|
Excise subq tumor/abd wall <3 cm 22902
|
$1,974.40 |
$1,974.40 |
$1,974.40 |
$3,322.80
|
|
Excise tendon forearm/wrist
|
$5,076.80 |
$5,076.80 |
$5,076.80 |
$3,839.54
|
|
Excise wrist tendon sheath
|
$3,595.20 |
$3,595.20 |
$3,595.20 |
$2,211.05
|
|
Excision addl breast lesion 19126
|
$1,047.20 |
$1,047.20 |
$1,047.20 |
$761.80
|
|
Excision aural polyp
|
$2,436.80 |
$2,436.80 |
$2,436.80 |
$2,133.48
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$600.80 |
$600.80 |
$600.80 |
$914.34
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$5,073.45 |
$5,073.45 |
$5,073.45 |
$2,064.75
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$576.80 |
$576.80 |
$576.80 |
$1,072.24
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$1,964.00 |
$1,964.00 |
$1,964.00 |
$2,865.00
|
|
Excision breast lesion
|
$3,748.00 |
$3,748.00 |
$3,748.00 |
$4,064.45
|
|
Excision coa w/graft
|
$16,232.00 |
$16,232.00 |
$16,232.00 |
$1,923.76
|
|
Excision floor mouth lesion 41116
|
$1,570.40 |
$1,570.40 |
$1,570.40 |
$3,892.91
|
|
Excision graft extremity
|
$2,924.00 |
$2,924.00 |
$2,924.00 |
$4,881.00
|
|
Excision gum each quadrant
|
$1,213.60 |
$1,213.60 |
$1,213.60 |
$4,560.40
|
|
Excision hand/finger tendon
|
$4,841.60 |
$4,841.60 |
$4,841.60 |
$3,839.54
|
|
Excision lesion mouth roof
|
$1,672.80 |
$1,672.80 |
$1,672.80 |
$3,837.72
|
|
Excision lesion mouth roof
|
$2,406.40 |
$2,406.40 |
$2,406.40 |
$6,465.11
|
|
Excision nasal polyp(s) simple 30110
|
$3,302.40 |
$3,302.40 |
$3,302.40 |
$1,752.89
|
|
Excision of anal lesion(s)
|
$856.00 |
$856.00 |
$856.00 |
$3,823.00
|
|
Excision of bowel lesion(s)
|
$3,429.60 |
$3,429.60 |
$3,429.60 |
$2,420.80
|
|
Excision of gum flap
|
$274.40 |
$274.40 |
$274.40 |
$2,000.80
|
|
Excision of gum lesion
|
$1,672.80 |
$1,672.80 |
$1,672.80 |
$1,944.80
|
|
Excision of gum lesion
|
$2,301.60 |
$2,301.60 |
$2,301.60 |
$7,000.36
|
|
Excision of gum lesion
|
$2,301.60 |
$2,301.60 |
$2,301.60 |
$4,560.40
|
|
Excision of gum lesion
|
$2,406.40 |
$2,406.40 |
$2,406.40 |
$6,547.81
|
|
Excision of gum lesion
|
$1,672.80 |
$1,672.80 |
$1,672.80 |
$3,710.62
|
|
Excision of gum lesion 41825
|
$1,672.80 |
$1,672.80 |
$1,672.80 |
$4,007.22
|
|
Excision of lingual tonsil
|
$1,278.40 |
$1,278.40 |
$1,278.40 |
$6,465.11
|
|
Excision of meckels diverticulum 44800
|
$3,736.00 |
$3,736.00 |
$3,736.00 |
$1,373.40
|
|
Excision of mouth lesion complex 40816
|
$2,407.20 |
$2,407.20 |
$2,407.20 |
$4,627.00
|
|
Excision of neck cyst
|
$3,783.20 |
$3,783.20 |
$3,783.20 |
$6,150.92
|
|
Excision of neck cyst confined 42810
|
$3,452.80 |
$3,452.80 |
$3,452.80 |
$4,560.40
|
|
Excision of penis lesion(s) 54060
|
$2,284.00 |
$2,284.00 |
$2,284.00 |
$2,837.09
|
|
Excision of salivary cyst
|
$1,884.00 |
$1,884.00 |
$1,884.00 |
$4,558.89
|
|
Excision of stomach lesion
|
$3,407.20 |
$3,407.20 |
$3,407.20 |
$1,494.24
|
|
Excision of tongue lesion
|
$1,570.40 |
$1,570.40 |
$1,570.40 |
$3,837.72
|
|
Excision of tongue lesion
|
$2,124.00 |
$2,124.00 |
$2,124.00 |
$4,558.89
|
|
Excision of tongue lesion w/closure 41113
|
$1,570.40 |
$1,570.40 |
$1,570.40 |
$3,837.72
|
|
Excision of tonsil tags
|
$997.60 |
$997.60 |
$997.60 |
$4,350.00
|
|
Excision of umbilicus 49250
|
$2,447.20 |
$2,447.20 |
$2,447.20 |
$3,986.00
|
|
Excision of uvula
|
$1,048.00 |
$1,048.00 |
$1,048.00 |
$3,837.72
|
|
Excision olecranon bursa
|
$2,889.60 |
$2,889.60 |
$2,889.60 |
$3,591.33
|
|
Excision radial head
|
$4,216.80 |
$4,216.80 |
$4,216.80 |
$3,986.00
|
|
Excision tongue lesion without closure 41110
|
$1,570.40 |
$1,570.40 |
$1,570.40 |
$3,819.23
|
|
Excision tumor soft tissue back/flank subcutaneous >= 3 cm
|
$2,614.40 |
$2,614.40 |
$2,614.40 |
$4,420.32
|
|
Excis partial tal calc
|
$3,991.20 |
$3,991.20 |
$3,991.20 |
$3,594.44
|
|
Excis uppr jaw cyst w/repair
|
$5,788.80 |
$5,788.80 |
$5,788.80 |
$6,839.00
|
|
Exc leg/ankle tum dep 5 cm/ > 27634
|
$4,918.40 |
$4,918.40 |
$4,918.40 |
$3,531.45
|
|
Exc leg/ankle tum subfasc<5cm 27619
|
$2,787.20 |
$2,787.20 |
$2,787.20 |
$3,127.88
|
|
Exc les/mucos/sub/ves mouth/no rpr 40810
|
$1,781.60 |
$1,781.60 |
$1,781.60 |
$3,104.42
|
|
Exc malig feenl <0.5cm 11640
|
$1,055.20 |
$1,055.20 |
$1,055.20 |
$1,186.00
|
|
Exc malig feenl 1.1-2 11642
|
$1,444.80 |
$1,444.80 |
$1,444.80 |
$1,082.00
|
|
Exc malig feenl 3.1-4.0 11644
|
$2,208.00 |
$2,208.00 |
$2,208.00 |
$2,070.30
|
|
Exc malig feenl >4cm 11646
|
$3,008.80 |
$3,008.80 |
$3,008.80 |
$3,253.05
|
|
Exc malig snhfg 0.5cm or less 11620
|
$1,053.60 |
$1,053.60 |
$1,053.60 |
$1,377.57
|
|
Exc malig snhfg 0.6-1.0 cm 11621
|
$1,078.40 |
$1,078.40 |
$1,078.40 |
$1,064.70
|
|
Exc malig snhfg 2.1-3 cm 11623
|
$1,929.60 |
$1,929.60 |
$1,929.60 |
$1,954.00
|
|
Exc malig tal <0.5cm 11600
|
$1,053.60 |
$1,053.60 |
$1,053.60 |
$973.71
|
|
Exc malig tal 0.6-1.0cm 11601
|
$620.80 |
$620.80 |
$620.80 |
$832.60
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$640.80 |
$640.80 |
$640.80 |
$889.20
|
|
Exc mal+marg tal 2.1-3 cm 11603
|
$1,126.40 |
$1,126.40 |
$1,126.40 |
$1,207.80
|
|
Exc mal+marg tal 3.1-4 cm 11604
|
$1,136.80 |
$1,136.80 |
$1,136.80 |
$1,294.80
|
|
Exc mandible 21025
|
$4,389.60 |
$4,389.60 |
$4,389.60 |
$6,289.53
|
|
Exc neck tum deep < 5 cm
|
$2,197.60 |
$2,197.60 |
$2,197.60 |
$3,813.50
|
|
Exc neck tum deep 5 cm/>
|
$3,488.00 |
$3,488.00 |
$3,488.00 |
$3,386.84
|
|
Exc of facial bones/osteomy/abcess 21026
|
$2,212.80 |
$2,212.80 |
$2,212.80 |
$5,753.00
|
|
Exc/pilonidal cyst/sinus/simple 11770
|
$8,243.00 |
$8,243.00 |
$8,243.00 |
$3,386.84
|
|
Exc prtl bn phlnx toe
|
$3,636.80 |
$3,636.80 |
$3,636.80 |
$3,839.54
|
|
Exc rect tum transanal full
|
$2,426.40 |
$2,426.40 |
$2,426.40 |
$4,119.00
|
|
Exc rect tum transanal part
|
$1,800.80 |
$1,800.80 |
$1,800.80 |
$3,786.00
|
|
Exc sac pr ulc prim str ostc
|
$2,529.60 |
$2,529.60 |
$2,529.60 |
$3,994.09
|
|
Exc sac pr ulc skn flp ostc
|
$2,532.80 |
$2,532.80 |
$2,532.80 |
$4,332.25
|
|
Exc sacral pr ulc prim sutr
|
$2,529.60 |
$2,529.60 |
$2,529.60 |
$3,386.84
|
|
Exc sacral pr ulc skn flap
|
$2,529.60 |
$2,529.60 |
$2,529.60 |
$4,332.25
|
|
Exc shoulder tum deep < 5 cm
|
$5,657.60 |
$5,657.60 |
$5,657.60 |
$3,849.30
|
|
Exc skn hdrdnt ax complex
|
$4,004.80 |
$4,004.80 |
$4,004.80 |
$3,494.40
|
|
Exc skn hdrdnt ax smpl/ntrm
|
$3,869.60 |
$3,869.60 |
$3,869.60 |
$3,386.84
|
|
Exc skn hdrdnt ing complex
|
$4,011.20 |
$4,011.20 |
$4,011.20 |
$3,994.09
|
|
Exc snhfg mal+mrg 1.1-2 11622
|
$1,126.40 |
$1,126.40 |
$1,126.40 |
$1,274.00
|
|
Exc snhfg mal+mrg 3.1-4 11624
|
$1,963.20 |
$1,963.20 |
$1,963.20 |
$2,171.00
|
|
Exc snhfg mal+mrg >4 cm 11626
|
$2,640.00 |
$2,640.00 |
$2,640.00 |
$3,386.84
|
|
Exc sq tum/leg or ankle area <3 cm 27618
|
$3,073.60 |
$3,073.60 |
$3,073.60 |
$2,937.55
|
|
Exc sq tum/neck/ant thorax 3cm/> 21552
|
$1,816.80 |
$1,816.80 |
$1,816.80 |
$4,744.88
|
|
Exc sq tum/neck or ant thorax <3cm 21555
|
$2,558.40 |
$2,558.40 |
$2,558.40 |
$3,322.80
|
|
Exc sq tumor/foot or toe < 1.5 cm 28039
|
$5,329.60 |
$5,329.60 |
$5,329.60 |
$4,160.80
|
|
Exc sq tumor/forearm/wrist/<3cm 25075
|
$3,092.80 |
$3,092.80 |
$3,092.80 |
$2,924.22
|
|
Exc sq tumor/leg/ankle 3cm/> 27632
|
$2,773.60 |
$2,773.60 |
$2,773.60 |
$4,425.20
|
|
Exc sq tumor/shoulder area 3cm/> 23071
|
$3,352.80 |
$3,352.80 |
$3,352.80 |
$4,014.40
|
|
Exc sq tumor/thigh/knee area 3cm/> 27337
|
$3,425.60 |
$3,425.60 |
$3,425.60 |
$4,019.60
|
|
Exc sq tum/vasc malform/hand/fngr 26111
|
$3,170.40 |
$3,170.40 |
$3,170.40 |
$1,917.33
|
|
Exc subq tum/sft tis/pel/hip 3cm/> 27043
|
$3,304.80 |
$3,304.80 |
$3,304.80 |
$4,529.20
|
|
Exc tendon sheath or cap lesion 26160
|
$2,008.00 |
$2,008.00 |
$2,008.00 |
$2,797.08
|
|
Exc thigh/knee les sc<3cm 27327
|
$3,999.20 |
$3,999.20 |
$3,999.20 |
$3,229.48
|
|
Exc thigh/knee tum deep <5cm
|
$3,290.40 |
$3,290.40 |
$3,290.40 |
$3,306.79
|
|
Exc thrombosed hemorrhoid 46320
|
$5,959.75 |
$5,959.75 |
$5,959.75 |
$2,175.36
|
|
Exc tmr sft tiss shldr subq <3cm
|
$3,070.40 |
$3,070.40 |
$3,070.40 |
$3,059.15
|
|
Exc torus mandibularis 21031
|
$2,256.80 |
$2,256.80 |
$2,256.80 |
$3,837.72
|
|
Exc trchntric pr ulcer w/prim sutr w/ostectomy 15951
|
$2,529.60 |
$2,529.60 |
$2,529.60 |
$3,425.00
|
|
Exc trchntr pr ulc flp clsr
|
$1,694.40 |
$1,694.40 |
$1,694.40 |
$2,837.09
|
|
Exc trchntr pr ulc flp ostc
|
$3,367.20 |
$3,367.20 |
$3,367.20 |
$4,332.25
|