118.20 |
|
|
Cytopathology concentration technique smears & interpretation
|
$23.50 |
$71.00 |
$304.50 |
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$27.50 |
$68.50 |
$330.00 |
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$21.50 |
$22.50 |
$65.00 |
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$41.50 |
$119.50 |
$460.50 |
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$68.50 |
$146.50 |
$660.00 |
|
|
Cytopath smear other source
|
$22.50 |
$92.00 |
$114.50 |
|
|
Cytopath smear other source
|
$38.50 |
$40.50 |
$263.00 |
|
|
Cytopath smear oth prep screen & interp
|
$25.00 |
$26.50 |
$88.50 |
|
|
Cytopath tbs c/v manual
|
$29.00 |
$50.50 |
$95.00 |
|
|
Cytotoxic antibody screening
|
$298.50 |
$298.50 |
$298.50 |
|
|
Cytp urine 3-5 probes cmptr
|
$175.50 |
$175.50 |
$741.50 |
|
|
Dacarbazine 100 mg intravenous solution
|
$39.32 |
$43.56 |
$104.76 |
|
|
Dactinomycin 0.5 mg intravenous solution
|
$3,024.59 |
$3,024.59 |
$3,024.59 |
|
|
Dalbavancin 500 mg intravenous solution
|
$13.50 |
$5,117.40 |
$9,733.50 |
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.50 |
$37.20 |
$1,012.92 |
|
|
Daptomycin (xellia) unrefrig
|
$24.80 |
$24.80 |
$99.22 |
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$14,958.79 |
$19,945.05 |
$26,504.40 |
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$11.50 |
$17.00 |
$12,903.60 |
|
|
Darbepoetin alfa, esrd use
|
$11.50 |
$17.00 |
$1,137.60 |
|
|
Dark field exam without collj
|
$61.00 |
$61.00 |
$61.00 |
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$227.00 |
$227.00 |
$227.00 |
|
|
D&c after delivery 59160
|
$199.00 |
$3,721.00 |
$6,839.00 |
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$240.50 |
$3,780.50 |
$6,570.00 |
|
|
Dch glucoscan
|
$7.00 |
$11.50 |
$30.00 |
|
|
Dch pulmonary stress test
|
$424.80 |
$446.50 |
$822.50 |
|
|
Dch validity tests
|
$8.00 |
$13.50 |
$36.00 |
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$1,870.50 |
$2,250.00 |
$4,702.00 |
|
|
Dcmprn plantar digital nerve
|
$6,923.50 |
$6,923.50 |
$6,923.50 |
|
|
Deamidated gliadin antibody iga
|
$11.40 |
$50.50 |
$285.00 |
|
|
Debr g/per/abd wall 11006
|
$151.50 |
$751.00 |
$1,700.50 |
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$28.00 |
$30.50 |
$1,859.50 |
|
|
Debridement (>20 cm) charge pt
|
$25.00 |
$278.50 |
$3,334.50 |
|
|
Debridement bone <= 20 sq cm
|
$234.00 |
$2,316.00 |
$50,740.00 |
|
|
Debridement/bone/20 sq cm or less 11046
|
$56.50 |
$396.50 |
$6,882.25 |
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$101.00 |
$1,046.50 |
$4,572.00 |
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$145.80 |
$1,729.00 |
$7,916.51 |
|
|
Debride nail1-5 11720
|
$15.00 |
$90.50 |
$1,804.67 |
|
|
Debride nail6 or more 11721
|
$56.50 |
$111.50 |
$494.50 |
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$307.50 |
$792.00 |
$8,775.00 |
|
|
Debride skin bone at fx site
|
$422.50 |
$676.00 |
$10,519.75 |
|
|
Debride skn/sq/musc/abd wall 11004
|
$600.50 |
$636.00 |
$8,032.50 |
|
|
Debride skn/sq t/m/f necro infctj abdl wall 11005
|
$831.50 |
$832.50 |
$28,291.00 |
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$26.00 |
$858.50 |
$3,546.00 |
|
|
Debrid mastoidectomy cavity simple 69220
|
$51.00 |
$128.00 |
$887.00 |
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$285.00 |
$831.00 |
$4,881.67 |
|
|
Debr inf skin add-on 11001
|
$14.50 |
$14.50 |
$23.20 |
|
|
Debr musc/fascia 20sq cm/< 11043
|
$335.40 |
$1,884.67 |
$10,409.34 |
|
|
Decalcification
|
$12.50 |
$44.50 |
$106.00 |
|
|
Decitabine 50 mg intravenous solution
|
$51.53 |
$72.56 |
$3,314.64 |
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$327.00 |
$469.50 |
$1,180.00 |
|
|
Decomp fasct leg ant+/lat+pst cmprt 27602
|
$510.00 |
$520.50 |
$4,575.00 |
|
|
Decomp forearm 1 space 25020
|
$738.50 |
$894.00 |
$9,028.50 |
|
|
Decompress forearm 1 space
|
$1,336.00 |
$1,384.50 |
$2,215.20 |
|
|
Decompression of leg
|
$873.50 |
$875.50 |
$1,400.80 |
|
|
Decompression of lower leg
|
$461.00 |
$469.50 |
$2,174.75 |
|
|
Decompression of tibia nerve
|
$377.50 |
$389.00 |
$8,311.67 |
|
|
Decompression unspecified nerve 64722
|
$1,442.13 |
$1,442.13 |
$1,442.13 |
|
|
Decompress optic nerve
|
$9,398.00 |
$9,398.00 |
$9,398.00 |
|
|
Decompress small bowel
|
$1,049.50 |
$1,069.00 |
$1,710.40 |
|
|
Decompress spinal cord lmbr
|
$5,605.50 |
$5,605.50 |
$13,065.00 |
|
|
Deep muscle biopsy 20205
|
$166.00 |
$3,046.00 |
$5,791.50 |
|
|
Deferoxamine 500 mg solution for injection
|
$46.13 |
$46.22 |
$78.05 |
|
|
Degarelix 120 mg subcutaneous solution
|
$6.00 |
$9.60 |
$2,151.09 |
|
|
Delayed breast prosthesis 19342
|
$5,144.00 |
$15,198.08 |
$62,540.00 |
|
|
Delay flap eye/nos/ear/lip
|
$2,052.50 |
$2,404.50 |
$6,784.00 |
|
|
Delay flap fccnaxghf 15620
|
$6,504.00 |
$6,504.00 |
$12,523.00 |
|
|
Delivery of placenta 59414
|
$100.50 |
$160.80 |
$3,152.00 |
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$695.50 |
$711.50 |
$6,994.50 |
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$112.50 |
$180.00 |
$466.00 |
|
|
Denervation of hip joint
|
$2,038.80 |
$2,038.80 |
$2,038.80 |
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$45.50 |
$4,993.01 |
$7,988.81 |
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$157.50 |
$200.00 |
$5,813.50 |
|
|
Dermabrasion other than face
|
$3,710.00 |
$3,710.00 |
$3,710.00 |
|
|
Dermabrasion segmental face 15781
|
$1,108.00 |
$2,909.50 |
$4,368.00 |
|
|
Dermabrasion suprfl any site
|
$467.50 |
$490.00 |
$965.00 |
|
|
Dermabrasion total face
|
$3,710.00 |
$3,710.00 |
$3,710.00 |
|
|
Derma-fat-fascia graft 15770
|
$2,465.25 |
$2,465.25 |
$2,465.25 |
|
|
Dermapure 1 square cm
|
$47.00 |
$48.50 |
$191.20 |
|
|
Derm autograft face/nck/hf/g
|
$759.00 |
$784.50 |
$3,488.50 |
|
|
Descend thora aorta rpr/lt sub art 33880
|
$4,970.00 |
$4,970.00 |
$7,774.50 |
|
