10060	"INCISION AND DRAINAGE OF ABSCESS (E.G., CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS OR SUBCUTANEOUS ABSCESS, CYST, FURUNCLE, OR PARONYCHIA)"	"7,098.00"	"5,460.00"	"1,638.00"
10080	INCISION AND DRAINAGE OF PILONIDAL CYST	"7,098.00"	"5,460.00"	"1,638.00"
10120	"INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS
TISSUES"	"7,098.00"	"5,460.00"	"1,638.00"
10140	"INCISION AND DRAINAGE OF HEMATOMA, SEROMA, OR FLUID
COLLECTION"	"7,098.00"	"5,460.00"	"1,638.00"
10160	"PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST"	"7,098.00"	"5,460.00"	"1,638.00"
10180	"INCISION AND DRAINAGE, COMPLEX, POSTOPERATIVE WOUND
INFECTION"	"10,842.00"	"8,385.00"	"2,457.00"
11000	DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN	"20,553.00"	"10,725.00"	"9,828.00"
11010	"DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL
ASSOCIATED W/ OPEN FRACTURE(S) AND/OR DISLOCATION(S); SKIN AND SUBCUTANEOUS TISSUES"	"20,553.00"	"10,725.00"	"9,828.00"
11011	"DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOCIATED W/ OPEN FRACTURE(S) AND/OR DISLOCATION(S); SKIN, SUBCUTANEOUS TISSUE, MUSCLE FASCIA, AND MUSCLE"	"23,361.00"	"11,895.00"	"11,466.00"
11012	"DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOCIATED W/ OPEN FRACTURE(S) AND/OR DISLOCATION(S); SKIN, SUBCUTANEOUS TISSUE, MUSCLE FASCIA, MUSCLE, AND
BONE"	"23,634.00"	"10,530.00"	"13,104.00"
11040	"DEBRIDEMENT; SKIN, PARTIAL THICKNESS"	"7,098.00"	"5,460.00"	"1,638.00"
11041	"DEBRIDEMENT; SKIN, FULL THICKNESS"	"7,098.00"	"5,460.00"	"1,638.00"
11042	"DEBRIDEMENT; SKIN, AND SUBCUTANEOUS TISSUE"	"11,076.00"	"7,800.00"	"3,276.00"
11043	"DEBRIDEMENT; SKIN, SUBCUTANEOUS TISSUE, AND MUSCLE"	"15,639.00"	"10,725.00"	"4,914.00"
11044	"DEBRIDEMENT; SKIN, SUBCUTANEOUS TISSUE, MUSCLE, AND
BONE"	"15,639.00"	"10,725.00"	"4,914.00"
11100	"BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE (INCLUDING SIMPLE CLOSURE), UNLESS OTHERWISE
LISTED; SINGLE OR MULTIPLE LESION"	"7,098.00"	"5,460.00"	"1,638.00"
11300	"SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 0.5 CM OR LESS"	"10,842.00"	"8,385.00"	"2,457.00"
11301	"SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 0.6 TO 1.0 CM"	"7,215.00"	"4,594.20"	"2,620.80"
11302	"SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 1.1 TO 2.0 CM"	"15,639.00"	"10,725.00"	"4,914.00"
11303	"SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER OVER 2.0 CM"	"16,458.00"	"10,725.00"	"5,733.00"
11305	"SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.5 CM
OR LESS"	"10,842.00"	"8,385.00"	"2,457.00"
11306	"SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.6 TO
1.0 CM"	"7,215.00"	"4,594.20"	"2,620.80"
11307	"SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 1.1 TO
2.0 CM"	"15,639.00"	"10,725.00"	"4,914.00"
11308	"SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER OVER
2.0 CM"	"16,458.00"	"10,725.00"	"5,733.00"
11310	"SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION,
FACE, EARS, EYELIDS, NOSE ,LIPS, MUCOUS MEMBRANE; LESION DIAMETER 0.5 CM OR LESS"	"7,215.00"	"4,594.20"	"2,620.80"
11311	"SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, EYELIDS, NOSE ,LIPS, MUCOUS MEMBRANE; LESION
DIAMETER 0.6 TO 1.0 CM"	"15,639.00"	"10,725.00"	"4,914.00"
11312	"SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, EYELIDS, NOSE ,LIPS, MUCOUS MEMBRANE; LESION
DIAMETER 1.1 TO 2.0 CM"	"16,458.00"	"10,725.00"	"5,733.00"
11313	"SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, EYELIDS, NOSE ,LIPS, MUCOUS MEMBRANE; LESION
DIAMETER OVER 2.0 CM"	"16,107.00"	"9,555.00"	"6,552.00"
11400	"EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; LESION DIAMETER 0.5 CM
OR LESS"	"7,098.00"	"5,460.00"	"1,638.00"
11401	"EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; LESION DIAMETER 0.6 TO
1.0 CM"	"7,098.00"	"5,460.00"	"1,638.00"
11402	"EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; LESION DIAMETER 1.1 TO
2.0 CM"	"7,098.00"	"5,460.00"	"1,638.00"
11403	"EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; LESION DIAMETER 2.1 TO
3.0 CM"	"7,098.00"	"5,460.00"	"1,638.00"
11404	"EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; LESION DIAMETER 3.1 TO
4.0 CM"	"7,098.00"	"5,460.00"	"1,638.00"
11406	"EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), TRUNK, ARMS OR LEGS; LESION DIAMETER OVER
4.0 CM"	"7,098.00"	"5,460.00"	"1,638.00"
11420	"EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; LESION
DIAMETER 0.5 CM OR LESS"	"7,098.00"	"5,460.00"	"1,638.00"
11421	"EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; LESION
DIAMETER 0.6 TO 1.0 CM"	"7,098.00"	"5,460.00"	"1,638.00"
11422	"EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED ELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; LESION
DIAMETER 1.1 TO 2.0 CM"	"7,098.00"	"5,460.00"	"1,638.00"
11423	"EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED
ELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 2.1 TO 3.0 CM"	"7,098.00"	"5,460.00"	"1,638.00"
11424	"EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED
ELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 3.1 TO 4.0 CM"	"7,098.00"	"5,460.00"	"1,638.00"
11426	"EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED
ELSEWHERE), SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER OVER 4.0 CM"	"7,098.00"	"5,460.00"	"1,638.00"
11440	"EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE),
FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 0.5 CM OR LESS"	"8,010.60"	"6,045.00"	"1,965.60"
11441	"EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE),
FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 0.6 TO 1.0 CM"	"8,010.60"	"6,045.00"	"1,965.60"
11442	"EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE),
FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 1.1 TO 2.0 CM"	"8,010.60"	"6,045.00"	"1,965.60"
11443	"EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE),
FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 2.1 TO 3.0 CM"	"8,010.60"	"6,045.00"	"1,965.60"
11444	"EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION
DIAMETER 3.1 TO 4.0 CM"	"8,010.60"	"6,045.00"	"1,965.60"
11446	"EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION
DIAMETER OVER 4.0 CM"	"8,010.60"	"6,045.00"	"1,965.60"
11450	"EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR
HIDRADENITIS, AXILLARY"	"15,639.00"	"10,725.00"	"4,914.00"
11462	"EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR
HIDRADENITIS, INGUINAL"	"15,639.00"	"10,725.00"	"4,914.00"
11470	"EXCISION OF SKIN AND SUBCUTANEOUS TISSUE FOR
HIDRADENITIS, PERIANAL, PERINEAL OR UMBILICAL"	"15,639.00"	"10,725.00"	"4,914.00"
11600	"EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESION
DIAMETER 0.5 CM OR LESS"	"10,842.00"	"8,385.00"	"2,457.00"
11601	"EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESION
DIAMETER 0.6 TO 1.0 CM"	"10,842.00"	"8,385.00"	"2,457.00"
11602	"EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESION
DIAMETER 1.1 TO 2.0 CM"	"10,842.00"	"8,385.00"	"2,457.00"
11603	"EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESION
DIAMETER 2.1 TO 3.0 CM"	"10,842.00"	"8,385.00"	"2,457.00"
11604	"EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESION
DIAMETER 3.1 TO 4.0 CM"	"10,842.00"	"8,385.00"	"2,457.00"
11606	"EXCISION, MALIGNANT LESION, TRUNK, ARMS, OR LEGS; LESION
DIAMETER OVER 4.0 CM"	"10,842.00"	"8,385.00"	"2,457.00"
11620	"EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET,
GENITALIA; LESION DIAMETER 0.5 CM OR LESS"	"11,076.00"	"7,800.00"	"3,276.00"
11621	"EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET,
GENITALIA; LESION DIAMETER 0.6 TO 1.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
11622	"EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET,
GENITALIA; LESION DIAMETER 1.1 TO 2.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
11623	"EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET,
GENITALIA; LESION DIAMETER 2.1 TO 3.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
11624	"EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET,
GENITALIA; LESION DIAMETER 3.1 TO 4.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
11626	"EXCISION, MALIGNANT LESION, SCALP, NECK, HANDS, FEET,
GENITALIA; LESION DIAMETER OVER 4.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
11640	"EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS;
LESION DIAMETER 0.5 CM OR LESS"	"11,076.00"	"7,800.00"	"3,276.00"
11641	"EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS;
LESION DIAMETER 0.6 TO 1.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
11642	"EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS;
LESION DIAMETER 1.1 TO 2.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
11643	"EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS;
LESION DIAMETER 2.1 TO 3.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
11644	"EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS;
LESION DIAMETER 3.1 TO 4.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
11646	"EXCISION, MALIGNANT LESION, FACE, EARS, EYELIDS, NOSE, LIPS;
LESION DIAMETER OVER 4.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
11720	DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); ONE TO FIVE	"7,098.00"	"5,460.00"	"1,638.00"
11721	DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); SIX OR MORE	"10,842.00"	"8,385.00"	"2,457.00"
11730	"AVULSION OF NAIL PLATE, PARTIAL OR COMPLETE"	"7,098.00"	"5,460.00"	"1,638.00"
11740	EVACUATION OF SUBUNGUAL HEMATOMA	"7,098.00"	"5,460.00"	"1,638.00"
11750	"EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE (E.G., INGROWN OR DEFORMED NAIL) FOR PERMANENT REMOVAL"	"7,098.00"	"5,460.00"	"1,638.00"
11752	"EXCISION OF NAIL AND NAIL MATRIX, PARTIAL OR COMPLETE (E.G., INGROWN OR DEFORMED NAIL) FOR PERMANENT REMOVAL W/ AMPUTATION OF TUFT OF DISTAL PHALANX"	"18,135.00"	"14,040.00"	"4,095.00"
11755	"BIOPSY OF NAIL UNIT, ANY METHOD (E.G., PLATE, BED, MATRIX, HYPONYCHIUM, PROXIMAL AND LATERAL NAIL FOLDS)"	"7,098.00"	"5,460.00"	"1,638.00"
11760	REPAIR OF NAIL BED	"10,842.00"	"8,385.00"	"2,457.00"
11762	RECONSTRUCTION OF NAIL BED W/ GRAFT	"18,135.00"	"14,040.00"	"4,095.00"
11765	"WEDGE EXCISION OF SKIN OF NAIL FOLD (E.G., FOR INGROWN
TOENAIL)"	"7,098.00"	"5,460.00"	"1,638.00"
11770	EXCISION OF PILONIDAL CYST OR SINUS	"11,076.00"	"7,800.00"	"3,276.00"
12001	"SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); 2.5 CM OR LESS"	"7,098.00"	"5,460.00"	"1,638.00"
12002	"SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); 2.6 CM TO 7.5 CM"	"10,842.00"	"8,385.00"	"2,457.00"
12004	"SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); 7.6 CM TO 12.5 CM"	"11,076.00"	"7,800.00"	"3,276.00"
12005	"SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); 12.6 CM TO 20.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
12006	"SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); 20.1 CM TO 30.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
12007	"SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF SCALP, NECK, AXILLAE, EXTERNAL GENITALIA, TRUNK AND/OR EXTREMITIES (INCLUDING HANDS AND FEET); OVER 30.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
12011	"SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 2.5 CM OR
LESS"	"11,076.00"	"7,800.00"	"3,276.00"
12013	"SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 2.6 CM TO 5.0
CM"	"18,135.00"	"14,040.00"	"4,095.00"
12014	"SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 5.1 CM TO 7.5
CM"	"18,626.40"	"14,040.00"	"4,586.40"
12015	"SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 7.6 CM TO
12.5 CM"	"15,639.00"	"10,725.00"	"4,914.00"
12016	"SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 12.6 CM TO
20.0 CM"	"15,639.00"	"10,725.00"	"4,914.00"
12017	"SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; 20.1 CM TO
30.0 CM"	"15,639.00"	"10,725.00"	"4,914.00"
12018	"SIMPLE REPAIR OF SUPERFICIAL WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANES; OVER 30.0
CM"	"15,639.00"	"10,725.00"	"4,914.00"
12031	"LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK, AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET); 2.5 CM OR LESS"	"7,098.00"	"5,460.00"	"1,638.00"
12032	"LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK, AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET); 2.6 CM TO 7.5 CM"	"10,842.00"	"8,385.00"	"2,457.00"
12034	"LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK, AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET); 7.6 CM TO 12.5 CM"	"11,076.00"	"7,800.00"	"3,276.00"
12035	"LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK, AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET); 12.6 CM TO 20.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
12036	"LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK, AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET); 20.1 CM TO 30.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
12037	"LAYER CLOSURE OF WOUNDS OF SCALP, AXILLAE, TRUNK, AND/OR EXTREMITIES (EXCLUDING HANDS AND FEET); OVER 30.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
12041	"LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR
EXTERNAL GENITALIA; 2.5 CM OR LESS"	"11,076.00"	"7,800.00"	"3,276.00"
12042	"LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR
EXTERNAL GENITALIA; 2.6 CM TO 7.5 CM"	"18,135.00"	"14,040.00"	"4,095.00"
12044	"LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR
EXTERNAL GENITALIA; 7.6 CM TO 12.5 CM"	"15,639.00"	"10,725.00"	"4,914.00"
12045	"LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR
EXTERNAL GENITALIA; 12.6 CM TO 20.0 CM"	"16,458.00"	"10,725.00"	"5,733.00"
12046	"LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR
EXTERNAL GENITALIA; 20.1 CM TO 30.0 CM"	"16,107.00"	"9,555.00"	"6,552.00"
12047	"LAYER CLOSURE OF WOUNDS OF NECK, HANDS, FEET AND/OR
EXTERNAL GENITALIA; OVER 30.0 CM"	"21,216.00"	"13,845.00"	"7,371.00"
12051	"LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS
AND/OR MUCOUS MEMBRANCES; 2.5 CM OR LESS"	"11,076.00"	"7,800.00"	"3,276.00"
12052	"LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANCES; 2.6 CM TO 5.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
12053	"LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANCES; 5.1 CM TO 7.5 CM"	"15,639.00"	"10,725.00"	"4,914.00"
12054	"LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANCES; 7.6 CM TO 12.5 CM"	"15,639.00"	"10,725.00"	"4,914.00"
12055	"LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANCES; 12.6 CM TO 20.0 CM"	"16,107.00"	"9,555.00"	"6,552.00"
12056	"LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS AND/OR MUCOUS MEMBRANCES; 20.1 CM TO 30.0 CM"	"16,107.00"	"9,555.00"	"6,552.00"
12057	"LAYER CLOSURE OF WOUNDS OF FACE, EARS, EYELIDS, NOSE, LIPS
AND/OR MUCOUS MEMBRANCES; OVER 30.0 CM"	"18,915.00"	"10,725.00"	"8,190.00"
14000	"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK;
DEFECT 10 SQ CM OR LESS"	"23,634.00"	"10,530.00"	"13,104.00"
14001	"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK;
DEFECT 10.1 SQ CM TO 30.0 SQ CM"	"23,634.00"	"10,530.00"	"13,104.00"
14020	"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS
AND/OR LEGS; DEFECT 10 SQ CM OR LESS"	"20,553.00"	"10,725.00"	"9,828.00"
14021	"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS
AND/OR LEGS; DEFECT 10.1 SQ CM TO 30.0 SQ CM"	"23,361.00"	"11,895.00"	"11,466.00"
14040	"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; DEFECT 10 SQ CM OR LESS"	"23,634.00"	"10,530.00"	"13,104.00"
14041	"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; DEFECT 10.1 SQ CM TO 30.0 SQ CM"	"35,100.00"	"18,720.00"	"16,380.00"
14060	"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10 SQ CM OR LESS"	"35,100.00"	"18,720.00"	"16,380.00"
14061	"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10.1 SQ CM TO 30.0 SQ CM"	"35,100.00"	"18,720.00"	"16,380.00"
14300	"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, MORE THAN
30 SQ CM, UNUSUAL OR COMPLICATED, ANY AREA"	"35,100.00"	"18,720.00"	"16,380.00"
14350	"FILLETED FINGER OR TOE FLAP, INCLUDING PREPARATION OF
RECIPIENT SITE"	"52,884.00"	"23,400.00"	"29,484.00"
15050	"PINCH GRAFT, SINGLE OR MULTIPLE, TO COVER SMALL ULCER, TIP
OR DIGIT, OR OTHER MINIMAL OPEN AREA (EXCEPT ON FACE), UP TO DEFECT SIZE 2 CM DIAMETER"	"16,107.00"	"9,555.00"	"6,552.00"
15100	"SPLIT GRAFT, TRUNK, SCALP, ARMS, LEGS, HANDS, AND/OR FEET (EXCEPT MULTIPLE DIGITS); 100 SQ CM OR LESS, OR EACH ONE PERCENT OF BODY AREA OF INFANTS AND CHILDREN (EXCEPT
15050)"	"16,107.00"	"9,555.00"	"6,552.00"
15120	"SPLIT GRAFT, FACE, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, AND/OR MULTIPLE DIGITS; 100 SQ CM OR LESS, OR EACH ONE PERCENT OF BODY AREA OF INFANTS AND CHILDREN
(EXCEPT 15050)"	"42,783.00"	"24,765.00"	"18,018.00"
15200	"FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF
DONOR SITE, TRUNK; 20 SQ CM OR LESS"	"42,783.00"	"24,765.00"	"18,018.00"
15220	"FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, SCALP, ARMS, AND/OR LEGS; 20 SQ CM OR LESS"	"42,783.00"	"24,765.00"	"18,018.00"
15240	"FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS, AND/OR FEET; 20 SQ CM OR LESS"	"59,943.00"	"33,735.00"	"26,208.00"
15260	"FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, NOSE, EARS, EYELIDS, AND/OR LIPS; 20 SQ CM OR
LESS"	"59,085.00"	"26,325.00"	"32,760.00"
15350	"APPLICATION OF ALLOGRAFT, SKIN"	"59,085.00"	"26,325.00"	"32,760.00"
15400	"APPLICATION OF XENOGRAFT, SKIN"	"59,085.00"	"26,325.00"	"32,760.00"
15570	"FORMATION OF DIRECT OR TUBED PEDICLE, W/ OR W/O
TRANSFER; TRUNK"	"35,100.00"	"18,720.00"	"16,380.00"
15572	"FORMATION OF DIRECT OR TUBED PEDICLE, W/ OR W/O
TRANSFER; SCALP, ARMS, OR LEGS"	"59,943.00"	"33,735.00"	"26,208.00"
15574	"FORMATION OF DIRECT OR TUBED PEDICLE, W/ OR W/O
TRANSFER; FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS OR FEET"	"59,943.00"	"33,735.00"	"26,208.00"
15576	"FORMATION OF DIRECT OR TUBED PEDICLE, W/ OR W/O
TRANSFER; EYELIDS, NOSE, EARS, LIPS OR INTRAORAL"	"59,085.00"	"26,325.00"	"32,760.00"
15580	"CROSS FINGER FLAP, INCLUDING FREE GRAFT TO DONOR SITE"	"42,783.00"	"24,765.00"	"18,018.00"
15650	"TRANSFER, INTERMEDIATE, OF ANY PEDICLE FLAP (E.G.,
ABDOMEN TO WRIST, ""WALKING"" TUBE), ANY LOCATION"	"42,783.00"	"24,765.00"	"18,018.00"
15732	"MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; HEAD AND NECK (E.G., TEMPORALIS, MASSETER,
STERNOCLEIDOMASTOID, LEVATOR SCAPULAE)"	"92,313.00"	"41,535.00"	"50,778.00"
15734	"MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; TRUNK"	"92,313.00"	"41,535.00"	"50,778.00"
15736	"MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; UPPER
EXTREMITY"	"92,313.00"	"41,535.00"	"50,778.00"
15738	"MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; LOWER
EXTREMITY"	"92,313.00"	"41,535.00"	"50,778.00"
15740	FLAP; ISLAND PEDICLE	"75,348.00"	"32,760.00"	"42,588.00"
15750	FLAP; NEUROVASCULAR PEDICLE	"75,348.00"	"32,760.00"	"42,588.00"
15756	"FREE MUSCLE FLAP W/ OR W/O SKIN GRAFT W/ MICROVASCULAR
ANASTOMOSIS"	"75,348.00"	"32,760.00"	"42,588.00"
15757	FREE SKIN FLAP W/ MICROVASCULAR ANASTOMOSIS	"75,348.00"	"32,760.00"	"42,588.00"
15758	FREE FASCIAL FLAP W/ MICROVASCULAR ANASTOMOSIS	"75,348.00"	"32,760.00"	"42,588.00"
15760	"GRAFT; COMPOSITE (E.G., FULL THICKNESS OF EXTERNAL EAR OR NASAL ALA), INCLUDING PRIMARY CLOSURE, DONOR AREA"	"42,783.00"	"24,765.00"	"18,018.00"
15770	GRAFT; DERMA-FAT-FASCIA	"42,783.00"	"24,765.00"	"18,018.00"
15820	"BLEPHAROPLASTY, LOWER EYELID"	"19,734.00"	"10,725.00"	"9,009.00"
15822	"BLEPHAROPLASTY, UPPER EYELID;"	"19,734.00"	"10,725.00"	"9,009.00"
15823	"BLEPHAROPLASTY, UPPER EYELID; WITH EXCESSIVE SKIN
WEIGHTING DOWN LID"	"23,361.00"	"11,895.00"	"11,466.00"
15840	"GRAFT FOR FACIAL NERVE PARALYSIS; FREE FASCIA  GRAFT
(INCLUDING OBTAINING FASCIA)"	"59,085.00"	"26,325.00"	"32,760.00"
15841	"GRAFT FOR FACIAL NERVE PARALYSIS; FREE MUSCLE GRAFT
(INCLUDING OBTAINING GRAFT)"	"59,085.00"	"26,325.00"	"32,760.00"
15842	"GRAFT FOR FACIAL NERVE PARALYSIS; FREE MUSCLE GRAFT BY
MICROSURGICAL TECHNIQUE"	"75,348.00"	"32,760.00"	"42,588.00"
15845	"GRAFT FOR FACIAL NERVE PARALYSIS; REGIONAL MUSCLE
TRANSFER"	"59,085.00"	"26,325.00"	"32,760.00"
15920	"EXCISION, COCCYGEAL PRESSURE ULCER, W/ COCCYGECTOMY; W/
PRIMARY SUTURE"	"59,943.00"	"33,735.00"	"26,208.00"
15922	"EXCISION, COCCYGEAL PRESSURE ULCER, W/ COCCYGECTOMY; W/
FLAP CLOSURE"	"59,085.00"	"26,325.00"	"32,760.00"
15931	"EXCISION, SACRAL PRESSURE ULCER, W/ PRIMARY SUTURE;"	"42,783.00"	"24,765.00"	"18,018.00"
15933	"EXCISION, SACRAL PRESSURE ULCER, W/ PRIMARY SUTURE; W/
OSTECTOMY"	"59,943.00"	"33,735.00"	"26,208.00"
15934	"EXCISION, SACRAL PRESSURE ULCER, W/ SKIN FLAP CLOSURE;"	"23,634.00"	"10,530.00"	"13,104.00"
15935	"EXCISION, SACRAL PRESSURE ULCER, W/ SKIN FLAP CLOSURE; W/
OSTECTOMY"	"59,085.00"	"26,325.00"	"32,760.00"
15936	"EXCISION, SACRAL PRESSURE ULCER, W/ MUSCLE OR
MYOCUTANEOUS FLAP CLOSURE;"	"74,958.00"	"36,465.00"	"38,493.00"
15937	"EXCISION, SACRAL PRESSURE ULCER, W/ MUSCLE OR
MYOCUTANEOUS FLAP CLOSURE; W/ OSTECTOMY"	"73,710.00"	"32,760.00"	"40,950.00"
15940	"EXCISION, ISCHIAL PRESSURE ULCER, W/ PRIMARY SUTURE;"	"23,634.00"	"10,530.00"	"13,104.00"
15941	"EXCISION, ISCHIAL PRESSURE ULCER, W/ PRIMARY SUTURE; W/
OSTECTOMY (ISCHIECTOMY)"	"42,783.00"	"24,765.00"	"18,018.00"
15944	"EXCISION, ISCHIAL PRESSURE ULCER, W/ SKIN FLAP CLOSURE;"	"59,943.00"	"33,735.00"	"26,208.00"
15945	"EXCISION, ISCHIAL PRESSURE ULCER, W/ SKIN FLAP CLOSURE; W/
OSTECTOMY"	"59,085.00"	"26,325.00"	"32,760.00"
15946	"EXCISION, ISCHIAL PRESSURE ULCER, W/ OSTECTOMY, W/
MUSCLE OR MYOCUTANEOUS FLAP CLOSURE"	"74,958.00"	"36,465.00"	"38,493.00"
15950	"EXCISION, TROCHANTERIC PRESSURE ULCER, W/ PRIMARY
SUTURE;"	"23,361.00"	"11,895.00"	"11,466.00"
15951	"EXCISION, TROCHANTERIC PRESSURE ULCER, W/ PRIMARY
SUTURE; W/ OSTECTOMY"	"42,783.00"	"24,765.00"	"18,018.00"
15952	"EXCISION, TROCHANTERIC PRESSURE ULCER, W/ SKIN FLAP
CLOSURE;"	"42,783.00"	"24,765.00"	"18,018.00"
15953	"EXCISION, TROCHANTERIC PRESSURE ULCER, W/ SKIN FLAP
CLOSURE; W/ OSTECTOMY"	"59,943.00"	"33,735.00"	"26,208.00"
15956	"EXCISION, TROCHANTERIC PRESSURE ULCER, W/ MUSCLE OR
MYOCUTANEOUS FLAP CLOSURE;"	"60,723.00"	"26,325.00"	"34,398.00"
15958	"EXCISION, TROCHANTERIC PRESSURE ULCER, W/ MUSCLE OR
MYOCUTANEOUS FLAP CLOSURE; W/ OSTECTOMY"	"74,958.00"	"36,465.00"	"38,493.00"
16010	"DRESSINGS AND/OR DEBRIDEMENT, INITIAL OR SUBSEQUENT"	"16,107.00"	"9,555.00"	"6,552.00"
16035	ESCHAROTOMY	"59,943.00"	"33,735.00"	"26,208.00"
16040	"EXCISION BURN WOUND, W/O SKIN GRAFTING, EMPLOYING
ALLOPLASTIC DRESSING (E.G., SYNTHETIC MESH), ANY ANATOMIC SITE"	"18,915.00"	"10,725.00"	"8,190.00"
17000	"DESTRUCTION BY ANY METHOD, INCLUDING LASER, W/ OR W/O SURGICAL CURETTEMENT, ALL BENIGN FACIAL LESIONS OR PREMALIGNANT LESIONS IN ANY LOCATION, OR BENIGN LESIONS OTHER THAN CUTANEOUS VASCULAR PROLIFERATIVE LESIONS, INCLUDING LOCAL ANESTHESIA; ANY NUMBER OF"	"11,700.00"	"7,410.00"	"4,290.00"
17106	"DESTRUCTION OF CUTANEOUS VASCULAR PROLIFERATIVE
LESIONS (E.G., LASER TECHNIQUE)"	"11,700.00"	"7,410.00"	"4,290.00"
17250	"CHEMICAL CAUTERIZATION OF GRANULATION TISSUE (PROUD
FLESH, SINUS OR FISTULA)"	"11,076.00"	"7,800.00"	"3,276.00"
17260	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK, ARMS
OR LEGS; LESION DIAMETER 0.5 CM OR LESS"	"11,076.00"	"7,800.00"	"3,276.00"
17261	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK, ARMS
OR LEGS; LESION DIAMETER 0.6 TO 1.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
17262	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK, ARMS
OR LEGS; LESION DIAMETER 1.1 TO 2.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
17263	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK, ARMS
OR LEGS; LESION DIAMETER 2.1 TO 3.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
17264	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK, ARMS
OR LEGS; LESION DIAMETER 3.1 TO 4.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
17266	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, TRUNK, ARMS
OR LEGS; LESION DIAMETER OVER 4.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
17270	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.5 CM OR LESS"	"11,076.00"	"7,800.00"	"3,276.00"
17271	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.6 TO 1.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
17272	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 1.1 TO 2.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
17273	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 2.1 TO 3.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
17274	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 3.1 TO 4.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
17276	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER OVER 4.0 CM"	"11,076.00"	"7,800.00"	"3,276.00"
17280	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 0.5
CM OR LESS"	"18,135.00"	"14,040.00"	"4,095.00"
17281	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 0.6
TO 1.0 CM"	"18,135.00"	"14,040.00"	"4,095.00"
17282	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 1.1
TO 2.0 CM"	"18,135.00"	"14,040.00"	"4,095.00"
17283	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 2.1
TO 3.0 CM"	"18,135.00"	"14,040.00"	"4,095.00"
17284	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, EARS,
EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER 3.1 TO 4.0 CM"	"18,135.00"	"14,040.00"	"4,095.00"
17286	"DESTRUCTION, MALIGNANT LESION, ANY METHOD, FACE, EARS,
EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION DIAMETER OVER 4.0 CM"	"18,135.00"	"14,040.00"	"4,095.00"
17304	"CHEMOSURGERY (MOHS MICROGRAPHIC TECHNIQUE), INCLUDING REMOVAL OF ALL GROSS TUMOR, SURGICAL EXCISION OF TISSUE SPECIMENS, MAPPING, COLOR CODING OF SPECIMENS, MICROSCOPIC EXAMINATION OF SPECIMENS BY THE SURGEON, AND COMPLETE HISTOPATHOLOGIC PREPARATION; FIR"	"15,639.00"	"10,725.00"	"4,914.00"
19000	PUNCTURE ASPIRATION OF CYST OF BREAST;	"7,098.00"	"5,460.00"	"1,638.00"
19020	"MASTOTOMY W/ EXPLORATION OR DRAINAGE OF ABSCESS, DEEP"	"18,915.00"	"10,725.00"	"8,190.00"
19100	BIOPSY OF BREAST; NEEDLE CORE	"7,098.00"	"5,460.00"	"1,638.00"
19101	BIOPSY OF BREAST; INCISIONAL	"10,842.00"	"8,385.00"	"2,457.00"
19110	"NIPPLE EXPLORATION, W/ OR W/O EXCISION OF A SOLITARY LACTIFEROUS DUCT OR A PAPILLOMA LACTIFEROUS DUCT"	"16,458.00"	"10,725.00"	"5,733.00"
19112	EXCISION OF LACTIFEROUS DUCT FISTULA	"16,107.00"	"9,555.00"	"6,552.00"
19120	"EXCISION OF CYST, FIBROADENOMA, OR OTHER BENIGN OR MALIGNANT TUMOR ABERRANT BREAST TISSUE, DUCT LESION OR NIPPLE LESION (EXCEPT 19140), MALE OR FEMALE, ONE OR MORE
LESIONS"	"15,639.00"	"10,725.00"	"4,914.00"
19125	EXCISION OF BREAST LESION IDENTIFIED BY PREOPERATIVE PLACEMENT OF RADIOLOGICAL MARKER; SINGLE LESION	"15,639.00"	"10,725.00"	"4,914.00"
19140	MASTECTOMY FOR GYNECOMASTIA	"42,900.00"	"25,740.00"	"17,160.00"
19160	"MASTECTOMY, PARTIAL;"	"42,900.00"	"25,740.00"	"17,160.00"
19162	"MASTECTOMY, PARTIAL; WITH AXILLARY LYMPHADENECTOMY"	"42,900.00"	"25,740.00"	"17,160.00"
19180	"MASTECTOMY, SIMPLE, COMPLETE"	"42,900.00"	"25,740.00"	"17,160.00"
19182	"MASTECTOMY, SUBCUTANEOUS"	"42,900.00"	"25,740.00"	"17,160.00"
19200	"MASTECTOMY, RADICAL, ICNLUDING PECTORAL MUSCLES,
AXILLARY LYMPH NODES"	"42,900.00"	"25,740.00"	"17,160.00"
19220	"MASTECTOMY, RADICAL, INCLUDING PECTORAL MUSCLES, AXILLARY AND INTERNAL MAMMARY LYMPH NODES (URBAN TYPE
OPERATION)"	"42,900.00"	"25,740.00"	"17,160.00"
19240	"MASTECTOMY, MODIFIED RADICAL, INCLUDING AXILLARY LYMPH
NODES, W/ OR W/O PECTORALIS MINOR MUSCLE, BUT EXCLUDING PECTORALIS MAJOR MUSCLE"	"42,900.00"	"25,740.00"	"17,160.00"
19260	EXCISION OF CHEST WALL TUMOR INCLUDING RIBS	"90,675.00"	"41,535.00"	"49,140.00"
19271	"EXCISION OF CHEST WALL TUMOR INVOLVING RIBS, W/ PLASTIC RECONSTRUCTION; W/O MEDIASTINAL LYMPHADENECTOMY"	"107,250.00"	"41,730.00"	"65,520.00"
19272	"EXCISION OF CHEST WALL TUMOR INVOLVING RIBS, W/ PLASTIC RECONSTRUCTION; W/ MEDIASTINAL LYMPHADENECTOMY"	"114,660.00"	"40,950.00"	"73,710.00"
19340	"IMMEDIATE INSERTION OF BREAST PROSTHESIS FOLLOWING MASTOPEXY, MASTECTOMY OR IN RECONSTRUCTION"	"73,710.00"	"32,760.00"	"40,950.00"
19342	"DELAYED INSERTION OF BREAST PROSTHESIS FOLLOWING
MASTOPEXY, MASTECTOMY OR IN RECONSTRUCTION"	"73,710.00"	"32,760.00"	"40,950.00"
19350	NIPPLE/AREOLA RECONSTRUCTION	"59,085.00"	"26,325.00"	"32,760.00"
19357	"BREAST RECONSTRUCTION, IMMEDIATE OR DELAYED, WITH TISSUE EXPANDER, INCLUDING SUBSEQUENT EXPANSION"	"73,710.00"	"32,760.00"	"40,950.00"
19361	"BREAST RECONSTRUCTION WITH LATISSIMUS DORSI FLAP, WITH
OR WITHOUT PROSTHETIC IMPLANT"	"107,250.00"	"41,730.00"	"65,520.00"
19364	BREAST RECONSTRUCTION WITH FREE FLAP	"107,250.00"	"41,730.00"	"65,520.00"
19366	BREAST RECONSTRUCTION WITH OTHER TECHNIQUE	"107,250.00"	"41,730.00"	"65,520.00"
19367	"BREAST RECONSTRUCTION WITH TRANSVERSE RECTUS
ABDOMINIS MYOCUTANEOUS FLAP (TRAM), SINGLE PEDICLE, INCLUDING CLOSURE OF DONOR SITE;"	"107,250.00"	"41,730.00"	"65,520.00"
19369	"BREAST RECONSTRUCTION WITH TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS FLAP (TRAM), DOUBLE PEDICLE,
INCLUDING CLOSURE OF DONOR SITE"	"107,250.00"	"41,730.00"	"65,520.00"
19370	"OPEN PERIPROSTHETIC CAPSULOTOMY, BREAST"	"59,085.00"	"26,325.00"	"32,760.00"
19371	"PERIPROSTHETIC CAPSULECTOMY, BREAST"	"73,710.00"	"32,760.00"	"40,950.00"
20200	"BIOPSY, MUSCLE"	"8,010.60"	"6,045.00"	"1,965.60"
20206	"BIOPSY, MUSCLE, PERCUTANEOUS NEEDLE"	"6,832.80"	"5,850.00"	982.80
20220	"BIOPSY, BONE, TROCAR, OR NEEDLE; SUPERFICIAL (E.G., ILIUM,
STERNUM, SPINOUS PROCESS, RIBS)"	"21,216.00"	"13,845.00"	"7,371.00"
20225	"BIOPSY, BONE, TROCAR, OR NEEDLE; DEEP (VERTEBRAL BODY,
FEMUR)"	"35,100.00"	"18,720.00"	"16,380.00"
20240	"BIOPSY, EXCISIONAL; SUPERFICIAL (E.G., ILIUM, STERNUM,
SPINOUS PROCESS, RIBS, TROCHANTER OF FEMUR)"	"18,915.00"	"10,725.00"	"8,190.00"
20245	"BIOPSY, EXCISIONAL; DEEP (E.G., HUMERUS, ISCHIUM, FEMUR)"	"24,453.00"	"10,530.00"	"13,923.00"
20250	"BIOPSY, VERTEBRAL BODY, OPEN; THORACIC"	"45,435.00"	"20,865.00"	"24,570.00"
20251	"BIOPSY, VERTEBRAL BODY, OPEN; LUMBAR OR CERVICAL"	"59,943.00"	"33,735.00"	"26,208.00"
20520	REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH	"15,639.00"	"10,725.00"	"4,914.00"
20600	"ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; SMALL JOINT, BURSA OR GANGLION CYST (E.G., FINGERS, TOES)"	"10,842.00"	"8,385.00"	"2,457.00"
20605	"ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; INTERMEDIATE JOINT, BURSA OR GANGLION CYST (E.G., TEMPOROMANDIBULAR, ACROMIOCLAVICULAR, WRIST, ELBOW
OR ANKLE, OLECRANON BURSA)"	"18,135.00"	"14,040.00"	"4,095.00"
20610	"ARTHROCENTESIS, ASPIRATION AND/OR INJECTION; MAJOR JOINT OR BURSA (E.G., SHOULDER, HIP, KNEE JOINT,
SUBACROMIAL BURSA)"	"18,135.00"	"14,040.00"	"4,095.00"
20615	ASPIRATION AND INJECTION FOR TREATMENT OF BONE CYST	"16,107.00"	"9,555.00"	"6,552.00"
20650	"INSERTION OF WIRE OR PIN W/ APPLICATION OF SKELETAL
TRACTION, INCLUDING REMOVAL"	"15,639.00"	"10,725.00"	"4,914.00"
20660	"APPLICATION OF CRANIAL TONGS, CALIPER, OR STEREOTACTIC
FRAME, INCLUDING REMOVAL"	"19,242.60"	"10,725.00"	"8,517.60"
20661	"APPLICATION OF HALO, INCLUDING REMOVAL; CRANIAL"	"16,785.60"	"10,725.00"	"6,060.60"
20662	"APPLICATION OF HALO, INCLUDING REMOVAL; PELVIC"	"45,435.00"	"20,865.00"	"24,570.00"
20663	"APPLICATION OF HALO, INCLUDING REMOVAL; FEMORAL"	"42,783.00"	"24,765.00"	"18,018.00"
20670	"REMOVAL OF IMPLANT; SUPERFICIAL (E.G., BURIED WIRE, PIN OR
ROD)"	"20,553.00"	"10,725.00"	"9,828.00"
20680	"REMOVAL OF IMPLANT; DEEP (E.G., BURIED WIRE, PIN, SCREW,
METAL BAND, NAIL, ROD OR PLATE)"	"23,361.00"	"11,895.00"	"11,466.00"
20690	"APPLICATION OF A UNIPLANE (PINS OR WIRES IN ONE PLANE),
UNILATERAL, EXTERNAL FIXATION SYSTEM"	"23,634.00"	"10,530.00"	"13,104.00"
20692	"APPLICATION OF MULTIPLANE (PINS OR WIRES IN MORE THAN ONE PLANE), UNILATERAL, EXTERNAL FIXATION SYSTEM (E.G.,
LLIZAROV, MONTICELLI TYPE)"	"76,596.00"	"36,465.00"	"40,131.00"
20802	"REPLANTATION, ARM (INCLUDES SURGICAL NECK OF HUMERUS THROUGH ELBOW JOINT), COMPLETE AMPUTATION"	"18,135.00"	"14,040.00"	"4,095.00"
20805	"REPLANTATION, FOREARM (INCLUDES RADIUS AND ULNA TO
RADIAL CARPAL JOINT), COMPLETE AMPUTATION"	"78,624.00"	"32,760.00"	"45,864.00"
20808	"REPLANTATION, HAND (INCLUDES HAND THROUGH METACARPOPHALANGEAL JOINT(S), COMPLETE AMPUTATION"	"78,624.00"	"32,760.00"	"45,864.00"
20816	"REPLANTATION, DIGIT, EXCLUDING THUMB (INCLUDES METACARPOPHALANGEAL JOINT TO INSERTION OF FLEXOR
SUBLIMIS TENDON), COMPLETE AMPUTATION"	"45,435.00"	"20,865.00"	"24,570.00"
20822	"REPLANTATION, DIGIT, EXCLUDING THUMB (INCLUDES DISTAL TIP TO SUBLIMIS TENDON INSERTION), COMPLETE AMPUTATION"	"45,435.00"	"20,865.00"	"24,570.00"
20824	"REPLANTATION, THUMB (INCLUDES CARPOMETACARPAL JOINT
TO MP JOINT), COMPLETE AMPUTATION"	"59,085.00"	"26,325.00"	"32,760.00"
20827	"REPLANTATION, THUMB (INCLUDES DISTAL TIP TO MP JOINT),
COMPLETE AMPUTATION"	"45,435.00"	"20,865.00"	"24,570.00"
20838	"REPLANTATION, FOOT, COMPLETE AMPUTATION"	"73,710.00"	"32,760.00"	"40,950.00"
20900	"BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL (E.G., DOWEL
OR BUTTON)"	"20,553.00"	"10,725.00"	"9,828.00"
20902	"BONE GRAFT, ANY DONOR AREA; MAJOR OR LARGE"	"35,100.00"	"18,720.00"	"16,380.00"
20910	CARTILAGE GRAFT; COSTOCHONDRAL	"23,634.00"	"10,530.00"	"13,104.00"
20912	CARTILAGE GRAFT; NASAL SEPTUM	"23,634.00"	"10,530.00"	"13,104.00"
20920	FASCIA LATA GRAFT; BY STRIPPER	"18,915.00"	"10,725.00"	"8,190.00"
20922	"FASCIA LATA GRAFT; BY INCISION AND AREA EXPOSURE, COMPLEX
OR SHEET"	"23,634.00"	"10,530.00"	"13,104.00"
20924	"TENDON GRAFT, FORM A DISTANCE (E.G., PALMARIS, TOE
EXTENSOR, PLANTARIS)"	"21,372.00"	"10,725.00"	"10,647.00"
20926	"TISSUE GRAFTS, OTHER (E.G., PARATENON, FAT, DERMIS)"	"18,915.00"	"10,725.00"	"8,190.00"
20930	ALLOGRAFT FOR SPINE SURGERY ONLY; MORSELIZED	"23,634.00"	"10,530.00"	"13,104.00"
20931	ALLOGRAFT FOR SPINE SURGERY ONLY; STRUCTURAL	"35,919.00"	"18,720.00"	"17,199.00"
20936	"AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); LOCAL (E.G., RIBS, SPINOUS PROCESS, OR LAMINAR FRAGMENTS) OBTAINED FROM SAME INCISION"	"20,553.00"	"10,725.00"	"9,828.00"
20937	"AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING
THE GRAFT); MORSELIZED (THORUGH SEPARATE SKIN OR FASCIAL INCISION)"	"20,553.00"	"10,725.00"	"9,828.00"
20938	"AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); STRUCTURAL, BICORTICAL OR TRICORTIAL (THROUGH SEPARATE SKIN OR FASCIAL INCISION)"	"35,100.00"	"18,720.00"	"16,380.00"
20955	BONE GRAFT W/ MICROVASCULAR ANASTOMOSIS; FIBULA	"73,710.00"	"32,760.00"	"40,950.00"
20956	BONE GRAFT W/ MICROVASCULAR ANASTOMOSIS; ILIAC CREST	"73,710.00"	"32,760.00"	"40,950.00"
20957	BONE GRAFT W/ MICROVASCULAR ANASTOMOSIS; METATARSAL	"40,911.00"	"21,255.00"	"19,656.00"
20962	"BONE GRAFT W/ MICROVASCULAR ANASTOMOSIS; OTHER THAN
FIBULA, ILIAC CREST, OR METATARSAL"	"52,884.00"	"23,400.00"	"29,484.00"
20969	"FREE OSTEOCUTANEOUS FLAP W/ MICROVASCULAR
ANASTOMOSIS; OTHER THAN ILIAC CREST, METATARSAL, OR GREAT TOE"	"73,710.00"	"32,760.00"	"40,950.00"
20970	"FREE OSTEOCUTANEOUS FLAP W/ MICROVASCULAR
ANASTOMOSIS; ILIAC CREST"	"59,085.00"	"26,325.00"	"32,760.00"
20972	"FREE OSTEOCUTANEOUS FLAP W/ MICROVASCULAR
ANASTOMOSIS; METATARSAL"	"45,435.00"	"20,865.00"	"24,570.00"
20973	"FREE OSTEOCUTANEOUS FLAP W/ MICROVASCULAR
ANASTOMOSIS; GREAT TOE W/ WEB SPACE"	"52,884.00"	"23,400.00"	"29,484.00"
20982	"ABLATION, BONE TUMOR(S) (E.G., OSTEOID OSTEOMA,
METASTASIS) RADIOFREQUENCY, PERCUTANEOUS, INCLUDING COMPUTED TOMOGRAPHIC GUIDANCE"	"18,915.00"	"10,725.00"	"8,190.00"
21010	"ARTHROTOMY, TEMPOROMANDIBULAR JOINT"	"18,915.00"	"10,725.00"	"8,190.00"
21015	"RADICAL RESECTION OF TUMOR (E.G., MALIGNANT NEOPLASM),
SOFT TISSUE OF FACE OR SCALP"	"45,435.00"	"20,865.00"	"24,570.00"
21025	"EXCISION OF BONE (E.G., FOR OSTEOMYELITIS OR BONE ABSCESS);
MANDIBLE"	"35,100.00"	"18,720.00"	"16,380.00"
21026	"EXCISION OF BONE (E.G., FOR OSTEOMYELITIS OR BONE ABSCESS);
FACIAL BONE(S)"	"35,100.00"	"18,720.00"	"16,380.00"
21029	"REMOVAL BY CONTOURING OF BENIGN TUMOR OF FACIAL BONE
(E.G., FIBROUS DYSPLASIA)"	"35,100.00"	"18,720.00"	"16,380.00"
21030	"EXCISION OF BENIGN TUMOR OR CYST OF FACIAL BONE OTHER
THAN MANDIBLE"	"35,100.00"	"18,720.00"	"16,380.00"
21031	EXCISION OF TORUS MANDIBULARIS	"35,100.00"	"18,720.00"	"16,380.00"
21032	EXCISION OF MAXILLARY TORUS PALATINUS	"35,100.00"	"18,720.00"	"16,380.00"
21034	"EXCISION OF MALIGNANT TUMOR OF FACIAL BONE OTHER THAN
MANDIBLE"	"45,435.00"	"20,865.00"	"24,570.00"
21040	EXCISION OF BENIGN CYST OR TUMOR OF MANDIBLE; SIMPLE	"35,100.00"	"18,720.00"	"16,380.00"
21041	EXCISION OF BENIGN CYST OR TUMOR OF MANDIBLE; COMPLEX	"42,783.00"	"24,765.00"	"18,018.00"
21044	EXCISION OF MALIGNANT TUMOR OF MANDIBLE;	"45,435.00"	"20,865.00"	"24,570.00"
21045	"EXCISION OF MALIGNANT TUMOR OF MANDIBLE; RADICAL
RESECTION"	"59,085.00"	"26,325.00"	"32,760.00"
21050	"CONDYLECTOMY, TEMPOROMANDIBULAR JOINT"	"59,085.00"	"26,325.00"	"32,760.00"
21060	"MENISCECTOMY, PARTIAL OR COMPLETE, TEMPOROMANDIBULAR
JOINT"	"59,085.00"	"26,325.00"	"32,760.00"
21070	CORONOIDECTOMY	"59,085.00"	"26,325.00"	"32,760.00"
21120	"GENIOPLASTY; AUGMENTATION (AUTOGRAFT, ALLOGRAFT,
PROSTHETIC MATERIAL)"	"35,100.00"	"18,720.00"	"16,380.00"
21121	"GENIOPLASTY; SLIDING OSTEOTOMY, SINGLE PIECE"	"90,675.00"	"41,535.00"	"49,140.00"
21122	"GENIOPLASTY; SLIDING OSTEOTOMIES, TWO OR MORE
OSTEOTOMIES (E.G., WEDGE EXCISION OR BONE WEDGE REVERSAL FOR ASYMMETRICAL CHIN)"	"59,085.00"	"26,325.00"	"32,760.00"
21123	"GENIOPLASTY; SLIDING, AUGMENTATION W/ INTERPOSITIONAL BONE GRAFTS (INCLUDES OBTAINING AUTOGRAFTS)"	"59,085.00"	"26,325.00"	"32,760.00"
21125	"AUGMENTATION, MANDIBULAR BODY OR ANGLE; PROSTHETIC
MATERIAL"	"59,085.00"	"26,325.00"	"32,760.00"
21127	"AUGMENTATION, MANDIBULAR BODY OR ANGLE; W/ BONE GRAFT, ONLAY OR INTERPOSITIONAL (INCLUDES OBTAINING AUTOGRAFT)"	"90,675.00"	"41,535.00"	"49,140.00"
21137	REDUCTION FOREHEAD; CONTOURING ONLY	"35,100.00"	"18,720.00"	"16,380.00"
21138	"REDUCTION FOREHEAD; CONTOURING AND APPLICATION OF PROSTHETIC MATERIAL OR BONE GRAFT (INCLUDES OBTAINING
AUTOGRAFT)"	"90,675.00"	"41,535.00"	"49,140.00"
21139	"REDUCTION FOREHEAD; CONTOURING AND SETBACK OF
ANTERIOR FRONTAL SINUS WALL"	"59,085.00"	"26,325.00"	"32,760.00"
21141	"RECONSTRUCTION MIDFACE, LEFORT I; SINGLE PIECE, SEGMENT
MOVEMENT IN ANY DIRECTION (E.G., FOR LONG FACE SYNDROME), W/O BONE GRAFT"	"104,130.00"	"46,800.00"	"57,330.00"
21142	"RECONSTRUCTION MIDFACE, LEFORT I; TWO PIECES, SEGMENT MOVEMENT IN ANY DIRECTION, W/O BONE GRAFT"	"90,675.00"	"41,535.00"	"49,140.00"
21143	"RECONSTRUCTION MIDFACE, LEFORT I; THREE OR MORE PIECES, SEGMENT MOVEMENT IN ANY DIRECTION, W/O BONE GRAFT"	"90,675.00"	"41,535.00"	"49,140.00"
21145	"RECONSTRUCTION MIDFACE, LEFORT I; SINGLE PIECE, SEGMENT MOVEMENT IN ANY DIRECTION, REQUIRING BONE GRAFTS
(INCLUDES OBTAINING AUTOGRAFTS)"	"90,675.00"	"41,535.00"	"49,140.00"
21146	"RECONSTRUCTION MIDFACE, LEFORT I; TWO PIECES, SEGMENT MOVEMENT IN ANY DIRECTION, REQUIRING BONE GRAFTS (INCLUDES OBTAINING AUTOGRAFTS) (E.G., UNGRAFTED
UNILATERAL ALVEOLAR CLEFT)"	"90,675.00"	"41,535.00"	"49,140.00"
21147	"RECONSTRUCTION MIDFACE, LEFORT I; THREE OR MORE PIECES, SEGMENT MOVEMENT IN ANY DIRECTION, REQUIRING BONE GRAFTS (INCLUDES OBTAINING AUTOGRAFTS) (E.G., UNGRAFTED BILATERAL ALVEOLAR CLEFT OR MULTIPLE OSTEOTOMIES)"	"107,250.00"	"41,730.00"	"65,520.00"
21150	"RECONSTRUCTION MIDFACE, LEFORT II; ANTERIOR INTRUSION
(E.G., TREACHER-COLLINS SYNDROME)"	"107,250.00"	"41,730.00"	"65,520.00"
21151	"RECONSTRUCTION MIDFACE, LEFORT II; ANY DIRECTION, REQUIRING BONE GRAFTS (INCLUDES OBTAINING AUTOGRAFTS)"	"107,250.00"	"41,730.00"	"65,520.00"
21154	"RECONSTRUCTION MIDFACE, LEFORT III (EXTRACRANIAL), ANY TYPE, REQUIRING BONE GRAFTS (INCLUDES OBTAINING
AUTOGRAFTS); W/O LEFORT I"	"114,660.00"	"40,950.00"	"73,710.00"
21155	"RECONSTRUCTION MIDFACE, LEFORT III (EXTRACRANIAL), ANY TYPE, REQUIRING BONE GRAFTS (INCLUDES OBTAINING
AUTOGRAFTS); W/ LEFORT I"	"107,250.00"	"41,730.00"	"65,520.00"
21159	"RECONSTRUCTION MIDFACE, LEFORT III (EXTRA AND INTRACRANIAL) W/ FOREHEAD ADVANCEMENT (E.G., MONO BLOC), REQUIRING BONE GRAFTS (INCLUDES OBTAINING
AUTOGRAFTS); W/O LEFORT I"	"107,250.00"	"41,730.00"	"65,520.00"
21160	"RECONSTRUCTION MIDFACE, LEFORT III (EXTRA AND INTRACRANIAL) W/ FOREHEAD ADVANCEMENT (E.G., MONO BLOC), REQUIRING BONE GRAFTS (INCLUDES OBTAINING
AUTOGRAFTS); W/ LEFORT I"	"90,675.00"	"41,535.00"	"49,140.00"
21172	"RECONSTRUCTION SUPERIOR-LATERAL ORBITAL RIM AND LOWER FOREHEAD, ADVANCEMENT OR ALTERATION, W/ OR W/O GRAFTS
(INCLUDES OBTAINING AUTOGRAFTS)"	"107,250.00"	"41,730.00"	"65,520.00"
21175	"RECONSTRUCTION, BIFRONTAL, SUPERIOR-LATERAL ORBITAL RIMS AND LOWER FOREHEAD, ADVANCEMENT OR ALTERATION (E.G., PLAGIOCEPHALY, TRIGONOCEPHALY, BRACHYCEPHALY), W/ OR W/O GRAFTS (INCLUDES OBTAINING AUTOGRAFTS)"	"107,250.00"	"41,730.00"	"65,520.00"
21179	"RECONSTRUCTION, ENTIRE OR MAJORITY OF FOREHEAD AND/OR SUPRAORBITAL RIMS; W/ GRAFTS (ALLOGRAFT OR PROSTHETIC
MATERIAL)"	"107,250.00"	"41,730.00"	"65,520.00"
21180	"RECONSTRUCTION, ENTIRE OR MAJORITY OF FOREHEAD AND/OR SUPRAORBITAL RIMS; W/ AUTOGRAFT (INCLUDES OBTAINING
GRAFTS)"	"107,250.00"	"41,730.00"	"65,520.00"
21181	"RECONSTRUCTION BY CONTOURING OF BENIGN TUMOR OF CRANIAL BONES (E.G., FIBROUS DYSPLASIA), EXTRACRANIAL"	"104,130.00"	"46,800.00"	"57,330.00"
21182	"RECONSTRUCTION OF ORBITAL WALLS, RIMS, FOREHEAD, NASOETHMOID COMPLEX FOLLOWING INTRA-AND EXTRACRANIAL EXCISION OF BENIGN TUMOR OF CRANIAL BONE (E.G., FIBROUS DYSPLASIA), W/ MULTIPLE AUTOGRAFTS (INCLUDES OBTAINING GRAFTS); TOTAL AREA OF BONE GRAFTING
LESS"	"90,675.00"	"41,535.00"	"49,140.00"
21183	"RECONSTRUCTION OF ORBITAL WALLS, RIMS, FOREHEAD, NASOETHMOID COMPLEX FOLLOWING INTRA-AND EXTRACRANIAL EXCISION OF BENIGN TUMOR OF CRANIAL BONE (E.G., FIBROUS DYSPLASIA), W/ MULTIPLE AUTOGRAFTS (INCLUDES OBTAINING GRAFTS); TOTAL AREA OF BONE GRAFTING GREATER THAN 40 CM2 BUT LESS THAN 80 CM2"	"104,130.00"	"46,800.00"	"57,330.00"
21184	"RECONSTRUCTION OF ORBITAL WALLS, RIMS, FOREHEAD, NASOETHMOID COMPLEX FOLLOWING INTRA-AND EXTRACRANIAL EXCISION OF BENIGN TUMOR OF CRANIAL BONE (E.G., FIBROUS DYSPLASIA), W/ MULTIPLE AUTOGRAFTS (INCLUDES OBTAINING GRAFTS); TOTAL AREA OF BONE GRAFTING
GREATER THAN 80 CM2"	"107,250.00"	"41,730.00"	"65,520.00"
21188	"RECONSTRUCTION MIDFACE, OSTEOTOMIES (OTHER THAN
LEFORT TYPE) AND BONE GRAFTS (INCLUDES OBTAINING AUTOGRAFTS)"	"107,250.00"	"41,730.00"	"65,520.00"
21193	"RECONSTRUCTION OF MANDIBULAR RAMI, HORIZONTAL,
VERTICAL, ""C"", OR ""L"" OSTEOTOMY; W/O BONE GRAFT"	"90,675.00"	"41,535.00"	"49,140.00"
21194	"RECONSTRUCTION OF MANDIBULAR RAMI, HORIZONTAL, VERTICAL, ""C"", OR ""L"" OSTEOTOMY; W/ BONE GRAFT (INCLUDES
OBTAINING GRAFT)"	"107,250.00"	"41,730.00"	"65,520.00"
21195	"RECONSTRUCTION OF MANDIBULAR RAMI AND/OR BODY,
SAGITTAL SPLIT; W/O INTERNAL RIGID FIXATION"	"90,675.00"	"41,535.00"	"49,140.00"
21196	"RECONSTRUCTION OF MANDIBULAR RAMI AND/OR BODY,
SAGITTAL SPLIT; W/ INTERNAL RIGID FIXATION"	"107,250.00"	"41,730.00"	"65,520.00"
21198	"OSTEOTOMY, MANDIBLE, SEGMENTAL"	"59,085.00"	"26,325.00"	"32,760.00"
21206	"OSTEOTOMY, MAXILLA, SEGMENTAL (E.G., WASSMUND OR
SCHUCHARD)"	"90,675.00"	"41,535.00"	"49,140.00"
21210	"GRAFT, BONE; NASAL, MAXILLARY OR MALAR AREAS (INCLUDES
OBTAINING GRAFT)"	"90,675.00"	"41,535.00"	"49,140.00"
21215	"GRAFT, BONE; MANDIBLE (INCLUDES OBTAINING GRAFT)"	"107,250.00"	"41,730.00"	"65,520.00"
21230	"GRAFT; RIB CARTILAGE, AUTOGENOUS, TO FACE, CHIN, NOSE OR
EAR (INCLUDES OBTAINING GRAFT)"	"90,675.00"	"41,535.00"	"49,140.00"
21235	"GRAFT; EAR CARTILAGE, AUTOGENOUS, TO NOSE OR EAR
(INCLUDES OBTAINING GRAFT)"	"59,085.00"	"26,325.00"	"32,760.00"
21240	"ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, W/ OR W/O
AUTOGRAFT (INCLUDES OBTAINING GRAFT)"	"90,675.00"	"41,535.00"	"49,140.00"
21242	"ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, W/ ALLOGRAFT"	"90,675.00"	"41,535.00"	"49,140.00"
21243	"ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, W/ PROSTHETIC
JOINT REPLACEMENT"	"107,250.00"	"41,730.00"	"65,520.00"
21244	"RECONSTRUCTION OF MANDIBLE, EXTRAORAL, W/ TRANSOSTEAL BONE PLATE (E.G., MANDIBULAR STAPLE BONE PLATE)"	"90,675.00"	"41,535.00"	"49,140.00"
21245	"RECONSTRUCTION OF MANDIBLE OR MAXILLA, SUBPERIOSTEAL
IMPLANT; PARTIAL"	"104,130.00"	"46,800.00"	"57,330.00"
21246	"RECONSTRUCTION OF MANDIBLE OR MAXILLA, SUBPERIOSTEAL
IMPLANT; COMPLETE"	"107,250.00"	"41,730.00"	"65,520.00"
21247	"RECONSTRUCTION OF MANDIBULAR CONDYLE W/ BONE AND
CARTILAGE AUTOGRAFTS (INCLUDES OBTAINING GRAFTS) (E.G., FOR HEMIFACIAL MICROSOMIA)"	"107,250.00"	"41,730.00"	"65,520.00"
21248	"RECONSTRUCTION OF MANDIBLE OR  MAXILLA, ENDOSTEAL
IMPLANT (E.G. BLADE, CYLINDER); PARTIAL"	"107,250.00"	"41,730.00"	"65,520.00"
21249	"RECONSTRUCTION OF MANDIBLE OR  MAXILLA, ENDOSTEAL
IMPLANT (E.G. BLADE, CYLINDER); COMPLETE"	"122,850.00"	"40,950.00"	"81,900.00"
21255	RECONSTRUCTION OF ZYGOMATIC ARCH AND GLENOID FOSSA W/ BONE AND CARTILAGE (INCLUDES OBTAINING AUTOGRAFTS)	"107,250.00"	"41,730.00"	"65,520.00"
21256	"RECONSTRUCTION OF ORBIT W/ OSTEOTOMIES (EXTRACRANIAL)
AND W/ BONE GRAFTS (INCLUDES OBTAINING AUTOGRAFTS) (E.G., MICRO-OPHTHALMIA)"	"107,250.00"	"41,730.00"	"65,520.00"
21260	"PERIORBITAL OSTEOTOMIES FOR ORBITAL HYPERTELORISM, W/
BONE GRAFTS"	"107,250.00"	"41,730.00"	"65,520.00"
21267	"ORBITAL REPOSITIONING, PERIORBITAL OSTEOTOMIES, UNILATERAL, W/ BONE GRAFTS; EXTRACRANIAL APPROACH"	"107,250.00"	"41,730.00"	"65,520.00"
21300	CLOSED TREATMENT OF SKULL FRACTURE W/O OPERATION	"20,553.00"	"10,725.00"	"9,828.00"
21315	CLOSED TREATMENT OF NASAL BONE FRACTURE	"20,553.00"	"10,725.00"	"9,828.00"
21325	OPEN TREATMENT OF NASAL FRACTURE; UNCOMPLICATED	"23,634.00"	"10,530.00"	"13,104.00"
21330	"OPEN TREATMENT OF NASAL FRACTURE; COMPLICATED, W/
INTERNAL AND/OR EXTERNAL SKELETAL FIXATION"	"23,634.00"	"10,530.00"	"13,104.00"
21335	"OPEN TREATMENT OF NASAL FRACTURE; W/ CONCOMITANT OPEN
TREATMENT OF FRACTURED SEPTUM"	"23,634.00"	"10,530.00"	"13,104.00"
21336	"OPEN TREATMENT OF NASAL SEPTAL FRACTURE, W/ OR W/O
STABILIZATION"	"23,634.00"	"10,530.00"	"13,104.00"
21337	CLOSED TREATMENT OF NASAL SEPTAL FRACTURE	"20,553.00"	"10,725.00"	"9,828.00"
21338	"OPEN TREATMENT OF NASOETHMOID FRACTURE; W/O EXTERNAL
FIXATION"	"23,634.00"	"10,530.00"	"13,104.00"
21339	"OPEN TREATMENT OF NASOETHMOID FRACTURE; W/ EXTERNAL
FIXATION"	"35,100.00"	"18,720.00"	"16,380.00"
21340	"PERCUTANEOUS TREATMENT OF NASOETHMOID COMPLEX FRACTURE, W/ SPLINT, WIRE OR HEADCAP FIXATION, INCLUDING REPAIR OF CANTHAL LIGAMENTS AND/OR THE NASOLACRIMAL
APPARATUS"	"42,783.00"	"24,765.00"	"18,018.00"
21343	OPEN TREATMENT OF DEPRESSED FRONTAL SINUS FRACTURE	"42,783.00"	"24,765.00"	"18,018.00"
21344	"OPEN TREATMENT OF COMPLICATED (E.G., COMMINUTED OR
INVOLVING POSTERIOR WALL) FRONTAL SINUS FRACTURE, VIA CORONAL OR MULTIPLE APPROACHES"	"45,435.00"	"20,865.00"	"24,570.00"
21345	"CLOSED TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE
(LEFORT II TYPE), W/ INTERDENTAL WIRE FIXATION OR FIXATION OF DENTURE OR SPLINT"	"44,187.00"	"21,255.00"	"22,932.00"
21346	OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFORT II TYPE); W/ WIRING AND/OR LOCAL FIXATION	"45,435.00"	"20,865.00"	"24,570.00"
21347	OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFORT II TYPE); REQUIRING MULTIPLE OPEN APPROACHES	"59,085.00"	"26,325.00"	"32,760.00"
21348	"OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE
(LEFORT II TYPE); W/ BONE GRAFTING (INCLUDES OBTAINING GRAFT)"	"73,710.00"	"32,760.00"	"40,950.00"
21355	"PERCUTANEOUS TREATMENT OF FRACTURE OF MALAR AREA, INCLUDING ZYGOMATIC ARCH AND MALAR TRIPOD, W/
MANIPULATION"	"42,783.00"	"24,765.00"	"18,018.00"
21356	"OPEN TREATMENT OF DEPRESSED ZYGOMATIC ARCH FRACTURE
(E.G., GILLES APPROACH)"	"45,435.00"	"20,865.00"	"24,570.00"
21360	"OPEN TREATMENT OF DEPRESSED MALAR FRACTURE, INCLUDING
ZYGOMATIC ARCH AND MALAR TRIPOD"	"59,085.00"	"26,325.00"	"32,760.00"
21365	"OPEN TREATMENT OF COMPLICATED (E.G., COMMINUTED OR INVOLVING CRANIAL NERVE FORAMINA) FRACTURE(S) OF MALAR AREA, INCLUDING ZYGOMATIC ARCH AND MALAR TRIPOD; W/ INTERNAL FIXATION AND MULTIPLE SURGICAL APPROACHES"	"73,710.00"	"32,760.00"	"40,950.00"
21366	"OPEN TREATMENT OF COMPLICATED (E.G., COMMINUTED OR INVOLVING CRANIAL NERVE FORAMINA) FRACTURE(S) OF MALAR AREA, INCLUDING ZYGOMATIC ARCH AND MALAR TRIPOD; W/ BONE GRAFTING (INCLUDES OBTAINING GRAFT)"	"90,675.00"	"41,535.00"	"49,140.00"
21385	"OPEN TREATMENT OF ORBITAL FLOOR ""BLOWOUT"" FRACTURE; TRANSANTRAL APPROACH (CALDWELL-LUC TYPE OPERATION)"	"40,911.00"	"21,255.00"	"19,656.00"
21386	"OPEN TREATMENT OF ORBITAL FLOOR ""BLOWOUT"" FRACTURE;
PERIORBITAL APPROACH"	"35,100.00"	"18,720.00"	"16,380.00"
21387	"OPEN TREATMENT OF ORBITAL FLOOR ""BLOWOUT"" FRACTURE;
COMBINED APPROACH"	"73,710.00"	"32,760.00"	"40,950.00"
21390	"OPEN TREATMENT OF ORBITAL FLOOR ""BLOWOUT"" FRACTURE; PERIORBITAL APPROACH, W/ ALLOPLASTIC OR OTHER IMPLANT"	"61,581.00"	"33,735.00"	"27,846.00"
21395	"OPEN TREATMENT OF ORBITAL FLOOR ""BLOWOUT"" FRACTURE; PERIORBITAL APPROACH W/ BONE GRAFT (INCLUDES OBTAINING
GRAFT)"	"61,581.00"	"33,735.00"	"27,846.00"
21400	"CLOSED TREATMENT OF FRACTURE OF ORBIT, EXCEPT
""BLOWOUT"""	"35,100.00"	"18,720.00"	"16,380.00"
21406	"OPEN TREATMENT OF FRACTURE OF ORBIT, EXCEPT ""BLOWOUT"";
W/O IMPLANT"	"40,911.00"	"21,255.00"	"19,656.00"
21407	"OPEN TREATMENT OF FRACTURE OF ORBIT, EXCEPT ""BLOWOUT"";
W/ IMPLANT"	"61,581.00"	"33,735.00"	"27,846.00"
21408	"OPEN TREATMENT OF FRACTURE OF ORBIT, EXCEPT ""BLOWOUT""; W/ BONE GRAFTING (INCLUDES OBTAINING GRAFT)"	"61,581.00"	"33,735.00"	"27,846.00"
21421	"CLOSED TREATMENT OF PALATAL OR MAXILLARY FRACTURE
(LEFORT I TYPE), W/ INTERDENTAL WIRE FIXATION OR FIXATION OF DENTURE OR SPLINT"	"23,634.00"	"10,530.00"	"13,104.00"
21422	"OPEN TREATMENT OF PALATAL OR MAXILLARY FRACTURE
(LEFORT I TYPE);"	"40,911.00"	"21,255.00"	"19,656.00"
21423	"OPEN TREATMENT OF PALATAL OR MAXILLARY FRACTURE (LEFORT I TYPE); COMPLICATED (COMMINUTED OR INVOLVING CRANIAL NERVE FORAMINA), MULTIPLE APPROACHES"	"45,435.00"	"20,865.00"	"24,570.00"
21431	"CLOSED TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT III
TYPE) USING INTERDENTAL WIRE FIXATION OF DENTURE OR SPLINT"	"23,634.00"	"10,530.00"	"13,104.00"
21432	OPEN TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT III TYPE); W/ WIRING AND/OR INTERNAL FIXATION	"45,435.00"	"20,865.00"	"24,570.00"
21433	"OPEN TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT III TYPE); COMPLICATED (E.G., COMMINUTED OR INVOLVING CRANIAL NERVE FORAMINA); MULTIPLE SURGICAL APPROACHES"	"35,100.00"	"18,720.00"	"16,380.00"
21435	"OPEN TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT III TYPE); COMPLICATED, UTILIZING INTERNAL AND/OR EXTERNAL FIXATION TECHNIQUES (E.G., HEAD CAP, HALO DEVICE, AND/OR
INTERMAXILLARY FIXATION)"	"45,435.00"	"20,865.00"	"24,570.00"
21436	"OPEN TREATMENT OF CRANIOFACIAL SEPARATION (LEFORT III TYPE); COMPLICATED, MULTIPLE SURGICAL APPROACHES, INTERNAL FIXATION, W/ BONE GRAFTING (INCLUDES OBTAINING
GRAFT)"	"90,675.00"	"41,535.00"	"49,140.00"
21440	"CLOSED TREATMENT OF MANDIBULAR OR MAXILLARY ALVEOLAR
RIDGE FRACTURE"	"23,634.00"	"10,530.00"	"13,104.00"
21445	"OPEN TREATMENT OF MANDIBULAR OR MAXILLARY ALVEOLAR
RIDGE FRACTURE"	"35,100.00"	"18,720.00"	"16,380.00"
21450	CLOSED TREATMENT OF MANDIBULAR FRACTURE	"35,100.00"	"18,720.00"	"16,380.00"
21452	"PERCUTANEOUS TREATMENT OF MANDIBULAR FRACTUE, W/
EXTERNAL FIXATION"	"45,435.00"	"20,865.00"	"24,570.00"
21453	"CLOSED TREATMENT OF MANDIBULAR FRACTURE; W/
INTERDENTAL FIXATION"	"29,172.00"	"14,430.00"	"14,742.00"
21454	"OPEN TREATMENT OF MANDIBULAR FRACTURE; W/ EXTERNAL
FIXATION"	"44,187.00"	"21,255.00"	"22,932.00"
21461	"OPEN TREATMENT OF MANDIBULAR FRACTURE; W/O
INTERDENTAL FIXATION"	"44,187.00"	"21,255.00"	"22,932.00"
21462	"OPEN TREATMENT OF MANDIBULAR FRACTURE; W/ INTERDENTAL
FIXATION"	"45,435.00"	"20,865.00"	"24,570.00"
21465	OPEN TREATMENT OF MANDIBULAR CONDYLAR FRACTURE	"59,085.00"	"26,325.00"	"32,760.00"
21470	"OPEN TREATMENT OF COMPLICATED MANDIBULAR FRACTURE BY MULTIPLE SURGICAL APPROACHES INCLUDING INTERNAL FIXATION, INTERDENTAL FIXATION, AND/OR WIRING OF
DENTURES OR SPLINTS"	"73,710.00"	"32,760.00"	"40,950.00"
21480	"CLOSED TREATMENT OF TEMPOROMANDIBULAR DISLOCATION;
INITIAL OR SUBSEQUENT"	"18,915.00"	"10,725.00"	"8,190.00"
21485	"CLOSED TREATMENT OF TEMPOROMANDIBULAR DISLOCATION; COMPLICATED (E.G., RECURRENT REQUIRING INTERMAXILLARY FIXATION OR SPLINTING), INITIAL OR SUBSEQUENT"	"40,911.00"	"21,255.00"	"19,656.00"
21490	OPEN TREATMENT OF TEMPOROMANDIBULAR DISLOCATION	"59,085.00"	"26,325.00"	"32,760.00"
21493	CLOSED TREATMENT OF HYOID FRACTURE	"35,100.00"	"18,720.00"	"16,380.00"
21495	OPEN TREATMENT OF HYOID FRACTURE	"45,435.00"	"20,865.00"	"24,570.00"
21497	"INTERDENTAL WIRING, FOR CONDITION OTHER THAN FRACTURE"	"23,634.00"	"10,530.00"	"13,104.00"
21501	"INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA, SOFT
TISSUES OF NECK OR THORAX;"	"11,076.00"	"7,800.00"	"3,276.00"
21502	"INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA, SOFT TISSUES OF NECK OR THORAX; W/ PARTIAL RIB OSTECTOMY"	"15,639.00"	"10,725.00"	"4,914.00"
21510	"INCISION, DEEP, W/ OPENING OF BONE CORTEX (E.G., FOR
OSTEOMYELITIS OR BONE ABSCESS), THORAX"	"8,010.60"	"6,045.00"	"1,965.60"
21550	"BIOPSY, SOFT TISSUE OF NECK OR THORAX"	"11,076.00"	"7,800.00"	"3,276.00"
21555	"EXCISION TUMOR, SOFT TISSUE OF NECK OR THORAX;
SUBCUTANEOUS"	"15,639.00"	"10,725.00"	"4,914.00"
21556	"EXCISION TUMOR, SOFT TISSUE OF NECK OR THORAX; DEEP,
SUBFASCIAL, INTRAMUSCULAR"	"18,915.00"	"10,725.00"	"8,190.00"
21557	"RADICAL RESECTION OF TUMOR (E.G., MALIGNANT NEOPLASM),
SOFT TISSUE OF NECK OR THORAX"	"59,085.00"	"26,325.00"	"32,760.00"
21600	"EXCISION OF RIB, PARTIAL"	"20,553.00"	"10,725.00"	"9,828.00"
21610	COSTOTRANSVERSECTOMY	"40,911.00"	"21,255.00"	"19,656.00"
21615	EXCISION FIRST AND/OR CERVICAL RIB;	"72,501.00"	"36,465.00"	"36,036.00"
21616	EXCISION FIRST AND/OR CERVICAL RIB; W/ SYMPATHECTOMY	"73,710.00"	"32,760.00"	"40,950.00"
21620	"OSTECTOMY OF STERNUM, PARTIAL"	"52,884.00"	"23,400.00"	"29,484.00"
21627	STERNAL DEBRIDEMENT	"23,961.60"	"10,530.00"	"13,431.60"
21630	RADICAL RESECTION OF STERNUM;	"73,710.00"	"32,760.00"	"40,950.00"
21700	"DIVISION OF SCALENUS ANTICUS; W/O RESECTION OF CERVICAL
RIB"	"35,100.00"	"18,720.00"	"16,380.00"
21705	DIVISION OF SCALENUS ANTICUS; W/ RESECTION OF CERVICAL RIB	"45,435.00"	"20,865.00"	"24,570.00"
21720	"DIVISION OF STERNOCLEIDOMASTOID FOR TORTICOLLIS, OPEN
OPERATION"	"35,100.00"	"18,720.00"	"16,380.00"
21740	"RECONSTRUCTIVE REPAIR OF PECTUS EXCAVATUM OR
CARINATUM"	"52,884.00"	"23,400.00"	"29,484.00"
21750	"CLOSURE OF STERNOTOMY SEPARATION W/ OR W/O
DEBRIDEMENT"	"45,435.00"	"20,865.00"	"24,570.00"
21800	CLOSED TREATMENT OF RIB FRACTURE	"15,639.00"	"10,725.00"	"4,914.00"
21805	OPEN TREATMENT OF RIB FRACTURE W/O FIXATION	"21,372.00"	"10,725.00"	"10,647.00"
21810	"TREATMENT OF RIB FRACTURE REQUIRING EXTERNAL FIXATION
(""FLAIL CHEST"")"	"40,911.00"	"21,255.00"	"19,656.00"
21820	CLOSED TREATMENT OF STERNUM FRACTURE	"19,242.60"	"10,725.00"	"8,517.60"
21825	"OPEN TREATMENT OF STERNUM FRACTURE W/ OR W/O SKELETAL
FIXATION"	"42,783.00"	"24,765.00"	"18,018.00"
21920	"BIOPSY, SOFT TISSUE OF BACK OR FLANK"	"6,832.80"	"5,850.00"	982.80
21930	"EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK"	"11,076.00"	"7,800.00"	"3,276.00"
21935	"RADICAL RESECTION OF TUMOR (E.G., MALIGNANT NEOPLASM),
SOFT TISSUE OF BACK OR FLANK"	"45,435.00"	"20,865.00"	"24,570.00"
22100	"PARTIAL EXCISION OF POSTERIOR VERTEBRAL COMPONENT (E.G., SPINOUS PROCESS, LAMINA OR FACET) FOR INTRINSIC BONY LESION, SINGLE VERTEBRAL SEGMENT; CERVICAL"	"52,884.00"	"23,400.00"	"29,484.00"
22101	"PARTIAL EXCISION OF POSTERIOR VERTEBRAL COMPONENT (E.G., SPINOUS PROCESS, LAMINA OR FACET) FOR INTRINSIC BONY LESION, SINGLE VERTEBRAL SEGMENT; THORACIC"	"52,884.00"	"23,400.00"	"29,484.00"
22102	"PARTIAL EXCISION OF POSTERIOR VERTEBRAL COMPONENT (E.G., SPINOUS PROCESS, LAMINA OR FACET) FOR INTRINSIC BONY LESION, SINGLE VERTEBRAL SEGMENT; LUMBAR"	"52,884.00"	"23,400.00"	"29,484.00"
22110	"PARTIAL EXCISION OF VERTEBRAL BODY, FOR INTRINSIC BONY LESION, W/O DECOMPRESSION OF SPINAL CORD OR NERVE
ROOT(S), SINGLE VERTEBRAL SEGMENT; CERVICAL"	"90,675.00"	"41,535.00"	"49,140.00"
22112	"PARTIAL EXCISION OF VERTEBRAL BODY, FOR INTRINSIC BONY LESION, W/O DECOMPRESSION OF SPINAL CORD OR NERVE
ROOT(S), SINGLE VERTEBRAL SEGMENT; THORACIC"	"59,085.00"	"26,325.00"	"32,760.00"
22114	"PARTIAL EXCISION OF VERTEBRAL BODY, FOR INTRINSIC BONY LESION, W/O DECOMPRESSION OF SPINAL CORD OR NERVE
ROOT(S), SINGLE VERTEBRAL SEGMENT; LUMBAR"	"59,085.00"	"26,325.00"	"32,760.00"
22210	"OSTEOTOMY OF SPINE, POSTERIOR OR POSTEROLATERAL
APPROACH, ONE VERTEBRAL SEGMENT; CERVICAL"	"90,675.00"	"41,535.00"	"49,140.00"
22212	"OSTEOTOMY OF SPINE, POSTERIOR OR POSTEROLATERAL
APPROACH, ONE VERTEBRAL SEGMENT; THORACIC"	"90,675.00"	"41,535.00"	"49,140.00"
22214	"OSTEOTOMY OF SPINE, POSTERIOR OR POSTEROLATERAL
APPROACH, ONE VERTEBRAL SEGMENT; LUMBAR"	"90,675.00"	"41,535.00"	"49,140.00"
22220	"OSTEOTOMY OF SPINE, INCLUDING DISKECTOMY, ANTERIOR APPROACH, SINGLE VERTEBRAL SEGMENT; CERVICAL"	"104,130.00"	"46,800.00"	"57,330.00"
22222	"OSTEOTOMY OF SPINE, INCLUDING DISKECTOMY, ANTERIOR APPROACH, SINGLE VERTEBRAL SEGMENT; THORACIC"	"104,130.00"	"46,800.00"	"57,330.00"
22224	"OSTEOTOMY OF SPINE, INCLUDING DISKECTOMY, ANTERIOR APPROACH, SINGLE VERTEBRAL SEGMENT; LUMBAR"	"104,130.00"	"46,800.00"	"57,330.00"
22305	CLOSED TREATMENT OF VERTEBRAL PROCESS FRACTURE(S)	"45,435.00"	"20,865.00"	"24,570.00"
22310	"CLOSED TREATMENT OF VERTEBRAL BODY FRACTURE(S),
REQUIRING AND INCLUDING CASTING OR BRACING"	"59,943.00"	"33,735.00"	"26,208.00"
22325	"OPEN TREATMENT AND/OR REDUCTION OF VERTEBRAL FRACTURE(S) AND/OR DISLOCATION(S), POSTERIOR APPROACH, ONE FRACTURED VERTEBRAE OR DISLOCATED SEGMENT; LUMBAR"	"75,777.00"	"36,465.00"	"39,312.00"
22326	"OPEN TREATMENT AND/OR REDUCTION OF VERTEBRAL FRACTURE(S) AND/OR DISLOCATION(S), POSTERIOR APPROACH, ONE FRACTURED VERTEBRAE OR DISLOCATED SEGMENT;
CERVICAL"	"75,348.00"	"32,760.00"	"42,588.00"
22327	"OPEN TREATMENT AND/OR REDUCTION OF VERTEBRAL FRACTURE(S) AND/OR DISLOCATION(S), POSTERIOR APPROACH, ONE FRACTURED VERTEBRAE OR DISLOCATED SEGMENT;
THORACIC"	"73,710.00"	"32,760.00"	"40,950.00"
22548	"ARTHRODESIS, ANTERIOR TRANSORAL OR EXTRAORAL TECHNIQUE, CLIVUS-C1-C2 (ATLAS-AXIS), W/ OR W/O EXCISION OF
ODONTOID PROCESS"	"78,624.00"	"32,760.00"	"45,864.00"
22554	"ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMAL DISKECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); CERVICAL BELOW C2"	"104,130.00"	"46,800.00"	"57,330.00"
22556	"ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMAL DISKECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); THORACIC"	"90,675.00"	"41,535.00"	"49,140.00"
22558	"ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE, INCLUDING MINIMAL DISKECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION); LUMBAR"	"90,675.00"	"41,535.00"	"49,140.00"
22590	"ARTHRODESIS; POSTERIOR TECHNIQUE, CRANIOCERVICAL
(OCCIPUT-C2)"	"104,130.00"	"46,800.00"	"57,330.00"
22595	"ARTHRODESIS, POSTERIOR TECHNIQUE, ATLAS-AXIS (C1-C2)"	"104,130.00"	"46,800.00"	"57,330.00"
22600	"ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL; CERVICAL BELOW C2 SEGMENT;"	"104,130.00"	"46,800.00"	"57,330.00"
22610	"ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL; CERVICAL BELOW C2 SEGMENT; THORACIC (W/ OR W/O LATERAL TRANSVERSE TECHNIQUE)"	"59,085.00"	"26,325.00"	"32,760.00"
22612	"ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE LEVEL; CERVICAL BELOW C2 SEGMENT; LUMBAR (W/ OR W/O LATERAL TRANSVERSE TECHNIQUE)"	"59,085.00"	"26,325.00"	"32,760.00"
22630	"ARTHRODESIS, POSTERIOR INTERBODY TECHNIQUE, SINGLE
INTERSPACE; LUMBAR"	"78,624.00"	"32,760.00"	"45,864.00"
22800	"ARTHRODESIS, POSTERIOR, FOR SPINAL DEFORMITY, W/ OR W/O
CAST; UP TO 6 VERTEBRAL SEGMENTS"	"114,660.00"	"40,950.00"	"73,710.00"
22802	"ARTHRODESIS, POSTERIOR, FOR SPINAL DEFORMITY, W/ OR W/O
CAST; 7 TO 12 VERTEBRAL SEGMENTS"	"122,850.00"	"40,950.00"	"81,900.00"
22804	"ARTHRODESIS, POSTERIOR, FOR SPINAL DEFORMITY, W/ OR W/O
CAST; 13 OR MORE VERTEBRAL SEGMENTS"	"131,040.00"	"40,950.00"	"90,090.00"
22808	"ARTHRODESIS, ANTERIOR, FOR  SPINAL DEFORMITY, W/ OR W/O
CAST; 2 TO 3 VERTEBRAL SEGMENTS"	"107,250.00"	"41,730.00"	"65,520.00"
22810	"ARTHRODESIS, ANTERIOR, FOR  SPINAL DEFORMITY, W/ OR W/O
CAST; 4 TO 7 VERTEBRAL SEGMENTS"	"114,660.00"	"40,950.00"	"73,710.00"
22812	"ARTHRODESIS, ANTERIOR, FOR  SPINAL DEFORMITY, W/ OR W/O
CAST; 8 OR MORE VERTEBRAL SEGMENTS"	"131,040.00"	"40,950.00"	"90,090.00"
22840	"POSTERIOR NON-SEGMENTAL INSTRUMENTATION (E.G., SINGLE
HARRINGTON ROD TECHNIQUE)"	"107,250.00"	"41,730.00"	"65,520.00"
22841	INTERNAL SPINAL FIXATION BY WIRING OF SPINOUS PROCESSES	"104,130.00"	"46,800.00"	"57,330.00"
22842	"POSTERIOR SEGMENTAL INSTRUMENTATION (E.G., PEDICLE FIXATION, DUAL RODS W/ MULTIPLE HOOKS AND SUBLAMINAL
WIRES); 3 TO 6 VERTEBRAL SEGMENTS"	"106,587.00"	"46,800.00"	"59,787.00"
22843	"POSTERIOR SEGMENTAL INSTRUMENTATION (E.G., PEDICLE FIXATION, DUAL RODS W/ MULTIPLE HOOKS AND SUBLAMINAL
WIRES); 7 TO 12 VERTEBRAL SEGMENTS"	"114,660.00"	"40,950.00"	"73,710.00"
22844	"POSTERIOR SEGMENTAL INSTRUMENTATION (E.G., PEDICLE FIXATION, DUAL RODS W/ MULTIPLE HOOKS AND SUBLAMINAL
WIRES); 13 OR MORE VERTEBRAL SEGMENTS"	"131,040.00"	"40,950.00"	"90,090.00"
22845	ANTERIOR INSTRUMENTATION; 2 TO 3 VERTEBRAL SEGMENTS	"107,250.00"	"41,730.00"	"65,520.00"
22846	ANTERIOR INSTRUMENTATION; 4 TO 7 VERTEBRAL SEGMENTS	"114,660.00"	"40,950.00"	"73,710.00"
22847	"ANTERIOR INSTRUMENTATION; 8 OR MORE VERTEBRAL
SEGMENTS"	"131,040.00"	"40,950.00"	"90,090.00"
22848	"PELVIC FIXATION (ATTACHMENT OF CAUDAL END OF INSTRUMENTATION TO PELVIC BONY STRUCTURES) OTHER THAN
SACRUM"	"107,250.00"	"41,730.00"	"65,520.00"
22849	REINSERTION OF SPINAL FIXATION DEVICE	"104,130.00"	"46,800.00"	"57,330.00"
22850	"REMOVAL OF POSTERIOR NONSEGMENTAL INSTRUMENTATION
(E.G., HARRINGTON ROD)"	"42,783.00"	"24,765.00"	"18,018.00"
22851	"APPLICATION OF PROSTHETIC DEVICE (E.G., METAL CAGES, METHYLMETHACRYLATE) TO VERTEBRAL DEFECT OR INTERSPACE"	"114,660.00"	"40,950.00"	"73,710.00"
22852	REMOVAL OF POSTERIOR SEGMENTAL INSTRUMENTATION	"52,884.00"	"23,400.00"	"29,484.00"
22855	REMOVAL OF ANTERIOR INSTRUMENTATION	"59,085.00"	"26,325.00"	"32,760.00"
22900	"EXCISION, ABDOMINAL WALL TUMOR, SUBFASCIAL (E.G.,
DESMOID)"	"45,435.00"	"20,865.00"	"24,570.00"
23000	"REMOVAL OF SUBDELTOID (OR INTRATENDINOUS) CALCAREOUS
DEPOSITS, OPEN METHOD"	"40,911.00"	"21,255.00"	"19,656.00"
23020	CAPSULAR CONTRACTURE RELEASE (SEVER TYPE PROCEDURE)	"52,884.00"	"23,400.00"	"29,484.00"
23030	"INCISION AND DRAINAGE, SHOULDER AREA; DEEP ABSCESS OR
HEMATOMA"	"35,100.00"	"18,720.00"	"16,380.00"
23031	"INCISION AND DRAINAGE, SHOULDER AREA; INFECTED BURSA"	"29,172.00"	"14,430.00"	"14,742.00"
23035	"INCISION, DEEP, W/ OPENING OF CORTEX (E.G., FOR
OSTEOMYELITIS OR BONE ABSCESS), SHOULDER AREA"	"40,911.00"	"21,255.00"	"19,656.00"
23040	"ARTHROTOMY, GLENOHUMERAL JOINT, FOR INFECTION, W/ EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY"	"45,435.00"	"20,865.00"	"24,570.00"
23044	"ARTHROTOMY, ACROMIOCLAVICULAR, STERNOCLAVICULAR JOINT, FOR INFECTION, W/ EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY"	"40,911.00"	"21,255.00"	"19,656.00"
23065	"BIOPSY, SOFT TISSUE OF SHOULDER AREA"	"6,832.80"	"5,850.00"	982.80
23075	"EXCISION, TUMOR, SHOULDER AREA; SUBCUTANEOUS"	"11,076.00"	"7,800.00"	"3,276.00"
23076	"EXCISION, TUMOR, SHOULDER AREA; DEEP, SUBFASCIAL, OR
INTRAMUSCULAR"	"15,639.00"	"10,725.00"	"4,914.00"
23077	"RADICAL RESECTION OF TUMOR (E.G., MALIGNANT NEOPLASM),
SOFT TISSUE OF SHOULDER AREA"	"73,710.00"	"32,760.00"	"40,950.00"
23100	"ARTHROTOMY W/ BIOPSY, GLENOHUMERAL JOINT"	"45,435.00"	"20,865.00"	"24,570.00"
23101	"ARTHROTOMY W/ BIOPSY, OR W/ EXCISION OF TORN CARTILAGE, ACROMIOCLAVICULAR, STERNOCLAVICULAR JOINT"	"52,884.00"	"23,400.00"	"29,484.00"
23105	ARTHROTOMY W/ SYNOVECTOMY; GLENOHUMERAL JOINT	"52,884.00"	"23,400.00"	"29,484.00"
23106	ARTHROTOMY W/ SYNOVECTOMY; STERNOCLAVICULAR JOINT	"42,549.00"	"21,255.00"	"21,294.00"
23107	"ARTHROTOMY, GLENOHUMERAL JOINT, W/ JOINT EXPLORATION, W/ OR W/O REMOVAL OF LOOSE OR FOREIGN BODY"	"59,943.00"	"33,735.00"	"26,208.00"
23120	CLAVICULECTOMY; PARTIAL	"45,435.00"	"20,865.00"	"24,570.00"
23125	CLAVICULECTOMY; TOTAL	"54,522.00"	"23,400.00"	"31,122.00"
23130	"ACROMIOPLASTY OR ACROMIONECTOMY, PARTIAL"	"53,703.00"	"23,400.00"	"30,303.00"
23140	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF
CLAVICLE OR SCAPULA;"	"40,911.00"	"21,255.00"	"19,656.00"
23145	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CLAVICLE OR SCAPULA; W/ AUTOGRAFT (INCLUDES OBTAINING
GRAFT)"	"43,368.00"	"21,255.00"	"22,113.00"
23146	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF
CLAVICLE OR SCAPULA; W/ ALLOGRAFT"	"43,368.00"	"21,255.00"	"22,113.00"
23150	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF
PROXIMAL HUMERUS;"	"59,943.00"	"33,735.00"	"26,208.00"
23155	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF PROXIMAL HUMERUS; W/ AUTOGRAFT (INCLUDES OBTAINING
GRAFT)"	"61,581.00"	"33,735.00"	"27,846.00"
23156	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF
PROXIMAL HUMERUS; W/ ALLOGRAFT"	"61,581.00"	"33,735.00"	"27,846.00"
23170	"SEQUESTRECTOMY (E.G., FOR OSTEOMYELITIS OR BONE ABSCESS),
CLAVICLE"	"40,911.00"	"21,255.00"	"19,656.00"
23172	"SEQUESTRECTOMY (E.G., FOR OSTEOMYELITIS OR BONE ABSCESS),
SCAPULA"	"42,549.00"	"21,255.00"	"21,294.00"
23174	"SEQUESTRECTOMY (E.G., FOR OSTEOMYELITIS OR BONE ABSCESS),
HUMERAL HEAD TO SURGICAL NECK"	"45,435.00"	"20,865.00"	"24,570.00"
23180	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION,OR DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS), CLAVICLE"	"41,730.00"	"21,255.00"	"20,475.00"
23182	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION,OR DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS), SCAPULA"	"42,221.40"	"21,255.00"	"20,966.40"
23184	"PARTIAL EXCISION (CRATERIZATION, SUACERIZATION, OR DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS),
PROXIMAL HUMERUS"	"42,549.00"	"21,255.00"	"21,294.00"
23190	"OSTECTOMY OF SCAPULA, PARTIAL (E.G., SUPERIOR MEDIAL
ANGLE)"	"42,549.00"	"21,255.00"	"21,294.00"
23195	RESECTION HUMERAL HEAD	"52,884.00"	"23,400.00"	"29,484.00"
23200	RADICAL RESECTION FOR TUMOR; CLAVICLE	"52,884.00"	"23,400.00"	"29,484.00"
23210	RADICAL RESECTION FOR TUMOR; SCAPULA	"53,703.00"	"23,400.00"	"30,303.00"
23220	RADICAL RESECTION FOR TUMOR; PROXIMAL HUMERUS;	"72,501.00"	"36,465.00"	"36,036.00"
23221	"RADICAL RESECTION FOR TUMOR; PROXIMAL HUMERUS; W/
AUTOGRAFT (INCLUDES OBTAINING GRAFT)"	"78,624.00"	"32,760.00"	"45,864.00"
23222	"RADICAL RESECTION FOR TUMOR; PROXIMAL HUMERUS; W/
PROSTHETIC REPLACEMENT"	"104,130.00"	"46,800.00"	"57,330.00"
23330	"REMOVAL OF FOREIGN BODY, SHOULDER; SUBCUTANEOUS"	"10,842.00"	"8,385.00"	"2,457.00"
23331	"REMOVAL OF FOREIGN BODY, SHOULDER; DEEP (E.G., NEER
PROSTHESIS REMOVAL)"	"25,155.00"	"12,870.00"	"12,285.00"
23332	"REMOVAL OF FOREIGN BODY, SHOULDER; COMPLICATED ,
INCLUDING ""TOTAL SHOULDER"""	"29,172.00"	"14,430.00"	"14,742.00"
23395	"MUSCLE TRANSFER, ANY TYPE, SHOULDER OR UPPER ARM;
SINGLE"	"43,368.00"	"21,255.00"	"22,113.00"
23397	"MUSCLE TRANSFER, ANY TYPE, SHOULDER OR UPPER ARM;
MULTIPLE"	"45,435.00"	"20,865.00"	"24,570.00"
23400	"SCAPULOPEXY (E.G., SPRENGELS DEFORMITY OR FOR PARALYSIS)"	"52,884.00"	"23,400.00"	"29,484.00"
23405	"TENOMYOTOMY, SHOULDER AREA; SINGLE"	"42,783.00"	"24,765.00"	"18,018.00"
23406	"TENOMYOTOMY, SHOULDER AREA; MULTIPLE THROUGH SAME
INCISION"	"45,006.00"	"21,255.00"	"23,751.00"
23410	"REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (E.G.,
ROTATOR CUFF); ACUTE"	"40,911.00"	"21,255.00"	"19,656.00"
23412	"REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (E.G.,
ROTATOR CUFF); CHRONIC"	"43,368.00"	"21,255.00"	"22,113.00"
23415	"CORACOACROMIAL LIGAMENT RELEASE, W/ OR W/O
ACROMIOPLASTY"	"41,238.60"	"21,255.00"	"19,983.60"
23420	"REPAIR OF COMPLETE SHOULDER (ROTATOR) CUFF AVULSION,
CHRONIC (INCLUDES ACROMIOPLASTY)"	"45,435.00"	"20,865.00"	"24,570.00"
23430	TENODESIS OF LONG TENDON OF BICEPS	"42,783.00"	"24,765.00"	"18,018.00"
23440	RESECTION OR TRANSPLANTATION OF LONG TENDON OF BICEPS	"40,911.00"	"21,255.00"	"19,656.00"
23450	"CAPSULORRHAPHY, ANTERIOR; PUTTI-PLATT PROCEDURE OR
MAGNUSON TYPE OPERATION"	"73,710.00"	"32,760.00"	"40,950.00"
23455	"CAPSULORRHAPHY, ANTERIOR; BANKART TYPE OPERATION W/ OR
W/O STAPLING"	"75,777.00"	"36,465.00"	"39,312.00"
23460	"CAPSULORRHAPHY, ANTERIOR, ANY TYPE; W/ BONE BLOCK"	"75,777.00"	"36,465.00"	"39,312.00"
23462	"CAPSULORRHAPHY, ANTERIOR, ANY TYPE; W/ CORACOID PROCESS
TRANSFER"	"72,501.00"	"36,465.00"	"36,036.00"
23465	"CAPSULORRHAPHY FOR RECURRENT DISLOCATION, POSTERIOR,
W/ OR W/O BONE BLOCK"	"73,710.00"	"32,760.00"	"40,950.00"
23466	"CAPSULORRHAPHY W/ ANY TYPE MULTI-DIRECTIONAL
INSTABILITY"	"78,624.00"	"32,760.00"	"45,864.00"
23470	"ARTHROPLASTY W/ PROXIMAL HUMERAL IMPLANT (E.G., NEER
TYPE OPERATION)"	"93,951.00"	"41,535.00"	"52,416.00"
23472	"ARTHROPLASTY W/ GLENOID AND PROXIMAL HUMERAL
REPLACEMENT (E.G. TOTAL SHOULDER)"	"104,130.00"	"46,800.00"	"57,330.00"
23480	"OSTEOTOMY, CLAVICLE, W/ OR W/O INTERNAL FIXATION;"	"52,884.00"	"23,400.00"	"29,484.00"
23485	"OSTEOTOMY, CLAVICLE, W/ OR W/O INTERNAL FIXATION; W/ BONE GRAFT FOR NONUNION OR MALUNION (INCLUDES
OBTAINING GRAFT AND/OR NECESSARY FIXATION)"	"55,341.00"	"23,400.00"	"31,941.00"
23490	"PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) W/ OR W/O METHYLMETHACRYLATE; CLAVICLE"	"52,884.00"	"23,400.00"	"29,484.00"
23491	"PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR
WIRING) W/ OR W/O METHYLMETHACRYLATE; PROXIMAL HUMERUS AND HUMERAL HEAD"	"52,884.00"	"23,400.00"	"29,484.00"
23500	CLOSED TREATMENT OF CLAVICULAR FRACTURE	"15,639.00"	"10,725.00"	"4,914.00"
23515	"OPEN TREATMENT OF CLAVICULAR FRACTURE, W/ OR W/O
INTERNAL OR EXTERNAL FIXATION"	"24,289.20"	"10,530.00"	"13,759.20"
23520	CLOSED TREATMENT OF STERNOCLAVICULAR DISLOCATION	"21,216.00"	"13,845.00"	"7,371.00"
23530	"OPEN TREATMENT OF STERNOCLAVICULAR DISLOCTION, ACUTE
OR CHRONIC;"	"40,911.00"	"21,255.00"	"19,656.00"
23532	"OPEN TREATMENT OF STERNOCLAVICULAR DISLOCTION, W/
FASCIAL GRAFT (INCLUDES OBTAINING GRAFT)"	"52,884.00"	"23,400.00"	"29,484.00"
23540	CLOSED TRATMENT OF ACROMIOCLAVICULAR DISLOCATION	"15,639.00"	"10,725.00"	"4,914.00"
23550	"OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION,
ACUTE OR CHRONIC;"	"42,783.00"	"24,765.00"	"18,018.00"
23552	"OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC; W/ FASCIAL GRAFT (INCLUDES OBTAINING
GRAFT)"	"40,911.00"	"21,255.00"	"19,656.00"
23570	CLOSED TREATMENT OF SCAPULAR FRACTURE	"15,639.00"	"10,725.00"	"4,914.00"
23585	"OPEN TREATMENT OF SCAPULAR FRACTURE (BODY, GLENOID OR
ACROMION) W/ OR W/O INTERNAL FIXATION"	"40,911.00"	"21,255.00"	"19,656.00"
23600	"CLOSED TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR
ANATOMICAL NECK) FRACTURE"	"20,553.00"	"10,725.00"	"9,828.00"
23615	"OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, W/ OR W/O INTERNAL OR EXTERNAL FIXATION, W/ OR W/O REPAIR OF TUBEROSITY(-IES);"	"45,435.00"	"20,865.00"	"24,570.00"
23616	"OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, W/ OR W/O INTERNAL OR EXTERNAL FIXATION, W/ OR W/O REPAIR OF TUBEROSITY(-IES);
W/ PROXIMAL HUMERAL PROSTHETIC REPLACEMENT"	"92,313.00"	"41,535.00"	"50,778.00"
23620	CLOSED TREATMENT OF GREATER TUBEROSITY FRACTURE	"18,915.00"	"10,725.00"	"8,190.00"
23630	"OPEN TREATMENT OF GREATER TUBEROSITY FRACTURE, W/ OR
W/O INTERNAL OR EXTERNAL FIXATION"	"45,435.00"	"20,865.00"	"24,570.00"
23650	CLOSED TREATMENT OF SHOULDER DISLOCATION	"20,553.00"	"10,725.00"	"9,828.00"
23657	"THORACOSCOPY, SURGICAL; W/ WEDGE RESECTION OF LUNG,
SINGLE OR MUTIPLE"	"80,262.00"	"32,760.00"	"47,502.00"
23660	OPEN TREATMENT OF ACUTE SHOULDER DISLOCATION	"52,884.00"	"23,400.00"	"29,484.00"
23665	"CLOSED TREATMENT OF SHOULDER DISLOCATION,/ FRACTURE OF
GREATER TUBEROSITY"	"23,361.00"	"11,895.00"	"11,466.00"
23670	"OPEN TREATMENT OF SHOULDER DISLOCATION, W/ FRACTURE OF
GREATER TUBEROSITY, W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"52,884.00"	"23,400.00"	"29,484.00"
23675	"CLOSED TREATMENT OF SHOULDER DISLOCATION, W/ SURGICAL
OR ANATOMICAL NECK FRACTURE"	"23,634.00"	"10,530.00"	"13,104.00"
23680	"OPEN TREATMENT OF SHOULDER DISLOCATION, W/ SURGICAL OR ANATOMICAL NECK FRACTURE, W/ OR W/O INTERNAL OR
EXTERNAL FIXATION"	"52,884.00"	"23,400.00"	"29,484.00"
23700	"MANIPULATION UNDER ANESTHESIA, SHOULDER JOINT,
INCLUDING APPLICATION OF FIXATION APPARATUS (DISLOCATION EXCLUDED)"	"18,915.00"	"10,725.00"	"8,190.00"
23800	"ARTHRODESIS, SHOULDER JOINT; W/ OR W/O LOCAL BONE GRAFT"	"24,289.20"	"10,530.00"	"13,759.20"
23802	"ARTHRODESIS, SHOULDER JOINT; W/ PRIMARY AUTOGENOUS
GRAFT (INCLUDES OBTAINING GRAFT)"	"72,501.00"	"36,465.00"	"36,036.00"
23900	INTERTHORACOSCAPULAR AMPUTATION (FOREQUARTER)	"59,085.00"	"26,325.00"	"32,760.00"
23920	DISARTICULATION OF SHOULDER;	"52,884.00"	"23,400.00"	"29,484.00"
23930	"INCISION AND DRAINAGE, UPPER ARM OR ELBOW AREA; DEEP
ABSCESS OR HEMATOMA"	"8,010.60"	"6,045.00"	"1,965.60"
23931	"INCISION AND DRAINAGE, UPPER ARM OR ELBOW AREA;
INFECTED BURSA"	"10,842.00"	"8,385.00"	"2,457.00"
23935	"INCISION, DEEP, W/ OPENING OF BONE CORTEX (E.G., FOR
OSTEOMYELITIS OF BONE ABSCESS), HUMERUS OR ELBOW"	"42,783.00"	"24,765.00"	"18,018.00"
24000	"ARTHROTOMY, ELBOW, FOR INFECTION, W/ EXPLORATION,
DRAINAGE OR REMOVAL OF FOREIGN BODY"	"43,602.00"	"24,765.00"	"18,837.00"
24006	"ARTHROTOMY OF THE ELBOW, W/ CAPSULAR EXCISION FOR
CAPSULAR RELEASE"	"40,911.00"	"21,255.00"	"19,656.00"
24065	"BIOPSY, SOFT TISSUE OF UPPER ARM OR ELBOW AREA"	"6,832.80"	"5,850.00"	982.80
24075	"EXCISION, TUMOR, UPPER ARM OR ELBOW AREA; SUBCUTANEOUS"	"11,076.00"	"7,800.00"	"3,276.00"
24076	"EXCISION, TUMOR, UPPER ARM OR ELBOW AREA; DEEP,
SUBFASCIAL OR INTRAMUSCULAR"	"15,639.00"	"10,725.00"	"4,914.00"
24077	"RADICAL RESECTION OF TUMOR (E.G., MALIGNANT NEOPLASM),
SOFT TISSUE OF UPPER ARM OR ELBOW AREA"	"45,435.00"	"20,865.00"	"24,570.00"
24100	"ARTHROTOMY, ELBOW; W/ SYNOVIAL BIOPSY ONLY"	"40,911.00"	"21,255.00"	"19,656.00"
24101	"ARTHROTOMY, ELBOW; W/ JOINT EXPLORATION, W/ OR W/O BIOPSY, W/ OR W/O REMOVAL OF  LOOSE OR FOREIGN BODY"	"42,549.00"	"21,255.00"	"21,294.00"
24102	"ARTHROTOMY, ELBOW; W/ SYNOVECTOMY"	"45,435.00"	"20,865.00"	"24,570.00"
24105	"EXCISION, OLECRANON BURSA"	"16,107.00"	"9,555.00"	"6,552.00"
24110	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR,
HUMERUS;"	"40,911.00"	"21,255.00"	"19,656.00"
24115	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, HUMERUS; W/ AUTOGRAFT (INCLUDES OBTAINING GRAFT)"	"45,006.00"	"21,255.00"	"23,751.00"
24116	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR,
HUMERUS; W/ ALLOGRAFT"	"45,006.00"	"21,255.00"	"23,751.00"
24120	EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF HEAD OR NECK OF RADIUS OR OLECRANON PROCESS;	"41,238.60"	"21,255.00"	"19,983.60"
24125	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF
HEAD OR NECK OF RADIUS OR OLECRANON PROCESS; W/ AUTOGRAFT (INCLUDES OBTAINING GRAFT)"	"42,549.00"	"21,255.00"	"21,294.00"
24126	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF
HEAD OR NECK OF RADIUS OR OLECRANON PROCESS; W/ ALLOGRAFT"	"42,549.00"	"21,255.00"	"21,294.00"
24130	"EXCISION, RADIAL HEAD"	"40,911.00"	"21,255.00"	"19,656.00"
24134	"SEQUESTRECTOMY (E.G., FOR OSTEOMYELITIS OR BONE ABSCESS),
SHAFT OR DISTAL HUMERUS"	"40,911.00"	"21,255.00"	"19,656.00"
24136	"SEQUESTRECTOMY (E.G., FOR OSTEOMYELITIS OR BONE ABSCESS),
RADIAL HEAD OR NECK"	"40,911.00"	"21,255.00"	"19,656.00"
24138	"SEQUESTRECTOMY (E.G., FOR OSTEOMYELITIS OR BONE ABSCESS),
OLECRANON PROCESS"	"40,911.00"	"21,255.00"	"19,656.00"
24140	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS),
HUMERUS"	"40,911.00"	"21,255.00"	"19,656.00"
24145	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR
DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS), RADIAL HEAD OR NECK"	"40,911.00"	"21,255.00"	"19,656.00"
24147	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR
DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS), OLECRANON PROCESS"	"40,911.00"	"21,255.00"	"19,656.00"
24149	"RADICAL RESECTION OF CAPSULE, SOFT TISSUE, AND
HETEROTOPIC BONE, ELBOW, W/ CONTRACTURE RELEASE"	"41,730.00"	"21,255.00"	"20,475.00"
24150	"RADICAL RESECTION FOR TUMOR, SHAFT OR DISTAL HUMERUS;"	"45,006.00"	"21,255.00"	"23,751.00"
24151	"RADICAL RESECTION FOR TUMOR, SHAFT OR DISTAL HUMERUS;
W/ AUTOGRAFT (INCLUDES OBTAINING GRAFT)"	"59,085.00"	"26,325.00"	"32,760.00"
24152	"RADICAL RESECTION FOR TUMOR, RADIAL HEAD OR NECK;"	"45,435.00"	"20,865.00"	"24,570.00"
24153	"RADICAL RESECTION FOR TUMOR, RADIAL HEAD OR NECK; W/
AUTOGRAFT (INCLUDES OBTAINING GRAFT)"	"52,884.00"	"23,400.00"	"29,484.00"
24155	RESECTION OF ELBOW JOINT (ARTHRECTOMY)	"52,884.00"	"23,400.00"	"29,484.00"
24160	IMPLANT REMOVAL; ELBOW JOINT	"42,783.00"	"24,765.00"	"18,018.00"
24164	IMPLANT REMOVAL; RADIAL HEAD	"43,602.00"	"24,765.00"	"18,837.00"
24200	"REMOVAL OF FOREIGN BODY, UPPER ARM OR ELBOW AREA"	"16,130.40"	"10,725.00"	"5,405.40"
24301	"MUSCLE OR TENDON TRANSFER, ANY TYPE, UPPER ARM OR
ELBOW, SINGLE"	"45,435.00"	"20,865.00"	"24,570.00"
24305	"TENDON LENGTHENING, UPPER ARM OR ELBOW, SINGLE, EACH"	"40,911.00"	"21,255.00"	"19,656.00"
24310	"TENOTOMY, OPEN, ELBOW TO SHOULDER, SINGLE, EACH"	"42,783.00"	"24,765.00"	"18,018.00"
24320	"TENOPLASTY, W/ MUSCLE TRANSFER, W/ OR W/O FREE GRAFT,
ELBOW TO SHOULDER, SINGLE (SEDDON-BROOKES TYPE PROCEDURE)"	"52,884.00"	"23,400.00"	"29,484.00"
24330	"FLEXOR-PLASTY, ELBOW (E.G., STEINDLER TYPE ADVANCEMENT);"	"59,943.00"	"33,735.00"	"26,208.00"
24331	"FLEXOR-PLASTY, ELBOW (E.G., STEINDLER TYPE ADVANCEMENT);
W/ EXTENSOR ADVANCEMENT"	"52,884.00"	"23,400.00"	"29,484.00"
24340	TENODESIS OF BICEPS TENDON AT ELBOW	"16,107.00"	"9,555.00"	"6,552.00"
24341	"REPAIR, TENDON OR MUSCLE, UPPER ARM OR ELBOW, EACH
TENDON OR MUSCLE, PRIMARY OR SECONDARY (EXCLUDES ROTATOR CUFF)"	"40,911.00"	"21,255.00"	"19,656.00"
24342	"REINSERTION OF RUPTURED BICEPS OR TRICEPS TENDON,
DISTAL, W/ OR W/O TENDON GRAFT"	"23,634.00"	"10,530.00"	"13,104.00"
24350	"FASCIOTOMY, LATERAL OR MEDIAL (E.G., ""TENNIS ELBOW"" OR
EPICONDYLITIS);"	"20,553.00"	"10,725.00"	"9,828.00"
24351	"FASCIOTOMY, LATERAL OR MEDIAL (E.G., ""TENNIS ELBOW"" OR
EPICONDYLITIS); W/ EXTENSOR ORIGIN DETACHMENT"	"23,634.00"	"10,530.00"	"13,104.00"
24352	"FASCIOTOMY, LATERAL OR MEDIAL (E.G., ""TENNIS ELBOW"" OR
EPICONDYLITIS); W/ ANNULAR LIGAMENT RESECTION"	"23,634.00"	"10,530.00"	"13,104.00"
24354	"FASCIOTOMY, LATERAL OR MEDIAL (E.G., ""TENNIS ELBOW"" OR
EPICONDYLITIS); W/ STRIPPING"	"23,634.00"	"10,530.00"	"13,104.00"
24356	"FASCIOTOMY, LATERAL OR MEDIAL (E.G., ""TENNIS ELBOW"" OR
EPICONDYLITIS); W/ PARTIAL OSTECTOMY"	"23,634.00"	"10,530.00"	"13,104.00"
24360	"ARTHROPLASTY, ELBOW; W/ MEMBRANE;"	"52,884.00"	"23,400.00"	"29,484.00"
24361	"ARTHROPLASTY, ELBOW; W/ MEMBRANE; W/ DISTAL HUMERAL
PROSTHETIC REPLACEMENT"	"72,501.00"	"36,465.00"	"36,036.00"
24362	"ARTHROPLASTY, ELBOW; W/ MEMBRANE; W/ IMPLANT AND
FASCIA LATA LIGAMENT RECONSTRUCTION"	"52,884.00"	"23,400.00"	"29,484.00"
24363	"ARTHROPLASTY, ELBOW; W/ MEMBRANE; W/ DISTAL HUMERUS
AND PROXIMAL ULNAR PROSTHETIC REPLACEMENT (""TOTAL ELBOW"")"	"75,348.00"	"32,760.00"	"42,588.00"
24365	"ARTHROPLASTY, RADIAL HEAD;"	"42,783.00"	"24,765.00"	"18,018.00"
24366	"ARTHROPLASTY, RADIAL HEAD; W/ IMPLANT"	"52,884.00"	"23,400.00"	"29,484.00"
24400	"OSTEOTOMY, HUMERUS, W/ OR W/O INTERNAL FIXATION"	"40,911.00"	"21,255.00"	"19,656.00"
24410	"MULTIPLE OSTEOTOMIES W/ REALIGNMENT ON INTRAMEDULLARY ROD, HUMERAL SHAFT (SOFIELD TYPE
PROCEDURE)"	"40,911.00"	"21,255.00"	"19,656.00"
24420	"OSTEOPLASTY, HUMERUS (E.G., SHORTENING OR LENGTHENING)"	"45,435.00"	"20,865.00"	"24,570.00"
24430	"REPAIR OF NON-UNION OR MALUNION, HUMERUS; W/O GRAFT
(E.G., COMPRESSION TECHNIQUE);"	"45,006.00"	"21,255.00"	"23,751.00"
24435	"REPAIR OF NON-UNION OR MALUNION, HUMERUS; W/O GRAFT (E.G., COMPRESSION TECHNIQUE); W/ ILIAC OR OTHER
AUTOGRAFT (INCLUDES OBTAINING GRAFT)"	"52,884.00"	"23,400.00"	"29,484.00"
24470	"HEMIEPIPHYSEAL ARREST (E.G., FOR CUBITUS VARUS OR VALGUS,
DISTAL HUMERUS)"	"43,602.00"	"24,765.00"	"18,837.00"
24495	"DECOMPRESSION FASCIOTOMY, FOREARM, W/ BRACHIAL ARTERY
EXPLORATION"	"52,884.00"	"23,400.00"	"29,484.00"
24498	"PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING), W/ OR W/O METHYLMETHACRYLATE, HUMERUS"	"40,911.00"	"21,255.00"	"19,656.00"
24500	CLOSED TREATMENT OF HUMERAL SHAFT FRACTURE	"19,734.00"	"10,725.00"	"9,009.00"
24515	"OPEN TREATMENT OF HUMERAL SHAFT FRACTURE W/
PLATE/SCREWS, W/ OR W/O CERCLAGE"	"59,943.00"	"33,735.00"	"26,208.00"
24516	"OPEN TREATMENT OF HUMERAL SHAFT FRACTURE, W/ INSERTION OF INTRAMEDULLARY IMPLANT, W/ OR W/O
CERCLAGE AND/OR LOCKING SCREWS"	"59,943.00"	"33,735.00"	"26,208.00"
24530	"CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR HUMERAL FRACTURE, W/ OR W/O INTERCONDYLAR EXTENSION"	"19,734.00"	"10,725.00"	"9,009.00"
24538	"PERCUTANEOUS SKELETAL FIXATION OF SUPRACONDYLAR OR TRANSCONDYLAR HUMERAL FRACTURE, W/ OR W/O
INTERCONDYLAR EXTENSION"	"52,884.00"	"23,400.00"	"29,484.00"
24545	"OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR
TRANSCONDYLAR FRACTURE, W/ OR W/O INTERNAL OR EXTERNAL FIXATION; W/O INTERCONDYLAR EXTENSION"	"24,289.20"	"10,530.00"	"13,759.20"
24546	"OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE, W/ OR W/O INTERNAL OR
EXTERNAL FIXATION;  W/ INTERCONDYLAR EXTENSION"	"62,400.00"	"33,735.00"	"28,665.00"
24560	"CLOSED TREATMENT OF HUMERAL EPICONDYLAR FRACTURE,
MEDIAL OR LATERAL;"	"21,216.00"	"13,845.00"	"7,371.00"
24566	"PERCUTANEOUS SKELETAL FIXATION OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR LATERAL, W/ MANIPULATION"	"52,884.00"	"23,400.00"	"29,484.00"
24575	"OPEN TREATMENT OF HUMERAL EPICONDYLAR FRACTURE,
MEDIAL OR LATERAL, W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"35,100.00"	"18,720.00"	"16,380.00"
24576	"CLOSED TREATMENT OF HUMERAL CONDYLAR FRACTURE,
MEDIAL OR LATERAL"	"21,216.00"	"13,845.00"	"7,371.00"
24579	"OPEN TREATMENT OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL, W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"35,100.00"	"18,720.00"	"16,380.00"
24582	"PERCUTANEOUS SKELETAL FIXATION OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL, W/ MANIPULATION"	"52,884.00"	"23,400.00"	"29,484.00"
24586	OPEN TREATMENT OF PERIARTICULAR FRACTURE AND/OR DISLOCATION OF THE ELBOW (FRACTURE DISTAL HUMERUS AND PROXIMAL ULNA AND/OR PROXIMAL RADIUS);	"44,187.00"	"21,255.00"	"22,932.00"
24587	"OPEN TREATMENT OF PERIARTICULAR FRACTURE AND/OR DISLOCATION OF THE ELBOW (FRACTURE DISTAL HUMERUS AND PROXIMAL ULNA AND/OR PROXIMAL RADIUS); W/ IMPLANT
ARTHROPLASTY"	"73,710.00"	"32,760.00"	"40,950.00"
24600	TREATMENT OF CLOSED ELBOW DISLOCATION	"20,553.00"	"10,725.00"	"9,828.00"
24615	OPEN TREATMENT OF ACUTE OR CHRONIC ELBOW DISLOCATION	"45,435.00"	"20,865.00"	"24,570.00"
24620	"CLOSED TREATMENT OF MONTEGGIA TYPE OF FRACTURE
DISLOCATION AT ELBOW (FRACTURE PROXIMAL END OF ULNA W/ DISLOCATION OF RADIAL HEAD)"	"21,216.00"	"13,845.00"	"7,371.00"
24635	"OPEN TREATMENT OF MONTEGGIA TYPE OF FRACTURE DISLOCATION AT ELBOW (FRACTURE PROXIMAL END OF ULNA W/ DISLOCATION OF RADIAL HEAD), W/ OR W/O INTERNAL OR
EXTERNAL FIXATION"	"42,783.00"	"24,765.00"	"18,018.00"
24640	"CLOSED TREATMENT OF RADIAL HEAD SUBLUXATION IN CHILD,
""NURSEMAID ELBOW"""	"11,076.00"	"7,800.00"	"3,276.00"
24650	CLOSED TREATMENT OF RADIAL HEAD OR NECK FRACTURE	"21,216.00"	"13,845.00"	"7,371.00"
24665	"OPEN TREATMENT OF RADIAL HEAD OR NECK FRACTURE, W/ OR W/O INTERNAL FIXATION OR RADIAL HEAD EXCISION;"	"40,911.00"	"21,255.00"	"19,656.00"
24666	"OPEN TREATMENT OF PERIARTICULAR FRACTURE AND/OR DISLOCATION OF THE ELBOW (FRACTURE DISTAL HUMERUS AND PROXIMAL ULNA AND/OR PROXIMAL RADIUS);  W/ RADIAL HEAD
PROSTHETIC REPLACEMENT"	"52,884.00"	"23,400.00"	"29,484.00"
24670	"CLOSED TREATMENT OF ULNAR FRACTURE, PROXIMAL END
(OLECRANON PROCESS)"	"21,216.00"	"13,845.00"	"7,371.00"
24685	"OPEN TREATMENT OF ULNAR FRACTURE PROXIMAL END (OLECRANON PROCESS), W/ OR W/O INTERNAL OR EXTERNAL
FIXATION"	"42,783.00"	"24,765.00"	"18,018.00"
24800	"ARTHRODESIS, ELBOW JOINT; W/ OR W/O LOCAL AUTOGRAFT OR
ALLOGRAFT"	"52,884.00"	"23,400.00"	"29,484.00"
24802	"ARTHRODESIS, ELBOW JOINT; W/ AUTOGRAFT (INCLUDES
OBTAINING GRAFT OTHER THAN LOCALLY OBTAINED)"	"55,341.00"	"23,400.00"	"31,941.00"
24900	"AMPUTATION, ARM THROUGH HUMERUS; W/ PRIMARY CLOSURE"	"35,100.00"	"18,720.00"	"16,380.00"
24920	"AMPUTATION, ARM THROUGH HUMERUS; OPEN, CIRCULAR
(GUILLOTINE)"	"23,634.00"	"10,530.00"	"13,104.00"
24925	"AMPUTATION, ARM THROUGH HUMERUS; SECONDARY CLOSURE
OR SCAR REVISION"	"21,372.00"	"10,725.00"	"10,647.00"
24930	"AMPUTATION, ARM THROUGH HUMERUS; RE-AMPUTATION"	"29,172.00"	"14,430.00"	"14,742.00"
24931	"AMPUTATION, ARM THROUGH HUMERUS; W/ IMPLANT"	"29,172.00"	"14,430.00"	"14,742.00"
24935	"STUMP ELONGATION, UPPER EXTREMITY"	"23,634.00"	"10,530.00"	"13,104.00"
24940	"CINEPLASTY, UPPER EXTREMITY, COMPLETE PROCEDURE"	"52,884.00"	"23,400.00"	"29,484.00"
25000	"TENDON SHEATH INCISION; AT RADIAL STYLOID (E.G., FOR
DEQUERVAINS DISEASE)"	"20,553.00"	"10,725.00"	"9,828.00"
25020	"DECOMPRESSION FASCIOTOMY, FOREARM AND/OR WRIST;
FLEXOR OR EXTENSOR COMPARTMENT"	"35,100.00"	"18,720.00"	"16,380.00"
25023	"DECOMPRESSION FASCIOTOMY, FOREARM AND/OR WRIST; W/
DEBRIDEMENT OF NONVIABLE MUSCLE AND/OR NERVE"	"29,172.00"	"14,430.00"	"14,742.00"
25028	"INCISION AND DRAINAGE, FOREARM AND/OR WRIST; DEEP
ABSCESS OR HEMATOMA"	"21,216.00"	"13,845.00"	"7,371.00"
25031	"INCISION AND DRAINAGE, FOREARM AND/OR WRIST; INFECTED
BURSA"	"19,734.00"	"10,725.00"	"9,009.00"
25035	"INCISION, DEEP, W/ OPENING OF BONE CORTEX (E.G., FOR OSTEOMYELITIS OR BONE ABSCESS), FOREARM AND/OR WRIST"	"23,634.00"	"10,530.00"	"13,104.00"
25040	"ARTHROTOMY, RADIOCARPAL OR MIDCARPAL JOINT, W/ EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY"	"19,734.00"	"10,725.00"	"9,009.00"
25065	"BIOPSY, SOFT TISSUE OF FOREARM AND/OR WRIST"	"6,832.80"	"5,850.00"	982.80
25075	"EXCISION, TUMOR, FOREARM AND/OR WRIST AREA;
SUBCUTANEOUS"	"11,076.00"	"7,800.00"	"3,276.00"
25076	"EXCISION, TUMOR, FOREARM AND/OR WRIST AREA; DEEP,
SUBFASCIAL OR INTRAMUSCULAR"	"15,639.00"	"10,725.00"	"4,914.00"
25077	"RADICAL RESECTION OF TUMOR (E.G., MALIGNANT NEOPLASM), SOFT TISSUE OF FOREARM AND/OR WRIST AREA"	"45,435.00"	"20,865.00"	"24,570.00"
25085	"CAPSULOTOMY, WRIST (E.G., FOR CONTRACTURE)"	"29,991.00"	"14,430.00"	"15,561.00"
25100	"ARTHROTOMY, WRIST JOINT; W/ BIOPSY"	"21,535.80"	"10,725.00"	"10,810.80"
25101	"ARTHROTOMY, WRIST JOINT; W/ JOINT EXPLORATION, W/ OR W/O BIOPSY, W/ OR W/O REMOVAL OF LOOSE OR FOREIGN BODY"	"24,453.00"	"10,530.00"	"13,923.00"
25105	"ARTHROTOMY, WRIST JOINT; W/ SYNOVECTOMY"	"40,911.00"	"21,255.00"	"19,656.00"
25107	"ARTHROTOMY, DISTAL RADIOULNAR JOINT FOR REPAIR OF
TRIANGLE CARTILAGE COMPLEX"	"40,911.00"	"21,255.00"	"19,656.00"
25110	"EXCISION, LESION OF TENDON SHEATH, FOREARM AND/OR WRIST"	"15,639.00"	"10,725.00"	"4,914.00"
25111	"EXCISION OF GANGLION, WRIST (DORSAL OR VOLAR)"	"16,107.00"	"9,555.00"	"6,552.00"
25115	"RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FOREARM TENDON SHEATHS (E.G., TENOSYNOVITIS, FUNGUS, TBC, OR OTHER GRANULOMAS, RHEUMATOID ARTHRITIS); FLEXORS"	"42,549.00"	"21,255.00"	"21,294.00"
25116	"RADICAL EXCISION OF BURSA, SYNOVIA OF WRIST, OR FOREARM TENDON SHEATHS (E.G., TENOSYNOVITIS, FUNGUS, TBC, OR OTHER GRANULOMAS, RHEUMATOID ARTHRITIS); EXTENSORS, W/ OR W/O TRANSPOSITION OF DORSAL RETINACULUM"	"35,919.00"	"18,720.00"	"17,199.00"
25118	"SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE
COMPARTMENT;"	"19,406.40"	"10,725.00"	"8,681.40"
25119	"SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE
COMPARTMENT; W/ RESECTION OF DISTAL ULNA"	"42,783.00"	"24,765.00"	"18,018.00"
25120	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF RADIUS OR ULNA (EXCLUDING HEAD OR NECK OF RADIUS AND
OLECRANON PROCESS);"	"40,911.00"	"21,255.00"	"19,656.00"
25125	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF RADIUS OR ULNA (EXCLUDING HEAD OR NECK OF RADIUS AND OLECRANON PROCESS); W/ AUTOGRAFT (INCLUDES OBTAINING
GRAFT)"	"42,549.00"	"21,255.00"	"21,294.00"
25126	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF RADIUS OR ULNA (EXCLUDING HEAD OR NECK OF RADIUS AND
OLECRANON PROCESS); W/ ALLOGRAFT"	"42,549.00"	"21,255.00"	"21,294.00"
25130	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF
CARPAL BONES;"	"19,406.40"	"10,725.00"	"8,681.40"
25135	EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CARPAL BONES; W/ AUTOGRAFT (INCLUDES OBTAINING GRAFT)	"25,155.00"	"12,870.00"	"12,285.00"
25136	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF
CARPAL BONES; W/ ALLOGRAFT"	"25,155.00"	"12,870.00"	"12,285.00"
25145	"SEQUESTRECTOMY (E.G., FOR OSTEOMYELITIS OR BONE ABSCESS),
FOREARM AND/OR WRIST"	"42,783.00"	"24,765.00"	"18,018.00"
25150	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS); ULNA"	"42,783.00"	"24,765.00"	"18,018.00"
25151	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS); RADIUS"	"42,783.00"	"24,765.00"	"18,018.00"
25170	"RADICAL RESECTION FOR TUMOR, RADIUS OR ULNA"	"52,884.00"	"23,400.00"	"29,484.00"
25210	CARPECTOMY; ONE BONE	"11,567.40"	"7,800.00"	"3,767.40"
25215	CARPECTOMY; ALL BONES OF PROXIMAL ROW	"43,602.00"	"24,765.00"	"18,837.00"
25230	RADIAL STYLOIDECTOMY	"20,553.00"	"10,725.00"	"9,828.00"
25240	"EXCISION DISTAL ULNA PARTIAL OR COMPLETE (E.G., DARRACH
TYPE OR MATCHED RESECTION)"	"20,553.00"	"10,725.00"	"9,828.00"
25248	"EXPLORATION W/ REMOVAL OF DEEP FOREIGN BODY, FOREARM
OR WRIST"	"16,107.00"	"9,555.00"	"6,552.00"
25250	REMOVAL OF WRIST PROSTHESIS;	"42,783.00"	"24,765.00"	"18,018.00"
25251	"REMOVAL OF WRIST PROSTHESIS; COMPLICATED, INCLUDING
""TOTAL WRIST"""	"59,943.00"	"33,735.00"	"26,208.00"
25260	"REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST;
PRIMARY, SINGLE, EACH TENDON OR MUSCLE"	"20,553.00"	"10,725.00"	"9,828.00"
25263	"REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST;
SECONDARY, SINGLE, EACH TENDON OR MUSCLE"	"16,107.00"	"9,555.00"	"6,552.00"
25265	"REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST;
SECONDARY, W/ FREE GRAFT (INCLUDES OBTAINING GRAFT), EACH TENDON OR MUSCLE"	"19,734.00"	"10,725.00"	"9,009.00"
25270	"REPAIR, TENDON OR MUSLCE, EXTENSOR, FOREARM AND/OR WRIST; PRIMARY, SINGLE, EACH TENDON OR MUSCLE"	"20,553.00"	"10,725.00"	"9,828.00"
25272	"REPAIR, TENDON OR MUSLCE, EXTENSOR, FOREARM AND/OR WRIST; SECONDARY, SINGLE, EACH TENDON OR MUSCLE"	"16,107.00"	"9,555.00"	"6,552.00"
25274	"REPAIR, TENDON OR MUSCLE, EXTENSOR, SECONDARY, W/
TENDON GRAFT (INCLUDES OBTAINING GRAFT), FOREARM AND/OR WRIST, EACH TENDON OR MUSCLE"	"20,553.00"	"10,725.00"	"9,828.00"
25280	"LENGTHENING OR SHORTENING OF FLEXOR OR EXTENSOR
TENDON, FOREARM AND/OR WRIST, SINGLE, EACH TENDON"	"21,216.00"	"13,845.00"	"7,371.00"
25290	"TENOTOMY, OPEN, FLEXOR OR EXTENSOR TENDON, FOREARM
AND/OR WRIST, SINGLE, EACH TENDON"	"21,216.00"	"13,845.00"	"7,371.00"
25295	"TENOLYSIS, FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR
WRIST, SINGLE EACH TENDON"	"16,107.00"	"9,555.00"	"6,552.00"
25300	TENODESIS AT WRIST; FLEXORS OF FINGERS	"21,372.00"	"10,725.00"	"10,647.00"
25301	TENODESIS AT WRIST; EXTENSORS OF FINGERS	"20,553.00"	"10,725.00"	"9,828.00"
25310	"TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTENSOR, FOREARM AND/OR WRIST, SINGLE; EACH TENDON"	"40,911.00"	"21,255.00"	"19,656.00"
25312	"TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTENSOR, FOREARM AND/OR WRIST, SINGLE; W/ TENDON
GRAFT(S) (INCLUDES OBTAINING GRAFT), EACH TENDON"	"42,549.00"	"21,255.00"	"21,294.00"
25315	"FLEXOR ORIGIN SLIDE (E.G., FOR CEREBRAL PALSY, VOLKMANN
CONTRACTURE), FOREARM AND/OR WRIST;"	"59,085.00"	"26,325.00"	"32,760.00"
25316	"FLEXOR ORIGIN SLIDE (E.G., FOR CEREBRAL PALSY, VOLKMANN CONTRACTURE), FOREARM AND/OR WRIST; W/ TENDON(S)
TRANSFER"	"72,501.00"	"36,465.00"	"36,036.00"
25320	"CAPSULORRHAPHY OR RECONSTRUCTION, WRIST, ANY METHOD (E.G., CAPSULODESIS, LIGAMENT REPAIR, TENDON TRANSFER OR GRAFT) (INCLUDES SYNOVECTOMY, CAPSULOTOMY AND OPEN REDUCTION) FOR CARPAL INSTABILITY"	"52,884.00"	"23,400.00"	"29,484.00"
25332	"ARTHROPLASTY, WRIST, W/ OR W/O INTERPOSITION, W/ OR W/O
EXTERNAL OR INTERNAL FIXATION"	"59,085.00"	"26,325.00"	"32,760.00"
25335	"CENTRALIZATION OF WRIST ON ULNA (E.G., RADIAL CLUB HAND)"	"60,723.00"	"26,325.00"	"34,398.00"
25337	"RECONSTRUCTION FOR STABILIZATION OF UNSTABLE DISTAL ULNA OR DISTAL RADIOULNAR JOINT, SECONDARY BY SOFT TISSUE STABILIZATION (E.G., TENDON TRANSFER, TENDON GRAFT OR WEAVE, OR TENODESIS) W/ OR W/O OPEN REDUCTION OF
DISTAL RADIOULNAR JOINT"	"54,522.00"	"23,400.00"	"31,122.00"
25350	"OSTEOTOMY, RADIUS; DISTAL THIRD"	"35,100.00"	"18,720.00"	"16,380.00"
25355	"OSTEOTOMY, RADIUS; MIDDLE OR PROXIMAL THIRD"	"42,783.00"	"24,765.00"	"18,018.00"
25360	OSTEOTOMY; ULNA	"35,919.00"	"18,720.00"	"17,199.00"
25365	OSTEOTOMY; RADIUS AND ULNA	"45,435.00"	"20,865.00"	"24,570.00"
25370	"MULTIPLE OSTEOTOMIES, W/ REALIGNMENT ON INTRAMEDULLARY ROD (SOFIELD TYPE PROCEDURE); RADIUS OR
ULNA"	"59,943.00"	"33,735.00"	"26,208.00"
25375	"MULTIPLE OSTEOTOMIES, W/ REALIGNMENT ON
INTRAMEDULLARY ROD (SOFIELD TYPE PROCEDURE); RADIUS AND ULNA"	"54,522.00"	"23,400.00"	"31,122.00"
25390	"OSTEOPLASTY, RADIUS OR ULNA; SHORTENING"	"52,884.00"	"23,400.00"	"29,484.00"
25391	"OSTEOPLASTY, RADIUS OR ULNA; LENGTHENING W/ AUTOGRAFT"	"54,522.00"	"23,400.00"	"31,122.00"
25392	"OSTEOPLASTY, RADIUS AND ULNA; SHORTENING"	"52,884.00"	"23,400.00"	"29,484.00"
25393	"OSTEOPLASTY, RADIUS AND ULNA; LENGTHENING W/ AUTOGRAFT"	"54,522.00"	"23,400.00"	"31,122.00"
25400	"REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; W/O
GRAFT (COMPRESSION TECHNIQUE)"	"40,911.00"	"21,255.00"	"19,656.00"
25405	"REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; W/ ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT)"	"45,435.00"	"20,865.00"	"24,570.00"
25415	"REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; W/O
GRAFT (E.G. COMPRESSION TECHNIQUE)"	"59,943.00"	"33,735.00"	"26,208.00"
25420	"REPAIR OF NONUNION OR MALUNION, RADIUS AND ULNA; W/ ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT)"	"54,522.00"	"23,400.00"	"31,122.00"
25425	REPAIR OF DEFECT W/ AUTOGRAFT; RADIUS OR ULNA	"42,783.00"	"24,765.00"	"18,018.00"
25426	REPAIR OF DEFECT W/ AUTOGRAFT; RADIUS AND ULNA	"59,943.00"	"33,735.00"	"26,208.00"
25440	"REPAIR OF NONUNION, SCAPHOID (NAVICULAR) BONE, W/ OR W/O RADIAL STYLOIDECTOMY (INCLUDES OBTAINING GRAFT AND
NECESSARY FIXATION)"	"46,254.00"	"20,865.00"	"25,389.00"
25441	ARTHROPLASTY W/ PROSTHETIC REPLACEMENT; DISTAL RADIUS	"59,085.00"	"26,325.00"	"32,760.00"
25442	ARTHROPLASTY W/ PROSTHETIC REPLACEMENT; DISTAL ULNA	"52,884.00"	"23,400.00"	"29,484.00"
25443	"ARTHROPLASTY W/ PROSTHETIC REPLACEMENT; SCAPHOID
(NAVICULAR)"	"52,884.00"	"23,400.00"	"29,484.00"
25444	ARTHROPLASTY W/ PROSTHETIC REPLACEMENT; LUNATE	"52,884.00"	"23,400.00"	"29,484.00"
25445	ARTHROPLASTY W/ PROSTHETIC REPLACEMENT; TRAPEZIUM	"61,581.00"	"33,735.00"	"27,846.00"
25446	"ARTHROPLASTY W/ PROSTHETIC REPLACEMENT; DISTAL RADIUS
AND PARTIAL OR ENTIRE CARPUS (""TOTAL WRIST"")"	"73,710.00"	"32,760.00"	"40,950.00"
25447	"ARTHROPLASTY W/ PROSTHETIC REPLACEMENT; INTERPOSITION ARTHROPLASTY, INTERCARPAL OR CARPOMETACARPAL JOINTS"	"54,522.00"	"23,400.00"	"31,122.00"
25449	"REVISION OF ARTHROPLASTY, INCLUDING REMOVAL OF IMPLANT,
WRIST JOINT"	"78,624.00"	"32,760.00"	"45,864.00"
25450	"EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; DISTAL
RADIUS OR ULNA"	"40,911.00"	"21,255.00"	"19,656.00"
25455	"EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; DISTAL
RADIUS AND ULNA"	"59,943.00"	"33,735.00"	"26,208.00"
25490	"PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR
WIRING) W/ OR W/O METHYLMETHACRYLATE; RADIUS"	"42,783.00"	"24,765.00"	"18,018.00"
25491	"PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR
WIRING) W/ OR W/O METHYLMETHACRYLATE; ULNA"	"42,783.00"	"24,765.00"	"18,018.00"
25492	"PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) W/ OR W/O METHYLMETHACRYLATE; RADIUS AND ULNA"	"72,501.00"	"36,465.00"	"36,036.00"
25500	CLOSED TREATMENT OF RADIAL SHAFT FRACTURE	"18,915.00"	"10,725.00"	"8,190.00"
25515	"OPEN TREATMENT OF RADIAL SHAFT FRACTURE, W/ OR W/O
INTERNAL OR EXTERNAL FIXATION"	"42,783.00"	"24,765.00"	"18,018.00"
25520	"CLOSED TREATMENT OF RADIAL SHAFT FRACTURE, W/
DISLOCATION OF DISTAL RADIO-ULNAR JOINT (GALEAZZI FRACTURE/DISLOCATION)"	"18,915.00"	"10,725.00"	"8,190.00"
25525	"OPEN TREATMENT OF RADIAL SHAFT FRACTURE, W/ INTERNAL AND/OR EXTERNAL FIXATION AND CLOSED TREATMENT OF DISLOCATION OF DISTAL RADIO-ULNAR JOINT (GALEAZZI FRACTURE/DISLOCATION), W/ OR W/O PERCUTANEOUS SKELETAL
FIXATION"	"40,911.00"	"21,255.00"	"19,656.00"
25526	"OPEN TREATMENT OF RADIAL SHAFT FRACTURE, W/ INTERNAL AND/OR EXTERNAL FIXATION AND OPEN TREATMENT, W/ OR W/O INTERNAL OR EXTERNAL FIXATION OF DISTAL RADIO-ULNAR JOINT (GALLEAZI FRACTURE/DISLOCATION), INCLUDES REPAIR OF TRIANGULAR CARTILAGE"	"44,187.00"	"21,255.00"	"22,932.00"
25530	CLOSED TREATMENT OF ULNAR SHAFT FRACTURE	"16,107.00"	"9,555.00"	"6,552.00"
25545	"OPEN TREATMENT OF ULNAR SHAFT FRACTURE, W/ OR W/O
INTERNAL OR EXTERNAL FIXATION"	"35,100.00"	"18,720.00"	"16,380.00"
25560	CLOSED TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES	"18,915.00"	"10,725.00"	"8,190.00"
25574	"OPEN TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES, W/ INTERNAL OR EXTERNAL FIXATION; OF RADIUS OR ULNA"	"54,522.00"	"23,400.00"	"31,122.00"
25575	"OPEN TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES, W/ INTERNAL OR EXTERNAL FIXATION; OF RADIUS AND ULNA"	"52,884.00"	"23,400.00"	"29,484.00"
25600	"CLOSED TREATMENT OF DISTAL RADIAL FRACTURE (E.G., COLLES OR SMITH TYPE) OR EPIPHYSEAL SEPARATION, W/ OR W/O
FRACTURE OF ULNAR STYLOID"	"16,107.00"	"9,555.00"	"6,552.00"
25611	"PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIAL FRACTURE (E.G., COLLES OR SMITH TYPE) OR EPIPHYSEAL SEPARATION, W/ OR W/O FRACTURE OF ULNAR STYLOID , REQUIRING MANIPULATION, W/ OR W/O EXTERNAL FIXATION"	"45,435.00"	"20,865.00"	"24,570.00"
25620	"OPEN TREATMENT OF DISTAL RADIAL FRACTURE (E.G., COLLES OR SMITH TYPE) OR EPIPHYSEAL SEPARATION, W/ OR W/O FRACTURE OF ULNAR STYLOID, W/ OR W/O INTERNAL OR EXTERNAL
FIXATION"	"45,435.00"	"20,865.00"	"24,570.00"
25622	"CLOSED TREATMENT OF CARPAL SCAPHOID (NAVICULAR)
FRACTURE"	"16,107.00"	"9,555.00"	"6,552.00"
25628	"OPEN TREATMENT OF CARPAL SCAPHOID (NAVICULAR)
FRACTURE, W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"42,549.00"	"21,255.00"	"21,294.00"
25630	"CLOSED TREATMENT OF CARPAL BONE FRACTURE (EXCLUDING
CARPAL SCAPHOID (NAVICULAR))"	"16,107.00"	"9,555.00"	"6,552.00"
25645	"OPEN TREATMENT OF CARPAL BONE FRACTURE (EXCLUDING
CARPAL SCAPHOID (NAVICULAR)), EACH BONE"	"42,712.80"	"21,255.00"	"21,457.80"
25650	CLOSED TREATMENT OF ULNAR STYLOID FRACTURE	"16,458.00"	"10,725.00"	"5,733.00"
25660	"CLOSED TREATMENT OF RADIOCARPAL OR INTERCARPAL
DISLOCATION, ONE OR MORE BONES"	"16,107.00"	"9,555.00"	"6,552.00"
25670	"OPEN TREATMENT OF RADIOCARPAL OR INTERCARPAL
DISLOCATION, ONE OR MORE BONES"	"35,100.00"	"18,720.00"	"16,380.00"
25675	CLOSED TREATMENT OF DISTAL RADIOULNAR DISLOCATION	"16,107.00"	"9,555.00"	"6,552.00"
25676	"OPEN TREATMENT OF DISTAL RADIOULNAR DISLOCATION, ACUTE
OR CHRONIC"	"42,549.00"	"21,255.00"	"21,294.00"
25680	"CLOSED TREATMENT OF TRANS-SCAPHOPERILUNAR TYPE OF
FRACTURE DISLOCATION"	"16,107.00"	"9,555.00"	"6,552.00"
25685	"OPEN TREATMENT OF TRANS-SCAPHOPERILUNAR TYPE OF
FRACTURE DISLOCATION"	"40,911.00"	"21,255.00"	"19,656.00"
25690	CLOSED TREATMENT OF LUNATE DISLOCATION	"16,107.00"	"9,555.00"	"6,552.00"
25695	OPEN TREATMENT OF LUNATE DISLOCATION	"42,783.00"	"24,765.00"	"18,018.00"
25800	"ARTHRODESIS, WRIST JOINT (INCLUDING RADIOCARPAL AND/OR
ULNOCARPAL FUSION); W/O BONE GRAFT"	"35,100.00"	"18,720.00"	"16,380.00"
25805	"ARTHRODESIS, WRIST JOINT (INCLUDING RADIOCARPAL AND/OR
ULNOCARPAL FUSION); W/ SLIDING GRAFT"	"42,549.00"	"21,255.00"	"21,294.00"
25810	"ARTHRODESIS, WRIST JOINT (INCLUDING RADIOCARPAL AND/OR ULNOCARPAL FUSION); W/ ILIAC OR OTHER AUTOGRAFT
(INCLUDES OBTAINING GRAFT)"	"42,549.00"	"21,255.00"	"21,294.00"
25820	INTERCARPAL FUSION; W/O BONE GRAFT	"25,155.00"	"12,870.00"	"12,285.00"
25825	"INTERCARPAL FUSION; W/ AUTOGRAFT (INCLUDES OBTAINING
GRAFT)"	"29,172.00"	"14,430.00"	"14,742.00"
25830	"DISTAL RADIOULNAR JOINT ARTHRODESIS AND SEGMENTAL
RESECTION OF ULNA (E.G. SAUVE-KAPANDJI PROCEDURE), W/ OR W/O BONE GRAFT"	"42,549.00"	"21,255.00"	"21,294.00"
25900	"AMPUTATION, FOREARM, THROUGH, RADIUS AND ULNA;"	"35,100.00"	"18,720.00"	"16,380.00"
25905	"AMPUTATION, FOREARM, THROUGH, OPEN, CIRCULAR
(GUILLOTINE)"	"23,634.00"	"10,530.00"	"13,104.00"
25907	"AMPUTATION, FOREARM, THROUGH, SECONDARY CLOSURE OR
SCAR REVISION"	"21,372.00"	"10,725.00"	"10,647.00"
25909	"AMPUTATION, FOREARM, THROUGH, RE-AMPUTATION"	"29,172.00"	"14,430.00"	"14,742.00"
25915	KRUKENBERG PROCEDURE	"73,710.00"	"32,760.00"	"40,950.00"
25920	DISARTICULATION THROUGH WRIST;	"29,172.00"	"14,430.00"	"14,742.00"
25922	"DISARTICULATION THROUGH WRIST; SECONDARY CLOSURE OR
SCAR REVISION"	"16,458.00"	"10,725.00"	"5,733.00"
25924	DISARTICULATION THROUGH WRIST; RE-AMPUTATION	"29,172.00"	"14,430.00"	"14,742.00"
25927	TRANSMETACARPAL AMPUTATION;	"29,172.00"	"14,430.00"	"14,742.00"
25929	"TRANSMETACARPAL AMPUTATION; SECONDARY CLOSURE OR
SCAR REVISION"	"16,458.00"	"10,725.00"	"5,733.00"
25931	TRANSMETACARPAL AMPUTATION; RE-AMPUTATION	"29,172.00"	"14,430.00"	"14,742.00"
26010	DRAINAGE OF FINGER ABSCESS; SIMPLE	"6,832.80"	"5,850.00"	982.80
26011	"DRAINAGE OF FINGER ABSCESS; COMPLICATED (E.G., FELON)"	"8,010.60"	"6,045.00"	"1,965.60"
26020	"DRAINAGE OF TENDON SHEATH, ONE DIGIT AND/OR PALM"	"15,639.00"	"10,725.00"	"4,914.00"
26025	"DRAINAGE OF PALMAR BURSA; SINGLE, ULNAR OR RADIAL"	"21,216.00"	"13,845.00"	"7,371.00"
26030	"DRAINAGE OF PALMAR BURSA; SINGLE, MULTIPLE OR
COMPLICATED"	"20,553.00"	"10,725.00"	"9,828.00"
26034	"INICISION, DEEP, W/ OPENING OF BONE CORTEX (E.G., FOR
OSTEOMYELITIS OR BONE ABSCESS), HAND OR FINGER"	"42,783.00"	"24,765.00"	"18,018.00"
26035	"DECOMPRESSION FINGERS AND/OR HAND, INJECTION INJURY
(E.G., GREASE GUN)"	"29,172.00"	"14,430.00"	"14,742.00"
26037	"DECOMPRESSIVE FASCIOTOMY, HAND (EXCLUDES 26035)"	"42,783.00"	"24,765.00"	"18,018.00"
26040	"FASCIOTOMY, PALMAR, FOR DUPUYTRENS CONTRACTURE;
PERCUTANEOUS"	"23,634.00"	"10,530.00"	"13,104.00"
26045	"FASCIOTOMY, PALMAR, FOR DUPUYTRENS CONTRACTURE; OPEN,
PARTIAL"	"23,634.00"	"10,530.00"	"13,104.00"
26055	"TENDON SHEATH INCISION (E.G., FOR TRIGGER FINGER)"	"20,553.00"	"10,725.00"	"9,828.00"
26060	"TENOTOMY, PERCUTANEOUS, SINGLE, EACH DIGIT"	"18,915.00"	"10,725.00"	"8,190.00"
26070	"ARTHROTOMY, W/ EXPLORATION, DRAINAGE, OR REMOVAL OF
FOREIGN BODY; CARPOMETACARPAL JOINT"	"21,216.00"	"13,845.00"	"7,371.00"
26075	"ARTHROTOMY, W/ EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY; METACARPOPHALANGEAL JOINT"	"21,216.00"	"13,845.00"	"7,371.00"
26080	"ARTHROTOMY, W/ EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY; INTERPHALANGEAL JOINT, EACH"	"16,107.00"	"9,555.00"	"6,552.00"
26100	"ARTHROTOMY W/ SYNOVIAL BIOPSY, CARPOMETACARPAL JOINT"	"23,634.00"	"10,530.00"	"13,104.00"
26105	"ARTHROTOMY W/ SYNOVIAL BIOPSY, METACARPOPHALANGEAL
JOINT"	"25,155.00"	"12,870.00"	"12,285.00"
26110	"ARTHROTOMY W/ SYNOVIAL BIOPSY, INTERPHALANGEAL JOINT,
EACH"	"23,361.00"	"11,895.00"	"11,466.00"
26115	"EXCISION, TUMOR OR VASCULAR MALFORMATION, HAND OR
FINGER; SUBCUTANEOUS"	"40,911.00"	"21,255.00"	"19,656.00"
26116	"EXCISION, TUMOR OR VASCULAR MALFORMATION, HAND OR
FINGER; DEEP, SUBFASCIAL, INTRAMUSCULAR"	"45,435.00"	"20,865.00"	"24,570.00"
26117	"RADICAL RESECTION OF TUMOR (E.G., MALIGNANT NEOPLASM),
SOFT TISSUE OF HAND OR FINGER"	"52,884.00"	"23,400.00"	"29,484.00"
26121	"FASCIECTOMY, PALM ONLY, W/ OR W/O Z-PLASTY, OTHER LOCAL
TISSUE REARRANGEMENT, OR SKIN GRAFTING (INCLUDES OBTAINING GRAFT)"	"52,884.00"	"23,400.00"	"29,484.00"
26123	"FASCIECTOMY, PARTIAL PALMAR W/ RELEASE OF SINGLE DIGIT INCLUDING PROXIMAL INTERPHALANGEAL JOINT, W/ OR W/O Z- PLASTY, OTHER LOCAL TISSUE REARRANGEMENT, OR SKIN GRAFTING (INCLUDES OBTAINING GRAFT);"	"44,187.00"	"21,255.00"	"22,932.00"
26125	"FASCIECTOMY, PARTIAL PALMAR W/ RELEASE OF SINGLE DIGIT INCLUDING PROXIMAL INTERPHALANGEAL JOINT, W/ OR W/O Z- PLASTY, OTHER LOCAL TISSUE REARRANGEMENT, OR SKIN GRAFTING (INCLUDES OBTAINING GRAFT); EACH ADDITIONAL DIGIT (LIST SEPARATELY IN ADDITION TO CODE"	"16,107.00"	"9,555.00"	"6,552.00"
26130	"SYNOVECTOMY, CAPOMETACARPAL JOINT"	"44,187.00"	"21,255.00"	"22,932.00"
26135	"SYNOVECTOMY, METACARPOPHALANGEAL JOINT INCLUDING INTRINSIC RELEASE AND EXTENSOR HOOD RECONSTRUCTION,
EACH DIGIT"	"25,318.80"	"12,870.00"	"12,448.80"
26140	"SYNOVECTOMY, PROXIMAL INTERPHALANGEAL JOINT, INCLUDING EXTENSOR RECONSTRUCTION, EACH
INTERPHALANGEAL JOINT"	"25,318.80"	"12,870.00"	"12,448.80"
26145	"SYNOVECTOMY TENDON SHEATH, RADICAL (TENOSYNOVECTOMY), FLEXOR, PALM OR FINGER, SINGLE, EACH DIGIT"	"29,991.00"	"14,430.00"	"15,561.00"
26160	"EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (E.G., CYST, MUCOUS CYST, OR GANGLION), HAND OR FINGER"	"23,361.00"	"11,895.00"	"11,466.00"
26170	"EXCISION OF TENDON, PALM, FLEXOR, SINGLE , EACH"	"16,458.00"	"10,725.00"	"5,733.00"
26180	"EXCISION OF TENDON, FINGER, FLEXOR"	"16,107.00"	"9,555.00"	"6,552.00"
26185	"SESAMOIDECTOMY, THUMB OR FINGER"	"29,991.00"	"14,430.00"	"15,561.00"
26200	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF
METACARPAL;"	"24,616.80"	"10,530.00"	"14,086.80"
26205	EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF METACARPAL; W/ AUTOGRAFT (INCLUDES OBTAINING GRAFT)	"42,783.00"	"24,765.00"	"18,018.00"
26210	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF PROXIMAL, MIDDLE; OR DISTAL PHALANX OF FINGER;"	"23,634.00"	"10,530.00"	"13,104.00"
26215	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF
PROXIMAL, MIDDLE; OR DISTAL PHALANX OF FINGER; W/ AUTOGRAFT (INCLUDES OBTAINING GRAFT)"	"29,991.00"	"14,430.00"	"15,561.00"
26230	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR
DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS); METACARPAL"	"42,783.00"	"24,765.00"	"18,018.00"
26235	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR
DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS); PROXIMAL OR MIDDLE PHALANX OF FINGER"	"29,991.00"	"14,430.00"	"15,561.00"
26236	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR
DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS); DISTAL PHALANX  OF FINGER"	"23,634.00"	"10,530.00"	"13,104.00"
26250	"RADICAL RESECTION (OSTECTOMY) FOR TUMOR, METACARPAL;"	"46,090.20"	"20,865.00"	"25,225.20"
26255	"RADICAL RESECTION (OSTECTOMY) FOR TUMOR, METACARPAL; W/ AUTOGRAFT (INCLUDES OBTAINING GRAFT)"	"62,400.00"	"33,735.00"	"28,665.00"
26260	"RADICAL RESECTION (OSTECTOMY) FOR TUMOR, PROXIMAL OR
MIDDLE PHALANX OF FINGER;"	"59,943.00"	"33,735.00"	"26,208.00"
26261	"RADICAL RESECTION (OSTECTOMY) FOR TUMOR, PROXIMAL OR MIDDLE PHALANX OF FINGER; W/ AUTOGRAFT (INCLUDES
OBTAINING GRAFT)"	"61,581.00"	"33,735.00"	"27,846.00"
26262	"RADICAL RESECTION (OSTECTOMY) FOR TUMOR, DISTAL PHALANX
OF FINGER"	"45,006.00"	"21,255.00"	"23,751.00"
26350	"FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE, NOT IN ""NO MANS LAND"", PRIMARY OR SECONDARY W/O FREE GRAFT, EACH
TENDON"	"23,634.00"	"10,530.00"	"13,104.00"
26352	"FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE, NOT IN ""NO MANS LAND"", SECONDARY W/ FREE GRAFT (INCLUDES OBTAINING
GRAFT), EACH TENDON"	"20,553.00"	"10,725.00"	"9,828.00"
26356	"FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE, IN ""NO
MANS LAND""; PRIMARY, EACH TENDON"	"21,216.00"	"13,845.00"	"7,371.00"
26357	"FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE, IN ""NO
MANS LAND""; SECONDARY, EACH TENDON"	"21,216.00"	"13,845.00"	"7,371.00"
26358	"FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE, IN ""NO MANS LAND""; SECONDARY W/ FREE GRAFT (INCLUDES OBTAINING
GRAFT), EACH TENDON"	"21,216.00"	"13,845.00"	"7,371.00"
26370	"PROFUNDUS TENDON REPAIR OR ADVANCEMENT, W/ INTACT
SUBLIMIS; PRIMARY"	"21,216.00"	"13,845.00"	"7,371.00"
26372	"PROFUNDUS TENDON REPAIR OR ADVANCEMENT, W/ INTACT SUBLIMIS; SECONDARY W/ FREE GRAFT (INCLUDES OBTAINING
GRAFT)"	"20,553.00"	"10,725.00"	"9,828.00"
26373	"PROFUNDUS TENDON REPAIR OR ADVANCEMENT, W/ INTACT
SUBLIMIS; SECONDARY W/O FREE GRAFT"	"21,707.40"	"13,845.00"	"7,862.40"
26390	"FLEXOR TENDON EXCISION, IMPLANTATION OF PLASTIC TUBE OR ROD FOR DELAYED TENDON GRAFT, HAND OR FINGER"	"21,216.00"	"13,845.00"	"7,371.00"
26392	"REMOVAL OF TUBE OR ROD AND INSERTION OF FLEXOR TENDON GRAFT (INCLUDES OBTAINING GRAFT), HAND OR FINGER"	"21,216.00"	"13,845.00"	"7,371.00"
26410	"EXTENSOR TENDON REPAIR, DORSUM OF HAND, SINGLE, PRIMARY
OR SECONDARY; W/O FREE GRAFT, EACH TENDON"	"16,107.00"	"9,555.00"	"6,552.00"
26412	"EXTENSOR TENDON REPAIR, DORSUM OF HAND, SINGLE, PRIMARY OR SECONDARY; W/ FREE GRAFT (INCLUDES OBTAINING GRAFT),
EACH TENDON"	"16,107.00"	"9,555.00"	"6,552.00"
26415	"EXTENSOR TENDON EXCISION, IMPLANTATION OF PLASTIC TUBE OR ROD FOR DELAYED EXTENSOR TENDON GRAFT, HAND OR
FINGER"	"21,216.00"	"13,845.00"	"7,371.00"
26416	"REMOVAL OF TUBE OR ROD AND INSERTION OF EXTENSOR TENDON GRAFT (INCLUDES OBTAINING GRAFT), HAND OR FINGER"	"16,949.40"	"10,725.00"	"6,224.40"
26418	"EXTENSOR TENDON REPAIR, DORSUM OF FINGER, SINGLE,
PRIMARY OR SECONDARY; W/O FREE GRAFT, EACH TENDON"	"16,107.00"	"9,555.00"	"6,552.00"
26420	"EXTENSOR TENDON REPAIR, DORSUM OF FINGER, SINGLE, PRIMARY OR SECONDARY; W/ FREE GRAFT (INCLUDES OBTAINING
GRAFT), EACH TENDON"	"16,107.00"	"9,555.00"	"6,552.00"
26426	"EXTENSOR TENDON REPAIR, CENTRAL SLIP REPAIR, SECONDARY (BOUTONNIERE DEFORMITY); USING LOCAL TISSUES"	"16,107.00"	"9,555.00"	"6,552.00"
26428	"EXTENSOR TENDON REPAIR, CENTRAL SLIP REPAIR, SECONDARY (BOUTONNIERE DEFORMITY); W/ FREE GRAFT (INCLUDES
OBTAINING GRAFT)"	"16,107.00"	"9,555.00"	"6,552.00"
26432	"EXTENSOR TENDON REPAIR, DISTAL INSERTION (""MALLET FINGER""), CLOSED SPLINTING W/ OR W/O PERCUTANEOUS
PINNING"	"16,107.00"	"9,555.00"	"6,552.00"
26433	"EXTENSOR TENDON REPAIR, DISTAL INSERTION (""MALLET FINGER""), OPEN, PRIMARY OR SECONDARY REPAIR; W/O GRAFT"	"16,107.00"	"9,555.00"	"6,552.00"
26434	"EXTENSOR TENDON REPAIR, DISTAL INSERTION (""MALLET FINGER""), OPEN, PRIMARY OR SECONDARY REPAIR; W/ FREE
GRAFT (INCLUDES OBTAINING GRAFT)"	"21,216.00"	"13,845.00"	"7,371.00"
26437	"EXTENSOR TENDON REALIGNMENT, HAND"	"20,553.00"	"10,725.00"	"9,828.00"
26440	"TENOLYSIS, SIMPLE, FLEXOR TENDON; PALM OR FINGER, SINGLE,
EACH TENDON"	"15,639.00"	"10,725.00"	"4,914.00"
26442	"TENOLYSIS, SIMPLE, FLEXOR TENDON; PALM AND FINGER, EACH
TENDON"	"16,458.00"	"10,725.00"	"5,733.00"
26445	"TENOLYSIS, EXTENSOR TENDON, DORSUM OF HAND OR FINGER;
EACH TENDON"	"15,639.00"	"10,725.00"	"4,914.00"
26449	"TENOLYSIS, COMPLEX, EXTENSOR TENDON, DORSUM OF HAND OR
FINGER, INCLUDING HAND AND FOREARM"	"16,458.00"	"10,725.00"	"5,733.00"
26450	"TENOTOMY, FLEXOR, SINGLE, PALM, OPEN, EACH"	"16,458.00"	"10,725.00"	"5,733.00"
26455	"TENOTOMY, FLEXOR, SINGLE, FINGER, OPEN, EACH"	"16,458.00"	"10,725.00"	"5,733.00"
26460	"TENOTOMY, EXTENSOR, HAND OR FINGER, SINGLE, OPEN, EACH"	"16,458.00"	"10,725.00"	"5,733.00"
26471	"TENODESIS; FOR PROXIMAL INTERPHALANGEAL JOINT
STABILIZATION"	"16,107.00"	"9,555.00"	"6,552.00"
26474	TENODESIS; FOR DISTAL JOINT STABILIZATON	"21,216.00"	"13,845.00"	"7,371.00"
26476	"TENDON LENGTHENING, EXTENSOR, HAND OR FINGER, SINGLE,
EACH"	"16,458.00"	"10,725.00"	"5,733.00"
26477	"TENDON SHORTENING, EXTENSOR, HAND OR FINGER, SINGLE,
EACH"	"16,458.00"	"10,725.00"	"5,733.00"
26478	"TENDON LENGTHENING, FLEXOR, HAND OR FINGER, SINGLE,
EACH"	"16,458.00"	"10,725.00"	"5,733.00"
26479	"TENDON SHORTENING, FLEXOR, HAND OR FINGER, SINGLE, EACH"	"16,458.00"	"10,725.00"	"5,733.00"
26480	"TENDON TRANSFER OR TRANSPLANT, CARPOMETACARPAL AREA OR DORSUM OF HAND, SINGLE; W/O FREE GRAFT, EACH"	"16,458.00"	"10,725.00"	"5,733.00"
26483	"TENDON TRANSFER OR TRANSPLANT, CARPOMETACARPAL AREA
OR DORSUM OF HAND, SINGLE; W/ FREE TENDON GRAFT (INCLUDES OBTAINING GRAFT), EACH TENDON"	"21,216.00"	"13,845.00"	"7,371.00"
26485	"TENDON TRANSFER OR TRANSPLANT, PALMAR, SINGLE, EACH
TENDON; W/O FREE TENDON GRAFT"	"16,107.00"	"9,555.00"	"6,552.00"
26489	"TENDON TRANSFER OR TRANSPLANT, PALMAR, SINGLE, EACH TENDON; W/ FREE TENDON GRAFT (INCLUDES OBTAINING
GRAFT), EACH TENDON"	"16,107.00"	"9,555.00"	"6,552.00"
26490	OPPONENSPLASTY; SUBLIMIS TENDON TRANSFER TYPE	"20,553.00"	"10,725.00"	"9,828.00"
26492	"OPPONENSPLASTY; TENDON TRANSFER W/ GRAFT (INCLUDES
OBTAINING GRAFT)"	"21,372.00"	"10,725.00"	"10,647.00"
26494	OPPONENSPLASTY; HYPOTHENAR MUSCLE TRANSFER	"20,553.00"	"10,725.00"	"9,828.00"
26496	OPPONENSPLASTY; OTHER METHODS	"20,553.00"	"10,725.00"	"9,828.00"
26497	"TENDON TRASFER TO RESTORE INTRINSIC FUNCTION; RING AND
SMALL FINGER"	"16,434.60"	"9,555.00"	"6,879.60"
26498	"TENDON TRASFER TO RESTORE INTRINSIC FUNCTION; ALL FOUR
FINGERS"	"35,100.00"	"18,720.00"	"16,380.00"
26499	"CORRECTION CLAW FINGER,OTHER METHODS"	"42,783.00"	"24,765.00"	"18,018.00"
26500	TENDON PULLEY RECONSTRUCTION; W/ LOCAL TISSUES	"21,216.00"	"13,845.00"	"7,371.00"
26502	"TENDON PULLEY RECONSTRUCTION; W/ TENDON OR FASCIAL
GRAFT (INCLUDES OBTAINING GRAFT)"	"19,734.00"	"10,725.00"	"9,009.00"
26504	TENDON PULLEY RECONSTRUCTION; W/ TENDON PROSTHESIS	"25,155.00"	"12,870.00"	"12,285.00"
26508	THENAR MUSCLE RELEASE FOR THUMB CONTRACTURE	"16,434.60"	"9,555.00"	"6,879.60"
26510	CROSS INTRINSIC TRANSFER	"21,372.00"	"10,725.00"	"10,647.00"
26516	CAPSULODESIS FOR M-P JOINT STABILIZATION; SINGLE DIGIT	"20,553.00"	"10,725.00"	"9,828.00"
26517	CAPSULODESIS FOR M-P JOINT STABILIZATION; TWO DIGITS	"23,634.00"	"10,530.00"	"13,104.00"
26518	"CAPSULODESIS FOR M-P JOINT STABILIZATION; THREE OR FOUR
DIGITS"	"35,100.00"	"18,720.00"	"16,380.00"
26520	"CAPSULECTOMY OR CAPSULOTOMY FOR CONTRACTURE;
METACARPOPHALANGEAL JOINT, SINGLE, EACH"	"21,216.00"	"13,845.00"	"7,371.00"
26525	"CAPSULECTOMY OR CAPSULOTOMY FOR CONTRACTURE;
INTERPHALANGEAL JOINT, SINGLE, EACH"	"10,974.60"	"3,658.20"	"7,316.40"
26530	"ARTHROPLASTY, METACARPOPHALANGEAL JOINT; SINGLE, EACH"	"9,336.60"	"3,112.20"	"6,224.40"
26531	"ARTHROPLASTY, METACARPOPHALANGEAL JOINT; W/
PROSTHETIC IMPLANT, SINGLE, EACH"	"15,639.00"	"10,725.00"	"4,914.00"
26535	"ARTHROPLASTY INTERPHALANGEAL JOINT, SINGLE, EACH"	"35,100.00"	"18,720.00"	"16,380.00"
26536	"ARTHROPLASTY INTERPHALANGEAL JOINT, W/ PROSTHETIC
IMPLANT, SINGLE, EACH"	"40,911.00"	"21,255.00"	"19,656.00"
26540	"REPAIR OF COLLATERAL LIGAMENT, METACARPOPHALANGEAL OR
INTERPHALANGEAL JOINT"	"16,434.60"	"9,555.00"	"6,879.60"
26541	"RECONSTRUCTION, COLLATERAL LIGAMENT, METACARPOPHALANGEAL JOINT, SINGLE, W/ TENDON OR FASCIAL
GRAFT (INCLUDES OBTAINIG GRAFT)"	"16,434.60"	"9,555.00"	"6,879.60"
26542	"RECONSTRUCTION, COLLATERAL LIGAMENT, METACARPOPHALANGEAL JOINT, SINGLE, W/ LOCAL TISSUE (E.G.,
ADDUCTOR ADVANCEMENT)"	"16,434.60"	"9,555.00"	"6,879.60"
26545	"RECONSTRUCTION, COLLATERAL LIGAMENT, INTERPHALANGEAL JOINT, SINGLE, INCLUDING GRAFT, EACH JOINT"	"21,216.00"	"13,845.00"	"7,371.00"
26546	"REPAIR NON-UNION, METACARPAL OR PHALANX, (INCLUDES OBTAINING BONE GRAFT W/ OR W/O EXTERNAL OR INTERNAL
FIXATION)"	"20,553.00"	"10,725.00"	"9,828.00"
26548	"REPAIR AND RECONSTRUCTION, FINGER, VOLAR PLATE,
INTERPHALANGEAL JOINT"	"16,434.60"	"9,555.00"	"6,879.60"
26550	POLLICIZATION OF A DIGIT	"40,911.00"	"21,255.00"	"19,656.00"
26551	"TOE-TO-HAND TRANSFER W/ MICROVASCULAR ANASTMOSIS; GREAT TOE ""WRAP-AROUND"" W/ BONE GRAFT"	"59,085.00"	"26,325.00"	"32,760.00"
26553	"TOE-TO-HAND TRANSFER W/ MICROVASCULAR ANASTMOSIS;
OTHER THAN GREAT TOE, SINGLE"	"59,943.00"	"33,735.00"	"26,208.00"
26554	"TOE-TO-HAND TRANSFER W/ MICROVASCULAR ANASTMOSIS;
OTHER THAN GREAT TOE, DOUBLE"	"52,884.00"	"23,400.00"	"29,484.00"
26555	POSITIONAL CHANGE OF OTHER FINGER	"29,172.00"	"14,430.00"	"14,742.00"
26556	FREE TOE JOINT TRANSFER W/ MICROVASCULAR ANASTOMOSIS	"52,884.00"	"23,400.00"	"29,484.00"
26560	"REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE; W/ SKIN
FLAPS"	"35,100.00"	"18,720.00"	"16,380.00"
26561	"REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE; W/ SKIN
FLAPS AND GRAFTS"	"40,911.00"	"21,255.00"	"19,656.00"
26562	"REPAIR OF SYNDACTYLY (WEB FINGER) EACH WEB SPACE;
COMPLEX (E.G., INVOLVING BONE, NAILS)"	"59,943.00"	"33,735.00"	"26,208.00"
26565	OSTEOTOMY FOR CORRECTION OF DEFORMITY; METACARPAL	"45,435.00"	"20,865.00"	"24,570.00"
26567	"OSTEOTOMY FOR CORRECTION OF DEFORMITY; PHALANX OF
FINGER"	"45,435.00"	"20,865.00"	"24,570.00"
26568	OSTEOPLASTY FOR LENGTHENING OF METACARPAL OR PHALANX	"45,435.00"	"20,865.00"	"24,570.00"
26580	REPAIR CLEFT HAND	"40,911.00"	"21,255.00"	"19,656.00"
26585	REPAIR BIFID DIGIT	"40,911.00"	"21,255.00"	"19,656.00"
26587	"RECONSTRUCTION OF SUPERNUMERARY DIGIT, SOFT TISSUE AND
BONE"	"45,435.00"	"20,865.00"	"24,570.00"
26590	REPAIR MACRODACTYLIA	"59,943.00"	"33,735.00"	"26,208.00"
26591	"REPAIR, INTRINSIC MUSCLES OF HAND (SPECIFY)"	"59,943.00"	"33,735.00"	"26,208.00"
26593	"RELEASE, INTRINSIC MUSCLES OF HAND (SPECIFY)"	"40,911.00"	"21,255.00"	"19,656.00"
26596	"EXCISION OF CONSTRICTING RING OF FINGER, W/ MULTIPLE Z-
PLASTIES"	"42,549.00"	"21,255.00"	"21,294.00"
26597	"RELEASE OF SCAR CONTRACTURE, FLEXOR OR EXTENSOR, W/ SKIN GRAFTS, REARRANGEMENT FLAPS, OR Z-PLASTIES, HAND
AND/OR FINGER"	"42,549.00"	"21,255.00"	"21,294.00"
26600	"CLOSED TREATMENT OF METACARPAL FRACTURE, SINGLE"	"19,734.00"	"10,725.00"	"9,009.00"
26607	"CLOSED TREATMENT OF METACARPAL FRACTURE, W/ INTERNAL
OR EXTERNAL FIXATION"	"25,155.00"	"12,870.00"	"12,285.00"
26608	"PERCUTANEOUS SKELETAL FIXATION OF METACARPAL FRACTURE,
EACH BONE"	"23,634.00"	"10,530.00"	"13,104.00"
26615	"OPEN TREATMENT OF METACARPAL FRACTURE, SINGLE, W/ OR W/O INTERNAL OR EXTERNAL FIXATION, EACH BONE"	"23,634.00"	"10,530.00"	"13,104.00"
26641	"CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION,
THUMB"	"20,553.00"	"10,725.00"	"9,828.00"
26645	"CLOSED TRATMENT OF CARPOMETACARPAL FRACTURE
DISLOCATION, THUMB (BENNETT FRACTURE)"	"23,634.00"	"10,530.00"	"13,104.00"
26650	"PERCUTANEOUS SKELETAL FIXATION OF CARPOMETACARPAL FRACTURE DISLOCATION, THUMB (BENNETT FRACTURE), W/ MANIPULATION, W/ OR W/O EXTERNAL FIXATION"	"29,172.00"	"14,430.00"	"14,742.00"
26665	"OPEN TREATMENT OF CARPOMETACARPAL FRACTURE DISLOCATION, THUMB (BENNETT FRACTURE), W/ OR W/O
INTERNAL OR EXTERNAL FIXATION"	"29,172.00"	"14,430.00"	"14,742.00"
26670	"CLOSED TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB (BENNETT FRACTURE); SINGLE"	"20,553.00"	"10,725.00"	"9,828.00"
26676	"PERCUTANEOUS SKELETAL FIXATION OF CARPOMETACARPAL
DISLOCATION, OTHER THAN THUMB (BENNETT FRACTURE), SINGLE, W/ MANIPULATION"	"29,172.00"	"14,430.00"	"14,742.00"
26685	"OPEN TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB (BENNETT FRACTURE); SINGLE, W/ OR W/O OPEN TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB (BENNETT FRACTURE); SINGLE, INTERNAL OR EXTERNAL
FIXATION"	"20,553.00"	"10,725.00"	"9,828.00"
26686	"OPEN TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB (BENNETT FRACTURE); SINGLE, COMPLEX,
MULTIPLE OR DELAYED REDUCTION"	"23,361.00"	"11,895.00"	"11,466.00"
26700	"CLOSED TREATMENT OF METACARPOPHALANGEAL DISLOCATION,
SINGLE"	"20,553.00"	"10,725.00"	"9,828.00"
26706	"PERCUTANEOUS SKELETAL FIXATION OF METACARPOPHALANGEAL DISLOCATION, SINGLE, W/
MANIPULATION"	"29,172.00"	"14,430.00"	"14,742.00"
26715	"OPEN TREATMENT OF METACARPOPHALANGEAL DISLOCATION, SINGLE, W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"24,453.00"	"10,530.00"	"13,923.00"
26720	"CLOSED TREATMENT OF PHALANGEAL SHAFT FRACTURE,
PROXIMAL OR MIDDLE PHALANX, FINGER OR THUMB"	"19,734.00"	"10,725.00"	"9,009.00"
26727	"PERCUTANEOUS SKELETAL FIXATION OF UNSTABLE PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR
THUMB, W/ MANIPULATION, EACH"	"29,172.00"	"14,430.00"	"14,742.00"
26735	"OPEN TREATMENT OF PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR THUMB, W/ OR W/O INTERNAL
OR EXTERNAL FIXATION, EACH"	"29,172.00"	"14,430.00"	"14,742.00"
26740	"CLOSED TREATMENT OF ARTICULAR FRACTURE, INVOLVING METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT"	"19,734.00"	"10,725.00"	"9,009.00"
26746	"OPEN TREATMENT OF ARTICULAR FRACTURE, INVOLVING METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT, W/ OR
W/O INTERNAL OR EXTERNAL FIXATION, EACH"	"24,453.00"	"10,530.00"	"13,923.00"
26750	"CLOSED TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER
OR THUMB"	"19,734.00"	"10,725.00"	"9,009.00"
26756	"PERCUTANEOUS SKELETAL FIXATION OF DISTAL PHALANGEAL
FRACTURE, FINGER OR THUMB, EACH"	"29,172.00"	"14,430.00"	"14,742.00"
26765	"OPEN TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB, W/ OR W/O INTERNAL OR EXTERNAL FIXATION, EACH"	"23,634.00"	"10,530.00"	"13,104.00"
26770	"CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION,
SINGLE"	"21,216.00"	"13,845.00"	"7,371.00"
26776	"PERCUTANEOUS SKELETAL FIXATION OF INTERPHALANGEAL JOINT DISLOCATION, SINGLE, W/ MANIPULATION"	"24,453.00"	"10,530.00"	"13,923.00"
26785	"OPEN TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, W/ OR W/O INTERNAL OR EXTERNAL FIXATION, SINGLE"	"24,453.00"	"10,530.00"	"13,923.00"
26820	"FUSION IN OPPOSITION, THUMB, W/ AUTOGENOUS GRAFT
(INCLUDES OBTAINING GRAFT)"	"42,549.00"	"21,255.00"	"21,294.00"
26841	"ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, W/ OR W/O
INTERNAL FIXATION;"	"40,911.00"	"21,255.00"	"19,656.00"
26842	"ARTHRODESIS, CARPOMETACARPAL JOINT, THUMB, W/ OR W/O INTERNAL FIXATION; W/ AUTOGRAFT (INCLUDES OBTAINING
GRAFT)"	"40,911.00"	"21,255.00"	"19,656.00"
26843	"ARTHRODESIS, CARPOMETACARPAL JOINT, DIGITS, OTHER THAN
THUMB;"	"42,783.00"	"24,765.00"	"18,018.00"
26844	"ARTHRODESIS, CARPOMETACARPAL JOINT, DIGITS, OTHER THAN THUMB; W/ AUTOGRAFT (INCLUDES OBTAINING GRAFT)"	"40,911.00"	"21,255.00"	"19,656.00"
26850	"ARTHRODESIS, METACARPOPHALANGEAL JOINT, W/ OR W/O
INTERNAL FIXATION;"	"40,911.00"	"21,255.00"	"19,656.00"
26852	"ARTHRODESIS, METACARPOPHALANGEAL JOINT, W/ OR W/O INTERNAL FIXATION; W/ AUTOGRAFT (INCLUDES OBTAINING
GRAFT)"	"42,549.00"	"21,255.00"	"21,294.00"
26860	"ARTHRODESIS, INTERPHALANGEAL JOINT, W/ OR W/O INTERNAL
FIXATION;"	"40,911.00"	"21,255.00"	"19,656.00"
26862	"ARTHRODESIS, INTERPHALANGEAL JOINT, W/ OR W/O INTERNAL FIXATION; W/ AUTOGRAFT (INCLUDES OBTAINING GRAFT)"	"42,549.00"	"21,255.00"	"21,294.00"
26910	"AMPUTATION, METACARPAL, W/ FINGER OR THUMB (RAY AMPUTATION), SINGLE, W/ OR W/O INTEROSSEOUS TRANSFER"	"23,634.00"	"10,530.00"	"13,104.00"
26951	"AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLUDING NEURECTOMIES; W/
DIRECT CLOSURE"	"23,361.00"	"11,895.00"	"11,466.00"
26952	"AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLUDING NEURECTOMIES; W/ LOCAL ADVANCEMENT FLAPS (V-Y, HOOD)"	"42,783.00"	"24,765.00"	"18,018.00"
26990	"INCISION AND DRAINAGE, PELVIS OR HIP JOINT AREA; DEEP
ABSCESS OR HEMATOMA"	"23,634.00"	"10,530.00"	"13,104.00"
26991	"INCISION AND DRAINAGE, PELVIS OR HIP JOINT AREA; INFECTED
BURSA"	"23,634.00"	"10,530.00"	"13,104.00"
26992	"INCISION, DEEP, W/ OPENING OF BONE CORTEX (E.G., FOR OSTEOMYELITIS OR BONE ABSCESS), PELVIS AND/OR HIP JOINT"	"45,435.00"	"20,865.00"	"24,570.00"
27000	"TENOTOMY, ADDUCTOR OF HIP, SUBCUTANEOUS, CLOSED"	"23,634.00"	"10,530.00"	"13,104.00"
27001	"TENOTOMY, ADDUCTOR OF HIP, SUBCUTANEOUS, OPEN"	"29,172.00"	"14,430.00"	"14,742.00"
27003	"TENOTOMY, ADDUCTOR, SUBCUTANEOUS, OPEN, W/ OBTURATOR
NEURECTOMY"	"59,943.00"	"33,735.00"	"26,208.00"
27005	"TENOTOMY, ILIOPSOAS, OPEN"	"45,435.00"	"20,865.00"	"24,570.00"
27006	"TENOTOMY, ABDUCTORS OF HIP, OPEN"	"45,435.00"	"20,865.00"	"24,570.00"
27025	"FASCIOTOMY, HIP OR THIGH, ANY TYPE"	"42,549.00"	"21,255.00"	"21,294.00"
27030	"ARTHROTOMY, HIP, FOR INFECTION, W/ DRAINAGE"	"59,943.00"	"33,735.00"	"26,208.00"
27033	"ARTHROTOMY, HIP, W/ EXPLORATION OR REMOVAL OF LOOSE OR
FOREIGN BODY"	"59,943.00"	"33,735.00"	"26,208.00"
27035	"HIP JOINT DENERVATION, INTRAPELVIC OR EXTRAPELVIC INTRA- ARTICULAR BRANCHES OF SCIATIC, FEMORAL, OR OBTURATOR
NERVES"	"59,085.00"	"26,325.00"	"32,760.00"
27036	"CAPSULECTOMY OR CAPSULOTOMY OF HIP, W/ OR W/O EXCISION OF HETEROTOPIC BONE, W/ RELEASE OF HIP FLEXOR MUSCLES (IE, GLUTEUS MEDIUS, GLUTEUS MINIMUS, TENSOR FASCIA LATAE, RECTUS FEMORIS, SARTORIUS, ILIOPSOAS)"	"73,710.00"	"32,760.00"	"40,950.00"
27040	"BIOPSY, SOFT TISSUE OF PELVIS AND HIP AREA"	"6,832.80"	"5,850.00"	982.80
27047	"EXCISION, TUMOR, PELVIS AND HIP AREA; SUBCUTANEOUS"	"11,076.00"	"7,800.00"	"3,276.00"
27048	"EXCISION, TUMOR, PELVIS AND HIP AREA; DEEP, SUBFASCIAL,
INTRAMUSCULAR"	"16,107.00"	"9,555.00"	"6,552.00"
27049	"RADICAL RESECTION OF TUMOR (E.G., MALIGNANT NEOPLASM),
SOFT TISSUE OF PELVIS AND HIP AREA"	"73,710.00"	"32,760.00"	"40,950.00"
27050	"ARTHROTOMY, W/ BIOPSY; SACROILIAC JOINT"	"54,522.00"	"23,400.00"	"31,122.00"
27052	"ARTHROTOMY, W/ BIOPSY; HIP JOINT"	"72,501.00"	"36,465.00"	"36,036.00"
27054	"ARTHROTOMY W/ SYNOVECTOMY, HIP JOINT"	"60,723.00"	"26,325.00"	"34,398.00"
27060	EXCISION; ISCHIAL BURSA	"52,884.00"	"23,400.00"	"29,484.00"
27062	EXCISION; TROCHANTERIC BURSA OR CALCIFICATION	"52,884.00"	"23,400.00"	"29,484.00"
27065	"EXCISION OF BONE CYST OR BENIGN TUMOR; SUPERFICIAL (WING OF ILIUM, SYMPHYSIS PUBIS, OR GREATER TROCHANTER OF
FEMUR) W/ OR W/O AUTOGRAFT"	"54,522.00"	"23,400.00"	"31,122.00"
27066	"EXCISION OF BONE CYST OR BENIGN TUMOR; DEEP, W/ OR W/O
AUTOGRAFT"	"59,085.00"	"26,325.00"	"32,760.00"
27067	"EXCISION OF BONE CYST OR BENIGN TUMOR; W/ AUTOGRAFT
REQUIRING SEPARATE INCISION"	"60,723.00"	"26,325.00"	"34,398.00"
27070	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION) (E.G., FOR OSTEOMYELITIS); SUPERFICIAL (E.G., WING OF ILIUM, SYMPHYSIS PUBIS OR GREATER TROCHANTER OF FEMUR)"	"90,675.00"	"41,535.00"	"49,140.00"
27071	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION) (E.G., FOR
OSTEOMYELITIS); DEEP"	"90,675.00"	"41,535.00"	"49,140.00"
27075	"RADICAL RESECTION OF TUMOR OR INFECTION; WING OF ILIUM, ONE PUBIC OR ISCHIAL RAMUS OR SYMPHYSIS PUBIS"	"75,777.00"	"36,465.00"	"39,312.00"
27076	"RADICAL RESECTION OF TUMOR OR INFECTION; ILIUM, INCLUDING ACETABULUM, BOTH PUBIC RAMI, OR ISCHIUM AND
ACETABULUM"	"75,777.00"	"36,465.00"	"39,312.00"
27077	"RADICAL RESECTION OF TUMOR OR INFECTION; INNOMINATE
BONE, TOTAL"	"72,501.00"	"36,465.00"	"36,036.00"
27078	"RADICAL RESECTION OF TUMOR OR INFECTION; ISCHIAL
TUBEROSITY AND GREATER TROCHANTER OF FEMUR"	"60,723.00"	"26,325.00"	"34,398.00"
27079	"RADICAL RESECTION OF TUMOR OR INFECTION; ISCHIAL TUBEROSITY AND GREATER TROCHANTER OF FEMUR, W/ SKIN
FLAPS"	"61,542.00"	"26,325.00"	"35,217.00"
27080	"COCCYGECTOMY, PRIMARY"	"29,991.00"	"14,430.00"	"15,561.00"
27086	"REMOVAL OF FOREIGN BODY, PELVIS OR HIP"	"29,172.00"	"14,430.00"	"14,742.00"
27090	REMOVAL OF HIP PROSTHESIS;	"59,085.00"	"26,325.00"	"32,760.00"
27091	"REMOVAL OF HIP PROSTHESIS; COMPLICATED, INCLUDING ""TOTAL HIP"" AND METHLMETHACRYLATE, WHEN APPLICABLE"	"74,139.00"	"36,465.00"	"37,674.00"
27097	"HAMSTRING RECESSION, PROXIMAL"	"44,187.00"	"21,255.00"	"22,932.00"
27098	ADDUCTOR TRANSFER TO ISCHIUM	"45,435.00"	"20,865.00"	"24,570.00"
27100	"TRANSFER EXTERNAL OBLIQUE MUSCLE TO GREATER
TROCHANTER INCLUDING FASCIAL OR TENDON EXTENSION (GRAFT)"	"59,943.00"	"33,735.00"	"26,208.00"
27105	"TRANSFER PARASPINAL MUSCLE TO HIP (INCLUDES FASCIAL OR
TENDON EXTENSION GRAFT)"	"59,943.00"	"33,735.00"	"26,208.00"
27110	TRANSFER ILIOPSOAS; TO GREATER TROCHANTER	"59,943.00"	"33,735.00"	"26,208.00"
27111	TRANSFER ILIOPSOAS; TO FEMORAL NECK	"59,943.00"	"33,735.00"	"26,208.00"
27120	"ACETABULOPLASTY; (E.G., WHITMAN, COLONNA, HAYGROVES, OR
CUP TYPE)"	"72,501.00"	"36,465.00"	"36,036.00"
27122	"ACETABULOPLASTY; RESECTION FEMORAL HEAD (GIRDLESTONE
PROCEDURE)"	"72,501.00"	"36,465.00"	"36,036.00"
27125	"PARTIAL HIP REPLACEMENT, PROSTHESIS (E.G., FEMORAL STEM
PROSTHESIS, BIPOLAR ARTHROPLASTY)"	"72,501.00"	"36,465.00"	"36,036.00"
27130	"ARTHROPLASTY, ACETABULAR AND PROXIMAL FEMORAL PROSTHETIC REPLACEMENT (TOTAL HIP REPLACEMENT), W/ OR
W/O AUTOGRAFT OR ALLOGRAFT"	"104,130.00"	"46,800.00"	"57,330.00"
27132	"CONVERSION OF PREVIOUS HIP SURGERY TO TOTAL HIP
REPLACEMENT, W/ OR W/O AUTOGRAFT OR ALLOGRAFT"	"107,406.00"	"46,800.00"	"60,606.00"
27134	"REVISION OF TOTAL HIP ARTHROPLASTY; BOTH COMPONENTS, W/
OR W/O AUTOGRAFT OR ALLOGRAFT"	"107,250.00"	"41,730.00"	"65,520.00"
27137	"REVISION OF TOTAL HIP ARTHROPLASTY; ACETABULAR COMPONENT ONLY, W/ OR W/O AUTOGRAFT OR ALLOGRAFT"	"75,348.00"	"32,760.00"	"42,588.00"
27138	"REVISION OF TOTAL HIP ARTHROPLASTY; FEMORAL COMPONENT
ONLY, W/ OR W/O ALLOGRAFT"	"75,348.00"	"32,760.00"	"42,588.00"
27140	OSTEOTOMY AND TRANSFER OF GREATER TROCHANTER	"54,522.00"	"23,400.00"	"31,122.00"
27146	"OSTEOTOMY , ILIAC, ACETABULAR OR INNOMINATE BONE;"	"59,085.00"	"26,325.00"	"32,760.00"
27147	"OSTEOTOMY , ILIAC, ACETABULAR OR INNOMINATE BONE; W/
OPEN REDUCTION OF HIP"	"60,723.00"	"26,325.00"	"34,398.00"
27151	"OSTEOTOMY , ILIAC, ACETABULAR OR INNOMINATE BONE; W/
FEMORAL OSTEOTOMY"	"72,501.00"	"36,465.00"	"36,036.00"
27156	"OSTEOTOMY , ILIAC, ACETABULAR OR INNOMINATE BONE; W/ FEMORAL OSTEOTOMY AND W/ OPEN REDUCTION OF HIP"	"74,139.00"	"36,465.00"	"37,674.00"
27158	"OSTEOTOMY, PELVIS, BILATERAL (E.G., FOR CONGENITAL
MALFORMATION)"	"73,710.00"	"32,760.00"	"40,950.00"
27161	"OSTEOTOMY, FEMORAL NECK"	"60,723.00"	"26,325.00"	"34,398.00"
27165	"OSTEOTOMY, INTERTROCHANTERIC OR SUBTROCHANTERIC INCLUDING INTERNAL OR EXTERNAL FIXATION AND/OR CAST"	"72,501.00"	"36,465.00"	"36,036.00"
27170	"BONE GRAFT, FEMORAL HEAD, NECK, INTERTROCHANTERIC OR SUBTROCHANTERIC AREA (INCLUDES OBTAINING BONE GRAFT)"	"60,723.00"	"26,325.00"	"34,398.00"
27175	"TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; BY TRACTION, W/O
REDUCTION"	"45,435.00"	"20,865.00"	"24,570.00"
27176	"TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; BY SINGLE OR
MULTIPLE PINNING, IN SITU"	"59,085.00"	"26,325.00"	"32,760.00"
27177	"OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; SINGLE OF
MULTIPLE PINNING OR BONE GRAFT (INCLUDES OBTAINING GRAFT)"	"60,723.00"	"26,325.00"	"34,398.00"
27178	OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; CLOSED MANIPULATION W/ SINGLE OR MULTIPLE PINNING	"60,723.00"	"26,325.00"	"34,398.00"
27179	OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; OSTEOPLASTY OF FEMORAL NECK (HEYMAN TYPE PROCEDURE)	"60,723.00"	"26,325.00"	"34,398.00"
27181	"OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; OSTEOTOMY
AND INTERNAL FIXATION"	"72,501.00"	"36,465.00"	"36,036.00"
27185	"EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING, GREATER
TROCHANTER"	"54,522.00"	"23,400.00"	"31,122.00"
27187	"PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING, OR WIRING) W/ OR W/O METHYLMETHACRYLATE, FEMORAL NECK AND PROXIMAL FEMUR"	"60,723.00"	"26,325.00"	"34,398.00"
27193	"CLOSED TREATMENT OF PELVIC RING FRACTURE, DISLOCATION,
DIASTASIS OR SUBLUXATION"	"54,522.00"	"23,400.00"	"31,122.00"
27200	CLOSED TREATMENT OF COCCYGEAL FRACTURE	"29,172.00"	"14,430.00"	"14,742.00"
27202	OPEN TREATMENT OF COCCYGEAL FRACTURE	"44,187.00"	"21,255.00"	"22,932.00"
27215	"OPEN TREATMENT OF ILIAC SPINE(S), TUBEROSITY AVULSION, OR ILIAC WING FRACTURE(S) (E.G., PELVIC FRACTURE(S) W/C DO NOT DISRUPT THE PELVIC RING), W/ INTERNAL FIXATION"	"73,710.00"	"32,760.00"	"40,950.00"
27216	"PERCUTANEOUS SKELETAL FIXATION OF POSTERIOR PELVIC RING FRACTURE AND/OR DISLOCATION (INCLUDES ILIUM, SACROILIAC
JOINT AND/OR SACRUM)"	"78,624.00"	"32,760.00"	"45,864.00"
27217	"OPEN TREATMENT OF ANTERIOR RING FRACTURE AND/OR DISLOCATION W/ INTERNAL FIXATION (INCLUDES PUBIC
SYMPHYSIS AND/OR RAMI)"	"90,675.00"	"41,535.00"	"49,140.00"
27218	"OPEN TREATMENT OF POSTERIOR RING FRACTURE AND/OR DISLOCATION W/ INTERNAL FIXATION (INCLUDES ILIUM,
SACROILIAC JOINT AND/OR SACRUM)"	"90,675.00"	"41,535.00"	"49,140.00"
27220	"CLOSED TREATMENT OF ACETABULUM (HIP SOCKET)
FRACTURE(S)"	"59,943.00"	"33,735.00"	"26,208.00"
27226	"OPEN TREATMENT OF POSTERIOR OR ANTERIOR ACETABULAR
WALL FRACTURE, W/ INTERNAL FIXATION"	"75,348.00"	"32,760.00"	"42,588.00"
27227	"OPEN TREATMENT OF ACETABULAR FRACTURE(S) INVOLVING ANTERIOR OR POSTERIOR (ONE) COLUMN, OR A FRACTURE RUNNING TRANSVERSELY ACROSS THE ACETABULUM, W/
INTERNAL FIXATION"	"78,624.00"	"32,760.00"	"45,864.00"
27228	"OPEN TREATMENT OF ACETABULAR FRACTURE(S) INVOLVING ANTERIOR AND POSTERIOR (TWO) COLUMNS, INCLUDES T- FRACTURE AND BOTH COLUMN FRACTURE W/ COMPLETE ARTICULAR DETACHMENT, OR SINGLE COLUMN OR TRANSVERSE FRACTURE W/ ASSOCIATED ACETABULAR WALL FRACTURE, W/
INTE"	"90,675.00"	"41,535.00"	"49,140.00"
27230	"CLOSED TREATMENT OF FEMORAL FRACTURE, PROXIMAL END,
NECK"	"45,435.00"	"20,865.00"	"24,570.00"
27235	"PERCUTANEOUS SKELETAL FIXATION OF FEMORAL FRACTURE,
PROXIMAL END, NECK, UNDISPLACED, MILDLY DISPLACED, OR IMPACTED FRACTURE"	"90,675.00"	"41,535.00"	"49,140.00"
27236	"OPEN TREATMENT OF FEMORAL FRACTURE, PROXIMAL END,
NECK, INTERNAL FIXATION OR PROSTHETIC REPLACEMENT (DIRECT FRACTURE EXPOSURE)"	"90,675.00"	"41,535.00"	"49,140.00"
27238	"CLOSED TREATMENT OF  INTERTROCHANTERIC, PERTROCHANTERIC, OR SUBTROCHANTERIC FEMORAL FRACTURE"	"45,435.00"	"20,865.00"	"24,570.00"
27244	"OPEN TREATMENT OF INTERTROCHANTERIC, PERTROCHANTERIC, OR SUBTROCHANTERIC FEMORAL FRACTURE; W/ PLATE/SCREW TYPE IMPLANT, W/ OR W/O CERCLAGE"	"90,675.00"	"41,535.00"	"49,140.00"
27245	"OPEN TREATMENT OF INTERTROCHANTERIC, PERTROCHANTERIC, OR SUBTROCHANTERIC FEMORAL FRACTURE; W/ INTRAMEDULLARY IMPLANT, W/ OR W/O INTERLOCKING SCREWS
AND/OR CERCLAGE"	"60,723.00"	"26,325.00"	"34,398.00"
27246	CLOSED TREATMENT OF GREATER TROCHANTERIC FRACTURE	"45,435.00"	"20,865.00"	"24,570.00"
27248	"OPEN TREATMENT OF GREATER TROCHANTERIC FRACTURE, W/
OR W/O INTERNAL OR EXTERNAL FIXATION"	"52,884.00"	"23,400.00"	"29,484.00"
27250	"CLOSED TREATMENT OF HIP DISLOCATION, TRAUMATIC"	"45,435.00"	"20,865.00"	"24,570.00"
27253	"OPEN TREATMENT OF  HIP DISLOCATION, TRAUMATIC, W/O
INTERNAL FIXATION"	"72,501.00"	"36,465.00"	"36,036.00"
27254	"OPEN TREATMENT OF HIP DISLOCATION, TRAUMATIC W/
ACETABULAR WALL AND FEMORAL HEAD FRACTURE, W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"78,624.00"	"32,760.00"	"45,864.00"
27258	"OPEN TREATMENT OF SPONTANEOUS HIP DISLOCATION (DEVELOPMENTAL, INCLUDING CONGENITAL OR PATHOLOGICAL), REPLACEMENT OF FEMORAL HEAD IN ACETABULUM (INCLUDING
TENOTOMY, ETC);"	"59,085.00"	"26,325.00"	"32,760.00"
27259	"OPEN TREATMENT OF SPONTANEOUS HIP DISLOCATION (DEVELOPMENTAL, INCLUDING CONGENITAL OR PATHOLOGICAL), REPLACEMENT OF FEMORAL HEAD IN ACETABULUM (INCLUDING TENOTOMY, ETC); W/ FEMORAL SHAFT SHORTENING"	"72,501.00"	"36,465.00"	"36,036.00"
27265	CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION	"35,100.00"	"18,720.00"	"16,380.00"
27280	"ARTHRODESIS, SACROILIAC JOINT (INCLUDING OBTAINING
GRAFT)"	"73,710.00"	"32,760.00"	"40,950.00"
27282	"ARTHRODESIS, SYMPHYSIS PUBIS (INCLUDING OBTAINING GRAFT)"	"54,522.00"	"23,400.00"	"31,122.00"
27284	"ARTHRODESIS, HIP JOINT (INCLUDES OBTAINING GRAFT);"	"73,710.00"	"32,760.00"	"40,950.00"
27286	"ARTHRODESIS, HIP JOINT (INCLUDES OBTAINING GRAFT); W/
SUBTROCHANTERIC OSTEOTOMY"	"78,624.00"	"32,760.00"	"45,864.00"
27290	"INTERPELVIABDOMINAL AMPUTATION (HINDQUARTER
AMPUTATION)"	"90,675.00"	"41,535.00"	"49,140.00"
27295	DISARTICULATION OF HIP	"59,085.00"	"26,325.00"	"32,760.00"
27301	"INCISION AND DRAINAGE OF DEEP ABSCESS, INFECTED BURSA, OR
HEMATOMA, THIGH OR KNEE REGION"	"16,107.00"	"9,555.00"	"6,552.00"
27303	"INCISION, DEEP, W/ OPENING OF BONE CORTEX (E.G., FOR
OSTEOMYELITIS OR BONE ABSCESS), FEMUR OR KNEE"	"45,435.00"	"20,865.00"	"24,570.00"
27305	"FASCIOTOMY, ILIOTIBIAL (TENOTOMY), OPEN"	"35,100.00"	"18,720.00"	"16,380.00"
27306	"TENOTOMY, SUBCUTANEOUS, CLOSED, ADDUCTOR OR
HAMSTRING; SINGLE"	"35,100.00"	"18,720.00"	"16,380.00"
27307	"TENOTOMY, SUBCUTANEOUS, CLOSED, ADDUCTOR OR
HAMSTRING; MULTIPLE"	"42,549.00"	"21,255.00"	"21,294.00"
27310	"ARTHROTOMY, KNEE, FOR INFECTION, W/ EXPLORATION,
DRAINAGE OR REMOVAL OF FOREIGN BODY"	"52,884.00"	"23,400.00"	"29,484.00"
27315	"NEURECTOMY, HAMSTRING MUSCLE"	"45,435.00"	"20,865.00"	"24,570.00"
27320	"NEURECTOMY, POPLITEAL (GASTROCNEMIUS)"	"45,435.00"	"20,865.00"	"24,570.00"
27323	"BIOPSY, SOFT TISSUE OF THIGH OR KNEE AREA"	"6,832.80"	"5,850.00"	982.80
27327	"EXCISION, TUMOR, THIGH OR KNEE AREA; SUBCUTANEOUS"	"11,076.00"	"7,800.00"	"3,276.00"
27328	"EXCISION, TUMOR, THIGH OR KNEE AREA; DEEP, SUBFASCIAL, OR
INTRAMUSCULAR"	"15,639.00"	"10,725.00"	"4,914.00"
27329	"RADICAL RESECTION OF TUMOR (E.G., MALIGNANT NEOPLASM),
SOFT TISSUE OF THIGH OR KNEE AREA"	"52,884.00"	"23,400.00"	"29,484.00"
27330	"ARTHROTOMY, KNEE; W/ SYNOVIAL BIOPSY ONLY"	"40,911.00"	"21,255.00"	"19,656.00"
27331	"ARTHROTOMY, KNEE; W/ JOINT EXPLORATION, W/ OR W/O BIOPSY, W/ OR W/O REMOVAL OF LOOSE OR FOREIGN BODIES"	"45,435.00"	"20,865.00"	"24,570.00"
27332	"ARTHROTOMY, KNEE, W/ EXCISION OF SEMILUNAR CARTILAGE
(MENISCECTOMY); MEDIAL OR LATERAL"	"61,581.00"	"33,735.00"	"27,846.00"
27333	"ARTHROTOMY, KNEE, W/ EXCISION OF SEMILUNAR CARTILAGE
(MENISCECTOMY); MEDIAL AND LATERAL"	"54,522.00"	"23,400.00"	"31,122.00"
27334	"ARTHROTOMY, KNEE, W/ SYNOVECTOMY; ANTERIOR OR
POSTERIOR"	"25,646.40"	"12,870.00"	"12,776.40"
27335	"ARTHROTOMY, KNEE, W/ SYNOVECTOMY; ANTERIOR AND
POSTERIOR INCLUDING POPLITEAL AREA"	"45,435.00"	"20,865.00"	"24,570.00"
27340	"EXCISION, PREPATELLAR BURSA"	"29,172.00"	"14,430.00"	"14,742.00"
27345	EXCISION OF SYNOVIAL CYST OF POPLITEAL SPACE (BAKERS CYST)	"40,911.00"	"21,255.00"	"19,656.00"
27350	PATELLECTOMY OR HEMIPATELLECTOMY	"59,943.00"	"33,735.00"	"26,208.00"
27355	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF
FEMUR;"	"43,368.00"	"21,255.00"	"22,113.00"
27356	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF
FEMUR; W/ ALLOGRAFT"	"46,254.00"	"20,865.00"	"25,389.00"
27357	EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF FEMUR; W/ AUTOGRAFT (INCLUDES OBTAINING GRAFT)	"46,254.00"	"20,865.00"	"25,389.00"
27358	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF
FEMUR; W/ INTERNAL FIXATION"	"52,884.00"	"23,400.00"	"29,484.00"
27360	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS), FEMUR,
PROXIMAL TIBIA AND/OR FIBULA"	"46,254.00"	"20,865.00"	"25,389.00"
27365	"RADICAL RESECTION OF TUMOR, BONE, FEMUR OR KNEE"	"52,884.00"	"23,400.00"	"29,484.00"
27372	"REMOVAL OF FOREIGN BODY, DEEP, THIGH REGION OR KNEE
AREA"	"35,100.00"	"18,720.00"	"16,380.00"
27380	SUTURE OF INFRAPATELLAR TENDON; PRIMARY	"45,435.00"	"20,865.00"	"24,570.00"
27381	"SUTURE OF INFRAPATELLAR TENDON; SECONDARY RECONSTRUCTION, INCLUDING FASCIAL OR TENDON GRAFT"	"52,884.00"	"23,400.00"	"29,484.00"
27385	"SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE;
PRIMARY"	"62,400.00"	"33,735.00"	"28,665.00"
27386	"SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE; SECONDARY RECONSTRUCTION, INCLUDING FASCIAL OR TENDON
GRAFT"	"52,884.00"	"23,400.00"	"29,484.00"
27390	"TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; SINGLE"	"35,100.00"	"18,720.00"	"16,380.00"
27391	"TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; MULTIPLE, ONE
LEG"	"42,783.00"	"24,765.00"	"18,018.00"
27392	"TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; MULTIPLE,
BILATERAL"	"40,911.00"	"21,255.00"	"19,656.00"
27393	LENGTHENING OF HAMSTRING TENDON; SINGLE	"45,435.00"	"20,865.00"	"24,570.00"
27394	"LENGTHENING OF HAMSTRING TENDON; MULTIPLE, ONE LEG"	"42,783.00"	"24,765.00"	"18,018.00"
27395	"LENGTHENING OF HAMSTRING TENDON; MULTIPLE, BILATERAL"	"40,911.00"	"21,255.00"	"19,656.00"
27396	"TRANSPLANT, HAMSTRING TENDON TO PATELLA; SINGLE"	"45,435.00"	"20,865.00"	"24,570.00"
27397	"TRANSPLANT, HAMSTRING TENDON TO PATELLA; MULTIPLE"	"43,602.00"	"24,765.00"	"18,837.00"
27400	"TENDON OR MUSCLE TRANSFER, HAMSTRINGS TO FEMUR
(E.G.GERS TYPE PROCEDURE)"	"45,435.00"	"20,865.00"	"24,570.00"
27403	ARTHROTOMY W/ OPEN MENISCUS REPAIR	"54,522.00"	"23,400.00"	"31,122.00"
27405	"REPAIR, PRIMARY, TORN LIGAMENT AND/OR CAPSULE, KNEE;
COLLATERAL"	"52,884.00"	"23,400.00"	"29,484.00"
27407	"REPAIR, PRIMARY, TORN LIGAMENT AND/OR CAPSULE, KNEE;
CRUCIATE"	"59,085.00"	"26,325.00"	"32,760.00"
27409	"REPAIR, PRIMARY, TORN LIGAMENT AND/OR CAPSULE, KNEE;
COLLATERAL AND CRUCIATE LIGAMENTS"	"73,710.00"	"32,760.00"	"40,950.00"
27418	"ANTERIOR TIBIAL TUBERCLEPLASTY (E.G., FOR
CHONDROMALACIA PATELLAE)"	"44,187.00"	"21,255.00"	"22,932.00"
27420	"RECONSTRUCTION FOR RECURRENT DISLOCATING PATELLA;
(HAUSER TYPE PROCEDURE)"	"45,006.00"	"21,255.00"	"23,751.00"
27422	"RECONSTRUCTION FOR RECURRENT DISLOCATING PATELLA; W/ EXTENSOR REALIGNMENT AND/OR MUSCLE ADVANCEMENT OR RELEASE (CAMPBELL, GOLDWAITE TYPE PROCEDURE)"	"59,943.00"	"33,735.00"	"26,208.00"
27424	"RECONSTRUCTION FOR RECURRENT DISLOCATING PATELLA; W/
PATELLECTOMY"	"59,943.00"	"33,735.00"	"26,208.00"
27425	LATERAL RETINACULAR RELEASE (ANY METHOD)	"42,549.00"	"21,255.00"	"21,294.00"
27427	"LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE;
EXTRA-ARTICULAR"	"59,085.00"	"26,325.00"	"32,760.00"
27428	"LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE;
INTRA-ARTICULAR (OPEN)"	"60,723.00"	"26,325.00"	"34,398.00"
27429	"LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE;
INTRA-ARTICULAR (OPEN) AND EXTRA-ARTICULAR"	"72,501.00"	"36,465.00"	"36,036.00"
27430	QUADRICEPSPLASTY (BENNETT OR THOMPSON TYPE)	"52,884.00"	"23,400.00"	"29,484.00"
27435	"CAPSULOTOMY, KNEE, POSTERIOR CAPSULAR RELEASE"	"59,943.00"	"33,735.00"	"26,208.00"
27437	"ARTHROPLASTY, PATELLA; W/O PROSTHESIS"	"59,943.00"	"33,735.00"	"26,208.00"
27438	"ARTHROPLASTY, PATELLA; W/ PROSTHESIS"	"60,723.00"	"26,325.00"	"34,398.00"
27440	"ARTHROPLASTY, KNEE, TIBIAL PLATEAU;"	"73,710.00"	"32,760.00"	"40,950.00"
27441	"ARTHROPLASTY, KNEE, TIBIAL PLATEAU; W/ DEBRIDEMENT AND
PARTIAL SYNOVECTOMY"	"75,348.00"	"32,760.00"	"42,588.00"
27442	"ARTHROPLASTY, KNEE, FEMORAL CONDYLES OR TIBIAL
PLATEAUS;"	"75,348.00"	"32,760.00"	"42,588.00"
27443	"ARTHROPLASTY, KNEE, FEMORAL CONDYLES OR TIBIAL PLATEAUS; W/ DEBRIDEMENT AND PARTIAL SYNOVECTOMY"	"76,986.00"	"32,760.00"	"44,226.00"
27445	"ARTHROPLASTY, KNEE, CONSTRAINED PROSTHESIS (E.G.,
WALLDIUS TYPE)"	"90,675.00"	"41,535.00"	"49,140.00"
27446	"ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL OR
LATERAL COMPARTMENT"	"76,986.00"	"32,760.00"	"44,226.00"
27447	"ARTHROPLASTY, KNEE, CONDYLE AND PLATEAU; MEDIAL AND LATERAL COMPARTMENTS W/ OR W/O PATELLA RESURFACING
(""TOTAL KNEE REPLACEMENT"")"	"78,624.00"	"32,760.00"	"45,864.00"
27448	"OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR; W/O FIXATION"	"35,919.00"	"18,720.00"	"17,199.00"
27450	"OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR; W/ FIXATION"	"45,435.00"	"20,865.00"	"24,570.00"
27454	"OSTEOTOMY, MULTIPLE, FEMORAL SHAFT, W/ REALIGNMENT ON INTRAMEDULLARY ROD (SOFIELD TYPE PROCEDURE)"	"52,884.00"	"23,400.00"	"29,484.00"
27455	"OSTEOTOMY, PROXIMAL TIBIA, INCLUDING FIBULAR EXCISION OR OSTEOTOMY (INCLUDES CORRECTION OF GENU VARUS (BOWLEG) OR GENU VALGUS (KNOCK-KNEE)); BEFORE EPIPHYSEAL CLOSURE"	"52,884.00"	"23,400.00"	"29,484.00"
27457	"OSTEOTOMY, PROXIMAL TIBIA, INCLUDING FIBULAR EXCISION OR OSTEOTOMY (INCLUDES CORRECTION OF GENU VARUS (BOWLEG) OR GENU VALGUS (KNOCK-KNEE)); AFTER EPIPHYSEAL CLOSURE"	"52,884.00"	"23,400.00"	"29,484.00"
27465	"OSTEOPLASTY, FEMUR; SHORTENING (EXCLUDING 64876)"	"52,884.00"	"23,400.00"	"29,484.00"
27466	"OSTEOPLASTY, FEMUR; LENGTHENING"	"52,884.00"	"23,400.00"	"29,484.00"
27468	"OSTEOPLASTY, FEMUR; COMBINED, LENGTHENING AND
SHORTENING W/ FEMORAL SEGMENT TRANSFER"	"72,501.00"	"36,465.00"	"36,036.00"
27470	"REPAIR, NONUNION OR MALUNION, FEMUR, DISTAL TO HEAD AND NECK; W/O GRAFT (E.G., COMPRESSION TECHNIQUE)"	"61,581.00"	"33,735.00"	"27,846.00"
27472	"REPAIR, NONUNION OR MALUNION, FEMUR, DISTAL TO HEAD AND
NECK; W/ ILIAC OR OTHER AUTOGENOUS BONE GRAFT (INCLUDES OBTAINING GRAFT)"	"54,522.00"	"23,400.00"	"31,122.00"
27475	"EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; DISTAL
FEMUR"	"59,943.00"	"33,735.00"	"26,208.00"
27477	"EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; TIBIA AND
FIBULA, PROXIMAL"	"45,435.00"	"20,865.00"	"24,570.00"
27479	"EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING;
COMBINED DISTAL FEMUR, PROXIMAL TIBIA AND FIBULA"	"52,884.00"	"23,400.00"	"29,484.00"
27485	"ARREST, HEMIEPIPHYSEAL, DISTAL FEMUR OR PROXIMAL LEG
(E.G., FOR GENU VARUS OR VALGUS)"	"59,943.00"	"33,735.00"	"26,208.00"
27486	"REVISION OF TOTAL KNEE ARTHROPLASTY, W/ OR W/O
ALLOGRAFT; ONE COMPONENT"	"104,130.00"	"46,800.00"	"57,330.00"
27487	"REVISION OF TOTAL KNEE ARTHROPLASTY, W/ OR W/O
ALLOGRAFT; ALL COMPONENTS"	"107,250.00"	"41,730.00"	"65,520.00"
27488	"REMOVAL OF KNEE PROSTHESIS, INCLUDING ""TOTAL KNEE"" METHYLMETHACRYLATE AND INSERTION OF SPACER, WHEN
APPLICABLE"	"72,501.00"	"36,465.00"	"36,036.00"
27495	"PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR
WRITING) W/ OR W/O METHYLMETHACRYLATE, FEMUR"	"59,943.00"	"33,735.00"	"26,208.00"
27496	"DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, ONE
COMPARTMENT (FLEXOR OR EXTENSOR OR ADDUCTOR);"	"40,911.00"	"21,255.00"	"19,656.00"
27497	"DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, ONE COMPARTMENT (FLEXOR OR EXTENSOR OR ADDUCTOR); W/
DEBRIDEMENT OF NONVIABLE MUSCLE AND/OR NERVE"	"42,549.00"	"21,255.00"	"21,294.00"
27498	"DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, MULTIPLE
COMPARTMENTS;"	"42,549.00"	"21,255.00"	"21,294.00"
27499	"DECOMPRESSION FASCIOTOMY, THIGH AND/OR KNEE, MULTIPLE
COMPARTMENTS; W/ DEBRIDEMENT OF NONVIABLE MUSCLE AND/OR NERVE"	"45,435.00"	"20,865.00"	"24,570.00"
27501	CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR FEMORAL FRACTURE W/ OR W/O INTERCONDYLAR EXTENSION	"29,172.00"	"14,430.00"	"14,742.00"
27502	"CLOSED TREATMENT OF FEMORAL SHAFT FRACTURE, W/ OR W/O
SKIN OR SKELETAL TRACTION"	"35,919.00"	"18,720.00"	"17,199.00"
27503	"CLOSED TREATMENT OF SUPRACONDYLAR OR TRANSCONDYLAR FEMORAL FRACTURE W/ OR W/O INTERCONDYLAR EXTENSION, W/ OR W/O SKIN OR SKELETAL TRACTION"	"35,919.00"	"18,720.00"	"17,199.00"
27506	"OPEN TREATMENT OF FEMORAL SHAFT FRACTURE, W/ OR W/O EXTERNAL FIXATION, W/ INSERTION OF INTRAMEDULLARY IMPLANT, W/ OR W/O CERCLAGE AND/OR LOCKING SCREWS"	"59,943.00"	"33,735.00"	"26,208.00"
27507	"OPEN TREATMENT OF FEMORAL SHAFT FRACTURE W/
PLATE/SCREWS, W/ OR W/O CERCLAGE"	"59,943.00"	"33,735.00"	"26,208.00"
27509	"PERCUTANEOUS SKELETAL FIXATION OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL CONDYLE, OR SUPRACONDYLAR OR TRANSCONDYLAR, W/ OR W/O INTERCONDYLAR EXTENSION, OR DISTAL  FEMORAL EPIPHYSEAL SEPARATION"	"72,501.00"	"36,465.00"	"36,036.00"
27510	"CLOSED TREATMENT OF FEMORAL FRACTURE, DISTAL END,
MEDIAL OR LATERAL CONDYLE"	"35,919.00"	"18,720.00"	"17,199.00"
27511	"OPEN TREATMENT OF FEMORAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE W/O INTERCONDYLAR EXTENSION, W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"72,501.00"	"36,465.00"	"36,036.00"
27513	"OPEN TREATMENT OF FEMORAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE W/ INTERCONDYLAR EXTENSION, W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"73,710.00"	"32,760.00"	"40,950.00"
27514	"OPEN TREATMENT OF FEMORAL FRACTURE, DISTAL END, MEDIAL
OR LATERAL CONDYLE, W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"59,943.00"	"33,735.00"	"26,208.00"
27516	"CLOSED TREATMENT OF DISTAL FEMORAL EPIPHYSEAL
SEPARATION"	"45,435.00"	"20,865.00"	"24,570.00"
27519	"OPEN TREATMENT OF DISTAL FEMORAL EPIPHYSEAL SEPARATION, W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"44,187.00"	"21,255.00"	"22,932.00"
27520	CLOSED TREATMENT OF PATELLAR FRACTURE	"40,911.00"	"21,255.00"	"19,656.00"
27524	"OPEN TREATMENT OF PATELLAR FRACTURE, W/ INTERNAL FIXATION AND/OR PARTIAL OR COMPLETE PATELLECTOMY AND
SOFT TISSUE REPAIR"	"40,911.00"	"21,255.00"	"19,656.00"
27530	"CLOSED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU)"	"35,919.00"	"18,720.00"	"17,199.00"
27535	"OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); UNICONDYLAR, W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"59,943.00"	"33,735.00"	"26,208.00"
27536	"OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU);
BICONDYLAR, W/ OR W/O INTERNAL FIXATION"	"52,884.00"	"23,400.00"	"29,484.00"
27538	"CLOSED TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR
TUBEROSITY FRACTURE(S) OF KNEE"	"20,553.00"	"10,725.00"	"9,828.00"
27540	"OPEN TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF THE KNEE, W/ OR W/O INTERNAL
OR EXTERNAL FIXATION"	"42,549.00"	"21,255.00"	"21,294.00"
27550	CLOSED TREATMENT OF KNEE DISLOCATION	"20,553.00"	"10,725.00"	"9,828.00"
27556	"OPEN TREATMENT OF KNEE DISLOCATION, W/ OR W/O INTERNAL OR EXTERNAL FIXATION; W/O PRIMARY LIGAMENTOUS REPAIR OR AUGMENTATION/RECONSTRUCTION"	"52,884.00"	"23,400.00"	"29,484.00"
27557	"OPEN TREATMENT OF KNEE DISLOCATION, W/ OR W/O INTERNAL OR EXTERNAL FIXATION; W/ PRIMARY LIGAMENTOUS REPAIR"	"54,522.00"	"23,400.00"	"31,122.00"
27558	"OPEN TREATMENT OF KNEE DISLOCATION, W/ OR W/O INTERNAL OR EXTERNAL FIXATION; W/ PRIMARY LIGAMENTOUS REPAIR, W/ AUGMENTATION/RECONSTRUCTION"	"73,710.00"	"32,760.00"	"40,950.00"
27560	CLOSED TREATMENT OF PATELLAR DISLOCATION	"40,911.00"	"21,255.00"	"19,656.00"
27566	"OPEN TREATMENT OF PATELLAR DISLOCATION, W/ OR W/O
PARTIAL OR TOTAL PATELLECTOMY"	"52,884.00"	"23,400.00"	"29,484.00"
27580	"FUSION OF KNEE, ANY TECHNIQUE"	"59,943.00"	"33,735.00"	"26,208.00"
27590	"AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL;"	"59,085.00"	"26,325.00"	"32,760.00"
27591	"AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; IMMEDIATE
FITTING TECHNIQUE INCLUDING FIRST CAST"	"45,435.00"	"20,865.00"	"24,570.00"
27592	"AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; OPEN,
CIRCULAR (GUILLOTINE)"	"45,435.00"	"20,865.00"	"24,570.00"
27594	"AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; SECONDARY
CLOSURE OR SCAR REVISION"	"23,361.00"	"11,895.00"	"11,466.00"
27596	"AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; RE-
AMPUTAION"	"44,187.00"	"21,255.00"	"22,932.00"
27598	DISARTICULATION AT KNEE	"52,884.00"	"23,400.00"	"29,484.00"
27600	"DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL
COMPARTMENTS ONLY"	"15,639.00"	"10,725.00"	"4,914.00"
27601	"DECOMPRESSION FASCIOTOMY, LEG; POSTERIOR
COMPARTMENTS(S) ONLY"	"15,639.00"	"10,725.00"	"4,914.00"
27602	"DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR
LATERAL, AND POSTERIOR COMPARTMENT(S)"	"16,107.00"	"9,555.00"	"6,552.00"
27603	"INCISION AND DRAINAGE, LEG OR ANKLE; DEEP ABSCESS OR
HEMATOMA"	"8,010.60"	"6,045.00"	"1,965.60"
27604	"INCISION AND DRAINAGE, LEG OR ANKLE; INFECTED BURSA"	"11,076.00"	"7,800.00"	"3,276.00"
27605	"TENOTOMY, ACHILLES TENDON, SUBCUTANEOUS ; LOCAL
ANESTHESIA;"	"24,453.00"	"10,530.00"	"13,923.00"
27606	"TENOTOMY, ACHILLES TENDON, SUBCUTANEOUS ; LOCAL
ANESTHESIA; GENERAL ANESTHESIA"	"35,919.00"	"18,720.00"	"17,199.00"
27607	"INCISION, DEEP, W/ OPENING OF BONE CORTEX (E.G., FOR
OSTEOMYELITIS OR BONE ABSCESS), LEG OR ANKLE"	"40,911.00"	"21,255.00"	"19,656.00"
27610	"ARTHROTOMY, ANKLE, FOR INFECTION, W/ EXPLORATION,
DRAINAGE, OR REMOVAL OF FOREIGN BODY"	"42,783.00"	"24,765.00"	"18,018.00"
27612	"ARTHROTOMY, ANKLE, POSTERIOR CAPSULAR RELEASE, W/ OR
W/O ACHILLES TENDON LENGTHENING"	"44,187.00"	"21,255.00"	"22,932.00"
27613	"BIOPSY, SOFT TISSUE OF LEG OR ANKLE AREA"	"6,832.80"	"5,850.00"	982.80
27615	"RADICAL RESECTION OF TUMOR (E.G., MALIGNANT NEOPLASM),
SOFT TISSUE OF LEG OR ANKLE AREA"	"40,911.00"	"21,255.00"	"19,656.00"
27618	"EXCISION, TUMOR, LEG OR ANKLE AREA; SUBCUTANEOUS"	"11,076.00"	"7,800.00"	"3,276.00"
27619	"EXCISION, TUMOR, LEG OR ANKLE AREA; DEEP, SUBFASCIAL OR
INTRAMUSCULAR"	"15,639.00"	"10,725.00"	"4,914.00"
27620	"ARTHROTOMY, ANKLE, W/ JOINT EXPLORATION, W/ OR W/O BIOPSY, W/ OR W/O REMOVAL OF LOOSE OR FOREIGN BODY"	"25,155.00"	"12,870.00"	"12,285.00"
27625	"ARTHROTOMY, ANKLE, W/ SYNOVECTOMY;"	"35,919.00"	"18,720.00"	"17,199.00"
27626	"ARTHROTOMY, ANKLE, W/ SYNOVECTOMY; INCLUDING
TENOSYNOVECTOMY"	"42,783.00"	"24,765.00"	"18,018.00"
27630	"EXCISION OF LESION OF TENDON SHEATH OR CAPSULE (E.G., CYST
OR GANGLION), LEG AND/OR ANKLE"	"11,076.00"	"7,800.00"	"3,276.00"
27635	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR,
TIBIA OR FIBULA;"	"29,172.00"	"14,430.00"	"14,742.00"
27637	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TIBIA OR FIBULA; W/ AUTOGRAFT(INCLUDES OBTAINING GRAFT)"	"42,783.00"	"24,765.00"	"18,018.00"
27638	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR,
TIBIA OR FIBULA; W/ ALLOGRAFT"	"42,783.00"	"24,765.00"	"18,018.00"
27640	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR
DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS OR EXOSTOSIS); TIBIA"	"35,919.00"	"18,720.00"	"17,199.00"
27641	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR
DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS OR EXOSTOSIS); FIBULA"	"35,100.00"	"18,720.00"	"16,380.00"
27645	"RADICAL RESECTION OF TUMOR, BONE; TIBIA"	"45,435.00"	"20,865.00"	"24,570.00"
27646	"RADICAL RESECTION OF TUMOR, BONE; FIBULA"	"44,187.00"	"21,255.00"	"22,932.00"
27647	"RADICAL RESECTION OF TUMOR, BONE; TALUS OR CALCANEUS"	"45,435.00"	"20,865.00"	"24,570.00"
27650	"REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED
ACHILLES TENDON;"	"42,783.00"	"24,765.00"	"18,018.00"
27652	"REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLES TENDON; W/ GRAFT (INCLUDES OBTAINING GRAFT)"	"45,435.00"	"20,865.00"	"24,570.00"
27654	"REPAIR, SECONDARY, RUPTURED ACHILLES TENDON, W/ OR W/O
GRAFT"	"42,549.00"	"21,255.00"	"21,294.00"
27656	"REPAIR, FASCIAL DEFECT OF LEG"	"11,076.00"	"7,800.00"	"3,276.00"
27658	"REPAIR OR SUTURE OF FLEXOR TENDON OF LEG; PRIMARY, W/O
GRAFT, SINGLE, EACH"	"29,991.00"	"14,430.00"	"15,561.00"
27659	"REPAIR OR SUTURE OF FLEXOR TENDON OF LEG; SECONDARY W/
OR W/O GRAFT, SINGLE TENDON, EACH"	"35,100.00"	"18,720.00"	"16,380.00"
27664	"REPAIR OR SUTURE OF EXTENSOR TENDON OF LEG; PRIMARY,
W/O GRAFT, SINGLE, EACH"	"29,991.00"	"14,430.00"	"15,561.00"
27665	"REPAIR OR SUTURE OF EXTENSOR TENDON OF LEG; SECONDARY
W/ OR W/O GRAFT, SINGLE TENDON, EACH"	"35,100.00"	"18,720.00"	"16,380.00"
27675	"REPAIR FOR DISLOCATING PERONEAL TENDONS; W/O FIBULAR
OSTEOTOMY"	"35,100.00"	"18,720.00"	"16,380.00"
27676	"REPAIR FOR DISLOCATING PERONEAL TENDONS; W/ FIBULAR
OSTEOTOMY"	"43,602.00"	"24,765.00"	"18,837.00"
27680	"TENOLYSIS, INCLUDING TIBIA, FIBULA, AND ANKLE FLEXOR;
SINGLE"	"35,100.00"	"18,720.00"	"16,380.00"
27681	"TENOLYSIS, INCLUDING TIBIA, FIBULA, AND ANKLE FLEXOR;
MULTIPLE (THROUGH SAME INCISION), EACH"	"42,783.00"	"24,765.00"	"18,018.00"
27685	"LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE;
SINGLE"	"35,100.00"	"18,720.00"	"16,380.00"
27686	"LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE;
MULTIPLE (THROUGH SAME INCISION), EACH"	"35,100.00"	"18,720.00"	"16,380.00"
27687	"GASTROCNEMIUS RECESSION (E.G., STRAYER PROCEDURE)"	"29,172.00"	"14,430.00"	"14,742.00"
27690	"TRANSFER OR TRANSPLANT OF SINGLE TENDON (W/ MUSCLE REDIRECTION OR REROUTING); SUPERFICIAL (E.G., ANTERIOR
TIBIAL EXTENSORS INTO MIDFOOT)"	"35,919.00"	"18,720.00"	"17,199.00"
27692	TRANSFER OR TRANSPLANT OF SINGLE TENDON (W/ MUSCLE REDIRECTION OR REROUTING); EACH ADDITIONAL TENDON	"29,991.00"	"14,430.00"	"15,561.00"
27695	"SUTURE, PRIMARY, TORN, RUPTURED OR SEVERED LIGAMENT,
ANKLE; COLLATERAL"	"35,100.00"	"18,720.00"	"16,380.00"
27696	"SUTURE, PRIMARY, TORN, RUPTURED OR SEVERED LIGAMENT,
ANKLE; BOTH COLLATERAL LIGAMENTS"	"45,435.00"	"20,865.00"	"24,570.00"
27698	"SUTURE, SECONDARY REPAIR, TORN, RUPTURED OR SEVERED LIGAMENT, ANKLE, COLLATERAL (WATSON-JONES PROCEDURE)"	"35,100.00"	"18,720.00"	"16,380.00"
27700	"ARTHROPLASTY, ANKLE;"	"52,884.00"	"23,400.00"	"29,484.00"
27702	"ARTHROPLASTY, ANKLE; W/ IMPLANT (""TOTAL ANKLE"")"	"60,723.00"	"26,325.00"	"34,398.00"
27703	"ARTHROPLASTY, ANKLE; SECONDARY RECONSTRUCTION, TOTAL
ANKLE"	"72,501.00"	"36,465.00"	"36,036.00"
27704	REMOVAL OF ANKLE IMPLANT	"42,549.00"	"21,255.00"	"21,294.00"
27705	OSTEOTOMY; TIBIA	"42,783.00"	"24,765.00"	"18,018.00"
27707	OSTEOTOMY; FIBULA	"35,100.00"	"18,720.00"	"16,380.00"
27709	OSTEOTOMY; TIBIA AND FIBULA	"44,187.00"	"21,255.00"	"22,932.00"
27712	"OSTEOTOMY; MULTIPLE, W/ REALIGNMENT ON INTRAMEDULLARY
ROD (SOFIELD TYPE PROCEDURE)"	"46,254.00"	"20,865.00"	"25,389.00"
27715	"OSTEOPLASTY, TIBIA AND FIBULA, LENGTHENING"	"54,522.00"	"23,400.00"	"31,122.00"
27720	"REPAIR OF NONUNION OR MALUNION, TIBIA; W/O GRAFT, (E.G.,
COMPRESSION TECHNIQUE)"	"35,100.00"	"18,720.00"	"16,380.00"
27722	"REPAIR OF NONUNION OR MALUNION, TIBIA; W/ SLIDING GRAFT"	"40,911.00"	"21,255.00"	"19,656.00"
27724	"REPAIR OF NONUNION OR MALUNION, TIBIA; W/ ILIAC OR OTHER
AUTOGRAFT (INCLUDES OBTAINING GRAFT)"	"42,549.00"	"21,255.00"	"21,294.00"
27725	"REPAIR OF NONUNION OR MALUNION, TIBIA; BY SYNOSTOSIS, W/
FIBULA, ANY METHOD"	"44,187.00"	"21,255.00"	"22,932.00"
27727	"REPAIR OF CONGENITAL PSEUDARTHROSIS, TIBIA"	"45,435.00"	"20,865.00"	"24,570.00"
27730	"EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; DISTAL
TIBIA"	"42,549.00"	"21,255.00"	"21,294.00"
27732	"EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; DISTAL
FIBULA"	"40,911.00"	"21,255.00"	"19,656.00"
27734	"EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING; DISTAL
TIBIA AND FIBULA"	"45,435.00"	"20,865.00"	"24,570.00"
27740	"EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING,
COMBINED, PROXIMAL AND DISTAL TIBIA AND FIBULA;"	"45,435.00"	"20,865.00"	"24,570.00"
27742	"EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING,
COMBINED, PROXIMAL AND DISTAL TIBIA AND FIBULA; AND DISTAL FEMUR"	"44,187.00"	"21,255.00"	"22,932.00"
27745	"PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR
WIRING) W/ OR W/O METHYLMETHACRYLATE, TIBIA"	"60,762.00"	"33,735.00"	"27,027.00"
27750	"CLOSED TREATMENT OF TIBIAL SHAFT FRACTURE (W/ OR W/O
FIBULAR FRACTURE)"	"23,634.00"	"10,530.00"	"13,104.00"
27752	"CLOSED TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE); WITH MANIPULATION, WITH OR
WITHOUT SKELETAL TRACTION"	"23,634.00"	"10,530.00"	"13,104.00"
27756	"PERCUTANEOUS SKELETAL FIXATION OF TIBIAL SHAFT FRACTURE (W/ OR W/O FIBULAR FRACTURE) (E.G., PINS OR SCREWS)"	"42,549.00"	"21,255.00"	"21,294.00"
27758	"OPEN TREATMENT OF TIBIAL SHAFT FRACTURE (W/ OR W/O FIBULAR FRACTURE) W/ PLATE/SCREWS, W/ OR W/O CERCLAGE"	"44,187.00"	"21,255.00"	"22,932.00"
27759	"OPEN TREATMENT OF TIBIAL SHAFT FRACTURE (W/ OR W/O FIBULAR FRACTURE) BY INTRAMEDULLARY IMPLANT, W/ OR W/O
INTERLOCKING SCREWS AND/OR CERCLAGE"	"52,884.00"	"23,400.00"	"29,484.00"
27760	CLOSED TREATMENT OF MEDIAL MALLEOLUS FRACTURE	"21,372.00"	"10,725.00"	"10,647.00"
27766	"OPEN TREATMENT OF MEDIAL MALLEOLUS FRACTURE, W/ OR
W/O INTERNAL OR EXTERNAL FIXATION"	"23,634.00"	"10,530.00"	"13,104.00"
27780	CLOSED TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE	"21,372.00"	"10,725.00"	"10,647.00"
27784	"OPEN TREATMENT OF PROXIMAL FIBULA OR SHAFT FRACTURE,
W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"44,187.00"	"21,255.00"	"22,932.00"
27786	"CLOSED TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL
MALLEOLUS)"	"20,553.00"	"10,725.00"	"9,828.00"
27792	"OPEN TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS), W/ OR W/O INTERNAL OR EXTERNAL FIXATION W/O
MANIPULATION"	"40,911.00"	"21,255.00"	"19,656.00"
27808	"CLOSED TREATMENT OF BIMALLEOLAR ANKLE FRACTURE,
(INCLUDING POTTS)"	"25,155.00"	"12,870.00"	"12,285.00"
27814	"OPEN TREATMENT OF BIMALLEOLAR ANKLE FRACTURE, W/ OR
W/O INTERNAL OR EXTERNAL FIXATION"	"45,435.00"	"20,865.00"	"24,570.00"
27816	CLOSED TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE	"45,435.00"	"20,865.00"	"24,570.00"
27822	"OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, W/ OR W/O INTERNAL OR EXTERNAL FIXATION, MEDIAL AND/OR LATERAL MALLEOLUS; W/O FIXATION OF POSTERIOR LIP"	"45,435.00"	"20,865.00"	"24,570.00"
27823	"OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, W/ OR W/O INTERNAL OR EXTERNAL FIXATION, MEDIAL AND/OR LATERAL MALLEOLUS; W/ FIXATION OF POSTERIOR LIP"	"45,435.00"	"20,865.00"	"24,570.00"
27824	"CLOSED TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR PORTION OF DISTAL TIBIA (E.G., PILON OR TIBIAL
PLAFOND)"	"20,553.00"	"10,725.00"	"9,828.00"
27826	"OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR SURFACE/PORTION OF DISTAL TIBIA (E.G., PILON OR TIBIAL PLAFOND), W/ INTERNAL OR EXTERNAL FIXATION; OF
FIBULA ONLY"	"40,911.00"	"21,255.00"	"19,656.00"
27827	"OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR SURFACE/PORTION OF DISTAL TIBIA (E.G., PILON OR TIBIAL PLAFOND), W/ INTERNAL OR EXTERNAL FIXATION; OF
TIBIA ONLY"	"42,783.00"	"24,765.00"	"18,018.00"
27828	"OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR SURFACE/PORTION OF DISTAL TIBIA (E.G., PILON OR TIBIAL PLAFOND), W/ INTERNAL OR EXTERNAL FIXATION; OF
BOTH TIBIA AND FIBULA"	"42,549.00"	"21,255.00"	"21,294.00"
27829	"OPEN TREATMENT OF DISTAL TIBIOFIBULAR JOINT (SYNDESMOSIS) DISRUPTION, W/ OR W/O INTERNAL OR
EXTERNAL FIXATION"	"40,911.00"	"21,255.00"	"19,656.00"
27830	"CLOSED TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT
DISLOCATION"	"21,372.00"	"10,725.00"	"10,647.00"
27832	"OPEN TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOCATION, W/ OR W/O INTERNAL OR EXTERNAL FIXATION, OR
W/ EXCISION OF PROXIMAL FIBULA"	"23,361.00"	"11,895.00"	"11,466.00"
27840	CLOSED TREATMENT OF ANKLE DISLOCATION	"21,372.00"	"10,725.00"	"10,647.00"
27846	"OPEN TREATMENT OF ANKLE DISLOCATION, W/ OR W/O PERCUTANEOUS SKELETAL FIXATION; W/O REPAIR OR INTERNAL
FIXATION"	"44,187.00"	"21,255.00"	"22,932.00"
27848	"OPEN TREATMENT OF ANKLE DISLOCATION, W/ OR W/O PERCUTANEOUS SKELETAL FIXATION; W/ REPAIR OR INTERNAL
OR EXTERNAL FIXATION"	"46,254.00"	"20,865.00"	"25,389.00"
27870	"ARTHRODESIS, ANKLE, ANY METHOD"	"35,100.00"	"18,720.00"	"16,380.00"
27871	"ARTHRODESIS, TIBIOFIBULAR JOINT, PROXIMAL OR DISTAL"	"41,730.00"	"21,255.00"	"20,475.00"
27880	"AMPUTATION, LEG, THROUGH TIBIA AND FIBULA;"	"59,085.00"	"26,325.00"	"32,760.00"
27881	"AMPUTATION, LEG, THROUGH TIBIA AND FIBULA; W/ IMMEDIATE FITTING TECHNIQUE INCLUDING APPLICATION OF FIRST CAST"	"59,943.00"	"33,735.00"	"26,208.00"
27882	"AMPUTATION, LEG, THROUGH TIBIA AND FIBULA; OPEN,
CIRCULAR (GUILLOTINE)"	"35,100.00"	"18,720.00"	"16,380.00"
27884	"AMPUTATION, LEG, THROUGH TIBIA AND FIBULA; SECONDARY
CLOSURE OR SCAR REVISION"	"23,634.00"	"10,530.00"	"13,104.00"
27886	"AMPUTATION, LEG, THROUGH TIBIA AND FIBULA; RE-
AMPUTATION"	"45,435.00"	"20,865.00"	"24,570.00"
27888	"AMPUTATION, ANKLE, THROUGH MALLEOLI OF TIBIA AND FIBULA (SYME, PIROGOFF TYPE PROCEDURES), W/ PLASTIC CLOSURE AND
RESECTION OF NERVES"	"45,435.00"	"20,865.00"	"24,570.00"
27889	ANKLE DISARTICULATION	"42,783.00"	"24,765.00"	"18,018.00"
27892	"DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL COMPARTMENTS ONLY, W/ DEBRIDEMENT OF NONVIABLE
MUSCLE AND/OR NERVE"	"35,100.00"	"18,720.00"	"16,380.00"
27893	"DECOMPRESSION FASCIOTOMY, LEG; POSTERIOR COMPARTMENT(S) ONLY, W/ DEBRIDEMENT OF NONVIABLE
MUSCLE AND/OR NERVE"	"35,100.00"	"18,720.00"	"16,380.00"
27894	"DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL, AND POSTERIOR COMPARTMENT(S), W/ DEBRIDEMENT
OF NONVIABLE MUSCLE AND/OR NERVE"	"35,919.00"	"18,720.00"	"17,199.00"
28001	"INCISION AND DRAINAGE, INFECTED BURSA, FOOT"	"11,076.00"	"7,800.00"	"3,276.00"
28002	"DEEP DISSECTION BELOW FASCIA, FOR DEEP INFECTION OF FOOT,
W/ OR W/O TENDON SHEATH INVOLVEMENT; SINGLE BURSAL SPACE, SPECIFY;"	"16,107.00"	"9,555.00"	"6,552.00"
28003	"DEEP DISSECTION BELOW FASCIA, FOR DEEP INFECTION OF FOOT, W/ OR W/O TENDON SHEATH INVOLVEMENT; SINGLE BURSAL
SPACE, SPECIFY; MULTIPLE AREAS"	"18,915.00"	"10,725.00"	"8,190.00"
28005	"INCISION, DEEP, W/ OPENING OF BONE CORTEX (E.G. FOR
OSTEOMYELITIS OR BONE ABSCESS), FOOT"	"20,553.00"	"10,725.00"	"9,828.00"
28008	"FASCIOTOMY, FOOT AND/OR TOE"	"23,634.00"	"10,530.00"	"13,104.00"
28010	"TENOTOMY, SUBCUTANEOUS, TOE; SINGLE"	"16,107.00"	"9,555.00"	"6,552.00"
28011	"TENOTOMY, SUBCUTANEOUS, TOE; MULTIPLE"	"20,553.00"	"10,725.00"	"9,828.00"
28020	"ARTHROTOMY, W/ EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY; INTERTARSAL OR TARSOMETATARSAL
JOINT"	"25,155.00"	"12,870.00"	"12,285.00"
28022	"ARTHROTOMY, W/ EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY; METATARSOPHALANGEAL JOINT"	"16,107.00"	"9,555.00"	"6,552.00"
28024	"ARTHROTOMY, W/ EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY; INTERPHALANGEAL JOINT"	"16,107.00"	"9,555.00"	"6,552.00"
28030	NEURECTOMY OF INTRINSIC MUSCULATURE OF FOOT	"21,707.40"	"13,845.00"	"7,862.40"
28035	"TARSAL TUNNEL RELEASE (POSTERIOR TIBIAL NERVE
DECOMPRESSION)"	"35,100.00"	"18,720.00"	"16,380.00"
28043	"EXCISION, TUMOR, FOOT; SUBCUTANEOUS"	"11,076.00"	"7,800.00"	"3,276.00"
28045	"EXCISION, TUMOR, FOOT; DEEP, SUBFASCIAL, INTRAMUSCULAR"	"15,639.00"	"10,725.00"	"4,914.00"
28046	"RADICAL RESECTION OF TUMOR (E.G., MALIGNANT NEOPLASM),
SOFT TISSUE OF FOOT"	"73,710.00"	"32,760.00"	"40,950.00"
28050	"ARTHROTOMY FOR SYNOVIAL BIOPSY; INTERTARSAL OR
TARSOMETATARSAL JOINT"	"19,734.00"	"10,725.00"	"9,009.00"
28052	"ARTHROTOMY FOR SYNOVIAL BIOPSY; METATARSOPHALANGEAL
JOINT"	"19,734.00"	"10,725.00"	"9,009.00"
28054	ARTHROTOMY FOR SYNOVIAL BIOPSY; INTERPHALANGEAL JOINT	"18,915.00"	"10,725.00"	"8,190.00"
28060	"FASCIECTOMY, EXCISION OF PLANTAR FASCIA; PARTIAL"	"18,915.00"	"10,725.00"	"8,190.00"
28062	"FASCIECTOMY, EXCISION OF PLANTAR FASCIA; RADICAL"	"21,372.00"	"10,725.00"	"10,647.00"
28070	"SYNOVECTOMY; INTERTARSAL OR TARSOMETATARSAL JOINT,
EACH"	"23,361.00"	"11,895.00"	"11,466.00"
28072	"SYNOVECTOMY; METATARSOPHALANGEAL JOINT, EACH"	"21,372.00"	"10,725.00"	"10,647.00"
28080	"EXCISION OF INTERDIGITAL (MORTON) NEUROMA, SINGLE, EACH"	"11,076.00"	"7,800.00"	"3,276.00"
28086	"SYNOVECTOMY, TENDON SHEATH, FOOT; FLEXOR"	"21,372.00"	"10,725.00"	"10,647.00"
28088	"SYNOVECTOMY, TENDON SHEATH, FOOT; EXTENSOR"	"21,372.00"	"10,725.00"	"10,647.00"
28090	EXCISION OF LESION OF TENDON OR FIBROUS SHEATH OR CAPSULE (INCLUDING SYNOVECTOMY) (CYST OR GANGLION); FOOT	"16,458.00"	"10,725.00"	"5,733.00"
28092	EXCISION OF LESION OF TENDON OR FIBROUS SHEATH OR CAPSULE (INCLUDING SYNOVECTOMY) (CYST OR GANGLION); TOES	"16,107.00"	"9,555.00"	"6,552.00"
28100	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR,
TALUS OR CALCANEUS;"	"29,991.00"	"14,430.00"	"15,561.00"
28102	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TALUS OR CALCANEUS; W/ ILIAC OR OTHER AUTOGRAFT
(INCLUDES OBTAINING GRAFT)"	"42,783.00"	"24,765.00"	"18,018.00"
28103	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR,
TALUS OR CALCANEUS; W/ ALLOGRAFT"	"42,783.00"	"24,765.00"	"18,018.00"
28104	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TALUS OR METATARSAL BONES, EXCEPT TARSAL OR CALCANEUS;"	"29,991.00"	"14,430.00"	"15,561.00"
28106	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TALUS OR METATARSAL BONES, EXCEPT TARSAL OR CALCANEUS; W/ ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT)"	"42,783.00"	"24,765.00"	"18,018.00"
28107	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR,
TALUS OR METATARSAL BONES, EXCEPT TARSAL OR CALCANEUS; W/ ALLOGRAFT"	"42,783.00"	"24,765.00"	"18,018.00"
28108	"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR,
PHALANGES OF FOOT"	"29,172.00"	"14,430.00"	"14,742.00"
28110	"OSTECTOMY, PARTIAL EXCISION, FIFTH METATARSAL HEAD
(BUNIONETTE)"	"42,783.00"	"24,765.00"	"18,018.00"
28111	"OSTECTOMY, COMPLETE EXCISION; FIRST METATARSAL HEAD"	"35,919.00"	"18,720.00"	"17,199.00"
28112	"OSTECTOMY, COMPLETE EXCISION; OTHER METATARSAL HEAD
(SECOND, THIRD OR FOURTH)"	"35,919.00"	"18,720.00"	"17,199.00"
28113	"OSTECTOMY, COMPLETE EXCISION; FIFTH METATARSAL HEAD"	"35,100.00"	"18,720.00"	"16,380.00"
28114	"OSTECTOMY, COMPLETE EXCISION; ALL METATARSAL HEADS, W/ PARTIAL PROXIMAL PHALANGECTOMY, EXCLUDING FIRST METATARSAL (CLAYTON TYPE PROCEDURE)"	"40,911.00"	"21,255.00"	"19,656.00"
28116	"OSTECTOMY, EXCISION OF TARSAL COALITION"	"29,991.00"	"14,430.00"	"15,561.00"
28118	"OSTECTOMY, CALCANEUS;"	"29,991.00"	"14,430.00"	"15,561.00"
28119	"OSTECTOMY, CALCANEUS; FOR SPUR, W/ OR  W/O PLANTAR
FASCIAL RELEASE"	"29,172.00"	"14,430.00"	"14,742.00"
28120	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS OR TALAR BOSSING); TALUS OR CALCANEUS"	"42,783.00"	"24,765.00"	"18,018.00"
28122	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS OR TARSAL BOSSING), TARSAL OR METATARSAL BONE, EXCEPT TALUS OR
CALCANEUS"	"35,100.00"	"18,720.00"	"16,380.00"
28124	"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) OF BONE (E.G., FOR OSTEOMYELITIS OR DORSAL
BOSSING), PHALANX OF TOE"	"35,100.00"	"18,720.00"	"16,380.00"
28126	"RESECTION, PARTIAL OR COMPLETE, PHALANGEAL BASE, SINGLE
TOE, EACH"	"24,453.00"	"10,530.00"	"13,923.00"
28130	TALECTOMY (ASTRAGALECTOMY)	"44,187.00"	"21,255.00"	"22,932.00"
28140	METATARSECTOMY	"35,100.00"	"18,720.00"	"16,380.00"
28150	"PHALANGECTOMY OF TOE, SINGLE, EACH"	"23,634.00"	"10,530.00"	"13,104.00"
28153	"RESECTION, HEAD OF PHALANX, TOE"	"23,634.00"	"10,530.00"	"13,104.00"
28160	"HEMIPHALANGECTOMY OR INTERPHALANGEAL JOINT EXCISION,
TOE, SINGLE, EACH"	"20,553.00"	"10,725.00"	"9,828.00"
28171	"RADICAL RESECTION OF TUMOR, BONE; TARSAL (EXCEPT TALUS
OR CALCANEUS)"	"59,943.00"	"33,735.00"	"26,208.00"
28173	"RADICAL RESECTION OF TUMOR, BONE; METATARSAL"	"44,187.00"	"21,255.00"	"22,932.00"
28175	"RADICAL RESECTION OF TUMOR, BONE; PHALANX OF TOE"	"42,783.00"	"24,765.00"	"18,018.00"
28200	"REPAIR OR SUTURE OF TENDON, FOOT, FLEXOR, SINGLE; PRIMARY
OR SECONDARY, W/O FREE GRAFT, EACH TENDON"	"35,100.00"	"18,720.00"	"16,380.00"
28202	"REPAIR OR SUTURE OF TENDON, FOOT, FLEXOR, SINGLE;
SECONDARY W/ FREE GRAFT, EACH TENDON (INCLUDES OBTAINING GRAFT)"	"35,100.00"	"18,720.00"	"16,380.00"
28208	"REPAIR OR SUTURE OF TENDON, FOOT, EXTENSOR, SINGLE;
PRIMARY OR SECONDARY, EACH TENDON"	"24,453.00"	"10,530.00"	"13,923.00"
28210	"REPAIR OR SUTURE OF TENDON, FOOT, EXTENSOR, SINGLE; SECONDARY W/ FREE GRAFT, EACH TENDON (INCLUDES
OBTAINING GRAFT)"	"24,453.00"	"10,530.00"	"13,923.00"
28220	"TENOLYSIS, FLEXOR, FOOT; SINGLE"	"21,216.00"	"13,845.00"	"7,371.00"
28222	"TENOLYSIS, FLEXOR, FOOT; MULTIPLE (THROUGH SAME INCISION)"	"21,372.00"	"10,725.00"	"10,647.00"
28225	"TENOLYSIS, EXTENSOR, FOOT; SINGLE"	"21,216.00"	"13,845.00"	"7,371.00"
28226	"TENOLYSIS, EXTENSOR, FOOT; MULTIPLE (THROUGH SAME
INCISION)"	"21,372.00"	"10,725.00"	"10,647.00"
28230	"TENOTOMY, OPEN, FLEXOR; FOOT, SINGLE OR MULTIPLE;"	"21,372.00"	"10,725.00"	"10,647.00"
28232	"TENOTOMY, OPEN, FLEXOR; FOOT, SINGLE OR MULTIPLE; TOE,
SINGLE"	"21,216.00"	"13,845.00"	"7,371.00"
28234	"TENOTOMY, OPEN, EXTENSOR, FOOT OR TOE"	"21,707.40"	"13,845.00"	"7,862.40"
28238	ADVANCEMENT OF POSTERIOR TIBIAL TENDON W/ EXCISION OF ACCESSORY NAVICULAR BONE (KIDNER TYPE PROCEDURE)	"35,919.00"	"18,720.00"	"17,199.00"
28240	"TENOTOMY, LENGTHENING, OR RELEASE, ABDUCTOR HALLUCIS
MUSCLE"	"24,453.00"	"10,530.00"	"13,923.00"
28250	"DIVISION OF PLANTAR FASCIA AND MUSCLE (""STEINDLER
STRIPPING"")"	"24,453.00"	"10,530.00"	"13,923.00"
28260	"CAPSULOTOMY, MIDFOOT; MEDIAL RELEASE ONLY"	"24,453.00"	"10,530.00"	"13,923.00"
28261	"CAPSULOTOMY, MIDFOOT; W/ TENDON LENGTHENING"	"35,100.00"	"18,720.00"	"16,380.00"
28262	"CAPSULOTOMY, MIDFOOT; EXTENSIVE, INCLUDING POSTERIOR TALOTIBIAL CAPSULOTOMY AND TENDON(S) LENGTHENING AS
FOR RESISTANT CLUBFOOT DEFORMITY"	"40,911.00"	"21,255.00"	"19,656.00"
28264	"CAPSULOTOMY, MIDTARSAL (HEYMAN TYPE PROCEDURE)"	"23,634.00"	"10,530.00"	"13,104.00"
28270	"CAPSULOTOMY; METATARSOPHALANGEAL JOINT, W/ OR W/O
TENORRHAPHY, SINGLE, EACH JOINT"	"23,634.00"	"10,530.00"	"13,104.00"
28272	"CAPSULOTOMY; INTERPHALANGEAL JOINT, SINGLE EACH JOINT"	"25,155.00"	"12,870.00"	"12,285.00"
28280	"WEBBING OPERATION (CREATE SYNDACTYLISM OF TOES)
(KELIKIAN TYPE PROCEDURE)"	"40,911.00"	"21,255.00"	"19,656.00"
28285	"HAMMERTOE OPERATION, ONE TOE (E.G., INTERPHALANGEAL FUSION, FILLETING, PHALANGECTOMY)"	"29,991.00"	"14,430.00"	"15,561.00"
28286	"COCK-UP FIFTH TOE OPERATION W/ PLASTIC SKIN CLOSURE (RUIZ-
MORA TYPE PROCEDURE)"	"42,783.00"	"24,765.00"	"18,018.00"
28288	"OSTECTOMY, PARTIAL, EXOSTECTOMY OR CONDYLECTOMY, SINGLE, METATARSAL HEAD, FIRST THROUGH FIFTH, EACH
METATARSAL HEAD"	"29,991.00"	"14,430.00"	"15,561.00"
28290	"HALLUX VALGUS (BUNION) CORRECTION, W/ OR W/O SESAMOIDECTOMY; SIMPLE EXOSTECTOMY (SILVER TYPE
PROCEDURE)"	"40,911.00"	"21,255.00"	"19,656.00"
28292	"HALLUX VALGUS (BUNION) CORRECTION, W/ OR W/O
SESAMOIDECTOMY; KELLER, MCBRIDE, OR MAYO TYPE PROCEDURE"	"42,549.00"	"21,255.00"	"21,294.00"
28293	"HALLUX VALGUS (BUNION) CORRECTION, W/ OR W/O
SESAMOIDECTOMY; RESECTION OF JOINT W/ IMPLANT"	"42,549.00"	"21,255.00"	"21,294.00"
28294	"HALLUX VALGUS (BUNION) CORRECTION, W/ OR W/O SESAMOIDECTOMY; W/ TENDON TRANSPLANTS (JOPLIN TYPE
PROCEDURE)"	"44,187.00"	"21,255.00"	"22,932.00"
28296	"HALLUX VALGUS (BUNION) CORRECTION, W/ OR W/O SESAMOIDECTOMY; W/ METATARSAL OSTEOTOMY (E.G.,
MITCHELL, CHEVRON, OR CONCENTRIC TYPE PROCEDURES)"	"44,187.00"	"21,255.00"	"22,932.00"
28297	"HALLUX VALGUS (BUNION) CORRECTION, W/ OR W/O
SESAMOIDECTOMY; LAPIDUS TYPE PROCEDURE"	"44,187.00"	"21,255.00"	"22,932.00"
28298	"HALLUX VALGUS (BUNION) CORRECTION, W/ OR W/O
SESAMOIDECTOMY; BY PHALANX OSTEOTOMY"	"45,006.00"	"21,255.00"	"23,751.00"
28299	"HALLUX VALGUS (BUNION) CORRECTION, W/ OR W/O SESAMOIDECTOMY; BY OTHER METHODS (E.G., DOUBLE
OSTEOTOMY)"	"45,006.00"	"21,255.00"	"23,751.00"
28300	"OSTEOTOMY; CALCANEUS (DWYER OR CHAMBERS TYPE
PROCEDURE), W/ OR W/O INTERNAL FIXATION"	"41,730.00"	"21,255.00"	"20,475.00"
28302	OSTEOTOMY; TALUS	"40,911.00"	"21,255.00"	"19,656.00"
28304	"OSTEOTOMY, MIDTARSAL BONES, OTHER THAN CALCANEUS OR
TALUS;"	"29,991.00"	"14,430.00"	"15,561.00"
28305	"OSTEOTOMY, MIDTARSAL BONES, OTHER THAN CALCANEUS OR TALUS; W/ AUTOGRAFT (INCLUDES OBTAINING GRAFT)(FOWLER
TYPE)"	"35,919.00"	"18,720.00"	"17,199.00"
28306	"OSTEOTOMY, METATARSAL, BASE OR SHAFT, SINGLE, W/ OR W/O LENGHTENING, FOR SHORTENING OR ANGULAR CORRECTION;
FIRST METATARSAL"	"43,602.00"	"24,765.00"	"18,837.00"
28307	"OSTEOTOMY, METATARSAL, BASE OR SHAFT, SINGLE, W/ OR W/O LENGHTENING, FOR SHORTENING OR ANGULAR CORRECTION;
FIRST METATARSAL W/ AUTOGRAFT"	"43,602.00"	"24,765.00"	"18,837.00"
28308	"OSTEOTOMY, METATARSAL, BASE OR SHAFT, SINGLE, W/ OR W/O LENGHTENING, FOR SHORTENING OR ANGULAR CORRECTION;
OTHER THAN FIRST METATARSAL"	"43,602.00"	"24,765.00"	"18,837.00"
28309	"OSTEOTOMY, METATARSALS, MULTIPLE, FOR CAVUS FOOT
(SWANSON TYPE PROCEDURE)"	"42,783.00"	"24,765.00"	"18,018.00"
28310	"OSTEOTOMY FOR SHORTENING, ANGULAR OR ROTATIONAL CORRECTION; PROXIMAL PHALANX, FIRST TOE"	"35,919.00"	"18,720.00"	"17,199.00"
28312	"OSTEOTOMY FOR SHORTENING, ANGULAR OR ROTATIONAL
CORRECTION; OTHER PHALANGES, ANY TOE"	"29,172.00"	"14,430.00"	"14,742.00"
28313	"RECONSTRUCTION, ANGULAR DEFORMITY OF TOE (OVERLAPPING SECOND TOE, FIFTH TOE, CURLY TOES), SOFT TISSUE PROCEDURES
ONLY"	"43,602.00"	"24,765.00"	"18,837.00"
28315	"SESAMOIDECTOMY, FIRST TOE"	"24,453.00"	"10,530.00"	"13,923.00"
28320	"REPAIR OF NONUNION OR MALUNION; TARSAL BONES (E.G.,
CALCANEUS, TALUS)"	"42,783.00"	"24,765.00"	"18,018.00"
28322	"REPAIR OF NONUNION OR MALUNION; METATARSAL, W/ OR W/O
BONE GRAFT (INCLUDES OBTAINING GRAFT)"	"29,172.00"	"14,430.00"	"14,742.00"
28340	"RECONSTRUCTION, TOE, MACRODACTYLY; SOFT TISSUE
RESECTION"	"23,634.00"	"10,530.00"	"13,104.00"
28341	"RECONSTRUCTION, TOE, MACRODACTYLY; REQUIRING BONE
RESECTION"	"24,453.00"	"10,530.00"	"13,923.00"
28344	"RECONSTRUCTION, TOE(S); POLYDACTYLY"	"42,783.00"	"24,765.00"	"18,018.00"
28345	"RECONSTRUCTION, TOE(S); SYNDACTYLY, W/ OR W/O SKIN
GRAFT(S)"	"43,602.00"	"24,765.00"	"18,837.00"
28360	"RECONSTRUCTION, CLEFT FOOT"	"29,991.00"	"14,430.00"	"15,561.00"
28400	CLOSED TREATMENT OF CALCANEAL FRACTURE	"21,372.00"	"10,725.00"	"10,647.00"
28406	"PERCUTANEOUS SKELETAL FIXATION OF CALCANEAL FRACTURE,
W/ MANIPULATION"	"23,361.00"	"11,895.00"	"11,466.00"
28415	"OPEN TREATMENT OF CALCANEAL FRACTURE, W/ OR W/O
INTERNAL OR EXTERNAL FIXATION;"	"35,100.00"	"18,720.00"	"16,380.00"
28420	"OPEN TREATMENT OF CALCANEAL FRACTURE, W/ OR W/O INTERNAL OR EXTERNAL FIXATION; W/ PRIMARY ILIAC OR OTHER AUTOGENOUS BONE GRAFT (INCLUDES OBTAINING GRAFT)"	"43,602.00"	"24,765.00"	"18,837.00"
28430	CLOSED TREATMENT OF TALUS FRACTURE	"21,372.00"	"10,725.00"	"10,647.00"
28436	"PERCUTANEOUS SKELETAL FIXATION OF TALUS FRACTURE, W/
MANIPULATION"	"18,915.00"	"10,725.00"	"8,190.00"
28445	"OPEN TREATMENT OF TALUS FRACTURE, W/ OR W/O INTERNAL OR
EXTERNAL FIXATION"	"29,991.00"	"14,430.00"	"15,561.00"
28450	"TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND
CALCANEUS)"	"21,707.40"	"13,845.00"	"7,862.40"
28456	"PERCUTANEOUS SKELETAL FIXATION OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS), W/ MANIPULATION"	"23,361.00"	"11,895.00"	"11,466.00"
28465	"OPEN TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS), W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"19,734.00"	"10,725.00"	"9,009.00"
28470	CLOSED TREATMENT OF METATARSAL FRACTURE	"21,216.00"	"13,845.00"	"7,371.00"
28476	"PERCUTANEOUS SKELETAL FIXATION OF METATARSAL FRACTURE,
W/ MANIPULATION"	"16,107.00"	"9,555.00"	"6,552.00"
28485	"OPEN TREATMENT OF METATARSAL FRACTURE, W/ OR W/O
INTERNAL OR EXTERNAL FIXATION"	"21,216.00"	"13,845.00"	"7,371.00"
28490	"CLOSED TREATMENT OF FRACTURE GREAT TOE, PHALANX OR
PHALANGES"	"19,734.00"	"10,725.00"	"9,009.00"
28496	"PERCUTANEOUS SKELETAL FIXATION OF FRACTURE GREAT TOE,
PHALANX OR PHALANGES, W/ MANIPULATION"	"20,553.00"	"10,725.00"	"9,828.00"
28505	"OPEN TREATMENT OF FRACTURE GREAT TOE, PHALANX OR PHALANGES, W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"23,634.00"	"10,530.00"	"13,104.00"
28510	"CLOSED TREATMENT OF FRACTURE, PHALANX OR PHALANGES,
OTHER THAN GREAT TOE"	"19,734.00"	"10,725.00"	"9,009.00"
28525	"OPEN TREATMENT OF FRACTURE, PHALANX OR PHALANGES, OTHER THAN GREAT TOE, W/ OR W/O INTERNAL OR EXTERNAL
FIXATION"	"23,634.00"	"10,530.00"	"13,104.00"
28530	CLOSED TREATMENT OF SESAMOID FRACTURE	"16,107.00"	"9,555.00"	"6,552.00"
28531	"OPEN TREATMENT OF SESAMOID FRACTURE, W/ OR W/O
INTERNAL FIXATION"	"19,734.00"	"10,725.00"	"9,009.00"
28540	"CLOSED TREATMENT OF TARSAL BONE DISLOCATION, OTHER
THAN TALOTARSAL"	"16,107.00"	"9,555.00"	"6,552.00"
28546	"PERCUTANEOUS SKELETAL FIXATION OF TARSAL BONE DISLOCATION, OTHER THAN TALOTARSAL ,W/ MANIPULATION"	"24,453.00"	"10,530.00"	"13,923.00"
28555	"OPEN TREATMENT OF TARSAL BONE DISLOCATION, W/ OR W/O
INTERNAL OR EXTERNAL FIXATION"	"24,453.00"	"10,530.00"	"13,923.00"
28570	CLOSED TREATMENT OF TALOTARSAL JOINT DISLOCATION	"21,216.00"	"13,845.00"	"7,371.00"
28576	"PERCUTANEOUS SKELETAL FIXATION OF TALOTARSAL JOINT
DISLOCATION, W/ MANIPULATION"	"24,453.00"	"10,530.00"	"13,923.00"
28585	"OPEN TREATMENT OF TALOTARSAL JOINT DISLOCATION, W/ OR
W/O INTERNAL OR EXTERNAL FIXATION"	"35,100.00"	"18,720.00"	"16,380.00"
28600	CLOSED TREATMENT OF TARSOMETATARSAL JOINT DISLOCATION	"21,372.00"	"10,725.00"	"10,647.00"
28606	"PERCUTANEOUS SKELETAL FIXATION OF TARSOMETATARSAL JOINT DISLOCATION, W/ MANIPULATION"	"24,453.00"	"10,530.00"	"13,923.00"
28615	"OPEN TREATMENT OF TARSOMETATARSAL JOINT DISLOCATION, W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"35,100.00"	"18,720.00"	"16,380.00"
28630	"CLOSED TREATMENT OF METATARSOPHALANGEAL JOINT
DISLOCATION"	"16,107.00"	"9,555.00"	"6,552.00"
28636	"PERCUTANEOUS SKELETAL FIXATION OF METATARSOPHALANGEAL JOINT DISLOCATION, W/
MANIPULATION"	"24,453.00"	"10,530.00"	"13,923.00"
28645	"OPEN TREATMENT OF METATARSOPHALANGEAL JOINT DISLOCATION, W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"35,100.00"	"18,720.00"	"16,380.00"
28660	CLOSED TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION	"21,216.00"	"13,845.00"	"7,371.00"
28666	"PERCUTANEOUS SKELETAL FIXATION OF INTERPHALANGEAL JOINT DISLOCATION, W/ MANIPULATION"	"24,453.00"	"10,530.00"	"13,923.00"
28675	"OPEN TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, W/ OR W/O INTERNAL OR EXTERNAL FIXATION"	"35,100.00"	"18,720.00"	"16,380.00"
28705	PANTALAR ARTHRODESIS	"52,884.00"	"23,400.00"	"29,484.00"
28715	TRIPLE ARTHRODESIS	"54,522.00"	"23,400.00"	"31,122.00"
28725	SUBTALAR ARTHRODESIS	"52,884.00"	"23,400.00"	"29,484.00"
28730	"ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE OR
TRANSVERSE;"	"45,435.00"	"20,865.00"	"24,570.00"
28735	"ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE OR TRANSVERSE; W/ OSTEOTOMY AS FOR FLATFOOT CORRECTION"	"45,006.00"	"21,255.00"	"23,751.00"
28737	"ARTHRODESIS, MIDTARSAL NAVICULAR-CUNEIFORM, W/ TENDON LENGTHENING AND ADVANCEMENT (MILLER TYPE PROCEDURE)"	"42,783.00"	"24,765.00"	"18,018.00"
28740	"ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE JOINT"	"35,919.00"	"18,720.00"	"17,199.00"
28750	"ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT"	"35,919.00"	"18,720.00"	"17,199.00"
28755	"ARTHRODESIS, GREAT TOE; INTERPHALANGEAL JOINT"	"29,991.00"	"14,430.00"	"15,561.00"
28760	"ARTHRODESIS, GREAT TOE, INTERPHALANGEAL JOINT, W/
EXTENSOR HALLUCIS LONGUS TRANSFER TO FIRST METATARSAL NECK (JONES TYPE PROCEDURE)"	"43,368.00"	"21,255.00"	"22,113.00"
28800	"AMPUTATION, FOOT; MIDTARSAL (CHOPART TYPE PROCEDURE)"	"45,435.00"	"20,865.00"	"24,570.00"
28802	"DEEP DISECTION BELOW FASCIA, FOR DEEP INFECTION OF FOOT, W/ OR W/O TENDON SHEALTH INVOLVEMENT; SINGLE BURSAL
SPACE SPECIFY"	"16,107.00"	"9,555.00"	"6,552.00"
28805	"DEEP DISECTION BELOW FASCIA, FOR DEEP INFECTION OF FOOT, W/ OR W/O TENDON SHEALTH INVOLVEMENT;
TRANSMETATARSAL"	"42,549.00"	"21,255.00"	"21,294.00"
28810	"AMPUTATION, METATARSAL, W/ TOE, SINGLE"	"23,634.00"	"10,530.00"	"13,104.00"
28820	"AMPUTATION, TOE; METATARSOPHALANGEAL JOINT"	"35,100.00"	"18,720.00"	"16,380.00"
28825	"AMPUTATION, TOE; INTERPHALANGEAL JOINT"	"23,634.00"	"10,530.00"	"13,104.00"
29000	"APPLICATION OF HALO TYPE BODY CAST (SEE 20661-20663 FOR
INSERTION)"	"20,553.00"	"10,725.00"	"9,828.00"
29010	"APPLICATION OF RISSER JACKET, LOCALIZER, BODY; ONLY"	"20,553.00"	"10,725.00"	"9,828.00"
29015	"APPLICATION OF RISSER JACKET, LOCALIZER, BODY; INCLUDING
HEAD"	"20,553.00"	"10,725.00"	"9,828.00"
29020	"APPLICATION OF TURNBUCKLE JACKET, BODY; ONLY"	"20,553.00"	"10,725.00"	"9,828.00"
29025	"APPLICATION OF TURNBUCKLE JACKET, BODY; INCLUDING HEAD"	"20,553.00"	"10,725.00"	"9,828.00"
29035	"APPLICATION OF BODY CAST, SHOULDER TO HIPS;"	"20,553.00"	"10,725.00"	"9,828.00"
29040	"APPLICATION OF BODY CAST, SHOULDER TO HIPS; INCLUDING
HEAD, MINERVA TYPE"	"20,553.00"	"10,725.00"	"9,828.00"
29044	"APPLICATION OF BODY CAST, SHOULDER TO HIPS; INCLUDING ONE
THIGH"	"23,634.00"	"10,530.00"	"13,104.00"
29046	"APPLICATION OF BODY CAST, SHOULDER TO HIPS; INCLUDING
BOTH THIGHS"	"23,634.00"	"10,530.00"	"13,104.00"
29055	"APPLICATION OF BODY CAST, SHOULDER TO HIPS; SHOULDER
SPICA"	"18,135.00"	"14,040.00"	"4,095.00"
29058	"APPLICATION OF BODY CAST, SHOULDER TO HIPS; PLASTER
VELPEAU"	"10,842.00"	"8,385.00"	"2,457.00"
29065	"APPLICATION OF BODY CAST, SHOULDER TO HIPS; SHOULDER TO
HAND (LONG ARM)"	"11,076.00"	"7,800.00"	"3,276.00"
29075	"APPLICATION OF BODY CAST, SHOULDER TO HIPS; ELBOW TO
FINGER (SHORT ARM)"	"10,842.00"	"8,385.00"	"2,457.00"
29085	"APPLICATION OF BODY CAST, SHOULDER TO HIPS; HAND AND
LOWER FOREARM (GAUNTLET)"	"10,842.00"	"8,385.00"	"2,457.00"
29305	APPLICATION OF HIP SPICA CAST; ONE LEG	"15,639.00"	"10,725.00"	"4,914.00"
29325	"APPLICATION OF HIP SPICA CAST; ONE AND ONE-HALF SPICA OR
BOTH LEGS"	"16,458.00"	"10,725.00"	"5,733.00"
29345	APPLICATION OF LONG LEG CAST (THIGH TO TOES);	"15,639.00"	"10,725.00"	"4,914.00"
29355	"APPLICATION OF LONG LEG CAST (THIGH TO TOES); WALKER OR
AMBULATORY TYPE"	"16,458.00"	"10,725.00"	"5,733.00"
29358	APPLICATION OF LONG LEG CAST BRACE	"16,458.00"	"10,725.00"	"5,733.00"
29365	APPLICATION OF CYLINDER CAST (THIGH TO ANKLE)	"15,639.00"	"10,725.00"	"4,914.00"
29405	APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES);	"15,639.00"	"10,725.00"	"4,914.00"
29425	"APPLICATION OF SHORT LEG CAST (BELOW KNEE TO TOES);
WALKING OR AMBULATORY TYPE"	"15,639.00"	"10,725.00"	"4,914.00"
29435	APPLICATION OF PATELLAR TENDON BEARING (PTB) CAST	"15,639.00"	"10,725.00"	"4,914.00"
29445	APPLICATION OF RIGID TOTAL CONTACT LEG CAST	"11,076.00"	"7,800.00"	"3,276.00"
29450	"APPLICATION OF CLUBFOOT CAST W/ MOLDING OR
MANIPULATION, LONG OR SHORT LEG"	"11,076.00"	"7,800.00"	"3,276.00"
29800	"ARTHROSCOPY, TEMPOROMANDIBULAR JOINT, DIAGNOSTIC, W/
OR W/O SYNOVIAL BIOPSY"	"35,100.00"	"18,720.00"	"16,380.00"
29804	"ARTHROSCOPY, TEMPOROMANDIBULAR JOINT, SURGICAL"	"40,911.00"	"21,255.00"	"19,656.00"
29815	"ARTHROSCOPY, SHOULDER, DIAGNOSTIC, W/ OR W/O SYNOVIAL
BIOPSY"	"35,100.00"	"18,720.00"	"16,380.00"
29819	"ARTHROSCOPY, SHOULDER, SURGICAL; W/ REMOVAL OF LOOSE
BODY OR FOREIGN BODY"	"42,783.00"	"24,765.00"	"18,018.00"
29820	"ARTHROSCOPY, SHOULDER, SURGICAL; SYNOVECTOMY, PARTIAL"	"40,911.00"	"21,255.00"	"19,656.00"
29821	"ARTHROSCOPY, SHOULDER, SURGICAL; SYNOVECTOMY,
COMPLETE"	"42,549.00"	"21,255.00"	"21,294.00"
29822	"ARTHROSCOPY, SHOULDER, SURGICAL; DEBRIDEMENT, LIMITED"	"40,911.00"	"21,255.00"	"19,656.00"
29823	"ARTHROSCOPY, SHOULDER, SURGICAL; DEBRIDEMENT,
EXTENSIVE"	"45,435.00"	"20,865.00"	"24,570.00"
29825	"ARTHROSCOPY, SHOULDER, SURGICAL; W/ LYSIS AND RESECTION
OF ADHESIONS, W/ OR W/O MANIPULATION"	"59,943.00"	"33,735.00"	"26,208.00"
29826	"ARTHROSCOPY, SHOULDER, SURGICAL; DECOMPRESSION OF SUBACROMIAL SPACE W/ PARTIAL ACROMIOPLASTY, W/ OR W/O
CORACOACROMIAL RELEASE"	"52,884.00"	"23,400.00"	"29,484.00"
29830	"ARTHROSCOPY, ELBOW, DIANOSTIC, W/ OR W/O SYNOVIAL BIOPSY"	"35,100.00"	"18,720.00"	"16,380.00"
29834	"ARTHROSCOPY, ELBOW, SURGICAL; W/ REMOVAL OF LOOSE BODY
OR FOREIGN BODY"	"42,783.00"	"24,765.00"	"18,018.00"
29835	"ARTHROSCOPY, ELBOW, SURGICAL; SYNOVECTOMY, PARTIAL"	"40,911.00"	"21,255.00"	"19,656.00"
29836	"ARTHROSCOPY, ELBOW, SURGICAL; SYNOVECTOMY, COMPLETE"	"42,549.00"	"21,255.00"	"21,294.00"
29837	"ARTHROSCOPY, ELBOW, SURGICAL; DEBRIDEMENT, LIMITED"	"40,911.00"	"21,255.00"	"19,656.00"
29838	"ARTHROSCOPY, ELBOW, SURGICAL; DEBRIDEMENT, EXTENSIVE"	"45,435.00"	"20,865.00"	"24,570.00"
29840	"ARTHROSCOPY, WRIST, DIAGNOSTIC, W/ OR W/O SYNOVIAL
BIOPSY"	"23,634.00"	"10,530.00"	"13,104.00"
29843	"ARTHROSCOPY, WRIST, SURGICAL; FOR INFECTION, LAVAGE AND
DRAINAGE"	"42,783.00"	"24,765.00"	"18,018.00"
29844	"ARTHROSCOPY, WRIST, SURGICAL; SYNOVECTOMY, PARTIAL"	"40,911.00"	"21,255.00"	"19,656.00"
29845	"ARTHROSCOPY, WRIST, SURGICAL; SYNOVECTOMY, COMPLETE"	"42,549.00"	"21,255.00"	"21,294.00"
29846	"ARTHROSCOPY, WRIST, SURGICAL; EXCISION AND/OR REPAIR OF TRIANGULAR FIBROCARTILAGE AND/OR JOINT DEBRIDEMENT"	"45,435.00"	"20,865.00"	"24,570.00"
29847	"ARTHROSCOPY, WRIST, SURGICAL; INTERNAL FIXATION FOR
FRACTURE OR INSTABILITY"	"45,435.00"	"20,865.00"	"24,570.00"
29848	"ARTHROSCOPY, WRIST, SURGICAL; W/ RELEASE OF TRANSVERSE
CARPAL LIGAMENT"	"45,435.00"	"20,865.00"	"24,570.00"
29850	"ARTHROSCOPICALLY AIDED TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF THE KNEE, W/ OR W/O MANIPULATION; W/O INTERNAL OR EXTERNAL FIXATION (INCLUDES ARTHROSCOPY)"	"52,884.00"	"23,400.00"	"29,484.00"
29851	"ARTHROSCOPICALLY AIDED TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF THE KNEE, W/ OR W/O MANIPULATION; W/ INTERNAL OR EXTERNAL FIXATION (INCLUDES ARTHROSCOPY)"	"52,884.00"	"23,400.00"	"29,484.00"
29855	"ARTHROSCOPICALLY AIDED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); UNICONDYLAR, W/ OR W/O INTERNAL OR EXTERNAL FIXATION (INCLUDES ARTHROSCOPY)"	"52,884.00"	"23,400.00"	"29,484.00"
29856	"ARTHROSCOPICALLY AIDED TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); BICONDYLAR, W/ OR W/O INTERNAL OR EXTERNAL FIXATION (INCLUDES ARTHROSCOPY)"	"54,522.00"	"23,400.00"	"31,122.00"
29870	"ARTHROSCOPY, KNEE, DIAGNOSTIC, W/ OR W/O SYNOVIAL BIOPSY"	"35,100.00"	"18,720.00"	"16,380.00"
29871	"ARTHROSCOPY, KNEE, SURGICAL; FOR INFECTION, LAVAGE AND
DRAINAGE"	"40,911.00"	"21,255.00"	"19,656.00"
29874	"ARTHROSCOPY, KNEE, SURGICAL; FOR REMOVAL OF LOOSE BODY OR FOREIGN BODY (E.G., OSTEOCHONDRITIS DISSECANS FRAGMENTATION, CHONDRAL FRAGMENTATION)"	"42,783.00"	"24,765.00"	"18,018.00"
29875	"ARTHROSCOPY, KNEE, SURGICAL; SYNOVECTOMY, LIMITED (E.G.,
PLICA OR SHELF RESECTION)"	"59,943.00"	"33,735.00"	"26,208.00"
29876	"ARTHROSCOPY, KNEE, SURGICAL; SYNOVECTOMY, MAJOR, TWO OR MORE COMPARTMENTS (E.G., MEDIAL OR LATERAL)"	"61,581.00"	"33,735.00"	"27,846.00"
29877	"ARTHROSCOPY, KNEE, SURGICAL; DEBRIDEMENT/SHAVING OF
ARTICULAR CARTILAGE (CHONDROPLASTY)"	"45,435.00"	"20,865.00"	"24,570.00"
29879	"ARTHROSCOPY, KNEE, SURGICAL; ABRASION ARTHROPLASTY (INCLUDES CHONDROPLASTY WHERE NECESSARY) OR MULTIPLE
DRILLING"	"45,435.00"	"20,865.00"	"24,570.00"
29880	"ARTHROSCOPY, KNEE, SURGICAL; W/ MENISCECTOMY (MEDIAL AND LATERAL, INCLUDING ANY MENISCAL SHAVING)"	"59,943.00"	"33,735.00"	"26,208.00"
29881	"ARTHROSCOPY, KNEE, SURGICAL; W/ MENISCECTOMY (MEDIAL OR LATERAL, INCLUDING ANY MENISCAL SHAVING)"	"59,943.00"	"33,735.00"	"26,208.00"
29882	"ARTHROSCOPY, KNEE, SURGICAL; W/ MENISCUS REPAIR (MEDIAL
OR LATERAL)"	"52,884.00"	"23,400.00"	"29,484.00"
29883	"ARTHROSCOPY, KNEE, SURGICAL; W/ MENISCUS REPAIR (MEDIAL
AND LATERAL)"	"59,085.00"	"26,325.00"	"32,760.00"
29884	"ARTHROSCOPY, KNEE, SURGICAL; W/ LYSIS OF ADHESIONS, W/ OR
W/O MANIPULATION"	"45,435.00"	"20,865.00"	"24,570.00"
29885	"ARTHROSCOPY, KNEE, SURGICAL; DRILLING FOR OSTEOCHONDRITIS DISSECANS W/ BONE GRAFTING, W/ OR W/O INTERNAL FIXATION (INCLUDING DEBRIDEMENT OF BASE OF
LESION)"	"45,435.00"	"20,865.00"	"24,570.00"
29886	"ARTHROSCOPY, KNEE, SURGICAL; DRILLING FOR INTACT
OSTEOCHONDRITIS DISSECANS LESION"	"52,884.00"	"23,400.00"	"29,484.00"
29887	"ARTHROSCOPY, KNEE, SURGICAL; DRILLING FOR INTACT OSTEOCHONDRITIS DISSECANS LESION W/ INTERNAL FIXATION"	"45,435.00"	"20,865.00"	"24,570.00"
29888	ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE LIGAMENT REPAIR/AUGMENTATION OR RECONSTRUCTION	"72,501.00"	"36,465.00"	"36,036.00"
29889	ARTHROSCOPICALLY AIDED POSTERIOR CRUCIATE LIGAMENT REPAIR/AUGMENTATION OR RECONSTRUCTION	"75,777.00"	"36,465.00"	"39,312.00"
29894	"ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; W/ REMOVAL OF LOOSE BODY OR FOREIGN BODY"	"42,783.00"	"24,765.00"	"18,018.00"
29895	"ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS),
SURGICAL; SYNOVECTOMY, PARTIAL"	"40,911.00"	"21,255.00"	"19,656.00"
29897	"ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS),
SURGICAL; DEBRIDEMENT, LIMITED"	"40,911.00"	"21,255.00"	"19,656.00"
29898	"ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS),
SURGICAL; DEBRIDEMENT, EXTENSIVE"	"42,549.00"	"21,255.00"	"21,294.00"
30000	"DRAINAGE ABSCESS OR HEMATOMA, NASAL, INTERNAL APPROACH"	"10,842.00"	"8,385.00"	"2,457.00"
30020	"DRAINAGE ABSCESS OR HEMATOMA, NASAL SEPTUM"	"10,842.00"	"8,385.00"	"2,457.00"
30100	"BIOPSY, INTRANASAL"	"11,076.00"	"7,800.00"	"3,276.00"
30110	"EXCISION, NASAL POLYP(S), SIMPLE"	"15,639.00"	"10,725.00"	"4,914.00"
30115	"EXCISION, NASAL POLYP(S), EXTENSIVE"	"18,915.00"	"10,725.00"	"8,190.00"
30117	"EXCISION OR DESTRUCTION, ANY METHOD (INCLUDING LASER),
INTRANASAL LESION; INTERNAL APPROACH"	"18,915.00"	"10,725.00"	"8,190.00"
30118	"EXCISION OR DESTRUCTION, ANY METHOD (INCLUDING LASER), INTRANASAL LESION; EXTERNAL APPROACH (LATERAL
RHINOTOMY)"	"18,915.00"	"10,725.00"	"8,190.00"
30130	"EXCISION TURBINATE, PARTIAL OR COMPLETE"	"25,155.00"	"12,870.00"	"12,285.00"
30140	"SUBMUCOUS RESECTION TURBINATE, PARTIAL OR COMPLETE"	"25,155.00"	"12,870.00"	"12,285.00"
30310	"REMOVAL FOREIGN BODY, INTRANASAL; REQUIRING GENERAL
ANESTHESIA"	"15,639.00"	"10,725.00"	"4,914.00"
30320	"REMOVAL FOREIGN BODY, INTRANASAL; BY LATERAL RHINOTOMY"	"15,639.00"	"10,725.00"	"4,914.00"
30460	"RHINOPLASTY FOR NASAL DEFORMITY SECONDARY TO CONGENITAL CLEFT TIP AND/OR PALATE, INCLUDING
COLUMELLAR LENGTHENING; TIP ONLY"	"59,085.00"	"26,325.00"	"32,760.00"
30462	"RHINOPLASTY FOR NASAL DEFORMITY SECONDARY TO CONGENITAL CLEFT TIP AND/OR PALATE, INCLUDING
COLUMELLAR LENGTHENING; TIP, SEPTUM, OSTEOTOMIES"	"59,085.00"	"26,325.00"	"32,760.00"
30465	RHINOPLASTY FOR NASAL VESTIBULAR STENOSIS	"73,710.00"	"32,760.00"	"40,950.00"
30520	"SEPTOPLASTY OR SUBMUCOUS RESECTION, W/ OR W/O CARTILAGE SCORING, CONTOURING OR REPLACEMENT W/ GRAFT"	"25,155.00"	"12,870.00"	"12,285.00"
30540	REPAIR CHOANAL ATRESIA; INTRANASAL	"25,155.00"	"12,870.00"	"12,285.00"
30545	REPAIR CHOANAL ATRESIA; TRANSPALATINE	"35,100.00"	"18,720.00"	"16,380.00"
30560	LYSIS INTRANASAL SYNECHIA	"16,107.00"	"9,555.00"	"6,552.00"
30580	"REPAIR FISTULA; OROMAXILLARY (COMBINE W/ 31030 IF
ANTROTOMY IS INCLUDED)"	"23,634.00"	"10,530.00"	"13,104.00"
30600	REPAIR FISTULA; ORONASAL	"23,634.00"	"10,530.00"	"13,104.00"
30630	REPAIR NASAL SEPTAL PERFORATIONS	"23,634.00"	"10,530.00"	"13,104.00"
30801	"CAUTERIZATION AND/OR ABLATION, MUCOSA OF TURBINATES, UNILATERAL OR BILATERAL, ANY METHOD, ; SUPERFICIAL"	"18,915.00"	"10,725.00"	"8,190.00"
30802	"CAUTERIZATION AND/OR ABLATION, MUCOSA OF TURBINATES, UNILATERAL OR BILATERAL, ANY METHOD, ; INTRAMURAL"	"18,915.00"	"10,725.00"	"8,190.00"
30905	"CONTROL NASAL HEMORRHAGE, POSTERIOR, W/ POSTERIOR NASAL PACKS AND/OR CAUTERIZATION, ANY METHOD; INITIAL"	"15,639.00"	"10,725.00"	"4,914.00"
30915	LIGATION ARTERIES; ETHMOIDAL	"23,634.00"	"10,530.00"	"13,104.00"
30920	"LIGATION ARTERIES; INTERNAL MAXILLARY ARTERY,
TRANSANTRAL"	"23,634.00"	"10,530.00"	"13,104.00"
30930	"FRACTURE NASAL TURBINATE(S), THERAPEUTIC"	"18,915.00"	"10,725.00"	"8,190.00"
31000	"LAVAGE BY CANNULATION; MAXILLARY SINUS (ANTRUM
PUNCTURE OR NATURAL OSTIUM)"	"18,135.00"	"14,040.00"	"4,095.00"
31002	LAVAGE BY CANNULATION; SPHENOID SINUS	"15,639.00"	"10,725.00"	"4,914.00"
31020	"SINUSOTOMY, MAXILLARY (ANTROTOMY); INTRANASAL"	"18,915.00"	"10,725.00"	"8,190.00"
31030	"SINUSOTOMY, MAXILLARY (ANTROTOMY); RADICAL (CALDWELL- LUC) W/O REMOVAL OF ANTROCHOANAL POLYPS"	"23,634.00"	"10,530.00"	"13,104.00"
31032	"SINUSOTOMY, MAXILLARY (ANTROTOMY); RADICAL (CALDWELL- LUC) W/ REMOVAL OF ANTROCHOANAL POLYPS"	"23,634.00"	"10,530.00"	"13,104.00"
31040	"PTERYGOMAXILLARY FOSSA SURGERY, ANY APPROACH"	"45,435.00"	"20,865.00"	"24,570.00"
31050	"SINUSOTOMY, SPHENOID, W/ OR W/O BIOPSY;"	"45,435.00"	"20,865.00"	"24,570.00"
31051	"SINUSOTOMY, SPHENOID, W/ OR W/O BIOPSY; W/ MUCOSAL
STRIPPING OR REMOVAL OF POLYP(S)"	"45,435.00"	"20,865.00"	"24,570.00"
31070	"SINUSOTOMY FRONTAL; EXTERNAL, SIMPLE (TREPHINE
OPERATION)"	"23,634.00"	"10,530.00"	"13,104.00"
31075	"SINUSOTOMY FRONTAL; TRANSORBITAL, UNILATERAL (FOR
MUCOCELE OR OSTEOMA, LYNCH TYPE)"	"23,634.00"	"10,530.00"	"13,104.00"
31080	"SINUSOTOMY FRONTAL; OBLITERATIVE W/O OSTEOPLASTIC FLAP, BROW INCISION (INCLUDES ABLATION)"	"23,634.00"	"10,530.00"	"13,104.00"
31081	"SINUSOTOMY FRONTAL; OBLITERATIVE, W/O OSTEOPLASTIC FLAP, CORONAL INICISION (INCLUDES ABLATION)"	"23,634.00"	"10,530.00"	"13,104.00"
31084	"SINUSOTOMY FRONTAL; OBLITERATIVE, W/ OSTEOPLASTIC FLAP,
BROW INCISION"	"23,634.00"	"10,530.00"	"13,104.00"
31085	"SINUSOTOMY FRONTAL; OBLITERATIVE, W/ OSTEOPLASTIC FLAP,
CORONAL INCISION"	"45,435.00"	"20,865.00"	"24,570.00"
31086	"SINUSOTOMY FRONTAL; NONOBLITERATIVE, W/ OSTEOPLASTIC
FLAP, BROW INCISION"	"45,435.00"	"20,865.00"	"24,570.00"
31087	"SINUSOTOMY FRONTAL; NONOBLITERATIVE, W/ OSTEOPLASTIC
FLAP, CORONAL INCISION"	"45,435.00"	"20,865.00"	"24,570.00"
31090	"SINUSOTOMY COMBINED, THREE OR MORE SINUSES"	"45,435.00"	"20,865.00"	"24,570.00"
31200	"ETHMOIDECTOMY; INTRANASAL, ANTERIOR"	"23,634.00"	"10,530.00"	"13,104.00"
31201	"ETHMOIDECTOMY; INTRANASAL, TOTAL"	"23,634.00"	"10,530.00"	"13,104.00"
31205	"ETHMOIDECTOMY; EXTRANASAL, TOTAL"	"23,634.00"	"10,530.00"	"13,104.00"
31225	MAXILLECTOMY; W/O ORBITAL EXENTERATION	"90,675.00"	"41,535.00"	"49,140.00"
31230	MAXILLECTOMY; W/ ORBITAL EXENTERATION (EN BLOC)	"104,130.00"	"46,800.00"	"57,330.00"
31231	"NASAL ENDOSCOPY, DIAGNOSTIC, UNILATERAL OR BILATERAL"	"20,553.00"	"10,725.00"	"9,828.00"
31233	"NASAL/SINUS ENDOSCOPY, DIAGNOSTIC W/ MAXILLARY SINUSOSCOPY (VIA INFERIOR MEATUS OR CANINE FOSSA
PUNCTURE)"	"20,553.00"	"10,725.00"	"9,828.00"
31235	"NASAL/SINUS ENDOSCOPY, DIAGNOSTIC W/ SPHENOID SINUSOSCOPY (VIA PUNCTURE OF SPHENOIDAL FACE OR
CANNULATION OF OSTIUM)"	"20,553.00"	"10,725.00"	"9,828.00"
31237	"NASAL/SINUS ENDOSCOPY, SURGICAL; W/ BIOPSY, POLYPECTOMY
OR DEBRIDEMENT"	"23,634.00"	"10,530.00"	"13,104.00"
31238	"NASAL/SINUS ENDOSCOPY, SURGICAL; W/ CONTROL OF EPISTAXIS"	"23,634.00"	"10,530.00"	"13,104.00"
31239	"NASAL/SINUS ENDOSCOPY, SURGICAL; W/
DACRYLOCYSTORHINOSTOMY"	"23,634.00"	"10,530.00"	"13,104.00"
31240	"NASAL/SINUS ENDOSCOPY, SURGICAL; W/ CONCHA BULLOSA
RESECTION"	"35,100.00"	"18,720.00"	"16,380.00"
31254	"NASAL/SINUS ENDOSCOPY, SURGICAL; W/ ETHMOIDECTOMY,
PARTIAL (ANTERIOR)"	"35,100.00"	"18,720.00"	"16,380.00"
31255	"NASAL/SINUS ENDOSCOPY, SURGICAL; W/ ETHMOIDECTOMY,
TOTAL (ANTERIOR AND POSTERIOR)"	"35,100.00"	"18,720.00"	"16,380.00"
31256	"NASAL/SINUS ENDOSCOPY, SURGICAL, W/ MAXILLARY
ANTROSTOMY"	"35,100.00"	"18,720.00"	"16,380.00"
31267	"NASAL/SINUS ENDOSCOPY, SURGICAL, W/ REMOVAL OF TISSUE
FROM MAXILLARY SINUS"	"35,100.00"	"18,720.00"	"16,380.00"
31276	"NASAL/SINUS ENDOSCOPY, SURGICAL W/ FRONTAL SINUS EXPLORATION, W/ OR W/O REMOVAL OF TISSUE FROM FRONTAL
SINUS"	"35,100.00"	"18,720.00"	"16,380.00"
31287	"NASAL/SINUS ENDOSCOPY, SURGICAL, W/ SPHENOIDOTOMY"	"35,100.00"	"18,720.00"	"16,380.00"
31288	"NASAL/SINUS ENDOSCOPY, SURGICAL, W/ REMOVAL OF TISSURE
FROM THE SPHENOID SINUS"	"35,100.00"	"18,720.00"	"16,380.00"
31290	"NASAL/SINUS ENDOSCOPY, SURGICAL, W/ REPAIR OF
CEREBROSPINAL FLUID LEAK; ETHMOID REGION"	"35,100.00"	"18,720.00"	"16,380.00"
31291	"NASAL/SINUS ENDOSCOPY, SURGICAL, SPHENOID REGION"	"35,100.00"	"18,720.00"	"16,380.00"
31292	"NASAL/SINUS ENDOSCOPY, SURGICAL; W/ MEDIAL OR INFERIOR
ORBITAL WALL DECOMPRESSION"	"35,100.00"	"18,720.00"	"16,380.00"
31293	"NASAL/SINUS ENDOSCOPY, SURGICAL; W/ MEDIAL ORBITAL WALL AND INFERIOR ORBITAL WALL DECOMPRESSION"	"35,100.00"	"18,720.00"	"16,380.00"
31294	"NASAL/SINUS ENDOSCOPY, SURGICAL; W/ OPTIC NERVE
DECOMPRESSION"	"45,435.00"	"20,865.00"	"24,570.00"
31300	"LARYNGOTOMY (THYROTOMY, LARYNGOFISSURE); W/ REMOVAL
OF TUMOR OR LARYNGOCELE, CORDECTOMY"	"35,100.00"	"18,720.00"	"16,380.00"
31360	"LARYNGECTOMY; TOTAL, W/O RADICAL NECK DISSECTION"	"60,723.00"	"26,325.00"	"34,398.00"
31365	"LARYNGECTOMY; TOTAL, W/ RADICAL NECK DISSECTION"	"73,710.00"	"32,760.00"	"40,950.00"
31367	"LARYNGECTOMY; SUBTOTAL SUPRAGLOTTIC, W/O RADICAL NECK
DISSECTION"	"72,501.00"	"36,465.00"	"36,036.00"
31368	"LARYNGECTOMY; SUBTOTAL SUPRAGLOTTIC, W/ RADICAL NECK
DISSECTION"	"75,777.00"	"36,465.00"	"39,312.00"
31370	PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); HORIZONTAL	"60,723.00"	"26,325.00"	"34,398.00"
31375	"PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY);
LATEROVERTICAL"	"60,723.00"	"26,325.00"	"34,398.00"
31380	"PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY);
ANTEROVERTICAL"	"60,723.00"	"26,325.00"	"34,398.00"
31382	"PARTIAL LARYNGECTOMY (HEMILARYNGECTOMY); ANTERO-
LATERO-VERTICAL"	"60,723.00"	"26,325.00"	"34,398.00"
31390	"PHARYNGOLARYNGECTOMY, W/ RADICAL NECK DISSECTION; W/O
RECONSTRUCTION"	"73,710.00"	"32,760.00"	"40,950.00"
31395	"PHARYNGOLARYNGECTOMY, W/ RADICAL NECK DISSECTION; W/
RECONSTRUCTION"	"90,675.00"	"41,535.00"	"49,140.00"
31400	"ARYTENOIDECTOMY OR ARYTENOIDOPEXY, EXTERNAL APPROACH"	"59,085.00"	"26,325.00"	"32,760.00"
31420	EPIGLOTTIDECTOMY	"45,435.00"	"20,865.00"	"24,570.00"
31515	"LARYNGOSCOPY DIRECT, W/ OR W/O TRACHEOSCOPY; FOR
ASPIRATION"	"15,639.00"	"10,725.00"	"4,914.00"
31520	"LARYNGOSCOPY DIRECT, W/ OR W/O TRACHEOSCOPY;
DIAGNOSTIC, NEWBORN"	"18,915.00"	"10,725.00"	"8,190.00"
31525	"LARYNGOSCOPY DIRECT, W/ OR W/O TRACHEOSCOPY;
DIAGNOSTIC, EXCEPT NEWBORN"	"15,639.00"	"10,725.00"	"4,914.00"
31526	"LARYNGOSCOPY DIRECT, W/ OR W/O TRACHEOSCOPY;
DIAGNOSTIC, W/ OPERATING MICROSCOPE"	"18,915.00"	"10,725.00"	"8,190.00"
31527	"LARYNGOSCOPY DIRECT, W/ OR W/O TRACHEOSCOPY; W/
INSERTION OF OBTURATOR"	"15,639.00"	"10,725.00"	"4,914.00"
31528	"LARYNGOSCOPY DIRECT, W/ OR W/O TRACHEOSCOPY; W/
DILATATION, INITIAL"	"15,639.00"	"10,725.00"	"4,914.00"
31529	"LARYNGOSCOPY DIRECT, W/ OR W/O TRACHEOSCOPY; W/
DILATATION, SUBSEQUENT"	"15,639.00"	"10,725.00"	"4,914.00"
31530	"LARYNGOSCOPY, DIRECT, OPERATIVE, W/ FOREIGN BODY
REMOVAL;"	"23,634.00"	"10,530.00"	"13,104.00"
31531	"LARYNGOSCOPY, DIRECT, OPERATIVE, W/ FOREIGN BODY
REMOVAL; W/ OPERATING MICROSCOPE"	"23,634.00"	"10,530.00"	"13,104.00"
31535	"LARYNGOSCOPY, DIRECT, OPERATIVE, W/ BIOPSY;"	"23,634.00"	"10,530.00"	"13,104.00"
31536	"LARYNGOSCOPY, DIRECT, OPERATIVE, W/ BIOPSY; W/ OPERATING
MICROSCOPE"	"23,634.00"	"10,530.00"	"13,104.00"
31540	"LARYNGOSCOPY, DIRECT, OPERATIVE, W/ EXCISION OF TUMOR AND/OR STRIPPING OF VOCAL CORDS OR EPIGLOTTIS;"	"23,634.00"	"10,530.00"	"13,104.00"
31541	"LARYNGOSCOPY, DIRECT, OPERATIVE, W/ EXCISION OF TUMOR
AND/OR STRIPPING OF VOCAL CORDS OR EPIGLOTTIS; W/ OPERATING MICROSCOPE"	"23,634.00"	"10,530.00"	"13,104.00"
31560	"LARYNGOSCOPY, DIRECT, OPERATIVE, W/ ARYTENOIDECTOMY;"	"59,085.00"	"26,325.00"	"32,760.00"
31561	"LARYNGOSCOPY, DIRECT, OPERATIVE, W/ ARYTENOIDECTOMY; W/
OPERATING MICROSCOPE"	"59,085.00"	"26,325.00"	"32,760.00"
31570	"LARYNGOSCOPY, DIRECT, W/ INJECTION INTO VOCAL CORD(S),
THERAPEUTIC;"	"23,634.00"	"10,530.00"	"13,104.00"
31571	"LARYNGOSCOPY, DIRECT, W/ INJECTION INTO VOCAL CORD(S),
THERAPEUTIC; W/ OPERATING MICROSCOPE"	"23,634.00"	"10,530.00"	"13,104.00"
31575	"LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; DIAGNOSTIC"	"23,634.00"	"10,530.00"	"13,104.00"
31576	"LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; W/ BIOPSY"	"23,634.00"	"10,530.00"	"13,104.00"
31577	"LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; W/ REMOVAL OF
FOREIGN BODY"	"23,634.00"	"10,530.00"	"13,104.00"
31578	"LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; W/ REMOVAL OF LESION"	"23,634.00"	"10,530.00"	"13,104.00"
31579	"LARYNGOSCOPY, FLEXIBLE OR RIGID FIBEROPTIC, W/
STROBOSCOPY"	"23,634.00"	"10,530.00"	"13,104.00"
31580	"LARYNGOPLASTY; FOR LARYNGEAL WEB, TWO STAGE, W/ KEEL
INSERTION AND REMOVAL"	"59,085.00"	"26,325.00"	"32,760.00"
31582	"LARYNGOPLASTY; FOR LARYNGEAL STENOSIS, W/ GRAFT OR CORE
MOLD, INCLUDING TRACHEOTOMY"	"59,085.00"	"26,325.00"	"32,760.00"
31584	LARYNGOPLASTY; W/ OPEN REDUCTION OF FRACTURE	"59,085.00"	"26,325.00"	"32,760.00"
31586	LARYNGOPLASTY; W/ CLOSED MANIPULATIVE REDUCTION	"59,085.00"	"26,325.00"	"32,760.00"
31587	"LARYNGOPLASTY, CRICOID SPLIT"	"59,085.00"	"26,325.00"	"32,760.00"
31588	"LARYNGOPLASTY, NOT OTHERWISE SPECIFIED (E.G., FOR BURNS, RECONSTRUCTION AFTER PARTIAL LARYNGECTOMY)"	"59,085.00"	"26,325.00"	"32,760.00"
31590	LARYNGEAL REINNERVATION BY NEUROMUSCULAR PEDICLE	"59,085.00"	"26,325.00"	"32,760.00"
31595	"SECTION RECURRENT LARYNGEAL NERVE, THERAPEUTIC ,
UNILATERAL"	"45,435.00"	"20,865.00"	"24,570.00"
31600	"TRACHEOSTOMY, PLANNED ;"	"23,634.00"	"10,530.00"	"13,104.00"
31601	"TRACHEOSTOMY, PLANNED ; UNDER TWO YEARS"	"24,453.00"	"10,530.00"	"13,923.00"
31603	"TRACHEOSTOMY, EMERGENCY PROCEDURE; TRANSTRACHEAL"	"13,923.00"	"4,641.00"	"9,282.00"
31605	"TRACHEOSTOMY, EMERGENCY PROCEDURE; CRICOTHYROID
MEMBRANE"	"24,453.00"	"10,530.00"	"13,923.00"
31610	"TRACHEOSTOMY, FENESTRATION PROCEDURE WITH SKIN FLAPS"	"24,453.00"	"10,530.00"	"13,923.00"
31611	"CONSTRUCTION OF TRACHEOESOPHAGEAL FISTULA AND SUBSEQUENT INSERTION OF AN ALARYNGEAL SPEECH PROSTHESIS (E.G., VOICE BUTTON, BLOM-SINGER PROSTHESIS)"	"29,172.00"	"14,430.00"	"14,742.00"
31612	"TRACHEAL PUNCTURE, PERCUTANEOUS W/ TRANSTRACHEAL
ASPIRATION AND/OR INJECTION"	"25,155.00"	"12,870.00"	"12,285.00"
31613	"TRACHEOSTOMA REVISION; SIMPLE, W/O FLAP ROTATION"	"23,634.00"	"10,530.00"	"13,104.00"
31614	"TRACHEOSTOMA REVISION; COMPLEX, W/ FLAP ROTATION"	"29,172.00"	"14,430.00"	"14,742.00"
31615	"TRACHEOBRONCHOSCOPY THROUGH ESTABLISHED
TRACHEOSTOMY INCISION"	"23,634.00"	"10,530.00"	"13,104.00"
31622	"BRONCHOSCOPY; DIAGNOSTIC, (FLEXIBLE OR RIGID), W/ OR W/O
CELL WASHING OR BRUSHING"	"21,372.00"	"10,725.00"	"10,647.00"
31625	BRONCHOSCOPY; W/ BIOPSY	"21,372.00"	"10,725.00"	"10,647.00"
31628	"BRONCHOSCOPY; W/ TRANSBRONCHIAL LUNG BIOPSY, W/ OR W/O
FLUOROSCOPIC GUIDANCE"	"21,372.00"	"10,725.00"	"10,647.00"
31629	"BRONCHOSCOPY; W/ TRANSBRONCHIAL NEEDLE ASPIRATION
BIOPSY"	"21,372.00"	"10,725.00"	"10,647.00"
31630	"BRONCHOSCOPY; W/ TRACHEAL OR BRONCHIAL DILATION OR
CLOSED REDUCTION OF FRACTURE"	"35,100.00"	"18,720.00"	"16,380.00"
31631	"BRONCHOSCOPY; W/ TRACHEAL DILATION AND PLACEMENT OF
TRACHEAL STENT"	"35,100.00"	"18,720.00"	"16,380.00"
31635	BRONCHOSCOPY; W/ REMOVAL OF FOREIGN BODY	"35,100.00"	"18,720.00"	"16,380.00"
31636	"BRONCHOSCOPY; DIAGNOSTIC, (FLEXIBLE OR RIGID),W/
PLACEMENT OF BRONCHIAL STENTS"	"35,100.00"	"18,720.00"	"16,380.00"
31640	BRONCHOSCOPY; W/ EXCISION OF TUMOR	"59,085.00"	"26,325.00"	"32,760.00"
31641	"BRONCHOSCOPY; W/ DESTRUCTION OF TUMOR OR RELIEF OF STENOSIS BY ANY METHOD OTHER THAN EXCISION (E.G., LASER)"	"59,085.00"	"26,325.00"	"32,760.00"
31643	"BRONCHOSCOPY; W/ PLACEMENT OF CATHETERS FOR
INTRACAVITARY RADIOELEMENT APPLICATION"	"35,100.00"	"18,720.00"	"16,380.00"
31645	"BRONCHOSCOPY; W/ THERAPEUTIC ASPIRATION OF TRACHEOBRONCHIAL TREE, (E.G., DRAINAGE OF LUNG ABSCESS)"	"45,435.00"	"20,865.00"	"24,570.00"
31710	"CATHETERIZATION FOR BRONCHOGRAPHY, W/ OR W/O
INSTILLATION OF CONTRAST MATERIAL"	"10,842.00"	"8,385.00"	"2,457.00"
31717	CATHETERIZATION W/ BRONCHIAL BRUSH BIOPSY	"45,435.00"	"20,865.00"	"24,570.00"
31750	TRACHEOPLASTY; CERVICAL	"73,710.00"	"32,760.00"	"40,950.00"
31755	"TRACHEOPLASTY; TRACHEOPHARYNGEAL FISTULIZATION, EACH
STAGE"	"73,710.00"	"32,760.00"	"40,950.00"
31760	TRACHEOPLASTY; INTRATHORACIC	"104,130.00"	"46,800.00"	"57,330.00"
31766	CARINAL RECONSTRUCTION	"107,250.00"	"41,730.00"	"65,520.00"
31770	BRONCHOPLASTY; GRAFT REPAIR	"107,250.00"	"41,730.00"	"65,520.00"
31775	BRONCHOPLASTY; EXCISION STENOSIS AND ANASTOMOSIS	"107,250.00"	"41,730.00"	"65,520.00"
31780	EXCISION TRACHEAL STENOSIS AND ANASTOMOSIS; CERVICAL	"90,675.00"	"41,535.00"	"49,140.00"
31781	"EXCISION TRACHEAL STENOSIS AND ANASTOMOSIS;
CERVICOTHORACIC"	"104,130.00"	"46,800.00"	"57,330.00"
31785	EXCISION OF TRACHEAL TUMOR OR CARCINOMA; CERVICAL	"73,710.00"	"32,760.00"	"40,950.00"
31786	EXCISION OF TRACHEAL TUMOR OR CARCINOMA; THORACIC	"107,250.00"	"41,730.00"	"65,520.00"
31800	SUTURE OF TRACHEAL WOUND OR INJURY; CERVICAL	"45,435.00"	"20,865.00"	"24,570.00"
31805	SUTURE OF TRACHEAL WOUND OR INJURY; INTRATHORACIC	"73,710.00"	"32,760.00"	"40,950.00"
31820	"SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA W/O PLASTIC
REPAIR"	"16,458.00"	"10,725.00"	"5,733.00"
31825	"SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA WITH PLASTIC
REPAIR"	"18,915.00"	"10,725.00"	"8,190.00"
32000	"THORACENTESIS, PUNCTURE OF PLEURAL CAVITY FOR
ASPIRATION, INITIAL OR SUBSEQUENT"	"2,457.00"	819.00	"1,638.00"
32002	"THORACENTESIS W/ INSERTION OF TUBE W/ OR W/O WATER SEAL
(E.G., FOR PNEUMOTHORAX)"	"20,553.00"	"10,725.00"	"9,828.00"
32005	"CHEMICAL PLEURODESIS (E.G., FOR RECURRENT OR PERSISTENT
PNEUMOTHORAX)"	"20,553.00"	"10,725.00"	"9,828.00"
32020	"TUBE THORACOSTOMY W/ OR W/O WATER SEAL (E.G., FOR
ABSCESS, HEMOTHORAX, EMPYEMA)"	"15,561.00"	"5,187.00"	"10,374.00"
32035	THORACOSTOMY; W/ RIB RESECTION FOR EMPYEMA	"23,634.00"	"10,530.00"	"13,104.00"
32036	THORACOSTOMY; W/ OPEN FLAP DRAINAGE FOR EMPYEMA	"35,919.00"	"18,720.00"	"17,199.00"
32095	"THORACOTOMY, LIMITED, FOR BIOPSY OF LUNG OR PLEURA"	"60,723.00"	"26,325.00"	"34,398.00"
32100	"THORACOTOMY, MAJOR; W/ EXPLORATION AND BIOPSY"	"73,710.00"	"32,760.00"	"40,950.00"
32110	"THORACOTOMY, MAJOR; W/ CONTROL OF TRAUMATIC
HEMORRHAGE AND/OR REPAIR OF LUNG TEAR"	"73,710.00"	"32,760.00"	"40,950.00"
32120	"THORACOTOMY, MAJOR; FOR POSTOPERATIVE COMPLICATIONS"	"73,710.00"	"32,760.00"	"40,950.00"
32124	"THORACOTOMY, MAJOR; W/ OPEN INTRAPLEURAL
PNEUMONOLYSIS"	"73,710.00"	"32,760.00"	"40,950.00"
32140	"THORACOTOMY, MAJOR; W/ CYST(S) REMOVAL, W/ OR W/O A
PLEURAL PROCEDURE"	"73,710.00"	"32,760.00"	"40,950.00"
32141	"THORACOTOMY, MAJOR; W/ EXCISION-PLICATION OF BULLAE, W/
OR W/O A PLEURAL PROCEDURE"	"80,262.00"	"32,760.00"	"47,502.00"
32150	"THORACOTOMY, MAJOR; W/ REMOVAL OF INTRAPLEURAL
FOREIGN BODY OR FIBRIN DEPOSIT"	"74,958.00"	"36,465.00"	"38,493.00"
32151	"THORACOTOMY, MAJOR; W/ REMOVAL OF INTRAPULMONARY
FOREIGN BODY"	"74,958.00"	"36,465.00"	"38,493.00"
32160	"THORACOTOMY, MAJOR; W/ CARDIAC MASSAGE"	"74,958.00"	"36,465.00"	"38,493.00"
32200	"PNEUMONOSTOMY, W/ OPEN DRAINAGE OF ABSCESS OR CYST"	"19,734.00"	"10,725.00"	"9,009.00"
32215	PLEURAL SCARIFICATION FOR REPEAT PNEUMOTHORAX	"75,348.00"	"32,760.00"	"42,588.00"
32220	"DECORTICATION, PULMONARY ; TOTAL"	"74,958.00"	"36,465.00"	"38,493.00"
32225	"DECORTICATION, PULMONARY ; PARTIAL"	"59,085.00"	"26,325.00"	"32,760.00"
32310	"PLEURECTOMY, PARIETAL"	"73,710.00"	"32,760.00"	"40,950.00"
32320	DECORTICATION AND PARIETAL PLEURECTOMY	"73,710.00"	"32,760.00"	"40,950.00"
32400	"BIOPSY, PLEURA; PERCUTANEOUS NEEDLE"	"10,842.00"	"8,385.00"	"2,457.00"
32402	"BIOPSY, PLEURA; OPEN"	"72,501.00"	"36,465.00"	"36,036.00"
32405	"BIOPSY, LUNG OR MEDIASTINUM, PERCUTANEOUS NEEDLE"	"16,458.00"	"10,725.00"	"5,733.00"
32420	"PNEUMONOCENTESIS, PUNCTURE OF LUNG FOR ASPIRATION"	"10,842.00"	"8,385.00"	"2,457.00"
32440	"REMOVAL OF LUNG, TOTAL PNEUMONECTOMY"	"90,675.00"	"41,535.00"	"49,140.00"
32442	"REMOVAL OF LUNG, W/ RESECTION OF SEGMENT OF  TRACHEA
FOLLOWED BY BRONCHO-TRACHEAL ANASTOMOSIS (SLEEVE PNEUMONECTOMY)"	"107,406.00"	"46,800.00"	"60,606.00"
32445	"REMOVAL OF LUNG, EXTRAPLEURAL"	"107,406.00"	"46,800.00"	"60,606.00"
32480	"REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY;
SINGLE LOBE (LOBECTOMY)"	"80,262.00"	"32,760.00"	"47,502.00"
32482	"REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY;
TWO LOBES (BILOBECTOMY)"	"90,675.00"	"41,535.00"	"49,140.00"
32484	"REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY;
SINGLE SEGMENT (SEGMENTECTOMY)"	"90,675.00"	"41,535.00"	"49,140.00"
32486	"REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY; W/ CIRCUMFERENTIAL RESECTION OF SEGMENT OF BRONCHUS FOLLOWED BY BRONCHO-BRONCHIAL ANASTOMOSIS (SLEEVE
LOBECTOMY)"	"107,406.00"	"46,800.00"	"60,606.00"
32488	"REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY; ALL REMAINING LUNG FOLLOWING PREVIOUS REMOVAL OF A PORTION OF LUNG (COMPLETION PNEUMONECTOMY)"	"104,130.00"	"46,800.00"	"57,330.00"
32491	"REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY; EXCISION-PLICATION OF EMPHYSEMATOUS LUNG(S) (BULLOUS OR NON-BULLOUS) FOR LUNG VOLUMEREMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY;  REDUCTION, STERNAL SPLIT OR TRANSTHORACIC APPROACH, W/ OR W/O ANY PLEURA"	"80,262.00"	"32,760.00"	"47,502.00"
32500	"REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY; WEDGE RESECTION, SINGLE OR MULTIPLE"	"78,624.00"	"32,760.00"	"45,864.00"
32520	RESECTION OF LUNG; W/ RESECTION OF CHEST WALL	"104,130.00"	"46,800.00"	"57,330.00"
32522	"RESECTION OF LUNG; W/ RECONSTRUCTION OF CHEST WALL, W/O
PROTHESIS"	"104,130.00"	"46,800.00"	"57,330.00"
32525	"RESECTION OF LUNG; W/ MAJOR RECONSTRUCTION OF CHEST
WALL, W/ PROSTHESIS"	"104,130.00"	"46,800.00"	"57,330.00"
32540	EXTRAPLEURAL ENUCLEATION OF EMPYEMA (EMPYEMECTOMY)	"74,958.00"	"36,465.00"	"38,493.00"
32601	"THORACOSCOPY, DIAGNOSTIC ; LUNGS AND PLEURAL SPACE, W/O
BIOPSY"	"23,361.00"	"11,895.00"	"11,466.00"
32602	"THORACOSCOPY, DIAGNOSTIC ; LUNGS AND PLEURAL SPACE, W/
BIOPSY"	"25,155.00"	"12,870.00"	"12,285.00"
32603	"THORACOSCOPY, DIAGNOSTIC ; PERICARDIAL SAC, W/O BIOPSY"	"23,634.00"	"10,530.00"	"13,104.00"
32604	"THORACOSCOPY, DIAGNOSTIC ; PERICARDIAL SAC, W/ BIOPSY"	"23,634.00"	"10,530.00"	"13,104.00"
32605	"THORACOSCOPY, DIAGNOSTIC ; MEDIASTINAL SPACE, W/O BIOPSY"	"23,634.00"	"10,530.00"	"13,104.00"
32606	"THORACOSCOPY, DIAGNOSTIC ; MEDIASTINAL SPACE, W/ BIOPSY"	"23,634.00"	"10,530.00"	"13,104.00"
32650	"THORACOSCOPY, SURGICAL; W/ PLEURODESIS, ANY METHOD"	"23,634.00"	"10,530.00"	"13,104.00"
32651	"THORACOSCOPY, SURGICAL; W/ PARTIAL PULMONARY
DECORTICATION"	"23,634.00"	"10,530.00"	"13,104.00"
32652	"THORACOSCOPY, SURGICAL; W/ TOTAL PULMONARY DECORTICATION, INCLUDING INTRAPLEURAL PNEUMONOLYSIS"	"23,634.00"	"10,530.00"	"13,104.00"
32653	"THORACOSCOPY, SURGICAL; W/ REMOVAL OF INTRAPLEURAL
FOREIGN BODY OR FIRBIN DEPOSIT"	"23,634.00"	"10,530.00"	"13,104.00"
32654	"THORACOSCOPY, SURGICAL; W/ CONTROL OF TRAUMATIC
HEMORRHAGE"	"59,085.00"	"26,325.00"	"32,760.00"
32655	"THORACOSCOPY, SURGICAL; W/ EXCISION-PLICATION OF BULLAE,
INCLUDING ANY PLEURAL PROCEDURE"	"80,262.00"	"32,760.00"	"47,502.00"
32656	"THORACOSCOPY, SURGICAL; W/ PARIETAL PLEURECTOMY"	"75,348.00"	"32,760.00"	"42,588.00"
32658	"THORACOSCOPY, SURGICAL; W/ REMOVAL OF CLOT OR FOREIGN
BODY FROM PERICARDIAL SAC"	"75,348.00"	"32,760.00"	"42,588.00"
32659	"THORACOSCOPY, SURGICAL; W/ CREATION OF PERCARDIAL WINDOW OR PARTIAL RESECTION OF PERICARDIAL SAC FOR
DRAINAGE"	"75,348.00"	"32,760.00"	"42,588.00"
32660	"THORACOSCOPY, SURGICAL; W/ TOTAL PERICARDIECTOMY"	"80,262.00"	"32,760.00"	"47,502.00"
32661	"THORACOSCOPY, SURGICAL; W/ EXCISION OF PERICARDIAL CYST,
TUMOR, OR MASS"	"80,262.00"	"32,760.00"	"47,502.00"
32662	"THORACOSCOPY, SURGICAL; W/ EXCISION OF MEDIASTINAL CYST,
TUMOR, OR MASS"	"80,262.00"	"32,760.00"	"47,502.00"
32663	"THORACOSCOPY, SURGICAL; W/ LOBECTOMY, TOTAL OR
SEGMENTAL"	"90,675.00"	"41,535.00"	"49,140.00"
32664	"THORACOSCOPY, SURGICAL; W/ THORACIC SYMPATHECTOMY"	"80,262.00"	"32,760.00"	"47,502.00"
32665	"THORACOSCOPY, SURGICAL; W/ ESOPHAGOMYOTOMY (HELLER
TYPE)"	"80,262.00"	"32,760.00"	"47,502.00"
32800	REPAIR LUNG HERNIA THROUGH CHEST WALL	"45,435.00"	"20,865.00"	"24,570.00"
32810	"CLOSURE OF CHEST WALL FOLLOWING OPEN FLAP DRAINAGE FOR
EMPYEMA (CLAGETT TYPE PROCEDURE)"	"45,435.00"	"20,865.00"	"24,570.00"
32815	OPEN CLOSURE OF MAJOR BRONCHIAL FISTULA	"90,675.00"	"41,535.00"	"49,140.00"
32820	"MAJOR RECONSTRUCTION, CHEST WALL (POSTTRAUMATIC)"	"90,675.00"	"41,535.00"	"49,140.00"
32850	"DONOR PNEUMONECTOMY(IES) W/ PREPARATION AND
MAINTENANCE OF ALLOGRAFT (CADAVER)"	"107,250.00"	"41,730.00"	"65,520.00"
32851	"LUNG TRANSPLANT, SINGLE; W/O CARDIOPULMONARY BYPASS"	"122,850.00"	"40,950.00"	"81,900.00"
32852	"LUNG TRANSPLANT, SINGLE; W/ CARDIOPULMONARY BYPASS"	"126,126.00"	"40,950.00"	"85,176.00"
32853	"LUNG TRANSPLANT, DOUBLE (BILATERAL SEQUENTIAL OR EN
BLOC); W/O CARDIOPULMONARY BYPASS"	"127,764.00"	"40,950.00"	"86,814.00"
32854	"LUNG TRANSPLANT, DOUBLE (BILATERAL SEQUENTIAL OR EN
BLOC); W/ CARDIOPULMONARY BYPASS"	"127,764.00"	"40,950.00"	"86,814.00"
32900	"RESECTION OF RIBS, EXTRAPLEURAL, ALL STAGES"	"90,675.00"	"41,535.00"	"49,140.00"
32905	"THORACOPLASTY, SCHEDE TYPE OR EXTRAPLEURAL (ALL
STAGES);"	"90,675.00"	"41,535.00"	"49,140.00"
32906	"THORACOPLASTY, SCHEDE TYPE OR EXTRAPLEURAL (ALL
STAGES); W/ CLOSURE OF BRONCHIAL FISTULA"	"90,675.00"	"41,535.00"	"49,140.00"
32940	"PNEUMONOLYSIS, EXTRAPERIOSTEAL, INCLUDING FILLING OR
PACKING PROCEDURES"	"59,085.00"	"26,325.00"	"32,760.00"
32960	"PNEUMOTHORAX, THERAPEUTIC, INTRAPLEURAL INJECTION OF
AIR"	"10,842.00"	"8,385.00"	"2,457.00"
33010	PERICARDIOCENTESIS	"15,639.00"	"10,725.00"	"4,914.00"
33015	TUBE PERICARDIOSTOMY	"18,915.00"	"10,725.00"	"8,190.00"
33020	"PERICARDIOTOMY FOR REMOVAL OF CLOT OR FOREIGN BODY
(PRIMARY PROCEDURE)"	"35,100.00"	"18,720.00"	"16,380.00"
33025	"CREATION OF PERICARDIAL WINDOW OR PARTIAL RESECTION FOR
DRAINAGE"	"62,400.00"	"33,735.00"	"28,665.00"
33030	"PERICARDIECTOMY, SUBTOTAL OR COMPLETE; W/O
CARDIOPULMONARY BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
33031	"PERICARDIECTOMY, SUBTOTAL OR COMPLETE; W/
CARDIOPULMONARY BYPASS"	"114,660.00"	"40,950.00"	"73,710.00"
33050	EXCISION OF PERICARDIAL CYST OR TUMOR	"73,710.00"	"32,760.00"	"40,950.00"
33120	"EXCISION OF INTRACARDIAC TUMOR, RESECTION W/
CARDIOPULMONARY BYPASS"	"118,755.00"	"40,950.00"	"77,805.00"
33130	RESECTION OF EXTERNAL CARDIAC TUMOR	"77,805.00"	"32,760.00"	"45,045.00"
33200	"INSERTION OF PERMANENT PACEMAKER W/ EPICARDIAL
ELECTRODE(S); BY THORACOTOMY"	"41,730.00"	"21,255.00"	"20,475.00"
33201	"INSERTION OF PERMANENT PACEMAKER W/ EPICARDIAL
ELECTRODE(S); BY XIPHOID APPROACH"	"41,730.00"	"21,255.00"	"20,475.00"
33206	"INSERTION OR REPLACEMENT OF PERMANENT PACEMAKER W/
TRANSVENOUS ELECTRODE(S); ATRIAL"	"35,100.00"	"18,720.00"	"16,380.00"
33207	INSERTION OR REPLACEMENT OF PERMANENT PACEMAKER W/ TRANSVENOUS ELECTRODE(S); VENTRICULAR	"35,100.00"	"18,720.00"	"16,380.00"
33208	INSERTION OR REPLACEMENT OF PERMANENT PACEMAKER W/ TRANSVENOUS ELECTRODE(S);  ATRIAL AND VENTRICULAR	"41,730.00"	"21,255.00"	"20,475.00"
33210	"INSERTION OR PLACEMENT OF TEMPORARY TRANSVENOUS
SINGLE CHAMBER CARDIAC ELECTRODES"	"18,915.00"	"10,725.00"	"8,190.00"
33211	"INSERTION OR REPLACEMENT OF TEMPORARY TRANSVENOUS
DUAL CHAMBER CARDIAC ELECTRODES"	"18,915.00"	"10,725.00"	"8,190.00"
33212	"INSERTION OR REPLACEMENT OF PACEMAKER PULSE GENERATOR
ONLY; SINGLE CHAMBER"	"18,915.00"	"10,725.00"	"8,190.00"
33213	"INSERTION OR REPLACEMENT OF PACEMAKER PULSE GENERATOR
ONLY; DUAL CHAMBER"	"25,155.00"	"12,870.00"	"12,285.00"
33214	"UPGRADE OF IMPLANTED PACEMAKER SYSTEM, CONVERSION OF SINGLE CHAMBER SYSTEM TO DUAL CHAMBER SYSTEM (INCLUDES REMOVAL OF PREVIOUSLY PLACED PULSE GENERATOR, TESTING OF EXISTING LEAD, INSERTION OF NEW LEAD, INSERTION OF NEW PULSE GENERATOR)"	"62,400.00"	"33,735.00"	"28,665.00"
33216	"INSERTION, REPLACEMENT OR REPOSITIONING OF PERMANENT TRANSVENOUS ELECTRODE(S) ONLY (15 DAYS OR MORE AFTER INITIAL INSERTION); SINGLE CHAMBER, ATRIAL OR VENTRICULAR"	"25,155.00"	"12,870.00"	"12,285.00"
33217	"INSERTION, REPLACEMENT OR REPOSITIONING OF PERMANENT TRANSVENOUS ELECTRODE(S) ONLY (15 DAYS OR MORE AFTER
INITIAL INSERTION); DUAL CHAMBER"	"35,100.00"	"18,720.00"	"16,380.00"
33218	"REPAIR OF SINGLE TRANSVENOUS ELECTRODE FOR A SINGLE CHAMBER, PERMANENT PACEMAKER OR SINGLE CHAMBER
PACING CARDIOVERTER-DEFIBRILLATOR"	"45,435.00"	"20,865.00"	"24,570.00"
33220	"REPAIR OF TWO TRANSVENOUS ELECTRODE FOR A DUAL CHAMBER, PERMANENT PACEMAKER OR DUAL CHAMBER PACING
CARDIOVERTER-DEFIBRILLATOR"	"45,435.00"	"20,865.00"	"24,570.00"
33222	REVISION OR RELOCATION OF SKIN POCKET FOR PACEMAKER	"35,100.00"	"18,720.00"	"16,380.00"
33223	REVISION OR RELOCATION OF SKIN POCKET FOR SINGLE OR DUAL CHAMBER PACING CARDIOVERTER-DEFIBRILLATOR	"35,100.00"	"18,720.00"	"16,380.00"
33233	REMOVAL OF TRANSVENOUS PACEMAKER PULSE GENERATOR	"25,155.00"	"12,870.00"	"12,285.00"
33234	"REMOVAL OF PERMANENT OF TRANSVENOUS PACEMAKER ELECTRODE(S); SINGLE LEAD SYSTEM, ATRIAL OR VENTRICULAR"	"45,435.00"	"20,865.00"	"24,570.00"
33235	"REMOVAL OF PERMANENT OF TRANSVENOUS PACEMAKER
ELECTRODE(S); DUAL LEAD CHAMBER"	"62,400.00"	"33,735.00"	"28,665.00"
33236	"REMOVAL OF PERMANENT EPICARDIAL PACEMAKER AND
ELECTRODES BY THORACOTOMY; SINGLE LEAD SYSTEM, ATRIAL OR VENTRICULAR"	"59,085.00"	"26,325.00"	"32,760.00"
33237	"REMOVAL OF PERMANENT EPICARDIAL PACEMAKER AND
ELECTRODES BY THORACOTOMY; DUAL LEAD CHAMBER"	"73,320.00"	"36,465.00"	"36,855.00"
33238	"REMOVAL OF PERMANENT TRANSVENOUS ELECTRODE(S) BY
THORACOTOMY"	"59,085.00"	"26,325.00"	"32,760.00"
33240	"INSERTION OR REPLACEMENT OF IMPLANTABLE CARDIOVERTER-
DEFIBRILLATOR PULSE GENERATOR"	"35,100.00"	"18,720.00"	"16,380.00"
33241	"REMOVAL OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR
PULSE GENERATOR"	"35,100.00"	"18,720.00"	"16,380.00"
33243	REMOVAL OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR PULSE GENERATOR AND/OR LEAD SYSTEM; BY THORACOTOMY	"59,085.00"	"26,325.00"	"32,760.00"
33244	"REMOVAL OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR PULSE GENERATOR AND/OR LEAD SYSTEM; BY TRANSVENOUS
EXTRACTION"	"59,085.00"	"26,325.00"	"32,760.00"
33245	"IMPLANTATION OR REPLACEMENT OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR PADS BY THORACOTOMY, W/ OR
W/O SENSING ELECTRODES;"	"25,155.00"	"12,870.00"	"12,285.00"
33246	"IMPLANTATION OR REPLACEMENT OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR PADS BY THORACOTOMY, W/ INSERTION OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR
PULSE GENERATOR"	"41,730.00"	"21,255.00"	"20,475.00"
33249	"IMPLANTATION OR REPLACEMENT OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR PADS BY THORACOTOMY, W/ INSERTION OF CARDIO-DEFIBRILLATOR PULSE GENERATOR"	"35,100.00"	"18,720.00"	"16,380.00"
33250	"OPERATIVE ABLATION OF SUPRAVENTICULAR ARRHYTHMOGENIC FOCUS OR PATHWAY (E.G., WOLFF-PARKINSON-WHITE, A-V NODE REENTRY), TRACT(S) AND/OR FOCUS (FOCI); W/O
CARDIOPULMONARY BYPASS"	"73,320.00"	"36,465.00"	"36,855.00"
33251	"OPERATIVE ABLATION OF SUPRAVENTICULAR ARRHYTHMOGENIC FOCUS OR PATHWAY (E.G., WOLFF-PARKINSON-WHITE, A-V NODE REENTRY), TRACT(S) AND/OR FOCUS (FOCI); W/
CARDIOPULMONARY BYPASS"	"104,130.00"	"46,800.00"	"57,330.00"
33253	"OPERATIVE INCISIONS AND RECONSTRUCTION OF ATRIA FOR TREATMENT OF ATRIAL FIBRILLATION OR ATRIAL FLUTTER (E.G.,
MAZE PROCEDURE)"	"114,660.00"	"40,950.00"	"73,710.00"
33261	"OPERATIVE ABLATION OF VENTRICULAR ARRHYTHMOGENIC
FOCUS W/ CARDIOPULMONARY BYPASS"	"114,660.00"	"40,950.00"	"73,710.00"
33300	REPAIR OF CARDIAC WOUND; W/O BYPASS	"90,675.00"	"41,535.00"	"49,140.00"
33305	REPAIR OF CARDIAC WOUND; W/ CARDIOPULMONARY BYPASS	"114,660.00"	"40,950.00"	"73,710.00"
33310	"CARDIOTOMY, EXPLORATORY (INCLUDES REMOVAL OF FOREIGN
BODY); W/O BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
33315	"CARDIOTOMY, EXPLORATORY (INCLUDES REMOVAL OF FOREIGN
BODY); W/ CARDIOPULMONARY BYPASS"	"114,660.00"	"40,950.00"	"73,710.00"
33320	"SUTURE REPAIR OF AORTA OR GREAT VESSELS; W/O SHUNT OR
CARDIOPULMONARY BYPASS"	"59,085.00"	"26,325.00"	"32,760.00"
33321	SUTURE REPAIR OF AORTA OR GREAT VESSELS; W/ SHUNT BYPASS	"114,660.00"	"40,950.00"	"73,710.00"
33322	"SUTURE REPAIR OF AORTA OR GREAT VESSELS; W/
CARDIOPULMONARY BYPASS"	"114,660.00"	"40,950.00"	"73,710.00"
33330	"INSERTION OF GRAFT, AORTA OR GREAT VESSELS; W/O SHUNT, OR
CARDIOPULMONARY BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
33332	"INSERTION OF GRAFT, AORTA OR GREAT VESSELS; W/ SHUNT
BYPASS"	"122,850.00"	"40,950.00"	"81,900.00"
33335	"INSERTION OF GRAFT, AORTA OR GREAT VESSELS; W/
CARDIOPULMONARY BYPASS"	"122,850.00"	"40,950.00"	"81,900.00"
33400	"VALVULOPLASTY, AORTIC VALVE; OPEN, W/ CARDIOPULMONARY
BYPASS"	"104,130.00"	"46,800.00"	"57,330.00"
33401	"VALVULOPLASTY, AORTIC VALVE; OPEN, W/ INFLOW OCCLUSION"	"104,130.00"	"46,800.00"	"57,330.00"
33403	"VALVULOPLASTY, AORTIC VALVE; USING TRANSVENTRICULAR DILATION, W/ CARDIOPULMONARY BYPASS"	"107,250.00"	"41,730.00"	"65,520.00"
33404	CONSTRUCTION OF APICA-AORTIC CONDUIT	"114,660.00"	"40,950.00"	"73,710.00"
33405	"REPLACEMENT, AORTIC VALVE, W/ CARDIOPULMONARY BYPASS;
W/ PROSTHETIC VALVE OTHER THAN HOMOGRAFT"	"104,130.00"	"46,800.00"	"57,330.00"
33406	"REPLACEMENT, AORTIC VALVE, W/ CARDIOPULMONARY BYPASS;
W/ HOMOGRAFT VALVE (FREEHAND)"	"114,660.00"	"40,950.00"	"73,710.00"
33411	"REPLACEMENT, AORTIC VALVE; W/ AORTIC ANNULUS
ENLARGEMENT, NONCORONARY CUSP"	"107,250.00"	"41,730.00"	"65,520.00"
33412	"REPLACEMENT, AORTIC VALVE; W/ TRANSVENTRICULAR AORTIC
ANNULUS ENLARGEMENT (KONNO PROCEDURE)"	"114,660.00"	"40,950.00"	"73,710.00"
33413	"REPLACEMENT, AORTIC VALVE; W/ TRANSLOCATION OF
AUTOLOGOUS PULMONARY VALVE W/ HEMOGRAFT REPACEMENT OF PULMONARY VALVE (ROSS PROCEDURE)"	"139,230.00"	"40,950.00"	"98,280.00"
33414	REPAIR OF LEFT VENTRICULAR OUTFLOW TRACT OBTRUCTION BY PATCH ENLARGEMENT OF THE OUTFLOW TRACT	"90,675.00"	"41,535.00"	"49,140.00"
33415	"RESECTION OR INCISION OF SUBVALVULAR TISSUE FOR DISCRETE SUBAORTIC STENOSIS (E.G., ASYMMETRIC SEPTAL HYPERTROPHY)"	"90,675.00"	"41,535.00"	"49,140.00"
33416	"VENTRICULOMYOTOMY (-MYECTOMY) FOR IDIOPATHIC HYPERTROPHIC SUBAORTIC STENOSIS (E.G., ASYMMETRIC SEPTAL
HYPERTROPHY)"	"107,250.00"	"41,730.00"	"65,520.00"
33417	AORTOPLASTY (GUSSET) FOR SUPRAVALVULAR STENOSIS	"90,675.00"	"41,535.00"	"49,140.00"
33420	"VALVOTOMY, MITRAL VALVE; CLOSED HEART"	"73,710.00"	"32,760.00"	"40,950.00"
33422	"VALVOTOMY, MITRAL VALVE; OPEN HEART, W/
CARDIOPULMONARY BYPASS"	"104,130.00"	"46,800.00"	"57,330.00"
33425	"VALVULOPLASTY, MITRAL VALVE, W/ CARDIOPULMONARY
BYPASS;"	"107,250.00"	"41,730.00"	"65,520.00"
33426	"VALVULOPLASTY, MITRAL VALVE, W/ CARDIOPULMONARY
BYPASS; W/ PROSTHETIC RING"	"111,345.00"	"41,730.00"	"69,615.00"
33427	"VALVULOPLASTY, MITRAL VALVE, W/ CARDIOPULMONARY
BYPASS; RADICAL RECONSTRUCTION, W/ OR W/O RING"	"114,660.00"	"40,950.00"	"73,710.00"
33430	"REPLACEMENT, MITRAL VALVE, W/ CARDIOPULMONARY BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
33460	"VALVECTOMY, TRICUSPID VALVE, W/ CARDIOPULMONARY BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
33463	"VALVULOPLASTY, TRICUSPID VALVE; W/O RING INSERTION"	"104,130.00"	"46,800.00"	"57,330.00"
33464	"VALVULOPLASTY, TRICUSPID VALVE; W/ RING INSERTION"	"107,250.00"	"41,730.00"	"65,520.00"
33465	"REPLACEMENT, TRICUSPID VALVE, W/ CARDIOPULMONARY
BYPASS"	"104,130.00"	"46,800.00"	"57,330.00"
33468	"TRICUSPID VALVE REPOSITIONING AND PLICATION FOR EBSTEIN
ANOMALY"	"114,660.00"	"40,950.00"	"73,710.00"
33470	"VALVOTOMY, PULMONARY VALVE, CLOSED HEART;
TRANSVENTRICULAR"	"59,085.00"	"26,325.00"	"32,760.00"
33471	"VALVOTOMY, PULMONARY VALVE, CLOSED HEART; VIA
PULMONARY ARTERY"	"45,435.00"	"20,865.00"	"24,570.00"
33472	"VALVOTOMY, PULMONARY VALVE, OPEN HEART; W/ INFLOW
OCCLUSION"	"90,675.00"	"41,535.00"	"49,140.00"
33474	"VALVOTOMY, PULMONARY VALVE, OPEN HEART; W/
CARDIOPULMONARY BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
33475	"REPLACEMENT, PULMONARY VALVE"	"104,130.00"	"46,800.00"	"57,330.00"
33476	"RIGHT VENTRICULAR RESECTION FOR INFUNDIBULAR STENOSIS,
WITH OR WITHOUT COMMISUROTOMY"	"90,675.00"	"41,535.00"	"49,140.00"
33478	"OUTFLOW TRACT AUGMENTATION (GUSSET), W/ OR W/O
COMMISSUROTOMY OR INFUNDIBULAR RESECTION"	"104,130.00"	"46,800.00"	"57,330.00"
33500	REPAIR OF CORONARY ARTERIOVENOUS OR ARTERIOCARDIAC CHAMBER FISTULA; W/ CARDIOPULMONARY BYPASS	"90,675.00"	"41,535.00"	"49,140.00"
33501	REPAIR OF CORONARY ARTERIOVENOUS OR ARTERIOCARDIAC CHAMBER FISTULA; W/O CARDIOPULMONARY BYPASS	"59,085.00"	"26,325.00"	"32,760.00"
33502	REPAIR OF ANOMALOUS CORONARY ARTERY; BY LIGATION	"59,085.00"	"26,325.00"	"32,760.00"
33503	"REPAIR OF ANOMALOUS CORONARY ARTERY; BY GRAFT, W/O
CARDIOPULMONARY BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
33504	"REPAIR OF ANOMALOUS CORONARY ARTERY; BY GRAFT, W/
CARDIOPULMONARY BYPASS"	"104,130.00"	"46,800.00"	"57,330.00"
33505	"REPAIR OF ANOMALOUS CORONARY ARTERY; WITH CONSTRUCTION OF INTRAPULMONARY ARTERY TUNNEL
(TAKEUCHI PROCEDURE)"	"104,130.00"	"46,800.00"	"57,330.00"
33506	"REPAIR OF ANOMALOUS CORONARY ARTERY; BY TRANSLOCATION
FROM PULMONARY ARTERY TO AORTA"	"104,130.00"	"46,800.00"	"57,330.00"
33510	"CORONARY ARTERY BYPASS, VEIN ONLY; SINGLE CORONARY
VENOUS GRAFT"	"104,130.00"	"46,800.00"	"57,330.00"
33511	"CORONARY ARTERY BYPASS, VEIN ONLY; TWO CORONARY VENOUS
GRAFTS"	"104,130.00"	"46,800.00"	"57,330.00"
33512	"CORONARY ARTERY BYPASS, VEIN ONLY; THREE CORONARY
VENOUS GRAFTS"	"107,250.00"	"41,730.00"	"65,520.00"
33513	"CORONARY ARTERY BYPASS, VEIN ONLY; FOUR CORONARY
VENOUS GRAFTS"	"114,660.00"	"40,950.00"	"73,710.00"
33514	"CORONARY ARTERY BYPASS, VEIN ONLY; FIVE CORONARY VENOUS
GRAFTS"	"114,660.00"	"40,950.00"	"73,710.00"
33516	"CORONARY ARTERY BYPASS, VEIN ONLY; SIX OR MORE CORONARY
VENOUS GRAFTS"	"114,660.00"	"40,950.00"	"73,710.00"
33517	"CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND ARTERIAL GRAFT(S); SINGLE VEIN GRAFT (LIST SEPARATELY IN
ADDITION TO CODE FOR ARTERIAL GRAFT)"	"104,130.00"	"46,800.00"	"57,330.00"
33518	"CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND ARTERIAL GRAFT(S); TWO VENOUS GRAFTS (LIST SEPARATELY IN
ADDITION TO CODE FOR ARTERIAL GRAFT)"	"104,130.00"	"46,800.00"	"57,330.00"
33519	"CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND ARTERIAL GRAFT(S); THREE VENOUS GRAFTS (LIST SEPARATELY
IN ADDITION TO CODE FOR ARTERIAL GRAFT)"	"107,250.00"	"41,730.00"	"65,520.00"
33521	"CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND ARTERIAL GRAFT(S); FOUR VENOUS GRAFTS (LIST SEPARATELY IN
ADDITION TO CODE FOR ARTERIAL GRAFT)"	"114,660.00"	"40,950.00"	"73,710.00"
33522	"CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND ARTERIAL GRAFT(S); FIVE VENOUS GRAFTS (LIST SEPARATELY IN
ADDITION TO CODE FOR ARTERIAL GRAFT)"	"114,660.00"	"40,950.00"	"73,710.00"
33523	"CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND ARTERIAL GRAFT(S); SIX OR MORE VENOUS GRAFTS (LIST
SEPARATELY IN ADDITION TO CODE FOR ARTERIAL GRAFT)"	"114,660.00"	"40,950.00"	"73,710.00"
33530	"REOPERATION, CORONARY ARTERY BYPASS PROCEDURE OR VALVE PROCEDURE, MORE THAN ONE MONTH AFTER ORIGINAL OPERATION (LIST SEPARATELY IN ADDITION TO CODE FOR
PRIMARY PROCEDURE)"	"122,850.00"	"40,950.00"	"81,900.00"
33533	"CORONARY ARTERY BYPASS, USING ARTERIAL GRAFT(S); SINGLE
ARTERIAL GRAFT"	"104,130.00"	"46,800.00"	"57,330.00"
33534	"CORONARY ARTERY BYPASS, USING ARTERIAL GRAFT(S); TWO
CORONARY ARTERIAL GRAFTS"	"104,130.00"	"46,800.00"	"57,330.00"
33535	"CORONARY ARTERY BYPASS, USING ARTERIAL GRAFT(S); THREE
CORONARY ARTERIAL GRAFTS"	"107,250.00"	"41,730.00"	"65,520.00"
33536	"CORONARY ARTERY BYPASS, USING ARTERIAL GRAFT(S); FOUR OR
MORE CORONARY ARTERIAL GRAFTS"	"114,660.00"	"40,950.00"	"73,710.00"
33542	"MYOCARDIAL RESECTION (E.G., VENTRICULAR
ANEURYSMECTOMY)"	"122,850.00"	"40,950.00"	"81,900.00"
33545	"REPAIR OF POSTINFARCTION VENTRICULAR SEPTAL DEFECT, W/
OR W/O MYOCARDIAL RESECTION"	"122,850.00"	"40,950.00"	"81,900.00"
33572	"CORONARY ENDARTERECTOMY, OPEN, ANY METHOD, OF LEFT ANTERIOR DESCENDING, CIRCUMFLEX, OR RIGHT CORONARY ARTERY PERFORMED IN CONJUCTION W/ CORONARY ARTERY BYPASS GRAFT PROCEDURE, EACH VESSEL (LIST SEPARATELY IN ADDITION TO PRIMARY PROCEDURE)"	"18,915.00"	"10,725.00"	"8,190.00"
33600	"CLOSURE OF ATRIOVENTRICULAR VALVE (MITRAL OR TRICUSPID)
BY SUTURE OR PATCH"	"90,675.00"	"41,535.00"	"49,140.00"
33602	"CLOSURE OF SEMILUNAR VALVE (AORTIC OR PULMONARY) BY
SUTURE OR PATCH"	"90,675.00"	"41,535.00"	"49,140.00"
33606	"ANASTOMOSIS OF PULMONARY ARTERY TO AORTA (DAMUS-KAYE-
STANSEL PROCEDURE)"	"104,130.00"	"46,800.00"	"57,330.00"
33608	REPAIR OF COMPLEX CARDIAC ANOMALY OTHER THAN PULMONARY ATRESIA WITH VENTRICULAR SEPTAL DEFECT BY CONSTRUCTION OR REPLACEMNET OF CONDUIT FROM RIGHT OR LEFT VENTRICLE TO PULMONARY ARTERY	"107,250.00"	"41,730.00"	"65,520.00"
33610	"REPAIR OF COMPLEX CARDIAC ANOMALIES (E.G., SINGLE VENTRICLE WITH SUBAORTIC OBSTRUCTION) BY SURGICAL
ENLARGEMENT OF INTERVENTRICULAR SEPTAL DEFECT"	"107,250.00"	"41,730.00"	"65,520.00"
33611	"REPAIR OF DOUBLE OUTLET RIGHT VENTRICLE WITH
INTRAVENTRICULAR TUNNEL REPAIR"	"107,250.00"	"41,730.00"	"65,520.00"
33612	"REPAIR OF DOUBLE OUTLET RIGHT VENTRICLE WITH INTRAVENTRICULAR TUNNEL REPAIR WITH REPAIR OF RIGHT
VENTRICULAR OUTFLOW TRACT OBSTRUCTION"	"107,250.00"	"41,730.00"	"65,520.00"
33615	"REPAIR OF COMPLEX CARDIAC ANOMALIES (E.G., TRICUSPID ATRESIA) BY CLOSURE OF ATRIAL SEPTAL DEFECT AND ANASTOMOSIS OF ATRIA OR VENA CAVA TO PULMONARY ARTERY
(SIMPLE FONTAN PROCEDURE)"	"107,250.00"	"41,730.00"	"65,520.00"
33617	"REPAIR OF COMPLEX CARDIAC ANOMALIES (E.G., SINGLE
VENTRICLE) BY MODIFIED FONTAN PROCEDURE"	"107,250.00"	"41,730.00"	"65,520.00"
33619	"REPAIR OF SINGLE VENTRICLE W/ AORTIC OUTFLOW OBSTRUCTION AND AORTIC ARCH HYPOPLASIA (HYPOPLASTIC LEFT HEART SYNDROME) (E.G., NORWOOD PROCEDURE)"	"122,850.00"	"40,950.00"	"81,900.00"
33641	"REPAIR ATRIAL SEPTAL DEFECT, SECUNDUM, W/
CARDIOPULMONARY BYPASS, W/ OR W/O PATCH"	"90,675.00"	"41,535.00"	"49,140.00"
33645	"DIRECT OR PATCH CLOSURE, SINUS VENOSUS, W/ OR W/O
ANOMALOUS PULMONARY VENOUS DRAINAGE"	"104,130.00"	"46,800.00"	"57,330.00"
33647	"REPAIR OF ATRIAL SEPTAL DEFECT AND VENTRICULAR SEPTAL
DEFECT, W/ DIRECT OR PATCH CLOSURE"	"107,250.00"	"41,730.00"	"65,520.00"
33660	"REPAIR OF INCOMPLETE OR PARTIAL ATRIOVENTRICULAR CANAL (OSTIUM PRIMUM ATRIAL SEPTAL DEFECT), W/ OR W/O
ATRIOVENTRICULAR VALVE REPAIR"	"107,250.00"	"41,730.00"	"65,520.00"
33665	"REPAIR OF INTERMEDIATE OR TRANSITIONAL ATRIOVENTRICULAR CANAL, W/ OR W/O ATRIOVENTRICULAR
VALVE REPAIR"	"107,250.00"	"41,730.00"	"65,520.00"
33670	"REPAIR OF COMPLETE ATRIOVENTRICULAR CANAL, W/ OR W/O
PROSTHETIC VALVE"	"114,660.00"	"40,950.00"	"73,710.00"
33681	"CLOSURE OF VENTRICULAR SEPTAL DEFECT, W/ OR W/O PATCH;"	"90,675.00"	"41,535.00"	"49,140.00"
33684	"CLOSURE OF VENTRICULAR SEPTAL DEFECT, W/ OR W/O PATCH;
WITH PULMONARY VALVOTOMY OR INFUNDIBULAR RESECTION (ACYANOTIC)"	"107,250.00"	"41,730.00"	"65,520.00"
33688	"CLOSURE OF VENTRICULAR SEPTAL DEFECT, W/ OR W/O PATCH;
WITH REMOVAL OF PULMONARY ARTERY BAND, W/ OR W/O GUSSET"	"107,250.00"	"41,730.00"	"65,520.00"
33690	BANDING OF PULMONARY ARTERY	"41,730.00"	"21,255.00"	"20,475.00"
33692	"COMPLETE REPAIR OF TETRALOGY OF FALLOT W/O PULMONARY
ATRESIA;"	"107,250.00"	"41,730.00"	"65,520.00"
33694	"COMPLETE REPAIR OF TETRALOGY OF FALLOT W/O PULMONARY
ATRESIA; WITH TRANSANNULAR PATCH"	"107,250.00"	"41,730.00"	"65,520.00"
33697	"COMPLETE REPAIR OF TETRALOGY OF FALLOT W/ PULMONARY ATRESIA INCLUDING CONSTRUCTION OF CONDUIT RIGHT VENTRICLE TO PULMONARY ARTERY AND CLOSURE OF
VENTRICULAR SEPTAL DEFECT"	"107,250.00"	"41,730.00"	"65,520.00"
33702	"REPAIR SINUS OF VALSALVA FISTULA, W/ CARDIOPULMONARY
BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
33710	"REPAIR SINUS OF VALSALVA FISTULA, WITH REPAIR OF
VENTRICULAR SEPTAL DEFECT"	"107,250.00"	"41,730.00"	"65,520.00"
33720	"REPAIR SINUS OF VALSALVA ANEURYSM, WITH
CARDIOPULMONARY BYPASS"	"104,130.00"	"46,800.00"	"57,330.00"
33722	CLOSURE OF AORTICO-LEFT VENTRICULAR TUNNEL	"104,130.00"	"46,800.00"	"57,330.00"
33730	"COMPLETE REPAIR OF ANOMALOUS VENOUS RETURN (SUPRACARDIAC, INTRACARDIAC, OR INFRACARDIAC TYPES)"	"107,250.00"	"41,730.00"	"65,520.00"
33732	"REPAIR OF COR TRIATUM OR SUPRAVALVULAR MITRA RING BY
RESECTION OF LEFT ATRIAL MEMBRANE"	"107,250.00"	"41,730.00"	"65,520.00"
33735	"ATRIAL SEPTECTOMY OR SEPTOSTOMY; CLOSED HEART (BLALOCK-
HANLON TYPE OPERATION)"	"41,730.00"	"21,255.00"	"20,475.00"
33736	"ATRIAL SEPTECTOMY OR SEPTOSTOMY; OPEN HEART W/
CARDIOPULMONARY BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
33737	"ATRIAL SEPTECTOMY OR SEPTOSTOMY; OPEN HEART W/ INFLOW
OCCLUSION"	"90,675.00"	"41,535.00"	"49,140.00"
33750	"SHUNT; SUBCLAVIAN TO PULMONARY ARTERY (BLALOCK- TAUSSIG
TYPE OPERATION)"	"59,085.00"	"26,325.00"	"32,760.00"
33764	"SHUNT; CENTRAL, W/ PROSTHETIC GRAFT"	"45,435.00"	"20,865.00"	"24,570.00"
33766	"SHUNT; SUPERIOR VENA CAVA TO PULMONARY ARTERY FOR FLOW
TO ONE LUNG (CLASSICAL GLENN PROCEDURE)"	"59,085.00"	"26,325.00"	"32,760.00"
33767	SHUNT; SUPERIOR VENA CAVA TO PULMONARY ARTERY FOR FLOW TO BOTH LUNGS (BIDIRECTIONAL GLENN PROCEDURE)	"90,675.00"	"41,535.00"	"49,140.00"
33770	REPAIR OF TRANSPOSITION OF GREAT ARTERIES W/ VENTRICULAR SEPTAL DEFECT AND SUBPULMONARY STENOSIS; W/O SURGICAL ENLARGEMENT OF VENTRICULAR SEPTAL DEFECT	"114,660.00"	"40,950.00"	"73,710.00"
33771	REPAIR OF TRANSPOSITION OF GREAT ARTERIES W/ VENTRICULAR SEPTAL DEFECT AND SUBPULMONARY STENOSIS; WITH SURGICAL ENLAGEMENT OF VENTRICULAR SEPTAL DEFECT	"114,660.00"	"40,950.00"	"73,710.00"
33774	"REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, ATRIAL BAFFLE PROCEDURE (E.G., MUSTARD OR SENNING TYPE) W/
CARDIOPULMONARY BYPASS"	"114,660.00"	"40,950.00"	"73,710.00"
33775	"REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, ATRIAL BAFFLE PROCEDURE (E.G., MUSTARD OR SENNING TYPE) W/
REMOVAL OF PULMONARY BAND"	"118,755.00"	"40,950.00"	"77,805.00"
33776	"REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, ATRIAL BAFFLE PROCEDURE (E.G., MUSTARD OR SENNING TYPE) W/
CLOSURE OF VENTRICULAR SEPTAL DEFECT"	"118,755.00"	"40,950.00"	"77,805.00"
33777	"REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, ATRIAL BAFFLE PROCEDURE (E.G., MUSTARD OR SENNING TYPE) W/
REPAIR OF SUBPULMONIC OBSTRUCTION"	"118,755.00"	"40,950.00"	"77,805.00"
33778	"REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, AORTIC PULMONARY ARTERY RECONSTRUCTION (E.G., JATENE TYPE)"	"122,850.00"	"40,950.00"	"81,900.00"
33779	"REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, AORTIC PULMONARY ARTERY RECONSTRUCTION (E.G., JATENE TYPE) W/
REMOVAL OF PULMONARY BAND"	"126,945.00"	"40,950.00"	"85,995.00"
33780	"REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, AORTIC PULMONARY ARTERY RECONSTRUCTION (E.G., JATENE TYPE) W/ CLOSURE OF VENTRICULAR SEPTAL DEFECT"	"139,230.00"	"40,950.00"	"98,280.00"
33781	"REPAIR OF TRANSPOSITION OF THE GREAT ARTERIES, AORTIC PULMONARY ARTERY RECONSTRUCTION (E.G., JATENE TYPE) W/
REPAIR OF SUBPULMONIC OBSTRUCTION"	"139,230.00"	"40,950.00"	"98,280.00"
33786	"TOTAL REPAIR, TRUNCUS ARTERIOSUS (RASTELLI TYPE
OPERATION)"	"114,660.00"	"40,950.00"	"73,710.00"
33788	REIMPLANTATION OF AN ANOMALOUS PULMONARY ARTERY	"107,250.00"	"41,730.00"	"65,520.00"
33800	"AORTIC SUSPENSION (AORTOPEXY) FOR TRACHEAL
DECOMPRESSION (E.G., FOR TRACHEOMALACIA)"	"41,730.00"	"21,255.00"	"20,475.00"
33802	DIVISION OF ABERRANT VESSEL (VASCULAR RING)	"41,730.00"	"21,255.00"	"20,475.00"
33803	"DIVISION OF ABERRANT VESSEL (VASCULAR RING) W/
REANASTOMOSIS"	"45,435.00"	"20,865.00"	"24,570.00"
33814	"DIVISION OF ABERRANT VESSEL (VASCULAR RING) W/
CARDIOPULMONARY BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
33820	REPAIR OF PATENT DUCTUS ARTERIOSUS; BY LIGATION	"62,400.00"	"33,735.00"	"28,665.00"
33822	"REPAIR OF PATENT DUCTUS ARTERIOSUS; BY DIVISION, UNDER 18
YEARS"	"59,085.00"	"26,325.00"	"32,760.00"
33824	"REPAIR OF PATENT DUCTUS ARTERIOSUS; BY DIVISION, 18 YEARS
AND OLDER"	"59,085.00"	"26,325.00"	"32,760.00"
33840	"EXCISION OF COARCTATION OF AORTA, W/ OR W/O ASSOCIATED PATENT DUCTUS ARTERIOSUS; W/ DIRECT ANASTOMOSIS"	"59,085.00"	"26,325.00"	"32,760.00"
33845	"EXCISION OF COARCTATION OF AORTA, W/ OR W/O ASSOCIATED
PATENT DUCTUS ARTERIOSUS; WITH GRAFT"	"59,085.00"	"26,325.00"	"32,760.00"
33851	"EXCISION OF COARCTATION OF AORTA, W/ OR W/O ASSOCIATED PATENT DUCTUS ARTERIOSUS; REPAIR USING EITHER LEFT SUBCLAVIAN ARTERY OR PROSTHETIC MATERIAL AS GUSSET FOR
ENLARGEMENT"	"59,085.00"	"26,325.00"	"32,760.00"
33852	"REPAIR OF HYPOPLASTIC OR INTERRUPTED AORTIC ARCH USING
AUTOGENOUS OR PROSTHETIC MATERIAL; W/O CARDIOPULMONARY BYPASS"	"59,085.00"	"26,325.00"	"32,760.00"
33853	"REPAIR OF HYPOPLASTIC OR INTERRUPTED AORTIC ARCH USING
AUTOGENOUS OR PROSTHETIC MATERIAL; W/ CARDIOPULMONARY BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
33860	"ASCENDING AORTA GRAFT, W/ CARDIOPULMONARY BYPASS, W/
OR W/O VALVE SUSPENSION;"	"107,250.00"	"41,730.00"	"65,520.00"
33861	"ASCENDING AORTA GRAFT, W/ CARDIOPULMONARY BYPASS, W/ OR W/O VALVE SUSPENSION; W/ CORONARY RECONSTRUCTION"	"114,660.00"	"40,950.00"	"73,710.00"
33863	"ASCENDING AORTA GRAFT, W/ CARDIOPULMONARY BYPASS, W/ OR W/O VALVE SUSPENSION; W/ AORTIC ROOT REPLACEMENT USING COMPOSITE PROSTHESIS AND CORONARY
RECONSTRUCTION"	"139,230.00"	"40,950.00"	"98,280.00"
33870	"TRANSVERSE ARCH GRAFT, W/ CARDIOPULMONARY BYPASS"	"139,230.00"	"40,950.00"	"98,280.00"
33875	"DESCENDING THORACIC AORTA GRAFT, W/ OR W/O BYPASS"	"122,850.00"	"40,950.00"	"81,900.00"
33877	"REPAIR OF THORACOABDOMINAL AORTIC ANEURYSM W/ GRAFT,
W/ OR W/O CARDIOPULMONARY BYPASS"	"139,230.00"	"40,950.00"	"98,280.00"
33910	"PULMONARY ARTERY EMBOLECTOMY; W/ CARDIOPULMONARY
BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
33915	"PULMONARY ARTERY EMBOLECTOMY; W/O CARDIOPULMONARY
BYPASS"	"59,085.00"	"26,325.00"	"32,760.00"
33916	"PULMONARY ENDARTERECTOMY, W/ OR W/O EMBOLECTOMY, W/
CARDIOPULMONARY BYPASS"	"104,130.00"	"46,800.00"	"57,330.00"
33917	"REPAIR OF PULMONARY ARTERY STENOSIS BY RECONSTRUCTION
W/ PATCH OR GRAFT"	"104,130.00"	"46,800.00"	"57,330.00"
33918	"REPAIR OF PULMONARY ATRESIA W/ VENTRICULAR SEPTAL
DEFECT, BY UNIFOCALIZATION OF PULMONARY ARTERIES; W/O CARDIOPULMONARY BYPASS"	"59,085.00"	"26,325.00"	"32,760.00"
33919	"REPAIR OF PULMONARY ATRESIA W/ VENTRICULAR SEPTAL
DEFECT, BY UNIFOCALIZATION OF PULMONARY ARTERIES; W/ CARDIOPULMONARY BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
33920	"REPAIR OF PULMONARY ATRESIA W/ VENTRICULAR SEPTAL DEFECT, BY CONSTRUCTION OR REPLACEMENT OF CONDUIT FROM RIGHT OR LEFT VENTRICLE TO PULMONARY ARTERY"	"114,660.00"	"40,950.00"	"73,710.00"
33922	"TRANSECTION OF PULMONARY ARTERY W/ CARDIOPULMONARY
BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
33924	"LIGATION AND TAKEDOWN OF A SYSTEMIC-TO-PULMONARY ARTERY SHUNT, PERFORMED IN CONJUCTION W/ A CONGENITAL HEART PROCEDURE (LIST SEPARATELY IN ADDITION TO CODE FOR
PRIMARY PROCEDURE)"	"35,100.00"	"18,720.00"	"16,380.00"
33930	"DONOR CARDIECTOMY-PNEUMONECTOMY, W/ PREPARATION AND
MAINTENANCE OF ALLOGRAFT"	"90,675.00"	"41,535.00"	"49,140.00"
33935	"HEART-LUNG TRANSPLANT W/ RECIPIENT CARDIECTOMY-
PNEUMONECTOMY"	"147,420.00"	"40,950.00"	"106,470.00"
33940	"DONOR CARDIECTOMY, W/ PREPARATION AND MAINTENANCE OF
ALLOGRAFT"	"90,675.00"	"41,535.00"	"49,140.00"
33945	"HEART TRANSPLANT, W/ OR W/O RECIPIENT CARDIECTOMY"	"147,420.00"	"40,950.00"	"106,470.00"
33970	"INSERTION OF INTRA-AORTIC BALLOON ASSIST DEVICE THROUGH
THE FEMORAL ARTERY, OPEN APPROACH"	"25,155.00"	"12,870.00"	"12,285.00"
33971	REMOVAL OF INTRA-AORTIC BALLOON ASSIST DEVICE INCLUDING REPAIR OF FEMORAL ARTERY W/ OR W/O GRAFT	"18,915.00"	"10,725.00"	"8,190.00"
33973	"INSERTION OF INTRA-AORTIC BALLOON ASSIST DEVICE THROUGH
THE ASCENDING AORTA"	"41,730.00"	"21,255.00"	"20,475.00"
33974	"REMOVAL OF INTRA-AORTIC BALLOON ASSIST DEVICE FROM THE
ASCENDING AORTA, INCLUDING REPAIR OF THE ASCENDING AORTA, W/ OR W/O GRAFT"	"59,085.00"	"26,325.00"	"32,760.00"
33975	"IMPLANTATION OF VENTRICULAR ASSIST DEVICE; SINGLE
VENTRICLE SUPPORT"	"90,675.00"	"41,535.00"	"49,140.00"
33976	"IMPLANTATION OF VENTRICULAR ASSIST DEVICE;
BIVENTRICULAR SUPPORT"	"107,250.00"	"41,730.00"	"65,520.00"
33977	"REMOVAL OF VENTRICULAR ASSIST DEVICE; SINGLE VENTRICLE
SUPPORT"	"73,710.00"	"32,760.00"	"40,950.00"
33978	"REMOVAL OF VENTRICULAR ASSIST DEVICE; BIVENTRICULAR
SUPPORT"	"90,675.00"	"41,535.00"	"49,140.00"
34001	"EMBOLECTOMY OR THROMBECTOMY, W/ OR W/O CATHETER;
CAROTID, SUBCLAVIAN OR INNOMINATE ARTERY, BY NECK INCISION"	"62,400.00"	"33,735.00"	"28,665.00"
34051	"EMBOLECTOMY OR THROMBECTOMY, W/ OR W/O CATHETER; INNOMINATE, SUBCLAVIAN ARTERY, BY THORACIC INCISION"	"62,400.00"	"33,735.00"	"28,665.00"
34101	"EMBOLECTOMY OR THROMBECTOMY, W/ OR W/O CATHETER; AXILLARY, BRACHIAL, INNOMINATE, SUBCLAVIAN ARTERY, BY
ARM INCISION"	"45,435.00"	"20,865.00"	"24,570.00"
34111	"EMBOLECTOMY OR THROMBECTOMY, W/ OR W/O CATHETER;
RADIAL OR ULNAR ARTERY, BY ARM INCISION"	"45,435.00"	"20,865.00"	"24,570.00"
34151	"EMBOLECTOMY OR THROMBECTOMY, W/ OR W/O CATHETER;
RENAL, CELIAC, MESENTERY, AORTOILIAC ARTERY, BY ABDOMINAL INCISION"	"59,085.00"	"26,325.00"	"32,760.00"
34201	"EMBOLECTOMY OR THROMBECTOMY, W/ OR W/O CATHETER; FEMOROPOPLITEAL, AORTOILIAC ARTERY, BY LEG INCISION"	"45,435.00"	"20,865.00"	"24,570.00"
34203	"EMBOLECTOMY OR THROMBECTOMY, W/ OR W/O CATHETER; POPLITEAL-TIBIO-PERONEAL ARTERY, BY LEG INCISION"	"45,435.00"	"20,865.00"	"24,570.00"
34401	"THROMBECTOMY, DIRECT OR W/ CATHETER; VENA CAVA, ILIAC
VEIN, BY ABDOMINAL INCISION"	"59,085.00"	"26,325.00"	"32,760.00"
34421	"THROMBECTOMY, DIRECT OR W/ CATHETER; VENA CAVA, ILIAC,
FEMOROPOPLITEAL VEIN, BY LEG INCISION"	"62,400.00"	"33,735.00"	"28,665.00"
34451	"THROMBECTOMY, DIRECT OR W/ CATHETER; VENA CAVA, ILIAC, FEMOROPOPLITEAL VEIN, BY ABDOMINAL AND  LEG INCISION"	"73,320.00"	"36,465.00"	"36,855.00"
34471	"THROMBECTOMY, DIRECT OR W/ CATHETER; SUBCLAVIAN VEIN,
BY NECK INCISION"	"62,400.00"	"33,735.00"	"28,665.00"
34490	"THROMBECTOMY, DIRECT OR W/ CATHETER; AXILLARY AND
SUBCLAVIAN VEIN, BY ARM INCISION"	"45,435.00"	"20,865.00"	"24,570.00"
34501	"VALVULOPLASTY, FEMORAL VEIN"	"59,085.00"	"26,325.00"	"32,760.00"
34502	"RECONSTRUCTION OF VENA CAVA, ANY METHOD"	"59,085.00"	"26,325.00"	"32,760.00"
34510	"VENOUS VALVE TRANSPOSITION, ANY VEIN DONOR"	"59,085.00"	"26,325.00"	"32,760.00"
34520	CROSS-OVER VEIN GRAFT TO VENOUS SYTEM	"59,085.00"	"26,325.00"	"32,760.00"
34530	SAPHENOPOPLITEAL VEIN ANASTOMOSIS	"59,085.00"	"26,325.00"	"32,760.00"
35001	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR ANEURYSM AND ASSOCIATED OCCLUSIVE DISEASE, CAROTID, SUBCLAVIAN ARTERY, BY NECK INCISION"	"45,435.00"	"20,865.00"	"24,570.00"
35002	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR RUPTURED ANEURYSM, CAROTID, SUBCLAVIAN
ARTERY, BY NECK INCISION"	"59,085.00"	"26,325.00"	"32,760.00"
35005	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR ANEURYSM, FALSE ANEURYSM, AND ASSOCIATED OCCLUSIVE DISEASE, VERTEBRAL ARTERY"	"59,085.00"	"26,325.00"	"32,760.00"
35011	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR ANEURYSM AND ASSOCIATED OCCLUSIVE DISEASE, AXILLARY-BRACHIAL ARTERY, BY ARM INCISION"	"35,100.00"	"18,720.00"	"16,380.00"
35013	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR RUPTURED ANEURYSM, AXILLARY-BRACHIAL
ARTERY, BY ARM INCISION"	"45,435.00"	"20,865.00"	"24,570.00"
35021	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR ANEURYSM, FALSE ANEURYSM, AND ASSOCIATED OCCLUSIVE DISEASE, INNOMINATE, SUBCLAVIAN ARTERY, BY
THORACIC INCISION"	"45,435.00"	"20,865.00"	"24,570.00"
35022	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR RUPTURED ANEURYSM, INNOMINATE, SUBCLAVIAN ARTERY, BY THORACIC INSERTION"	"59,085.00"	"26,325.00"	"32,760.00"
35045	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR ANEURYSM, FALSE ANEURYSM, AND ASSOCIATED OCCLUSIVE DISEASE, RADIAL OR ULNAR ARTERY"	"35,100.00"	"18,720.00"	"16,380.00"
35081	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR ANEURYSM, FALSE ANEURYSM, AND ASSOCIATED
OCCLUSIVE DISEASE, ABDOMINAL AORTA"	"90,675.00"	"41,535.00"	"49,140.00"
35082	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR RUPTURED ANEURYSM, ABDOMINAL AORTA"	"104,130.00"	"46,800.00"	"57,330.00"
35091	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR ANEURYSM, FALSE ANEURYSM, AND ASSOCIATED OCCLUSIVE DISEASE, ABDOMINAL AORTA INVOLVING VISCERAL VESSELS (MESENTERIC, CELIAC, RENAL)"	"104,130.00"	"46,800.00"	"57,330.00"
35092	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR RUPTURED ANEURYSM, ABDOMINAL AORTA INVOLVING VISCERAL VESSELS (MESENTERIC, CELIAC, RENAL)"	"107,250.00"	"41,730.00"	"65,520.00"
35102	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR ANEURYSM, FALSE ANEURYSM, AND ASSOCIATED OCCLUSIVE DISEASE, ABDOMINAL AORTA INVOLVING ILIAC VESSELS (COMMON, HYPOGASTRIC, EXTERNAL)"	"90,675.00"	"41,535.00"	"49,140.00"
35103	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR RUPTURED ANEURYSM, ABDOMINAL AORTA INVOLVING ILIAC VESSELS (COMMON, HYPOGASTRIC, EXTERNAL)"	"104,130.00"	"46,800.00"	"57,330.00"
35111	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR ANEURYSM, FALSE ANEURYSM, AND ASSOCIATED
OCCLUSIVE DISEASE, SPLENIC ARTERY"	"90,675.00"	"41,535.00"	"49,140.00"
35112	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR RUPTURED ANEURYSM, SPLENIC ARTERY"	"104,130.00"	"46,800.00"	"57,330.00"
35121	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR ANEURYSM, FALSE ANEURYSM, AND ASSOCIATED OCCLUSIVE DISEASE, HEPATIC, CELIAC, RENAL, OR MESENTERIC
ARTERY"	"90,675.00"	"41,535.00"	"49,140.00"
35122	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR RUPTURED ANEURYSM, HEPATIC, CELIAC, RENAL, OR
MESENTERIC ARTERY"	"104,130.00"	"46,800.00"	"57,330.00"
35131	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR ANEURYSM, FALSE ANEURYSM, AND ASSOCIATED OCCLUSIVE DISEASE, ILIAC ARTERY (COMMON, HYPOGASTRIC,
EXTERNAL)"	"45,435.00"	"20,865.00"	"24,570.00"
35132	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR RUPTURED ANEURYSM, ILIAC ARTERY (COMMON,
HYPOGASTRIC, EXTERNAL)"	"59,085.00"	"26,325.00"	"32,760.00"
35141	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR ANEURYSM, FALSE ANEURYSM, AND ASSOCIATED OCCLUSIVE DISEASE, COMMON FEMORAL ARTERY (PROFUNDA
FEMORIS, SUPERFICIAL FEMORAL)"	"45,435.00"	"20,865.00"	"24,570.00"
35142	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR RUPTURED ANEURYSM, COMMON FEMORAL ARTERY (PROFUNDA FEMORIS, SUPERFICIAL FEMORAL)"	"59,085.00"	"26,325.00"	"32,760.00"
35151	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR ANEURYSM, FALSE ANEURYSM, AND ASSOCIATED
OCCLUSIVE DISEASE, POPLITEAL ARTERY"	"59,085.00"	"26,325.00"	"32,760.00"
35152	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR RUPTURED ANEURYSM, POPLITEAL ARTERY"	"73,710.00"	"32,760.00"	"40,950.00"
35161	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR ANEURYSM, FALSE ANEURYSM, AND ASSOCIATED
OCCLUSIVE DISEASE, OTHER ARTERIES"	"59,085.00"	"26,325.00"	"32,760.00"
35162	"DIRECT REPAIR OF ANEURYSM, FALSE ANEURYSM, OR EXCISION (PARTIAL OR TOTAL) AND GRAFT INSERTION, W/ OR W/O PATCH GRAFT; FOR RUPTURED ANEURYSM, OTHER ARTERIES"	"73,710.00"	"32,760.00"	"40,950.00"
35180	"REPAIR, CONGENITAL ARTERIOVENOUS FISTULA; HEAD AND NECK"	"45,435.00"	"20,865.00"	"24,570.00"
35182	"REPAIR, CONGENITAL ARTERIOVENOUS FISTULA; THORAX AND
ABDOMEN"	"59,085.00"	"26,325.00"	"32,760.00"
35184	"REPAIR, CONGENITAL ARTERIOVENOUS FISTULA; EXTREMITIES"	"45,435.00"	"20,865.00"	"24,570.00"
35188	"REPAIR, ACQUIRED OR TRAUMATIC ARTERIOVENOUS FISTULA;
HEAD AND NECK"	"45,435.00"	"20,865.00"	"24,570.00"
35189	"REPAIR, ACQUIRED OR TRAUMATIC ARTERIOVENOUS FISTULA;
THORAX AND ABDOMEN"	"59,085.00"	"26,325.00"	"32,760.00"
35190	"REPAIR, ACQUIRED OR TRAUMATIC ARTERIOVENOUS FISTULA;
EXTREMITIES"	"45,435.00"	"20,865.00"	"24,570.00"
35201	"REPAIR BLOOD VESSEL, DIRECT; NECK"	"35,100.00"	"18,720.00"	"16,380.00"
35206	"REPAIR BLOOD VESSEL, DIRECT; UPPER EXTREMITY"	"35,100.00"	"18,720.00"	"16,380.00"
35207	"REPAIR BLOOD VESSEL, DIRECT; HAND, FINGER"	"35,100.00"	"18,720.00"	"16,380.00"
35211	"REPAIR BLOOD VESSEL, DIRECT; INTRATHORACIC, W/ BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
35216	"REPAIR BLOOD VESSEL, DIRECT; INTRATHORACIC, W/O BYPASS"	"59,085.00"	"26,325.00"	"32,760.00"
35221	"REPAIR BLOOD VESSEL, DIRECT; INTRA-ABDOMINAL"	"35,100.00"	"18,720.00"	"16,380.00"
35226	"REPAIR BLOOD VESSEL, DIRECT; LOWER EXTREMITY"	"35,100.00"	"18,720.00"	"16,380.00"
35231	REPAIR BLOOD VESSEL W/ VEIN GRAFT; NECK	"45,435.00"	"20,865.00"	"24,570.00"
35236	REPAIR BLOOD VESSEL W/ VEIN GRAFT; UPPER EXTREMITY	"35,100.00"	"18,720.00"	"16,380.00"
35241	"REPAIR BLOOD VESSEL W/ VEIN GRAFT; INTRATHORACIC, W/
BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
35246	"REPAIR BLOOD VESSEL W/ VEIN GRAFT; INTRATHORACIC, W/O
BYPASS"	"59,085.00"	"26,325.00"	"32,760.00"
35251	REPAIR BLOOD VESSEL W/ VEIN GRAFT; INTRA-ABDOMINAL	"45,435.00"	"20,865.00"	"24,570.00"
35256	REPAIR BLOOD VESSEL W/ VEIN GRAFT; LOWER EXTREMITY	"35,100.00"	"18,720.00"	"16,380.00"
35261	REPAIR BLOOD VESSEL W/ GRAFT OTHER THAN VEIN; NECK	"45,435.00"	"20,865.00"	"24,570.00"
35266	"REPAIR BLOOD VESSEL W/ GRAFT OTHER THAN VEIN; UPPER
EXTREMITY"	"35,100.00"	"18,720.00"	"16,380.00"
35271	"REPAIR BLOOD VESSEL W/ GRAFT OTHER THAN VEIN;
INTRATHORACIC, W/ BYPASS"	"90,675.00"	"41,535.00"	"49,140.00"
35276	"REPAIR BLOOD VESSEL W/ GRAFT OTHER THAN VEIN;
INTRATHORACIC, W/O BYPASS"	"59,085.00"	"26,325.00"	"32,760.00"
35281	"REPAIR BLOOD VESSEL W/ GRAFT OTHER THAN VEIN; INTRA-
ABDOMINAL"	"45,435.00"	"20,865.00"	"24,570.00"
35286	"REPAIR BLOOD VESSEL W/ GRAFT OTHER THAN VEIN; LOWER
EXTREMITY"	"35,100.00"	"18,720.00"	"16,380.00"
35301	"THROMBOENDARTERECTOMY, W/ OR W/O PATCH GRAFT;
CAROTID, VERTEBRAL, SUBCLAVIAN, BY NECK INCISION"	"73,320.00"	"36,465.00"	"36,855.00"
35311	"THROMBOENDARTERECTOMY, W/ OR W/O PATCH GRAFT;
SUBCLAVIAN, INNOMINATE, BY THORACIC INCISION"	"73,320.00"	"36,465.00"	"36,855.00"
35321	"THROMBOENDARTERECTOMY, W/ OR W/O PATCH GRAFT;
AXILLARY-BRACHIAL"	"73,320.00"	"36,465.00"	"36,855.00"
35331	"THROMBOENDARTERECTOMY, W/ OR W/O PATCH GRAFT;
ABDOMINAL AORTA"	"73,320.00"	"36,465.00"	"36,855.00"
35341	"THROMBOENDARTERECTOMY, W/ OR W/O PATCH GRAFT;
MESENTERIC, CELIAC, OR RENAL"	"73,320.00"	"36,465.00"	"36,855.00"
35351	"THROMBOENDARTERECTOMY, W/ OR W/O PATCH GRAFT; ILIAC"	"59,085.00"	"26,325.00"	"32,760.00"
35355	"THROMBOENDARTERECTOMY, W/ OR W/O PATCH GRAFT;
ILIOFEMORAL"	"59,085.00"	"26,325.00"	"32,760.00"
35361	"THROMBOENDARTERECTOMY, W/ OR W/O PATCH GRAFT;
COMBINED AORTOILIAC"	"90,675.00"	"41,535.00"	"49,140.00"
35363	"THROMBOENDARTERECTOMY, W/ OR W/O PATCH GRAFT;
COMBINED AORTOILIOFEMORAL"	"45,435.00"	"20,865.00"	"24,570.00"
35371	"THROMBOENDARTERECTOMY, W/ OR W/O PATCH GRAFT;
COMMON FEMORAL"	"45,435.00"	"20,865.00"	"24,570.00"
35372	"THROMBOENDARTERECTOMY, W/ OR W/O PATCH GRAFT; DEEP
(PROFUNDA) FEMORAL"	"45,435.00"	"20,865.00"	"24,570.00"
35381	"THROMBOENDARTERECTOMY, W/ OR W/O PATCH GRAFT;
FEMORAL AND/OR POPLITEAL, AND/OR TIBIOPERONEAL"	"59,085.00"	"26,325.00"	"32,760.00"
35450	"TRANSLUMINAL BALLOON ANGIOPLASTY, OPEN; RENAL OR OTHER
VISCERAL ARTERY"	"41,730.00"	"21,255.00"	"20,475.00"
35452	"TRANSLUMINAL BALLOON ANGIOPLASTY, OPEN; AORTIC"	"41,730.00"	"21,255.00"	"20,475.00"
35454	"TRANSLUMINAL BALLOON ANGIOPLASTY, OPEN; ILIAC"	"41,730.00"	"21,255.00"	"20,475.00"
35456	"TRANSLUMINAL BALLOON ANGIOPLASTY, OPEN; FEMORAL-
POPLITEAL"	"41,730.00"	"21,255.00"	"20,475.00"
35458	"TRANSLUMINAL BALLOON ANGIOPLASTY, OPEN;
BRACHIOCEPHALIC TRUNK OR BRANCHES, EACH VESSEL"	"41,730.00"	"21,255.00"	"20,475.00"
35459	"TRANSLUMINAL BALLOON ANGIOPLASTY, OPEN; TIBIOPERONEAL
TRUNK AND BRANCHES"	"41,730.00"	"21,255.00"	"20,475.00"
35460	"TRANSLUMINAL BALLOON ANGIOPLASTY, OPEN; VENOUS"	"41,730.00"	"21,255.00"	"20,475.00"
35470	"TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS;
TIBIOPERONEAL TRUNK OR BRANCHES, EACH VESSEL"	"25,155.00"	"12,870.00"	"12,285.00"
35471	"TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS; RENAL
OR VISCERAL ARTERY"	"25,155.00"	"12,870.00"	"12,285.00"
35472	"TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS;
AORTIC"	"25,155.00"	"12,870.00"	"12,285.00"
35473	"TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS; ILIAC"	"25,155.00"	"12,870.00"	"12,285.00"
35474	"TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS;
FEMORAL-POPLITEAL"	"25,155.00"	"12,870.00"	"12,285.00"
35475	"TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS;
BRANCHIOCEPHALIC TRUNK OR BRANCHES, EACH VESSEL"	"25,155.00"	"12,870.00"	"12,285.00"
35476	"TRANSLUMINAL BALLOON ANGIOPLASTY, PERCUTANEOUS;
VENOUS"	"25,155.00"	"12,870.00"	"12,285.00"
35480	"TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; RENAL OR
OTHER VISCERAL ARTERY"	"45,435.00"	"20,865.00"	"24,570.00"
35481	"TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; AORTIC"	"45,435.00"	"20,865.00"	"24,570.00"
35482	"TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; ILIAC"	"45,435.00"	"20,865.00"	"24,570.00"
35483	"TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; FEMORAL-
POPLITEAL"	"45,435.00"	"20,865.00"	"24,570.00"
35484	"TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN;
BRACHIOCEPHALIC TRUNK OR BRANCHES, EACH VESSEL"	"45,435.00"	"20,865.00"	"24,570.00"
35485	"TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN;
TIBIOPERONEAL TRUNK AND BRANCHES"	"45,435.00"	"20,865.00"	"24,570.00"
35490	"TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS;
RENAL OR OTHER VISCERAL ARTERY"	"41,730.00"	"21,255.00"	"20,475.00"
35491	"TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS;
AORTIC"	"41,730.00"	"21,255.00"	"20,475.00"
35492	"TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS;
ILIAC"	"41,730.00"	"21,255.00"	"20,475.00"
35493	"TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS;
FEMORAL-POPLITEAL"	"41,730.00"	"21,255.00"	"20,475.00"
35494	"TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS; BRANCHIOCEPHALIC TRUNK OR BRANCHES, EACH VESSEL"	"41,730.00"	"21,255.00"	"20,475.00"
35495	"TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS;
TIBIOPERONEAL TRUNK AND BRANCHES"	"41,730.00"	"21,255.00"	"20,475.00"
35501	"BYPASS GRAFT, W/ VEIN; CAROTID"	"73,320.00"	"36,465.00"	"36,855.00"
35506	"BYPASS GRAFT, W/ VEIN; CAROTID-SUBCLAVIAN"	"73,320.00"	"36,465.00"	"36,855.00"
35507	"BYPASS GRAFT, W/ VEIN; SUBCLAVIAN-CAROTID"	"73,320.00"	"36,465.00"	"36,855.00"
35508	"BYPASS GRAFT, W/ VEIN; CAROTID-VERTEBRAL"	"73,320.00"	"36,465.00"	"36,855.00"
35509	"BYPASS GRAFT, W/ VEIN; CAROTID-CAROTID"	"73,320.00"	"36,465.00"	"36,855.00"
35511	"BYPASS GRAFT, W/ VEIN; SUBCLAVIAN-SUBCLAVIAN"	"73,320.00"	"36,465.00"	"36,855.00"
35515	"BYPASS GRAFT, W/ VEIN; SUBCLAVIAN-VERTEBRAL"	"73,320.00"	"36,465.00"	"36,855.00"
35516	"BYPASS GRAFT, W/ VEIN; SUBCLAVIAN-AXILLARY"	"73,320.00"	"36,465.00"	"36,855.00"
35518	"BYPASS GRAFT, W/ VEIN; AXILLARY-AXILLARY"	"73,320.00"	"36,465.00"	"36,855.00"
35521	"BYPASS GRAFT, W/ VEIN; AXILLARY-FEMORAL"	"73,320.00"	"36,465.00"	"36,855.00"
35526	"BYPASS GRAFT, W/ VEIN; AORTOSUBCLAVIAN OR CAROTID"	"90,675.00"	"41,535.00"	"49,140.00"
35531	"BYPASS GRAFT, W/ VEIN; AORTOCELIAC OR AORTOMESENTERIC"	"90,675.00"	"41,535.00"	"49,140.00"
35533	"BYPASS GRAFT, W/ VEIN; AXILLARY-FEMORAL-FEMORAL"	"90,675.00"	"41,535.00"	"49,140.00"
35536	"BYPASS GRAFT, W/ VEIN; SPLENORENAL"	"90,675.00"	"41,535.00"	"49,140.00"
35541	"BYPASS GRAFT, W/ VEIN; AORTOILIAC OR BI-ILIAC"	"90,675.00"	"41,535.00"	"49,140.00"
35546	"BYPASS GRAFT, W/ VEIN; AORTOFEMORAL OR BIFEMORAL"	"90,675.00"	"41,535.00"	"49,140.00"
35548	"BYPASS GRAFT, W/ VEIN; AORTOILLIOFEMORAL, UNILATERAL"	"90,675.00"	"41,535.00"	"49,140.00"
35549	"BYPASS GRAFT, W/ VEIN; AORTOILLIOFEMORAL, BILATERAL"	"90,675.00"	"41,535.00"	"49,140.00"
35551	"BYPASS GRAFT, W/ VEIN; AORTOFEMORAL - POPLITEAL"	"90,675.00"	"41,535.00"	"49,140.00"
35556	"BYPASS GRAFT, W/ VEIN; FEMORAL - POPLITEAL"	"59,085.00"	"26,325.00"	"32,760.00"
35558	"BYPASS GRAFT, W/ VEIN; FEMORAL-FEMORAL"	"45,435.00"	"20,865.00"	"24,570.00"
35560	"BYPASS GRAFT, W/ VEIN; AORTORENAL"	"73,710.00"	"32,760.00"	"40,950.00"
35563	"BYPASS GRAFT, W/ VEIN; ILIOILIAC"	"59,085.00"	"26,325.00"	"32,760.00"
35565	"BYPASS GRAFT, W/ VEIN; ILIOFEMORAL"	"59,085.00"	"26,325.00"	"32,760.00"
35566	"BYPASS GRAFT, W/ VEIN; FEMORAL - ANTERIOR TIBIAL, POSTERIOR TIBIAL, PERONEAL ARTERY OR OTHER DISTAL
VESSELS"	"59,085.00"	"26,325.00"	"32,760.00"
35571	"BYPASS GRAFT, W/ VEIN; POPLITEAL-TIBIAL, PERONEAL ARTERY
OR OTHER DISTAL VESSELS"	"45,435.00"	"20,865.00"	"24,570.00"
35582	"IN-SITU VEIN BYPASS; AORTOFEMORAL-POPLITEAL (ONLY
FEMORAL-POPLITEAL PORTION IN-SITU)"	"90,675.00"	"41,535.00"	"49,140.00"
35583	IN-SITU VEIN BYPASS;FEMORAL-POPLITEAL	"73,710.00"	"32,760.00"	"40,950.00"
35585	"IN-SITU VEIN BYPASS; FEMORAL-ANTERIOR TIBIAL, POSTERIOR
TIBIAL, OR PERONEAL ARTERY"	"73,710.00"	"32,760.00"	"40,950.00"
35587	"IN-SITU VEIN BYPASS; POPLITEAL -TIBIAL, PERONEAL"	"73,710.00"	"32,760.00"	"40,950.00"
35601	"BYPASS GRAFT, WITH OTHER THAN VEIN; CAROTID"	"73,320.00"	"36,465.00"	"36,855.00"
35606	"BYPASS GRAFT, WITH OTHER THAN VEIN; CAROTID-SUBCLAVIAN"	"73,320.00"	"36,465.00"	"36,855.00"
35612	"BYPASS GRAFT, WITH OTHER THAN VEIN; SUBCLAVIAN-
SUBCLAVIAN"	"73,320.00"	"36,465.00"	"36,855.00"
35616	"BYPASS GRAFT, WITH OTHER THAN VEIN; SUBCLAVIAN-AXILLARY"	"73,320.00"	"36,465.00"	"36,855.00"
35621	"BYPASS GRAFT, WITH OTHER THAN VEIN; AXILLARY-FEMORAL"	"73,320.00"	"36,465.00"	"36,855.00"
35623	"BYPASS GRAFT, WITH OTHER THAN VEIN; AXILLARY-POPLITEAL
OR -TIBIAL"	"73,320.00"	"36,465.00"	"36,855.00"
35626	"BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOSUBCLAVIAN OR
CAROTID"	"90,675.00"	"41,535.00"	"49,140.00"
35631	"BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOCELIAC,
AORTOMESENTERIC, AORTORENAL"	"90,675.00"	"41,535.00"	"49,140.00"
35636	"BYPASS GRAFT, WITH OTHER THAN VEIN; SPLENORENAL (SPLENIC
TO RENAL ARTERIAL ANASTOMOSIS)"	"90,675.00"	"41,535.00"	"49,140.00"
35641	"BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOILIAC OR BI-ILIAC"	"90,675.00"	"41,535.00"	"49,140.00"
35642	"BYPASS GRAFT, WITH OTHER THAN VEIN; CAROTID-VERTEBRAL"	"73,320.00"	"36,465.00"	"36,855.00"
35645	"BYPASS GRAFT, WITH OTHER THAN VEIN; SUBCLAVIAN-
VERTEBRAL"	"73,320.00"	"36,465.00"	"36,855.00"
35646	"BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOFEMORAL OR
BIFEMORAL"	"90,675.00"	"41,535.00"	"49,140.00"
35650	"BYPASS GRAFT, WITH OTHER THAN VEIN; AXILLARY-AXILLARY"	"73,320.00"	"36,465.00"	"36,855.00"
35651	"BYPASS GRAFT, WITH OTHER THAN VEIN; AORTOFEMORAL-
POPLITEAL"	"90,675.00"	"41,535.00"	"49,140.00"
35654	"BYPASS GRAFT, WITH OTHER THAN VEIN; AXILLARY-FEMORAL-
FEMORAL"	"73,320.00"	"36,465.00"	"36,855.00"
35656	"BYPASS GRAFT, WITH OTHER THAN VEIN; FEMORAL-POPLITEAL"	"59,085.00"	"26,325.00"	"32,760.00"
35661	"BYPASS GRAFT, WITH OTHER THAN VEIN; FEMORAL-FEMORAL"	"45,435.00"	"20,865.00"	"24,570.00"
35663	"BYPASS GRAFT, WITH OTHER THAN VEIN; ILIOILIAC"	"59,085.00"	"26,325.00"	"32,760.00"
35665	"BYPASS GRAFT, WITH OTHER THAN VEIN; ILIOFEMORAL"	"59,085.00"	"26,325.00"	"32,760.00"
35666	"BYPASS GRAFT, WITH OTHER THAN VEIN; FEMORAL-ANTERIOR TIBIAL, POSTERIOR TIBIAL, OR PERONEAL ARTERY"	"59,085.00"	"26,325.00"	"32,760.00"
35671	"BYPASS GRAFT, WITH OTHER THAN VEIN; POPLITEAL-TIBIAL OR -
PERONEAL ARTERY"	"45,435.00"	"20,865.00"	"24,570.00"
35681	"BYPASS GRAFT, COMPOSITE"	"90,675.00"	"41,535.00"	"49,140.00"
35691	"TRANSPOSITION AND/OR REIMPLANTATION; VERTEBRAL TO
CAROTID ARTERY"	"73,320.00"	"36,465.00"	"36,855.00"
35693	"TRANSPOSITION AND/OR REIMPLANTATION; VERTEBRAL TO
SUBCLAVIAN ARTERY"	"73,320.00"	"36,465.00"	"36,855.00"
35694	"TRANSPOSITION AND/OR REIMPLANTATION; SUBCLAVIAN TO
CAROTID ARTERY"	"73,320.00"	"36,465.00"	"36,855.00"
35695	"TRANSPOSITION AND/OR REIMPLANTATION; CAROTID TO
SUBCLAVIAN ARTERY"	"73,320.00"	"36,465.00"	"36,855.00"
35700	"REOPERATION, FEMORAL-POPLITEAL OR FEMORAL (POPLITEAL) - ANTERIOR TIBIAL,POSTERIOR TIBIAL, PERONEAL ARTERY OR OTHER DISTAL VESSELS, MORE THAN ONE MONTH AFTER ORIGINAL OPERATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)"	"35,100.00"	"18,720.00"	"16,380.00"
35701	"EXPLORATION (NOT FOLLOWED BY SURGICAL REPAIR), W/ OR
W/O LYSIS OF ARTERY; CAROTID ARTERY"	"35,100.00"	"18,720.00"	"16,380.00"
35721	"EXPLORATION (NOT FOLLOWED BY SURGICAL REPAIR), W/ OR
W/O LYSIS OF ARTERY; FEMORAL ARTERY"	"35,100.00"	"18,720.00"	"16,380.00"
35741	"EXPLORATION (NOT FOLLOWED BY SURGICAL REPAIR), W/ OR
W/O LYSIS OF ARTERY; POPLITEAL ARTERY"	"35,100.00"	"18,720.00"	"16,380.00"
35761	"EXPLORATION (NOT FOLLOWED BY SURGICAL REPAIR), W/ OR
W/O LYSIS OF ARTERY; OTHER VESSELS"	"35,100.00"	"18,720.00"	"16,380.00"
35800	"EXPLORATION FOR POSTOPERATIVE HEMORRHAGE, THROMBOSIS
OR INFECTION; NECK"	"18,915.00"	"10,725.00"	"8,190.00"
35820	"EXPLORATION FOR POSTOPERATIVE HEMORRHAGE, THROMBOSIS
OR INFECTION; CHEST"	"35,100.00"	"18,720.00"	"16,380.00"
35840	"EXPLORATION FOR POSTOPERATIVE HEMORRHAGE, THROMBOSIS
OR INFECTION; ABDOMEN"	"35,100.00"	"18,720.00"	"16,380.00"
35860	"EXPLORATION FOR POSTOPERATIVE HEMORRHAGE, THROMBOSIS
OR INFECTION; EXTREMITY"	"18,915.00"	"10,725.00"	"8,190.00"
35870	REPAIR OF GRAFT-ENTERIC FISTULA	"45,435.00"	"20,865.00"	"24,570.00"
35875	THROMBECTOMY OF ARTERIAL OR VENOUS GRAFT;	"45,435.00"	"20,865.00"	"24,570.00"
35876	"THROMBECTOMY OF ARTERIAL OR VENOUS GRAFT; W/ REVISION
OF ARTERIAL OR VENOUS GRAFT"	"45,435.00"	"20,865.00"	"24,570.00"
35901	EXCISION OF INFECTED GRAFT; NECK	"59,085.00"	"26,325.00"	"32,760.00"
35903	EXCISION OF INFECTED GRAFT; EXTREMITY	"59,085.00"	"26,325.00"	"32,760.00"
35905	EXCISION OF INFECTED GRAFT; THORAX	"73,710.00"	"32,760.00"	"40,950.00"
35907	EXCISION OF INFECTED GRAFT; ABDOMEN	"59,085.00"	"26,325.00"	"32,760.00"
36010	"INTRODUCTION OF CATHETER, SUPERIOR OR INFERIOR VENA
CAVA"	"7,098.00"	"5,460.00"	"1,638.00"
36011	"SELECTIVE CATHETER PLACEMENT, VENOUS SYSTEM; FIRST
ORDER BRANCH (E.G., RENAL VEIN, JUGULAR VEIN)"	"18,135.00"	"14,040.00"	"4,095.00"
36012	"SELECTIVE CATHETER PLACEMENT, VENOUS SYSTEM;  SECOND ORDER, OR MORE SELECTIVE, BRANCH (E.G., LEFT ADRENAL VEIN,
PETROSAL SINUS)"	"15,639.00"	"10,725.00"	"4,914.00"
36013	"INTRODUCTION OF CATHETER, RIGHT HEART OR MAIN
PULMONARY ARTERY"	"15,639.00"	"10,725.00"	"4,914.00"
36014	"SELECTIVE CATHETER PLACEMENT, LEFT OR RIGHT PULMONARY
ARTERY"	"15,639.00"	"10,725.00"	"4,914.00"
36015	"SELECTIVE CATHETER PLACEMENT, SEGMENTAL OR
SUBSEGMENTAL PULMONARY ARTERY"	"16,458.00"	"10,725.00"	"5,733.00"
36100	"INTRODUCTION OF NEEDLE OR INTRACATHETER, CAROTID OR
VERTEBRAL ARTERY"	"16,458.00"	"10,725.00"	"5,733.00"
36120	"INTRODUCTION OF NEEDLE OR INTRACATHETER; RETROGRADE
BRACHIAL ARTERY"	"18,135.00"	"14,040.00"	"4,095.00"
36140	"INTRODUCTION OF NEEDLE OR INTRACATHETER; EXTREMITY
ARTERY"	"18,135.00"	"14,040.00"	"4,095.00"
36145	"INTRODUCTION OF NEEDLE OR INTRACATHETER; ARTERIOVENOUS SHUNT CREATED FOR DIALYSIS (CANNULA,
FISTULA, OR GRAFT)"	"16,107.00"	"9,555.00"	"6,552.00"
36200	"INTRODUCTION OF CATHETER, AORTA"	"18,135.00"	"14,040.00"	"4,095.00"
36215	"SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; EACH
FIRST ORDER THORACIC OR BRACHIOCEPHALIC BRANCH, W/IN A VASCULAR FAMILY"	"18,135.00"	"14,040.00"	"4,095.00"
36216	"SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIAL
SECOND ORDER THORACIC OR BRACHIOCEPHALIC BRANCH, W/IN A VASCULAR FAMILY"	"18,135.00"	"14,040.00"	"4,095.00"
36217	"SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIAL THIRD ORDER OR MORE SELECTIVE THORACIC OR
BRACHIOCEPHALIC BRANCH, W/IN A VASCULAR FAMILY"	"15,639.00"	"10,725.00"	"4,914.00"
36245	"SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; EACH FIRST ORDER ABDOMINAL, PELVIC, OR LOWER EXTREMITY
ARTERY BRANCH, W/IN A VASCULAR FAMILY"	"18,135.00"	"14,040.00"	"4,095.00"
36246	"SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIAL SECOND ORDER ABDOMINAL, PELVIC OR LOWER EXTREMITY
ARTERY BRANCH, W/IN A VASCULAR FAMILY"	"18,135.00"	"14,040.00"	"4,095.00"
36247	"SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM; INITIAL THIRD ORDER OR MORE SELECTIVE ABDOMINAL, PELVIC OR LOWER EXTREMITY ARTERY BRANCH, W/IN A VASCULAR FAMILY"	"15,639.00"	"10,725.00"	"4,914.00"
36260	"INSERTION OF IMPLANTABLE INTRA-ARTERIAL INFUSION PUMP
(E.G., FOR CHEMOTHERAPY OF LIVER)"	"45,435.00"	"20,865.00"	"24,570.00"
36261	REVISION OF IMPLANTED INTRA-ARTERIAL INFUSION PUMP	"18,915.00"	"10,725.00"	"8,190.00"
36262	REMOVAL OF IMPLANTED INTRA-ARTERIAL INFUSION PUMP	"18,915.00"	"10,725.00"	"8,190.00"
36430	"OUTPATIENT TRANSFUSION OF BLOOD OR BLOOD PRODUCTS; ONE
OR MORE UNITS"	"7,098.00"	"5,460.00"	"1,638.00"
36450	"EXCHANGE TRANSFUSION, BLOOD"	"11,076.00"	"7,800.00"	"3,276.00"
36481	"PERCUTANEOUS PORTAL VEIN CATHETERIZATION BY ANY
METHOD"	"18,135.00"	"14,040.00"	"4,095.00"
36488	"PLACEMENT OF CENTRAL VENOUS CATHETER (SUBCLAVIAN, JUGULAR, OR OTHER VEIN) (E.G., FOR CENTRAL VENOUS PRESSURE, HYPERALIMENTATION, HEMODIALYSIS, OR CHEMOTHERAPY); PERCUTANEOUS OR CUTDOWN"	"18,915.00"	"10,725.00"	"8,190.00"
36510	"CATHETERIZATION OF UMBILICAL VEIN FOR DIAGNOSIS OR
THERAPY, NEWBORN"	"7,098.00"	"5,460.00"	"1,638.00"
36511	THERAPEUTIC APHERESIS	"7,098.00"	"5,460.00"	"1,638.00"
36568	"INSERTION OF PERIPHERALLY INSERTED CENTRAL VENOUS
CATHETER (PICC)"	"18,915.00"	"10,725.00"	"8,190.00"
36640	"ARTERIAL CATHETERIZATION FOR PROLONGED INFUSION
THERAPY (CHEMOTHERAPY), CUTDOWN"	"7,098.00"	"5,460.00"	"1,638.00"
36660	"CATHETERIZATION, UMBILICAL ARTERY, NEWBORN, FOR
DIAGNOSIS OR THERAPY"	"11,076.00"	"7,800.00"	"3,276.00"
36781	"PERCUTANEOUSPORTAL VEIN CATHETERIZATION BY ANY
METHOD"	"18,135.00"	"14,040.00"	"4,095.00"
36800	"INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPOSE ;
VEIN TO VEIN"	"18,135.00"	"14,040.00"	"4,095.00"
36810	"INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPOSE ;
ARTERIOVENOUS, EXTERNAL (SCRIBNER TYPE)"	"18,915.00"	"10,725.00"	"8,190.00"
36815	"INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPOSE ; ARTERIOVENOUS, EXTERNAL REVISION, OR CLOSURE"	"18,915.00"	"10,725.00"	"8,190.00"
36821	"ARTERIOVENOUS ANASTOMOSIS, DIRECT, ANY SITE (E.G., CIMINO
TYPE)"	"18,915.00"	"10,725.00"	"8,190.00"
36822	INSERTION OF CANNULA(S) FOR PROLONGED EXTRACORPOREAL CIRCULATION FOR CARDIOPULMONARY INSUFFICIENCY (ECMO)	"35,100.00"	"18,720.00"	"16,380.00"
36825	CREATION OF ARTERIOVENOUS FISTULA BY OTHER THAN DIRECT ARTERIOVENOUS ANASTOMOSIS ; AUTOGENOUS GRAFT	"25,155.00"	"12,870.00"	"12,285.00"
36830	CREATION OF ARTERIOVENOUS FISTULA BY OTHER THAN DIRECT ARTERIOVENOUS ANASTOMOSIS ; NONAUTOGENOUS GRAFT	"25,155.00"	"12,870.00"	"12,285.00"
36832	"REVISION OF AN ARTERIOVENOUS FISTULA, W/ OR W/O THROMBECTOMY, AUTOGENOUS OR NONAUTOGENOUS GRAFT"	"18,915.00"	"10,725.00"	"8,190.00"
36834	PLASTIC REPAIR OF ARTERIOVENOUS ANEURYSM	"16,107.00"	"9,555.00"	"6,552.00"
36835	INSERTION OF THOMAS SHUNT	"18,135.00"	"14,040.00"	"4,095.00"
37140	VENOUS ANASTOMOSIS; PORTOCAVAL	"59,085.00"	"26,325.00"	"32,760.00"
37145	VENOUS ANASTOMOSIS; RENOPORTAL	"73,710.00"	"32,760.00"	"40,950.00"
37160	VENOUS ANASTOMOSIS; CAVAL-MESENTERIC	"59,085.00"	"26,325.00"	"32,760.00"
37180	"VENOUS ANASTOMOSIS; SPLENORENAL, PROXIMAL"	"73,320.00"	"36,465.00"	"36,855.00"
37181	"VENOUS ANASTOMOSIS; SPLENORENAL, DISTAL (SELECTIVE DECOMPRESSION OF ESOPHAGOGASTRIC VARICES, ANY
TECHNIQUE)"	"73,710.00"	"32,760.00"	"40,950.00"
37182	"INSERTION OF TRANSVENOUS INTRAHEPATIC PORTOSYSTEMIC SHUNT(S) (TIPS) INCLUDES VENOUS ACCESS, HEPATIC AND PORTAL VEIN CATHETERIZATION, PORTOGRAPHY, HEMODYNAMIC EVALUATION, INTRAHEPATIC TRACT FORMATION/DILATATION, STENT PLACEMENT AND ALL ASSOCIATED IMAGING G"	"104,130.00"	"46,800.00"	"57,330.00"
37184	"PRIMARY PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, NON-CORONARY, ARTERIAL OR ARTERIAL BYPASS GRAFT INCLUDING FLUOROSCOPIC GUIDANCE AND INTRAPROCEDURAL PHARMACOLOGICAL THROMBOLYTIC
INJECTIONS; ONE OR MORE VESSELS"	"90,675.00"	"41,535.00"	"49,140.00"
37187	"PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, VEINS, INCLUDING INTRAPROCEDURAL PHARMACOLOGICAL THROMBOLYTIC INJECTIONS AND FLUOROSCOPIC GUIDANCE; ONE
OR MORE VESSELS"	"90,675.00"	"41,535.00"	"49,140.00"
37200	TRANSCATHETER BIOPSY	"16,107.00"	"9,555.00"	"6,552.00"
37201	"TRANSCATHETER THERAPY, INFUSION FOR THROMBOLYSIS
OTHER THAN CORONARY"	"15,639.00"	"10,725.00"	"4,914.00"
37202	"TRANSCHATHETER THERAPY, INFUSION OTHER THAN FOR
THROMBOLYSIS, ANY TYPE (E.G., SPASMOLYTIC, VASOCONSTRICTIVE)"	"15,639.00"	"10,725.00"	"4,914.00"
37203	"TRANSCATHETER RETRIEVAL, PERCUTANEOUS, OF INTRAVASCULAR FOREIGN BODY (E.G., FRACTURED VENOUS OR
ARTERIAL CATHETER)"	"18,915.00"	"10,725.00"	"8,190.00"
37204	"TRANSCATHETER OCCLUSION OR EMBOLIZATION (E.G., FOR TUMOR DESTRUCTION, TO ACHIEVE HEMOSTASIS, TO OCCLUDE A VASCULAR MALFORMATION), PERCUTANEOUS, ANY METHOD, NON CENTRAL NERVOUS SYSTEM, NON-HEAD OR NECK"	"90,675.00"	"41,535.00"	"49,140.00"
37205	"TRANSCATHETER PLACEMENT OF AN INTRAVASCULAR STENT(S), (NON-CORONARY VESSEL), PERCUTANEOUS; INITIAL VESSEL"	"90,675.00"	"41,535.00"	"49,140.00"
37207	"TRANSCATHETER PLACEMENT OF AN INTRAVASCULAR STENT(S), (NON-CORONARY VESSEL), OPEN; INITIAL VESSEL"	"45,435.00"	"20,865.00"	"24,570.00"
37565	"LIGATION, INTERNAL JUGULAR VEIN"	"11,076.00"	"7,800.00"	"3,276.00"
37600	LIGATION; EXTERNAL CAROTID ARTERY	"11,076.00"	"7,800.00"	"3,276.00"
37605	LIGATION; INTERNAL OR COMMON CAROTID ARTERY	"35,100.00"	"18,720.00"	"16,380.00"
37606	"LIGATION; INTERNAL OR COMMON CAROTID ARTERY, W/ GRADUAL OCCLUSION, AS W/ SELVERSTONE OR CRUTCHFIELD
CAMP"	"42,783.00"	"24,765.00"	"18,018.00"
37607	"LIGATION OR BANDING OF ANGIOACCESS ARTERIOVENOUS
FISTULA"	"18,135.00"	"14,040.00"	"4,095.00"
37609	"LIGATION OR BIOPSY, TEMPORAL ARTERY"	"18,135.00"	"14,040.00"	"4,095.00"
37615	"LIGATION, MAJOR ARTERY (E.G., POST-TRAUMATIC, RUPTURE);
NECK"	"35,100.00"	"18,720.00"	"16,380.00"
37616	"LIGATION, MAJOR ARTERY (E.G., POST-TRAUMATIC, RUPTURE);
CHEST"	"41,730.00"	"21,255.00"	"20,475.00"
37617	"LIGATION, MAJOR ARTERY (E.G., POST-TRAUMATIC, RUPTURE);
ABDOMEN"	"35,100.00"	"18,720.00"	"16,380.00"
37618	"LIGATION, MAJOR ARTERY (E.G., POST-TRAUMATIC, RUPTURE);
EXTREMITY"	"25,155.00"	"12,870.00"	"12,285.00"
37620	"INTERRUPTION, PARTIAL OR COMPLETE, OF INFERIOR VENA CAVA BY SUTURE, LIGATION, PLICATION, CLIP, EXTRAVASCULAR,
INTRAVASCULAR (UMBRELLA DEVICE)"	"45,435.00"	"20,865.00"	"24,570.00"
37650	LIGATION OF FEMORAL VEIN	"18,135.00"	"14,040.00"	"4,095.00"
37660	LIGATION OF COMMON ILIAC VEIN	"25,155.00"	"12,870.00"	"12,285.00"
37700	"LIGATION AND DIVISION OF LONG SAPHENOUS VEIN AT
SAPHENOFEMORAL JUNCTION, OR DISTAL INTERRUPTIONS"	"18,135.00"	"14,040.00"	"4,095.00"
37720	"LIGATION AND DIVISION AND COMPLETE STRIPPING OF LONG OR
SHORT SAPHENOUS VEINS"	"25,155.00"	"12,870.00"	"12,285.00"
37730	"LIGATION AND DIVISION AND COMPLETE STRIPPING OF LONG AND
SHORT SAPHENOUS VEINS"	"35,100.00"	"18,720.00"	"16,380.00"
37735	"LIGATION AND DIVISION AND COMPLETE STRIPPING OF LONG OR SHORT SAPHENOUS VEINS W/ RADICAL EXCISION OF ULCER AND SKIN GRAFT AND/OR INTERRUPTION OF COMMUNICATING VEINS OF LOWER LEG, W/ EXCISION OF DEEP FASCIA"	"41,730.00"	"21,255.00"	"20,475.00"
37760	"LIGATION OF PERFORATORS, SUBFASCIAL, RADICAL (LINTON
TYPE), W/ OR W/O SKIN GRAFT"	"41,730.00"	"21,255.00"	"20,475.00"
37780	"LIGATION AND DIVISION OF SHORT SAPHENOUS VEIN AT
SAPHENOPOPLITEAL JUNCTION"	"18,915.00"	"10,725.00"	"8,190.00"
37788	"PENILE REVASCULARIZATION, ARTERY, W/ OR W/O VEIN GRAFT"	"90,675.00"	"41,535.00"	"49,140.00"
37790	PENILE VENOUS OCCLUSIVE PROCEDURE	"45,435.00"	"20,865.00"	"24,570.00"
38100	SPLENECTOMY; TOTAL	"59,943.00"	"33,735.00"	"26,208.00"
38101	SPLENECTOMY; PARTIAL	"45,435.00"	"20,865.00"	"24,570.00"
38102	"SPLENECTOMY; TOTAL, EN BLOC FOR EXTENSIVE DISEASE, IN
CONJUCTION W/ OTHER PROCEDURE"	"62,400.00"	"33,735.00"	"28,665.00"
38115	"REPAIR OF RUPTURED SPLEEN (SPLENORRHAPHY) W/ OR W/O
PARTIAL SPLENECTOMY"	"59,085.00"	"26,325.00"	"32,760.00"
38120	"LAPAROSCOPY, SURGICAL; SPLENECTOMY"	"59,943.00"	"33,735.00"	"26,208.00"
38205	"BLOOD-DERIVED HEMATOPOIETIC PROGENITOR CELL
HARVESTING FOR TRANSPLANTATION"	"21,216.00"	"13,845.00"	"7,371.00"
38220	BONE MARROW ASPIRATION AND/OR BIOPSY	"21,216.00"	"13,845.00"	"7,371.00"
38230	BONE MARROW HARVESTING FOR TRANSPLANTATION	"35,100.00"	"18,720.00"	"16,380.00"
38240	"BONE MARROW OR PERIPHERAL BLOOD DERIVED PERIPHERAL
STEM CELL TRANSPLANTATION"	"73,710.00"	"32,760.00"	"40,950.00"
38300	DRAINAGE OF LYMPH NODE ABSCESS OR LYMPHADENITIS	"16,107.00"	"9,555.00"	"6,552.00"
38380	"SUTURE AND/OR LIGATION OF THORACIC DUCT; CERVICAL
APPROACH"	"59,085.00"	"26,325.00"	"32,760.00"
38381	"SUTURE AND/OR LIGATION OF THORACIC DUCT; THORACIC
APPROACH"	"59,085.00"	"26,325.00"	"32,760.00"
38382	"SUTURE AND/OR LIGATION OF THORACIC DUCT; ABDOMINAL
APPROACH"	"59,085.00"	"26,325.00"	"32,760.00"
38500	BIOPSY OR EXCISION OR LYMPH NODE(S); SUPERFICIAL	"11,076.00"	"7,800.00"	"3,276.00"
38505	"BIOPSY OR EXCISION OR LYMPH NODE(S); BY NEEDLE,
SUPERFICIAL (E.G., CERVICAL, INGUINAL, AXILLARY)"	"11,076.00"	"7,800.00"	"3,276.00"
38510	"BIOPSY OR EXCISION OR LYMPH NODE(S); DEEP CERVICAL
NODE(S)"	"16,107.00"	"9,555.00"	"6,552.00"
38520	"BIOPSY OR EXCISION OR LYMPH NODE(S); DEEP CERVICAL
NODE(S) W/ EXCISION SCALENE FAT PAD"	"18,135.00"	"14,040.00"	"4,095.00"
38525	"BIOPSY OR EXCISION OR LYMPH NODE(S); DEEP AXILLARY
NODE(S)"	"18,135.00"	"14,040.00"	"4,095.00"
38530	"BIOPSY OR EXCISION OR LYMPH NODE(S); INTERNAL MAMMARY
NODE(S)"	"18,135.00"	"14,040.00"	"4,095.00"
38542	"DISSECTION, DEEP JUGULAR NODE(S)"	"42,783.00"	"24,765.00"	"18,018.00"
38550	"EXCISION OF CYSTIC HYGROMA, AXILLARY OR CERVICAL; W/O
DEEP NEUROVASCULAR DISSECTION"	"73,710.00"	"32,760.00"	"40,950.00"
38555	"EXCISION OF CYSTIC HYGROMA, AXILLARY OR CERVICAL; W/ DEEP
NEUROVASCULAR DISSECTION"	"90,675.00"	"41,535.00"	"49,140.00"
38570	"LAPAROSCOPY, SURGICAL; WITH RETROPERITONEAL LYMPH
NODE SAMPLING (BIOPSY), SINGLE OR MULTIPLE"	"52,884.00"	"23,400.00"	"29,484.00"
38571	"LAPAROSCOPY, SURGICAL; WITH BILATERAL TOTAL PELVIC
LYMPHADENECTOMY"	"59,085.00"	"26,325.00"	"32,760.00"
38572	"LAPAROSCOPY, SURGICAL; WITH BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PERI-AORTIC LYMPH NODE SAMPLING
(BIOPSY), SINGLE OR MULTIPLE"	"114,660.00"	"40,950.00"	"73,710.00"
38700	SUPRAHYOID LYMPHADENECTOMY	"52,884.00"	"23,400.00"	"29,484.00"
38720	CERVICAL LYMPHADENECTOMY (COMPLETE)	"59,085.00"	"26,325.00"	"32,760.00"
38724	"CERVICAL LYMPHADENECTOMY (MODIFIED RADICAL NECK
DISSECTION)"	"59,085.00"	"26,325.00"	"32,760.00"
38740	AXILLARY LYMPHADENECTOMY; SUPERFICIAL	"45,435.00"	"20,865.00"	"24,570.00"
38745	AXILLARY LYMPHADENECTOMY; COMPLETE	"59,085.00"	"26,325.00"	"32,760.00"
38746	"THORACIC LYMPHADENECTOMY, REGIONAL, INCLUDING
MEDIASTINAL AND PERITRACHEAL NODES"	"73,710.00"	"32,760.00"	"40,950.00"
38747	"ABDOMINAL LYMPHADENECTOMY, REGIONAL, INCLUDING
CELIAC, PARA-AORTIC AND VENAL CAVAL NODES"	"45,435.00"	"20,865.00"	"24,570.00"
38760	"INGUINOFEMORAL LYMPHADENECTOMY, SUPERFICIAL,
INCLUDING CLOQUETS NODE"	"45,435.00"	"20,865.00"	"24,570.00"
38765	"INGUINOFEMORAL LYMPHADENECTOMY, SUPERFICIAL, IN CONTINUITY W/ PELVIC LYMPHADENECTOMY, INCLUDING
EXTERNAL ILIAC, HYPOGASTRIC, AND OBTURATOR NODES"	"45,435.00"	"20,865.00"	"24,570.00"
38770	"PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIAC,
HYPOGASTRIC, AND OBTURATOR NODES"	"73,710.00"	"32,760.00"	"40,950.00"
38780	"RETROPERITONEAL TRANSABDOMINAL LYMPHADENECTOMY, EXTENSIVE, INCLUDING PELVIC, AORTIC, AND RENAL NODES"	"73,710.00"	"32,760.00"	"40,950.00"
39000	"MEDIASTINOTOMY WITH EXPLORATION, DRAINAGE, REMOVAL OF FOREIGN BODY, OR BIOPSY; CERVICAL APPROACH"	"35,100.00"	"18,720.00"	"16,380.00"
39010	"TRANSTHORACIC APPROACH, INCLUDING EITHER
TRANSTHORACIC OR MEDIAN STERNOTOMY"	"45,435.00"	"20,865.00"	"24,570.00"
39200	EXCISION OF MEDIASTINAL CYST	"73,710.00"	"32,760.00"	"40,950.00"
39220	EXCISION OF MEDIASTINAL TUMOR	"80,262.00"	"32,760.00"	"47,502.00"
39400	"MEDIASTINOSCOPY, WITH OR WITHOUT BIOPSY"	"29,172.00"	"14,430.00"	"14,742.00"
39501	"REPAIR, LACERATION OF DIAPHRAGM, ANY APPROACH"	"73,710.00"	"32,760.00"	"40,950.00"
39502	"REPAIR, PARAESOPHAGEAL HIATUS HERNIA, TRANSABDOMINAL, WITH OR WITHOUT FUNDOPLASTY, VAGOTOMY, AND/OR
PYLOROPLASTY, EXCEPT NEONATAL"	"78,624.00"	"32,760.00"	"45,864.00"
39503	"REPAIR, NEONATAL DIAPHRAGMATIC HERNIA, WITH OR WITHOUT CHEST TUBE INSERTION AND WITH OR WITHOUT CREATION OF
VENTRAL HERNIA"	"78,624.00"	"32,760.00"	"45,864.00"
39520	"REPAIR, DIAPHRAGMATIC HERNIA (ESOPHAGEAL HIATAL);
TRANSTHORACIC"	"78,624.00"	"32,760.00"	"45,864.00"
39530	"REPAIR, DIAPHRAGMATIC HERNIA (ESOPHAGEAL HIATAL);
COMBINED, THORACOABDOMINAL"	"78,624.00"	"32,760.00"	"45,864.00"
39531	"REPAIR, DIAPHRAGMATIC HERNIA (ESOPHAGEAL HIATAL); COMBINED, THORACOABDOMINAL, WITH DILATION OF STRICTURE
(WITH OR WITHOUT GASTROPLASTY)"	"78,624.00"	"32,760.00"	"45,864.00"
39540	"REPAIR, DIAPHRAGMATIC HERNIA (OTHER THAN NEONATAL),
TRAUMATIC; ACUTE"	"78,624.00"	"32,760.00"	"45,864.00"
39541	"REPAIR, DIAPHRAGMATIC HERNIA (OTHER THAN NEONATAL),
TRAUMATIC; CHRONIC"	"90,675.00"	"41,535.00"	"49,140.00"
39545	"IMBRICATION OF DIAPHRAGM FOR EVENTRATION, TRANSTHORACIC OR TRANSABDOMINAL, PARALYTIC OR
NONPARALYTIC"	"78,624.00"	"32,760.00"	"45,864.00"
40490	BIOPSY OF LIP	"10,842.00"	"8,385.00"	"2,457.00"
40500	"VERMILIONECTOMY (LIP SHAVE), W/ MUCOSAL ADVANCEMENT"	"15,639.00"	"10,725.00"	"4,914.00"
40510	"EXCISION OF LIP; TRANSVERSE WEDGE EXCISION W/ PRIMARY
CLOSURE"	"15,639.00"	"10,725.00"	"4,914.00"
40520	V-EXCISION W/ PRIMARY DEFECT LINEAR CLOSURE;	"15,639.00"	"10,725.00"	"4,914.00"
40525	"V-EXCISION W/ PRIMARY DEFECT LINEAR CLOSURE; FULL THICKNESS, RECONSTRUCTION W/ LOCAL FLAP (E.G., ESTLANDER
OR FAN)"	"45,435.00"	"20,865.00"	"24,570.00"
40527	"V-EXCISION W/ PRIMARY DEFECT LINEAR CLOSURE; FULL
THICKNESS, RECONSTRUCTION W/ CROSS LIP FLAP (ABBE- ESTLANDER)"	"59,943.00"	"33,735.00"	"26,208.00"
40530	"RESECTION OF LIP, MORE THAN ONE-FOURTH, W/O
RECONSTRUCTION"	"16,107.00"	"9,555.00"	"6,552.00"
40650	"REPAIR LIP, FULL THICKNESS; VERMILION ONLY"	"18,915.00"	"10,725.00"	"8,190.00"
40652	"REPAIR LIP, FULL THICKNESS; UP TO HALF VERTICAL HEIGHT"	"18,915.00"	"10,725.00"	"8,190.00"
40654	"REPAIR LIP, FULL THICKNESS; OVER ONE-HALF VERTICAL
HEIGHT, OR COMPLEX"	"18,915.00"	"10,725.00"	"8,190.00"
40700	"PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; PRIMARY,
PARTIAL OR COMPLETE, UNILATERAL"	"73,710.00"	"32,760.00"	"40,950.00"
40701	"PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; PRIMARY
BILATERAL, ONE STAGE PROCEDURE"	"73,710.00"	"32,760.00"	"40,950.00"
40702	"PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; PRIMARY
BILATERAL, ONE OF TWO STAGES"	"59,085.00"	"26,325.00"	"32,760.00"
40720	"PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; SECONDARY,
BY RECREATION OF DEFECT AND RECLOSURE"	"59,085.00"	"26,325.00"	"32,760.00"
40761	"PLASTIC REPAIR OF CLEFT LIP/NASAL DEFORMITY; W/ CROSS LIP PEDICLE FLAP (ABBE-ESTLANDER TYPE), INCLUDING SECTIONING
AND INSERTING OF PEDICLE"	"73,710.00"	"32,760.00"	"40,950.00"
40800	"DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OF MOUTH"	"11,076.00"	"7,800.00"	"3,276.00"
40808	"BIOPSY, VESTIBULE OF MOUTH"	"11,076.00"	"7,800.00"	"3,276.00"
40810	"EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE
OF MOUTH"	"11,076.00"	"7,800.00"	"3,276.00"
40818	EXCISION OF MUCOSA OF VESTIBULE OF MOUTH AS DONOR GRAFT	"16,458.00"	"10,725.00"	"5,733.00"
40819	"EXCISION OF FRENUM, LABIAL OR BUCCAL (FRENUMECTOMY,
FRENULECTOMY, FRENECTOMY)"	"18,135.00"	"14,040.00"	"4,095.00"
40830	"CLOSURE OF LACERATION, VESTIBULE OF MOUTH; 2.5 CM OR LESS"	"11,076.00"	"7,800.00"	"3,276.00"
40831	"CLOSURE OF LACERATION, VESTIBULE OF MOUTH; OVER 2.5 CM
OR COMPLEX"	"11,076.00"	"7,800.00"	"3,276.00"
40840	VESTIBULOPLASTY; ANTERIOR	"23,634.00"	"10,530.00"	"13,104.00"
40842	"VESTIBULOPLASTY; POSTERIOR, UNILATERAL"	"23,634.00"	"10,530.00"	"13,104.00"
40843	"VESTIBULOPLASTY; POSTERIOR, BILATERAL"	"23,634.00"	"10,530.00"	"13,104.00"
40844	VESTIBULOPLASTY; ENTIRE ARCH	"35,100.00"	"18,720.00"	"16,380.00"
40845	"VESTIBULOPLASTY; COMPLEX (INCLUDING RIDGE EXTENSION,
MUSCLE REPOSITIONING)"	"35,100.00"	"18,720.00"	"16,380.00"
41000	"INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH; LINGUAL"	"11,076.00"	"7,800.00"	"3,276.00"
41005	"INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR
HEMATOMA OF TONGUE OR FLOOR OF MOUTH; SUBLINGUAL, SUPERFICIAL"	"11,076.00"	"7,800.00"	"3,276.00"
41006	"INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR
HEMATOMA OF TONGUE OR FLOOR OF MOUTH; SUBLINGUAL, DEEP, SUPRAMYLOHYOID"	"11,076.00"	"7,800.00"	"3,276.00"
41007	"INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR
HEMATOMA OF TONGUE OR FLOOR OF MOUTH; SUBMENTAL SPACE"	"11,076.00"	"7,800.00"	"3,276.00"
41008	"INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR
HEMATOMA OF TONGUE OR FLOOR OF MOUTH; SUBMANDIBULAR SPACE"	"11,076.00"	"7,800.00"	"3,276.00"
41009	"INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH; MASTICATOR
SPACE"	"11,076.00"	"7,800.00"	"3,276.00"
41015	"EXTRAORAL INCISION AND DRAINAGE OF ABSCESS,CYST,OR
HEMATOMA OF FLOOR OF MOUTH; SUBLINGUAL"	"11,076.00"	"7,800.00"	"3,276.00"
41016	"EXTRAORAL INCISION AND DRAINAGE OF ABSCESS,CYST,OR
HEMATOMA OF FLOOR OF MOUTH; SUBMENTAL"	"11,076.00"	"7,800.00"	"3,276.00"
41017	"EXTRAORAL INCISION AND DRAINAGE OF ABSCESS,CYST,OR
HEMATOMA OF FLOOR OF MOUTH; SUBMANDIBULAR"	"11,076.00"	"7,800.00"	"3,276.00"
41018	"EXTRAORAL INCISION AND DRAINAGE OF ABSCESS,CYST,OR
HEMATOMA OF FLOOR OF MOUTH; MASTICATOR SPACE"	"11,076.00"	"7,800.00"	"3,276.00"
41100	BIOPSY OF TONGUE; ANTERIOR TWO-THIRDS	"10,842.00"	"8,385.00"	"2,457.00"
41105	BIOPSY OF TONGUE; POSTERIOR ONE-THIRD	"10,842.00"	"8,385.00"	"2,457.00"
41108	BIOPSY OF FLOOR OF MOUTH	"10,842.00"	"8,385.00"	"2,457.00"
41110	EXCISION OF LESION OF TONGUE W/O CLOSURE	"18,135.00"	"14,040.00"	"4,095.00"
41112	"EXCISION OF LESION OF TONGUE W/ CLOSURE; ANTERIOR TWO-
THIRDS"	"18,135.00"	"14,040.00"	"4,095.00"
41113	"EXCISION OF LESION OF TONGUE W/ CLOSURE; POSTERIOR ONE-
THIRD"	"18,135.00"	"14,040.00"	"4,095.00"
41114	"EXCISION OF LESION OF TONGUE W/ CLOSURE; W/ LOCAL TONGUE
FLAP"	"18,135.00"	"14,040.00"	"4,095.00"
41115	EXCISION OF LINGUAL FRENUM (FRENECTOMY)	"18,135.00"	"14,040.00"	"4,095.00"
41116	"EXCISION, LESION OF FLOOR OF MOUTH"	"18,135.00"	"14,040.00"	"4,095.00"
41120	GLOSSECTOMY; LESS THAN ONE-HALF TONGUE	"16,107.00"	"9,555.00"	"6,552.00"
41130	GLOSSECTOMY; HEMIGLOSSECTOMY	"21,216.00"	"13,845.00"	"7,371.00"
41135	"GLOSSECTOMY; PARTIAL, W/ UNILATERAL RADICAL NECK
DISSECTION"	"73,710.00"	"32,760.00"	"40,950.00"
41140	"GLOSSECTOMY; COMPLETE OR TOTAL, W/ OR W/O
TRACHEOSTOMY, W/O RADICAL NECK DISSECTION"	"73,710.00"	"32,760.00"	"40,950.00"
41145	"GLOSSECTOMY; COMPLETE OR TOTAL, W/ OR W/O TRACHEOSTOMY, W/ UNILATERAL RADICAL NECK DISSECTION"	"73,710.00"	"32,760.00"	"40,950.00"
41150	"GLOSSECTOMY; COMPOSITE PROCEDURE W/ RESECTION FLOOR
OF MOUTH AND MANDIBULAR RESECTION, W/O RADICAL NECK DISSECTION"	"78,624.00"	"32,760.00"	"45,864.00"
41153	"GLOSSECTOMY; COMPOSITE PROCEDURE W/ RESECTION FLOOR
OF MOUTH, W/ SUPRAHYOID NECK DISSECTION"	"90,675.00"	"41,535.00"	"49,140.00"
41155	"GLOSSECTOMY; COMPOSITE PROCEDURE W/ RESECTION FLOOR
OF MOUTH, MANDIBULAR RESECTION, AND RADICAL NECK DISSECTION (COMMANDO TYPE)"	"104,130.00"	"46,800.00"	"57,330.00"
41250	"REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH
AND/OR ANTERIOR TWO-THIRDS OF TONGUE"	"18,915.00"	"10,725.00"	"8,190.00"
41251	"REPAIR OF LACERATION 2.5 CM OR LESS; POSTERIOR ONE-THIRD
OF TONGUE"	"18,915.00"	"10,725.00"	"8,190.00"
41252	"REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6
CM OR COMPLEX"	"18,915.00"	"10,725.00"	"8,190.00"
41500	"FRENOPLASTY (SURGICAL REVISION OF FRENUM, EG, W/ Z-
PLASTY)"	"18,915.00"	"10,725.00"	"8,190.00"
41510	"SUTURE OF TONGUE TO LIP FOR MICROGNATHIA (DOUGLAS TYPE
PROCEDURE)"	"18,915.00"	"10,725.00"	"8,190.00"
41520	"FRENOPLASTY (SURGICAL REVISION OF FRENUM, EG, W/ Z-
PLASTY)"	"18,915.00"	"10,725.00"	"8,190.00"
41800	"DRAINAGE OF ABSCESS, CYST, HEMATOMA FROM
DENTOALVEOLAR STRUCTURES"	"11,076.00"	"7,800.00"	"3,276.00"
41805	"REMOVAL OF EMBEDDED FOREIGN BODY FROM DENTOALVEOLAR
STRUCTURES; SOFT TISSUES"	"7,098.00"	"5,460.00"	"1,638.00"
41806	"REMOVAL OF EMBEDDED FOREIGN BODY FROM DENTOALVEOLAR
STRUCTURES; BONE"	"7,098.00"	"5,460.00"	"1,638.00"
41820	"GINGIVECTOMY, EXCISION GINGIVA"	"15,639.00"	"10,725.00"	"4,914.00"
41821	"OPERCULECTOMY, EXCISION PERICORONAL TISSUES"	"15,639.00"	"10,725.00"	"4,914.00"
41822	"EXCISION OF FIBROUS TUBEROSITIES, DENTOALVEOLAR
STRUCTURES"	"15,639.00"	"10,725.00"	"4,914.00"
41823	"EXCISION OF OSSEOUS TUBEROSITIES, DENTOALVEOLAR
STRUCTURES"	"15,639.00"	"10,725.00"	"4,914.00"
41825	"EXCISION OF LESION OR OR TUMOR (EXCEPT LISTED ABOVE),
DENTOALVEOLAR STRUCTURES"	"15,639.00"	"10,725.00"	"4,914.00"
41828	EXCISION OF HYPERPLASTIC ALVEOLAR MUCOSA	"15,639.00"	"10,725.00"	"4,914.00"
41830	"ALVEOLECTOMY, INCLUDING CURETTAGE OF OSTEITIS OR
SEQUESTRECTOMY"	"16,107.00"	"9,555.00"	"6,552.00"
41850	"DESTRUCTION OF LESION (EXCEPT EXCISION), DENTOALVEOLAR
STRUCTURES"	"16,107.00"	"9,555.00"	"6,552.00"
41870	PERIODONTAL MUCOSAL GRAFTING	"16,107.00"	"9,555.00"	"6,552.00"
41872	GINGIVOPLASTY	"35,100.00"	"18,720.00"	"16,380.00"
41874	ALVEOLOPLASTY	"35,100.00"	"18,720.00"	"16,380.00"
42000	"DRAINAGE OF ABSCESS OF PALATE, UVULA"	"15,639.00"	"10,725.00"	"4,914.00"
42100	"BIOPSY OF PALATE, UVULA"	"10,842.00"	"8,385.00"	"2,457.00"
42104	"EXCISION, LESION  OF PALATE , UVULA; W/O CLOSURE"	"11,076.00"	"7,800.00"	"3,276.00"
42106	"EXCISION, LESION  OF PALATE , UVULA; W/ SIMPLE PRIMARY
CLOSURE"	"18,135.00"	"14,040.00"	"4,095.00"
42107	"EXCISION, LESION  OF PALATE , UVULA; W/ LOCAL FLAP CLOSURE"	"18,135.00"	"14,040.00"	"4,095.00"
42120	RESECTION OF PALATE OR EXTENSIVE RESECTION OF LESION	"40,911.00"	"21,255.00"	"19,656.00"
42140	"UVULECTOMY, EXCISION OF UVULA"	"23,634.00"	"10,530.00"	"13,104.00"
42145	"PALATOPHARYNGOPLASTY (E.G., UVULOPALATOPHARYNGOPLASTY, UVULOPHARYNGOPLASTY)"	"45,435.00"	"20,865.00"	"24,570.00"
42160	"DESTRUCTION OF LESION, PALATE OR UVULA (THERMAL, CRYO OR
CHEMICAL)"	"20,553.00"	"10,725.00"	"9,828.00"
42180	"REPAIR, LACERATION OF PALATE; UP TO 2 CM"	"23,634.00"	"10,530.00"	"13,104.00"
42182	"REPAIR, LACERATION OF PALATE; OVER 2 CM OR COMPLEX"	"35,100.00"	"18,720.00"	"16,380.00"
42200	"PALATOPLASTY FOR CLEFT PALATE, SOFT AND/OR HARD PALATE
ONLY"	"40,911.00"	"21,255.00"	"19,656.00"
42205	"PALATOPLASTY FOR CLEFT PALATE, W/ CLOSURE OF ALVEOLAR
RIDGE; SOFT TISSUE ONLY"	"42,549.00"	"21,255.00"	"21,294.00"
42210	"PALATOPLASTY FOR CLEFT PALATE, W/ CLOSURE OF ALVEOLAR RIDGE; W/ BONE GRAFT TO ALVEOLAR RIDGE (INCLUDES
OBTAINING GRAFT)"	"44,187.00"	"21,255.00"	"22,932.00"
42215	PALATOPLASTY FOR CLEFT PALATE; MAJOR REVISION	"45,435.00"	"20,865.00"	"24,570.00"
42220	"PALATOPLASTY FOR CLEFT PALATE; SECONDARY LENGTHENING
PROCEDURE"	"45,435.00"	"20,865.00"	"24,570.00"
42225	"PALATOPLASTY FOR CLEFT PALATE; ATTACHMENT PHARYNGEAL
FLAP"	"59,943.00"	"33,735.00"	"26,208.00"
42226	"LENGTHENING OF PALATE, AND PHARYNGEAL FLAP"	"45,435.00"	"20,865.00"	"24,570.00"
42227	"LENGTHENING OF PALATE, W/ ISLAND FLAP"	"45,435.00"	"20,865.00"	"24,570.00"
42235	"REPAIR OF ANTERIOR PALATE, INCLUDING VOMER FLAP"	"45,435.00"	"20,865.00"	"24,570.00"
42260	REPAIR OF NASOLABIAL FISTULA	"23,634.00"	"10,530.00"	"13,104.00"
42300	DRAINAGE OF ABSCESS; PAROTID	"11,076.00"	"7,800.00"	"3,276.00"
42310	"DRAINAGE OF ABSCESS; SUBMAXILLARY OR SUBLINGUAL,
INTRAORAL"	"11,076.00"	"7,800.00"	"3,276.00"
42320	"DRAINAGE OF ABSCESS; SUBMAXILLARY, EXTERNAL"	"11,076.00"	"7,800.00"	"3,276.00"
42325	FISTULIZATION OF SUBLINGUAL SALIVARY CYST (RANULA);	"11,076.00"	"7,800.00"	"3,276.00"
42326	"FISTULIZATION OF SUBLINGUAL SALIVARY CYST (RANULA); W/
PROSTHESIS"	"18,135.00"	"14,040.00"	"4,095.00"
42330	"SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAXILLARY),
SUBLINGUAL OR PAROTID, INTRAORAL"	"18,135.00"	"14,040.00"	"4,095.00"
42400	BIOPSY OF SALIVARY GLAND; NEEDLE	"10,842.00"	"8,385.00"	"2,457.00"
42405	BIOPSY OF SALIVARY GLAND; INCISIONAL	"10,842.00"	"8,385.00"	"2,457.00"
42408	EXCISION OF SUBLINGUAL SALIVARY CYST (RANULA)	"18,135.00"	"14,040.00"	"4,095.00"
42409	MARSUPIALIZATION OF SUBLINGUAL SALIVARY CYST (RANULA)	"18,135.00"	"14,040.00"	"4,095.00"
42410	"EXCISION OF PAROTID TUMOR OR PAROTID GLAND; LATERAL
LOBE, W/O NERVE DISSECTION"	"45,435.00"	"20,865.00"	"24,570.00"
42415	"EXCISION OF PAROTID TUMOR OR PAROTID GLAND; LATERAL LOBE, W/ DISSECTION AND PRESERVATION OF FACIAL NERVE"	"59,085.00"	"26,325.00"	"32,760.00"
42420	"EXCISION OF PAROTID TUMOR OR PAROTID GLAND; TOTAL, W/ DISSECTION AND PRESERVATION OF FACIAL NERVE"	"59,085.00"	"26,325.00"	"32,760.00"
42425	"EXCISION OF PAROTID TUMOR OR PAROTID GLAND; TOTAL, EN BLOC REMOVAL W/ SACRIFICE OF FACIAL NERVE"	"59,085.00"	"26,325.00"	"32,760.00"
42426	"EXCISION OF PAROTID TUMOR OR PAROTID GLAND; TOTAL, W/
UNILATERAL RADICAL NECK DISSECTION"	"73,710.00"	"32,760.00"	"40,950.00"
42440	EXCISION OF SUBMANDIBULAR (SUBMAXILLARY) GLAND	"35,100.00"	"18,720.00"	"16,380.00"
42450	EXCISION OF SUBLINGUAL GLAND	"35,100.00"	"18,720.00"	"16,380.00"
42500	"PLASTIC REPAIR OF SALIVARY DUCT, SIALODOCHOPLASTY;
PRIMARY OR SIMPLE"	"35,100.00"	"18,720.00"	"16,380.00"
42505	"PLASTIC REPAIR OF SALIVARY DUCT, SIALODOCHOPLASTY;
SECONDARY OR COMPLICATED"	"35,100.00"	"18,720.00"	"16,380.00"
42507	"PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE
PROCEDURE);"	"35,100.00"	"18,720.00"	"16,380.00"
42508	"PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROCEDURE); W/ EXCISION OF ONE SUBMANDIBULAR GLAND"	"35,100.00"	"18,720.00"	"16,380.00"
42509	"PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROCEDURE); W/ EXCISION OF BOTH SUBMANDIBULAR GLANDS"	"35,100.00"	"18,720.00"	"16,380.00"
42510	"PAROTID DUCT DIVERSION, BILATERAL (WILKE TYPE PROCEDURE); W/ LIGATION OF BOTH SUBMANDIBULAR
(WHARTONS) DUCTS"	"35,100.00"	"18,720.00"	"16,380.00"
42600	CLOSURE SALIVARY FISTULA	"16,107.00"	"9,555.00"	"6,552.00"
42665	"LIGATION SALIVARY DUCT, INTRAORAL"	"16,107.00"	"9,555.00"	"6,552.00"
42700	INCISION AND DRAINAGE ABSCESS; PERITONSILLAR	"16,107.00"	"9,555.00"	"6,552.00"
42720	"INCISION AND DRAINAGE ABSCESS; RETROPHARYNGEAL OR
PARAPHARYNGEAL, INTRAORAL APPROACH"	"16,107.00"	"9,555.00"	"6,552.00"
42725	"INCISION AND DRAINAGE ABSCESS; RETROPHARYNGEAL OR
PARAPHARYNGEAL, EXTERNAL APPROACH"	"16,107.00"	"9,555.00"	"6,552.00"
42800	BIOPSY; OROPHARYNX	"15,639.00"	"10,725.00"	"4,914.00"
42802	BIOPSY; HYPOPHARYNX	"15,639.00"	"10,725.00"	"4,914.00"
42804	"BIOPSY; NASOPHARYNX, VISIBLE LESION, SIMPLE"	"15,639.00"	"10,725.00"	"4,914.00"
42806	"BIOPSY; NASOPHARYNX, SURVEY FOR UNKNOWN PRIMARY
LESION"	"15,639.00"	"10,725.00"	"4,914.00"
42808	"EXCISION OR DESTRUCTION OF LESION OF PHARYNX, ANY
METHOD"	"15,639.00"	"10,725.00"	"4,914.00"
42809	REMOVAL OF FOREIGN BODY FROM PHARYNX	"15,639.00"	"10,725.00"	"4,914.00"
42810	"EXCISION BRANCHIAL CLEFT CYST OR VESTIGE, CONFINED TO
SKIN AND SUBCUTANEOUS TISSUES"	"35,100.00"	"18,720.00"	"16,380.00"
42815	"EXCISION BRANCHIAL CLEFT CYST, VESTIGE, OR FISTULA, EXTENDING BENEATH SUBCUTANEOUS TISSUES AND/OR INTO
PHARYNX"	"35,100.00"	"18,720.00"	"16,380.00"
42820	TONSILLECTOMY AND ADENOIDECTOMY	"35,100.00"	"18,720.00"	"16,380.00"
42825	"TONSILLECTOMY, PRIMARY OR SECONDARY"	"35,100.00"	"18,720.00"	"16,380.00"
42830	"ADENOIDECTOMY, PRIMARY"	"35,100.00"	"18,720.00"	"16,380.00"
42835	"ADENOIDECTOMY, SECONDARY"	"35,100.00"	"18,720.00"	"16,380.00"
42842	"RADICAL RESECTION OF TONSIL, TONSILLAR PILLARS, AND/OR
RETROMOLAR TRIGONE; W/O CLOSURE"	"20,553.00"	"10,725.00"	"9,828.00"
42844	"RADICAL RESECTION OF TONSIL, TONSILLAR PILLARS, AND/OR RETROMOLAR TRIGONE; CLOSURE W/ LOCAL FLAP (E.G., TONGUE,
BUCCAL)"	"23,634.00"	"10,530.00"	"13,104.00"
42845	"RADICAL RESECTION OF TONSIL, TONSILLAR PILLARS, AND/OR RETROMOLAR TRIGONE; CLOSURE W/ OTHER FLAP"	"23,634.00"	"10,530.00"	"13,104.00"
42860	EXCISION OF TONSIL TAGS	"15,639.00"	"10,725.00"	"4,914.00"
42870	"EXCISION OR DESTRUCTION LINGUAL TONSIL, ANY METHOD"	"15,639.00"	"10,725.00"	"4,914.00"
42890	LIMITED PHARYNGECTOMY	"73,710.00"	"32,760.00"	"40,950.00"
42892	"RESECTION OF LATERAL PHARYNGEAL WALL OR PYRIFORM SINUS, DIRECT CLOSURE BY ADVANCEMENT OF LATERAL AND POSTERIOR
PHARYNGEAL WALLS"	"90,675.00"	"41,535.00"	"49,140.00"
42894	"RESECTION OF PHARYNGEAL WALL REQUIRING CLOSURE W/
MYOCUTANEOUS FLAP"	"104,130.00"	"46,800.00"	"57,330.00"
42900	SUTURE PHARYNX FOR WOUND OR INJURY	"40,911.00"	"21,255.00"	"19,656.00"
42950	"PHARYNGOPLASTY (PLASTIC OR RECONSTRUCTIVE OPERATION ON
PHARYNX)"	"40,911.00"	"21,255.00"	"19,656.00"
42953	PHARYNGOESOPHAGEAL REPAIR	"45,435.00"	"20,865.00"	"24,570.00"
42955	"PHARYNGOSTOMY (FISTULIZATION OF PHARYNX, EXTERNAL FOR
FEEDING)"	"15,639.00"	"10,725.00"	"4,914.00"
43020	"ESOPHAGOTOMY, CERVICAL APPROACH, W/ REMOVAL OF
FOREIGN BODY"	"23,634.00"	"10,530.00"	"13,104.00"
43030	CRICOPHARYNGEAL MYOTOMY	"35,100.00"	"18,720.00"	"16,380.00"
43045	"ESOPHAGOTOMY, THORACIC APPROACH, W/ REMOVAL OF
FOREIGN BODY"	"73,710.00"	"32,760.00"	"40,950.00"
43100	"EXCISION OF LESION, ESOPHAGUS, W/ PRIMARY REPAIR;
CERVICAL APPROACH"	"45,435.00"	"20,865.00"	"24,570.00"
43101	"EXCISION OF LESION, ESOPHAGUS, W/ PRIMARY REPAIR;
THORACIC OR ABDOMINAL APPROACH"	"73,710.00"	"32,760.00"	"40,950.00"
43107	"TOTAL OR NEAR ESOPHAGECTOMY, W/O THORACOTOMY; W/ PHARYNGOGASTROSTOMY OR CERVICAL ESOPHAGOGASTROSTOMY, W/ OR W/O PYLOROPLASTY
(TRANSHIATAL)"	"107,250.00"	"41,730.00"	"65,520.00"
43108	"TOTAL OR NEAR ESOPHAGECTOMY, W/O THORACOTOMY; W/ COLON INTERPOSITION OR SMALL BOWEL RECONSTRUCTION, INCLUDING BOWEL MOBILIZATION, PREPARATION AND
ANASTOMOSIS(ES)"	"114,660.00"	"40,950.00"	"73,710.00"
43112	"TOTAL OR NEAR TOTAL ESOPHAGECTOMY, W/ THORACOTOMY; W/ PHARYNGOGASTROSTOMY, OR CERVICAL ESOPHAGOGASTROSTOMY, W/ OR W/O PYLOROPLASTY"	"116,298.00"	"40,950.00"	"75,348.00"
43113	"TOTAL OR NEAR TOTAL ESOPHAGECTOMY, W/ THORACOTOMY; W/ COLON INTERPOSITION OR SMALL BOWEL RECONSTRUCTION, INCLUDING BOWEL MOBILIZATION, PREPARATION AND
ANASTOMOSIS(ES)"	"122,850.00"	"40,950.00"	"81,900.00"
43116	"PARTIAL ESOPHAGECTOMY, CERVICAL, W/ FREE INTESTINAL GRAFT, INCLUDING MICROVASCULAR ANASTOMOSIS, OBTAINING THE GRAFT AND INTESTINAL RECONSTRUCTION"	"107,250.00"	"41,730.00"	"65,520.00"
43117	"PARTIAL ESOPHAGECTOMY, DISTAL TWO-THIRDS, W/ THORACOTOMY AND SEPARATE ABDOMINAL INCISION, W/ OR W/O PROXIMAL GASTRECTOMY; W/ THORACIC ESOPHAGOGASTROTOMY, W/ OR W/O PYLOROPLASTY (IVOR
LEWIS)"	"107,250.00"	"41,730.00"	"65,520.00"
43118	"PARTIAL ESOPHAGECTOMY, DISTAL TWO-THIRDS, W/ THORACOTOMY AND SEPARATE ABDOMINAL INCISION, W/ OR W/O PROXIMAL GASTRECTOMY; W/ COLON INTERPOSITION OR SMALL BOWEL RECONSTRUCTION, INCLUDING BOWEL MOBILIZATION, PREPARATION, AND ANASTOMOSIS(SES)"	"114,660.00"	"40,950.00"	"73,710.00"
43121	"PARTIAL ESOPHAGECTOMY, DISTAL TWO-THIRDS, W/ THORACOTOMY ONLY, W/ OR W/O PROXIMAL GASTRECTOMY, W/ THORACIC ESOPHAGOGASTROSTOMY, W/ OR W/O PYLOROPLASTY"	"107,250.00"	"41,730.00"	"65,520.00"
43122	"PARTIAL ESOPHAGECTOMY, THORACOABDOMINAL OR ABDOMINAL APPROACH, W/ OR W/O PROXIMAL GASTRECTOMY; W/ ESOPHAGOGASTROTOMY, W/ OR W/O PYLOROPLASTY"	"107,250.00"	"41,730.00"	"65,520.00"
43123	"PARTIAL ESOPHAGECTOMY, THORACOABDOMINAL OR ABDOMINAL APPROACH, W/ OR W/O PROXIMAL GASTRECTOMY; W/ COLON INTERPOSITION OR SMALL BOWEL RECONSTRUCTION, INCLUDING BOWEL MOBILIZATION, PREPARATION, AND
ANASTOMOSIS(SES)"	"114,660.00"	"40,950.00"	"73,710.00"
43124	"TOTAL OR PARTIAL ESOPHAGECTOMY, W/O RECONSTRUCTION (ANY APPROACH), W/ CERVICAL ESOPHAGOSTOMY"	"90,675.00"	"41,535.00"	"49,140.00"
43130	"DIVERTICULECTOMY OF HYPOPHARYNX, OR ESOPHAGUS, W/ OR
W/O MYOTOMY; CERVICAL APPROACH"	"45,435.00"	"20,865.00"	"24,570.00"
43135	"DIVERTICULECTOMY OF HYPOPHARYNX, OR ESOPHAGUS, W/ OR
W/O MYOTOMY; THORACIC APPROACH"	"73,710.00"	"32,760.00"	"40,950.00"
43200	"ESOPHAGOSCOPY, RIGID OR FLEXIBLE; DIAGNOSTIC, W/ OR W/O COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING"	"20,553.00"	"10,725.00"	"9,828.00"
43202	"ESOPHAGOSCOPY, RIGID OR FLEXIBLE; W/ BIOPSY, SINGLE OR
MULTIPLE"	"20,553.00"	"10,725.00"	"9,828.00"
43204	"ESOPHAGOSCOPY, RIGID OR FLEXIBLE; W/ INJECTION SCLEROSIS
OF ESOPHAGEAL VARICES"	"29,172.00"	"14,430.00"	"14,742.00"
43205	"ESOPHAGOSCOPY, RIGID OR FLEXIBLE; W/ BAND LIGATION OF
ESOPHAGEAL VARICES"	"29,172.00"	"14,430.00"	"14,742.00"
43215	"ESOPHAGOSCOPY, RIGID OR FLEXIBLE; W/ REMOVAL OF FOREIGN
BODY"	"29,172.00"	"14,430.00"	"14,742.00"
43216	"ESOPHAGOSCOPY, RIGID OR FLEXIBLE; W/ REMOVAL OF
TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FORCEPS OR BIPOLAR CAUTERY"	"23,361.00"	"11,895.00"	"11,466.00"
43217	"ESOPHAGOSCOPY, RIGID OR FLEXIBLE; W/ REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE"	"23,634.00"	"10,530.00"	"13,104.00"
43219	"ESOPHAGOSCOPY, RIGID OR FLEXIBLE; W/ INSERTION OF PLASTIC
TUBE OR STENT"	"35,100.00"	"18,720.00"	"16,380.00"
43220	"ESOPHAGOSCOPY, RIGID OR FLEXIBLE; W/ BALLOON DILATION
(LESS THAN 30 MM DIAMETER)"	"35,100.00"	"18,720.00"	"16,380.00"
43226	"ESOPHAGOSCOPY, RIGID OR FLEXIBLE; W/ INSERTION OF GUIDE
WIRE FOLLOWED BY DILATION OVER GUIDE WIRE"	"35,100.00"	"18,720.00"	"16,380.00"
43227	"ESOPHAGOSCOPY, RIGID OR FLEXIBLE; W/ CONTROL OF
BLEEDING, ANY METHOD"	"29,172.00"	"14,430.00"	"14,742.00"
43228	"ESOPHAGOSCOPY, RIGID OR FLEXIBLE; W/ ABLATION OF TUMOR(S) POLYP(S), OR OTHER LESION(S), NOT AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE
TECHNIQUE"	"35,100.00"	"18,720.00"	"16,380.00"
43234	"UPPER GASTROINTESTINAL ENDOSCOPY, SIMPLE PRIMARY EXAMINATION ( E.G. W/ SMALL DIAMETER FLEXIBLE  ENDOSCOPE)"	"20,553.00"	"10,725.00"	"9,828.00"
43235	"UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; DIAGNOSTIC, W/ OR W/O COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING"	"20,553.00"	"10,725.00"	"9,828.00"
43239	"UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; W/ BIOPSY, SINGLE OR MULTIPLE"	"20,553.00"	"10,725.00"	"9,828.00"
43241	"UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; W/ TRANSENDOSCOPIC TUBE OR CATHETER
PLACEMENT"	"23,634.00"	"10,530.00"	"13,104.00"
43243	"UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; W/ INJECTION SCLEROSIS OF ESOPHAGEAL
AND/OR GASTRIC VARICES"	"29,172.00"	"14,430.00"	"14,742.00"
43244	"UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; W/ BAND LIGATION OF ESOPHAGEAL AND/OR
GASTRIC VARICES"	"29,172.00"	"14,430.00"	"14,742.00"
43245	"UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; W/ DILATION OF GASTRIC OUTLET FOR
OBSTRUCTION, ANY METHOD"	"35,100.00"	"18,720.00"	"16,380.00"
43246	"UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; W/ DIRECTED PLACEMENT OF PERCUTANEOUS
GASTROSTOMY TUBE"	"35,100.00"	"18,720.00"	"16,380.00"
43247	"UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; W/ REMOVAL OR FOREIGN BODY"	"29,172.00"	"14,430.00"	"14,742.00"
43248	"UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; W/ INSERTION OF GUIDE WIRE FOLLOWED BY DILATION OF  ESOPHAGUS OVER GUIDE WIRE"	"35,100.00"	"18,720.00"	"16,380.00"
43249	"UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; W/ BALLON DILATION OF ESOPHAGUS (LESS THAN
30 MM DIAMETER)"	"35,100.00"	"18,720.00"	"16,380.00"
43250	"UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; W/ REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FORCEPS OR BIPOLAR CAUTERY"	"23,361.00"	"11,895.00"	"11,466.00"
43251	"UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; W/ REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE"	"23,634.00"	"10,530.00"	"13,104.00"
43255	"UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; W/ CONTROL OF BLEEDING, ANY METHOD"	"29,172.00"	"14,430.00"	"14,742.00"
43258	"UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; W/ ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE"	"35,100.00"	"18,720.00"	"16,380.00"
43259	"UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM AS APPROPRIATE; W/ ENDOSCOPIC ULTRASOUND EXAMINATION"	"29,172.00"	"14,430.00"	"14,742.00"
43260	"ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); DIAGNOSTIC, W/ OR W/O COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING"	"40,911.00"	"21,255.00"	"19,656.00"
43261	"ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); W/ BIOPSY, SINGLE OR MULTIPLE"	"40,911.00"	"21,255.00"	"19,656.00"
43262	ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); W/ SPHINCTEROTOMY/PAPILLOTOMY	"42,549.00"	"21,255.00"	"21,294.00"
43263	ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); W/ PRESSURE MEASUREMENT OF SPHINCTER OF ODDI (PANCREATIC DUCT OR COMMON BILE DUCT)	"42,549.00"	"21,255.00"	"21,294.00"
43264	ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); W/ ENDOSCOPIC RETROGRADE REMOVAL OF STONE(S) FROM BILIARY AND/OR PANCREATIC DUCTS	"45,435.00"	"20,865.00"	"24,570.00"
43265	"ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); W/ ENDOSCOPIC RETROGRADE DESTRUCTION, LITHOTRIPSY OF STONE(S), ANY METHOD"	"59,943.00"	"33,735.00"	"26,208.00"
43267	ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); W/ ENDOSCOPIC RETROGRADE INSERTION OF NASOBILIARY OR NASOPANCREATIC DRAINAGE TUBE	"44,187.00"	"21,255.00"	"22,932.00"
43268	ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); W/ ENDOSCOPIC RETROGRADE INSERTION OF TUBE OR STENT INTO BILE OR PANCREATIC DUCT	"44,187.00"	"21,255.00"	"22,932.00"
43269	ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); W/ ENDOSCOPIC RETROGRADE REMOVAL OF FOREIGN BODY AND/OR CHANGE OF TUBE OR STENT	"44,187.00"	"21,255.00"	"22,932.00"
43271	"ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); W/ ENDOSCOPIC RETROGRADE BALLOON DILATION OF AMPULLA, BILIARY AND/OR PANCREATIC DUCT(S)"	"45,435.00"	"20,865.00"	"24,570.00"
43272	"ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); W/ ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE"	"45,435.00"	"20,865.00"	"24,570.00"
43280	"LAPAROSCOPY, SURGICAL, ESOPHAGOGASTIC FUNDOPLASTY (E.G.,
NISSEN, TOUPET PROCEDURES)"	"90,675.00"	"41,535.00"	"49,140.00"
43300	"ESOPHAGOPLASTY, (PLASTIC REPAIR OR RECONSTRUCTION),
CERVICAL APPROACH; W/O REPAIR OF TRACHEOESOPHAGEAL FISTULA"	"59,085.00"	"26,325.00"	"32,760.00"
43305	"ESOPHAGOPLASTY, (PLASTIC REPAIR OR RECONSTRUCTION), CERVICAL APPROACH; W/ REPAIR OF TRACHEOESOPHAGEAL
FISTULA"	"59,085.00"	"26,325.00"	"32,760.00"
43310	"ESOPHAGOPLASTY, (PLASTIC REPAIR OR RECONSTRUCTION),
THORACIC APPROACH; W/O REPAIR OF TRACHEOESOPHAGEAL FISTULA"	"90,675.00"	"41,535.00"	"49,140.00"
43312	"ESOPHAGOPLASTY, (PLASTIC REPAIR OR RECONSTRUCTION),
THORACIC APPROACH; W/ REPAIR OF TRACHEOESOPHAGEAL FISTULA"	"104,130.00"	"46,800.00"	"57,330.00"
43320	"ESOPHAGOGASTROSTOMY (CARDIOPLASTY), W/ OR W/O
VAGOTOMY AND PYLOROPLASTY, TRANSABDOMINAL OR TRANSTHORACIC APPROACH"	"90,675.00"	"41,535.00"	"49,140.00"
43324	"ESOPHAGOGASTRIC FUNDOPLASTY (E.G., NISSEN, BELSEY IV, HILL
PROCEDURES)"	"90,675.00"	"41,535.00"	"49,140.00"
43325	"ESOPHAGOGASTRIC FUNDOPLASTY; W/ FUNDIC PATCH (THAL-
NISSEN PROCEDURE)"	"90,675.00"	"41,535.00"	"49,140.00"
43326	"ESOPHAGOGASTRIC FUNDOPLASTY; W/ GASTROPLASTY (E.G.,
COLLIS)"	"94,770.00"	"41,535.00"	"53,235.00"
43330	ESOPHAGOMYOTOMY (HELLER TYPE); ABDOMINAL APPROACH	"73,710.00"	"32,760.00"	"40,950.00"
43331	ESOPHAGOMYOTOMY (HELLER TYPE); THORACIC APPROACH	"90,675.00"	"41,535.00"	"49,140.00"
43340	"ESOPHAGOJEJUNOSTOMY (W/O TOTAL GASTRECTOMY);
ABDOMINAL APPROACH"	"73,710.00"	"32,760.00"	"40,950.00"
43341	"ESOPHAGOJEJUNOSTOMY (W/O TOTAL GASTRECTOMY);
THORACIC APPROACH"	"90,675.00"	"41,535.00"	"49,140.00"
43350	"ESOPHAGOSTOMY, FISTULIZATION OF ESOPHAGUS, EXTERNAL;
ABDOMINAL APPROACH"	"45,435.00"	"20,865.00"	"24,570.00"
43351	"ESOPHAGOSTOMY, FISTULIZATION OF ESOPHAGUS, EXTERNAL;
THORACIC APPROACH"	"59,085.00"	"26,325.00"	"32,760.00"
43352	"ESOPHAGOSTOMY, FISTULIZATION OF ESOPHAGUS, EXTERNAL;
CERVICAL APPROACH"	"23,634.00"	"10,530.00"	"13,104.00"
43360	"GASTROINTESTINAL RECONSTRUCTION FOR PREVIOUS ESOPHAGECTOMY, FOR OBSTRUCTING ESOPHAGEAL LESION OR FISTULA, OR FOR PREVIOUS ESOPHAGEAL EXCLUSION; W/
STOMACH, W/ OR W/O PYLOROPLASTY"	"114,660.00"	"40,950.00"	"73,710.00"
43361	"GASTROINTESTINAL RECONSTRUCTION FOR PREVIOUS ESOPHAGECTOMY, FOR OBSTRUCTING ESOPHAGEAL LESION OR FISTULA, OR FOR PREVIOUS ESOPHAGEAL EXCLUSION; W/ COLON INTERPOSITION OR SMALL BOWEL RECONSTRUCTION, INCLUDING BOWEL MOBILIZATION, PREPARATION, AND ANASTOMOSI"	"122,850.00"	"40,950.00"	"81,900.00"
43400	"LIGATION, DIRECT, ESOPHAGEAL VARICES"	"73,710.00"	"32,760.00"	"40,950.00"
43401	"TRANSECTION OF ESOPHAGUS W/ REPAIR, FOR ESOPHAGEAL
VARICES"	"73,710.00"	"32,760.00"	"40,950.00"
43405	"LIGATION OR STAPLING AT GASTROESOPHAGEAL JUNCTION FOR
PRE-EXISTING ESOPHAGEAL PERFORATION"	"73,710.00"	"32,760.00"	"40,950.00"
43410	"SUTURE OF ESOPHAGEAL WOUND OR INJURY; CERVICAL
APPROACH"	"23,634.00"	"10,530.00"	"13,104.00"
43415	"SUTURE OF ESOPHAGEAL WOUND OR INJURY; TRANSTHORACIC
OR TRANSABDOMINAL APPROACH"	"73,710.00"	"32,760.00"	"40,950.00"
43420	CLOSURE OF ESOPHAGOSTOMY OR FISTULA; CERVICAL APPROACH	"23,634.00"	"10,530.00"	"13,104.00"
43425	"CLOSURE OF ESOPHAGOSTOMY OR FISTULA; TRANSTHORACIC OR
TRANSABDOMINAL APPROACH"	"73,710.00"	"32,760.00"	"40,950.00"
43450	"DILATION OF ESOPHAGUS, BY UNGUIDED SOUND OR BOUGIE,
SINGLE OR MULTIPLE PASSES"	"16,107.00"	"9,555.00"	"6,552.00"
43453	"DILATION OF ESOPHAGUS, OVER GUIDE WIRE"	"16,107.00"	"9,555.00"	"6,552.00"
43456	"DILATION OF ESOPHAGUS, BY BALLOON OR DILATOR,
RETROGRADE"	"16,107.00"	"9,555.00"	"6,552.00"
43458	"DILATION OF ESOPHAGUS W/ BALLOON (30 MM DIAMETER OR
LARGER) FOR ACHALASIA"	"16,107.00"	"9,555.00"	"6,552.00"
43460	"ESOPHAGOGASTRIC TAMPONADE, W/ BALLOON (SENGSTAAKEN
TYPE)"	"18,915.00"	"10,725.00"	"8,190.00"
43496	FREE JEJUNUM TRANSFER W/ MICROVASCULAR ANASTOMOSIS	"114,660.00"	"40,950.00"	"73,710.00"
43500	GASTROTOMY; W/ EXPLORATION OR FOREIGN BODY REMOVAL	"59,085.00"	"26,325.00"	"32,760.00"
43501	GASTROTOMY; W/ SUTURE REPAIR OF BLEEDING ULCER	"74,139.00"	"36,465.00"	"37,674.00"
43502	"GASTROTOMY; W/ SUTURE REPAIR OF PRE-EXISTING
ESOPHAGOGASTRIC LACERATION (E.G., MALLORY-WEISS)"	"74,139.00"	"36,465.00"	"37,674.00"
43510	"GASTROTOMY; W/ ESOPHAGEAL DILATION AND INSERTION OF
PERMANENT INTRALUMINAL TUBE (E.G., CELESTIN OR MOUSSEAUX-BARBIN)"	"74,139.00"	"36,465.00"	"37,674.00"
43520	"PYLOROMYOTOMY, CUTTING OF PYLORIC MUSCLE (FREDET-
RAMSTEDT TYPE OPERATION)"	"74,139.00"	"36,465.00"	"37,674.00"
43600	"BIOPSY OF STOMACH; BY CAPSULE, TUBE, PERORAL (ONE OR
MORE SPECIMENS)"	"16,107.00"	"9,555.00"	"6,552.00"
43605	BIOPSY OF STOMACH; BY LAPAROTOMY	"59,085.00"	"26,325.00"	"32,760.00"
43610	"EXCISION, LOCAL; ULCER OR BENIGN TUMOR OF STOMACH"	"74,139.00"	"36,465.00"	"37,674.00"
43611	"EXCISION, LOCAL; MALIGNANT TUMOR OF STOMACH"	"74,139.00"	"36,465.00"	"37,674.00"
43620	"GASTRECTOMY, TOTAL; W/ ESOPHAGOENTEROSTOMY"	"122,850.00"	"40,950.00"	"81,900.00"
43621	"GASTRECTOMY, TOTAL; W/ ROUX-EN-Y RECONSTRUCTION"	"131,040.00"	"40,950.00"	"90,090.00"
43622	"GASTRECTOMY, TOTAL; W/ FORMATION OF INTESTINAL POUCH,
ANY TYPE"	"131,040.00"	"40,950.00"	"90,090.00"
43631	"GASTRECTOMY, PARTIAL, DISTAL; W/ GASTRODUODENOSTOMY"	"107,250.00"	"41,730.00"	"65,520.00"
43632	"GASTRECTOMY, PARTIAL, DISTAL; W/ GASTROJEJUNOSTOMY"	"107,250.00"	"41,730.00"	"65,520.00"
43633	"GASTRECTOMY, PARTIAL, DISTAL; W/ ROUX-EN-Y
RECONSTRUCTION"	"122,850.00"	"40,950.00"	"81,900.00"
43634	"GASTRECTOMY, PARTIAL, DISTAL; W/ FORMATION OF INTESTINAL
POUCH"	"122,850.00"	"40,950.00"	"81,900.00"
43638	"GASTRECTOMY, PARTIAL, PROXIMAL, THORACIC OR ABDOMINAL APPROACH INCLUDING ESOPHAGOGASTROSTOMY, W/ VAGOTOMY;"	"122,850.00"	"40,950.00"	"81,900.00"
43639	"GASTRECTOMY, PARTIAL, PROXIMAL, THORACIC OR ABDOMINAL APPROACH INCLUDING ESOPHAGOGASTROSTOMY, W/ VAGOTOMY; W/ PYLOROPLASTY OR PYLOROMYOTOMY"	"131,040.00"	"40,950.00"	"90,090.00"
43640	"VAGOTOMY INCLUDING PYLOROPLASTY, W/ OR W/O
GASTROSTOMY; TRUNCAL OR SELECTIVE"	"73,710.00"	"32,760.00"	"40,950.00"
43641	"VAGOTOMY INCLUDING PYLOROPLASTY, W/ OR W/O
GASTROSTOMY; PARIETAL CELL (HIGHLY SELECTIVE)"	"90,675.00"	"41,535.00"	"49,140.00"
43651	"LAPAROSCOPY, SURGICAL; TRANSECTION OF VAGUS NERVES,
TRUNCAL"	"35,100.00"	"18,720.00"	"16,380.00"
43652	"LAPAROSCOPY, SURGICAL; TRANSECTION OF VAGUS NERVE,
SELECTIVE OR HIGHLY SELECTIVE"	"42,783.00"	"24,765.00"	"18,018.00"
43653	"LAPAROSCOPY, SURGICAL; GASTROSTOMY, WITHOUT CONSTRUCTION OF GASTRIC TUBE (E.G., STAMM PROCEDURE)"	"35,100.00"	"18,720.00"	"16,380.00"
43750	PERCUTANEOUS PLACEMENT OF GASTROSTOMY TUBE	"15,639.00"	"10,725.00"	"4,914.00"
43760	CHANGE OF GASTROSTOMY TUBE	"10,842.00"	"8,385.00"	"2,457.00"
43800	PYLOROPLASTY	"73,710.00"	"32,760.00"	"40,950.00"
43810	GASTRODUODENOSTOMY	"122,850.00"	"40,950.00"	"81,900.00"
43820	GASTROJEJUNOSTOMY; W/O VAGOTOMY	"90,675.00"	"41,535.00"	"49,140.00"
43825	"GASTROJEJUNOSTOMY; W/ VAGOTOMY, ANY TYPE"	"104,130.00"	"46,800.00"	"57,330.00"
43830	"GASTROSTOMY, TEMPORARY (TUBE, RUBBER OR PLASTIC) ;"	"73,710.00"	"32,760.00"	"40,950.00"
43831	"GASTROSTOMY, TEMPORARY (TUBE, RUBBER OR PLASTIC) ;
NEONATAL, FOR FEEDING"	"73,710.00"	"32,760.00"	"40,950.00"
43832	"GASTROSTOMY, PERMANENT, W/ CONSTRUCTION OF GASTRIC
TUBE"	"73,710.00"	"32,760.00"	"40,950.00"
43840	"GASTRORRHAPHY, SUTURE OF PERFORATED DUODENAL OR
GASTRIC ULCER, WOUND, OR INJURY"	"90,675.00"	"41,535.00"	"49,140.00"
43842	"GASTRIC RESTRICTIVE PROCEDURE, W/O GASTRIC BYPASS, FOR
MORBID OBESITY; VERTICAL-BANDED GASTROPLASTY"	"107,250.00"	"41,730.00"	"65,520.00"
43843	"GASTRIC RESTRICTIVE PROCEDURE, W/O GASTRIC BYPASS, FOR MORBID OBESITY; OTHER THAN VERTICAL-BANDED
GASTROPLASTY"	"114,660.00"	"40,950.00"	"73,710.00"
43846	"GASTRIC RESTRICTIVE PROCEDURE, W/ GASTRIC BYPASS FOR MORBID OBESITY; W/ SHORT LIMB (LESS THAN 100 CM) ROUX-EN-
Y GASTROENTEROSTOMY"	"114,660.00"	"40,950.00"	"73,710.00"
43847	"GASTRIC RESTRICTIVE PROCEDURE, W/ GASTRIC BYPASS FOR MORBID OBESITY; W/ SMALL BOWEL RECONSTRUCTION TO LIMIT
ABSORPTION"	"114,660.00"	"40,950.00"	"73,710.00"
43848	"REVISION OF GASTRIC RESTRICTIVE PROCEDURE FOR MORBID
OBESITY"	"114,660.00"	"40,950.00"	"73,710.00"
43850	"REVISION OF GASTRODUODENAL ANASTOMOSIS (GASTRODUODENOSTOMY) W/ RECONSTRUCTION; W/O
VAGOTOMY"	"114,660.00"	"40,950.00"	"73,710.00"
43855	REVISION OF GASTRODUODENAL ANASTOMOSIS (GASTRODUODENOSTOMY) W/ RECONSTRUCTION; W/ VAGOTOMY	"122,850.00"	"40,950.00"	"81,900.00"
43860	"REVISION OF GASTROJEJUNAL ANASTOMOSIS (GASTROJEJUNOSTOMY) W/ RECONSTRUCTION, W/ OR W/O PARTIAL GASTRECTOMY OR BOWEL RESECTION; W/O VAGOTOMY"	"114,660.00"	"40,950.00"	"73,710.00"
43865	"REVISION OF GASTROJEJUNAL ANASTOMOSIS (GASTROJEJUNOSTOMY) W/ RECONSTRUCTION, W/ OR W/O PARTIAL GASTRECTOMY OR BOWEL RESECTION; W/ VAGOTOMY"	"122,850.00"	"40,950.00"	"81,900.00"
43870	"CLOSURE OF GASTROSTOMY, SURGICAL"	"90,675.00"	"41,535.00"	"49,140.00"
43880	CLOSURE OF GASTROCOLIC FISTULA	"114,660.00"	"40,950.00"	"73,710.00"
44005	ENTEROLYSIS (FREEING OF INTESTINAL ADHESION)	"114,660.00"	"40,950.00"	"73,710.00"
44010	"DUODENOTOMY, FOR EXPLORATION, BIOPSY(S), OR FOREIGN
BODY REMOVAL"	"104,130.00"	"46,800.00"	"57,330.00"
44020	"ENTEROTOMY, SMALL BOWEL, OTHER THAN DUODENUM; FOR EXPLORATION, BIOPSY(S), OR FOREIGN BODY REMOVAL;"	"73,710.00"	"32,760.00"	"40,950.00"
44021	"ENTEROTOMY, SMALL BOWEL, OTHER THAN DUODENUM; FOR EXPLORATION, BIOPSY(S), OR FOREIGN BODY REMOVAL; FOR
DECOMPRESSION (E.G., BAKER TUBE)"	"73,710.00"	"32,760.00"	"40,950.00"
44025	"COLOTOMY, FOR EXPLORATION, BIOPSY(S), OR FOREIGN BODY
REMOVAL"	"73,710.00"	"32,760.00"	"40,950.00"
44050	"REDUCTION OF VOLVULUS, INTUSSUSCEPTION, INTERNAL
HERNIA, BY LAPAROTOMY"	"104,130.00"	"46,800.00"	"57,330.00"
44055	"CORRECTION OF MALROTATION BY LYSIS OF DUODENAL BANDS
AND/OR REDUCTION OF MIDGUT VOLVULUS (E.G., LADD PROCEDURE)"	"107,250.00"	"41,730.00"	"65,520.00"
44100	"BIOPSY OF INTESTINE BY CAPSULE, TUBE, PERORAL (ONE OR
MORE SPECIMENS)"	"35,100.00"	"18,720.00"	"16,380.00"
44110	"EXCISION OF ONE OR MORE LESSIONS OF SMALL OR LARGE BOWEL NOT REQUIRING ANASTOMOSIS, EXTERIORIZATION, OR FISTULIZATION; SINGLE ENTEROTOMY"	"73,710.00"	"32,760.00"	"40,950.00"
44111	"EXCISION OF ONE OR MORE LESSIONS OF SMALL OR LARGE BOWEL NOT REQUIRING ANASTOMOSIS, EXTERIORIZATION, OR FISTULIZATION; MULTIPLE ENTEROTOMIES"	"90,675.00"	"41,535.00"	"49,140.00"
44120	"ENTERECTOMY, RESECTION OF SMALL INTESTINE; SINGLE
RESECTION AND ANASTOMOSIS"	"90,675.00"	"41,535.00"	"49,140.00"
44125	"ENTERECTOMY, RESECTION OF SMALL INTESTINE; W/
ENTEROSTOMY"	"90,675.00"	"41,535.00"	"49,140.00"
44130	"ENTEROENTEROSTOMY, ANASTOMOSIS OF INTESTINE, W/ OR W/O
CUTANEOUS ENTEROSTOMY"	"104,130.00"	"46,800.00"	"57,330.00"
44140	"COLECTOMY, PARTIAL; W/ ANASTOMOSIS"	"114,660.00"	"40,950.00"	"73,710.00"
44141	"COLECTOMY, PARTIAL; W/ SKIN LEVEL CECOSTOMY OR
COLOSTOMY"	"114,660.00"	"40,950.00"	"73,710.00"
44143	"COLECTOMY, PARTIAL; W/ END COLOSTOMY AND CLOSURE OF
DISTAL SEGMENT (HARTMANN TYPE PROCEDURE)"	"114,660.00"	"40,950.00"	"73,710.00"
44144	"COLECTOMY, PARTIAL; W/ RESECTION, W/ COLOSTOMY OR
ILEOSTOMY AND CREATION OF MUCOFISTULA"	"114,660.00"	"40,950.00"	"73,710.00"
44145	"COLECTOMY, PARTIAL; W/ COLOPROCTOSTOMY  (LOW PELVIC
ANASTOMOSIS)"	"110,526.00"	"41,730.00"	"68,796.00"
44146	"COLECTOMY, PARTIAL; W/ COLOPROCTOSTOMY (LOW PELVIC
ANASTOMOSIS), W/ COLOSTOMY"	"114,660.00"	"40,950.00"	"73,710.00"
44147	"COLECTOMY, PARTIAL; ABDOMINAL AND TRANSANAL APPROACH"	"122,850.00"	"40,950.00"	"81,900.00"
44150	"COLECTOMY, TOTAL, ABDOMINAL, W/O PROCTECTOMY; W/
ILEOSTOMY OR ILEOPROCTOSTOMY"	"122,850.00"	"40,950.00"	"81,900.00"
44151	"COLECTOMY, TOTAL, ABDOMINAL, W/O PROCTECTOMY; W/
CONTINENT ILEOSTOMY"	"122,850.00"	"40,950.00"	"81,900.00"
44152	"COLECTOMY, TOTAL, ABDOMINAL, W/O PROCTECTOMY; W/ RECTAL MUCOSECTOMY, ILEOANAL ANASTOMOSIS, W/ OR W/O
LOOP ILEOSTOMY"	"131,040.00"	"40,950.00"	"90,090.00"
44153	"COLECTOMY, TOTAL, ABDOMINAL, W/O PROCTECTOMY; W/ RECTAL MUCOSECTOMY, ILEOANAL ANASTOMOSIS, CREATION OF ILEAL RESERVIOR (S OR J), W/ OR W/O LOOP ILEOSTOMY"	"131,040.00"	"40,950.00"	"90,090.00"
44155	"COLECTOMY, TOTAL, ABDOMINAL, W/ PROCTECTOMY; W/
ILEOSTOMY"	"131,040.00"	"40,950.00"	"90,090.00"
44156	"COLECTOMY, TOTAL, ABDOMINAL, W/ PROCTECTOMY; W/
CONTINENT ILEOSTOMY"	"131,040.00"	"40,950.00"	"90,090.00"
44160	"COLECTOMY W/ REMOVAL OF TERMINAL ILEUM AND
ILEOCOLOSTOMY"	"131,040.00"	"40,950.00"	"90,090.00"
44180	"LAPAROSCOPY, SURGICAL, ENTEROLYSIS (FREEING OF
INTESTINAL ADHESION)"	"35,100.00"	"18,720.00"	"16,380.00"
44186	"LAPAROSCOPY, SURGICAL; JEJUNOSTOMY (E.G., FOR
DECOMPRESSION OR FEEDING;"	"23,634.00"	"10,530.00"	"13,104.00"
44187	"LAPAROSCOPY, SURGICAL; JEJUNOSTOMY (E.G., FOR DECOMPRESSION OR FEEDING); ILEOSTOMY OR JEJUNOSTOMY,
NON-TUBE"	"23,634.00"	"10,530.00"	"13,104.00"
44188	"LAPAROSCOPY, SURGICAL, COLOSTOMY OR SKIN LEVEL
CECOSTOMY"	"35,100.00"	"18,720.00"	"16,380.00"
44202	"LAPAROSCOPY, SURGICAL; ENTERECTOMY, RESECTION OF SMALL
INTESTINE, SINGLE RESECTION AND ANASTOMOSIS"	"45,435.00"	"20,865.00"	"24,570.00"
44204	"LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH
ANASTOMOSIS"	"73,710.00"	"32,760.00"	"40,950.00"
44205	"LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH REMOVAL
OF TERMINAL ILEUM WITH ILEOCOLOSTOMY"	"114,660.00"	"40,950.00"	"73,710.00"
44206	"LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH END COLOSTOMY AND CLOSURE OF  DISTAL SEGMENT  (HARTMANN
TYPE PROCEDURE)"	"73,710.00"	"32,760.00"	"40,950.00"
44207	"LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH ANASTOMOSIS, WITH COLOPROCTOSTOMY (LOW PELVIC
ANASTOMOSIS)"	"107,250.00"	"41,730.00"	"65,520.00"
44208	"LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH ANASTOMOSIS, WITH COLOPROCTOSTOMY (LOW PELVIC
ANASTOMOSIS) WITH COLOSTOMY"	"114,660.00"	"40,950.00"	"73,710.00"
44210	"LAPAROSCOPY, SURGICAL; COLECTOMY, TOTAL, ABDOMINAL, WITHOUT PROTECTOMY, WITH ILEOSTOMY OR
ILEOPROCTOSTOMY"	"107,250.00"	"41,730.00"	"65,520.00"
44211	"LAPAROSCOPY, SURGICAL; COLECTOMY, TOTAL, ABDOMINAL, WITH PROTECTOMY, WITH ILEO-ANAL ANASTOMOSIS, CREATION OF ILEAL RESERVOIR (S OR J), WITH LOOP ILEOSTOMY, WITH OR WITHOUT RECTAL MUCOSECTOMY"	"114,660.00"	"40,950.00"	"73,710.00"
44212	"LAPAROSCOPY, SURGICAL; COLECTOMY, TOTAL, ABDOMINAL,
WITH PROTECTOMY, WITH ILEOSTOMY"	"107,250.00"	"41,730.00"	"65,520.00"
44227	"LAPAROSCOPY, SURGICAL; CLOSURE OF ENTEROSTOMY, LARGE OR SMALL INTESTINE, WITH RESECTION AND ANASTOMOSIS"	"45,435.00"	"20,865.00"	"24,570.00"
44300	"ENTEROSTOMY OR CECOSTOMY, TUBE (E.G., FOR DECOMPRESSION
OR FEEDING)"	"35,100.00"	"18,720.00"	"16,380.00"
44310	"ILEOSTOMY OR JEJUNOSTOMY, NON- TUBE"	"42,549.00"	"21,255.00"	"21,294.00"
44312	"REVISION OF ILEOSTOMY; SIMPLE (RELEASE OF SUPERFICIAL
SCAR)"	"45,435.00"	"20,865.00"	"24,570.00"
44314	"REVISION OF ILEOSTOMY; COMPLICATED (RECONSTRUCTION IN-
DEPTH)"	"42,549.00"	"21,255.00"	"21,294.00"
44316	CONTINENT ILEOSTOMY (KOCH PROCEDURE)	"59,085.00"	"26,325.00"	"32,760.00"
44320	COLOSTOMY OR SKIN LEVEL CECOSTOMY;	"45,435.00"	"20,865.00"	"24,570.00"
44322	"COLOSTOMY OR SKIN LEVEL CECOSTOMY; W/ MULTIPLE BIOPSIES
(E.G., FOR HIRSCHSPRUNG DISEASE)"	"59,085.00"	"26,325.00"	"32,760.00"
44340	"REVISION OF COLOSTOMY; SIMPLE (RELEASE OF SUPERFICIAL
SCAR)"	"45,435.00"	"20,865.00"	"24,570.00"
44345	"REVISION OF COLOSTOMY; COMPLICATED (RECONSTRUCTION IN -
DEPTH )"	"59,085.00"	"26,325.00"	"32,760.00"
44346	"REVISION OF COLOSTOMY; W/ REPAIR OF PARACOLOSTOMY
HERNIA"	"59,085.00"	"26,325.00"	"32,760.00"
44360	"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY, BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; DIAGNOSTIC, W/ OR W/O COLLECTION OF SPECIMEN(S) BY BRUSHING OR
WASHING"	"29,172.00"	"14,430.00"	"14,742.00"
44361	"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY, BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; W/ BIOPSY,
SINGLE OR MULTIPLE"	"29,172.00"	"14,430.00"	"14,742.00"
44363	"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY, BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; W/ REMOVAL
OF FOREIGN BODY"	"35,100.00"	"18,720.00"	"16,380.00"
44364	"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY, BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; W/ REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESIONS(S) BY SNARE
TECHNIQUE"	"35,100.00"	"18,720.00"	"16,380.00"
44365	"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY, BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; W/ REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY
FORCEPS OR BIPOLAR CAUTERY"	"35,100.00"	"18,720.00"	"16,380.00"
44366	"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY, BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; W/ CONTROL
OF BLEEDING, ANY METHOD"	"35,100.00"	"18,720.00"	"16,380.00"
44369	"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY, BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; W/ ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE
TENCHNIQUE"	"42,783.00"	"24,765.00"	"18,018.00"
44372	"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY, BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; W/
PLACEMENT OF PERCUTANEOUS JEJUNOSTOMY TUBE"	"42,783.00"	"24,765.00"	"18,018.00"
44373	"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY, BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; W/ CONVERSION OF PERCUTANEOUS GASTROSTOMY TUBE TO
PERCUTANEOUS JEJUNOSTOMY TUBE"	"42,783.00"	"24,765.00"	"18,018.00"
44376	"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, INCLUDING ILEUM; DIAGNOSTIC, W/ OR W/O COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING"	"35,100.00"	"18,720.00"	"16,380.00"
44377	"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND
PORTION OF DUODENUM, INCLUDING ILEUM;W/ BIOPSY, SINGLE OR MULTIPLE"	"35,100.00"	"18,720.00"	"16,380.00"
44378	"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND
PORTION OF DUODENUM, INCLUDING ILEUM;W/ CONTROL OF BLEEDING, ANY METHOD"	"42,783.00"	"24,765.00"	"18,018.00"
44380	"ILEOSCOPY, THROUGH STOMA; DIAGNOSTIC, W/ OR W/O
COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING"	"29,172.00"	"14,430.00"	"14,742.00"
44382	"ILEOSCOPY, THROUGH STOMA; W/ BIOPSY, SINGLE OR MULTIPLE"	"29,172.00"	"14,430.00"	"14,742.00"
44385	"ENDOSCOPIC EVALUATION OF SMALL INTESTINAL (ABDOMINAL OR PELVIC) POUCH; DIAGNOSTIC, W/ OR W/O COLLECTION OF
SPECIMEN(S) BY BRUSHING OR WASHING"	"29,172.00"	"14,430.00"	"14,742.00"
44386	"ENDOSCOPIC EVALUATION OF SMALL INTESTINAL (ABDOMINAL OR PELVIC) POUCH; W/ BIOPSY, SINGLE OR MULTIPLE"	"29,172.00"	"14,430.00"	"14,742.00"
44388	"COLONOSCOPY THROUGH STOMA; DIAGNOSTIC, W/ OR W/O
COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING"	"29,172.00"	"14,430.00"	"14,742.00"
44389	"COLONOSCOPY THROUGH STOMA; W/ BIOPSY, SINGLE OR
MULTIPLE"	"29,172.00"	"14,430.00"	"14,742.00"
44390	"COLONOSCOPY THROUGH STOMA; W/ REMOVAL OF FOREIGN
BODY"	"35,100.00"	"18,720.00"	"16,380.00"
44391	"COLONOSCOPY THROUGH STOMA; W/ CONTROL OF BLEEDING,
ANY METHOD"	"35,100.00"	"18,720.00"	"16,380.00"
44392	"COLONOSCOPY THROUGH STOMA; W/ REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FORCEPS OR
BIPOLAR CAUTERY"	"35,100.00"	"18,720.00"	"16,380.00"
44393	"COLONOSCOPY THROUGH STOMA; W/ ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT  AMENABLE TO REMOVAL  BY HOT BIOPSY  FORCEPS,  BIPOLAR CAURTERY OR SNARE
TECHNIQUE"	"42,783.00"	"24,765.00"	"18,018.00"
44394	"COLONOSCOPY THROUGH STOMA; W/ REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE"	"42,783.00"	"24,765.00"	"18,018.00"
44500	"INTRODUCTION OF LONG GASTROINTESTINAL TUBE (E.G., MILLER-
ABBOTT)"	"15,639.00"	"10,725.00"	"4,914.00"
44602	"SUTURE OF SMALL INTESTINE (ENTERORRHAPHY) FOR PERFORATED ULCER, DIVERTICULUM, WOUND, INJURY OR
RUPTURE; SINGLE PERFORATION"	"73,710.00"	"32,760.00"	"40,950.00"
44603	"SUTURE OF SMALL INTESTINE (ENTERORRHAPHY) FOR PERFORATED ULCER, DIVERTICULUM, WOUND, INJURY OR
RUPTURE; MULTIPLE PERFORATION"	"73,710.00"	"32,760.00"	"40,950.00"
44604	"SUTURE OF LARGE INTESTINE (COLORRHAPHY) FOR PERFORATED ULCER, DIVERTICULUM, WOUND, INJURY OR RUPTURE (SINGLE OR MULTIPLE PERFORATIONS); W/O COLOSTOMY"	"73,710.00"	"32,760.00"	"40,950.00"
44605	"SUTURE OF LARGE INTESTINE (COLORRHAPHY) FOR PERFORATED ULCER, DIVERTICULUM, WOUND, INJURY OR RUPTURE (SINGLE OR MULTIPLE PERFORATIONS); W/ COLOSTOMY"	"73,710.00"	"32,760.00"	"40,950.00"
44615	"INTESTINAL STRICTUROPLASTY (ENTEROTOMY AND ENTERORRHAPHY) W/ OR W/O DILATION, FOR INTESTINAL
OBSTRUCTION"	"73,710.00"	"32,760.00"	"40,950.00"
44620	"CLOSURE OF ENTEROSTOMY, LARGE OR SMALL INTESTINE;"	"59,085.00"	"26,325.00"	"32,760.00"
44625	"CLOSURE OF ENTEROSTOMY, LARGE OR SMALL INTESTINE; W/
RESECTION AND ANASTOMOSIS"	"59,085.00"	"26,325.00"	"32,760.00"
44640	CLOSURE OF INTESTINAL CUTANEOUS FISTULA	"59,085.00"	"26,325.00"	"32,760.00"
44650	CLOSURE OF ENTEROENTERIC OR ENTEROCOLIC FISTULA	"59,085.00"	"26,325.00"	"32,760.00"
44660	"CLOSURE OF ENTEROVESICAL FISTULA; W/O INTESTINAL OR
BLADDER RESECTION"	"73,710.00"	"32,760.00"	"40,950.00"
44661	"CLOSURE OF ENTEROVESICAL FISTULA; W/ BOWEL AND/OR
BLADDER RESECTION"	"73,710.00"	"32,760.00"	"40,950.00"
44800	"EXCISION OF MECKELS DIVERTICULUM (DIVERTICULECTOMY) OR
OMPHALOMESENTERIC DUCT"	"35,100.00"	"18,720.00"	"16,380.00"
44820	EXCISION OF LESION OF MESENTERY	"35,100.00"	"18,720.00"	"16,380.00"
44850	SUTURE OF MESENTERY	"23,634.00"	"10,530.00"	"13,104.00"
44900	"INCISION AND DRAINAGE OF APPENDICEAL ABSCESS,
TRANSABDOMINAL"	"20,553.00"	"10,725.00"	"9,828.00"
44950	APPENDECTOMY;	"46,800.00"	"28,080.00"	"18,720.00"
44960	"APPENDECTOMY; FOR RUPTURED APPENDIX W/ ABSCESS OR
GENERALIZED PERITONITIS"	"46,800.00"	"28,080.00"	"18,720.00"
44970	"LAPAROSCOPY, SURGICAL; APPENDECTOMY"	"46,800.00"	"28,080.00"	"18,720.00"
45000	TRANSRECTAL DRAINAGE OF PELVIC ABSCESS	"59,085.00"	"26,325.00"	"32,760.00"
45005	"INCISION AND DRAINAGE OF SUBMUCOSAL ABSCESS, RECTUM"	"35,100.00"	"18,720.00"	"16,380.00"
45020	"INCISION AND DRAINAGE OF DEEP SUPRALEVATOR, PELVIRECTAL,
OR RETRORECTAL ABSCESS"	"59,085.00"	"26,325.00"	"32,760.00"
45100	"BIOPSY OF ANORECTAL WALL, ANAL APPROACH (E.G.,
CONGENITAL MEGACOLON)"	"45,435.00"	"20,865.00"	"24,570.00"
45108	ANORECTAL MYOMECTOMY	"59,085.00"	"26,325.00"	"32,760.00"
45110	"PROCTECTOMY; COMPLETE, COMBINED ABDOMINOPERINEAL, W/
COLOSTOMY"	"107,250.00"	"41,730.00"	"65,520.00"
45111	"PROCTECTOMY; PARTIAL RESECTION OF RECTUM,
TRANSABDOMINAL APPROACH"	"107,250.00"	"41,730.00"	"65,520.00"
45112	"PROCTECTOMY, COMBINED ABDOMINOPERINEAL, PULL-
THROUGH PROCEDURE (E.G., COLO-ANAL ANASTOMOSIS)"	"107,250.00"	"41,730.00"	"65,520.00"
45113	"PROCTECTOMY, PARTIAL, W/ RECTAL MUCOSECTOMY, ILEOANAL ANASTOMOSIS, CREATION OF ILEAL RESERVOIR (S OR J), W/ OR
W/O LOOP ILEOSTOMY"	"114,660.00"	"40,950.00"	"73,710.00"
45114	"PROCTECTOMY, PARTIAL, W/ ANASTOMOSIS; ABDOMINAL AND
TRANSSACRAL APPROACH"	"114,660.00"	"40,950.00"	"73,710.00"
45116	"PROCTECTOMY, PARTIAL, W/ ANASTOMOSIS; TRANSSACRAL
APPROACH ONLY (KRASKE TYPE)"	"107,250.00"	"41,730.00"	"65,520.00"
45120	"PROCTECTOMY, COMPLETE (FOR CONGENITAL MEGACOLON), ABDOMINAL AND PERINEAL APPROACH; W/ PULL-THROUGH PROCEDURE AND ANASTOMOSIS (E.G., SWENSON, DUHAMEL, OR
SOAVE TYPE OPERATION)"	"114,660.00"	"40,950.00"	"73,710.00"
45121	"PROCTECTOMY, COMPLETE (FOR CONGENITAL MEGACOLON), ABDOMINAL AND PERINEAL APPROACH; W/ SUBTOTAL OR TOTAL
COLECTOMY, W/ MULTIPLE BIOPSIES"	"114,660.00"	"40,950.00"	"73,710.00"
45123	"PROCTECTOMY, PARTIAL, W/O ANASTOMOSIS, PERINEAL
APPROACH"	"107,250.00"	"41,730.00"	"65,520.00"
45130	"EXCISION OF RECTAL PROCIDENTIA, W/ ANATOMOSIS; PERINEAL
APPROACH"	"104,130.00"	"46,800.00"	"57,330.00"
45135	"EXCISION OF RECTAL PROCIDENTIA, W/ ANATOMOSIS;
ABDOMINAL AND PERINEAL APPROACH"	"107,250.00"	"41,730.00"	"65,520.00"
45150	DIVISION OF STRICTURE OF RECTUM	"23,634.00"	"10,530.00"	"13,104.00"
45160	"EXCISION OF RECTAL TUMOR BY PROCTOTOMY, TRANSSACRAL OR
TRANSCOCCYGEAL APPROACH"	"107,250.00"	"41,730.00"	"65,520.00"
45170	"EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH"	"35,100.00"	"18,720.00"	"16,380.00"
45190	"DESTRUCTION OF RECTAL TUMOR, ANY METHOD (E.G.,
ELECTRODESICCATION) TRANSANAL APPROACH"	"35,100.00"	"18,720.00"	"16,380.00"
45300	"PROCTOSIGMOIDOSCOPY, RIGID; DIAGNOSTIC, W/ OR W/O
COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING"	"15,639.00"	"10,725.00"	"4,914.00"
45303	"PROCTOSIGMOIDOSCOPY, RIGID; W/ DILATION, ANY METHOD"	"18,915.00"	"10,725.00"	"8,190.00"
45305	"PROCTOSIGMOIDOSCOPY, RIGID; W/ BIOPSY, SINGLE OR MULTIPLE"	"15,639.00"	"10,725.00"	"4,914.00"
45307	"PROCTOSIGMOIDOSCOPY, RIGID; W/ REMOVAL OF FOREIGN BODY"	"16,107.00"	"9,555.00"	"6,552.00"
45308	"PROCTOSIGMOIDOSCOPY, RIGID; W/ REMOVAL OF SINGLE TUMOR, POLYP, OR OTHER LESION BY HOT BIOPSY FORCEPS OR BIPOLAR
CAUTERY"	"18,915.00"	"10,725.00"	"8,190.00"
45309	"PROCTOSIGMOIDOSCOPY, RIGID; W/ REMOVAL OF SINGLE TUMOR,
POLYP, OR OTHER LESION BY SNARE TECHNIQUE"	"18,915.00"	"10,725.00"	"8,190.00"
45315	"PROCTOSIGMOIDOSCOPY, RIGID; W/ REMOVAL OF MULTIPLE TUMORS, POLYPS OR OTHER LESIONS BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE"	"20,553.00"	"10,725.00"	"9,828.00"
45317	"PROCTOSIGMOIDOSCOPY, RIGID; W/ CONTROL OF BLEEDING, ANY
METHOD"	"20,553.00"	"10,725.00"	"9,828.00"
45320	"PROCTOSIGMOIDOSCOPY, RIGID; W/ ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE
(E.G., LASER)"	"20,553.00"	"10,725.00"	"9,828.00"
45321	"PROCTOSIGMOIDOSCOPY, RIGID; W/ DECOMPRESSION OF
VOLVULUS"	"20,553.00"	"10,725.00"	"9,828.00"
45330	"SIGMOIDOSCOPY, FLEXIBLE; DIAGNOSTIC, W/ OR W/O
COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING"	"16,107.00"	"9,555.00"	"6,552.00"
45331	"SIGMOIDOSCOPY, FLEXIBLE; W/ BIOPSY, SINGLE OR MULTIPLE"	"16,107.00"	"9,555.00"	"6,552.00"
45332	"SIGMOIDOSCOPY, FLEXIBLE; W/ REMOVAL OF FOREIGN BODY"	"18,915.00"	"10,725.00"	"8,190.00"
45333	"SIGMOIDOSCOPY, FLEXIBLE; W/ REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FORCEPS OR
BIPOLAR CAUTERY"	"18,915.00"	"10,725.00"	"8,190.00"
45334	"SIGMOIDOSCOPY, FLEXIBLE; W/ CONTROL OF BLEEDING, ANY
METHOD"	"20,553.00"	"10,725.00"	"9,828.00"
45337	"SIGMOIDOSCOPY, FLEXIBLE; W/ DECOMPRESSION OF VOLVULUS,
ANY METHOD"	"23,634.00"	"10,530.00"	"13,104.00"
45338	"SIGMOIDOSCOPY, FLEXIBLE; W/ REMOVAL OF TUMOR(S),
POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE"	"20,553.00"	"10,725.00"	"9,828.00"
45339	"SIGMOIDOSCOPY, FLEXIBLE; W/ ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE"	"23,361.00"	"11,895.00"	"11,466.00"
45355	"COLONOSCOPY, RIGID OR FLEXIBLE, TRANSABDOMINAL VIA
COLOTOMY, SINGLE OR MULTIPLE"	"20,553.00"	"10,725.00"	"9,828.00"
45378	"COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; DIAGNOSTIC,  W/ OR W/O COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING,  W/ OR W/O COLON DECOMPRESSION"	"23,634.00"	"10,530.00"	"13,104.00"
45379	"COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; W/
REMOVAL OF FOREIGN BODY"	"23,634.00"	"10,530.00"	"13,104.00"
45380	"COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; W/
BIOPSY, SINGLE OR MULTIPLE"	"23,634.00"	"10,530.00"	"13,104.00"
45382	"COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; W/
CONTROL OF BLEEDING, ANY METHOD"	"35,100.00"	"18,720.00"	"16,380.00"
45383	"COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; W/ ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE"	"29,172.00"	"14,430.00"	"14,742.00"
45384	"COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; W/ REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT
BIOPSY FORCEPS OR BIPOLAR CAUTERY"	"29,172.00"	"14,430.00"	"14,742.00"
45385	"COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; W/ REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE
TECHNIQUE"	"35,100.00"	"18,720.00"	"16,380.00"
45395	"LAPAROSCOPY, SURGICAL; PROCTECTOMY, COMPLETE COMBINED
ABDOMINOPERINEAL, WITH COLOSTOMY"	"107,250.00"	"41,730.00"	"65,520.00"
45397	"LAPAROSCOPY, SURGICAL; PROTECTOMY, COMBINED ABDOMINOPERINEAL PULL THROUGH PROCEDURE (E.G., COLO- ANAL ANASTOMOSIS), WITH CREATION OF COLONIC RESERVOIR (E.G.,  J-POUCH), WITH DIVERTING ENTEROSTOMY, WHEN
PERFORMED"	"107,250.00"	"41,730.00"	"65,520.00"
45400	"LAPAROSCOPY, SURGICAL; PROCTOPEXY (FOR PROLAPSE)"	"52,884.00"	"23,400.00"	"29,484.00"
45402	"LAPAROSCOPY, SURGICAL; PROCTOPEXY (FOR PROLAPSE), WITH
SIGMOID RESECTION"	"59,085.00"	"26,325.00"	"32,760.00"
45500	PROCTOPLASTY; FOR STENOSIS	"35,100.00"	"18,720.00"	"16,380.00"
45505	PROCTOPLASTY; FOR PROLAPSE OF MUCOUS MEMBRANE	"35,100.00"	"18,720.00"	"16,380.00"
45540	PROCTOPEXY FOR PROLAPSE; ABDOMINAL APPROACH	"52,884.00"	"23,400.00"	"29,484.00"
45541	PROCTOPEXY FOR PROLAPSE; PERINEAL APPROACH	"52,884.00"	"23,400.00"	"29,484.00"
45550	"PROCTOPEXY COMBINED W/ SIGMOID RESECTION, ABDOMINAL
APPROACH"	"59,085.00"	"26,325.00"	"32,760.00"
45560	REPAIR OF RECTOCELE	"35,100.00"	"18,720.00"	"16,380.00"
45562	"EXPLORATION, REPAIR AND PRESACRAL DRAINAGE FOR RECTAL
INJURY;"	"45,435.00"	"20,865.00"	"24,570.00"
45563	"EXPLORATION, REPAIR AND PRESACRAL DRAINAGE FOR RECTAL
INJURY; W/ COLOSTOMY"	"52,884.00"	"23,400.00"	"29,484.00"
45800	CLOSURE OF RECTOVESICAL FISTULA;	"59,085.00"	"26,325.00"	"32,760.00"
45805	CLOSURE OF RECTOVESICAL FISTULA; W/ COLOSTOMY	"73,710.00"	"32,760.00"	"40,950.00"
45820	CLOSURE OF RECTOURETHRAL FISTULA;	"59,085.00"	"26,325.00"	"32,760.00"
45825	CLOSURE OF RECTOURETHRAL FISTULA; W/ COLOSTOMY	"73,710.00"	"32,760.00"	"40,950.00"
45905	"DILATION OF ANAL SPHINCTER  UNDER ANESTHESIA OTHER THAN
LOCAL"	"16,107.00"	"9,555.00"	"6,552.00"
45910	"DILATION OF RECTAL STRICTURE  UNDER ANESTHESIA OTHER
THAN LOCAL"	"16,107.00"	"9,555.00"	"6,552.00"
45915	"REMOVAL OF FECAL IMPACTION OR FOREIGN BODY  UNDER
ANESTHESIA"	"16,107.00"	"9,555.00"	"6,552.00"
46040	"INCISION AND DRAINAGE OF ISCHIORECTAL AND/OR PERIRECTAL
ABSCESS"	"16,107.00"	"9,555.00"	"6,552.00"
46045	"INCISION AND DRAINAGE OF INTRAMURAL, INTRAMUSCULAR, OR SUBMUCOSAL ABSCESS, TRANSANAL, UNDER ANESTHESIA"	"18,915.00"	"10,725.00"	"8,190.00"
46050	"INCISION AND DRAINAGE, PERIANAL ABSCESS, SUPERFICIAL"	"16,107.00"	"9,555.00"	"6,552.00"
46060	"INCISION AND DRAINAGE OF ISCHIORECTAL OR INTRAMURAL ABSCESS, W/ FISTULECTOMY OR FISTULOTOMY, SUBMUSCULAR, W/ OR W/O PLACEMENT OF SETON"	"18,915.00"	"10,725.00"	"8,190.00"
46070	"INCISION, ANAL SEPTUM (INFANT)"	"18,915.00"	"10,725.00"	"8,190.00"
46080	"SPHINCTEROTOMY, ANAL, DIVISION OF SPHINCTER"	"18,915.00"	"10,725.00"	"8,190.00"
46083	"INCISION OF THROMBOSED HEMORRHOID, EXTERNAL"	"15,639.00"	"10,725.00"	"4,914.00"
46200	"FISSURECTOMY, W/ OR W/O SPHINCTEROTOMY"	"16,107.00"	"9,555.00"	"6,552.00"
46210	CRYPTECTOMY; SINGLE	"16,107.00"	"9,555.00"	"6,552.00"
46211	CRYPTECTOMY; MULTIPLE	"18,915.00"	"10,725.00"	"8,190.00"
46220	"PAPILLECTOMY OR EXCISION OF SINGLE TAG, ANUS"	"16,107.00"	"9,555.00"	"6,552.00"
46221	"HEMORRHOIDECTOMY, BY SIMPLE LIGATURE (E.G., RUBBER
BAND)"	"23,634.00"	"10,530.00"	"13,104.00"
46230	"EXCISION OF EXTERNAL HEMORRHOID TAGS AND/OR MULTIPLE
PAPILLAE"	"23,634.00"	"10,530.00"	"13,104.00"
46250	"HEMORRHOIDECTOMY, EXTERNAL, COMPLETE"	"23,634.00"	"10,530.00"	"13,104.00"
46255	"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SIMPLE;"	"23,634.00"	"10,530.00"	"13,104.00"
46257	"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SIMPLE; W/
FISSURECTOMY"	"23,634.00"	"10,530.00"	"13,104.00"
46258	"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SIMPLE; W/
FISTULECTOMY, W/ OR W/O FISSURECTOMY"	"23,634.00"	"10,530.00"	"13,104.00"
46260	"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, COMPLEX OR
EXTENSIVE;"	"23,634.00"	"10,530.00"	"13,104.00"
46261	"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, COMPLEX OR
EXTENSIVE; W/ FISSURECTOMY"	"23,634.00"	"10,530.00"	"13,104.00"
46262	"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, COMPLEX OR EXTENSIVE; W/ FISTULECTOMY, W/ OR W/O FISSURECTOMY"	"23,634.00"	"10,530.00"	"13,104.00"
46270	"SURGICAL TREATMENT OF ANAL FISTULA
(FISTULECTOMY/FISTULOTOMY); SUBCUTANEOUS"	"23,634.00"	"10,530.00"	"13,104.00"
46275	"SURGICAL TREATMENT OF ANAL FISTULA
(FISTULECTOMY/FISTULOTOMY); SUBMUSCULAR"	"23,634.00"	"10,530.00"	"13,104.00"
46280	"SURGICAL TREATMENT OF ANAL FISTULA
(FISTULECTOMY/FISTULOTOMY); COMPLEX OR MULTIPLE, W/ OR W/O PLACEMENT OF SETON"	"23,634.00"	"10,530.00"	"13,104.00"
46285	"SURGICAL TREATMENT OF ANAL FISTULA
(FISTULECTOMY/FISTULOTOMY); SECOND STAGE"	"23,634.00"	"10,530.00"	"13,104.00"
46288	CLOSURE OF ANAL FISTULA W/ RECTAL ADVANCEMENT FLAP	"35,100.00"	"18,720.00"	"16,380.00"
46320	"ENUCLEATION OR EXCISION OF EXTERNAL THROMBOTIC
HEMORRHOID"	"23,634.00"	"10,530.00"	"13,104.00"
46600	"ANOSCOPY; DIAGNOSTIC, W/ OR W/O COLLECTION OF
SPECIMEN(S) BY BRUSHING OR WASHING"	"11,076.00"	"7,800.00"	"3,276.00"
46604	"ANOSCOPY; W/ DILATION, ANY METHOD"	"11,076.00"	"7,800.00"	"3,276.00"
46606	"ANOSCOPY; W/ BIOPSY, SINGLE OR MULTIPLE"	"11,076.00"	"7,800.00"	"3,276.00"
46608	ANOSCOPY; W/ REMOVAL OF FOREIGN BODY	"11,076.00"	"7,800.00"	"3,276.00"
46610	"ANOSCOPY; W/ REMOVAL OF SINGLE TUMOR, POLYP, OR OTHER LESION BY HOT BIOPSY FORCEPS OR BIPOLAR CAUTERY"	"15,639.00"	"10,725.00"	"4,914.00"
46611	"ANOSCOPY; W/ REMOVAL OF SINGLE TUMOR, POLYP OR OTHER
LESION BY SNARE TECHNIQUE"	"16,107.00"	"9,555.00"	"6,552.00"
46612	"ANOSCOPY; W/ REMOVAL OF MULTIPLE TUMOR, POLYPS, OR OTHER LESIONS  BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR
SNARE TECHNIQUE"	"16,107.00"	"9,555.00"	"6,552.00"
46614	"ANOSCOPY; W/ CONTROL OF BLEEDING, ANY METHOD"	"15,639.00"	"10,725.00"	"4,914.00"
46615	"ANOSCOPY; W/ ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE"	"18,915.00"	"10,725.00"	"8,190.00"
46700	"ANOPLASTY, PLASTIC OPERATION FOR STRICTURE; ADULT"	"25,155.00"	"12,870.00"	"12,285.00"
46705	"ANOPLASTY, PLASTIC OPERATION FOR STRICTURE; INFANT"	"45,435.00"	"20,865.00"	"24,570.00"
46715	"REPAIR OF LOW IMPERFORATE ANUS; W/ ANOPERINEAL FISTULA
(""CUT-BACK"" PROCEDURE)"	"45,435.00"	"20,865.00"	"24,570.00"
46716	REPAIR OF LOW IMPERFORATE ANUS; W/ TRANSPORTATION OF ANOPERINEAL OR ANOVESTIBULAR FISTULA	"73,710.00"	"32,760.00"	"40,950.00"
46730	"REPAIR OF HIGH IMPERFORATE ANUS W/O FISTULA; PERINEAL OR
SACROPERINEAL APPROACH"	"73,710.00"	"32,760.00"	"40,950.00"
46735	REPAIR OF HIGH IMPERFORATE ANUS W/O FISTULA; COMBINED TRANSABDOMINAL AND SACROPERINEAL APPROACHES	"90,675.00"	"41,535.00"	"49,140.00"
46740	"REPAIR OF HIGH IMPERFORATE ANUS W/ RECTOURETHRAL OR
RECTOVAGINAL FISTULA; PERINEAL OR SACROPERINEAL APPROACH"	"59,085.00"	"26,325.00"	"32,760.00"
46742	"REPAIR OF HIGH IMPERFORATE ANUS W/ RECTOURETHRAL OR
RECTOVAGINAL FISTULA; COMBINED TRANSABDOMINAL AND SACROPERINEAL APPROACHES"	"104,130.00"	"46,800.00"	"57,330.00"
46744	"REPAIR OF CLOACAL ANOMALY BY ANORECTOVAGINOPLASTY AND URETHROPLASTY, SACROPERINEAL APPROACH"	"114,660.00"	"40,950.00"	"73,710.00"
46746	"REPAIR OF CLOACAL ANOMALY BY ANORECTOVAGINOPLASTY AND URETHROPLASTY, COMBINED ABDOMINAL AND SACROPERINEAL
APPROACH;"	"122,850.00"	"40,950.00"	"81,900.00"
46748	"REPAIR OF CLOACAL ANOMALY BY ANORECTOVAGINOPLASTY AND URETHROPLASTY, COMBINED ABDOMINAL AND SACROPERINEAL APPROACH; W/ VAGINAL LENGTHENING BY INTESTINAL GRAFT OR PEDICLE FLAPS"	"122,850.00"	"40,950.00"	"81,900.00"
46750	"SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE OR PROLAPSE;
ADULT"	"29,172.00"	"14,430.00"	"14,742.00"
46751	"SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE OR PROLAPSE;
CHILD"	"45,435.00"	"20,865.00"	"24,570.00"
46753	"GRAFT (THIERSCH OPERATION) FOR RECTAL INCONTINENCE
AND/OR PROLAPSE"	"18,915.00"	"10,725.00"	"8,190.00"
46754	"REMOVAL OF THIERSCH WIRE OR SUTURE, ANAL CANAL"	"16,107.00"	"9,555.00"	"6,552.00"
46760	"SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT; MUSCLE
TRANSPLANT"	"78,624.00"	"32,760.00"	"45,864.00"
46761	"SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT; LEVATOR MUSCLE IMBRICATION (PARK POSTERIOR ANAL REPAIR)"	"40,911.00"	"21,255.00"	"19,656.00"
46762	"SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT;
IMPLANTATION ARTIFICIAL SPHINCTER"	"78,624.00"	"32,760.00"	"45,864.00"
46900	"DESTRUCTION OF LESION(S), ANUS (E.G., CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE),
SIMPLE; CHEMICAL"	"16,107.00"	"9,555.00"	"6,552.00"
46910	"DESTRUCTION OF LESION(S), ANUS (E.G., CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE),
SIMPLE; ELECTRODESICCATION"	"16,107.00"	"9,555.00"	"6,552.00"
46916	"DESTRUCTION OF LESION(S), ANUS (E.G., CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE),
SIMPLE; CRYOSURGERY"	"16,107.00"	"9,555.00"	"6,552.00"
46917	"DESTRUCTION OF LESION(S), ANUS (E.G., CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE),
SIMPLE; LASER SURGERY"	"16,107.00"	"9,555.00"	"6,552.00"
46922	"DESTRUCTION OF LESION(S), ANUS (E.G., CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE),
SIMPLE; SURGICAL EXCISION"	"16,107.00"	"9,555.00"	"6,552.00"
46924	"DESTRUCTION OF LESION(S), ANUS (E.G., CONDYLOMA,
PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE), EXTENSIVE, ANY METHOD"	"18,915.00"	"10,725.00"	"8,190.00"
46934	"DESTRUCTION OF HEMORRHOIDS, ANY METHOD; INTERNAL"	"18,915.00"	"10,725.00"	"8,190.00"
46935	"DESTRUCTION OF HEMORRHOIDS, ANY METHOD; EXTERNAL"	"18,915.00"	"10,725.00"	"8,190.00"
46936	"DESTRUCTION OF HEMORRHOIDS, ANY METHOD; INTERNAL AND
EXTERNAL"	"18,915.00"	"10,725.00"	"8,190.00"
46937	CRYOSURGERY OF RECTAL TUMOR; BENIGN	"18,915.00"	"10,725.00"	"8,190.00"
46938	CRYOSURGERY OF RECTAL TUMOR; MALIGNANT	"18,915.00"	"10,725.00"	"8,190.00"
46940	"CURETTAGE OR CAUTERIZATION OF ANAL FISSURE, INCLUDING
DILATION OF ANAL SPHINCTER"	"18,915.00"	"10,725.00"	"8,190.00"
46945	LIGATION OF INTERNAL HEMORRHOIDS	"16,107.00"	"9,555.00"	"6,552.00"
47000	"BIOPSY OF LIVER, NEEDLE; PERCUTANEOUS"	"15,639.00"	"10,725.00"	"4,914.00"
47010	"HEPATOTOMY FOR DRAINAGE OF ABSCESS OR CYST, ONE OR TWO
STAGES"	"35,100.00"	"18,720.00"	"16,380.00"
47015	"LAPAROTOMY, W/ ASPIRATION AND/OR INJECTION OF HEPATIC PARASITIC (E.G., AMOEBIC OR ECHINOCOCCAL) CYST(S) OR
ABSCESS(ES)"	"35,100.00"	"18,720.00"	"16,380.00"
47100	"BIOPSY OF LIVER, WEDGE"	"35,100.00"	"18,720.00"	"16,380.00"
47120	"HEPATECTOMY, RESECTION OF LIVER; PARTIAL LOBECTOMY"	"104,130.00"	"46,800.00"	"57,330.00"
47122	"HEPATECTOMY, RESECTION OF LIVER; TRISEGMENTECTOMY"	"107,250.00"	"41,730.00"	"65,520.00"
47125	"HEPATECTOMY, RESECTION OF LIVER; TOTAL LEFT LOBECTOMY"	"90,675.00"	"41,535.00"	"49,140.00"
47130	"HEPATECTOMY, RESECTION OF LIVER; TOTAL RIGHT LOBECTOMY"	"104,130.00"	"46,800.00"	"57,330.00"
47134	"DONOR HEPATECTOMY, W/ PREPARATION AND MAINTENANCE OF ALLOGRAFT; PARTIAL, FROM LIVING DONOR"	"90,675.00"	"41,535.00"	"49,140.00"
47135	"LIVER ALLOTRANSPLANTATION; ORTHOTOPIC, PARTIAL OR
WHOLE, FROM CADAVER OR LIVING DONOR, ANY AGE"	"107,250.00"	"41,730.00"	"65,520.00"
47136	"LIVER ALLOTRANSPLANTATION; HETEROTOPIC, PARTIAL OR
WHOLE, FROM CADAVER OR LIVING DONOR, ANY AGE"	"107,250.00"	"41,730.00"	"65,520.00"
47300	MARSUPIALIZATION OF CYST OR ABSCESS OF LIVER	"35,100.00"	"18,720.00"	"16,380.00"
47350	"MANAGEMENT OF LIVER HEMORRHAGE; SIMPLE SUTURE OF
LIVER WOUND OR INJURY"	"45,435.00"	"20,865.00"	"24,570.00"
47360	"MANAGEMENT OF LIVER HEMORRHAGE; COMPLEX SUTURE OF LIVER WOUND OR INJURY, W/ OR W/O HEPATIC ARTERY LIGATION"	"90,675.00"	"41,535.00"	"49,140.00"
47361	"MANAGEMENT OF LIVER HEMORRHAGE; EXPLORATION OF HEPATIC WOUND, EXTENSIVE DEBRIDEMENT, COAGULATION AND/OR SUTURE,  W/ OR W/O PACKING OF LIVER"	"73,710.00"	"32,760.00"	"40,950.00"
47362	"MANAGEMENT OF LIVER HEMORRHAGE; RE-EXPLORATION OF
HEPATIC WOUND FOR REMOVAL OF PACKING"	"73,710.00"	"32,760.00"	"40,950.00"
47370	"LAPAROSCOPY, SURGICAL, ABLATION OF ONE OR MORE LIVER
TUMOR(S); RADIOFREQUENCY"	"35,100.00"	"18,720.00"	"16,380.00"
47371	"LAPAROSCOPY, SURGICAL, ABLATION OF ONE OR MORE LIVER
TUMOR(S); CRYOSURGICAL"	"35,100.00"	"18,720.00"	"16,380.00"
47380	"ABLATION, OPEN, OF OR MORE LIVER TUMOR(S);
RADIOFREQUENCY"	"18,915.00"	"10,725.00"	"8,190.00"
47381	"ABLATION, OPEN, OF OR MORE LIVER TUMOR(S); CRYOSURGICAL"	"18,915.00"	"10,725.00"	"8,190.00"
47382	"ABLATION, ONE OR MORE LIVER TUMOR(S), PERCUTANEOUS
RADIOFREQUENCY"	"18,915.00"	"10,725.00"	"8,190.00"
47400	"HEPATICOTOMY OR HEPATICOSTOMY W/ EXPLORATION,
DRAINAGE, OR REMOVAL OF CALCULUS"	"104,130.00"	"46,800.00"	"57,330.00"
47420	"CHOLEDOCHOTOMY OR CHOLEDOCHOSTOMY W/ EXPLORATION, DRAINAGE, OR REMOVAL OF CALCULUS, W/ OR W/O CHOLECYSTOTOMY; W/O TRANSDUODENAL SPHINCTEROTOMY OR
SPHINCTEROPLASTY"	"73,710.00"	"32,760.00"	"40,950.00"
47425	"CHOLEDOCHOTOMY OR CHOLEDOCHOSTOMY W/ EXPLORATION, DRAINAGE, OR REMOVAL OF CALCULUS, W/ OR W/O CHOLECYSTOTOMY; W/ TRANSDUODENAL SPHINCTEROTOMY OR
SPHINCTEROPLASTY"	"90,675.00"	"41,535.00"	"49,140.00"
47460	"TRANSDUODENAL SPHINCTEROTOMY OR SPHINCTEROPLASTY, W/ OR W/O TRANSDUODENAL EXTRACTION OF CALCULUS"	"90,675.00"	"41,535.00"	"49,140.00"
47480	"CHOLECYSTOTOMY OR CHOLECYSTOSTOMY W/ EXPLORATION,
DRAINAGE, OR REMOVAL OF CALCULUS"	"59,085.00"	"26,325.00"	"32,760.00"
47490	PERCUTANEOUS CHOLECYSTOSTOMY	"59,085.00"	"26,325.00"	"32,760.00"
47510	"INTRODUCTION OF PERCUTANEOUS TRANSHEPATIC CATHETER
FOR BILIARY DRAINAGE"	"59,085.00"	"26,325.00"	"32,760.00"
47511	"INTRODUCTION OF PERCUTANEOUS TRANSHEPATIC STENT FOR
INTERNAL AND EXTERNAL BILIARY DRAINAGE"	"59,085.00"	"26,325.00"	"32,760.00"
47525	CHANGE OF PERCUTANEOUS BILIARY DRAINAGE CATHETER	"15,639.00"	"10,725.00"	"4,914.00"
47530	REVISION AND/OR REINSERTION OF TRANSHEPATIC TUBE	"16,107.00"	"9,555.00"	"6,552.00"
47552	"BILIARY ENDOSCOPY, PERCUTANEOUS VIA T- TUBE OR OTHER
TRACT; DIAGNOSTIC, W/ OR W/O COLLECTION OF SPECIMEN(S) BY BRUSHING AND/OR WASHING"	"45,435.00"	"20,865.00"	"24,570.00"
47553	"BILIARY ENDOSCOPY, PERCUTANEOUS VIA T- TUBE OR OTHER
TRACT; W/ BIOPSY, SINGLE OR MULTIPLE"	"45,435.00"	"20,865.00"	"24,570.00"
47554	"BILIARY ENDOSCOPY, PERCUTANEOUS VIA T- TUBE OR OTHER
TRACT; W/ REMOVAL OF STONE(S)"	"45,435.00"	"20,865.00"	"24,570.00"
47555	"BILIARY ENDOSCOPY, PERCUTANEOUS VIA T- TUBE OR OTHER TRACT; W/ DILATION OF BILIARY DUCT STRICTURE(S) W/O STENT"	"45,435.00"	"20,865.00"	"24,570.00"
47556	"BILIARY ENDOSCOPY, PERCUTANEOUS VIA T- TUBE OR OTHER TRACT; W/ DILATION OF BILIARY DUCT STRICTURE(S) W/ STENT"	"45,435.00"	"20,865.00"	"24,570.00"
47560	"LAPAROSCOPY, SURGICAL; WITH GUIDED TRANSHEPATIC
CHOLANGIOGRAPHY, WITHOUT BIOPSY"	"60,450.00"	"36,270.00"	"24,180.00"
47561	"LAPAROSCOPY, SURGICAL; WITH GUIDED TRANSHEPATIC
CHOLANGIOGRAPHY, WITH BIOPSY"	"60,450.00"	"36,270.00"	"24,180.00"
47562	"LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY (ANY METHOD)"	"60,450.00"	"36,270.00"	"24,180.00"
47563	"LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY WITH
CHOLANGIOGRAPHY"	"60,450.00"	"36,270.00"	"24,180.00"
47564	"LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY WITH
EXPLORATION OF COMMON DUCT"	"90,675.00"	"41,535.00"	"49,140.00"
47570	"LAPAROSCOPY, SURGICAL; CHOLECYSTOENTEROSTOMY"	"60,450.00"	"36,270.00"	"24,180.00"
47600	CHOLECYSTECTOMY;	"60,450.00"	"36,270.00"	"24,180.00"
47605	CHOLECYSTECTOMY; W/ CHOLANGIOGRAPHY	"60,450.00"	"36,270.00"	"24,180.00"
47610	CHOLECYSTECTOMY W/ EXPLORATION OF COMMON DUCT;	"90,675.00"	"41,535.00"	"49,140.00"
47612	"CHOLECYSTECTOMY W/ EXPLORATION OF COMMON DUCT; W/
CHOLEDOCHOENTEROSTOMY"	"104,130.00"	"46,800.00"	"57,330.00"
47620	"CHOLECYSTECTOMY W/ EXPLORATION OF COMMON DUCT; W/ TRANSDUODENAL SPHINCTEROTOMY OR SPHINCTEROPLASTY,  W/
OR W/O CHOLANGIOGRAPHY"	"90,675.00"	"41,535.00"	"49,140.00"
47630	"BILIARY DUCT STONE EXTRACTION,  PERCUTANEOUS VIA T-TUBE TRACT, BASKET, OR SNARE (E.G., BURHENNE TECHNIQUE)"	"45,435.00"	"20,865.00"	"24,570.00"
47700	"EXPLORATION FOR CONGENITAL ATRESIA OF BILE DUCTS, W/O REPAIR, W/ OR W/O LIVER BIOPSY, W/ OR W/O
CHOLANGIOGRAPHY"	"104,130.00"	"46,800.00"	"57,330.00"
47701	"PORTOENTEROSTOMY (E.G., KASAI PROCEDURE)"	"107,250.00"	"41,730.00"	"65,520.00"
47711	"EXCISION OF BILE DUCT TUMOR, W/ OR W/O PRIMARY REPAIR OF
BILE DUCT; EXTRAHEPATIC"	"107,250.00"	"41,730.00"	"65,520.00"
47712	"EXCISION OF BILE DUCT TUMOR, W/ OR W/O PRIMARY REPAIR OF
BILE DUCT; INTRAHEPATIC"	"114,660.00"	"40,950.00"	"73,710.00"
47715	EXCISION OF CHOLEDOCHAL CYST	"107,250.00"	"41,730.00"	"65,520.00"
47716	"ANASTOMOSIS, CHOLEDOCHAL CYST, W/O EXCISION"	"90,675.00"	"41,535.00"	"49,140.00"
47720	CHOLECYSTOENTEROSTOMY; DIRECT	"73,710.00"	"32,760.00"	"40,950.00"
47721	CHOLECYSTOENTEROSTOMY; W/ GASTROENTEROSTOMY	"90,675.00"	"41,535.00"	"49,140.00"
47740	ROUX-EN-Y	"104,130.00"	"46,800.00"	"57,330.00"
47741	ROUX-EN-Y W/ GASTROENTEROSTOMY	"104,130.00"	"46,800.00"	"57,330.00"
47760	"ANASTOMOSIS, OF EXTRAHEPATIC BILIARY DUCTS AND
GASTROINTESTINAL TRACT"	"90,675.00"	"41,535.00"	"49,140.00"
47765	"ANASTOMOSIS, OF INTRAHEPATIC DUCTS AND
GASTROINTESTINAL TRACT"	"104,130.00"	"46,800.00"	"57,330.00"
47780	"ANASTOMOSIS, ROUX-EN-Y, OF EXTRAHEPATIC BILIARY DUCTS
AND GASTROINTESTINAL TRACT"	"90,675.00"	"41,535.00"	"49,140.00"
47785	"ANASTOMOSIS, ROUX-EN-Y, OF INTRAHEPATIC BILIARY DUCTS
AND GASTROINTESTINAL TRACT"	"104,130.00"	"46,800.00"	"57,330.00"
47800	"RECONSTRUCTION, PLASTIC, OF EXTRAHEPATIC BILIARY DUCTS
W/ END-TO-END ANASTOMOSIS"	"90,675.00"	"41,535.00"	"49,140.00"
47801	PLACEMENT OF CHOLEDOCHAL STENT	"73,710.00"	"32,760.00"	"40,950.00"
47802	U-TUBE HEPATICOENTEROSTOMY	"73,710.00"	"32,760.00"	"40,950.00"
47900	"SUTURE OF EXTRAHEPATIC BILIARY DUCT FOR PRE-EXISTING
INJURY"	"90,675.00"	"41,535.00"	"49,140.00"
48000	"PLACEMENT OF DRAINS, PERIPANCREATIC, FOR ACUTE
PANCREATITIS;"	"45,435.00"	"20,865.00"	"24,570.00"
48001	"PLACEMENT OF DRAINS, PERIPANCREATIC, FOR ACUTE PANCREATITIS; W/ CHOLECYSTOSTOMY, GASTROSTOMY, AND
JEJUNOSTOMY"	"90,675.00"	"41,535.00"	"49,140.00"
48005	"RESECTION OR DEBRIDEMENT OF PANCREAS AND PERIPANCREATIC TISSUE FOR ACUTE NECROTIZING
PANCREATITIS"	"90,675.00"	"41,535.00"	"49,140.00"
48020	REMOVAL OF PANCREATIC CALCULUS	"73,710.00"	"32,760.00"	"40,950.00"
48100	"BIOPSY OF PANCREAS, OPEN, ANY METHOD (E.G., FINE NEEDLE ASPIRATION, NEEDLE CORE BIOPSY, WEDGE BIOPSY)"	"23,634.00"	"10,530.00"	"13,104.00"
48102	"BIOPSY OF PANCREAS, PERCUTANEOUS NEEDLE"	"18,915.00"	"10,725.00"	"8,190.00"
48120	"EXCISION OF LESION OF PANCREAS (E.G., CYST, ADENOMA)"	"59,085.00"	"26,325.00"	"32,760.00"
48140	"PANCREATECTOMY, DISTAL SUBTOTAL, W/ OR W/O
SPLENECTOMY; W/O PANCREATICOJEJUNOSTOMY"	"90,675.00"	"41,535.00"	"49,140.00"
48145	"PANCREATECTOMY, DISTAL SUBTOTAL, W/ OR W/O
SPLENECTOMY; W/ PANCREATICOJEJUNOSTOMY"	"104,130.00"	"46,800.00"	"57,330.00"
48146	"PANCREATECTOMY, DISTAL, NEAR-TOTAL W/ PRESERVATION OF
DUODENUM (CHILD-TYPE PROCEDURE)"	"104,130.00"	"46,800.00"	"57,330.00"
48148	EXCISION OF AMPULLA OF VATER	"90,675.00"	"41,535.00"	"49,140.00"
48150	"PANCREATECTOMY, PROXIMAL SUBTOTAL W/ TOTAL DUODENECTOMY, PARTIAL GASTRECTOMY, CHOLEDOCHOENTEROSTOMY AND GASTROJEJUNOSTOMY (WHIPPLE-TYPE PROCEDURE); W/ PANCREATOJEJUNOSTOMY"	"114,660.00"	"40,950.00"	"73,710.00"
48152	"PANCREATECTOMY, PROXIMAL SUBTOTAL W/ TOTAL DUODENECTOMY, PARTIAL GASTRECTOMY, CHOLEDOCHOENTEROSTOMY AND GASTROJEJUNOSTOMY (WHIPPLE-TYPE PROCEDURE); W/O PANCREATOJEJUNOSTOMY"	"107,250.00"	"41,730.00"	"65,520.00"
48153	"PANCREATECTOMY, PROXIMAL SUBTOTAL W/ NEAR TOTAL DUODENECTOMY, CHOLEDOCHOENTEROSTOMY AND DUODENOJEJUNOSTOMY (PYLORUS-SPARING, WHIPPLE-TYPE
PROCEDURE); W/ PANCREATOJEJUNOSTOMY"	"122,850.00"	"40,950.00"	"81,900.00"
48154	"PANCREATECTOMY, PROXIMAL SUBTOTAL W/ NEAR TOTAL DUODENECTOMY, CHOLEDOCHOENTEROSTOMY AND DUODENOJEJUNOSTOMY (PYLORUS-SPARING, WHIPPLE-TYPE
PROCEDURE); W/O PANCREATOJEJUNOSTOMY"	"114,660.00"	"40,950.00"	"73,710.00"
48155	"PANCREATECTOMY, TOTAL"	"122,850.00"	"40,950.00"	"81,900.00"
48160	"PANCREATECTOMY, TOTAL OR SUBTOTAL, W/ AUTOLOGOUS TRANSPLANTATION OF PANCREAS OR PANCREATIC ISLETS"	"122,850.00"	"40,950.00"	"81,900.00"
48180	"PANCREATICOJEJUNOSTOMY, SIDE-TO-SIDE ANASTOMOSIS
(PUESTOW-TYPE OPERATION)"	"107,250.00"	"41,730.00"	"65,520.00"
48500	MARSUPIALIZATION OF CYST OF PANCREAS	"59,085.00"	"26,325.00"	"32,760.00"
48510	"EXTERNAL DRAINAGE, PSUEDOCYST OF PANCREAS"	"45,435.00"	"20,865.00"	"24,570.00"
48520	"INTERNAL ANASTOMOSIS OF PACREATIC CYST TO
GASTROINTESTINAL TRACT; DIRECT"	"90,675.00"	"41,535.00"	"49,140.00"
48540	"INTERNAL ANASTOMOSIS OF PACREATIC CYST TO
GASTROINTESTINAL TRACT; ROUX-EN-Y"	"90,675.00"	"41,535.00"	"49,140.00"
48545	PANCREATORRHAPHY FOR TRAUMA	"104,130.00"	"46,800.00"	"57,330.00"
48547	"DUODENAL EXCLUSION W/ GASTROJEJUNOSTOMY FOR
PANCREATIC TRAUMA"	"104,130.00"	"46,800.00"	"57,330.00"
48550	"DONOR PANCREATECTOMY, W/ PREPARATION AND MAINTENANCE OF ALLOGRAFT FROM CADAVER DONOR, W/ OR W/O DUODENAL
SEGMENT FOR TRANSPLANTATION"	"59,085.00"	"26,325.00"	"32,760.00"
48554	TRANSPLANTATION OF PANCREATIC ALLOGRAFT	"59,085.00"	"26,325.00"	"32,760.00"
48556	REMOVAL OF TRANSPLANTED PANCREATIC ALLOGRAFT	"45,435.00"	"20,865.00"	"24,570.00"
49000	"EXPLORATORY LAPAROTOMY, EXPLORATORY CELIOTOMY W/ OR
W/O BIOPSY(S)"	"45,435.00"	"20,865.00"	"24,570.00"
49010	"EXPLORATION, RETROPERITONEAL AREA W/ OR W/O BIOPSY(S)"	"45,435.00"	"20,865.00"	"24,570.00"
49020	"DRAINAGE OF PERITONEAL ABSCESS OR LOCALIZED PERITONITIS,
EXCLUSIVE OF APPENDICEAL ABSCESS; OPEN"	"45,435.00"	"20,865.00"	"24,570.00"
49021	"DRAINAGE OF PERITONEAL ABSCESS OR LOCALIZED PERITONITIS, EXCLUSIVE OF APPENDICEAL ABSCESS; PERCUTANEOUS"	"16,107.00"	"9,555.00"	"6,552.00"
49040	DRAINAGE OF SUBDIAPHARGMATIC OR SUBPHRENIC ABSCESS	"45,435.00"	"20,865.00"	"24,570.00"
49060	DRAINAGE OF RETROPERITONEAL ABSCESS	"45,435.00"	"20,865.00"	"24,570.00"
49080	"PERITONEOCENTESIS, ABDOMINAL PARACENTESIS, OR
PERITONEAL LAVAGE (DIAGNOSTIC OR THERAPEUTIC)"	"15,639.00"	"10,725.00"	"4,914.00"
49085	"REMOVAL OF PERITONEAL FOREIGN BODY FROM PERITONEAL
CAVITY"	"45,435.00"	"20,865.00"	"24,570.00"
49180	"BIOPSY, ABDOMINAL OR RETROPERITONEAL MASS,
PERCUTANEOUS NEEDLE"	"16,107.00"	"9,555.00"	"6,552.00"
49200	"EXCISION OR DESTRUCTION BY ANY METHOD OF INTRA- ABDOMINAL OR RETROPERITONEAL TUMORS OR CYSTS OR
ENDOMETRIOMAS;"	"73,710.00"	"32,760.00"	"40,950.00"
49201	"EXCISION OR DESTRUCTION BY ANY METHOD OF INTRA- ABDOMINAL OR RETROPERITONEAL TUMORS OR CYSTS OR
ENDOMETRIOMAS; EXTENSIVE"	"104,130.00"	"46,800.00"	"57,330.00"
49215	EXCISION OF PRESACRAL OR  SACROCOCCYGEAL TUMOR	"90,675.00"	"41,535.00"	"49,140.00"
49220	"STAGING CELIOTOMY (LAPAROTOMY) FOR HODGKINS DISEASE OR LYMPHOMA (INCLUDES SPLENECTOMY, NEEDLE OR OPEN BIOPSIES OF BOTH LIVER LOBES, POSSIBLY ALSO REMOVAL OF ABDOMINAL NODES, ABDOMINAL NODE AND/OR BONE MARROW BIOPSIES, OVARIAN REPOSITIONING)"	"45,435.00"	"20,865.00"	"24,570.00"
49250	"UMBILECTOMY, OMPHALECTOMY, EXCISION OF UMBILICUS"	"18,915.00"	"10,725.00"	"8,190.00"
49255	"OMENTECTOMY, EPIPLOECTOMY, RESECTION OF OMENTUM"	"18,915.00"	"10,725.00"	"8,190.00"
49320	"LAPAROSCOPY, ABDOMEN, PERITONEUM, AND OMENTUM, DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY
BRUSHING OR WASHING"	"11,076.00"	"7,800.00"	"3,276.00"
49321	"LAPAROSCOPY, SURGICAL; WITH BIOPSY (SINGLE OR MULTIPLE)"	"18,915.00"	"10,725.00"	"8,190.00"
49322	"LAPAROSCOPY, SURGICAL; WITH ASPIRATION OF CAVITY OR CYST
(SINGLE OR MULTIPLE)"	"23,634.00"	"10,530.00"	"13,104.00"
49323	"LAPAROSCOPY, SURGICAL; WITH DRAINAGE OF LYMPHOCELE TO
PERITONEAL CAVITY"	"16,107.00"	"9,555.00"	"6,552.00"
49420	"INSERTION OF INTRAPERITONEAL CANNULA OR CATHETER FOR
DRAINAGE OR DIALYSIS"	"16,107.00"	"9,555.00"	"6,552.00"
49425	INSERTION OF PERITONEAL-VENOUS SHUNT	"35,100.00"	"18,720.00"	"16,380.00"
49495	"REPAIR INITIAL INGUINAL HERNIA, UNDER AGE 6 MONTHS, W/ OR
W/O HYDROCELECTOMY; REDUCIBLE"	"40,950.00"	"24,570.00"	"16,380.00"
49496	"REPAIR INITIAL INGUINAL HERNIA, UNDER AGE 6 MONTHS, W/ OR
W/O HYDROCELECTOMY; INCARCERATED"	"40,950.00"	"24,570.00"	"16,380.00"
49497	"REPAIR INITIAL INGUINAL HERNIA, UNDER AGE 6 MONTHS, W/ OR
W/O HYDROCELECTOMY; STRANGULATED"	"40,950.00"	"24,570.00"	"16,380.00"
49500	"REPAIR INITIAL INGUINAL HERNIA, AGE 6 MONTHS TO UNDER 5 YEARS, W/ OR W/O HYDROCELECTOMY; REDUCIBLE"	"40,950.00"	"24,570.00"	"16,380.00"
49501	"REPAIR INITIAL INGUINAL HERNIA, AGE 6 MONTHS TO UNDER 5 YEARS, W/ OR W/O HYDROCELECTOMY; INCARCERATED"	"40,950.00"	"24,570.00"	"16,380.00"
49502	"REPAIR INITIAL INGUINAL HERNIA, AGE 6 MONTHS TO UNDER 5 YEARS, W/ OR W/O HYDROCELECTOMY; STRANGULATED"	"40,950.00"	"24,570.00"	"16,380.00"
49505	"REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OVER;
REDUCIBLE"	"40,950.00"	"24,570.00"	"16,380.00"
49507	"REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OVER;
INCARCERATED"	"40,950.00"	"24,570.00"	"16,380.00"
49509	"REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OVER;
STRANGULATED"	"40,950.00"	"24,570.00"	"16,380.00"
49520	"REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; REDUCIBLE"	"40,950.00"	"24,570.00"	"16,380.00"
49521	"REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; INCARCERATED"	"40,950.00"	"24,570.00"	"16,380.00"
49522	"REPAIR RECURRENT INGUINAL HERNIA, ANY AGE;
STRANGULATED"	"40,950.00"	"24,570.00"	"16,380.00"
49525	"REPAIR INGUINAL HERNIA, SLIDING, ANY AGE"	"40,950.00"	"24,570.00"	"16,380.00"
49540	REPAIR LUMBAR HERNIA	"40,950.00"	"24,570.00"	"16,380.00"
49550	"REPAIR INITIAL FEMORAL HERNIA, ANY AGE; REDUCIBLE"	"40,950.00"	"24,570.00"	"16,380.00"
49553	"REPAIR INITIAL FEMORAL HERNIA, ANY AGE; INCARCERATED"	"40,950.00"	"24,570.00"	"16,380.00"
49554	"REPAIR INITIAL FEMORAL HERNIA, ANY AGE; STRANGULATED"	"40,950.00"	"24,570.00"	"16,380.00"
49555	REPAIR RECURRENT FEMORAL HERNIA; REDUCIBLE	"40,950.00"	"24,570.00"	"16,380.00"
49557	REPAIR RECURRENT FEMORAL HERNIA; INCARCERATED	"40,950.00"	"24,570.00"	"16,380.00"
49558	REPAIR RECURRENT FEMORAL HERNIA; STRANGULATED	"40,950.00"	"24,570.00"	"16,380.00"
49560	REPAIR INITIAL INCISIONAL HERNIA; REDUCIBLE	"40,950.00"	"24,570.00"	"16,380.00"
49561	REPAIR INITIAL INCISIONAL HERNIA; INCARCERATED	"40,950.00"	"24,570.00"	"16,380.00"
49562	REPAIR INITIAL INCISIONAL HERNIA; STRANGULATED	"40,950.00"	"24,570.00"	"16,380.00"
49565	REPAIR RECURRENT INCISIONAL HERNIA; REDUCIBLE	"40,950.00"	"24,570.00"	"16,380.00"
49566	REPAIR RECURRENT INCISIONAL HERNIA; INCARCERATED	"40,950.00"	"24,570.00"	"16,380.00"
49567	REPAIR RECURRENT INCISIONAL HERNIA; STRANGULATED	"40,950.00"	"24,570.00"	"16,380.00"
49570	"REPAIR EPIGASTRIC HERNIA (E.G., PREPERITONEAL FAT);
REDUCIBLE"	"40,950.00"	"24,570.00"	"16,380.00"
49572	"REPAIR EPIGASTRIC HERNIA (E.G., PREPERITONEAL FAT);
INCARCERATED"	"40,950.00"	"24,570.00"	"16,380.00"
49573	"REPAIR EPIGASTRIC HERNIA (E.G., PREPERITONEAL FAT);
STRANGULATED"	"40,950.00"	"24,570.00"	"16,380.00"
49580	"REPAIR UMBILICAL HERNIA, UNDER AGE 5 YEARS; REDUCIBLE"	"40,950.00"	"24,570.00"	"16,380.00"
49582	"REPAIR UMBILICAL HERNIA, UNDER AGE 5 YEARS; INCARCERATED"	"40,950.00"	"24,570.00"	"16,380.00"
49583	"REPAIR UMBILICAL HERNIA, UNDER AGE 5 YEARS;
STRANGULATED"	"40,950.00"	"24,570.00"	"16,380.00"
49585	"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OVER; REDUCIBLE"	"40,950.00"	"24,570.00"	"16,380.00"
49587	"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OVER;
INCARCERATED"	"40,950.00"	"24,570.00"	"16,380.00"
49588	"REPAIR UMBILICAL HERNIA, AGE 5 YEARS OR OVER;
STRANGULATED"	"40,950.00"	"24,570.00"	"16,380.00"
49590	REPAIR SPIGELIAN HERNIA	"40,950.00"	"24,570.00"	"16,380.00"
49600	"REPAIR OF SMALL OMPHALOCELE,  W/ PRIMARY CLOSURE"	"45,435.00"	"20,865.00"	"24,570.00"
49605	"REPAIR LARGE OMPHALOCELE OR GASTROSCHISIS; W/ OR W/O
PROSTHESIS"	"73,710.00"	"32,760.00"	"40,950.00"
49606	"REPAIR LARGE OMPHALOCELE OR GASTROSCHISIS; W/ REMOVAL OF PROSTHESIS, FINAL REDUCTION AND CLOSURE, IN OPERATING
ROOM"	"59,085.00"	"26,325.00"	"32,760.00"
49610	"REPAIR OF OMPHALOCELE (GROSS TYPE OPERATION); FIRST
STAGE"	"45,435.00"	"20,865.00"	"24,570.00"
49611	"REPAIR OF OMPHALOCELE (GROSS TYPE OPERATION); SECOND
STAGE"	"59,085.00"	"26,325.00"	"32,760.00"
49650	"LAPAROSCOPY, SURGICAL; REPAIR OF INITIAL INGUINAL HERNIA"	"40,950.00"	"24,570.00"	"16,380.00"
49651	"LAPAROSCOPY, SURGICAL; REPAIR OF RECURRENT INGUINAL
HERNIA"	"40,950.00"	"24,570.00"	"16,380.00"
49900	"SUTURE, SECONDARY, OF ABDOMINAL WALL FOR EVISCERATION
OR DEHISCENCE"	"35,100.00"	"18,720.00"	"16,380.00"
49905	"OMENTAL FLAP (E.G., FOR RECONSTRUCTION OF STERNAL AND CHEST WALL DEFECTS) (LIST SEPARATELY IN ADDITION TO CODE
FOR PRIMARY PROCEDURE)"	"45,435.00"	"20,865.00"	"24,570.00"
49906	FREE OMENTAL FLAP W/ MICROVASCULAR ANASTOMOSIS	"59,085.00"	"26,325.00"	"32,760.00"
50010	"RENAL EXPLORATION, NOT NECESSITATING OTHER SPECIFIC
PROCEDURES"	"40,911.00"	"21,255.00"	"19,656.00"
50020	DRAINAGE OF PERIRENAL OR RENAL ABSCESS	"35,100.00"	"18,720.00"	"16,380.00"
50040	"NEPHROSTOMY, NEPHROTOMY W/ DRAINAGE"	"35,100.00"	"18,720.00"	"16,380.00"
50045	"NEPHROTOMY, W/ EXPLORATION"	"35,100.00"	"18,720.00"	"16,380.00"
50060	NEPHROLITHOTOMY; REMOVAL OF CALCULUS	"52,884.00"	"23,400.00"	"29,484.00"
50065	"NEPHROLITHOTOMY; SECONDARY SURGICAL OPERATION FOR
CALCULUS"	"59,085.00"	"26,325.00"	"32,760.00"
50070	"NEPHROLITHOTOMY; COMPLICATED BY CONGENITAL KIDNEY
ABNORMALITY"	"52,884.00"	"23,400.00"	"29,484.00"
50075	"NEPHROLITHOTOMY; REMOVAL OF LARGE STAGHORN CALCULUS FILLING RENAL PELVIS AND CALYCES (INCLUDING ANATROPHIC
PYELOLITHOTOMY)"	"73,710.00"	"32,760.00"	"40,950.00"
50080	"PERCUTANEOUS NEPHROSTOLITHOTOMY OR PYELOSTOLITHOTOMY, W/ OR W/O DILATION, ENDOSCOPY, LITHOTRIPSY, STENTING, OR BASKET EXTRACTION; UP TO 2 CM"	"59,085.00"	"26,325.00"	"32,760.00"
50081	"PERCUTANEOUS NEPHROSTOLITHOTOMY OR PYELOSTOLITHOTOMY, W/ OR W/O DILATION, ENDOSCOPY, LITHOTRIPSY, STENTING, OR BASKET EXTRACTION; OVER 2 CM"	"59,085.00"	"26,325.00"	"32,760.00"
50100	TRANSECTION OR REPOSITIONING OF ABERRANT RENAL VESSELS	"59,085.00"	"26,325.00"	"32,760.00"
50120	PYELOTOMY; W/ EXPLORATION	"35,100.00"	"18,720.00"	"16,380.00"
50125	"PYELOTOMY; W/ DRAINAGE, PYELOSTOMY"	"35,100.00"	"18,720.00"	"16,380.00"
50130	"PYELOTOMY; W/ REMOVAL OF CALCULUS (PYELOLITHOTOMY, PELVIOLITHOTOMY, INCLUDING COAGULUM PYELOLITHOTOMY)"	"45,435.00"	"20,865.00"	"24,570.00"
50135	"PYELOTOMY; COMPLICATED (E.G., SECONDARY OPERATION,
CONGENITAL KIDNEY ABNORMALITY)"	"61,581.00"	"33,735.00"	"27,846.00"
50200	"RENAL BIOPSY; PERCUTANEOUS, BY TROCAR OR NEEDLE"	"15,639.00"	"10,725.00"	"4,914.00"
50220	"NEPHRECTOMY, INCLUDING PARTIAL URETERECTOMY, ANY
APPROACH INCLUDING RIB RESECTION;"	"52,884.00"	"23,400.00"	"29,484.00"
50225	"NEPHRECTOMY, INCLUDING PARTIAL URETERECTOMY, ANY APPROACH INCLUDING RIB RESECTION; COMPLICATED BECAUSE
OF PREVIOUS SURGERY ON SAME KIDNEY"	"59,085.00"	"26,325.00"	"32,760.00"
50230	"NEPHRECTOMY, INCLUDING PARTIAL URETERECTOMY, ANY APPROACH INCLUDING RIB RESECTION; RADICAL, W/ REGIONAL LYMPHADENECTOMY AND/OR VENA CAVAL THROMBECTOMY"	"59,085.00"	"26,325.00"	"32,760.00"
50234	"NEPHRECTOMY W/ TOTAL URETERECTOMY AND BLADDER CUFF;
THROUGH SAME INCISION"	"59,085.00"	"26,325.00"	"32,760.00"
50236	"NEPHRECTOMY W/ TOTAL URETERECTOMY AND BLADDER CUFF;
THROUGH SEPARATE INCISION"	"59,085.00"	"26,325.00"	"32,760.00"
50240	"NEPHRECTOMY, PARTIAL"	"52,884.00"	"23,400.00"	"29,484.00"
50250	"ABLATION, OPEN, ONE OR MORE  RENAL MASS LESION(S), CRYOSURGICAL, INCLUDING INTRAOPERATIVE ULTRASOUND, IF
PERFORMED"	"18,915.00"	"10,725.00"	"8,190.00"
50280	EXCISION OR UNROOFING OF CYST(S) OF KIDNEY	"40,911.00"	"21,255.00"	"19,656.00"
50290	EXCISION OF PERINEPHRIC CYST	"40,911.00"	"21,255.00"	"19,656.00"
50320	"DONOR NEPHRECTOMY, W/ PREPARATION AND MAINTENANCE OF
ALLOGRAFT; FROM LIVING DONOR"	"52,884.00"	"23,400.00"	"29,484.00"
50340	RECIPIENT NEPHRECTOMY	"45,435.00"	"20,865.00"	"24,570.00"
50360	"RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT; EXCLUDING DONOR AND RECIPIENT NEPHRECTOMY"	"90,675.00"	"41,535.00"	"49,140.00"
50365	"RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT; W/
RECIPIENT NEPHRECTOMY"	"119,574.00"	"40,950.00"	"78,624.00"
50370	REMOVAL OF TRANSPLANTED RENAL ALLOGRAFT	"59,085.00"	"26,325.00"	"32,760.00"
50380	"RENAL AUTOTRANSPLANTATION, REIMPLANTATION OF KIDNEY"	"104,130.00"	"46,800.00"	"57,330.00"
50390	"ASPIRATION AND/OR INJECTION OF RENAL CYST OR PELVIS BY
NEEDLE, PERCUTANEOUS"	"11,076.00"	"7,800.00"	"3,276.00"
50391	"INSTILLATION OF THERAPEUTIC AGENT INTO RENAL PELVIS
AND/OR URETER THROUGH ESTABLISHED NEPHROSTOMY, PYELOSTOMY OR URETEROSTOMY TUBE"	"18,915.00"	"10,725.00"	"8,190.00"
50392	"INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PERCUTANEOUS"	"18,915.00"	"10,725.00"	"8,190.00"
50393	"INTRODUCTION OF URETERAL CATHETER OR STENT INTO URETER THROUGH RENAL PELVIS FOR DRAINAGE AND/OR
INJECTION, PERCUTANEOUS"	"18,915.00"	"10,725.00"	"8,190.00"
50395	"INTRODUCTION OF GUIDE INTO RENAL PELVIS AND/OR URETER W/ DILATION TO ESTABLISH NEPHROSTOMY TRACT,
PERCUTANEOUS"	"16,107.00"	"9,555.00"	"6,552.00"
50400	"PYELOPLASTY (FOLEY Y-PYELOPLASTY), PLASTIC OPERATION ON RENAL PELVIS, W/ OR W/O PLASTIC OPERATION ON URETER, NEPHROPEXY, NEPHROSTOMY, PYELOSTOMY, OR URETERAL
SPLINTING; SIMPLE"	"59,085.00"	"26,325.00"	"32,760.00"
50405	"PYELOPLASTY (FOLEY Y-PYELOPLASTY), PLASTIC OPERATION ON RENAL PELVIS, W/ OR W/O PLASTIC OPERATION ON URETER, NEPHROPEXY, NEPHROSTOMY, PYELOSTOMY, OR URETERAL SPLINTING; COMPLICATED (CONGENITAL KIDNEY ABNORMALITY, SECONDARY PYELOPLASTY, SOLITARY KIDNEY, CA"	"72,501.00"	"36,465.00"	"36,036.00"
50500	"NEPHRORRHAPHY, SUTURE OF KIDNEY WOUND OR INJURY"	"45,435.00"	"20,865.00"	"24,570.00"
50520	CLOSURE OF NEPHROCUTANEOUS OR PYELOCUTANEOUS FISTULA	"35,100.00"	"18,720.00"	"16,380.00"
50525	"CLOSURE OF NEPHROVISCERAL FISTULA (E.G., RENOCOLIC),
INCLUDING VISCERAL REPAIR; ABDOMINAL APPROACH"	"45,435.00"	"20,865.00"	"24,570.00"
50526	"CLOSURE OF NEPHROVISCERAL FISTULA (E.G., RENOCOLIC),
INCLUDING VISCERAL REPAIR; THORACIC APPROACH"	"59,085.00"	"26,325.00"	"32,760.00"
50540	"SYMPHYSIOTOMY FOR HORSESHOE KIDNEY W/ OR W/O PYELOPLASTY AND/OR OTHER PLASTIC PROCEDURE, UNILATERAL
OR BILATERAL (ONE OPERATION)"	"59,085.00"	"26,325.00"	"32,760.00"
50541	"LAPAROSCOPY, SURGICAL; ABLATION OF RENAL CYSTS"	"20,553.00"	"10,725.00"	"9,828.00"
50542	"LAPAROSCOPY, SURGICAL; ABLATION OF RENAL MASS LESION(S)"	"18,915.00"	"10,725.00"	"8,190.00"
50543	"LAPAROSCOPY, SURGICAL; PARTIAL NEPHRECTOMY"	"59,085.00"	"26,325.00"	"32,760.00"
50544	"LAPAROSCOPY, SURGICAL; PYELOPLASTY"	"52,884.00"	"23,400.00"	"29,484.00"
50545	"LAPAROSCOPY, SURGICAL; RADICAL NEPHRECTOMY (INCLUDES REMOVAL OF GEROTAS FASCIA AND SURROUNDING FATTY TISSUE, REMOVAL OF REGIONAL LYMPH NODES AND ADRENALECTOMY)"	"52,884.00"	"23,400.00"	"29,484.00"
50546	"LAPAROSCOPY, SURGICAL; NEPHRECTOMY, INCLUDING PARTIAL
URETERECTOMY"	"45,435.00"	"20,865.00"	"24,570.00"
50547	"LAPAROSCOPY, SURGICAL; DONOR NEPHRECTOMY (INCLUDING
COLD PRESERVATION), FROM LIVING DONOR"	"45,435.00"	"20,865.00"	"24,570.00"
50548	"LAPAROSCOPY, SURGICAL; NEPHRECTOMY WITH TOTAL
URETERECTOMY"	"59,085.00"	"26,325.00"	"32,760.00"
50551	"RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, W/ OR  W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE;"	"16,949.40"	"10,725.00"	"6,224.40"
50553	"RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, W/ OR  W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ URETERAL CATHETERIZATION, W/ OR W/O DILATION OF URETER"	"16,107.00"	"9,555.00"	"6,552.00"
50555	"RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, W/ OR  W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/
BIOPSY"	"21,216.00"	"13,845.00"	"7,371.00"
50557	"RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, W/ OR  W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ FULGURATION AND/OR INCISION, W/ OR W/O BIOPSY"	"15,802.80"	"10,725.00"	"5,077.80"
50559	"RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, W/ OR  W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ INSERTION OF RADIOACTIVE SUBSTANCE W/ OR W/OUT BIOPSY AND/OR FULGURATION"	"16,294.20"	"10,725.00"	"5,569.20"
50561	"RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, W/ OR  W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ REMOVAL OF FOREIGN BODY OR CALCULUS"	"18,915.00"	"10,725.00"	"8,190.00"
50570	"RENAL ENDOSCOPY THROUGH NEPHROTOMY OR PYELOTOMY, W/ OR  W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE;"	"16,107.00"	"9,555.00"	"6,552.00"
50572	"RENAL ENDOSCOPY THROUGH NEPHROTOMY OR PYELOTOMY, W/ OR  W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ URETERAL CATHETERIZATION, W/ OR W/O DILATION OF URETER"	"16,107.00"	"9,555.00"	"6,552.00"
50574	"RENAL ENDOSCOPY THROUGH NEPHROTOMY OR PYELOTOMY, W/ OR  W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ BIOPSY"	"16,107.00"	"9,555.00"	"6,552.00"
50575	"RENAL ENDOSCOPY THROUGH NEPHROTOMY OR PYELOTOMY, W/ OR  W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ ENDOPYELOTOMY (INCLUDES CYSTOSCOPY, URETEROSCOPY, DILATION OF URETER AND URETERAL PELVIC JUNCTION, INCISION OF"	"18,915.00"	"10,725.00"	"8,190.00"
50576	"RENAL ENDOSCOPY THROUGH NEPHROTOMY OR PYELOTOMY, W/ OR  W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ FULGURATION AND/OR INCISION, W/ OR W/O BIOPSY"	"18,915.00"	"10,725.00"	"8,190.00"
50578	"RENAL ENDOSCOPY THROUGH NEPHROTOMY OR PYELOTOMY, W/ OR  W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ INSERTION OF RADIOACTIVE SUBSTANCE, W/ OR W/O BIOPSY AND/OR
FULGURATION"	"18,915.00"	"10,725.00"	"8,190.00"
50580	"RENAL ENDOSCOPY THROUGH NEPHROTOMY OR PYELOTOMY, W/ OR  W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ REMOVAL OF FOREIGN
BODY OR CALCULUS"	"18,915.00"	"10,725.00"	"8,190.00"
50590	"LITHOTRIPSY, EXTRACORPOREAL SHOCK WAVE"	"35,100.00"	"18,720.00"	"16,380.00"
50592	"ABLATION, ONE OR MORE RENAL TUMOR(S), PERCUTANEOUS,
UNILATERAL FREQUENCY"	"18,915.00"	"10,725.00"	"8,190.00"
50600	URETEROTOMY W/ EXPLORATION OR DRAINAGE	"23,634.00"	"10,530.00"	"13,104.00"
50605	"URETEROTOMY FOR INSERTION OF INDWELLING STENT, ALL
TYPES"	"23,634.00"	"10,530.00"	"13,104.00"
50610	URETEROLITHOTOMY; UPPER ONE-THIRD OF URETER	"42,549.00"	"21,255.00"	"21,294.00"
50620	URETEROLITHOTOMY; MIDDLE ONE-THIRD OF URETER	"40,911.00"	"21,255.00"	"19,656.00"
50630	URETEROLITHOTOMY; LOWER ONE-THIRD OF URETER	"42,549.00"	"21,255.00"	"21,294.00"
50650	"URETERECTOMY, W/ BLADDER CUFF"	"42,549.00"	"21,255.00"	"21,294.00"
50660	"URETERECTOMY, TOTAL, ECTOPIC URETER, COMBINATION
ABDOMINAL, VAGINAL AND/OR PERINEAL APPROACH"	"40,911.00"	"21,255.00"	"19,656.00"
50700	"URETEROPLASTY, PLASTIC OPERATION ON URETER (E.G.,
STRICTURE)"	"42,549.00"	"21,255.00"	"21,294.00"
50715	"URETEROLYSIS, W/ OR W/O REPOSITIONING OF URETER FOR
RETROPERITONEAL FIBROSIS"	"42,549.00"	"21,255.00"	"21,294.00"
50722	URETEROLYSIS FOR OVARIAN VEIN SYNDROME	"40,911.00"	"21,255.00"	"19,656.00"
50725	"URETEROLYSIS FOR RETROCAVAL URETER, W/ REANASTOMOSIS OF UPPER URINARY TRACT OR VENA CAVA"	"45,435.00"	"20,865.00"	"24,570.00"
50727	"REVISION OF URINARY-CUTANEOUS ANASTOMOSIS (ANY TYPE
UROSTOMY);"	"44,187.00"	"21,255.00"	"22,932.00"
50728	REVISION OF URINARY-CUTANEOUS ANASTOMOSIS (ANY TYPE UROSTOMY); W/ REPAIR OF FASCIAL DEFECT AND HERNIA	"44,187.00"	"21,255.00"	"22,932.00"
50740	"URETEROPYELOSTOMY, ANASTOMOSIS OF URETER AND RENAL
PELVIS"	"45,435.00"	"20,865.00"	"24,570.00"
50750	"URETEROCALYCOSTOMY, ANASTOMOSIS OF URETER TO RENAL
CALYX"	"52,884.00"	"23,400.00"	"29,484.00"
50760	URETEROURETEROSTOMY	"42,549.00"	"21,255.00"	"21,294.00"
50770	"TRANSURETEROURETEROSTOMY, ANASTOMOSIS OF URETER TO
CONTRALATERAL URETER"	"52,884.00"	"23,400.00"	"29,484.00"
50780	"URETERONEOCYSTOSTOMY; ANASTOMOSIS OF SINGLE URETER TO
BLADDER"	"52,884.00"	"23,400.00"	"29,484.00"
50782	"URETERONEOCYSTOSTOMY; ANASTOMOSIS OF DUPLICATED
URETER TO BLADDER"	"59,085.00"	"26,325.00"	"32,760.00"
50783	URETERONEOCYSTOSTOMY; W/ EXTENSIVE URETERAL TAILORING	"73,710.00"	"32,760.00"	"40,950.00"
50785	"URETERONEOCYSTOSTOMY; W/ VESICO-PSOAS HITCH OR
BLADDER FLAP"	"59,085.00"	"26,325.00"	"32,760.00"
50800	"URETEROENTEROSTOMY, DIRECT ANASTOMOSIS OF URETER TO
INTESTINE"	"59,943.00"	"33,735.00"	"26,208.00"
50810	"URETEROSIGMOIDOSTOMY, W/ CREATION OF SIGMOID BLADDER AND ESTABLISHMENT OF ABDOMINAL OR PERINEAL COLOSTOMY,
INCLUDING BOWEL ANASTOMOSIS"	"73,710.00"	"32,760.00"	"40,950.00"
50815	"URETEROCOLON CONDUIT, INCLUDING BOWEL ANASTOMOSIS"	"73,710.00"	"32,760.00"	"40,950.00"
50820	"URETEROILEAL CONDUIT (ILEAL BLADDER), INCLUDING BOWEL
ANASTOMOSIS (BRICKER OPERATION)"	"78,624.00"	"32,760.00"	"45,864.00"
50825	"CONTINENT DIVERSION, INCLUDING BOWEL ANASTOMOSIS USING ANY SEGMENT OF SMALL AND/OR LARGE BOWEL (KOCK POUCH
OR CAMEY ENTEROCYSTOPLASTY"	"90,675.00"	"41,535.00"	"49,140.00"
50830	"URINARY UNDIVERSION (E.G., TAKING DOWN OF URETEROILEAL CONDUIT, URETEROSIGMOIDOSTOMY OR URETEROENTEROSTOMY W/ URETEROURETEROSTOMY OR
URETERONEOCYSTOSTOMY)"	"73,710.00"	"32,760.00"	"40,950.00"
50840	"REPLACEMENT OF ALL OR PART OF URETER BY BOWEL SEGMENT,
INCLUDING BOWEL ANASTOMOSIS"	"73,710.00"	"32,760.00"	"40,950.00"
50845	CUTANEOUS APPENDICO-VESICOSTOMY	"59,085.00"	"26,325.00"	"32,760.00"
50860	"URETEROSTOMY, TRANSPLANTATION OF URETER TO SKIN"	"40,911.00"	"21,255.00"	"19,656.00"
50900	"URETERORRHAPHY, SUTURE OF URETER"	"35,100.00"	"18,720.00"	"16,380.00"
50920	CLOSURE OF URETEROCUTANEOUS FISTULA	"40,911.00"	"21,255.00"	"19,656.00"
50930	"CLOSURE OF URETEROVISCERAL FISTULA (INCLUDING VISCERAL
REPAIR)"	"45,435.00"	"20,865.00"	"24,570.00"
50940	DELIGATION OF URETER	"42,549.00"	"21,255.00"	"21,294.00"
50945	"LAPAROSCOPY, SURGICAL; URETEROLITHOTOMY"	"42,783.00"	"24,765.00"	"18,018.00"
50947	"LAPAROSCOPY, SURGICAL; URETERONEOCYSTOSTOMY WITH
CYSTOSCOPY AND URETERAL STENT PLACEMENT"	"45,435.00"	"20,865.00"	"24,570.00"
50948	"LAPAROSCOPY, SURGICAL; URETERONEOCYSTOSTOMY WITHOUT CYSTOSCOPY AND URETERAL STENT PLACEMENT"	"45,435.00"	"20,865.00"	"24,570.00"
50951	"URETERAL ENDOSCOPY THROUGH ESTABLISHED URETEROSTOMY, W/ OR W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE;"	"16,107.00"	"9,555.00"	"6,552.00"
50953	"URETERAL ENDOSCOPY THROUGH ESTABLISHED  URETEROSTOMY, W/ OR W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ URETERAL CATHETERIZATION, W/ OR W/O DILATION OF URETER"	"16,107.00"	"9,555.00"	"6,552.00"
50955	"URETERAL ENDOSCOPY THROUGH ESTABLISHED  URETEROSTOMY, W/ OR W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/
BIOPSY"	"16,107.00"	"9,555.00"	"6,552.00"
50957	"URETERAL ENDOSCOPY THROUGH ESTABLISHED  URETEROSTOMY, W/ OR W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ FULGURATION AND/OR INCISION, W/ OR W/O BIOPSY"	"21,216.00"	"13,845.00"	"7,371.00"
50959	"URETERAL ENDOSCOPY THROUGH ESTABLISHED  URETEROSTOMY, W/ OR W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ INSERTION OF RADIOACTIVE SUBSTANCE, W/ OR W/O BIOPSY AND/OR FULGURATION (NOT INCLUDING PROVISION OF MATERIA"	"18,915.00"	"10,725.00"	"8,190.00"
50961	"URETERAL ENDOSCOPY THROUGH ESTABLISHED  URETEROSTOMY, W/ OR W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/
REMOVAL OF FOREIGN BODY OR CALCULUS"	"23,361.00"	"11,895.00"	"11,466.00"
50970	"URETERAL ENDOSCOPY THROUGH URETEROTOMY, W/ OR W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE;"	"16,107.00"	"9,555.00"	"6,552.00"
50972	"URETERAL ENDOSCOPY THROUGH ESTABLISHED  URETEROSTOMY, W/ OR W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ URETERAL CATHETERIZATION, W/ OR W/O DILATION OF URETER"	"16,107.00"	"9,555.00"	"6,552.00"
50974	"URETERAL ENDOSCOPY THROUGH ESTABLISHED  URETEROSTOMY, W/ OR W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/
BIOPSY"	"16,107.00"	"9,555.00"	"6,552.00"
50976	"URETERAL ENDOSCOPY THROUGH ESTABLISHED  URETEROSTOMY, W/ OR W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ FULGURATION AND/OR INCISION, W/ OR W/O BIOPSY"	"21,216.00"	"13,845.00"	"7,371.00"
50978	"URETERAL ENDOSCOPY THROUGH ESTABLISHED  URETEROSTOMY, W/ OR W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ INSERTION OF RADIOACTIVE SUBSTANCE, W/ OR W/O BIOPSY AND/OR FULGURATION (NOT INCLUDING PROVISION OF MATERIA"	"18,915.00"	"10,725.00"	"8,190.00"
50980	"URETERAL ENDOSCOPY THROUGH ESTABLISHED  URETEROSTOMY, W/ OR W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/
REMOVAL OF FOREIGN BODY OR CALCULUS"	"23,361.00"	"11,895.00"	"11,466.00"
51010	"ASPIRATION OF BLADDER; BY TROCAR OR INTRACATHETER W/
INSERTION OF SUPRAPUBIC CATHETER"	"11,076.00"	"7,800.00"	"3,276.00"
51020	"CYSTOTOMY OR CYSTOSTOMY; W/ FULGURATION AND/OR
INSERTION OF RADIOACTIVE MATERIAL"	"18,915.00"	"10,725.00"	"8,190.00"
51030	"CYSTOTOMY OR CYSTOSTOMY; W/ CRYOSURGICAL DESTRUCTION
OF INTRAVESICAL LESION"	"18,915.00"	"10,725.00"	"8,190.00"
51040	"CYSTOSTOMY, CYSTOTOMY W/ DRAINAGE"	"18,915.00"	"10,725.00"	"8,190.00"
51045	"CYSTOTOMY, W/ INSERTION OF URETERAL CATHETER OR STENT"	"20,553.00"	"10,725.00"	"9,828.00"
51050	"CYSTOLITHOTOMY, CYSTOTOMY W/ REMOVAL OF CALCULUS, W/O
VESICAL NECK RESECTION"	"24,453.00"	"10,530.00"	"13,923.00"
51060	TRANSVESICAL URETEROLITHOTOMY	"42,549.00"	"21,255.00"	"21,294.00"
51065	"CYSTOTOMY, W/ STONE BASKET EXTRACTION AND/OR ULTRASONIC OR ELECTROHYDRAULIC FRAGMENTATION OF
URETERAL CALCULUS"	"42,549.00"	"21,255.00"	"21,294.00"
51080	DRAINAGE OF PERIVESICAL OR PREVESICAL SPACE ABSCESS	"20,553.00"	"10,725.00"	"9,828.00"
51500	"EXCISION OF URACHAL CYST OR SINUS, W/ OR W/O UMBILICAL
HERNIA REPAIR"	"59,085.00"	"26,325.00"	"32,760.00"
51520	CYSTOTOMY; FOR SIMPLE EXCISION OF VESICAL NECK	"40,911.00"	"21,255.00"	"19,656.00"
51525	"CYSTOTOMY; FOR EXCISION OF BLADDER DIVERTICULUM, SINGLE
OR MULTIPLE"	"52,884.00"	"23,400.00"	"29,484.00"
51530	CYSTOTOMY; FOR EXCISION OF BLADDER TUMOR	"52,884.00"	"23,400.00"	"29,484.00"
51535	"CYSTOTOMY FOR EXCISION, INCISION, OR REPAIR OF
URETEROCELE"	"45,435.00"	"20,865.00"	"24,570.00"
51550	"CYSTECTOMY, PARTIAL"	"59,943.00"	"33,735.00"	"26,208.00"
51555	"CYSTECTOMY, COMPLICATED (E.G., POSTRADIATION, PREVIOUS
SURGERY, DIFFICULT LOCATION)"	"73,710.00"	"32,760.00"	"40,950.00"
51565	"CYSTECTOMY, PARTIAL, W/ REIMPLANTATION OF URETER(S) INTO
BLADDER (URETERONEOCYSTOSTOMY)"	"59,085.00"	"26,325.00"	"32,760.00"
51570	"CYSTECTOMY, COMPLETE;"	"73,710.00"	"32,760.00"	"40,950.00"
51575	"CYSTECTOMY, COMPLETE; W/ BILATERAL PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIAC,
HYPOGASTRIC, AND OBTURATOR NODES"	"90,675.00"	"41,535.00"	"49,140.00"
51580	"CYSTECTOMY, COMPLETE, W/ URETEROSIGMOIDOSTOMY OR
URETEROCUTANEOUS TRANSPLANTATIONS;"	"78,624.00"	"32,760.00"	"45,864.00"
51585	"CYSTECTOMY, COMPLETE, W/ URETEROSIGMOIDOSTOMY OR URETEROCUTANEOUS TRANSPLANTATIONS; W/ BILATERAL PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIAC,
HYPOGASTRIC, AND OBTURATOR NODES"	"104,130.00"	"46,800.00"	"57,330.00"
51590	"CYSTECTOMY, COMPLETE, W/ URETEROILEAL CONDUIT OR
SIGMOID BLADDER, INCLUDING BOWEL ANASTOMOSIS;"	"109,044.00"	"46,800.00"	"62,244.00"
51595	"CYSTECTOMY, COMPLETE, W/ URETEROILEAL CONDUIT OR SIGMOID BLADDER, INCLUDING BOWEL ANASTOMOSIS; W/ BILATERAL PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL
ILIAC, HYPOGASTRIC, AND OBTURATOR NODES"	"108,888.00"	"41,730.00"	"67,158.00"
51596	"CYSTECTOMY, COMPLETE, W/ CONTINENT DIVERSION, ANY
TECHNIQUE, USING ANY SEGMENT OF SMALL AND/OR LARGE BOWEL TO CONSTRUCT NEOBLADDER"	"114,660.00"	"40,950.00"	"73,710.00"
51597	"PELVIC EXENTERATION, COMPLETE, FOR VESICAL, PROSTATIC OR URETHRAL MALIGNANCY, W/ REMOVAL OF BLADDER AND URETERAL TRANSPLANTATIONS, W/ OR W/O HYSTERECTOMY AND/OR ABDOMINOPERINEAL RESECTION OF RECTUM AND COLON AND COLOSTOMY, OR ANY COMBINATION THEREOF"	"139,230.00"	"40,950.00"	"98,280.00"
51600	"INJECTION PROCEDURE FOR CYSTOGRAPHY OR VOIDING
URETHROCYSTOGRAPHY"	"15,639.00"	"10,725.00"	"4,914.00"
51720	BLADDER INSTILLATION OF ANTICARCINOGENIC AGENT	"15,639.00"	"10,725.00"	"4,914.00"
51800	"CYSTOPLASTY OR CYSTOURETHROPLASTY, PLASTIC OPERATION ON BLADDER AND/OR VESICAL NECK (ANTERIOR Y-PLASTY, VESICAL FUNDUS RESECTION), ANY PROCEDURE, W/ OR W/O WEDGE RESECTION OF POSTERIOR VESICAL NECK"	"40,911.00"	"21,255.00"	"19,656.00"
51820	"CYSTOURETHROPLASTY W/ UNILATERAL OR BILATERAL
URETERONEOCYSTOSTOMY"	"52,884.00"	"23,400.00"	"29,484.00"
51840	"ANTERIOR VESICOURETHROPEXY, OR URETHROPEXY (MARSHALL-
MARCHETTI-KRANTZ TYPE)"	"40,911.00"	"21,255.00"	"19,656.00"
51841	"COMPLICATED (E.G., SECONDARY REPAIR)"	"59,943.00"	"33,735.00"	"26,208.00"
51845	"ABDOMINO-VAGINAL VESICAL NECK SUSPENSION, W/ OR W/O ENDOSCOPIC CONTROL (E.G., STAMEY, RAZ, MODIFIED PEREYRA)"	"40,911.00"	"21,255.00"	"19,656.00"
51860	"CYSTORRHAPHY, SUTURE OF BLADDER WOUND, INJURY OR
RUPTURE"	"23,634.00"	"10,530.00"	"13,104.00"
51880	CLOSURE OF CYSTOSTOMY	"21,216.00"	"13,845.00"	"7,371.00"
51900	"CLOSURE OF VESICOVAGINAL FISTULA, ABDOMINAL APPROACH"	"45,435.00"	"20,865.00"	"24,570.00"
51920	CLOSURE OF VESICOUTERINE FISTULA;	"45,435.00"	"20,865.00"	"24,570.00"
51925	CLOSURE OF VESICOUTERINE FISTULA; W/ HYSTERECTOMY	"59,085.00"	"26,325.00"	"32,760.00"
51940	CLOSURE OF BLADDER EXSTROPHY	"59,085.00"	"26,325.00"	"32,760.00"
51960	"ENTEROCYSTOPLASTY, INCLUDING BOWEL ANASTOMOSIS"	"59,943.00"	"33,735.00"	"26,208.00"
51980	CUTANEOUS VESICOSTOMY	"23,634.00"	"10,530.00"	"13,104.00"
51990	"LAPAROSCOPY, SURGICAL; URETHRAL SUSPENSION FOR STRESS
INCONTINENCE"	"59,085.00"	"26,325.00"	"32,760.00"
51992	"LAPAROSCOPY, SURGICAL; SLING OPERATION FOR STRESS
INCONTINENCE (E.G., FASCIA OR SYNTHETIC)"	"59,085.00"	"26,325.00"	"32,760.00"
52000	CYSTOURETHROSCOPY	"16,107.00"	"9,555.00"	"6,552.00"
52005	"CYSTOURETHROSCOPY, W/ URETERAL CATHETERIZATION, W/ OR W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE;"	"18,915.00"	"10,725.00"	"8,190.00"
52007	"CYSTOURETHROSCOPY, W/ URETERAL CATHETERIZATION, W/ OR W/O IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; W/ BRUSH BIOPSY OF URETER AND/OR RENAL PELVIS"	"16,107.00"	"9,555.00"	"6,552.00"
52010	"CYSTOURETHROSCOPY, W/ EJACULATORY DUCT CATHETERIZATION, W/ OR W/O IRRIGATION, INSTILLATION, OR DUCT RADIOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE"	"16,107.00"	"9,555.00"	"6,552.00"
52204	"CYSTOURETHROSCOPY, W/ BIOPSY"	"20,553.00"	"10,725.00"	"9,828.00"
52214	"CYSTOURETHROSCOPY, W/ FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) OF TRIGONE, BLADDER NECK, PROSTATIC FOSSA, URETHRA, OR PERIURETHRAL GLANDS"	"23,361.00"	"11,895.00"	"11,466.00"
52224	"CYSTOURETHROSCOPY, W/ FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) OR TREATMENT OF MINOR
(LESS THAN 0.5 CM) LESION(S) W/ OR W/O BIOPSY"	"23,361.00"	"11,895.00"	"11,466.00"
52234	"CYSTOURETHROSCOPY, W/ FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) AND/OR RESECTION OF;
SMALL BLADDER TUMOR(S) (0.5 CM TO 2.0 CM)"	"40,911.00"	"21,255.00"	"19,656.00"
52235	"CYSTOURETHROSCOPY, W/ FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) AND/OR RESECTION OF
MEDIUM BLADDER TUMOR(S) (2.0 TO 5.0 CM)"	"43,368.00"	"21,255.00"	"22,113.00"
52240	LARGE BLADDER TUMOR(S)	"45,435.00"	"20,865.00"	"24,570.00"
52250	"CYSTOURETHROSCOPY W/ INSERTIONOF RADIOACTIVE
SUBSTANCE, W/ OR W/O BIOPSY OR FULGURATION"	"59,943.00"	"33,735.00"	"26,208.00"
52260	"CYSTOURETHROSCOPY, W/ DILATION OF BLADDER FOR INSTERSTITIAL CYSTITIS; GENERAL OR CONDUCTION (SPINAL)
ANESTHESIA"	"23,361.00"	"11,895.00"	"11,466.00"
52265	"CYSTOURETHROSCOPY, W/ DILATION OF BLADDER FOR
INSTERSTITIAL CYSTITIS; LOCAL ANESTHESIA"	"15,639.00"	"10,725.00"	"4,914.00"
52270	"CYSTOURETHROSCOPY, W/ INTERNAL URETHROTOMY; FEMALE"	"25,155.00"	"12,870.00"	"12,285.00"
52275	"CYSTOURETHROSCOPY, W/ INTERNAL URETHROTOMY; MALE"	"25,155.00"	"12,870.00"	"12,285.00"
52276	"CYSTOURETHROSCOPY W/ DIRECT VISION INTERNAL
URETHROTOMY"	"24,453.00"	"10,530.00"	"13,923.00"
52277	"CYSTOURETHROSCOPY, W/ RESECTION OF EXTERNAL SPHINCTER
(SPHINCTEROTOMY)"	"23,634.00"	"10,530.00"	"13,104.00"
52281	"CYSTOURETHROSCOPY, W/  CALIBRATION AND/OR DILATION OF URETHRAL STRICTURE OR STENOSIS, W/ OR W/O MEATOTOMY AND INJECTION PROCEDURE FOR CYSTOGRAPHY, MALE OR
FEMALE"	"15,639.00"	"10,725.00"	"4,914.00"
52283	"CYSTOURETHROSCOPY, W/ STEROID INJECTION INTO STRICTURE"	"15,639.00"	"10,725.00"	"4,914.00"
52285	"CYSTOURETHROSCOPY, FOR TREATMENT OF THE FEMALE URETHRAL SYNDROME W/ ANY OR ALL OF THE FOLLOWING: URETHRAL MEATOTOMY, URETHRAL DILATION, INTERNAL URETHROTOMY, LYSIS OF URETHROVAGINAL SEPTAL FIBROSIS, LATERAL INCISIONS OF THE BLADDER NECK, AND FULGURATION
O"	"20,553.00"	"10,725.00"	"9,828.00"
52290	"CYSTOURETHROSCOPY; W/ URETERAL MEATOTOMY, UNILATERAL
OR BILATERAL"	"23,361.00"	"11,895.00"	"11,466.00"
52300	"CYSTOURETHROSCOPY; W/ RESECTION OR FULGURATION OF ORTHOTOPIC URETEROCELE(S), UNILATERAL OR BILATERAL"	"42,783.00"	"24,765.00"	"18,018.00"
52301	"CYSTOURETHROSCOPY; W/ RESECTION OR FULGURATION OF
ECTOPIC URETEROCELE(S), UNILATERAL OR BILATERAL"	"42,783.00"	"24,765.00"	"18,018.00"
52305	"CYSTOURETHROSCOPY; W/ INCISION OR RESECTION OF ORIFICE OF BLADDER DIVERTICULUM, SINGLE OR MULTIPLE"	"23,634.00"	"10,530.00"	"13,104.00"
52310	"CYSTOURETHROSCOPY, W/ REMOVAL OF FOREIGN BODY, CALCULUS, OR URETERAL STENT FROM URETHRA OR BLADDER"	"20,553.00"	"10,725.00"	"9,828.00"
52317	"LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY
ANY MEANS IN BLADDER AND REMOVAL OF FRAGMENTS; SIMPLE OR SMALL (LESS THAN 2.5 CM)"	"35,100.00"	"18,720.00"	"16,380.00"
52318	"LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY
ANY MEANS IN BLADDER AND REMOVAL OF FRAGMENTS; COMPLICATED OR LARGE (OVER 2.5 CM)"	"42,783.00"	"24,765.00"	"18,018.00"
52320	CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); W/ REMOVAL OF URETERAL CALCULUS	"23,361.00"	"11,895.00"	"11,466.00"
52325	"CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); W/ FRAGMENTATION OF URETERAL CALCULUS (E.G., ULTRASONIC OR ELECTRO-HYDRAULIC
TECHNIQUE)"	"35,100.00"	"18,720.00"	"16,380.00"
52327	"CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); W/ SUBURETERIC INJECTION OF IMPLANT
MATERIAL"	"18,915.00"	"10,725.00"	"8,190.00"
52330	"CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); W/ MANIPULATION, W/O REMOVAL OF
URETERAL CALCULUS"	"20,553.00"	"10,725.00"	"9,828.00"
52332	"CYSTOURETHROSCOPY, W/ INSERTION OF INDWELLING
URETERAL STENT (E.G., GIBBONS OR DOUBLE-J TYPE)"	"20,553.00"	"10,725.00"	"9,828.00"
52334	"CYSTOURETHROSCOPY W/ INSERTION OF URETERAL GUIDE WIRE THROUGH KIDNEY TO ESTABLISH A PERCUTANEOUS
NEPHROSTOMY, RETROGRADE"	"18,915.00"	"10,725.00"	"8,190.00"
52335	"CYSTOURETHROSCOPY, W/ URETEROSCOPY AND/OR  PYELOSCOPY (INCLUDES DILATION OF THE URETER AND/OR PYELOURETERAL
JUNCTION BY ANY METHOD);"	"23,634.00"	"10,530.00"	"13,104.00"
52336	"CYSTOURETHROSCOPY, W/ URETEROSCOPY AND/OR  PYELOSCOPY (INCLUDES DILATION OF THE URETER AND/OR PYELOURETERAL JUNCTION BY ANY METHOD); W/ REMOVAL OR MANIPULATION OF CALCULUS (URETERAL CATHETERIZATION IS INCLUDED)"	"23,634.00"	"10,530.00"	"13,104.00"
52337	"CYSTOURETHROSCOPY, W/ URETEROSCOPY AND/OR  PYELOSCOPY (INCLUDES DILATION OF THE URETER AND/OR PYELOURETERAL JUNCTION BY ANY METHOD); W/ LITHOTRIPSY (URETERAL CATHETERIZATION IS INCLUDED)"	"42,783.00"	"24,765.00"	"18,018.00"
52338	"CYSTOURETHROSCOPY, W/ URETEROSCOPY AND/OR  PYELOSCOPY (INCLUDES DILATION OF THE URETER AND/OR PYELOURETERAL JUNCTION BY ANY METHOD); W/ BIOPSY AND/OR FULGURATION
OF LESION"	"42,783.00"	"24,765.00"	"18,018.00"
52339	"CYSTOURETHROSCOPY, W/ URETEROSCOPY AND/OR  PYELOSCOPY (INCLUDES DILATION OF THE URETER AND/OR PYELOURETERAL JUNCTION BY ANY METHOD); W/ RESECTION OF TUMOR"	"23,634.00"	"10,530.00"	"13,104.00"
52340	"CYSTOURETHROSCOPY W/ INCISION, FULGURATION, OR RESECTION OF CONGENITAL POSTERIOR URETHRAL VALVES, OR CONGENITAL OBSTRUCTIVE HYPERTROPHIC MUCOSAL FOLDS"	"42,783.00"	"24,765.00"	"18,018.00"
52450	TRANSURETHRAL INCISION OF PROSTATE	"45,435.00"	"20,865.00"	"24,570.00"
52500	TRANSURETHRAL RESECTION OF BLADDER NECK	"45,435.00"	"20,865.00"	"24,570.00"
52510	"TRANSURETHRAL BALLOON DILATION OF THE PROSTATIC
URETHRA, ANY METHOD"	"23,634.00"	"10,530.00"	"13,104.00"
52601	"TRANSURETHRAL ELECTROSURGICAL RESECTION OF PROSTATE, INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE (VASECTOMY, MEATOMY, CYSTOURETHROSCOPY, URETHRAL CALIBRATION AND/OR DILATION, AND INTERNAL URETHROTOMY
ARE INCLUDED)"	"73,710.00"	"32,760.00"	"40,950.00"
52606	"TRANSURETHRAL FULGURATION FOR POSTOPERATIVE BLEEDING
OCCURING AFTER THE USUAL FOLLOW-UP TIME"	"35,100.00"	"18,720.00"	"16,380.00"
52612	"TRANSURETHRAL RESECTION OF PROSTATE; FIRST STAGE OF TWO-
STAGE RESECTION (PARTIAL RESECTION)"	"42,783.00"	"24,765.00"	"18,018.00"
52614	TRANSURETHRAL RESECTION OF PROSTATE; SECOND STAGE OF TWO-STAGE RESECTION (RESECTION COMPLETED)	"42,783.00"	"24,765.00"	"18,018.00"
52620	"TRANSURETHRAL RESECTION; OF RESIDUAL OBSTRUCTIVE
TISSUE AFTER 90 DAYS POSTOPERATIVE"	"40,911.00"	"21,255.00"	"19,656.00"
52630	TRANSURETHRAL RESECTION; OF REGROWTH OF OBSTRUCTIVE TISSUE LONGER THAN ONE YEAR POSTOPERATIVE	"73,710.00"	"32,760.00"	"40,950.00"
52640	"TRANSURETHRAL RESECTION; OF POSTOPERATIVE BLADDER
NECK CONTRACTURE"	"40,911.00"	"21,255.00"	"19,656.00"
52647	"NON-CONTACT LASER COAGULATION OF PROSTATE, INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE (VASECTOMY, MEATOTOMY, CYSTOURETHROSCOPY, URETHRAL CALIBRATION AND/OR DILATION, AND INTERNAL URETHROTOMY
ARE INCLUDED)"	"52,884.00"	"23,400.00"	"29,484.00"
52648	"CONTACT LASER VAPORIZATION W/ OR W/O TRANSURETHRAL RESECTION OF PROSTATE, INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE (VASECTOMY, MEATOTOMY, CYSTOURETHROSCOPY, URETHRAL CALIBRATION AND/OR DILATION, AND INTERNAL URETHROTOMY ARE
INCLUDED)"	"52,884.00"	"23,400.00"	"29,484.00"
52649	"HIGH INTENSITY FOCUSED ULTRASOUND (HIFU) OF THE PROSTATE INCLUDING TRANSURETHRAL RESECTION OF THE
PROSTATE (TURP)"	"73,710.00"	"32,760.00"	"40,950.00"
52700	TRANSURETHRAL DRAINAGE OF PROSTATIC ABSCESS	"35,100.00"	"18,720.00"	"16,380.00"
53000	"URETHROTOMY OR URETHROSTOMY, EXTERNAL ; PENDULOUS
URETHRA"	"11,076.00"	"7,800.00"	"3,276.00"
53010	"URETHROTOMY OR URETHROSTOMY, EXTERNAL ; PERINEAL
URETHRA, EXTERNAL"	"16,107.00"	"9,555.00"	"6,552.00"
53020	"MEATOTOMY, CUTTING OF MEATUS ; EXCEPT INFANT"	"10,842.00"	"8,385.00"	"2,457.00"
53025	"MEATOTOMY, CUTTING OF MEATUS ; INFANT"	"16,107.00"	"9,555.00"	"6,552.00"
53040	DRAINAGE OF DEEP PERIURETHRAL ABSCESS	"18,135.00"	"14,040.00"	"4,095.00"
53060	DRAINAGE OF SKENES GLAND ABSCESS OR CYST	"10,842.00"	"8,385.00"	"2,457.00"
53080	DRAINAGE OF PERINEAL URINARY EXTRAVASATION	"15,639.00"	"10,725.00"	"4,914.00"
53200	BIOPSY OF URETHRA	"10,842.00"	"8,385.00"	"2,457.00"
53210	"URETHRECTOMY, TOTAL, INCLUDING CYSTOSTOMY; FEMALE"	"42,783.00"	"24,765.00"	"18,018.00"
53215	"URETHRECTOMY, TOTAL, INCLUDING CYSTOSTOMY; MALE"	"42,549.00"	"21,255.00"	"21,294.00"
53220	EXCISION OF FULGURATION OF CARCINOMA OF URETHRA	"18,915.00"	"10,725.00"	"8,190.00"
53230	EXCISION OF URETHRAL DIVERTICULUM ; FEMALE	"35,100.00"	"18,720.00"	"16,380.00"
53235	EXCISION OF URETHRAL DIVERTICULUM ; MALE	"29,172.00"	"14,430.00"	"14,742.00"
53240	"MARSUPIALIZATION OF URETHRAL DIVERTICULUM, MALE OR
FEMALE"	"18,135.00"	"14,040.00"	"4,095.00"
53250	EXCISION OF BULBOURETHRAL GLAND (COWPERS GLAND)	"23,634.00"	"10,530.00"	"13,104.00"
53260	"EXCISION OR FULGURATION; URETHRAL POLYP(S), DISTAL
URETHRA"	"10,842.00"	"8,385.00"	"2,457.00"
53265	EXCISION OR FULGURATION; URETHRAL CARUNCLE	"10,842.00"	"8,385.00"	"2,457.00"
53270	SKENES GLANDS	"10,842.00"	"8,385.00"	"2,457.00"
53275	SKENES GLANDS URETHRAL PROLAPSE	"18,135.00"	"14,040.00"	"4,095.00"
53400	"URETHROPLASTY; FIRST STAGE, FOR FISTULA, DIVERTICULUM, OR
STRICTURE (E.G., JOHANNSEN TYPE)"	"59,085.00"	"26,325.00"	"32,760.00"
53405	"URETHROPLASTY; SECOND STAGE (FORMATION OF URETHRA),
INCLUDING URINARY DIVERSION"	"52,884.00"	"23,400.00"	"29,484.00"
53410	"URETHROPLASTY, ONE-STAGE RECONSTRUCTION OF MALE
ANTERIOR URETHRA"	"29,172.00"	"14,430.00"	"14,742.00"
53415	"URETHROPLASTY, TRANSPUBIC OR PERINEAL, ONE STAGE, FOR
RECONSTRUCTION OR REPAIR OF PROSTATIC OR MEMBRANOUS URETHRA"	"78,624.00"	"32,760.00"	"45,864.00"
53420	"URETHROPLASTY, TWO-STAGE RECONSTRUCTION OR REPAIR OF PROSTATIC OR MEMBRANOUS URETHRA; FIRST STAGE"	"73,710.00"	"32,760.00"	"40,950.00"
53425	"URETHROPLASTY, TWO-STAGE RECONSTRUCTION OR REPAIR OF PROSTATIC OR MEMBRANOUS URETHRA; SECOND STAGE"	"52,884.00"	"23,400.00"	"29,484.00"
53430	"URETHROPLASTY, RECONSTRUCTION OF FEMALE URETHRA"	"35,100.00"	"18,720.00"	"16,380.00"
53440	"OPERATION FOR CORRECTION OF MALE URINARY INCONTINENCE, W/ OR W/O INTRODUCTION OF PROSTHESIS"	"35,100.00"	"18,720.00"	"16,380.00"
53442	"REMOVAL OF PERINEAL PROSTHESIS INTRODUCED FOR
CONTINENCE"	"35,100.00"	"18,720.00"	"16,380.00"
53443	"URETHROPLASTY W/ TUBULARIZATION OF POSTERIOR URETHRA AND/OR LOWER BLADDER FOR INCONTINENCE (E.G., TENAGO,
LEADBETTER PROCEDURE)"	"60,723.00"	"26,325.00"	"34,398.00"
53445	"OPERATION FOR CORRECTION OF URINARY INCONTINENCE W/ PLACEMENT OF INFLATABLE URETHRAL OR BLADDER NECK SPHINCTER, INCLUDING PLACEMENT OF PUMP AND/OR
RESERVOIR"	"72,501.00"	"36,465.00"	"36,036.00"
53447	"REMOVAL, REPAIR, OR REPLACEMENT OF INFLATABLE SPHINCTER INCLUDING PUMP AND/OR RESERVOIR AND/OR CUFF"	"78,624.00"	"32,760.00"	"45,864.00"
53449	"SURGICAL CORRECTION OF HYDRAULIC ABNORMALITY OF
INFLATABLE SPHINCTER DEVICE"	"35,100.00"	"18,720.00"	"16,380.00"
53450	"URETHROMEATOPLASTY, W/ MUCOSAL ADVANCEMENT"	"16,107.00"	"9,555.00"	"6,552.00"
53460	"URETHROMEATOPLASTY, W/ PARTIAL EXCISION OF DISTAL URETHRAL SEGMENT (RICHARDSON TYPE PROCEDURE)"	"16,107.00"	"9,555.00"	"6,552.00"
53502	"URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY,
FEMALE"	"18,915.00"	"10,725.00"	"8,190.00"
53505	"URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY;
PENILE"	"18,915.00"	"10,725.00"	"8,190.00"
53510	"URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY;
PERINEAL"	"20,553.00"	"10,725.00"	"9,828.00"
53515	"URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY;
PROSTATOMEMBRANOUS"	"20,553.00"	"10,725.00"	"9,828.00"
53520	"CLOSURE OF URETHROSTOMY OR URETHROCUTANEOUS FISTULA,
MALE"	"15,639.00"	"10,725.00"	"4,914.00"
53600	"DILATION OF URETHRAL STRICTURE BY PASSAGE OF SOUND OR
URETHRAL DILATOR, MALE"	"11,076.00"	"7,800.00"	"3,276.00"
53605	"DILATION OF URETHRAL STRICTURE OR VESICAL NECK, MALE,
GENERAL OR CONDUCTION (SPINAL) ANESTHESIA"	"11,076.00"	"7,800.00"	"3,276.00"
53665	"DILATION OF FEMALE URETHRA, GENERAL OR CONDUCTION
(SPINAL) ANESTHESIA"	"11,076.00"	"7,800.00"	"3,276.00"
53850	"TRANSURETHRAL DESTRUCTION OF PROSTATE TISSUE; BY
MICROWAVE THERMOTHERAPY I.E. TRANSURETHRAL MICROWAVE THERMOTHERAPY (TUMT)"	"73,710.00"	"32,760.00"	"40,950.00"
53852	"TRANSURETHRAL DESTRUCTION OF PROSTATE TISSUE; BY RADIOFREQUNCY ABLATION I.E., TRANSURETHRAL NEEDLE ABLATION (TUNA), TRANSURETHRAL LASER INCISION OF THE
PROSTATE (TULIP)"	"73,710.00"	"32,760.00"	"40,950.00"
54015	INCISION AND DRAINAGE OF PENIS	"7,098.00"	"5,460.00"	"1,638.00"
54050	"DESTRUCTION OF LESION(S), PENIS (E.G., CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE),
ANY METHOD"	"7,098.00"	"5,460.00"	"1,638.00"
54100	BIOPSY OF PENIS	"6,832.80"	"5,850.00"	982.80
54110	EXCISION OF PENILE PLAQUE (PEYRONIE DISEASE);	"18,135.00"	"14,040.00"	"4,095.00"
54111	"EXCISION OF PENILE PLAQUE (PEYRONIE DISEASE); W/ GRAFT TO
5 CM IN LENGTH"	"20,553.00"	"10,725.00"	"9,828.00"
54112	"EXCISION OF PENILE PLAQUE (PEYRONIE DISEASE); W/ GRAFT
GREATER THAN 5 CM IN LENGTH"	"23,361.00"	"11,895.00"	"11,466.00"
54115	"REMOVAL OF FOREIGN BODY FROM DEEP PENILE TISSUE (E.G.,
PLASTIC IMPLANT)"	"16,107.00"	"9,555.00"	"6,552.00"
54120	AMPUTATION OF PENIS; PARTIAL	"20,553.00"	"10,725.00"	"9,828.00"
54125	AMPUTATION OF PENIS; COMPLETE	"41,730.00"	"21,255.00"	"20,475.00"
54130	"AMPUTATION OF PENIS, RADICAL; W/ BILATERAL
INGUINOFEMORAL LYMPHADENECTOMY"	"73,710.00"	"32,760.00"	"40,950.00"
54135	"AMPUTATION OF PENIS, RADICAL; IN CONTINUITY W/ BILATERAL PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIAC,
HYPOGASTRIC AND OBTURATOR NODES"	"90,675.00"	"41,535.00"	"49,140.00"
54150	"CIRCUMCISION, USING CLAMP OR OTHER DEVICE; NEWBORN"	"2,457.00"	819.00	"1,638.00"
54152	"CIRCUMCISION, USING CLAMP OR OTHER DEVICE; EXCEPT
NEWBORN"	"2,457.00"	819.00	"1,638.00"
54160	"CIRCUMCISION, SURGICAL EXCISION OTHER THAN CLAMP, DEVICE
OR DORSAL SLIT; NEWBORN"	"2,457.00"	819.00	"1,638.00"
54161	"CIRCUMCISION, SURGICAL EXCISION OTHER THAN CLAMP, DEVICE
OR DORSAL SLIT; EXCEPT NEWBORN"	"2,457.00"	819.00	"1,638.00"
54200	INJECTION PROCEDURE FOR PEYRONIE DISEASE;	"10,842.00"	"8,385.00"	"2,457.00"
54205	"INJECTION PROCEDURE FOR PEYRONIE DISEASE;W/ SURGICAL
EXPOSURE OF PLAQUE"	"11,076.00"	"7,800.00"	"3,276.00"
54220	IRRIGATION OF CORPORA CAVERNOSA FOR PRIAPISM	"15,639.00"	"10,725.00"	"4,914.00"
54300	"PLASTIC OPERATION OF PENIS FOR STRAIGHTENING OF CHORDEE (E.G., HYPOSPADIAS), W/ OR W/O MOBILIZATION OF URETHRA"	"18,915.00"	"10,725.00"	"8,190.00"
54304	PLASTIC OPERATION ON PENIS FOR CORRECTION OF CHORDEE OR FOR FIRST STAGE HYPOSPADIAS REPAIR W/ OR W/O TRANSPLANTATION OF PREPUCE AND/OR SKIN FLAPS	"29,172.00"	"14,430.00"	"14,742.00"
54308	URETHROPLASTY FOR SECOND STAGE HYPOSPADIAS REPAIR (INCLUDING URINARY DIVERSION); LESS THAN 3 CM	"45,435.00"	"20,865.00"	"24,570.00"
54312	URETHROPLASTY FOR SECOND STAGE HYPOSPADIAS REPAIR (INCLUDING URINARY DIVERSION); GREATER THAN 3 CM	"45,435.00"	"20,865.00"	"24,570.00"
54316	"URETHROPLASTY FOR SECOND STAGE HYPOSPADIAS REPAIR (INCLUDING URINARY DIVERSION) W/ FREE SKIN GRAFT
OBTAINED FROM SITE OTHER THAN GENITALIA"	"45,435.00"	"20,865.00"	"24,570.00"
54318	"URETHROPLASTY FOR THIRD STAGE HYPOSPADIAS REPAIR TO RELEASE PENIS FROM SCROTUM (E.G., THIRD STAGE CECIL
REPAIR)"	"23,634.00"	"10,530.00"	"13,104.00"
54322	"ONE STAGE DISTAL HYPOSPADIAS REPAIR (W/ OR W/O CHORDEE OR CIRCUMCISION); W/ SIMPLE MEATAL ADVANCEMENT (E.G.,
MAGPI, V-FLAP)"	"52,884.00"	"23,400.00"	"29,484.00"
54324	"ONE STAGE DISTAL HYPOSPADIAS REPAIR (W/ OR W/O CHORDEE OR CIRCUMCISION); W/ URETHROPLASTY BY LOCAL SKIN FLAPS
(E.G., FLIP-FLAP, PREPUCIAL FLAP)"	"52,884.00"	"23,400.00"	"29,484.00"
54326	"ONE STAGE DISTAL HYPOSPADIAS REPAIR (W/ OR W/O CHORDEE OR CIRCUMCISION); W/ URETHROPLASTY BY LOCAL SKIN FLAPS
AND MOBILIZATION OF URETHRA"	"52,884.00"	"23,400.00"	"29,484.00"
54328	"ONE STAGE DISTAL HYPOSPADIAS REPAIR (W/ OR W/O CHORDEE OR CIRCUMCISION); W/ EXTENSIVE DISSECTION TO CORRECT CHORDEE AND URETHROPLASTY W/ LOCAL SKIN FLAPS, SKIN
GRAFT PATCH, AND/OR ISLAND FLAP"	"59,085.00"	"26,325.00"	"32,760.00"
54332	"ONE STAGE PROXIMAL PENILE OR PENOSCROTAL HYPOSPADIAS REPAIR REQUIRING EXTENSIVE DISSECTION TO CORRECT CHORDEE AND URETHROPLASTY BY USE OF SKIN GRAFT TUBE
AND/OR ISLAND FLAP"	"72,501.00"	"36,465.00"	"36,036.00"
54336	"ONE STAGE PERINEAL HYPOSPADIAS REPAIR REQUIRING EXTENSIVE DISSECTION TO CORRECT CHORDEE AND URETHROPLASTY BY USE OF SKIN GRAFT TUBE AND/OR ISLAND
FLAP"	"72,501.00"	"36,465.00"	"36,036.00"
54340	"REPAIR OF HYPOSPADIAS COMPLICATIONS (IE, FISTULA, STRICTURE, DIVERTICULA); BY CLOSURE, INCISION, OR EXCISION,
SIMPLE"	"72,501.00"	"36,465.00"	"36,036.00"
54344	"REPAIR OF HYPOSPADIAS COMPLICATIONS (IE, FISTULA, STRICTURE, DIVERTICULA); REQUIRING MOBILIZATION OF SKIN FLAPS AND URETHROPLASTY W/ FLAP OR PATCH GRAFT"	"35,100.00"	"18,720.00"	"16,380.00"
54348	"REPAIR OF HYPOSPADIAS COMPLICATIONS (IE, FISTULA, STRICTURE, DIVERTICULA); REQUIRING EXTENSIVE DISSECTION AND URETHROPLASTY W/ FLAP, PATCH OR TUBED GRAFT
(INCLUDES URINARY DIVERSION)"	"40,911.00"	"21,255.00"	"19,656.00"
54352	REPAIR OF HYPOSPADIAS CRIPPLE REQUIRING EXTENSIVE DISSECTION AND EXCISION OF PREVIOUSLY CONSTRUCTED STRUCTURES INCLUDING RE-RELEASE OF CHORDEE AND RECONSTRUCTION OF URETHRA AND PENIS BY USE OF LOCAL SKIN AS GRAFTS AND ISLAND FLAPS AND SKIN BROUGHT IN AS F	"73,710.00"	"32,760.00"	"40,950.00"
54380	"PLASTIC OPERATION ON PENIS FOR EPISPADIAS DISTAL TO
EXTERNAL SPHINCTER;"	"59,085.00"	"26,325.00"	"32,760.00"
54385	"PLASTIC OPERATION ON PENIS FOR EPISPADIAS DISTAL TO
EXTERNAL SPHINCTER;W/ INCONTINENCE"	"72,501.00"	"36,465.00"	"36,036.00"
54390	"PLASTIC OPERATION ON PENIS FOR EPISPADIAS DISTAL TO
EXTERNAL SPHINCTER;W/ EXSTROPHY OF BLADDER"	"73,710.00"	"32,760.00"	"40,950.00"
54420	"CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT (PRIAPISM
OPERATION), UNILATERAL OR BILATERAL"	"23,634.00"	"10,530.00"	"13,104.00"
54430	"CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT (PRIAPISM
OPERATION), UNILATERAL OR BILATERAL"	"23,634.00"	"10,530.00"	"13,104.00"
54435	"CORPORA CAVERNOSA-GLANS PENIS FISTULIZATION (E.G., BIOPSY
NEEDLE, WINTER PROCEDURE, RONGEUR, OR PUNCH) FOR PRIAPISM"	"16,107.00"	"9,555.00"	"6,552.00"
54440	PLASTIC OPERATION OF PENIS FOR INJURY	"23,634.00"	"10,530.00"	"13,104.00"
54500	"BIOPSY OF TESTIS, NEEDLE"	"6,832.80"	"5,850.00"	982.80
54505	"BIOPSY OF TESTIS, INCISIONAL"	"11,076.00"	"7,800.00"	"3,276.00"
54510	EXCISION OF LOCAL LESION OF TESTIS	"11,076.00"	"7,800.00"	"3,276.00"
54520	"ORCHIECTOMY, SIMPLE (INCLUDING SUBCAPSULAR), W/ OR W/O TESTICULAR PROSTHESIS, SCROTAL OR INGUINAL APPROACH"	"20,553.00"	"10,725.00"	"9,828.00"
54530	"ORCHIECTOMY, RADICAL, FOR TUMOR; INGUINAL APPROACH"	"21,372.00"	"10,725.00"	"10,647.00"
54535	"ORCHIECTOMY, RADICAL, FOR TUMOR; W/ ABDOMINAL
EXPLORATION"	"24,453.00"	"10,530.00"	"13,923.00"
54550	"EXPLORATION FOR UNDESCENDED TESTIS (INGUINAL OR
SCROTAL AREA)"	"20,553.00"	"10,725.00"	"9,828.00"
54560	"EXPLORATION FOR UNDESCENDED TESTIS W/ ABDOMINAL
EXPLORATION"	"24,453.00"	"10,530.00"	"13,923.00"
54600	"REDUCTION OF TORSION OF TESTIS, SURGICAL, W/ OR W/O
FIXATION OF CONTRALATERAL TESTIS"	"21,372.00"	"10,725.00"	"10,647.00"
54620	FIXATION OF CONTRALATERAL TESTIS	"18,135.00"	"14,040.00"	"4,095.00"
54640	"ORCHIOPEXY, INGUINAL APPROACH, W/ OR W/O HERNIA REPAIR"	"20,553.00"	"10,725.00"	"9,828.00"
54650	"ORCHIOPEXY, ABDOMINAL APPROACH, FOR INTRA-ABDOMINAL
TESTIS (E.G., FOWLER-STEPHENS)"	"24,453.00"	"10,530.00"	"13,923.00"
54670	SUTURE OR REPAIR OF TESTICULAR INJURY	"18,915.00"	"10,725.00"	"8,190.00"
54680	"TRANSPLANTATION OF TESTIS(ES) TO THIGH (BECAUSE OF
SCROTAL DESTRUCTION)"	"16,107.00"	"9,555.00"	"6,552.00"
54690	"LAPAROSCOPY, SURGICAL; ORCHIECTOMY"	"18,915.00"	"10,725.00"	"8,190.00"
54692	"LAPAROSCOPY, SURGICAL; ORCHIOPEXY FOR INTRA-ABDOMINAL
TESTIS"	"23,361.00"	"11,895.00"	"11,466.00"
54700	"INCISION AND DRAINAGE OF EPIDIDYMIS, TESTIS AND/OR
SCROTAL SPACE (E.G., ABSCESS OR HEMATOMA)"	"8,010.60"	"6,045.00"	"1,965.60"
54800	"BIOPSY OF EPIDIDYMIS, NEEDLE"	"6,832.80"	"5,850.00"	982.80
54820	"EXPLORATION OF EPIDIDYMIS, W/ OR W/O BIOPSY"	"18,135.00"	"14,040.00"	"4,095.00"
54830	EXCISION OF LOCAL LESION OF EPIDYDIMIS	"11,076.00"	"7,800.00"	"3,276.00"
54840	"EXCISION OF SPERMATOCELE, W/ OR W/O EPIDIDYMECTOMY"	"15,639.00"	"10,725.00"	"4,914.00"
54860	EPIDIDYMECTOMY; UNILATERAL	"18,135.00"	"14,040.00"	"4,095.00"
54861	EPIDIDYMECTOMY; BILATERAL	"16,458.00"	"10,725.00"	"5,733.00"
54900	"EPIDIDYMOVASOSTOMY, ANASTOMOSIS OF EPIDIDYMIS TO VAS
DEFERENS; UNILATERAL"	"20,553.00"	"10,725.00"	"9,828.00"
54901	"EPIDIDYMOVASOSTOMY, ANASTOMOSIS OF EPIDIDYMIS TO VAS
DEFERENS; BILATERAL"	"35,100.00"	"18,720.00"	"16,380.00"
55000	"PUNCTURE ASPIRATION OF HYDROCELE, TUNICA VAGINALIS, W/
OR W/O INJECTION OF MEDICATION"	"6,832.80"	"5,850.00"	982.80
55040	EXCISION OF HYDROCELE; UNILATERAL	"18,915.00"	"10,725.00"	"8,190.00"
55041	EXCISION OF HYDROCELE; BILATERAL	"35,100.00"	"18,720.00"	"16,380.00"
55060	REPAIR OF TUNICA VAGINALIS HYDROCELE (BOTTLE TYPE)	"18,915.00"	"10,725.00"	"8,190.00"
55100	DRAINAGE OF SCROTAL WALL ABSCESS	"6,832.80"	"5,850.00"	982.80
55101	"DRAINAGE AND DEBRIDEMENT OF FOURNIERS GANGRENE OF THE
SCROTUM"	"18,135.00"	"14,040.00"	"4,095.00"
55110	SCROTAL EXPLORATION	"18,135.00"	"14,040.00"	"4,095.00"
55120	REMOVAL OF FOREIGN BODY IN SCROTUM	"8,010.60"	"6,045.00"	"1,965.60"
55150	RESECTION OF SCROTUM	"10,842.00"	"8,385.00"	"2,457.00"
55175	SCROTOPLASTY	"11,076.00"	"7,800.00"	"3,276.00"
55200	"VASOTOMY, CANNULIZATION W/ OR W/O INCISION OF VAS,
UNILATERAL OR BILATERAL"	"11,076.00"	"7,800.00"	"3,276.00"
55250	"VASECTOMY, UNILATERAL OR BILATERAL"	"7,800.00"	"5,850.00"	"1,950.00"
55400	"VASOVASOSTOMY, VASOVASORRHAPHY"	"20,553.00"	"10,725.00"	"9,828.00"
55500	"EXCISION OF HYDROCELE OF SPERMATIC CORD, UNILATERAL"	"18,915.00"	"10,725.00"	"8,190.00"
55520	EXCISION OF LESION OF SPERMATIC CORD	"16,107.00"	"9,555.00"	"6,552.00"
55530	"EXCISION OF VARICOCELE OR LIGATION OF SPERMATIC VEINS FOR
VARICOCELE;"	"25,155.00"	"12,870.00"	"12,285.00"
55535	"EXCISION OF VARICOCELE OR LIGATION OF SPERMATIC VEINS FOR
VARICOCELE; ABDOMINAL APPROACH"	"29,172.00"	"14,430.00"	"14,742.00"
55540	"EXCISION OF VARICOCELE OR LIGATION OF SPERMATIC VEINS FOR
VARICOCELE; W/ HERNIA REPAIR"	"29,172.00"	"14,430.00"	"14,742.00"
55550	"LAPAROSCOPY, SURGICAL; WITH LIGATION OF SPERMATIC VEINS
FOR VARICOCELE"	"29,172.00"	"14,430.00"	"14,742.00"
55600	VESICULOTOMY;	"19,734.00"	"10,725.00"	"9,009.00"
55650	"VESICULECTOMY, ANY APPROACH"	"35,100.00"	"18,720.00"	"16,380.00"
55680	EXCISION OF MULLERIAN DUCT CYST	"35,100.00"	"18,720.00"	"16,380.00"
55700	"BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE,
ANY APPROACH"	"18,135.00"	"14,040.00"	"4,095.00"
55720	"PROSTATOTOMY, EXTERNAL DRAINAGE OF PROSTATIC ABSCESS,
ANY APPROACH"	"11,076.00"	"7,800.00"	"3,276.00"
55801	"PROSTATECTOMY, PERINEAL, SUBTOTAL (INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, VASECTOMY, MEATOTOMY, URETHRAL CALIBRATION AND/OR DILATION, AND INTERNAL
URETHROTOMY)"	"75,777.00"	"36,465.00"	"39,312.00"
55810	"PROSTATECTOMY, PERINEAL RADICAL;"	"90,675.00"	"41,535.00"	"49,140.00"
55812	"PROSTATECTOMY, PERINEAL RADICAL; W/ LYMPH NODE BIOPSY(S)
(LIMITED PELVIC LYMPHADENECTOMY)"	"93,951.00"	"41,535.00"	"52,416.00"
55815	"PROSTATECTOMY, PERINEAL RADICAL; W/ BILATERAL PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIAC, HYPOGASTRIC
AND OBTURATOR NODES"	"93,951.00"	"41,535.00"	"52,416.00"
55821	"PROSTATECTOMY (INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, VASECTOMY, MEATOTOMY, URETHRAL CALIBRATION AND/OR DILATION, AND INTERNAL URETHROTOMY); SUPRAPUBIC, SUBTOTAL, ONE OR TWO STAGES"	"75,777.00"	"36,465.00"	"39,312.00"
55831	"PROSTATECTOMY (INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, VASECTOMY, MEATOTOMY, URETHRAL CALIBRATION AND/OR DILATION, AND INTERNAL URETHROTOMY);
RETROPUBIC, SUBTOTAL"	"59,085.00"	"26,325.00"	"32,760.00"
55840	"PROSTATECTOMY, RETROPUBIC RADICAL, W/ OR W/O NERVE
SPARING;"	"90,675.00"	"41,535.00"	"49,140.00"
55842	"PROSTATECTOMY, RETROPUBIC RADICAL, W/ OR W/O NERVE SPARING; W/ LYMPH NODE BIOPSY(S) (LIMITED PELVIC
LYMPHADENECTOMY)"	"93,951.00"	"41,535.00"	"52,416.00"
55845	"PROSTATECTOMY, RETROPUBIC RADICAL, W/ OR W/O NERVE SPARING; W/ BILATERAL PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIAC, HYPOGASTRIC, AND OBTURATOR
NODES"	"93,951.00"	"41,535.00"	"52,416.00"
55859	"TRANSPERINEAL PLACEMENT OF NEEDLES, CATHETERS OR PELLETS INTO PROSTATE FOR INTERSTITIAL RADIOELEMENT APPLICATION, WITH OR WITHOUT CYSTOSCOPY, ULTRASOUND OR
CT SCAN GUIDANCE"	"35,100.00"	"18,720.00"	"16,380.00"
55860	"EXPOSURE OF PROSTATE, ANY APPROACH, FOR INSERTION OF
RADIOACTIVE SUBSTANCE;"	"18,915.00"	"10,725.00"	"8,190.00"
55862	"EXPOSURE OF PROSTATE, ANY APPROACH, FOR INSERTION OF RADIOACTIVE SUBSTANCE; W/ LYMPH NODE BIOPSY(S) (LIMITED
PELVIC LYMPHADENECTOMY)"	"35,100.00"	"18,720.00"	"16,380.00"
55865	"EXPOSURE OF PROSTATE, ANY APPROACH, FOR INSERTION OF RADIOACTIVE SUBSTANCE; W/ BILATERAL PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIAC, HYPOGASTRIC
AND OBTURATOR NODES"	"45,435.00"	"20,865.00"	"24,570.00"
55866	"LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC
RADICAL, INCLUDING NERVE SPARING"	"90,675.00"	"41,535.00"	"49,140.00"
55873	"CRYOSURGICAL ABLATION OF THE PROSTATE (CRYOTHERAPY OF
THE PROSTATE)"	"107,250.00"	"41,730.00"	"65,520.00"
56405	INCISION AND DRAINAGE OF VULVA OR PERINEAL ABSCESS	"10,842.00"	"8,385.00"	"2,457.00"
56420	INCISION AND DRAINAGE OF BARTHOLINS GLAND ABSCESS	"18,135.00"	"14,040.00"	"4,095.00"
56440	MARSUPIALIZATION OF BARTHOLINS GLAND CYST	"18,915.00"	"10,725.00"	"8,190.00"
56441	LYSIS OF LABIAL ADHESIONS	"18,135.00"	"14,040.00"	"4,095.00"
56501	"DESTRUCTION OF LESION(S), VULVA; ANY METHOD"	"18,135.00"	"14,040.00"	"4,095.00"
56605	BIOPSY OF VULVA OR PERINEUM ; ONE LESION	"18,135.00"	"14,040.00"	"4,095.00"
56620	VULVECTOMY SIMPLE; PARTIAL	"23,634.00"	"10,530.00"	"13,104.00"
56625	VULVECTOMY SIMPLE; COMPLETE	"45,435.00"	"20,865.00"	"24,570.00"
56630	"VULVECTOMY, RADICAL, PARTIAL;"	"52,884.00"	"23,400.00"	"29,484.00"
56631	"VULVECTOMY, RADICAL, PARTIAL; W/ UNILATERAL
INGUINOFEMORAL LYMPHADENECTOMY"	"59,085.00"	"26,325.00"	"32,760.00"
56632	"VULVECTOMY, RADICAL, PARTIAL; W/ BILATERAL
INGUINOFEMORAL LYMPHADENECTOMY"	"73,710.00"	"32,760.00"	"40,950.00"
56633	"VULVECTOMY, RADICAL, COMPLETE;"	"90,675.00"	"41,535.00"	"49,140.00"
56634	"VULVECTOMY, RADICAL, COMPLETE; W/ UNILATERAL
INGUINOFEMORAL LYMPHADENECTOMY"	"104,130.00"	"46,800.00"	"57,330.00"
56637	"VULVECTOMY, RADICAL, COMPLETE; W/ BILATERAL
INGUINOFEMORAL LYMPHADENECTOMY"	"107,250.00"	"41,730.00"	"65,520.00"
56640	"VULVECTOMY, RADICAL, COMPLETE, W/ INGUINOFEMORAL, ILIAC, AND PELVIC LYMPHADENECTOMY"	"114,660.00"	"40,950.00"	"73,710.00"
56700	PARTIAL HYMENECTOMY OR REVISION OF HYMENAL RING	"18,915.00"	"10,725.00"	"8,190.00"
56720	"HYMENOTOMY, SIMPLE INCISION"	"18,135.00"	"14,040.00"	"4,095.00"
56740	EXCISION OF BARTHOLINS GLAND OR CYST	"18,915.00"	"10,725.00"	"8,190.00"
57000	COLPOTOMY; W/ EXPLORATION	"23,634.00"	"10,530.00"	"13,104.00"
57020	COLPOCENTESIS	"11,076.00"	"7,800.00"	"3,276.00"
57061	DESTRUCTION OF VAGINAL LESION(S)	"11,076.00"	"7,800.00"	"3,276.00"
57100	BIOPSY OF VAGINAL MUCOSA	"11,076.00"	"7,800.00"	"3,276.00"
57108	"COLPECTOMY, OBLITERATION OF VAGINA; PARTIAL"	"45,435.00"	"20,865.00"	"24,570.00"
57110	"COLPECTOMY, OBLITERATION OF VAGINA; COMPLETE"	"59,085.00"	"26,325.00"	"32,760.00"
57120	COLPOCLEISIS (LE FORT TYPE)	"52,884.00"	"23,400.00"	"29,484.00"
57130	EXCISION OF VAGINAL SEPTUM	"18,135.00"	"14,040.00"	"4,095.00"
57135	EXCISION OF VAGINAL CYST OR TUMOR	"18,915.00"	"10,725.00"	"8,190.00"
57155	"INSERTION OF UTERINE TANDEMS AND/OR VAGINAL OVOIDS FOR
CLINICAL BRACHYTHERAPY"	"18,915.00"	"10,725.00"	"8,190.00"
57200	"COLPORRHAPHY, SUTURE OF INJURY OF VAGINA
(NONOBSTERICAL)"	"15,639.00"	"10,725.00"	"4,914.00"
57210	"COLPOPERINEORRHAPHY, SUTURE OF INJURY OF VAGINA AND/OR
PERINEUM (NONOBSTETRICAL)"	"20,553.00"	"10,725.00"	"9,828.00"
57220	"PLASTIC OPERATION ON URETHRAL SPHINCTER, VAGINAL
APPROACH (E.G., KELLY URETHRAL PLICATION)"	"23,634.00"	"10,530.00"	"13,104.00"
57230	PLASTIC REPAIR OF URETHROCELE	"23,634.00"	"10,530.00"	"13,104.00"
57240	"ANTERIOR COLPORRHAPHY, REPAIR OF CYSTOCELE W/ OR W/O
REPAIR OF URETHROCELE"	"40,911.00"	"21,255.00"	"19,656.00"
57250	"POSTERIOR COLPORRHAPHY, REPAIR OF RECTOCELE W/ OR W/O
PERINEORRHAPHY"	"40,911.00"	"21,255.00"	"19,656.00"
57260	COMBINED ANTEROPOSTERIOR COLPORRHAPHY;	"45,435.00"	"20,865.00"	"24,570.00"
57265	"COMBINED ANTEROPOSTERIOR COLPORRHAPHY; W/
ENTEROCELE REPAIR"	"59,085.00"	"26,325.00"	"32,760.00"
57268	"REPAIR OF ENTEROCELE, VAGINAL APPROACH"	"45,435.00"	"20,865.00"	"24,570.00"
57270	"REPAIR OF ENTEROCELE, ABDOMINAL APPROACH"	"52,884.00"	"23,400.00"	"29,484.00"
57280	"COLPOPEXY, ABDOMINAL APPROACH"	"52,884.00"	"23,400.00"	"29,484.00"
57282	SACROSPINOUS LIGAMENT FIXATION FOR PROLAPSE OF VAGINA	"52,884.00"	"23,400.00"	"29,484.00"
57284	"PARAVAGINAL DEFECT REPAIR (INCLUDING REPAIR OF CYSTOCELE, STRESS URINARY INCONTINENCE, AND/OR
INCOMPLETE VAGINAL PROLAPSE)"	"52,884.00"	"23,400.00"	"29,484.00"
57288	"SLING OPERATION FOR STRESS INCONTINENCE (E.G., FASCIA OR
SYNTHETIC)"	"59,085.00"	"26,325.00"	"32,760.00"
57289	"PEREYRA PROCEDURE, INCLUDING ANTERIOR COLPORRHAPHY"	"59,085.00"	"26,325.00"	"32,760.00"
57300	"CLOSURE OF RECTOVAGINAL FISTULA; VAGINAL OR TRANSANAL
APPROACH"	"40,911.00"	"21,255.00"	"19,656.00"
57305	CLOSURE OF RECTOVAGINAL FISTULA; ABDOMINAL APPROACH	"45,435.00"	"20,865.00"	"24,570.00"
57307	"CLOSURE OF RECTOVAGINAL FISTULA; ABDOMINAL APPROACH,
W/ CONCOMITANT COLOSTOMY"	"59,085.00"	"26,325.00"	"32,760.00"
57310	CLOSURE OF URETHROVAGINAL FISTULA;	"40,911.00"	"21,255.00"	"19,656.00"
57311	"CLOSURE OF URETHROVAGINAL FISTULA; W/ BULBOCAVERNOSUS
TRANSPLANT"	"59,085.00"	"26,325.00"	"32,760.00"
57320	CLOSURE OF VESICOVAGINAL FISTULA; VAGINAL APPROACH	"45,435.00"	"20,865.00"	"24,570.00"
57330	"CLOSURE OF VESICOVAGINAL FISTULA; TRANSVESICAL AND
VAGINAL APPROACH"	"59,085.00"	"26,325.00"	"32,760.00"
57415	"REMOVAL OF IMPACTED VAGINAL FOREIGN BODY  UNDER
ANESTHESIA"	"16,107.00"	"9,555.00"	"6,552.00"
57425	"LAPAROSCOPY, SURGICAL, COLPOPEXY (SUSPENSION OF VAGINAL
APEX)"	"52,884.00"	"23,400.00"	"29,484.00"
57452	COLPOSCOPY (VAGINOSCOPY)	"15,639.00"	"10,725.00"	"4,914.00"
57454	"COLPOSCOPY; W/ BIOPSY(S) OF THE CERVIX AND/OR
ENDOCERVICAL CURETTAGE"	"16,107.00"	"9,555.00"	"6,552.00"
57460	"COLPOSCOPY; W/ LOOP ELECTRODE EXCISION PROCEDURE OF
THE CERVIX"	"18,915.00"	"10,725.00"	"8,190.00"
57500	"BIOPSY, SINGLE OR MULTIPLE, OR LOCAL EXCISION OF LESION, W/
OR W/O FULGURATION"	"11,076.00"	"7,800.00"	"3,276.00"
57510	CAUTERIZATION OF CERVIX; ANY METHOD	"11,076.00"	"7,800.00"	"3,276.00"
57520	"CONIZATION OF CERVIX, W/ OR W/O FULGURATION, W/ OR W/O DILATION AND CURETTAGE, W/ OR W/O REPAIR; COLD KNIFE OR
LASER"	"18,915.00"	"10,725.00"	"8,190.00"
57522	"CONIZATION OF CERVIX, W/ OR W/O FULGURATION, W/ OR W/O DILATION AND CURETTAGE, W/ OR W/O REPAIR; LOOP
ELECTRODE EXCISION"	"25,155.00"	"12,870.00"	"12,285.00"
57530	"TRACHELECTOMY (CERVICECTOMY), AMPUTATION OF CERVIX"	"35,100.00"	"18,720.00"	"16,380.00"
57540	"EXCISION OF CERVICAL STUMP, ABDOMINAL APPROACH;"	"59,085.00"	"26,325.00"	"32,760.00"
57545	"EXCISION OF CERVICAL STUMP, ABDOMINAL APPROACH; W/
PELVIC FLOOR REPAIR"	"73,710.00"	"32,760.00"	"40,950.00"
57550	"EXCISION OF CERVICAL STUMP, VAGINAL APPROACH;"	"45,435.00"	"20,865.00"	"24,570.00"
57555	"EXCISION OF CERVICAL STUMP, VAGINAL APPROACH; W/
ANTERIOR AND/OR POSTERIOR REPAIR"	"73,710.00"	"32,760.00"	"40,950.00"
57556	"EXCISION OF CERVICAL STUMP, VAGINAL APPROACH; W/ REPAIR
OF ENTEROCELE"	"77,805.00"	"32,760.00"	"45,045.00"
57700	"CERCLAGE OF UTERINE CERVIX, NONOBSTETRICAL"	"18,915.00"	"10,725.00"	"8,190.00"
57720	"TRACHELORRHAPHY, PLASTIC REPAIR OF UTERINE CERVIX,
VAGINAL APPROACH"	"35,100.00"	"18,720.00"	"16,380.00"
58100	"ENDOMETRIAL SAMPLING (BIOPSY) W/ OR W/O ENDOCERVICAL SAMPLING (BIOPSY), W/O CERVICAL DILATION, ANY METHOD"	"21,450.00"	"12,870.00"	"8,580.00"
58120	DILATION AND CURETTAGE	"21,450.00"	"12,870.00"	"8,580.00"
58140	"MYOMECTOMY, EXCISION OF FIBROID TUMOR OF UTERUS, SINGLE
OR MULTIPLE ; ABDOMINAL APPROACH"	"45,435.00"	"20,865.00"	"24,570.00"
58145	"MYOMECTOMY, EXCISION OF FIBROID TUMOR OF UTERUS, SINGLE
OR MULTIPLE ; VAGINAL APPROACH"	"35,100.00"	"18,720.00"	"16,380.00"
58150	"TOTAL ABDOMINAL HYSTERECTOMY (CORPUS AND CERVIX), W/ OR W/O REMOVAL OF TUBE(S), W/ OR W/O REMOVAL OF
OVARY(S);"	"58,500.00"	"35,100.00"	"23,400.00"
58152	"TOTAL ABDOMINAL HYSTERECTOMY (CORPUS AND CERVIX), W/ OR W/O REMOVAL OF TUBE(S), W/ OR W/O REMOVAL OF OVARY(S); W/ COLPO-URETHROCYSTOPEXY (MARSHALL-
MARCHETTI-KRANTZ TYPE)"	"58,500.00"	"35,100.00"	"23,400.00"
58180	"SUPRACERVICAL ABDOMINAL HYSTERECTOMY (SUBTOTAL HYSTERECTOMY), W/ OR W/O REMOVAL OF TUBE(S), W/ OR W/O
REMOVAL OF OVARY(S)"	"58,500.00"	"35,100.00"	"23,400.00"
58200	"TOTAL ABDOMINAL HYSTERECTOMY, INCLUDING PARTIAL VAGINECTOMY, W/ PARA-AORTIC AND PELVIC LYMPH NODE SAMPLING, W/ OR W/O REMOVAL OF TUBE(S), W/ OR W/O
REMOVAL OF OVARY(S)"	"58,500.00"	"35,100.00"	"23,400.00"
58210	"RADICAL ABDOMINAL HYSTERECTOMY, W/ BILATERAL TOTAL PELVIC LYMPHADENECTOMY AND PARA-AORTIC LYMPH NODE SAMPLING (BIOPSY), W/ OR W/O REMOVAL OF TUBE(S), W/ OR W/O
REMOVAL OF OVARY(S)"	"107,250.00"	"41,730.00"	"65,520.00"
58240	"PELVIC EXENTERATION FOR GYNECOLOGIC MALIGNANCY, W/ TOTAL ABDOMINAL HYSTERECTOMY OR CERVICECTOMY, W/ OR W/O REMOVAL OF TUBE(S), W/ OR W/O REMOVAL OF OVARY(S), W/ REMOVAL OF BLADDER AND URETERAL TRANSPLANTATIONS, AND/OR ABDOMINOPERINEAL RESECTION OF RECTUM"	"139,230.00"	"40,950.00"	"98,280.00"
58260	VAGINAL HYSTERECTOMY;	"59,085.00"	"26,325.00"	"32,760.00"
58262	"VAGINAL HYSTERECTOMY; W/ REMOVAL OF TUBE(S), AND/OR
OVARY(S)"	"59,085.00"	"26,325.00"	"32,760.00"
58263	"VAGINAL HYSTERECTOMY; W/ REMOVAL OF TUBE(S), AND/OR
OVARY(S), W/ REPAIR OF ENTEROCELE"	"73,710.00"	"32,760.00"	"40,950.00"
58267	"VAGINAL HYSTERECTOMY; W/ COLPO-URETHROCYSTOPEXY (MARSHALL-MARCHETTI-KRANTZ TYPE, PEREYRA TYPE, W/ OR
W/O ENDOSCOPIC CONTROL)"	"90,675.00"	"41,535.00"	"49,140.00"
58270	VAGINAL HYSTERECTOMY; W/ REPAIR OF ENTEROCELE	"90,675.00"	"41,535.00"	"49,140.00"
58275	"VAGINAL HYSTERECTOMY, W/ TOTAL OR PARTIAL COLPECTOMY;"	"73,710.00"	"32,760.00"	"40,950.00"
58280	"VAGINAL HYSTERECTOMY, W/ TOTAL OR PARTIAL COLPECTOMY;
W/ REPAIR OF ENTEROCELE"	"90,675.00"	"41,535.00"	"49,140.00"
58285	"VAGINAL HYSTERECTOMY, RADICAL (SCHAUTA TYPE OPERATION)"	"90,675.00"	"41,535.00"	"49,140.00"
58345	"TRANSCERVICAL INTRODUCTION OF FALLOPIAN TUBE CATHETER FOR DIAGNOSIS AND/OR RE-ESTABLISHING PATENCY (ANY METHOD), W/ OR W/O HYSTEROSALPINGOGRAPHY"	"35,100.00"	"18,720.00"	"16,380.00"
58346	INSERTION OF HEYMAN CAPSULES FOR BRACHYTHERAPY	"18,915.00"	"10,725.00"	"8,190.00"
58400	"UTERINE SUSPENSION, W/ OR W/O SHORTENING OF ROUND
LIGAMENTS, W/ OR W/O SHORTENING OF SACROUTERINE LIGAMENTS;"	"45,435.00"	"20,865.00"	"24,570.00"
58410	"UTERINE SUSPENSION, W/ OR W/O SHORTENING OF ROUND
LIGAMENTS, W/ OR W/O SHORTENING OF SACROUTERINE LIGAMENTS; W/ PRESACRAL SYMPATHECTOMY"	"52,884.00"	"23,400.00"	"29,484.00"
58520	"HYSTERORRHAPHY, REPAIR OF RUPTURED UTERUS
(NONOBSTETRICAL)"	"45,435.00"	"20,865.00"	"24,570.00"
58540	"HYSTEROPLASTY, REPAIR OF UTERINE ANOMALY (STRASSMAN
TYPE)"	"73,710.00"	"32,760.00"	"40,950.00"
58545	"LAPAROSCOPY, SURGICAL, MYOMECTOMY, EXCISION; INTRAMURAL MYOMAS AND/OR REMOVAL OF SURFACE MYOMAS"	"45,435.00"	"20,865.00"	"24,570.00"
58550	"LAPAROSCOPY SURGICAL, WITH VAGINAL HYSTERECTOMY;"	"59,085.00"	"26,325.00"	"32,760.00"
58552	"LAPAROSCOPY SURGICAL, WITH VAGINAL HYSTERECTOMY; WITH
REMOVAL OF TUBE(S) AND/OR OVARY(S)"	"59,085.00"	"26,325.00"	"32,760.00"
58555	"HYSTEROSCOPY, DIAGNOSTIC"	"18,915.00"	"10,725.00"	"8,190.00"
58558	"HYSTEROSCOPY, SURGICAL; WITH SAMPLING (BIOPSY) OF ENDOMETRIUM AND/OR POLYPECTOMY, WITH OR WITHOUT D&C"	"25,155.00"	"12,870.00"	"12,285.00"
58559	"HYSTEROSCOPY, SURGICAL; WITH LYSIS OF INTRAUTERINE
ADHESIONS (ANY METHOD)"	"35,100.00"	"18,720.00"	"16,380.00"
58560	"HYSTEROSCOPY, SURGICAL; WITH DIVISION OR RESECTION OF
INTRAUTERINE SEPTUM (ANY METHOD)"	"35,100.00"	"18,720.00"	"16,380.00"
58561	"HYSTEROSCOPY, SURGICAL; WITH REMOVAL OF LEIOMYOMATA"	"45,435.00"	"20,865.00"	"24,570.00"
58562	"HYSTEROSCOPY, SURGICAL; WITH REMOVAL OF IMPACTED
FOREIGN BODY"	"25,155.00"	"12,870.00"	"12,285.00"
58563	"HYSTEROSCOPY, SURGICAL; WITH ENDOMETRIAL ABLATION (E.G., ENDOMETRIAL RESECTION, ELECTROSURGICAL ABLATION
THERMOABLATION)"	"23,634.00"	"10,530.00"	"13,104.00"
58565	"HYSTEROSCOPY, SURGICAL; WITH BILATERAL FALLOPIAN TUBE CANNULATION TO INDUCE OCCLUSION BY PLACEMENT OF
PERMANENT   IMPLANTS"	"11,076.00"	"7,800.00"	"3,276.00"
58600	"LIGATION OR TRANSECTION OF FALLOPIAN TUBE(S), ABDOMINAL OR VAGINAL APPROACH, UNILATERAL OR BILATERAL"	"7,800.00"	"5,850.00"	"1,950.00"
58660	"LAPAROSCOPY, SURGICAL; WITH LYSIS OF ADHESIONS
(SALPHINGOLYSIS, OVARIOLYSIS)"	"41,730.00"	"21,255.00"	"20,475.00"
58661	"LAPAROSCOPY, SURGICAL; WITH REMOVAL OF ADNEXAL STRUCTURES (PARTIAL OR TOTAL OOPHORECTOMY AND/OR
SALPINGECTOMY)"	"104,130.00"	"46,800.00"	"57,330.00"
58662	"LAPAROSCOPY, SURGICAL; WITH FULGURATION OR EXCISION OF LESIONS OF THE OVARY, PELVIC VISCERA, OR PERITONEAL
SURFACE BY ANY METHOD"	"29,172.00"	"14,430.00"	"14,742.00"
58670	"LAPAROSCOPY, SURGICAL; WITH FULGURATION OF OVIDUCTS
(WITH OR WITHOUT TRANSECTION)"	"29,172.00"	"14,430.00"	"14,742.00"
58671	"LAPAROSCOPY, SURGICAL; WITH OCCLUSION OF OVIDUCTS BY
DEVICE (E.G., BAND, CLIP, OR FALOPE RING)"	"25,155.00"	"12,870.00"	"12,285.00"
58672	"LAPAROSCOPY, SURGICAL; WITH FIMBRIOPLASTY"	"41,730.00"	"21,255.00"	"20,475.00"
58673	"LAPAROSCOPY, SURGICAL; WITH SALPHINGOSTOMY
(SALPINGONEOSTOMY)"	"45,435.00"	"20,865.00"	"24,570.00"
58700	"SALPINGECTOMY, COMPLETE OR PARTIAL, UNILATERAL OR
BILATERAL"	"40,911.00"	"21,255.00"	"19,656.00"
58720	"SALPINGO-OOPHORECTOMY, COMPLETE OR PARTIAL,
UNILATERAL OR BILATERAL"	"45,435.00"	"20,865.00"	"24,570.00"
58740	"LYSIS OF ADHESIONS (SALPINGOLYSIS, OVARIOLYSIS)"	"45,435.00"	"20,865.00"	"24,570.00"
58750	TUBOTUBAL ANASTOMOSIS	"35,100.00"	"18,720.00"	"16,380.00"
58760	FIMBRIOPLASTY	"45,435.00"	"20,865.00"	"24,570.00"
58770	SALPINGOSTOMY (SALPINGONEOSTOMY)	"45,435.00"	"20,865.00"	"24,570.00"
58800	"DRAINAGE OF OVARIAN CYST(S), UNILATERAL OR BILATERAL ;
VAGINAL APPROACH"	"40,911.00"	"21,255.00"	"19,656.00"
58805	"DRAINAGE OF OVARIAN CYST(S), UNILATERAL OR BILATERAL ;
ABDOMINAL APPROACH"	"40,911.00"	"21,255.00"	"19,656.00"
58820	DRAINAGE OF OVARIAN ABSCESS; VAGINAL APPROACH	"40,911.00"	"21,255.00"	"19,656.00"
58822	DRAINAGE OF OVARIAN ABSCESS; ABDOMINAL APPROACH	"40,911.00"	"21,255.00"	"19,656.00"
58825	"TRANSPOSITION, OVARY(S)"	"40,911.00"	"21,255.00"	"19,656.00"
58900	"BIOPSY OF OVARY, UNILATERAL OR BILATERAL"	"35,100.00"	"18,720.00"	"16,380.00"
58920	"WEDGE RESECTION OR BISECTION OF OVARY, UNILATERAL OR
BILATERAL"	"35,100.00"	"18,720.00"	"16,380.00"
58925	"OVARIAN CYSTECTOMY, UNILATERAL OR BILATERAL"	"45,435.00"	"20,865.00"	"24,570.00"
58940	"OOPHORECTOMY, PARTIAL OR TOTAL, UNILATERAL OR
BILATERAL;"	"35,100.00"	"18,720.00"	"16,380.00"
58943	"OOPHORECTOMY, PARTIAL OR TOTAL, UNILATERAL OR BILATERAL; FOR OVARIAN MALIGNANCY, W/ PARA-AORTIC AND PELVIC LYMPH NODE BIOPSIES, PERITONEAL WASHINGS, PERITONEAL BIOPSIES, DIAPHRAGMATIC ASSESSMENTS, W/ OR W/O SALPINGECTOMY(S), W/ OR W/O OMENTECTOMY"	"59,085.00"	"26,325.00"	"32,760.00"
58950	"RESECTION OF OVARIAN MALIGNANCY W/ BILATERAL SALPINGO-
OOPHORECTOMY AND OMENTECTOMY;"	"104,130.00"	"46,800.00"	"57,330.00"
58951	"RESECTION OF OVARIAN MALIGNANCY W/ BILATERAL SALPINGO- OOPHORECTOMY AND OMENTECTOMY; W/ TOTAL ABDOMINAL HYSTERECTOMY, PELVIC AND LIMITED PARA-AORTIC
LYMPHADENECTOMY"	"107,250.00"	"41,730.00"	"65,520.00"
58952	"RESECTION OF OVARIAN MALIGNANCY W/ BILATERAL SALPINGO- OOPHORECTOMY AND OMENTECTOMY; W/ RADICAL DISSECTION
FOR DEBULKING"	"114,660.00"	"40,950.00"	"73,710.00"
58960	"LAPAROTOMY, FOR STAGING OR RESTAGING OF OVARIAN MALIGNANCY (""SECOND LOOK""), W/ OR W/O OMENTECTOMY, PERITONEAL WASHING, BIOPSY OF ABDOMINAL AND PELVIC PERITONEUM, DIAPHRAGMATIC ASSESSMENT W/ PELVIC AND LIMITED PARA-AORTIC LYMPHADENECTOMY"	"52,884.00"	"23,400.00"	"29,484.00"
59100	"HYSTEROTOMY, ABDOMINAL (E.G., FOR HYDATIDIFORM MOLE,
ABORTION)"	"45,435.00"	"20,865.00"	"24,570.00"
59120	"SURGICAL TREATMENT OF ECTOPIC PREGNANCY; TUBAL OR OVARIAN, REQUIRING SALPINGECTOMY AND/OR
OOPHORECTOMY, ABDOMINAL OR VAGINAL APPROACH"	"52,884.00"	"23,400.00"	"29,484.00"
59121	"SURGICAL TREATMENT OF ECTOPIC PREGNANCY; TUBAL OR OVARIAN, W/O SALPINGECTOMY AND/OR OOPHORECTOMY"	"52,884.00"	"23,400.00"	"29,484.00"
59130	"SURGICAL TREATMENT OF ECTOPIC PREGNANCY; ABDOMINAL
PREGNANCY"	"90,675.00"	"41,535.00"	"49,140.00"
59135	"SURGICAL TREATMENT OF ECTOPIC PREGNANCY; INTERSTITIAL, UTERINE PREGNANCY REQUIRING TOTAL HYSTERECTOMY"	"73,710.00"	"32,760.00"	"40,950.00"
59136	"SURGICAL TREATMENT OF ECTOPIC PREGNANCY; INTERSTITIAL, UTERINE PREGNANCY W/ PARTIAL RESECTION OF UTERUS"	"73,320.00"	"36,465.00"	"36,855.00"
59140	"SURGICAL TREATMENT OF ECTOPIC PREGNANCY; CERVICAL, W/
EVACUATION"	"59,085.00"	"26,325.00"	"32,760.00"
59150	"LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNANCY; W/O
SALPINGECTOMY AND/OR OOPHORECTOMY"	"52,884.00"	"23,400.00"	"29,484.00"
59151	"LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNANCY; W/
SALPINGECTOMY AND/OR OOPHORECTOMY"	"52,884.00"	"23,400.00"	"29,484.00"
59320	"CERCLAGE OF CERVIX, DURING PREGNANCY; VAGINAL"	"35,100.00"	"18,720.00"	"16,380.00"
59325	"CERCLAGE OF CERVIX, DURING PREGNANCY; ABDOMINAL"	"35,100.00"	"18,720.00"	"16,380.00"
59350	HYSTERORRHAPHY OF RUPTURED UTERUS	"59,085.00"	"26,325.00"	"32,760.00"
59403	"UNDELIVERED CASES (BABY DELIVERED IN REFERRAL FACILITY)
IN NON-HOSPITAL FACILITIES"	"1,267.50"	760.50	507.00
59409	VAGINAL DELIVERY ONLY (W/ EPISIOTOMY)	"18,915.00"	"10,725.00"	"8,190.00"
59411	BREECH EXTRACTION	"23,634.00"	"10,530.00"	"13,104.00"
59513	"CAESARIAN SECTION, PRIMARY"	"37,050.00"	"22,230.00"	"14,820.00"
59514	CESARIAN DELIVERY	"37,050.00"	"22,230.00"	"14,820.00"
59525	"SUBTOTAL OR TOTAL HYSTERECTOMY AFTER CESAREAN
DELIVERY"	"58,500.00"	"35,100.00"	"23,400.00"
59612	"VAGINAL DELIVERY ONLY, AFTER PREVIOUS CESAREAN DELIVERY
(W/ OR W/O EPISIOTOMY)"	"23,634.00"	"10,530.00"	"13,104.00"
59620	"CESAREAN DELIVERY ONLY, FOLLOWING ATTEMPTED VAGINAL DELIVERY AFTER PREVIOUS CESAREAN DELIVERY;"	"37,050.00"	"22,230.00"	"14,820.00"
59812	"TREATMENT OF INCOMPLETE ABORTION, ANY TRIMESTER,
COMPLETED SURGICALLY"	"21,450.00"	"12,870.00"	"8,580.00"
59814	MANUAL VACUUM ASPIRATION FOR SPONTANEOUS ABORTION	"21,450.00"	"12,870.00"	"8,580.00"
59870	"UTERINE EVACUATION AND CURETTAGE FOR HYDATIDIFORM
MOLE"	"23,634.00"	"10,530.00"	"13,104.00"
60000	"INCISION AND DRAINAGE OF THYROGLOSSAL CYST, INFECTED"	"6,832.80"	"5,850.00"	982.80
60001	"ASPIRATION AND/OR INJECTION, THYROID CYST"	"16,107.00"	"9,555.00"	"6,552.00"
60100	"BIOPSY THYROID, PERCUTANEOUS CORE NEEDLE"	"16,107.00"	"9,555.00"	"6,552.00"
60200	"EXCISION OF CYST OR ADENOMA OF THYROID , OR TRANSECTION
OF ISTHMUS"	"40,911.00"	"21,255.00"	"19,656.00"
60210	"PARTIAL THYROID LOBECTOMY, UNILATERAL; W/ OR W/O
ISTHMUSECTOMY"	"60,450.00"	"36,270.00"	"24,180.00"
60212	"PARTIAL THYROID LOBECTOMY, UNILATERAL; W/ CONTRALATERAL SUBTOTAL LOBECTOMY, INCLUDING
ISTHMUSECTOMY"	"60,450.00"	"36,270.00"	"24,180.00"
60220	"TOTAL THYROID LOBECTOMY, UNILATERAL; W/ OR W/O
ISTHMUSECTOMY"	"60,450.00"	"36,270.00"	"24,180.00"
60225	"TOTAL THYROID LOBECTOMY, UNILATERAL; W/ CONTRALATERAL SUBTOTAL LOBECTOMY, INCLUDING ISTHMUSECTOMY"	"60,450.00"	"36,270.00"	"24,180.00"
60240	"THYROIDECTOMY, TOTAL OR COMPLETE"	"60,450.00"	"36,270.00"	"24,180.00"
60252	"THYROIDECTOMY, TOTAL OR SUBTOTAL FOR MALIGNANCY; W/
LIMITED NECK DISSECTION"	"60,450.00"	"36,270.00"	"24,180.00"
60254	"THYROIDECTOMY, TOTAL OR SUBTOTAL FOR MALIGNANCY; W/
RADICAL NECK DISSECTION"	"90,675.00"	"41,535.00"	"49,140.00"
60260	"THYROIDECTOMY, REMOVAL OF ALL REMAINING  THYROID TISSUE FOLLOWING PREVIOUS REMOVAL OF A PORTION OF
THYROID"	"60,450.00"	"36,270.00"	"24,180.00"
60270	"THYROIDECTOMY, INCLUDING SUBSTERNAL THYROID GLAND;
STERNAL SPLIT OR TRANSHORACIC APPROACH"	"90,675.00"	"41,535.00"	"49,140.00"
60271	"THYROIDECTOMY, INCLUDING SUBSTERNAL THYROID GLAND;
CERVICAL APPROACH"	"90,675.00"	"41,535.00"	"49,140.00"
60280	EXCISION OF THYROGLOSSAL DUCT CYST OR SINUS;	"40,911.00"	"21,255.00"	"19,656.00"
60281	EXCISION OF THYROGLOSSAL DUCT CYST OR SINUS; RECURRENT	"45,435.00"	"20,865.00"	"24,570.00"
60500	PARATHYROIDECTOMY OR EXPLORATION OF PARATHYROID(S);	"59,943.00"	"33,735.00"	"26,208.00"
60502	"PARATHYROIDECTOMY OR EXPLORATION OF PARATHYROID(S); RE-
EXPLORATION"	"52,884.00"	"23,400.00"	"29,484.00"
60505	"PARATHYROIDECTOMY OR EXPLORATION OF PARATHYROID(S); W/ MEDIASTINAL EXPLORATION, STERNAL SPLIT OR
TRANSTHORACIC APPROACH"	"77,805.00"	"32,760.00"	"45,045.00"
60512	PARATHYROID AUTOTRANSPLANTATION	"59,085.00"	"26,325.00"	"32,760.00"
60520	"THYMECTOMY, PARTIAL OR TOTAL; TRANSCERVICAL APPROACH"	"77,805.00"	"32,760.00"	"45,045.00"
60521	"THYMECTOMY, PARTIAL OR TOTAL; STERNAL SPLIT OR TRANSTHORACIC APPROACH, W/O RADICAL MEDIASTINAL
DISSECTION"	"77,805.00"	"32,760.00"	"45,045.00"
60522	"THYMECTOMY, PARTIAL OR TOTAL; STERNAL SPLIT OR
TRANSTHORACIC APPROACH, W/ RADICAL MEDIASTINAL DISSECTION"	"77,805.00"	"32,760.00"	"45,045.00"
60540	"ADRENALECTOMY, PARTIAL OR COMPLETE, OR EXPLORATION OF ADRENAL GLAND W/ OR W/O BIOPSY, TRANSABDOMINAL, LUMBAR
OR DORSAL;"	"59,085.00"	"26,325.00"	"32,760.00"
60545	"ADRENALECTOMY, PARTIAL OR COMPLETE, OR EXPLORATION OF ADRENAL GLAND W/ OR W/O BIOPSY, TRANSABDOMINAL, LUMBAR OR DORSAL; W/ EXCISION OF ADJACENT RETROPERITONEAL
TUMOR"	"73,320.00"	"36,465.00"	"36,855.00"
60600	"EXCISION OF CAROTID BODY TUMOR; W/O EXCISION OF CAROTID
ARTERY"	"59,085.00"	"26,325.00"	"32,760.00"
60605	"EXCISION OF CAROTID BODY TUMOR; W/ EXCISION OF CAROTID
ARTERY"	"73,710.00"	"32,760.00"	"40,950.00"
60650	"LAPAROSCOPY, SURGICAL, WITH ADRENALECTOMY, PARTIAL OR COMPLETE, OR EXPLORATION OF ADRENAL GLAND WITH OR WITHOUT BIOPSY, TRANSABDOMINAL, LUMBAR OR DORSAL"	"59,085.00"	"26,325.00"	"32,760.00"
61000	"SUBDURAL TAP THROUGH FONTANELLE, OR SUTURE, INFANT,
UNILATERAL OR BILATERAL"	"11,076.00"	"7,800.00"	"3,276.00"
61020	"VENTRICULAR PUNCTURE THROUGH PREVIOUS BURR HOLE, FONTANELLE, SUTURE, OR IMPLANTED VENTRICULAR
CATHETER/RESERVOIR"	"11,076.00"	"7,800.00"	"3,276.00"
61050	CISTERNAL OR LATERAL CERVICAL (C1-C2) PUNCTURE	"20,553.00"	"10,725.00"	"9,828.00"
61105	"TWIST DRILL HOLE FOR SUBDURAL OR VENTRICULAR PUNCTURE;
NOT FOLLOWED BY OTHER SURGERY"	"35,100.00"	"18,720.00"	"16,380.00"
61106	"TWIST DRILL HOLE FOR SUBDURAL OR VENTRICULAR PUNCTURE;
FOLLOWED BY OTHER SURGERY"	"35,919.00"	"18,720.00"	"17,199.00"
61107	"TWIST DRILL HOLE FOR SUBDURAL OR VENTRICULAR PUNCTURE; FOR IMPLANTING VENTICULAR CATHETER OR PRESSURE
RECORDING DEVICE"	"59,085.00"	"26,325.00"	"32,760.00"
61108	TWIST DRILL HOLE FOR SUBDURAL OR VENTRICULAR PUNCTURE; FOR EVACUATION AND/OR DRAINAGE OF SUBDURAL HEMATOMA	"73,710.00"	"32,760.00"	"40,950.00"
61120	"BURR HOLE(S) FOR VENTRICULAR PUNCTURE (INCLUDING INJECTION OF GAS, CONTRAST MEDIA, DYE, OR RADIOACTIVE MATERIAL); NOT FOLLOWED BY OTHER SURGERY"	"45,435.00"	"20,865.00"	"24,570.00"
61130	"BURR HOLE(S) FOR VENTRICULAR PUNCTURE (INCLUDING
INJECTION OF GAS, CONTRAST MEDIA, DYE, OR RADIOACTIVE MATERIAL); FOLLOWED BY OTHER SURGERY"	"43,368.00"	"21,255.00"	"22,113.00"
61140	"BURR HOLE(S) OR TREPHINE; W/ BIOPSY OF BRAIN OR
INTRACRANIAL LESION"	"73,710.00"	"32,760.00"	"40,950.00"
61150	"BURR HOLE(S) OR TREPHINE; W/ DRAINAGE OF BRAIN ABSCESS
OR CYST"	"73,710.00"	"32,760.00"	"40,950.00"
61154	"BURR HOLE(S) W/ EVACUATION AND/OR DRAINAGE OF
HEMATOMA, EXTRADURAL OR SUBDURAL"	"73,710.00"	"32,760.00"	"40,950.00"
61156	"BURR HOLE(S); W/ ASPIRATION OF HEMATOMA OR CYST,
INTRACEREBRAL"	"73,710.00"	"32,760.00"	"40,950.00"
61250	"BURR HOLE(S) OR TREPHINE, SUPRATENTORIAL"	"45,435.00"	"20,865.00"	"24,570.00"
61253	"BURR HOLE(S) OR TREPHINE, INFRATENTORIAL, UNILATERAL OR
BILATERAL"	"59,085.00"	"26,325.00"	"32,760.00"
61304	"CRANIECTOMY OR CRANIOTOMY, EXPLORATORY;
SUPRATENTORIAL"	"73,710.00"	"32,760.00"	"40,950.00"
61305	"CRANIECTOMY OR CRANIOTOMY, EXPLORATORY;
INFRATENTORIAL (POSTERIOR FOSSA)"	"90,675.00"	"41,535.00"	"49,140.00"
61312	"CRANIECTOMY OR CRANIOTOMY FOR EVACUATION OF HEMATOMA, SUPRATENTORIAL; EXTRADURAL OR SUBDURAL"	"90,675.00"	"41,535.00"	"49,140.00"
61313	"CRANIECTOMY OR CRANIOTOMY FOR EVACUATION OF
HEMATOMA, SUPRATENTORIAL; INTRACEREBRAL"	"90,675.00"	"41,535.00"	"49,140.00"
61314	"CRANIECTOMY OR CRANIOTOMY FOR EVACUATION OF HEMATOMA, INFRATENTORIAL; EXTRADURAL OR SUBDURAL"	"104,130.00"	"46,800.00"	"57,330.00"
61315	"CRANIECTOMY OR CRANIOTOMY FOR EVACUATION OF
HEMATOMA, INFRATENTORIAL; INTRACEREBELLAR"	"104,130.00"	"46,800.00"	"57,330.00"
61320	"CRANIECTOMY OR CRANIOTOMY, DRAINAGE OF INTRACRANIAL
ABSCESS; SUPRATENTORIAL"	"90,675.00"	"41,535.00"	"49,140.00"
61321	"CRANIECTOMY OR CRANIOTOMY, DRAINAGE OF INTRACRANIAL
ABSCESS; INFRATENTORIAL"	"104,130.00"	"46,800.00"	"57,330.00"
61330	"DECOMPRESSION OF ORBIT ONLY, TRANSCRANIAL APPROACH"	"90,675.00"	"41,535.00"	"49,140.00"
61332	EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH); W/ BIOPSY	"104,130.00"	"46,800.00"	"57,330.00"
61333	"EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH); W/
REMOVAL OF LESION"	"104,130.00"	"46,800.00"	"57,330.00"
61334	"EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH); W/
REMOVAL OF FOREIGN BODY"	"104,130.00"	"46,800.00"	"57,330.00"
61340	"OTHER CRANIAL DECOMPRESSION (E.G., SUBTEMPORAL),
SUPRATENTORIAL"	"73,710.00"	"32,760.00"	"40,950.00"
61343	"CRANIECTOMY, SUBOCCIPITAL W/ CERVICAL LAMINECTOMY FOR DECOMPRESSION OF MEDULLA AND  SPINAL CORD, W/ OR W/O DURAL GRAFT (E.G., ARNOLD-CHIARI MALFORMATION)"	"104,130.00"	"46,800.00"	"57,330.00"
61345	"OTHER CRANIAL DECOMPRESSION, POSTERIOR FOSSA"	"90,675.00"	"41,535.00"	"49,140.00"
61440	CRANIOTOMY FOR SECTION OF TENTORIUM CEREBELLI	"90,675.00"	"41,535.00"	"49,140.00"
61450	"CRANIECTOMY, SUBTEMPORAL, FOR SECTION, COMPRESSION, OR DECOMPRESSION OF SENSORY ROOT OF GASSERIAN GANGLION"	"104,130.00"	"46,800.00"	"57,330.00"
61458	"CRANIECTOMY, SUBOCCIPITAL; FOR EXPLORATION OR
DECOMPRESSION OF CRANIAL NERVES"	"104,130.00"	"46,800.00"	"57,330.00"
61460	"CRANIECTOMY, SUBOCCIPITAL; FOR SECTION OF ONE OR MORE
CRANIAL NERVES"	"107,250.00"	"41,730.00"	"65,520.00"
61470	"CRANIECTOMY, SUBOCCIPITAL; FOR MEDULLARY TRACTOTOMY"	"107,250.00"	"41,730.00"	"65,520.00"
61480	"CRANIECTOMY, SUBOCCIPITAL; FOR MESENCEPHALIC
TRACTOTOMY OR PEDUNCULOTOMY"	"107,250.00"	"41,730.00"	"65,520.00"
61490	"CRANIOTOMY FOR LOBOTOMY, INCLUDING CINGULOTOMY"	"90,675.00"	"41,535.00"	"49,140.00"
61500	"CRANIECTOMY; W/ EXCISION OF TUMOR OR OTHER BONE LESION
OF SKULL"	"107,250.00"	"41,730.00"	"65,520.00"
61501	CRANIECTOMY; FOR OSTEOMYELITIS	"73,710.00"	"32,760.00"	"40,950.00"
61510	"CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY; FOR EXCISION OF BRAIN TUMOR, SUPRATENTORIAL, EXCEPT
MENINGIOMA"	"107,250.00"	"41,730.00"	"65,520.00"
61512	"CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY; FOR
EXCISION OF MENINGIOMA, SUPRATENTORIAL"	"122,850.00"	"40,950.00"	"81,900.00"
61514	"CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY; FOR
EXCISION OF BRAIN ABSCESS, SUPRATENTORIAL"	"104,130.00"	"46,800.00"	"57,330.00"
61516	"CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY; FOR EXCISION OR FENESTRATION OF CYST, SUPRATENTORIAL"	"104,130.00"	"46,800.00"	"57,330.00"
61518	"CRANIECTOMY FOR EXCISION OF BRAIN TUMOR,  INFRATENTORIAL OR POSTERIOR FOSSA; EXCEPT MENINGIOMA, CEREBELLOPONTINE ANGLE TUMOR, OR MIDLINE TUMOR AT BASE
OF SKULL"	"126,945.00"	"40,950.00"	"85,995.00"
61519	"CRANIECTOMY FOR EXCISION OF BRAIN TUMOR,
INFRATENTORIAL OR POSTERIOR FOSSA; MENINGIOMA"	"131,040.00"	"40,950.00"	"90,090.00"
61520	"CRANIECTOMY FOR EXCISION OF BRAIN TUMOR, INFRATENTORIAL OR POSTERIOR FOSSA; CEREBELLOPONTINE
ANGLE TUMOR"	"139,230.00"	"40,950.00"	"98,280.00"
61521	"CRANIECTOMY FOR EXCISION OF BRAIN TUMOR, INFRATENTORIAL OR POSTERIOR FOSSA; MIDLINE TUMOR AT
BASE OF SKULL"	"139,230.00"	"40,950.00"	"98,280.00"
61522	"CRANIECTOMY, INFRATENTORIAL OR POSTERIOR FOSSA; FOR
EXCISION OF BRAIN ABSCESS"	"107,250.00"	"41,730.00"	"65,520.00"
61524	"CRANIECTOMY, INFRATENTORIAL OR POSTERIOR FOSSA; FOR
EXCISION OR FENESTRATION OF CYST,"	"107,250.00"	"41,730.00"	"65,520.00"
61526	"CRANIECTOMY, BONE FLAP CRANIOTOMY, TRANSTEMPORAL (MASTOID) FOR EXCISION OF CEREBELLOPONTINE ANGLE TUMOR;"	"147,420.00"	"40,950.00"	"106,470.00"
61530	"CRANIECTOMY, BONE FLAP CRANIOTOMY, TRANSTEMPORAL (MASTOID) FOR EXCISION OF CEREBELLOPONTINE ANGLE TUMOR; COMBINED W/ MIDDLE/POSTERIOR FOSSA CRANIOTOMY/
CRANIECTOMY"	"147,420.00"	"40,950.00"	"106,470.00"
61531	"SUBDURAL IMPLANTATION OF STRIP ELECTRODES THROUGH ONE OR MORE BURR OR TREPHINE HOLE(S) FOR LONG TERM SEIZURE
MONITORING"	"104,130.00"	"46,800.00"	"57,330.00"
61533	"CRANIOTOMY W/ ELEVATION OF BONE FLAP; FOR SUBDURAL IMPLANTATION OF AN ELECTRODE ARRAY, FOR LONG TERM
SEIZURE MONITORING"	"104,130.00"	"46,800.00"	"57,330.00"
61534	"CRANIOTOMY W/ ELEVATION OF BONE FLAP; FOR EXCISION OF EPILEPTOGENIC FOCUS W/O ELECTROCORTICOGRAPHY DURING
SURGERY"	"104,130.00"	"46,800.00"	"57,330.00"
61535	"CRANIOTOMY W/ ELEVATION OF BONE FLAP; FOR REMOVAL OF
EPIDURAL OR SUBDURAL ELECTRODE ARRAY, W/O EXCISION OF CEREBRAL TISSUE"	"104,130.00"	"46,800.00"	"57,330.00"
61536	"CRANIOTOMY W/ ELEVATION OF BONE FLAP; FOR EXCISION OF CEREBRAL EPILEPTOGENIC FOCUS, W/ ELECTROCORTICOGRAPHY DURING SURGERY (INCLUDES REMOVAL OF ELECTRODE ARRAY)"	"107,250.00"	"41,730.00"	"65,520.00"
61538	"CRANIOTOMY W/ ELEVATION OF BONE FLAP; FOR LOBECTOMY W/ ELECTROCORTICOGRAPHY DURING SURGERY, TEMPORAL LOBE"	"104,130.00"	"46,800.00"	"57,330.00"
61539	"CRANIOTOMY W/ ELEVATION OF BONE FLAP; FOR LOBECTOMY W/ ELECTROCORTICOGRAPHY DURING SURGERY, OTHER THAN TEMPORAL LOBE, PARTIAL OR TOTAL"	"104,130.00"	"46,800.00"	"57,330.00"
61541	"CRANIOTOMY W/ ELEVATION OF BONE FLAP; FOR TRANSECTION
OF CORPUS CALLOSUM"	"104,130.00"	"46,800.00"	"57,330.00"
61542	"CRANIOTOMY W/ ELEVATION OF BONE FLAP; FOR TOTAL
HEMISPHERECTOMY"	"131,040.00"	"40,950.00"	"90,090.00"
61543	"CRANIOTOMY W/ ELEVATION OF BONE FLAP; FOR PARTIAL OR
SUBTOTAL HEMISPHERECTOMY"	"122,850.00"	"40,950.00"	"81,900.00"
61544	"CRANIOTOMY W/ ELEVATION OF BONE FLAP; FOR EXCISION OF
COAGULATION OF CHOROID PLEXUS"	"104,130.00"	"46,800.00"	"57,330.00"
61545	"CRANIOTOMY W/ ELEVATION OF BONE FLAP; FOR EXCISION OF
CRANIOPHARYNGIOMA"	"122,850.00"	"40,950.00"	"81,900.00"
61546	"CRANIOTOMY FOR HYPOPHYSECTOMY OR EXCISION OF PITUITARY
TUMOR, INTRACRANIAL APPROACH"	"122,850.00"	"40,950.00"	"81,900.00"
61548	"HYPOPHYSECTOMY OR EXCISION OF PITUITARY TUMOR, TRANSNASAL OR TRANSSEPTAL APPROACH, NONSTEREOTACTIC"	"122,850.00"	"40,950.00"	"81,900.00"
61550	"CRANIECTOMY FOR CRANIOSYNOSTOSIS; SINGLE CRANIAL
SUTURE"	"73,710.00"	"32,760.00"	"40,950.00"
61552	"CRANIECTOMY FOR CRANIOSYNOSTOSIS; MULTIPLE CRANIAL
SUTURES"	"90,675.00"	"41,535.00"	"49,140.00"
61556	"CRANIOTOMY FOR CRANIOSYNOSTOSIS; FRONTAL OR PARIETAL
BONE FLAP"	"90,675.00"	"41,535.00"	"49,140.00"
61557	CRANIOTOMY FOR CRANIOSYNOSTOSIS; BIFRONTAL BONE FLAP	"90,675.00"	"41,535.00"	"49,140.00"
61558	"EXTENSIVE CRANIECTOMY FOR MULTIPLE CRANIAL SUTURE CRANIOSYNOSTOSIS (E.G., CLOVERLEAF SKULL); NOT REQUIRING
BONE GRAFTS"	"114,660.00"	"40,950.00"	"73,710.00"
61559	"EXTENSIVE CRANIECTOMY FOR MULTIPLE CRANIAL SUTURE CRANIOSYNOSTOSIS (E.G., CLOVERLEAF SKULL); RECONTOURING W/ MULTIPLE OSTEOTOMIES AND BONE AUTOGRAFTS (E.G., BARREL-STAVE PROCEDURE) (INCLUDES OBTAINING GRAFTS)"	"114,660.00"	"40,950.00"	"73,710.00"
61563	"EXCISION, INTRA AND EXTRACRANIAL, BENIGN TUMOR OF CRANIAL BONE (E.G., FIBROUS DYSPLASIA); W/O OPTIC NERVE
DECOMPRESSION"	"114,660.00"	"40,950.00"	"73,710.00"
61564	"EXCISION, INTRA AND EXTRACRANIAL, BENIGN TUMOR OF
CRANIAL BONE (E.G., FIBROUS DYSPLASIA); W/ OPTIC NERVE DECOMPRESSION"	"114,660.00"	"40,950.00"	"73,710.00"
61570	"CRANIECTOMY OR CRANIOTOMY; W/ EXCISION OF FOREIGN BODY
FROM BRAIN"	"104,130.00"	"46,800.00"	"57,330.00"
61571	"CRANIECTOMY OR CRANIOTOMY; W/ TREATMENT OF
PENETRATING WOUND OF BRAIN"	"108,225.00"	"46,800.00"	"61,425.00"
61575	"TRANSORAL APPROACH TO SKULL BASE, BRAIN STEM OR UPPER
SPINAL CORD FOR BIOPSY, DECOMPRESSION OR EXCISION OF LESION;"	"147,420.00"	"40,950.00"	"106,470.00"
61576	"TRANSORAL APPROACH TO SKULL BASE, BRAIN STEM OR UPPER SPINAL CORD FOR BIOPSY, DECOMPRESSION OR EXCISION OF LESION; REQUIRING SPLITTING OF TONGUE AND/OR MANDIBLE
(INCLUDING TRACHEOSTOMY)"	"147,420.00"	"40,950.00"	"106,470.00"
61580	"CRANIOFACIAL APPROACH TO ANTERIOR CRANIAL FOSSA; EXTRADURAL, INCLUDING LATERAL RHINOTOMY, ETHMOIDECTOMY, SPHENOIDECTOMY, W/O MAXILLECTOMY OR
ORBITAL EXENTERATION"	"122,850.00"	"40,950.00"	"81,900.00"
61581	"CRANIOFACIAL APPROACH TO ANTERIOR CRANIAL FOSSA; EXTRADURAL, INCLUDING LATERAL RHINOTOMY, ORBITAL EXENTERATION, ETHMOIDECTOMY, SPHENOIDECTOMY AND/OR
MAXILLECTOMY"	"122,850.00"	"40,950.00"	"81,900.00"
61582	"CRANIOFACIAL APPROACH TO ANTERIOR CRANIAL FOSSA; EXTRADURAL, INCLUDING UNILATERAL OR BIFRONTAL CRANIOTOMY, ELEVATION OF FRONTAL LOBE(S), OSTEOTOMY OF
BASE OF ANTERIOR CRANIAL FOSSA"	"122,850.00"	"40,950.00"	"81,900.00"
61583	"CRANIOFACIAL APPROACH TO ANTERIOR CRANIAL FOSSA; INTRADURAL, INCLUDING UNILATERAL OR BIFRONTAL CRANIOTOMY, ELEVATION OR RESECTION OF FRONTAL LOBE,
OSTEOTOMY OF BASE OF ANTERIOR CRANIAL FOSSA"	"122,850.00"	"40,950.00"	"81,900.00"
61584	"ORBITOCRANIAL APPROACH TO ANTERIOR CRANIAL FOSSA, EXTRADURAL, INCLUDING SUPRAORBITAL RIDGE OSTEOTOMY AND ELEVATION OF FRONTAL AND/OR TEMPORAL LOBE(S); W/O
ORBITAL EXENTERATION"	"122,850.00"	"40,950.00"	"81,900.00"
61585	"ORBITOCRANIAL APPROACH TO ANTERIOR CRANIAL FOSSA, EXTRADURAL, INCLUDING SUPRAORBITAL RIDGE OSTEOTOMY AND ELEVATION OF FRONTAL AND/OR TEMPORAL LOBE(S); W/
ORBITAL EXENTERATION"	"122,850.00"	"40,950.00"	"81,900.00"
61586	"BICORONAL, TRANSZYGOMATIC AND/OR LEFORT I OSTEOTOMY
APPROACH TO ANTERIOR CRANIAL FOSSA W/ OR W/O INTERNAL FIXATION, W/O BONE GRAFT"	"122,850.00"	"40,950.00"	"81,900.00"
61590	"INFRATEMPORAL PRE-AURICULAR APPROACH TO MIDDLE CRANIAL FOSSA (PARAPHARYNGEAL SPACE, INFRATEMPORAL AND MIDLINE SKULL BASE, NASOPHARYNX), W/ OR W/O DISARTICULATION OF THE MANDIBLE, INCLUDING PAROTIDECTOMY, CRANIOTOMY, DECOMPRESSION AND/OR
MOBILIZATION OF TH"	"139,230.00"	"40,950.00"	"98,280.00"
61591	"INFRATEMPORAL POST-AURICULAR APPROACH TO MIDDLE CRANIAL FOSSA (INTERNAL AUDITORY MEATUS, PETROUS APEX, TENTORIUM, CAVERNOUS SINUS, PARASELLAR AREA, INFRATEMPORAL FOSSA) INLCUDING MASTOIDECTOMY, RESECTION OF SIGMOID SINUS, W/ OR W/O DECOMPRESSION
AND/OR MO"	"139,230.00"	"40,950.00"	"98,280.00"
61592	"ORBITOCRANIAL ZYGOMATIC APPROACH TO MIDDLE CRANIAL FOSSA (CAVERNOUS SINUS AND CAROTID ARTERY, CLIVUS, BASILAR ARTERY OR PETROUS APEX) INCLUDING OSTEOTOMY OF ZYGOMA, CRANIOTOMY, EXTRA- OR INTRADURAL ELEVATION OF
TEMPORAL LOBE"	"131,040.00"	"40,950.00"	"90,090.00"
61595	"TRANSTEMPORAL APPROACH TO POSTERIOR CRANIAL FOSSA, JUGULAR FORAMEN OR MIDLINE SKULL BASE, INCLUDING MASTOIDECTOMY, DECOMPRESSION OF SIGMOID SINUS AND/OR FACIAL NERVE, W/ OR W/O MOBILIZATION"	"139,230.00"	"40,950.00"	"98,280.00"
61596	"TRANSCOCHLEAR APPROACH TO POSTERIOR CRANIAL FOSSA, JUGULAR FORAMEN OR MIDLINE SKULL BASE, INCLUDING LABYRINTHECTOMY, DECOMPRESSION, W/ OR W/O MOBILIZATION OF FACIAL NERVE AND/OR PETROUS CAROTID ARTERY"	"139,230.00"	"40,950.00"	"98,280.00"
61597	"TRANSCONDYLAR (FAR LATERAL) APPROACH TO POSTERIOR CRANIAL FOSSA, JUGULAR FORAMEN OR MIDLINE SKULL BASE, INCLUDING OCCIPTAL CONDYLECTOMY, MASTOIDECTOMY, RESECTION OF C1-C3 VERTEBRAL BODY(S), DECOMPRESSION OF VERTEBRAL ARTERY, W/ OR W/O MOBILIZATION"	"139,230.00"	"40,950.00"	"98,280.00"
61598	"TRANSPETROSAL APPROACH TO POSTERIOR CRANIAL FOSSA, CLIVUS OR FRAMEN MAGNUM, INCLUDING LIGATION OF SUPERIOR PETROSAL SINUS AND/OR SIGMOID SINUS"	"139,230.00"	"40,950.00"	"98,280.00"
61600	"RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF BASE OF ANTERIOR CRANIAL FOSSA;
EXTRADURAL"	"131,040.00"	"40,950.00"	"90,090.00"
61601	"RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF BASE OF ANTERIOR CRANIAL FOSSA; INTRADURAL, INCLUDING DURAL REPAIR,W/ OR W/O GRAFT"	"131,040.00"	"40,950.00"	"90,090.00"
61605	"RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR
INFECTIOUS LESION OF INFRATEMPORAL FOSSA, PARAPHARYNGEAL SPACE, PETROUS APEX; EXTRADURAL"	"139,230.00"	"40,950.00"	"98,280.00"
61606	"RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF INFRATEMPORAL FOSSA, PARAPHARYNGEAL SPACE, PETROUS APEX; INTRADURAL,
INCLUDING DURAL REPAIR, W/ OR W/O GRAFT"	"139,230.00"	"40,950.00"	"98,280.00"
61607	"RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF PARASELLAR AREA, CAVERNOUS SINUS,
CLIVUS OR MIDLINE SKULL BASE; EXTRADURAL"	"139,230.00"	"40,950.00"	"98,280.00"
61608	"RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF PARASELLAR AREA, CAVERNOUS SINUS, CLIVUS OR MIDLINE SKULL BASE; INTRADURAL, INCLUDING
DURAL REPAIR, W/ OR W/O GRAFT"	"139,230.00"	"40,950.00"	"98,280.00"
61609	"TRANSECTION OR LIGATION, CAROTID ARTERY IN CAVERNOUS
SINUS; W/O REPAIR"	"139,230.00"	"40,950.00"	"98,280.00"
61610	"TRANSECTION OR LIGATION, CAROTID ARTERY IN CAVERNOUS SINUS; W/ REPAIR BY ANASTOMOSIS OR GRAFT"	"139,230.00"	"40,950.00"	"98,280.00"
61611	"TRANSECTION OR LIGATION , CAROTID ARTERY IN PETROUS
CANAL; W/O REPAIR"	"122,850.00"	"40,950.00"	"81,900.00"
61612	"TRANSECTION OR LIGATION , CAROTID ARTERY IN PETROUS
CANAL; W/ REPAIR BY ANASTOMOSIS OR GRAFT"	"139,230.00"	"40,950.00"	"98,280.00"
61613	"OBLITERATION OF CAROTID ANEURYSM, ARTERIOVENOUS
MALFORMATION, OR CAROTID-CAVERNOUS FISTULA BY DISSECTION W/IN CAVERNOUS SINUS"	"139,230.00"	"40,950.00"	"98,280.00"
61615	"RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF BASE OF POSTERIOR CRANIAL FOSSA, JUGULAR FORAMEN, FORAMEN MAGNUM, OR CI-C3 VERTEBRAL
BODIES; EXTRADURAL"	"139,230.00"	"40,950.00"	"98,280.00"
61616	"RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF BASE OF POSTERIOR CRANIAL FOSSA, JUGULAR FORAMEN, FORAMEN MAGNUM, OR CI-C3 VERTEBRAL BODIES; INTRADURAL, INCLUDING DURAL REPAIR, W/ OR W/O
GRAFT"	"139,230.00"	"40,950.00"	"98,280.00"
61618	"SECONDARY REPAIR OF DURA FOR CSF LEAK, ANTERIOR, MIDDLE OR POSTERIOR CRANIAL FOSSA FOLLOWING SURGERY OF THE SKULL BASE; BY FREE TISSUE GRAFT (E.G., PERICRANIUM, FASCIA, TENSOR FASCIA LATA, ADIPOSE TISSUE, HOMOLOGOUS OR
SYNTHETIC GRAFTS)"	"131,040.00"	"40,950.00"	"90,090.00"
61619	"SECONDARY REPAIR OF DURA FOR CSF LEAK, ANTERIOR, MIDDLE OR POSTERIOR CRANIAL FOSSA FOLLOWING SURGERY OF THE SKULL BASE; BY LOCAL OR REGIONALIZED VASCULARIZED PEDICLE FLAP OR MYOCUTANEOUS FLAP (INCLUDING GALEA,TEMPORALIS, FRONTALIS OR OCCIPITALIS MUSCLE)"	"122,850.00"	"40,950.00"	"81,900.00"
61624	"TRANSCATHETER OCLUSSION OR EMBOLIZATION (E.G., FOR TUMOR DESTRUCTION, TO ACHIEVE HEMOSTASIS, TO OCCLUDE A VASCULAR MALFORMATION), PERCUTANEOUS, ANY METHOD; CENTRAL NERVOUS SYSTEM (INTRACRANIAL, SPINAL CORD)"	"139,230.00"	"40,950.00"	"98,280.00"
61626	"TRANSCATHETER OCLUSSION OR EMBOLIZATION (E.G., FOR TUMOR DESTRUCTION, TO ACHIEVE HEMOSTASIS, TO OCCLUDE A VASCULAR MALFORMATION), PERCUTANEOUS, ANY METHOD; NON CENTRAL NERVOUS SYSTEM, HEAD OR NECK (EXTRACRANIAL,
BRACHIOCEPHALIC BRANCH)"	"107,250.00"	"41,730.00"	"65,520.00"
61680	"SURGERY OF INTRACRANIAL ARTERIOVENOUS MALFORMATION;
SUPRATENTORIAL, SIMPLE"	"122,850.00"	"40,950.00"	"81,900.00"
61682	"SURGERY OF INTRACRANIAL ARTERIOVENOUS MALFORMATION;
SUPRATENTORIAL, COMPLEX"	"139,230.00"	"40,950.00"	"98,280.00"
61684	"SURGERY OF INTRACRANIAL ARTERIOVENOUS MALFORMATION;
INFRATENTORIAL, SIMPLE"	"122,850.00"	"40,950.00"	"81,900.00"
61686	"SURGERY OF INTRACRANIAL ARTERIOVENOUS MALFORMATION;
INFRATENTORIAL, COMPLEX"	"139,230.00"	"40,950.00"	"98,280.00"
61690	"SURGERY OF INTRACRANIAL ARTERIOVENOUS MALFORMATION;
DURAL, SIMPLE"	"107,250.00"	"41,730.00"	"65,520.00"
61692	"SURGERY OF INTRACRANIAL ARTERIOVENOUS MALFORMATION;
DURAL, COMPLEX"	"122,850.00"	"40,950.00"	"81,900.00"
61700	"SURGERY OF INTRACRANIAL ANEURYSM, INTRACRANIAL
APPROACH; CAROTID CIRCULATION"	"139,230.00"	"40,950.00"	"98,280.00"
61702	"SURGERY OF INTRACRANIAL ANEURYSM, INTRACRANIAL
APPROACH; VERTEBRAL-BASILAR CIRCULATION"	"147,420.00"	"40,950.00"	"106,470.00"
61703	"SURGERY OF INTRACRANIAL ANEURYSM, CERVICAL APPROACH BY APPLICATION OF OCCLUDING CLAMP TO CERVICAL CAROTID ARTERY (SELVERSTONE-CRUTCHFIELD TYPE)"	"45,435.00"	"20,865.00"	"24,570.00"
61705	"SURGERY OF ANEURYSM, VASCULAR MALFORMATION OR CAROTID CAVERNOUS FISTULA; BY INTRACRANIAL AND CERVICAL
OCCLUSION OF CAROTID ARTERY"	"139,230.00"	"40,950.00"	"98,280.00"
61708	"SURGERY OF ANEURYSM, VASCULAR MALFORMATION OR CAROTID CAVERNOUS FISTULA; BY INTRACRANIAL ELECTROTHROMBOSIS"	"73,710.00"	"32,760.00"	"40,950.00"
61710	"SURGERY OF ANEURYSM, VASCULAR MALFORMATION OR CAROTID CAVERNOUS FISTULA; BY INTRA-ARTERIAL EMBOLIZATION, INJECTION PROCEDURE OR BALLOON CATHETER"	"122,850.00"	"40,950.00"	"81,900.00"
61711	"ANASTOMOSIS, ARTERIAL, EXTRACRANIAL-INTRACRANIAL (E.G.,
MIDDLE CEREBRAL/CORTICAL) ARTERIES"	"131,040.00"	"40,950.00"	"90,090.00"
61712	"MICRODISSECTION, INTRACRANIAL OR SPINAL PROCEDURE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)"	"131,040.00"	"40,950.00"	"90,090.00"
61720	"CREATION OF LESION BY STEREOTACTIC METHOD, INCLUDING BURR HOLE(S) AND LOCALIZING AND RECORDING TECHNIQUES, SINGLE OR MULTIPLE STAGES; GLOBUS PALLIDUS OR THALAMUS"	"131,040.00"	"40,950.00"	"90,090.00"
61735	"CREATION OF LESION BY STEREOTACTIC METHOD, INCLUDING BURR HOLE(S) AND LOCALIZING AND RECORDING TECHNIQUES, SINGLE OR MULTIPLE STAGES; SUBCORTICAL STRUCTURE(S) OTHER THAN GLOBUS PALLIDUS OR THALAMUS"	"122,850.00"	"40,950.00"	"81,900.00"
61750	"STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION,INCLUDING BURR HOLE(S), FOR INTRACRANIAL LESION;"	"122,850.00"	"40,950.00"	"81,900.00"
61751	"STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION,INCLUDING
BURR HOLE(S), FOR INTRACRANIAL LESION; W/ COMPUTERIZED AXIAL TOMOGRAPHY"	"122,850.00"	"40,950.00"	"81,900.00"
61760	STEREOTACTIC IMPLANTATION OF DEPTH ELECTRODES INTO THE CEREBRUM FOR LONG TERM SEIZURE MONITORING	"122,850.00"	"40,950.00"	"81,900.00"
61770	"STEREOTACTIC LOCALIZATION , ANY METHOD, INCLUDING BURR HOLE(S), W/ INSERTION OF CATHETER(S) FOR BRACHYTHERAPY"	"59,085.00"	"26,325.00"	"32,760.00"
61790	"CREATION OF LESION BY STEREOTACTIC METHOD, PERCUTANEOUS, BY NEUROLYTIC AGENT (E.G., ALCOHOL, THERMAL, ELECTRICAL, RADIOFREQUENCY); GASSERIAN
GANGLION"	"73,710.00"	"32,760.00"	"40,950.00"
61791	"CREATION OF LESION BY STEREOTACTIC METHOD, PERCUTANEOUS, BY NEUROLYTIC AGENT (E.G., ALCOHOL, THERMAL, ELECTRICAL, RADIOFREQUENCY); TRIGEMINAL
MEDULLARY TRACT"	"73,710.00"	"32,760.00"	"40,950.00"
61793	"STEREOTACTIC RADIOSURGERY (PARTICLE BEAM,GAMMA RAY OR
LINEAR ACCELERATOR)"	"122,850.00"	"40,950.00"	"81,900.00"
61795	"STEREOTACTIC COMPUTER ASSISTED VOLUMETRIC
INTRACRANIAL PROCEDURE"	"122,850.00"	"40,950.00"	"81,900.00"
61850	"TWIST DRILL OR BURR HOLE(S) FOR IMPLANTATION OF
NEUROSTIMULATOR ELECTRODES; CORTICAL"	"104,130.00"	"46,800.00"	"57,330.00"
61855	"TWIST DRILL OR BURR HOLE(S) FOR IMPLANTATION OF
NEUROSTIMULATOR ELECTRODES; SUBCORTICAL"	"131,040.00"	"40,950.00"	"90,090.00"
61860	"CRANIECTOMY OR CRANIOTOMY FOR IMPLANTATION OF
NEUROSTIMULATOR ELECTRODES, CEREBRAL; CORTICAL"	"114,660.00"	"40,950.00"	"73,710.00"
61865	"CRANIECTOMY OR CRANIOTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CEREBRAL; SUBCORTICAL"	"90,675.00"	"41,535.00"	"49,140.00"
61870	"CRANIECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR
ELECTRODES, CEREBELLAR; CORTICAL"	"114,660.00"	"40,950.00"	"73,710.00"
61875	"CRANIECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CEREBELLAR; SUBCORTICAL"	"131,040.00"	"40,950.00"	"90,090.00"
61885	"INCISION AND SUBCUTANEOUS PLACEMENT OF CRANIAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER, DIRECT
OR INDUCTIVE COUPLING"	"73,710.00"	"32,760.00"	"40,950.00"
62000	"ELEVATION OF DEPRESSED SKULL FRACTURE; SIMPLE,
EXTRADURAL"	"59,085.00"	"26,325.00"	"32,760.00"
62005	"ELEVATION OF DEPRESSED SKULL FRACTURE; COMPOUND OR
COMMINUTED, EXTRADURAL"	"73,710.00"	"32,760.00"	"40,950.00"
62010	"ELEVATION OF DEPRESSED SKULL FRACTURE; W/ REPAIR OF
DURA AND /OR DEBRIDEMENT OF BRAIN"	"90,675.00"	"41,535.00"	"49,140.00"
62100	"CRANIOTOMY FOR REPAIR OF DURAL /CSF LEAK, INCLUDING
SURGERY FOR RHINORRHEA/OTORRHEA"	"139,230.00"	"40,950.00"	"98,280.00"
62115	"REDUCTION OF CRANIOMEGALIC SKULL (E.G., TREATED HYDROCEPHALUS); NOT REQUIRING BONE GRAFTS OR
CRANIOPLASTY"	"73,710.00"	"32,760.00"	"40,950.00"
62116	"REDUCTION OF CRANIOMEGALIC SKULL (E.G., TREATED
HYDROCEPHALUS); W/ SIMPLE CRANIOPLASTY"	"90,675.00"	"41,535.00"	"49,140.00"
62117	"REDUCTION OF CRANIOMEGALIC SKULL (E.G., TREATED HYDROCEPHALUS); REQUIRING CRANIOTOMY AND RECONSTRUCTION W/ OR W/O BONE GRAFT (INCLUDES
OBTAINING GRAFTS)"	"104,130.00"	"46,800.00"	"57,330.00"
62120	"REPAIR OF ENCEPHALOCELE, SKULL VAULT, INCLUDING
CRANIOPLASTY"	"114,660.00"	"40,950.00"	"73,710.00"
62121	"CRANIOTOMY FOR REPAIR OF ENCEPHALOCELE , SKULL BASE"	"107,250.00"	"41,730.00"	"65,520.00"
62140	CRANIOPLASTY FOR SKULL DEFECT; UP TO 5 CM DIAMETER	"59,085.00"	"26,325.00"	"32,760.00"
62141	"CRANIOPLASTY FOR SKULL DEFECT; LARGER THAN 5 CM
DIAMETER"	"59,085.00"	"26,325.00"	"32,760.00"
62142	REMOVAL OF BONE FLAP OR PROSTHETIC PLATE OF SKULL	"59,085.00"	"26,325.00"	"32,760.00"
62143	REPLACEMENT OF BONE FLAP OR PROSTHETIC PLATE OF SKULL	"59,085.00"	"26,325.00"	"32,760.00"
62145	"CRANIOPLASTY FOR SKULL DEFECT W/ REPARATIVE BRAIN
SURGERY"	"104,130.00"	"46,800.00"	"57,330.00"
62146	"CRANIOPLASTY W/ AUTOGRAFT (INCLUDES OBTAINING BONE
GRAFTS); UP TO 5 CM DIAMETER"	"104,130.00"	"46,800.00"	"57,330.00"
62147	"CRANIOPLASTY W/ AUTOGRAFT (INCLUDES OBTAINING BONE
GRAFTS); LARGER THAN 5 CM DIAMETER"	"107,250.00"	"41,730.00"	"65,520.00"
62160	"NEUROENDOSCOPY, INTRACRANIAL, FOR PLACEMENT OR
REPLACEMENT OF VENTRICULAR CATHETER AND ATTACHMENT TO SHUNT SYSTEM OR EXTERNAL DRAINAGE"	"73,710.00"	"32,760.00"	"40,950.00"
62161	"NEUROENDOSCOPY, INTRACRANIAL; WITH DISSECTION OF ADHESIONS, FENESTRATION OF SEPTUM PELLUCIDUM OR INTRAVENTRICULAR CYST (INCLUDING PLACEMENT,
REPLACEMENT OR REMOVAL OF VENTRICULAR CATHETER)"	"90,675.00"	"41,535.00"	"49,140.00"
62162	"NEUROENDOSCOPY, INTRACRANIAL; WITH FENESTRATION OR
EXCISION OF COLLOID CYST, INCLUDING PLACEMENT OF EXTERNAL VENTRICULAR CATHETER FOR DRAINAGE"	"90,675.00"	"41,535.00"	"49,140.00"
62163	"NEUROENDOSCOPY, INTRACRANIAL; WITH RETRIEVAL OF
FOREIGN BODY"	"90,675.00"	"41,535.00"	"49,140.00"
62165	"NEUROENDOSCOPY, INTRACRANIAL; WITH EXCISION OF PITUITARY TUMOR, TRANSNASAL OR TRANSPHENOIDAL
APPROACH"	"90,675.00"	"41,535.00"	"49,140.00"
62180	VENTRICULOCISTERNOSTOMY (TORKILDSEN TYPE OPERATION)	"73,710.00"	"32,760.00"	"40,950.00"
62190	"CREATION OF SHUNT; SUBARACHNOID/SUBDURAL-ATRIAL,  -
JUGULAR,   -AURICULAR"	"45,435.00"	"20,865.00"	"24,570.00"
62192	"CREATION OF SHUNT; SUBARACHNOID/SUBDURAL-PERITONIAL, -
PLEURAL, OTHER TERMINUS"	"45,435.00"	"20,865.00"	"24,570.00"
62200	"VENTRICULOCISTERNOSTOMY, THIRD VENTRICLE;"	"73,710.00"	"32,760.00"	"40,950.00"
62201	"VENTRICULOCISTERNOSTOMY, THIRD VENTRICLE; STEREOTACTIC
METHOD"	"90,675.00"	"41,535.00"	"49,140.00"
62220	"CREATION OF SHUNT; VENTRICULO-ATRIAL, -JUGULAR,-
AURICULAR"	"59,085.00"	"26,325.00"	"32,760.00"
62223	"CREATION OF SHUNT; VENTRICULO-PERITONIAL,-PLEURAL,
OTHER TERMINUS"	"59,085.00"	"26,325.00"	"32,760.00"
62230	"REPLACEMENT OR REVISION OF CSF (VP) SHUNT, OBSTRUCTED VALVE, OR DISTAL CATHETER IN SHUNT SYSTEM"	"45,435.00"	"20,865.00"	"24,570.00"
62268	"PERCUTANEOUS ASPIRATION, SPINAL CORD CYST OR SYRINX"	"25,155.00"	"12,870.00"	"12,285.00"
62269	"BIOPSY OF SPINAL  CORD, PERCUTANEOUS NEEDLE"	"25,155.00"	"12,870.00"	"12,285.00"
62270	"SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC"	"11,076.00"	"7,800.00"	"3,276.00"
62272	"SPINAL PUNCTURE , THERAPEUTIC, FOR DRAINAGE OF SPINAL
FLUID (BY NEEDLE OR CATHETER)"	"10,842.00"	"8,385.00"	"2,457.00"
62287	"ASPIRATION PROCEDURE, PERCUTANEOUS, OF NUCLEUS
PULPOSUS OF INTERVERTEBRAL  DISK, ANY METHOD, SINGLE OR MULTIPLE LEVELS, LUMBAR"	"45,435.00"	"20,865.00"	"24,570.00"
62350	"IMPLANTATION, REVISION OR REPOSITIONING OF INTRATHECAL OR EPIDURAL CATHETER, FOR IMPLANTABLE RESERVOIR OR IMPLANTABLE INFUSION PUMP; W/O LAMINECTOMY"	"35,100.00"	"18,720.00"	"16,380.00"
62351	"IMPLANTATION, REVISION OR REPOSITIONING OF INTRATHECAL OR EPIDURAL CATHETER, FOR IMPLANTABLE RESERVOIR OR IMPLANTABLE INFUSION PUMP; W/ LAMINECTOMY"	"73,710.00"	"32,760.00"	"40,950.00"
62360	IMPLANTATION OR REPLACEMENT OF DEVICE FOR INTRATHECAL OR EPIDURAL DRUG INFUSION; SUBCUTANEOUS RESERVOIR	"18,915.00"	"10,725.00"	"8,190.00"
62361	IMPLANTATION OR REPLACEMENT OF DEVICE FOR INTRATHECAL OR EPIDURAL DRUG INFUSION; NON-PROGRAMMABLE PUMP	"35,100.00"	"18,720.00"	"16,380.00"
62362	"IMPLANTATION OR REPLACEMENT OF DEVICE FOR INTRATHECAL OR EPIDURAL DRUG INFUSION; PROGRAMMABLE PUMP, INCLUDING PREPARATION OF PUMP, W/ OR W/O PROGRAMMING"	"45,435.00"	"20,865.00"	"24,570.00"
62464	"IMPLANTATION OR REPLACEMENT OF DEVICE FOR INTRATHECAL OR EPIDURAL DRUG INFUSION; WITH EXCISION OF BRAIN TUMOR, INCLUDING PLACEMENT OF EXTERNAL VENTRICULAR CATHETER
FOR DRAINAGE"	"90,675.00"	"41,535.00"	"49,140.00"
63001	"LAMINECTOMY W/ EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, W/O FACETECTOMY, FORAMINOTOMY OR DISKECTOMY, (E.G., SPINAL STENOSIS), ONE OR TWO VERTEBRAL SEGMENTS; CERVICAL"	"107,250.00"	"41,730.00"	"65,520.00"
63003	"LAMINECTOMY W/ EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, W/O FACETECTOMY, FORAMINOTOMY OR DISKECTOMY, (E.G., SPINAL STENOSIS), ONE OR TWO VERTEBRAL SEGMENTS; THORACIC"	"104,130.00"	"46,800.00"	"57,330.00"
63005	"LAMINECTOMY W/ EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, W/O FACETECTOMY, FORAMINOTOMY OR DISKECTOMY, (E.G., SPINAL STENOSIS), ONE OR TWO VERTEBRAL SEGMENTS; LUMBAR,EXCEPT FOR
SPONDYLOLISTHESIS"	"73,710.00"	"32,760.00"	"40,950.00"
63011	"LAMINECTOMY W/ EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, W/O FACETECTOMY, FORAMINOTOMY OR DISKECTOMY, (E.G., SPINAL STENOSIS), ONE OR TWO VERTEBRAL SEGMENTS; SACRAL"	"73,710.00"	"32,760.00"	"40,950.00"
63012	"LAMINECTOMY W/ REMOVAL OF ABNORMAL FACETS AND/OR PARS INTER-ARTICULARIS W/ DECOMPRESSION OF CAUDA EQUINA AND NERVE ROOTS FOR SPONDYLOLISTHESIS, LUMBAR
(GILL TYPE PROCEDURE)"	"104,130.00"	"46,800.00"	"57,330.00"
63015	"LAMINECTOMY W/ EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, W/O FACETECTOMY, FORAMINOTOMY OR DISKECTOMY, (E.G., SPINAL STENOSIS) , MORE THAN 2 VERTEBRAL SEGMENTS; CERVICAL"	"107,250.00"	"41,730.00"	"65,520.00"
63016	"LAMINECTOMY W/ EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, W/O FACETECTOMY, FORAMINOTOMY OR DISKECTOMY, (E.G., SPINAL STENOSIS) , MORE THAN 2 VERTEBRAL SEGMENTS; THORACIC"	"104,130.00"	"46,800.00"	"57,330.00"
63017	"LAMINECTOMY W/ EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, W/O FACETECTOMY, FORAMINOTOMY OR DISKECTOMY, (E.G., SPINAL STENOSIS) , MORE THAN 2 VERTEBRAL SEGMENTS; LUMBAR"	"90,675.00"	"41,535.00"	"49,140.00"
63020	"LAMINOTOMY (HEMILAMINECTOMY), W/ DECOMPRESSION OF NERVE ROOT (S), INCLUDING PARTIAL FACETECTOMY , FORAMINOTOMY  AND/OR EXCISION OF HERNIATED
INTERVERTEBRAL DISK; ONE INTERSPACE, CERVICAL"	"107,250.00"	"41,730.00"	"65,520.00"
63030	"LAMINOTOMY (HEMILAMINECTOMY), W/ DECOMPRESSION OF NERVE ROOT (S), INCLUDING PARTIAL FACETECTOMY , FORAMINOTOMY  AND/OR EXCISION OF HERNIATED
INTERVERTEBRAL DISK; ONE INTERSPACE,LUMBAR"	"90,675.00"	"41,535.00"	"49,140.00"
63040	"LAMINOTOMY (HEMILAMINECTOMY), W/ DECOMPRESSION OF NERVE ROOT (S), INCLUDING PARTIAL FACETECTOMY , FORAMINOTOMY  AND/OR EXCISION OR HERNIATED
INTERVERTEBRAL DISK; RE-EXPLORATION; CERVICAL"	"104,130.00"	"46,800.00"	"57,330.00"
63042	"LAMINOTOMY (HEMILAMINECTOMY), W/ DECOMPRESSION OF NERVE ROOT (S), INCLUDING PARTIAL FACETECTOMY , FORAMINOTOMY  AND/OR EXCISION OR HERNIATED
INTERVERTEBRAL DISK; RE-EXPLORATION; LUMBAR"	"90,675.00"	"41,535.00"	"49,140.00"
63045	"LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL W/ DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT(S), ( EG, SPINAL OR LATERAL RECESS STENOSIS), SINGLE VERTEBRAL SEGMENT;
CERVICAL"	"107,250.00"	"41,730.00"	"65,520.00"
63046	"LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL W/ DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT(S), ( EG, SPINAL OR LATERAL RECESS STENOSIS), SINGLE VERTEBRAL SEGMENT;
THORACIC"	"104,130.00"	"46,800.00"	"57,330.00"
63047	"LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL W/ DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT(S), ( EG, SPINAL OR LATERAL RECESS STENOSIS), SINGLE VERTEBRAL SEGMENT;
LUMBAR"	"90,675.00"	"41,535.00"	"49,140.00"
63055	"TRANSPEDICULAR APPROACH W/ DECOMPRESSION OF SPINAL CORD, EQUINA AND/ OR NERVE ROOT(S) (E.G., HERNIATED INTERVETEBRAL DISK), SINGLE SEGMENT; THORACIC"	"104,130.00"	"46,800.00"	"57,330.00"
63056	"TRANSPEDICULAR APPROACH W/ DECOMPRESSION OF SPINAL CORD, EQUINA AND/ OR NERVE ROOT(S) (E.G., HERNIATED INTERVETEBRAL DISK), SINGLE SEGMENT; LUMBAR"	"90,675.00"	"41,535.00"	"49,140.00"
63064	"COSTOVERTEBRAL APPROACH W/ DECOMPRESSION OF SPINAL
CORD OR NERVE ROOT(S), (E.G., HERNIATED INTERVERTEBRAL DISK), THORACIC; SINGLE SEGMENT"	"104,130.00"	"46,800.00"	"57,330.00"
63075	"DISKECTOMY, ANTERIOR, W/ DECOMPRESSION OF SPINAL CORD
AND/ OR NERVE ROOT(S), INCLUDING OSTEOPHYTECTOMY; CERVICAL, SINGLE INTERSPACE"	"107,250.00"	"41,730.00"	"65,520.00"
63077	"DISKECTOMY, ANTERIOR, W/ DECOMPRESSION OF SPINAL CORD AND/ OR NERVE ROOT(S), INCLUDING OSTEOPHYTECTOMY;
THORACIC, SINGLE INTERSPACE"	"73,710.00"	"32,760.00"	"40,950.00"
63081	"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, ANTERIOR APPROACH W/ DECOMPRESSION OF SPINAL CORD AND/ OR NERVE ROOT(S);
CERVICAL, SINGLE SEGMENT"	"107,250.00"	"41,730.00"	"65,520.00"
63085	"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, TRANSTHORACIC APPROACH W/ DECOMPRESSION OF SPINAL CORD AND/ OR NERVE ROOT(S);
THORACIC, SINGLE SEGMENT"	"104,130.00"	"46,800.00"	"57,330.00"
63087	"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, COMBINED THORACOLUMBAR APPROACH W/ DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA OR NERVE ROOT(S), LOWER THORACIC OR LUMBAR; SINGLE SEGMENT"	"90,675.00"	"41,535.00"	"49,140.00"
63090	"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, TRANSPERITONEAL OR RETROPERITONEAL APPROACH W/ DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA OR NERVE ROOT(S), LOWER THORACIC,
LUMBAR, OR SACRAL; SINGLE SEGMENT"	"104,130.00"	"46,800.00"	"57,330.00"
63170	"LAMINECTOMY W/ MYELOTOMY (E.G., BISCHOF OR DREZ TYPE),
CERVICAL THORACIC, OR THORACOLUMBAR"	"114,660.00"	"40,950.00"	"73,710.00"
63172	"LAMINECTOMY W/ DRAINAGE OF INTRAMEDULLARY CYST/
SYRINX; TO SUBARACHNOID SPACE"	"104,130.00"	"46,800.00"	"57,330.00"
63173	"LAMINECTOMY W/ DRAINAGE OF INTRAMEDULLARY CYST/
SYRINX; TO PERITONEAL SPACE"	"107,250.00"	"41,730.00"	"65,520.00"
63180	"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, W/ OR
W/O DURAL GRAFT, CERVICAL; ONE OF TWO SEGMENTS"	"107,250.00"	"41,730.00"	"65,520.00"
63182	"LAMINECTOMY AND SECTION OF DENTATE LIGAMENTS, W/ OR W/O DURAL GRAFT, CERVICAL; MORE THAN TWO SEGMENTS"	"107,250.00"	"41,730.00"	"65,520.00"
63185	LAMINECTOMY W/ RHIZOTOMY; ONE OR TWO SEGMENTS	"104,130.00"	"46,800.00"	"57,330.00"
63190	LAMINECTOMY W/ RHIZOTOMY; MORE THAN TWO SEGMENTS	"104,130.00"	"46,800.00"	"57,330.00"
63191	LAMINECTOMY W/ SECTION OF SPINAL ACCESSORY NERVE	"112,164.00"	"41,730.00"	"70,434.00"
63194	"LAMINECTOMY W/ CORDOTOMY, W/ SECTION OF ONE
SPINOTHALAMIC TRACT, ONE STAGE; CERVICAL"	"107,250.00"	"41,730.00"	"65,520.00"
63195	"LAMINECTOMY W/ CORDOTOMY, W/ SECTION OF ONE
SPINOTHALAMIC TRACT, ONE STAGE; THORACIC"	"104,130.00"	"46,800.00"	"57,330.00"
63196	"LAMINECTOMY W/ CORDOTOMY W/ SECTION OF BOTH
SPINOTHALAMIC TRACTS, ONE STAGE; CERVICAL"	"107,250.00"	"41,730.00"	"65,520.00"
63197	"LAMINECTOMY W/ CORDOTOMY W/ SECTION OF BOTH
SPINOTHALAMIC TRACTS, ONE STAGE; THORACIC"	"104,130.00"	"46,800.00"	"57,330.00"
63198	"LAMINECTOMY W/ CORDOTOMY W/ SECTION OF BOTH SPINOTHALAMIC TRACTS, TWO STAGES W/IN 14 DAYS; CERVICAL"	"107,250.00"	"41,730.00"	"65,520.00"
63199	"LAMINECTOMY W/ CORDOTOMY W/ SECTION OF BOTH SPINOTHALAMIC TRACTS, TWO STAGES W/IN 14 DAYS; THORACIC"	"104,130.00"	"46,800.00"	"57,330.00"
63200	"LAMINECTOMY, W/ RELEASE OF TETHERED SPINAL CORD,
LUMBAR"	"95,589.00"	"41,535.00"	"54,054.00"
63250	LAMINECTOMY FOR EXCISION OR OCCLUSION OF ARTERIOVENOUS MALFORMATION OF SPINAL CORD; CERVICAL	"107,250.00"	"41,730.00"	"65,520.00"
63251	LAMINECTOMY FOR EXCISION OR OCCLUSION OF ARTERIOVENOUS MALFORMATION OF SPINAL CORD; THORACIC	"104,130.00"	"46,800.00"	"57,330.00"
63252	"LAMINECTOMY FOR EXCISION OR OCCLUSION OF
ARTERIOVENOUS MALFORMATION OF SPINAL CORD; THORACOLUMBAR"	"90,675.00"	"41,535.00"	"49,140.00"
63265	LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM; EXTRADURAL; CERVICAL	"107,250.00"	"41,730.00"	"65,520.00"
63266	LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM; EXTRADURAL; THORACIC	"104,130.00"	"46,800.00"	"57,330.00"
63267	LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM; EXTRADURAL; LUMBAR	"90,675.00"	"41,535.00"	"49,140.00"
63268	LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM; EXTRADURAL; SACRAL	"73,710.00"	"32,760.00"	"40,950.00"
63270	"LAMINECTOMY FOR EXCISION OF INTRASPINAL LESION OTHER
THAN NEOPLASM; INTRADURAL; CERVICAL"	"107,250.00"	"41,730.00"	"65,520.00"
63271	"LAMINECTOMY FOR EXCISION OF INTRASPINAL LESION OTHER
THAN NEOPLASM; INTRADURAL; THORACIC"	"104,130.00"	"46,800.00"	"57,330.00"
63272	"LAMINECTOMY FOR EXCISION OF INTRASPINAL LESION OTHER
THAN NEOPLASM; INTRADURAL; LUMBAR"	"90,675.00"	"41,535.00"	"49,140.00"
63273	"LAMINECTOMY FOR EXCISION OF INTRASPINAL LESION OTHER
THAN NEOPLASM; INTRADURAL; SACRAL"	"73,710.00"	"32,760.00"	"40,950.00"
63275	"LAMINECTOMY FOR BIOPSY/ EXCISION OF INTRASPINAL
NEOPLASM; EXTRADURAL, CERVICAL"	"107,250.00"	"41,730.00"	"65,520.00"
63276	"LAMINECTOMY FOR BIOPSY/ EXCISION OF INTRASPINAL
NEOPLASM; EXTRADURAL, EXTRADURAL, THORACIC"	"104,130.00"	"46,800.00"	"57,330.00"
63277	"LAMINECTOMY FOR BIOPSY/ EXCISION OF INTRASPINAL
NEOPLASM; EXTRADURAL, EXTRADURAL, LUMBAR"	"90,675.00"	"41,535.00"	"49,140.00"
63278	"LAMINECTOMY FOR BIOPSY/ EXCISION OF INTRASPINAL
NEOPLASM; EXTRADURAL, EXTRADURAL, SACRAL"	"73,710.00"	"32,760.00"	"40,950.00"
63280	"LAMINECTOMY FOR BIOPSY/ EXCISION OF INTRASPINAL
NEOPLASM; EXTRADURAL, INTRADURAL, EXTRAMEDULLARY, CERVICAL"	"114,660.00"	"40,950.00"	"73,710.00"
63281	"LAMINECTOMY FOR BIOPSY/ EXCISION OF INTRASPINAL
NEOPLASM; EXTRADURAL, INTRADURAL, EXTRAMEDULLARRY, THORACIC"	"107,250.00"	"41,730.00"	"65,520.00"
63282	"LAMINECTOMY FOR BIOPSY/ EXCISION OF INTRASPINAL
NEOPLASM; EXTRADURAL, INTRADURAL, EXTRAMEDULLARY, LUMBAR"	"104,130.00"	"46,800.00"	"57,330.00"
63283	"LAMINECTOMY FOR BIOPSY/ EXCISION OF INTRASPINAL
NEOPLASM; EXTRADURAL, INTRADURAL, SACRAL"	"90,675.00"	"41,535.00"	"49,140.00"
63285	"LAMINECTOMY FOR BIOPSY/ EXCISION OF INTRASPINAL NEOPLASM; EXTRADURAL, INTRADURAL, INTRAMEDULLARY,
CERVICAL"	"114,660.00"	"40,950.00"	"73,710.00"
63286	"LAMINECTOMY FOR BIOPSY/ EXCISION OF INTRASPINAL NEOPLASM; EXTRADURAL, INTRADURAL, INTRAMEDULLARY,
THORACIC"	"107,250.00"	"41,730.00"	"65,520.00"
63287	"LAMINECTOMY FOR BIOPSY/ EXCISION OF INTRASPINAL NEOPLASM; EXTRADURAL, INTRADURAL, INTRAMEDULLARY,
THORACOLUMBAR"	"104,130.00"	"46,800.00"	"57,330.00"
63290	"LAMINECTOMY FOR BIOPSY/ EXCISION OF INTRASPINAL NEOPLASM; EXTRADURAL, COMBINED EXTRADURAL-INTRADURAL
LESION, ANY LEVEL"	"90,675.00"	"41,535.00"	"49,140.00"
63300	"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASPINAL LESION,
SINGLE SEGMENT; EXTRADURAL, CERVICAL"	"107,250.00"	"41,730.00"	"65,520.00"
63301	"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASPINAL LESION, SINGLE SEGMENT; EXTRADURAL, THORACIC BY TRANSTHORACIC
APPROACH"	"104,130.00"	"46,800.00"	"57,330.00"
63302	"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASPINAL LESION, SINGLE SEGMENT; EXTRADURAL, THORACIC BY THORACOLUMBAR
APPROACH"	"104,130.00"	"46,800.00"	"57,330.00"
63303	"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASPINAL LESION, SINGLE SEGMENT; EXTRADURAL, LUMBAR OR SACRAL BY TRANSPERITONEAL OR RETROPERITONEAL APPROACH"	"104,130.00"	"46,800.00"	"57,330.00"
63304	"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASPINAL LESION,
SINGLE SEGMENT; INTRADURAL, CERVICAL"	"107,250.00"	"41,730.00"	"65,520.00"
63305	"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASPINAL LESION, SINGLE SEGMENT; INTRADURAL, THORACIC BY TRANSTHORACIC
APPROACH"	"104,130.00"	"46,800.00"	"57,330.00"
63306	"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASPINAL LESION, SINGLE SEGMENT; INTRADURAL, THORACIC BY THORACOLUMBAR
APPROACH"	"104,130.00"	"46,800.00"	"57,330.00"
63307	"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASPINAL LESION, SINGLE SEGMENT; INTRADURAL, LUMBAR OR SACRAL BY TRANSPERITONEAL OR RETROPERITONEAL APPROACH"	"104,130.00"	"46,800.00"	"57,330.00"
63600	"CREATION OF LESION OF SPINAL CORD BY STEREOTACTIC
METHOD, PERCUTANEOUS, ANY MODALITY (INCLUDING STIMULATION AND/ OR RECORDING)"	"59,085.00"	"26,325.00"	"32,760.00"
63610	"STEREOTACTIC STIMULATION OF SPINAL CORD, PERCUTANEOUS, SEPARATE PROCEDURE NOT FOLLOWED BY OTHER SURGERY"	"59,085.00"	"26,325.00"	"32,760.00"
63615	"STEREOTACTIC BIOPSY, ASPIRATION, OR EXCISION OF LESION,
SPINAL CORD"	"73,320.00"	"36,465.00"	"36,855.00"
63650	"PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR
ELECTRODES; EPIDURAL"	"15,639.00"	"10,725.00"	"4,914.00"
63655	"LAMINECTOMY FOR IMPLANTATION OF NEUROSTIMULATOR
ELECTRODES; EPIDURAL"	"90,675.00"	"41,535.00"	"49,140.00"
63685	"INCISION AND SUBSCUTANEOUS PLACEMENT OF SPINAL
NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER, DIRECT OR INDUCTIVE COUPLING"	"42,549.00"	"21,255.00"	"21,294.00"
63700	REPAIR OF MENINGOCELE; LESS THAN 5 CM DIAMETER	"59,085.00"	"26,325.00"	"32,760.00"
63702	REPAIR OF MENINGOCELE; LARGER THAN 5 DIAMETER	"72,501.00"	"36,465.00"	"36,036.00"
63704	REPAIR OF MYELOMENINGOCELE; LESS THAN 5 CM DIAMETER	"73,710.00"	"32,760.00"	"40,950.00"
63706	REPAIR OF MYELOMENINGOCELE; LARGER THAN 5 DIAMETER	"90,675.00"	"41,535.00"	"49,140.00"
63707	"REPAIR OF DURAL/ CSF LEAK, NOT REQUIRING LAMINECTOMY"	"59,085.00"	"26,325.00"	"32,760.00"
63709	"REPAIR OF DURAL/ CSF LEAK OR PSEUDOMENINGOCELE, W/
LAMINECTOMY"	"90,675.00"	"41,535.00"	"49,140.00"
63710	"DURAL GRAFT, SPINAL"	"90,675.00"	"41,535.00"	"49,140.00"
63740	"CREATION OF SHUNT, LUMBAR, SUBARACHNOID-PERITONEAL, - PLEURAL, OR OTHER; INCLUDING LAMINECTOMY"	"59,085.00"	"26,325.00"	"32,760.00"
63741	"CREATION OF SHUNT, LUMBAR, SUBARACHNOID-PERITONEAL, - PLEURAL, OR OTHER; PERCUTANEOUS, NOT REQUIRING
LAMINECTOMY"	"45,435.00"	"20,865.00"	"24,570.00"
64702	"NEUROPLASTY; DIGITAL, ONE OR BOTH, SAME DIGIT"	"23,634.00"	"10,530.00"	"13,104.00"
64704	NEUROPLASTY; NERVE OF HAND OR FOOT	"23,634.00"	"10,530.00"	"13,104.00"
64708	"NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG; OTHER
THAN SPECIFIED"	"35,100.00"	"18,720.00"	"16,380.00"
64712	"NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG; SCIATIC
NERVE"	"40,911.00"	"21,255.00"	"19,656.00"
64713	"NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG;
BRACHIAL PLEXUS"	"40,911.00"	"21,255.00"	"19,656.00"
64714	"NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG;
LUMBAR PLEXUS"	"40,911.00"	"21,255.00"	"19,656.00"
64716	"NEUROPLASTY AND/OR TRANSPOSITION; CRANIAL NERVE
(SPECIFY)"	"73,710.00"	"32,760.00"	"40,950.00"
64718	"NEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT
ELBOW"	"35,100.00"	"18,720.00"	"16,380.00"
64719	NEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT WRIST	"35,100.00"	"18,720.00"	"16,380.00"
64721	"NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT
CARPAL TUNNEL"	"35,100.00"	"18,720.00"	"16,380.00"
64722	DECOMPRESSION; UNSPECIFIED NERVE(S) (SPECIFY)	"35,100.00"	"18,720.00"	"16,380.00"
64726	DECOMPRESSION; PLANTAR DIGITAL NERVE	"35,100.00"	"18,720.00"	"16,380.00"
64727	"INTERNAL NEUROLYSIS, REQUIRING USE OF OPERATING MICROSCOPE (LIST SEPARATELY IN ADDITION TO CODE FOR NEUROPLASTY) (NEUROPLASTY INLCUDES EXTERNAL
NEUROLYSIS)"	"59,085.00"	"26,325.00"	"32,760.00"
64732	TRANSECTION OR AVULSION OF; SUPRAORBITAL NERVE	"18,915.00"	"10,725.00"	"8,190.00"
64734	TRANSECTION OR AVULSION OF; INFRAORBITAL NERVE	"18,915.00"	"10,725.00"	"8,190.00"
64736	TRANSECTION OR AVULSION OF; MENTAL NERVE	"18,915.00"	"10,725.00"	"8,190.00"
64738	"TRANSECTION OR AVULSION OF; INFERIOR ALVEOLAR NERVE BY
OSTEOTOMY"	"18,915.00"	"10,725.00"	"8,190.00"
64740	TRANSECTION OR AVULSION OF; LINGUAL NERVE	"18,915.00"	"10,725.00"	"8,190.00"
64742	"TRANSECTION OR AVULSION OF; FACIAL NERVE, DIFFERENTIAL
OR COMPLETE"	"23,634.00"	"10,530.00"	"13,104.00"
64744	TRANSECTION OR AVULSION OF; GREATER OCCIPITAL NERVE	"18,915.00"	"10,725.00"	"8,190.00"
64746	TRANSECTION OR AVULSION OF; PHRENIC NERVE	"23,634.00"	"10,530.00"	"13,104.00"
64752	"TRANSECTION OR AVULSION OF; VAGUS NERVE (VAGOTOMY),
TRANSTHORACIC"	"42,783.00"	"24,765.00"	"18,018.00"
64755	"TRANSECTION OR AVULSION OF; VAGI LIMITED TO PROXIMAL STOMACH (SELECTIVE PROXIMAL VAGOTOMY, PROXIMAL GASTRIC VAGOTOMY, PARIETAL CELL VAGOTOMY, SUPRA- OR HIGHLY
SELECTIVE VAGOTOMY)"	"42,783.00"	"24,765.00"	"18,018.00"
64760	"TRANSECTION OR AVULSION OF; VAGUS NERVE (VAGOTOMY),
ABDOMINAL"	"35,100.00"	"18,720.00"	"16,380.00"
64761	TRANSECTION OR AVULSION OF; PUDENDAL NERVE	"18,915.00"	"10,725.00"	"8,190.00"
64763	"TRANSECTION OR AVULSION OF OBTURATOR NERVE,
EXTRAPELVIC, W/ OR W/O ADDUCTOR TENOTOMY"	"35,100.00"	"18,720.00"	"16,380.00"
64766	"TRANSECTION OR AVULSION OF OBTURATOR NERVE,
INTRAPELVIC, W/ OR W/O ADDUCTOR TENOTOMY"	"35,100.00"	"18,720.00"	"16,380.00"
64771	"TRANSECTION OR AVULSION OF OTHER CRANIAL NERVE,
INTRADURAL"	"73,710.00"	"32,760.00"	"40,950.00"
64772	"TRANSECTION OR AVULSION OF OTHER SPINAL NERVE,
EXTRADURAL"	"59,085.00"	"26,325.00"	"32,760.00"
64774	"EXCISION OF NEUROMA; CUTANEOUS NERVE, SURGICALLY
IDENTIFIABLE"	"15,639.00"	"10,725.00"	"4,914.00"
64776	"EXCISION OF NEUROMA; DIGITAL NERVE, ONE OR BOTH, SAME
DIGIT"	"15,639.00"	"10,725.00"	"4,914.00"
64782	"EXCISION OF NEUROMA; HAND OR FOOT, EXCEPT DIGITAL NERVE"	"15,639.00"	"10,725.00"	"4,914.00"
64784	"EXCISION OF NEUROMA; MAJOR PERIPHERAL NERVE, EXCEPT
SCIATIC"	"15,639.00"	"10,725.00"	"4,914.00"
64786	EXCISION OF NEUROMA; SCIATIC NERVE	"18,915.00"	"10,725.00"	"8,190.00"
64788	"EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; CUTANEOUS
NERVE"	"15,639.00"	"10,725.00"	"4,914.00"
64790	"EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; MAJOR
PERIPHERAL NERVE"	"15,639.00"	"10,725.00"	"4,914.00"
64792	"EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; EXTENSIVE
(INCLUDING MALIGNANT TYPE)"	"18,915.00"	"10,725.00"	"8,190.00"
64795	BIOPSY OF NERVE	"15,639.00"	"10,725.00"	"4,914.00"
64802	"SYMPATHECTOMY, CERVICAL"	"35,100.00"	"18,720.00"	"16,380.00"
64804	"SYMPATHECTOMY, CERVICOTHORACIC"	"35,100.00"	"18,720.00"	"16,380.00"
64809	"SYMPATHECTOMY, THORACOLUMBAR"	"35,100.00"	"18,720.00"	"16,380.00"
64818	"SYMPATHECTOMY, LUMBAR"	"35,100.00"	"18,720.00"	"16,380.00"
64820	"SYMPATHECTOMY, DIGITAL ARTERIES, W/ MAGNIFICATION, EACH
DIGIT"	"23,634.00"	"10,530.00"	"13,104.00"
64830	"MICRODISSECTION AND/OR MICROREPAIR OF NERVE (LIST
SEPARATELY IN ADDITION TO CODE FOR NERVE REPAIR)"	"40,911.00"	"21,255.00"	"19,656.00"
64831	"SUTURE OF DIGITAL NERVE, HAND OR FOOT; ONE NERVE"	"35,100.00"	"18,720.00"	"16,380.00"
64832	"SUTURE OF DIGITAL NERVE, HAND OR FOOT; EACH ADDITIONAL
DIGITAL NERVE"	"15,639.00"	"10,725.00"	"4,914.00"
64834	"SUTURE OF ONE NERVE, HAND OR FOOT; COMMON SENSORY
NERVE"	"35,100.00"	"18,720.00"	"16,380.00"
64835	"SUTURE OF ONE NERVE, HAND OR FOOT; MEDIAN MOTOR THENAR"	"35,100.00"	"18,720.00"	"16,380.00"
64836	"SUTURE OF ONE NERVE, HAND OR FOOT; ULNAR MOTOR"	"35,100.00"	"18,720.00"	"16,380.00"
64837	"SUTURE OF EACH ADDITIONAL NERVE, HAND OR FOOT"	"15,639.00"	"10,725.00"	"4,914.00"
64840	SUTURE OF POSTERIOR TIBIAL NERVE	"35,100.00"	"18,720.00"	"16,380.00"
64856	"SUTURE OF MAJOR PERIPHERAL NERVE, ARM OR LEG, EXCEPT
SCIATIC; INCLUDING TRANSPOSITION"	"40,911.00"	"21,255.00"	"19,656.00"
64857	"SUTURE OF MAJOR PERIPHERAL NERVE, ARM OR LEG, EXCEPT
SCIATIC; W/O TRANSPOSITION"	"35,100.00"	"18,720.00"	"16,380.00"
64858	SUTURE OF SCIATIC NERVE	"35,100.00"	"18,720.00"	"16,380.00"
64859	SUTURE OF EACH ADDITIONAL MAJOR PERIPHERAL NERVE	"15,639.00"	"10,725.00"	"4,914.00"
64861	SUTURE OF; BRACHIAL PLEXUS	"40,911.00"	"21,255.00"	"19,656.00"
64862	SUTURE OF; LUMBAR PLEXUS	"40,911.00"	"21,255.00"	"19,656.00"
64864	SUTURE OF FACIAL NERVE; EXTRACRANIAL	"40,911.00"	"21,255.00"	"19,656.00"
64865	"SUTURE OF FACIAL NERVE; INFRATEMPORAL, W/ OR W/O
GRAFTING"	"40,911.00"	"21,255.00"	"19,656.00"
64866	ANASTOMOSIS; FACIAL-SPINAL ACCESSORY	"45,435.00"	"20,865.00"	"24,570.00"
64868	ANASTOMOSIS; FACIAL-HYPOGLOSSAL	"45,435.00"	"20,865.00"	"24,570.00"
64870	ANASTOMOSIS; FACIAL-PHRENIC	"45,435.00"	"20,865.00"	"24,570.00"
64885	"NERVE GRAFT (INCLUDES OBTAINING GRAFT), HEAD OR NECK; UP
TO 4CM IN LENGTH"	"45,435.00"	"20,865.00"	"24,570.00"
64886	"NERVE GRAFT (INCLUDES OBTAINING GRAFT), HEAD OR NECK;
MORE THAN 4 CM LENGTH"	"61,581.00"	"33,735.00"	"27,846.00"
64890	"NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND,
HAND OR FOOT; UP TO 4 CM LENGTH"	"59,085.00"	"26,325.00"	"32,760.00"
64891	"NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND,
HAND OR FOOT; MORE THAN 4 CM LENGTH"	"59,085.00"	"26,325.00"	"32,760.00"
64892	"NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND,
ARM OR LEG; UP TO 4 CM LENGTH"	"45,435.00"	"20,865.00"	"24,570.00"
64893	"NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND,
ARM OR LEG; MORE THAN 4 CM LENGTH"	"61,581.00"	"33,735.00"	"27,846.00"
64895	"NERVE GRAFT (INCLUDES OBTAINING GRAFT), MULTIPLE
STRANDS (CABLE), HAND OR FOOT; UP TO 4 CM LENGTH"	"52,884.00"	"23,400.00"	"29,484.00"
64896	"NERVE GRAFT (INCLUDES OBTAINING GRAFT), MULTIPLE STRANDS (CABLE), HAND OR FOOT; MORE THAN 4 CM LENGTH"	"59,085.00"	"26,325.00"	"32,760.00"
64897	"NERVE GRAFT (INCLUDES OBTAINING GRAFT), MULTIPLE
STRANDS (CABLE), ARM OR LEG; UP TO 4 CM LENGTH"	"45,435.00"	"20,865.00"	"24,570.00"
64898	"NERVE GRAFT (INCLUDES OBTAINING GRAFT), MULTIPLE
STRANDS (CABLE), ARM OR LEG; MORE THAN 4 CM LENGTH"	"61,581.00"	"33,735.00"	"27,846.00"
64901	"NERVE GRAFT, EACH ADDITIONAL NERVE; SINGLE STRAND"	"15,639.00"	"10,725.00"	"4,914.00"
64902	"NERVE GRAFT, EACH ADDITIONAL NERVE; MULTIPLE STRANDS
(CABLE)"	"15,639.00"	"10,725.00"	"4,914.00"
64905	NERVE PEDICLE TRANSFER; FIRST STAGE	"40,911.00"	"21,255.00"	"19,656.00"
64907	NERVE PEDICLE TRANSFER; SECOND STAGE	"40,911.00"	"21,255.00"	"19,656.00"
65091	EVISCERATION OF OCULAR CONTENTS; W/O IMPLANT	"23,634.00"	"10,530.00"	"13,104.00"
65093	EVISCERATION OF OCULAR CONTENTS; W/ IMPLANT	"23,634.00"	"10,530.00"	"13,104.00"
65101	ENUCLEATION OF EYE; W/O IMPLANT	"23,634.00"	"10,530.00"	"13,104.00"
65103	"ENUCLEATION OF EYE; W/ IMPLANT, MUSCLES NOT ATTACHED TO
IMPLANT"	"23,634.00"	"10,530.00"	"13,104.00"
65105	"ENUCLEATION OF EYE; W/ IMPLANT, MUSCLES ATTACHED TO
IMPLANT"	"23,634.00"	"10,530.00"	"13,104.00"
65110	"EXENTERATION OF ORBIT WITHOUT SKIN GRAFT, REMOVAL OF
ORBITAL CONTENTS; ONLY"	"73,710.00"	"32,760.00"	"40,950.00"
65112	"EXENTERATION OF ORBIT WITHOUT SKIN GRAFT, REMOVAL OF ORBITAL CONTENTS; W/ THERAPEUTIC REMOVAL OF BONE"	"75,348.00"	"32,760.00"	"42,588.00"
65114	"EXENTERATION OF ORBIT WITHOUT SKIN GRAFT, REMOVAL OF ORBITAL CONTENTS; W/ MUSCLE OR MYOCUTANEOUS FLAP"	"76,986.00"	"32,760.00"	"44,226.00"
65130	"INSERTION OF OCULAR IMPLANT; AFTER EVISCERATION, IN
SCLERAL SHELL"	"21,372.00"	"10,725.00"	"10,647.00"
65135	"INSERTION OF OCULAR IMPLANT; AFTER ENUCLEATION, MUSCLES
NOT ATTACHED TO IMPLANT"	"21,372.00"	"10,725.00"	"10,647.00"
65140	"INSERTION OF OCULAR IMPLANT; AFTER ENUCLEATION, MUSCLES
ATTACHED TO IMPLANT"	"23,361.00"	"11,895.00"	"11,466.00"
65150	"REINSERTION OF OCULAR IMPLANT; WITH OR WITHOUT
CONJUNCTIVAL GRAFT"	"23,361.00"	"11,895.00"	"11,466.00"
65155	"REINSERTION OF OCULAR IMPLANT; WITH USE OF FOREIGN MATERIAL FOR REINFORCEMENT AND/OR ATTACHMENT OF
MUSCLES TO IMPLANT"	"23,361.00"	"11,895.00"	"11,466.00"
65175	REMOVAL OF OCULAR IMPLANT	"18,915.00"	"10,725.00"	"8,190.00"
65205	"REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CONJUNCTIVAL,
SUPERFICIAL"	975.00	585.00	390.00
65210	"REMOVAL OF FOREIGN BODY, EXTERNAL EYE; SUBCONJUNCTIVAL
OR SCLERAL, WITH SLIT LAMP"	"8,775.00"	"4,875.00"	"3,900.00"
65222	"REMOVAL OF FOREIGN BODY, EXTERNAL EYE; CORNEA, WITH SLIT
LAMP"	"8,151.00"	"4,875.00"	"3,276.00"
65235	"REMOVAL OF FOREIGN BODY, INTRAOCULAR; FROM ANTERIOR
CHAMBER OR LENS"	"35,100.00"	"18,720.00"	"16,380.00"
65260	"REMOVAL OF FOREIGN BODY, INTRAOCULAR; FROM POSTERIOR SEGMENT, MAGNETIC EXTRACTION, ANTERIOR OR POSTERIOR
ROUTE"	"104,130.00"	"46,800.00"	"57,330.00"
65265	"REMOVAL OF FOREIGN BODY, INTRAOCULAR; FROM POSTERIOR
SEGMENT, NONMAGNETIC EXTRACTION"	"107,250.00"	"41,730.00"	"65,520.00"
65270	"REPAIR OF LACERATION; CONJUNCTIVA, W/ OR W/O
NONPERFORATING LACERATION SCLERA, DIRECT CLOSURE"	"15,639.00"	"10,725.00"	"4,914.00"
65273	"REPAIR OF LACERATION; CONJUNCTIVA, BY MOBILIZATION AND
REARRANGEMENT"	"15,639.00"	"10,725.00"	"4,914.00"
65275	"REPAIR OF LACERATION; CORNEA, NONPERFORATING, W/ OR W/O
REMOVAL FOREIGN BODY"	"18,915.00"	"10,725.00"	"8,190.00"
65280	"REPAIR OF LACERATION; CORNEA AND/OR SCLERA,
PERFORATING, NOT INVOLVING UVEAL TISSUE"	"40,911.00"	"21,255.00"	"19,656.00"
65285	"REPAIR OF LACERATION; CORNEA AND/OR SCLERA, PERFORATING, W/ REPOSITION OR RESECTION OF UVEAL TISSUE"	"45,435.00"	"20,865.00"	"24,570.00"
65286	"REPAIR OF LACERATION; APPLICATION OF TISSUE GLUE, WOUNDS
OF CORNEA AND/OR SCLERA"	"18,915.00"	"10,725.00"	"8,190.00"
65290	"REPAIR OF WOUND, EXTRAOCULAR MUSCLE, TENDON AND/ OR
TENONS CAPSULE"	"18,915.00"	"10,725.00"	"8,190.00"
65400	"EXCISION OF LESION, CORNEA (KERATECTOMY, LAMELLAR,
PARTIAL), EXCEPT PTERYGIUM"	"16,107.00"	"9,555.00"	"6,552.00"
65410	BIOPSY OF CORNEA	"15,639.00"	"10,725.00"	"4,914.00"
65426	EXCISION OR TRANSPOSITION OF PTERYGIUM; WITH GRAFT	"18,915.00"	"10,725.00"	"8,190.00"
65450	"DESTRUCTION OF LESION OF CORNEA BY CRYOTHERAPY,
PHOTOCOAGULATION OR THERMOCAUTERIZATION"	"15,639.00"	"10,725.00"	"4,914.00"
65710	KERATOPLASTY (CORNEAL TRANSPLANT); LAMELLAR	"59,085.00"	"26,325.00"	"32,760.00"
65730	"KERATOPLASTY (CORNEAL TRANSPLANT); PENETRATING (EXCEPT
IN APHAKIA)"	"59,085.00"	"26,325.00"	"32,760.00"
65750	"KERATOPLASTY (CORNEAL TRANSPLANT); PENETRATING (IN
APHAKIA)"	"59,085.00"	"26,325.00"	"32,760.00"
65755	"KERATOPLASTY (CORNEAL TRANSPLANT); PENETRATING (IN
PSEUDOPHAKIA)"	"59,085.00"	"26,325.00"	"32,760.00"
65765	KERATOPHAKIA	"20,553.00"	"10,725.00"	"9,828.00"
65767	EPIKERATOPLASTY	"35,100.00"	"18,720.00"	"16,380.00"
65770	KERATOPROSTHESIS	"59,085.00"	"26,325.00"	"32,760.00"
65772	"CORNEAL RELAXING INCISION FOR CORRECTION OF SURGICALLY
INDUCED ASTIGMATISM"	"19,500.00"	"11,700.00"	"7,800.00"
65775	"CORNEAL WEDGE RESECTION FOR CORRECTION OF SURGICALLY
INDUCED ASTIGMATISM"	"29,172.00"	"14,430.00"	"14,742.00"
65780	"OCULAR SURFACE RECONSTRUCTION; AMNIOTIC MEMBRANE
TRANSPLANTATION"	"59,085.00"	"26,325.00"	"32,760.00"
65781	"OCULAR SURFACE RECONSTRUCTION; LIMBAL STEM CELL
ALLOGRAFT (EG, CADAVERIC OR LIVING DONOR)"	"59,085.00"	"26,325.00"	"32,760.00"
65782	OCULAR SURFACE RECONSTRUCTION; LIMBAL CONJUNCTIVAL AUTOGRAFT (INCLUDES OBTAINING GRAFT)	"59,085.00"	"26,325.00"	"32,760.00"
65805	"PARACENTESIS OF ANTERIOR CHAMBER OF EYE; W/ THERAPEUTIC
RELEASE OF AQUEOUS"	"15,639.00"	"10,725.00"	"4,914.00"
65810	"PARACENTESIS OF ANTERIOR CHAMBER OF EYE; W/ REMOVAL OF VITREOUS AND/OR DISCISSION OF ANTERIOR HYALOID
MEMBRANE, W/ OR W/O AIR INJECTION"	"18,915.00"	"10,725.00"	"8,190.00"
65815	"PARACENTESIS OF ANTERIOR CHAMBER OF EYE; W/ REMOVAL OF BLOOD, W/ OR W/O IRRIGATION AND/OR AIR INJECTION"	"18,915.00"	"10,725.00"	"8,190.00"
65820	GONIOTOMY	"45,435.00"	"20,865.00"	"24,570.00"
65850	TRABECULOTOMY AB EXTERNO	"45,435.00"	"20,865.00"	"24,570.00"
65855	"TRABECULOPLASTY BY LASER SURGERY, ONE OR MORE SESSIONS
(DEFINED TREATMENT SERIES)"	"23,634.00"	"10,530.00"	"13,104.00"
65860	"SEVERING ADHESIONS OF ANTERIOR SEGMENT, LASER
TECHNIQUE"	"20,553.00"	"10,725.00"	"9,828.00"
65865	"SEVERING ADHESIONS OF ANTERIOR SEGMENT OF EYE,
INCISIONAL TECHNIQUE (W/ OR W/O INJECTION OF AIR OR LIQUID); GONIOSYNECHIAE"	"20,553.00"	"10,725.00"	"9,828.00"
65870	"SEVERING ADHESIONS OF ANTERIOR SEGMENT OF EYE,
INCISIONAL TECHNIQUE (W/ OR W/O INJECTION OF AIR OR LIQUID); ANTERIOR SYNECHIAE, EXCEPT GONIOSYNECHIAE"	"20,553.00"	"10,725.00"	"9,828.00"
65875	"SEVERING ADHESIONS OF ANTERIOR SEGMENT OF EYE,
INCISIONAL TECHNIQUE (W/ OR W/O INJECTION OF AIR OR LIQUID); POSTERIOR SYNECHIAE"	"20,553.00"	"10,725.00"	"9,828.00"
65880	"SEVERING ADHESIONS OF ANTERIOR SEGMENT OF EYE,
INCISIONAL TECHNIQUE (W/ OR W/O INJECTION OF AIR OR LIQUID); CORNEOVITREAL ADHESIONS"	"20,553.00"	"10,725.00"	"9,828.00"
65900	"REMOVAL OF EPITHELIAL MATERIAL, ANTERIOR SEGMENT EYE"	"20,553.00"	"10,725.00"	"9,828.00"
65920	"REMOVAL OF IMPLANTED MATERIAL, ANTERIOR SEGMENT EYE"	"23,634.00"	"10,530.00"	"13,104.00"
65930	"REMOVAL OF BLOOD CLOT, ANTERIOR SEGMENT EYE"	"15,639.00"	"10,725.00"	"4,914.00"
66130	"EXCISION OF LESION, SCLERA"	"16,107.00"	"9,555.00"	"6,552.00"
66150	"FISTULIZATION OF SCALERA FOR GLAUCOMA; TREPHINATION W/
IRIDECTOMY"	"35,100.00"	"18,720.00"	"16,380.00"
66155	"FISTULIZATION OF SCALERA FOR GLAUCOMA;
THERMOCAUTERIZATION W/ IRIDECTOMY"	"35,100.00"	"18,720.00"	"16,380.00"
66160	"FISTULIZATION OF SCALERA FOR GLAUCOMA; SCLERECTOMY W/
PUNCH OR SCISSORS, W/ IRIDECTOMY"	"35,100.00"	"18,720.00"	"16,380.00"
66165	"FISTULIZATION OF SCALERA FOR GLAUCOMA; IRIDENCLEISIS OR
IRIDOTASIS"	"35,100.00"	"18,720.00"	"16,380.00"
66170	FISTULIZATION OF SCALERA FOR GLAUCOMA; TRABECULECTOMY AB EXTERNO IN ABSENCE OF PREVIOUS SURGERY	"35,100.00"	"18,720.00"	"16,380.00"
66172	FISTULIZATION OF SCALERA FOR GLAUCOMA; TRABECULECTOMY AB EXTERNO W/ SCARRING FROM PREVIOUS OCULAR SURGERY OR TRAUMA (INCLUDES INJECTION OF ANTIFIBROTIC AGENTS)	"52,884.00"	"23,400.00"	"29,484.00"
66180	"AQUENOUS SHUNT TO EXTRAOCULAR RESERVOIR (E.G.,
MOLTENO, SCHOCKET, DENVER-KRUPIN)"	"59,085.00"	"26,325.00"	"32,760.00"
66185	REVISION OF AQUEOUS SHUNT TO EXTRAOCULAR RESERVOIR	"59,085.00"	"26,325.00"	"32,760.00"
66220	REPAIR OF SCLERAL STAPHYLOMA; W/O GRAFT	"23,634.00"	"10,530.00"	"13,104.00"
66225	REPAIR OF SCLERAL STAPHYLOMA; W/ GRAFT	"45,435.00"	"20,865.00"	"24,570.00"
66250	"REVISION OR REPAIR OF OPERATIVE WOUND OF ANTERIOR
SEGMENT, ANY TYPE, EARLY OR LATE, MAJOR OR MINOR PROCEDURE"	"29,172.00"	"14,430.00"	"14,742.00"
66500	IRIDOTOMY BY STAB INCISION; EXCEPT TRANSFIXION	"20,553.00"	"10,725.00"	"9,828.00"
66505	"IRIDOTOMY BY STAB INCISION; W/ TRANSFIXION AS FOR IRIS
BOMBE"	"20,553.00"	"10,725.00"	"9,828.00"
66600	"IRIDECTOMY, W/ CORNEOSCLERAL OR CORNEAL SECTION; FOR
REMOVAL OF LESION"	"23,634.00"	"10,530.00"	"13,104.00"
66605	"IRIDECTOMY, W/ CORNEOSCLERAL OR CORNEAL SECTION; W/
CYCLECTOMY"	"35,100.00"	"18,720.00"	"16,380.00"
66625	"IRIDECTOMY, W/ CORNEOSCLERAL OR CORNEAL SECTION;
PERIPHERAL FOR GLAUCOMA"	"23,634.00"	"10,530.00"	"13,104.00"
66630	"IRIDECTOMY, W/ CORNEOSCLERAL OR CORNEAL SECTION;
SECTOR FOR GLAUCOMA"	"23,634.00"	"10,530.00"	"13,104.00"
66680	"REPAIR OF IRIS, CILIARY BODY (AS FOR IRIDODIALYSIS)"	"35,100.00"	"18,720.00"	"16,380.00"
66682	"SUTURE OF IRIS, CILIARY BODY  W/ RETRIEVAL OF SUTURE
THROUGH SMALL INCISION (E.G., MCCANNEL SUTURE)"	"29,172.00"	"14,430.00"	"14,742.00"
66700	CILIARY BODY DESTRUCTION; DIATHERMY	"23,361.00"	"11,895.00"	"11,466.00"
66710	CILIARY BODY DESTRUCTION; CYCLOPHOTOCOAGULATION	"23,361.00"	"11,895.00"	"11,466.00"
66720	CILIARY BODY DESTRUCTION; CRYOTHERAPY	"23,361.00"	"11,895.00"	"11,466.00"
66740	CILIARY BODY DESTRUCTION; CYCLODIALYSIS	"23,361.00"	"11,895.00"	"11,466.00"
66761	"IRIDOTOMY/IRIDECTOMY BY LASER SURGERY (E.G., FOR
GLAUCOMA) ( ONE OR MORE SESSIONS)"	"20,553.00"	"10,725.00"	"9,828.00"
66762	"IRIDOPLASTY BY PHOTOCOAGULATION (ONE OR MORE SESSIONS) (E.G., FOR IMPROVEMENT OF VISION, FOR WIDENING OF
ANTERIOR CHAMBER ANGLE)"	"23,634.00"	"10,530.00"	"13,104.00"
66770	"DESTRUCTION OF CYST OR LESION IRIS OR CILIARY BODY
(NONEXCISIONAL PROCEDURE)"	"20,553.00"	"10,725.00"	"9,828.00"
66820	DISCISSION OF SECONDARY MEMBRANOUS CATARACT (OPACIFIED POSTERIOR LENS CAPSULE AND/OR ANTERIOR HYALOID); STAB INCISION TECHNIQUE (ZIEGLER OR WHEELER KNIFE)	"23,634.00"	"10,530.00"	"13,104.00"
66821	"DISCISSION OF SECONDARY MEMBRANOUS CATARACT (OPACIFIED POSTERIOR LENS CAPSULE AND/OR ANTERIOR
HYALOID); LASER SURGERY (E.G., YAG LASER) (ONE OR MORE
STAGES)"	"16,107.00"	"9,555.00"	"6,552.00"
66825	"REPOSITIONING OF INTRAOCULAR LENS PROSTHESIS, REQUIRING
AN INCISION"	"35,100.00"	"18,720.00"	"16,380.00"
66830	"REMOVAL OF SECONDARY MEMBRANOUS CATARACT (OPACIFIED POSTERIOR LENS CAPSULE AND/OR ANTERIOR HYALOID) W/ CORNEO-SCLERAL SECTION, W/ OR W/O IRIDECTOMY (IRIDOCAPSULOTOMY, IRIDOCAPSULECTOMY)"	"23,634.00"	"10,530.00"	"13,104.00"
66985	"INSERTION OF INTRAOCULAR LENS PROSTHESIS, NOT
ASSOCIATED WITH CATARACT REMOVAL"	"31,200.00"	"18,720.00"	"12,480.00"
66986	EXCHANGE OF INTRAOCULAR LENS	"31,200.00"	"18,720.00"	"12,480.00"
66991	"REVISION OF FAILED FILTER; WITH OR WITHOUT
EXPLANTATION/EXCHANGE OF SHUNT"	"73,710.00"	"32,760.00"	"40,950.00"
66992	REVISION OF FAILED FILTER; WITH EXCISION OF BLEB CYST	"73,710.00"	"32,760.00"	"40,950.00"
66993	REVISION OF FAILED FILTER; WITH CHOROIDAL TAP	"59,085.00"	"26,325.00"	"32,760.00"
66994	REVISION OF FAILED FILTER; WITH POSTERIOR SCLEROTOMY	"59,085.00"	"26,325.00"	"32,760.00"
66995	"REVISION OF FAILED FILTER; WITH ANTERIOR CHAMBER
REFORMATION"	"59,085.00"	"26,325.00"	"32,760.00"
66996	"REVISION OF FILTERING BLEB, NEEDLING TECHNIQUE; WITHOUT
INJECTION OF ANTI-METABOLITE"	"23,634.00"	"10,530.00"	"13,104.00"
66997	"REVISION OF FILTERING BLEB, NEEDLING TECHNIQUE; WITH
INJECTION OF ANTI-METABOLITE"	"35,100.00"	"18,720.00"	"16,380.00"
66998	"RELEASE OF SCLERAL FLAP SUTURE BY LASER SUTURE LYSIS (NEW
CODE)"	"18,915.00"	"10,725.00"	"8,190.00"
66999	"REVISION OF OVERFILTERING BLEB (INCLUDES AUTOLOGOUS BLOOD INJECTION, CRYOTHERAPY, MATTRESS SUTURES, ETC.)"	"35,100.00"	"18,720.00"	"16,380.00"
67005	"REMOVAL OF VITREOUS, ANTERIOR APPROACH (OPEN SKY
TECHNIQUE OR LIMBAL INCISION); PARTIAL REMOVAL"	"73,710.00"	"32,760.00"	"40,950.00"
67010	"REMOVAL OF VITREOUS, ANTERIOR APPROACH (OPEN SKY
TECHNIQUE OR LIMBAL INCISION); SUBTOTAL REMOVAL W/ MECHANICAL VITRECTOMY"	"87,750.00"	"46,800.00"	"40,950.00"
67015	"ASPIRATION OR RELEASE OF VITREOUS, SUBRETINAL OR
CHOROIDAL FLUID, PARS PLANA APPROACH (POSTERIOR SCLEROTOMY)"	"18,915.00"	"10,725.00"	"8,190.00"
67025	"INJECTION OF VITREOUS SUBSTITUTE, PARS PLANA OR LIMBAL APPROACH, (FLUID-GAS EXCHANGE), W/ OR W/O ASPIRATION"	"23,634.00"	"10,530.00"	"13,104.00"
67027	"IMPLANTATION OF INTRAVITREAL DRUG DELIVERY SYSTEM (EG,
GANCICLOVIR IMPLANT), INCLUDES CONCOMITANT REMOVAL OF VITREOUS"	"61,581.00"	"33,735.00"	"27,846.00"
67030	"DISCISSION OF VITREOUS STRANDS (W/O REMOVAL), PARS PLANA
APPROACH"	"25,155.00"	"12,870.00"	"12,285.00"
67031	"SEVERING OF VITREOUS STRANDS, VITREOUS FACE ADHESIONS,
SHEETS, MEMBRANES OR OPACITIES, LASER SURGERY (ONE OR MORE STAGES)"	"20,553.00"	"10,725.00"	"9,828.00"
67036	"VITRECTOMY, MECHANICAL, PARS PLANA APPROACH;"	"90,675.00"	"41,535.00"	"49,140.00"
67038	"VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; W/
EPIRETINAL MEMBRANE STRIPPING"	"90,675.00"	"41,535.00"	"49,140.00"
67039	"VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; W/ FOCAL
ENDOLASER PHOTOCOAGULATION"	"90,675.00"	"41,535.00"	"49,140.00"
67040	"VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; W/
ENDOLASER PANRETINAL PHOTOCOAGULATION"	"90,675.00"	"41,535.00"	"49,140.00"
67041	"VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH
INTERNAL LIMITING MEMBRANE (ILM) PEELING"	"90,675.00"	"41,535.00"	"49,140.00"
67046	"VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH
REMOVAL OF SUBRETINAL MEMBRANES"	"90,675.00"	"41,535.00"	"49,140.00"
67047	"VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH
REMOVAL OF CHOROIDAL NEOVASCULAR MEMBRANE"	"90,675.00"	"41,535.00"	"49,140.00"
67048	"VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH
ENDODRAINAGE OF SUBRETINAL HEMORRHAGE (WITH OR WITHOUT TPA INJECTION)"	"90,675.00"	"41,535.00"	"49,140.00"
67049	"VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH
REMOVAL OF DROPPED IOL"	"90,675.00"	"41,535.00"	"49,140.00"
67050	"VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH PHACOFRAGMENTATION FOR DROPPED LENS MATERIAL"	"90,675.00"	"41,535.00"	"49,140.00"
67051	"VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH
INTERNAL TAMPONADE WITH AIR, GAS, SILICONE OIL, PERFLUOROCARBON LIQUID"	"90,675.00"	"41,535.00"	"49,140.00"
67052	"VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; WITH
INSERTION OF SCLERAL FIXATED INTRAOCULAR LENS, WITH OR WITHOUT ANTERIOR VITRECTOMY"	"73,710.00"	"32,760.00"	"40,950.00"
67101	"REPAIR OF RETINAL DETACHMENT, ONE OR MORE SESSIONS; CRYOTHERAPY OR DIATHERMY, W/ OR W/O DRAINAGE OF
SUBRETINAL FLUID"	"90,675.00"	"41,535.00"	"49,140.00"
67105	"REPAIR OF RETINAL DETACHMENT, ONE OR MORE SESSIONS; PHOTOCOAGULATION, W/ OR W/O DRAINAGE OF SUBRETINAL
FLUID"	"72,501.00"	"36,465.00"	"36,036.00"
67107	"REPAIR OF RETINAL DETACHMENT; SCLERAL BUCKLING (SUCH AS LAMELLAR SCLERAL DISSECTION, IMBRICATION OR ENCIRCLING PROCEDURE), W/ OR W/O IMPLANT, W/ OR W/O CRYOTHERAPY, PHOTOCOAGULATION, AND DRAINAGE OF SUBRETINAL FLUID"	"90,675.00"	"41,535.00"	"49,140.00"
67108	"REPAIR OF RETINAL DETACHMENT; W/ VITRECTOMY, ANY METHOD, W/ OR W/O AIR OR GAS TAMPONADE, FOCAL ENDOLASER PHOTOCOAGULATION, CRYOTHERAPY, DRAINAGE OF SUBRETINAL FLUID, SCLERAL BUCKLING, AND/OR REMOVAL OF
LENS BY SAME TECHNIQUE"	"90,675.00"	"41,535.00"	"49,140.00"
67110	"REPAIR OF RETINAL DETACHMENT; BY INJECTION OF AIR OR
OTHER GAS (E.G., PNEUMATIC RETINOPEXY)"	"59,085.00"	"26,325.00"	"32,760.00"
67112	"REPAIR OF RETINAL DETACHMENT; BY SCLERAL BUCKLING OR VITRECTOMY, ON PATIENT HAVING PREVIOUS IPSILATERAL RETINAL DETACHMENT REPAIR(S) USING SCLERAL BUCKLING OR
VITRECTOMY TECHNIQUES"	"90,675.00"	"41,535.00"	"49,140.00"
67115	RELEASE OF ENCIRCLING MATERIAL (POSTERIOR SEGMENT)	"23,634.00"	"10,530.00"	"13,104.00"
67120	"REMOVAL OF IMPLANTED MATERIAL, POSTERIOR SEGMENT;
EXTRAOCULAR"	"23,634.00"	"10,530.00"	"13,104.00"
67121	"REMOVAL OF IMPLANTED MATERIAL, POSTERIOR SEGMENT;
INTRAOCULAR"	"40,911.00"	"21,255.00"	"19,656.00"
67208	"DESTRUCTION OF LOCALIZED LESION OF RETINA (E.G., MACULOPATHY, CHOROIDOPATHY, SMALL TUMORS),  ONE OR
MORE SESSIONS; CRYOTHERAPY, DIATHERMY"	"23,634.00"	"10,530.00"	"13,104.00"
67210	"DESTRUCTION OF LOCALIZED LESION OF RETINA (E.G., MACULOPATHY, CHOROIDOPATHY, SMALL TUMORS),  ONE OR MORE SESSIONS; PHOTOCOAGULATION (LASER OR XENON ARC)"	"23,634.00"	"10,530.00"	"13,104.00"
67218	"DESTRUCTION OF LOCALIZED LESION OF RETINA (E.G., MACULOPATHY, CHOROIDOPATHY, SMALL TUMORS),  ONE OR MORE SESSIONS; RADIATION BY IMPLANTATION OF SOURCE
(INCLUDES REMOVAL OF SOURCE)"	"23,634.00"	"10,530.00"	"13,104.00"
67220	"DESTRUCTION OF LOCALIZED LESION OF CHOROID (E.G., CHOROIDAL NEOVASCULARIZATION); PHOTOCOAGULATION (E.G., LASER), ONE OR MORE SESSIONS"	"23,634.00"	"10,530.00"	"13,104.00"
67221	"DESTRUCTION OF LOCALIZED LESION OF CHOROID (E.G., CHOROIDAL NEOVASCULARIZATION); PHOTODYNAMIC THERAPY
(INCLUDES INTRAVENOUS INFUSIONS"	"23,634.00"	"10,530.00"	"13,104.00"
67222	"DESTRUCTION OF LOCALIZED LESION OF CHOROID (E.G., CHOROIDAL NEOVASCULARIZATION); TRANSPUPILLARY
THERMOTHERAPY"	"23,634.00"	"10,530.00"	"13,104.00"
67227	"DESTRUCTION OF EXTENSIVE OR PROGRESSIVE RETINOPATHY (E.G., DIABETIC RETINOPATHY), ONE OR MORE SESSIONS;
CRYOTHERAPY, DIATHERMY"	"23,634.00"	"10,530.00"	"13,104.00"
67228	"DESTRUCTION OF EXTENSIVE OR PROGRESSIVE RETINOPATHY (E.G., DIABETIC RETINOPATHY), ONE OR MORE SESSIONS; PHOTOCOAGULATION (LASER OR XENON ARC)"	"23,634.00"	"10,530.00"	"13,104.00"
67250	SCLERAL REINFORCEMENT	"23,634.00"	"10,530.00"	"13,104.00"
67311	"STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE (PATIENT NOT PREVIOUSLY OPERATED ON); ONE HORIZONTAL
MUSCLE"	"19,734.00"	"10,725.00"	"9,009.00"
67312	"STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE (PATIENT NOT PREVIOUSLY OPERATED ON); TWO HORIZONTAL
MUSCLES"	"23,634.00"	"10,530.00"	"13,104.00"
67314	"STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE (PATIENT NOT PREVIOUSLY OPERATED ON); ONE VERTICAL
MUSCLE (EXCLUDING SUPERIOR OBLIQUE)"	"23,634.00"	"10,530.00"	"13,104.00"
67316	"STRABISMUS SURGERY, RECESSION OR RESECTION PROCEDURE (PATIENT NOT PREVIOUSLY OPERATED ON); TWO OR MORE VERTICAL MUSCLES (EXCLUDING SUPERIOR OBLIQUE)"	"35,100.00"	"18,720.00"	"16,380.00"
67318	"STRABISMUS SURGERY, ANY PROCEDURE (PATIENT NOT
PREVIOUSLY OPERATED ON), SUPERIOR OBLIQUE MUSCLE"	"35,100.00"	"18,720.00"	"16,380.00"
67320	"TRANSPOSITION PROCEDURE (E.G., FOR PARETIC EXTRAOCULAR MUSCLE), ANY EXTRAOCULAR MUSCLE  (SPECIFY)"	"35,100.00"	"18,720.00"	"16,380.00"
67331	STRABISMUS SURGERY ON PATIENT W/ PREVIOUS EYE SURGERY OR INJURY THAT DID NOT INVOLVE THE EXTRAOCULAR MUSCLES	"35,100.00"	"18,720.00"	"16,380.00"
67332	"STRABISMUS SURGERY ON PATIENT W/ SCARING OF EXTRAOCULAR MUSCLES (E.G., PRIOR OCULAR INJURY, STRABISMUS OR RETINAL DETACHMENT SURGERY) OR RESTRICTIVE MYOPATHY (E.G., DYSTHYROID OPHTHALMOPATHY)"	"42,783.00"	"24,765.00"	"18,018.00"
67334	"STRABISMUS SURGERY BY POSTERIOR FIXATION SUTURE
TECHNIQUE, W/ OR W/O MUSCLE RECESSION"	"23,361.00"	"11,895.00"	"11,466.00"
67340	"STRABISMUS SURGERY INVOLVING EXPLORATION AND/OR
REPAIR OF DETACHED EXTRAOCULAR MUSCLE(S)"	"44,187.00"	"21,255.00"	"22,932.00"
67343	"RELEASE OF EXTENSIVE SCAR TISSUE W/O DETACHING
EXTRAOCULAR MUSCLE"	"35,100.00"	"18,720.00"	"16,380.00"
67345	CHEMODENERVATION OF EXTRAOCULAR MUSCLE	"18,915.00"	"10,725.00"	"8,190.00"
67350	BIOPSY OF EXTRAOCULAR MUSCLE	"18,915.00"	"10,725.00"	"8,190.00"
67400	"ORBITOTOMY W/O BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL APPROACH); FOR EXPLORATION, W/ OR
W/O BIOPSY"	"90,675.00"	"41,535.00"	"49,140.00"
67405	"ORBITOTOMY W/O BONE FLAP (FRONTAL OR
TRANSCONJUNCTIVAL APPROACH); W/ DRAINAGE ONLY"	"90,675.00"	"41,535.00"	"49,140.00"
67412	ORBITOTOMY W/O BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL APPROACH); W/ REMOVAL OF LESION	"90,675.00"	"41,535.00"	"49,140.00"
67413	"ORBITOTOMY W/O BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL APPROACH); W/ REMOVAL OF FOREIGN
BODY"	"90,675.00"	"41,535.00"	"49,140.00"
67414	"ORBITOTOMY W/O BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL APPROACH); W/ REMOVAL OF BONE FOR
DECOMPRESSION"	"90,675.00"	"41,535.00"	"49,140.00"
67415	FINE NEEDLE ASPIRATION OF ORBITAL CONTENTS	"90,675.00"	"41,535.00"	"49,140.00"
67420	"ORBITOTOMY W/ BONE FLAP OR WINDOW, LATERAL APPROACH
(E.G., KROENLEIN); W/ REMOVAL OF LESION"	"90,675.00"	"41,535.00"	"49,140.00"
67430	"ORBITOTOMY W/ BONE FLAP OR WINDOW, LATERAL APPROACH (E.G., KROENLEIN); W/ REMOVAL OF FOREIGN BODY"	"90,675.00"	"41,535.00"	"49,140.00"
67440	"ORBITOTOMY W/ BONE FLAP OR WINDOW, LATERAL APPROACH
(E.G., KROENLEIN); W/ DRAINAGE"	"90,675.00"	"41,535.00"	"49,140.00"
67445	"ORBITOTOMY W/ BONE FLAP OR WINDOW, LATERAL APPROACH (E.G., KROENLEIN); W/ REMOVAL OF BONE FOR DECOMPRESSION"	"90,675.00"	"41,535.00"	"49,140.00"
67550	ORBITAL IMPLANT (IMPLANT OUTSIDE MUSCLE CONE); INSERTION	"21,372.00"	"10,725.00"	"10,647.00"
67560	"ORBITAL IMPLANT (IMPLANT OUTSIDE MUSCLE CONE); REMOVAL
OR REVISION"	"21,372.00"	"10,725.00"	"10,647.00"
67570	"OPTIC NERVE DECOMPRESSION (E.G., INCISION OR FENESTRATION
OF OPTIC NERVE SHEATH)"	"104,130.00"	"46,800.00"	"57,330.00"
67580	"REPAIR OF ANOPHTHALMIC SOCKET; WITH INSERTION OR
REMOVAL OF ORBITAL IMPLANT WITHIN MUSCLE CONE"	"23,634.00"	"10,530.00"	"13,104.00"
67581	"REPAIR OF ANOPHTHALMIC SOCKET; WITH EXCHANGE OR
ORBITAL IMPLANT"	"40,911.00"	"21,255.00"	"19,656.00"
67582	"REPAIR OF ANOPHTHALMIC SOCKET; WITH EXCHANGE OF
ORBITAL IMPLANT AND REATTACHMENT OF MUSCLES"	"40,911.00"	"21,255.00"	"19,656.00"
67583	"REPAIR OF ANOPHTHALMIC SOCKET; WITH FORNIX
RECONSTRUCTION USING SUTURES"	"40,911.00"	"21,255.00"	"19,656.00"
67584	"REPAIR OF ANOPHTHALMIC SOCKET; WITH FORNIX RECONSTRUCTION USING BUCCAL MUCOSAL GRAFT OR AMNION
GRAFT, INCLUDING HARVESTING OF GRAFT"	"40,911.00"	"21,255.00"	"19,656.00"
67585	"REPAIR OF ANOPHTHALMIC SOCKET; WITH REVISION OF IMPLANT
AND FORNIX RECONSTRUCTION USING SUTURES"	"40,911.00"	"21,255.00"	"19,656.00"
67586	"REPAIR OF ANOPHTHALMIC SOCKET; WITH REVISION OF IMPLANT AND FORNIX RECONSTRUCTION USING BUCCAL MUCOSAL GRAFT, OR AMNION GRAFT (INCLUDING HARVESTING OF GRAFT)"	"40,911.00"	"21,255.00"	"19,656.00"
67700	"BLEPHAROTOMY, DRAINAGE OF ABSCESS, EYELID"	"11,076.00"	"7,800.00"	"3,276.00"
67710	SEVERING OF TARSORRHAPHY	"11,076.00"	"7,800.00"	"3,276.00"
67715	CANTHOTOMY	"11,076.00"	"7,800.00"	"3,276.00"
67800	EXCISION OF CHALAZION	"11,076.00"	"7,800.00"	"3,276.00"
67810	BIOPSY OF EYELID	"11,076.00"	"7,800.00"	"3,276.00"
67825	"REPAIR OF TRICHIASIS; BY ELECTROEPILATION,
ELECTROSURGERY, CRYOTHERAPY OR LASER SURGERY"	"11,076.00"	"7,800.00"	"3,276.00"
67830	REPAIR OF TRICHIASIS; INCISION OF LID MARGIN	"7,098.00"	"5,460.00"	"1,638.00"
67835	"REPAIR OF TRICHIASIS; INCISION OF LID MARGIN, WITH FREE
MUCOUS MEMBRANE GRAFT"	"18,135.00"	"14,040.00"	"4,095.00"
67840	"EXCISION OF LESION OF EYELID (EXCEPT CHALAZION) WITHOUT
CLOSURE OR WITH SIMPLE DIRECT CLOSURE"	"10,842.00"	"8,385.00"	"2,457.00"
67875	"TEMPORARY CLOSURE OF EYELIDS SUTURE (E.G., FROST SUTURE)"	"11,076.00"	"7,800.00"	"3,276.00"
67880	"CONSTRUCTION OF INTERMARGIN ADHESIONS, MEDIAN
TARSORRHAPHY, OR CANTHORRHAPHY;"	"11,076.00"	"7,800.00"	"3,276.00"
67882	"CONSTRUCTION OF INTERMARGIN ADHESIONS, MEDIAN TARSORRHAPHY, OR CANTHORRHAPHY; WITH TRANSPORTATION
OF TARSAL PLATE"	"15,639.00"	"10,725.00"	"4,914.00"
67900	"REPAIR OF BROW PTOSIS (SUPRACILIARY, MIDFOREHEAD OR
CORONAL APPROACH)"	"35,100.00"	"18,720.00"	"16,380.00"
67901	"REPAIR OF BLEPHAROPTOSIS; FRONTALIS MUSCLE TECHNIQUE
WITH SUTURE OR OTHER MATERIAL"	"35,100.00"	"18,720.00"	"16,380.00"
67902	REPAIR OF BLEPHAROPTOSIS; FRONTALIS MUSCLE TECHNIQUE WITH FASCIAL SLING (INCLUDES OBTAINING FASCIA)	"40,911.00"	"21,255.00"	"19,656.00"
67903	"REPAIR OF BLEPHAROPTOSIS; (TARSO) LEVATOR RESECTION OR
ADVANCEMENT, INTERNAL APPROACH"	"35,100.00"	"18,720.00"	"16,380.00"
67904	"REPAIR OF BLEPHAROPTOSIS; (TARSO) LEVATOR RESECTION OR
ADVANCEMENT, EXTERNAL APPROACH"	"35,100.00"	"18,720.00"	"16,380.00"
67906	REPAIR OF BLEPHAROPTOSIS; SUPERIOR RECTUS TECHNIQUE WITH FASCIAL SLING (INCLUDES OBTAINING FASCIA)	"35,100.00"	"18,720.00"	"16,380.00"
67908	REPAIR OF BLEPHAROPTOSIS; CONJUNCTIVO-TARSO-MULLERS MUSCLE-LEVATOR RESECTION (FASANELLA-SERVAT TYPE)	"35,100.00"	"18,720.00"	"16,380.00"
67911	"REPAIR OF LID RETRACTION (EYELID RECESSION); WITHOUT
SPACER"	"41,730.00"	"21,255.00"	"20,475.00"
67912	"CORRECTION OF LAGOPHTHALMOS, WITH IMPLANTATION OF
UPPER EYELID LOAD"	"62,400.00"	"33,735.00"	"28,665.00"
67914	REPAIR OF ECTROPION; SUTURE	"15,639.00"	"10,725.00"	"4,914.00"
67915	REPAIR OF ECTROPION; THERMOCAUTERIZATION	"15,639.00"	"10,725.00"	"4,914.00"
67916	"BLEPHAROPLASTY, EXCISION TARSAL WEDGE"	"18,915.00"	"10,725.00"	"8,190.00"
67917	"BLEPHAROPLASTY, EXTENSIVE (E.G., KUHNT-SZYMANOWSKI OR
TARSAL STRIP OPERATIONS)"	"25,155.00"	"12,870.00"	"12,285.00"
67921	REPAIR OF ENTROPION; SUTURE	"11,076.00"	"7,800.00"	"3,276.00"
67922	REPAIR OF ENTROPION; THERMOCAUTERIZATION	"11,076.00"	"7,800.00"	"3,276.00"
67923	"BLEPHAROPLASTY, EXCISION TARSAL WEDGE"	"18,915.00"	"10,725.00"	"8,190.00"
67924	"BLEPHAROPLASTY, EXTENSIVE (E.G., WHEELER OPERATION)"	"25,155.00"	"12,870.00"	"12,285.00"
67930	"SUTURE OF RECENT WOUND, EYELID, INVOLVING LID MARGIN,
TARSUS, AND/ OR PALPEBRAL CONJUNCTIVA DIRECT CLOSURE; PARTIAL THICKNESS"	"18,915.00"	"10,725.00"	"8,190.00"
67935	"SUTURE OF RECENT WOUND, EYELID, INVOLVING LID MARGIN, TARSUS, AND/ OR PALPEBRAL CONJUNCTIVA DIRECT CLOSURE;
FULL THICKNESS"	"23,634.00"	"10,530.00"	"13,104.00"
67950	CANTHOPLASTY (RECONSTRUCTION OF CANTHUS)	"23,634.00"	"10,530.00"	"13,104.00"
67961	"EXCISION AND REPAIR OF EYELID, INVOLVING LID MARGIN, TARSUS, CONJUNCTIVA, CANTHUS, OR FULL THICKNESS, MAY INCLUDE PREPARATION FOR SKIN GRAFT OR PEDICLE FLAP WITH ADJACENT TISSUE TRANSFER OR REARRANGEMENT; UP TO ONE-
FOURTH OF LID MARGIN"	"59,943.00"	"33,735.00"	"26,208.00"
67966	"EXCISION AND REPAIR OF EYELID, INVOLVING LID MARGIN, TARSUS, CONJUNCTIVA, CANTHUS, OR FULL THICKNESS, MAY INCLUDE PREPARATION FOR SKIN GRAFT OR PEDICLE FLAP WITH ADJACENT TISSUE TRANSFER OR REARRANGEMENT; OVER ONE-
FOURTH OF LID MARGIN"	"52,884.00"	"23,400.00"	"29,484.00"
67971	"RECONSTRUCTION OF EYELID, FULL THICKNESS BY TRANSFER OF TARSOCONJUNCTIVAL FLAP FROM OPPOSING EYELID; UP TO TWO- THIRDS OF EYELID, ONE STAGE OR FIRST STAGE"	"59,085.00"	"26,325.00"	"32,760.00"
67973	"RECONSTRUCTION OF EYELID, FULL THICKNESS BY TRANSFER OF TARSOCONJUNCTIVAL FLAP FROM OPPOSING EYELID; TOTAL EYELID,  LOWER, ONE STAGE OR FIRST STAGE"	"73,710.00"	"32,760.00"	"40,950.00"
67974	"RECONSTRUCTION OF EYELID, FULL THICKNESS BY TRANSFER OF TARSOCONJUNCTIVAL FLAP FROM OPPOSING EYELID; TOTAL EYELID, UPPER, ONE STAGE OR FIRST STAGE"	"73,710.00"	"32,760.00"	"40,950.00"
67975	"RECONSTRUCTION OF EYELID, FULL THICKNESS BY TRANSFER OF
TARSOCONJUNCTIVAL FLAP FROM OPPOSING EYELID; SECOND STAGE"	"59,085.00"	"26,325.00"	"32,760.00"
68100	BIOPSY OF CONJUNCTIVA	"11,076.00"	"7,800.00"	"3,276.00"
68110	"EXCISION OF LESION, CONJUNCTIVA; UP TO 1 CM"	"15,639.00"	"10,725.00"	"4,914.00"
68115	"EXCISION OF LESION, CONJUNCTIVA; OVER 1 CM"	"15,639.00"	"10,725.00"	"4,914.00"
68130	"EXCISION OF LESION, CONJUNCTIVA; WITH ADJACENT SCLERA"	"15,639.00"	"10,725.00"	"4,914.00"
68320	"CONJUNCTIVOPLASTY; WITH CONJUNCTIVAL GRAFT OR
EXTENSIVE REARRANGEMENT"	"20,553.00"	"10,725.00"	"9,828.00"
68325	"CONJUNCTIVOPLASTY; WITH BUCCAL MUCOUS MEMBRANE GRAFT
(INCLUDES OBTAINING GRAFT)"	"23,634.00"	"10,530.00"	"13,104.00"
68326	CONJUNCTIVOPLASTY RECONSTRUCTION CUL-DE-SAC; WITH CONJUNCTIVAL GRAFT OR EXTENSIVE REARRANGEMENT	"29,172.00"	"14,430.00"	"14,742.00"
68328	"CONJUNCTIVOPLASTY RECONSTRUCTION CUL-DE-SAC; WITH BUCCAL MUCOUS MEMBRANE GRAFT (INCLUDES OBTAINING
GRAFT)"	"35,100.00"	"18,720.00"	"16,380.00"
68330	"REPAIR OF SYMBLEPHARON; CONJUNCTIVOPLASTY, WITHOUT
GRAFT"	"29,172.00"	"14,430.00"	"14,742.00"
68335	REPAIR OF SYMBLEPHARON; WITH FREE GRAFT CONJUNCTIVA OR BUCCAL MUCOUS MEMBRANE (INCLUDES OBTAINING GRAFT)	"42,783.00"	"24,765.00"	"18,018.00"
68340	"REPAIR OF SYMBLEPHARON; DIVISION OF SYMBLEPHARON, WITH OR WITHOUT INSERTION OF CONFORMER OR CONTACT LENS"	"35,100.00"	"18,720.00"	"16,380.00"
68360	CONJUNCTIVAL FLAP; BRIDGE OR PARTIAL	"23,361.00"	"11,895.00"	"11,466.00"
68362	"CONJUNCTIVAL FLAP; TOTAL (SUCH AS GUNDERSON THIN FLAP OR
PURSE STRING FLAP)"	"23,361.00"	"11,895.00"	"11,466.00"
68371	"HARVESTING CONJUNCTIVAL ALLOGRAFT, LIVING DONOR"	"40,911.00"	"21,255.00"	"19,656.00"
68400	"INCISION, DRAINAGE OF LACRIMAL GLAND"	"11,076.00"	"7,800.00"	"3,276.00"
68420	"INCISION, DRAINAGE OF LACRIMAL SAC (DACRYOCYSTOSTOMY)"	"11,076.00"	"7,800.00"	"3,276.00"
68440	SNIP INCISION OF LACRIMAL PUNCTUM	"11,076.00"	"7,800.00"	"3,276.00"
68500	"EXCISION OF LACRIMAL GLAND (DACRYOADENECTOMY), EXCEPT
FOR TUMOR"	"23,634.00"	"10,530.00"	"13,104.00"
68510	BIOPSY OF LACRIMAL GLAND	"11,076.00"	"7,800.00"	"3,276.00"
68520	EXCISION OF LACRIMAL SAC (DACRYOCYSTECTOMY)	"23,634.00"	"10,530.00"	"13,104.00"
68525	BIOPSY OF LACRIMAL SAC	"11,076.00"	"7,800.00"	"3,276.00"
68540	EXCISION OF LACRIMAL GLAND TUMOR; FRONTAL APPROACH	"35,100.00"	"18,720.00"	"16,380.00"
68550	EXCISION OF LACRIMAL GLAND TUMOR; INVOLVING OSTEOTOMY	"35,100.00"	"18,720.00"	"16,380.00"
68700	PLASTIC REPAIR OF CANALICULI	"18,915.00"	"10,725.00"	"8,190.00"
68705	"CORRECTION OF EVERTED PUNCTUM, CAUTERY"	"7,098.00"	"5,460.00"	"1,638.00"
68720	"DACRYOCYSTORHINOSTOMY (FISTULIZATION OF LACRIMAL SAC
TO NASAL CAVITY)"	"35,100.00"	"18,720.00"	"16,380.00"
68745	"CONJUNCTIVORHINOSTOMY (FISTULIZATION OF CONJUNCTIVA TO
NASAL CAVITY); WITHOUT TUBE"	"35,100.00"	"18,720.00"	"16,380.00"
68750	CONJUNCTIVORHINOSTOMY (FISTULIZATION OF CONJUNCTIVA TO NASAL CAVITY); WITH INSERTION OF TUBE OR STENT	"40,911.00"	"21,255.00"	"19,656.00"
68760	"CLOSURE OF THE LACRIMAL PUNCTUM; BY
THERMOCAUTERIZATION, LIGATION, OR LASER SURGERY"	"15,639.00"	"10,725.00"	"4,914.00"
68770	CLOSURE OF LACRIMAL FISTULA	"21,216.00"	"13,845.00"	"7,371.00"
68811	"PROBING OF NASOLACRIMAL DUCT; REQUIRING GENERAL
ANESTHESIA"	"15,639.00"	"10,725.00"	"4,914.00"
68815	"PROBING OF NASOLACRIMAL DUCT; WITH INSERTION OF TUBE OR
STENT"	"18,915.00"	"10,725.00"	"8,190.00"
69000	"DRAINAGE EXTERNAL EAR, ABSCESS OR HEMATOMA"	"7,160.40"	"5,850.00"	"1,310.40"
69020	"DRAINAGE EXTERNAL AUDITORY CANAL, ABSCESS"	"6,770.40"	"6,279.00"	491.40
69100	BIOPSY EXTERNAL EAR	"11,076.00"	"7,800.00"	"3,276.00"
69105	BIOPSY EXTERNAL AUDITORY CANAL	"11,076.00"	"7,800.00"	"3,276.00"
69110	"EXCISION EXTERNAL EAR; PARTIAL, SIMPLE REPAIR"	"16,107.00"	"9,555.00"	"6,552.00"
69120	EXCISION EXTERNAL EAR; COMPLETE AMPUTATION	"23,634.00"	"10,530.00"	"13,104.00"
69140	"EXCISION EXOSTOSIS(ES), EXTERNAL AUDITORY CANAL"	"18,915.00"	"10,725.00"	"8,190.00"
69145	"EXCISION SOFT TISSUE LESION, EXTERNAL AUDITORY CANAL"	"18,915.00"	"10,725.00"	"8,190.00"
69150	"RADICAL EXCISION EXTERNAL AUDITORY CANAL LESION; W/O
NECK DISSECTION"	"45,435.00"	"20,865.00"	"24,570.00"
69155	"RADICAL EXCISION EXTERNAL AUDITORY CANAL LESION; W/
NECK DISSECTION"	"59,085.00"	"26,325.00"	"32,760.00"
69200	"REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL; W/
GENERAL ANESTHESIA"	"18,135.00"	"14,040.00"	"4,095.00"
69220	"DEBRIDEMENT, MASTOIDECTOMY CAVITY, SIMPLE (E.G., ROUTINE
CLEANING)"	"15,639.00"	"10,725.00"	"4,914.00"
69222	"DEBRIDEMENT, MASTOIDECTOMY CAVITY, COMPLEX (E.G., W/
ANESTHESIA OR MORE THAN ROUTINE CLEANING)"	"18,915.00"	"10,725.00"	"8,190.00"
69310	"RECONSTRUCTION OF EXTERNAL AUDITORY CANAL (MEATOPLASTY) (E.G., FOR STENOSIS DUE TO TRAUMA,
INFECTION)"	"45,435.00"	"20,865.00"	"24,570.00"
69320	"RECONSTRUCTION EXTERNAL AUDITORY CANAL FOR
CONGENITAL ATRESIA, SINGLE STAGE"	"45,435.00"	"20,865.00"	"24,570.00"
69400	"EUSTACHIAN TUBE INFLATION, TRANSNASAL; W/
CATHETERIZATION"	"11,333.40"	"8,385.00"	"2,948.40"
69405	"EUSTACHIAN TUBE CATHETERIZATION, TRANSTYMPANIC"	"11,076.00"	"7,800.00"	"3,276.00"
69420	"MYRINGOTOMY INCLUDING ASPIRATION AND/OR EUSTACHIAN
TUBE INFLATION"	"11,076.00"	"7,800.00"	"3,276.00"
69421	MYRINGOTOMY INCLUDING ASPIRATION AND/OR EUSTACHIAN TUBE INFLATION REQUIRING GENERAL ANESTHESIA	"15,639.00"	"10,725.00"	"4,914.00"
69433	"TYMPANOSTOMY (REQUIRING INSERTION OF VENTILATING TUBE),
LOCAL OR TOPICAL ANESTHESIA"	"16,107.00"	"9,555.00"	"6,552.00"
69436	"TYMPANOSTOMY (REQUIRING INSERTION OF VENTILATING TUBE),
W/ GENERAL ANESTHESIA"	"16,107.00"	"9,555.00"	"6,552.00"
69440	"MIDDLE EAR EXPLORATION THROUGH POSTAURICULAR OR EAR
CANAL INCISION"	"35,100.00"	"18,720.00"	"16,380.00"
69450	"TYMPANOLYSIS, TRANSCANAL"	"18,915.00"	"10,725.00"	"8,190.00"
69501	"TRANSMASTOID ANTROTOMY (""SIMPLE"" MASTOIDECTOMY)"	"40,911.00"	"21,255.00"	"19,656.00"
69502	MASTOIDECTOMY; COMPLETE	"45,435.00"	"20,865.00"	"24,570.00"
69505	MASTOIDECTOMY; MODIFIED RADICAL	"45,435.00"	"20,865.00"	"24,570.00"
69511	MASTOIDECTOMY; RADICAL	"45,435.00"	"20,865.00"	"24,570.00"
69530	PETROUS APICECTOMY INCLUDING RADICAL MASTOIDECTOMY	"45,435.00"	"20,865.00"	"24,570.00"
69535	"RESECTION TEMPORAL BONE, EXTERNAL APPROACH"	"90,675.00"	"41,535.00"	"49,140.00"
69540	EXCISION AURAL POLYP	"15,639.00"	"10,725.00"	"4,914.00"
69550	EXCISION AURAL GLOMUS TUMOR; TRANSCANAL	"59,085.00"	"26,325.00"	"32,760.00"
69552	EXCISION AURAL GLOMUS TUMOR; TRANSMASTOID	"59,085.00"	"26,325.00"	"32,760.00"
69554	EXCISION AURAL GLOMUS TUMOR; EXTENDED (EXTRATEMPORAL)	"59,085.00"	"26,325.00"	"32,760.00"
69601	"REVISION MASTOIDECTOMY; RESULTING IN COMPLETE
MASTOIDECTOMY"	"45,435.00"	"20,865.00"	"24,570.00"
69602	"REVISION MASTOIDECTOMY; RESULTING IN MODIFIED RADICAL
MASTOIDECTOMY"	"61,581.00"	"33,735.00"	"27,846.00"
69603	"REVISION MASTOIDECTOMY; RESULTING IN RADICAL
MASTOIDECTOMY"	"45,435.00"	"20,865.00"	"24,570.00"
69604	REVISION MASTOIDECTOMY; RESULTING IN TYMPANOPLASTY	"45,435.00"	"20,865.00"	"24,570.00"
69605	REVISION MASTOIDECTOMY; W/ APICECTOMY	"45,435.00"	"20,865.00"	"24,570.00"
69610	"TYMPANIC MEMBRANE REPAIR, W/ OR W/O SITE PREPARATION OR PERFORATION FOR CLOSURE, W/ OR W/O PATCH"	"23,634.00"	"10,530.00"	"13,104.00"
69620	"MYRINGOPLASTY (SURGERY CONFINED TO DRUMHEAD AND
DONOR AREA)"	"40,911.00"	"21,255.00"	"19,656.00"
69631	"TYMPANOPLASTY W/O MASTOIDECTOMY (INCLUDING CANALPLASTY, ATTICOTOMY AND/ OR MIDDLE EAR SURGERY), INITIAL OR REVISION; W/O OSSICULAR CHAIN RECONSTRUCTION"	"59,943.00"	"33,735.00"	"26,208.00"
69632	"TYMPANOPLASTY W/O MASTOIDECTOMY (INCLUDING CANALPLASTY, ATTICOTOMY AND/ OR MIDDLE EAR SURGERY), INITIAL OR REVISION; W/ OSSICULAR CHAIN RECONSTRUCTION
(E.G., POSTFENESTRATION)"	"59,943.00"	"33,735.00"	"26,208.00"
69633	"TYMPANOPLASTY W/O MASTOIDECTOMY (INCLUDING CANALPLASTY, ATTICOTOMY AND/ OR MIDDLE EAR SURGERY), INITIAL OR REVISION; W/ OSSICULAR CHAIN RECONSTRUCTION AND SYNTHETIC PROSTHESIS (E.G., PARTIAL OSSICULAR REPLACEMENT PROSTHESIS, (PORP), TOTAL OSSICULAR REPLAC"	"59,943.00"	"33,735.00"	"26,208.00"
69635	"TYMPANOPLASTY W/ ANTROTOMY OR MASTOIDOTOMY (INCLUDING CANALPLASTY, ATTICOTOMY, MIDDLE EAR SURGERY, AND/ OR TYMPANIC MEMBRANE REPAIR); W/O OSSICULAR CHAIN
RECONSTRUCTION"	"90,675.00"	"41,535.00"	"49,140.00"
69636	"TYMPANOPLASTY W/ ANTROTOMY OR MASTOIDOTOMY (INCLUDING CANALPLASTY, ATTICOTOMY, MIDDLE EAR SURGERY, AND/ OR TYMPANIC MEMBRANE REPAIR); W/ OSSICULAR CHAIN
RECONSTRUCTION"	"92,313.00"	"41,535.00"	"50,778.00"
69637	"TYMPANOPLASTY W/ ANTROTOMY OR MASTOIDOTOMY (INCLUDING CANALPLASTY, ATTICOTOMY, MIDDLE EAR SURGERY, AND/ OR TYMPANIC MEMBRANE REPAIR); W/ OSSICULAR CHAIN RECONSTRUCTION AND SYNTHETIC PROSTHESIS (E.G. PARTIAL OSSICULAR REPLACEMENT PROSTHESIS, (PORP), TOTAL"	"92,313.00"	"41,535.00"	"50,778.00"
69641	"TYMPANOPLASTY W/ MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBRANE REPAIR); W/O OSSICULAR CHAIN RECONSTRUCTION"	"90,675.00"	"41,535.00"	"49,140.00"
69642	"TYMPANOPLASTY W/ MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBRANE REPAIR); W/ OSSICULAR CHAIN RECONSTRUCTION"	"92,313.00"	"41,535.00"	"50,778.00"
69643	"TYMPANOPLASTY W/ MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBRANE REPAIR); W/ INTACT OR RECONSTRUCTED WALL, W/O OSSICULAR
CHAIN RECONSTRUCTION"	"93,951.00"	"41,535.00"	"52,416.00"
69644	"TYMPANOPLASTY W/ MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBRANE REPAIR); W/ INTACT OR RECONSTRUCTED CANAL WALL, W/
OSSICULAR CHAIN RECONSTRUCTION"	"95,589.00"	"41,535.00"	"54,054.00"
69645	"TYMPANOPLASTY W/ MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBRANE REPAIR); RADICAL OR COMPLETE, W/O OSSICULAR CHAIN
RECONSTRUCTION"	"90,675.00"	"41,535.00"	"49,140.00"
69646	"TYMPANOPLASTY W/ MASTOIDECTOMY (INCLUDING CANALPLASTY, MIDDLE EAR SURGERY, TYMPANIC MEMBRANE REPAIR); RADICAL OR COMPLETE, W/ OSSICULAR CHAIN
RECONSTRUCTION"	"90,675.00"	"41,535.00"	"49,140.00"
69650	STAPES MOBILIZATION	"73,710.00"	"32,760.00"	"40,950.00"
69660	"STAPEDECTOMY OR STAPEDOTOMY W/ REESTABLISHMENT OF OSSICULAR CONTINUITY, W/ OR W/O USE OF FOREIGN MATERIAL;"	"75,348.00"	"32,760.00"	"42,588.00"
69661	"STAPEDECTOMY OR STAPEDOTOMY W/ REESTABLISHMENT OF OSSICULAR CONTINUITY, W/ OR W/O USE OF FOREIGN MATERIAL;
W/ FOOTPLATE DRILL OUT"	"75,348.00"	"32,760.00"	"42,588.00"
69662	REVISION OF STAPEDECTOMY OR STAPEDOTOMY	"75,348.00"	"32,760.00"	"42,588.00"
69666	REPAIR OVAL WINDOW FISTULA	"75,348.00"	"32,760.00"	"42,588.00"
69667	REPAIR ROUND WINDOW FISTULA	"75,348.00"	"32,760.00"	"42,588.00"
69670	MASTOID OBLITERATION	"61,581.00"	"33,735.00"	"27,846.00"
69676	TYMPANIC NEURECTOMY	"59,085.00"	"26,325.00"	"32,760.00"
69700	"CLOSURE POSTAURICULAR FISTULA, MASTOID"	"20,553.00"	"10,725.00"	"9,828.00"
69720	"DECOMPRESSION FACIAL NERVE, INTRATEMPORAL; LATERAL TO
GENICULATE GANGLION"	"59,085.00"	"26,325.00"	"32,760.00"
69725	"DECOMPRESSION FACIAL NERVE, INTRATEMPORAL; INCLUDING
MEDIAL TO GENICULATE GANGLION"	"59,085.00"	"26,325.00"	"32,760.00"
69740	"SUTURE FACIAL NERVE, INTRATEMPORAL, W/ OR W/O GRAFT OR DECOMPRESSION; LATERAL TO GENICULATE GANGLION"	"73,710.00"	"32,760.00"	"40,950.00"
69745	"SUTURE FACIAL NERVE, INTRATEMPORAL, W/ OR W/O GRAFT OR DECOMPRESSION; INCLUDING MEDIAL TO GENICULATE
GANGLION"	"73,710.00"	"32,760.00"	"40,950.00"
69801	"LABYRINTHOTOMY, W/ OR W/O CRYOSURGERY INCLUDING OTHER NONEXCISIONAL DESTRUCTIVE PROCEDURES OR PERFUSION OF VESTBULOACTIVE DRUGS (SINGLE OR MULTIPLE PERFUSIONS);
TRANSCANAL"	"75,348.00"	"32,760.00"	"42,588.00"
69802	"LABYRINTHOTOMY, W/ OR W/O CRYOSURGERY INCLUDING OTHER NONEXCISIONAL DESTRUCTIVE PROCEDURES OR PERFUSION OF VESTBULOACTIVE DRUGS (SINGLE OR MULTIPLE PERFUSIONS); W/
MASTOIDECTOMY"	"76,986.00"	"32,760.00"	"44,226.00"
69805	ENDOLYMPHATIC SAC OPERATION; W/O SHUNT	"90,675.00"	"41,535.00"	"49,140.00"
69806	ENDOLYMPHATIC SAC OPERATION; W/ SHUNT	"104,130.00"	"46,800.00"	"57,330.00"
69820	FENESTRATION SEMICIRCULAR CANAL	"90,675.00"	"41,535.00"	"49,140.00"
69840	REVISION FENESTRATION OPERATION	"104,130.00"	"46,800.00"	"57,330.00"
69905	LABYRINTHECTOMY; TRANSCANAL	"90,675.00"	"41,535.00"	"49,140.00"
69910	LABYRINTHECTOMY; W/ MASTOIDECTOMY	"104,130.00"	"46,800.00"	"57,330.00"
69915	"VESTIBULAR NERVE SECTION, TRANSLABYRINTHINE APPROACH"	"104,130.00"	"46,800.00"	"57,330.00"
69930	"COCHLEAR DEVICE IMPLANTATION, W/ OR W/O MASTOIDECTOMY"	"107,250.00"	"41,730.00"	"65,520.00"
69950	"VESTIBULAR NERVE SECTION, TRANSCRANIAL APPROACH"	"107,250.00"	"41,730.00"	"65,520.00"
69955	"TOTAL FACIAL NERVE DECOMPRESSION AND/OR REPAIR (MAY
INCLUDE GRAFT)"	"107,250.00"	"41,730.00"	"65,520.00"
69960	DECOMPRESSION INTERNAL AUDITORY CANAL	"104,130.00"	"46,800.00"	"57,330.00"
69970	"REMOVAL OF TUMOR, TEMPORAL BONE"	"90,675.00"	"41,535.00"	"49,140.00"
70010	"MYELOGRAPHY, BRAIN, INCLUDING SPINAL PUNCTURE AND
RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
70390	"SIALOGRAPHY; INCLUDING DUCT CATHETERIZATION AND
RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
71090	"INSERTION PACEMAKER, FLUOROSCOPY AND RADIOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
72240	"MYELOGRAPHY, SPINE, INCLUDING SPINAL PUNCTURE AND
RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
74300	"CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY, INTRAOPERATIVE, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
74328	"ENDOSCOPIC CATHETERIZATION OF THE BILIARY DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
74329	"ENDOSCOPIC CATHETERIZATION OF THE PANCREATIC DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
74330	"COMBINED ENDOSCOPIC CATHETERIZATION OF THE BILIARY AND PANCREATIC DUCTAL SYSTEM, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
74340	"INTRODUCTION OF LONG GASTROINTESTINAL TUBE (E.G., MILLER- ABBOTT ), RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
74350	"PERCUTANEOUS PLACEMENT OF GASTROSTOMY TUBE,
RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
74355	"PERCUTANEOUS PLACEMENT OF ENTEROCLYSIS TUBE,
RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
74360	"INTRALUMINAL DILATION OF STRICTURES AND/OR
OBSTRUCTIONS, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
74363	"PERCUTANEOUS TRANSHEPATIC DILATION OF SBILIARY DUCT STRICTURE, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"35,100.00"	"18,720.00"	"16,380.00"
74475	"INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PERCUTANEOUS, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"35,100.00"	"18,720.00"	"16,380.00"
74480	"INTRODUCTION OF URETERAL CATHETER OR STENT INTO URETER THROUGH RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PERCUTANEOUS, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"35,100.00"	"18,720.00"	"16,380.00"
74742	"TRANSCERVICAL CATHETERIZATION OF FALLOPIAN TUBE,
RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
75600	"AORTOGRAPHY, THORACIC, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75625	"AORTOGRAPHY, ABDOMINAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75630	"AORTOGRAPHY, ABDOMINAL PLUS BILATERAL ILIOFEMORAL
LOWER EXTREMITY, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75635	"COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMINAL AORTA
AND BILATERAL ILIOFEMORAL LOWER EXTREMITY, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75650	"ANGIOGRAPHY, CERVICOCEREBRAL, RADIOLOGICAL SUPERVISION
AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75658	"ANGIOGRAPHY, BRACHIAL RETROGRADE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75660	"ANGIOGRAPHY, EXTERNAL CAROTID, UNILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75662	"ANGIOGRAPHY, EXTERNAL CAROTID, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75665	"ANGIOGRAPHY, CEREBRAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75671	"ANGIOGRAPHY, CAROTID, CEREBRAL, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75676	"ANGIOGRAPHY, CAROTID, CERVICAL, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75680	"ANGIOGRAPHY, CAROTID, CERVICAL, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75685	"ANGIOGRAPHY, VERTEBRAL, CERVICAL AND/OR INTRACRANIAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75705	"ANGIOGRAPHY, SPINAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75710	"ANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75716	"ANGIOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75722	"ANGIOGRAPHY, RENAL, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75724	"ANGIOGRAPHY, RENAL, BILATERAL, RADIOLOGICAL SUPERVISION
AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75726	"ANGIOGRAPHY, VISCERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75731	"ANGIOGRAPHY, ADRENAL, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75733	"ANGIOGRAPHY, ADRENAL, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75736	"ANGIOGRAPHY, PELVIS, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75741	"ANGIOGRAPHY, PULMONARY, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75743	"ANGIOGRAPHY, PULMONARY, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75746	"ANGIOGRAPHY, PULMONARY, NONSELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75756	"ANGIOGRAPHY, INTERNAL MAMMARY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75757	"ANGIOGRAPHY, FLUORESCEIN (EYE)"	"6,825.00"	"5,850.00"	975.00
75790	"ANGIOGRAPHY, ARTERIOVENOUS SHUNT (E.G., DIALYSIS PATIENT), RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75801	"LYMPHANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75803	"LYMPHANGIOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75805	"LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, UNILATERAL ,
RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75807	"LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, BILATERAL,
RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75810	"SPLENOPORTOGRAPHY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75820	"VENOGRAPHY, EXTREMITY, UNILATERAL OR BILATERAL,
RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75825	"VENOGRAPHY, CAVAL, INFERIOR, RADIOLOGICAL SUPERVISION
AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75827	"VENOGRAPHY, CAVAL, SUPERIOR, RADIOLOGICAL SUPERVISION
AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75831	"VENOGRAPHY, RENAL, UNILATERAL, RADIOLOGICAL SUPERVISION
AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75833	"VENOGRAPHY, RENAL, BILATERAL, RADIOLOGICAL SUPERVISION
AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75840	"VENOGRAPHY, ADRENAL, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75842	"VENOGRAPHY, ADRENAL, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75860	"VENOGRAPHY, VENOUS SINUS(E.G., PETROSAL AND INFERIOR SAGITTAL) OR JUGULAR, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75870	"VENOGRAPHY, SUPERIOR SAGITTAL SINUS, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75872	"VENOGRAPHY, EPIDURAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75880	"VENOGRAPHY, ORBITAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75885	"PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"25,155.00"	"12,870.00"	"12,285.00"
75889	"HEPATIC VENOGRAPHY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"25,155.00"	"12,870.00"	"12,285.00"
75900	"EXCHANGED OF A PREVIOUSLY PLACED INTRAVASCULAR CATHETER DURING THROMBOLYTIC THERAPY WITH CONTRAST MONITORING, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"59,085.00"	"26,325.00"	"32,760.00"
75901	"MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTIVE MATERIAL (E.G., FIBRIN SHEATH) FROM CENTRAL VENOUS DEVICE VIA SEPARATE VENOUS ACCESS, RADIOLOGIC SUPERVISION AND
INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75902	"MECHANICAL REMOVAL OF INTRALUMINAL (INTRACATHETER) OBSTRUCTIVE MATERIAL FROM CENTRAL VENOUS DEVICE THROUGH DEVICE LUMEN, RADIOLOGIC SUPERVISION AND
INTERPRETATION"	"18,915.00"	"10,725.00"	"8,190.00"
75940	"PERCUTANEOUS PLACEMENT OF IVC FILTER, RADIOLOGIC
SUPERVISION AND INTERPRETATION"	"45,435.00"	"20,865.00"	"24,570.00"
75945	"INTRAVASCULAR ULTRASOUND (NON-CORONARY-VESSEL), RADIOLOGICAL SUPERVISION AND INTERPRETATION; INITIAL
VESSEL"	"18,915.00"	"10,725.00"	"8,190.00"
75952	"ENDOVASCULAR REPAIR OF INFRARENAL ABDOMINAL AORTIC ANEURYSM OR DISSECTION, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"104,130.00"	"46,800.00"	"57,330.00"
75953	"PLACEMENT OF PROXIMAL OR DISTAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAIR OF INFRARENAL AORTIC OR ILIAC ARTERY ANEURYSM,  PSEUDOANUERYSM, OR DISSECTION, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"107,250.00"	"41,730.00"	"65,520.00"
75954	"ENDOVASCULAR REPAIR OF ILIAC ARTERY ANEURYSM, PSEUDOANEURYSM, ARTERIOVENOUS MALFORMATION, OR TRAUMA, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"104,130.00"	"46,800.00"	"57,330.00"
75956	"ENDOVASCULAR REPAIR OF DESCENDING THORACIC AORTA (E.G., ANEURYSM, PSUEDOANEURYSM, DISSECTION, PENETRATING ULCER, INTRAMURAL HEMATOMA, OR TRAUMATIC  DISRUPTION); INVOLVING COVERAGE OF LEFT SUBCLAVIAN ARTERY ORIGIN, INITIAL ENDOPROSTHESIS PLUS
DESCENDING TH"	"107,250.00"	"41,730.00"	"65,520.00"
75957	"ENDOVASCULAR REPAIR OF DESCENDING THORACIC AORTA (E.G., ANEURYSM, PSUEDOANEURYSM, DISSECTION, PENETRATING ULCER, INTRAMURAL HEMATOMA, OR TRAUMATIC  DISRUPTION); NOT INVOLVING COVERAGE OF LEFT SUBCLAVIAN ARTERY ORIGIN, INITIAL ENDOPROSTHESIS PLUS DESCENDIN"	"104,130.00"	"46,800.00"	"57,330.00"
75958	"PLACEMENT OF PROXIMAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAIR OF DESCENDING THORACIC AORTA (E.G., ANEURYSM, PSEUDOANEURYSM, DISSECTION, PENETRATING ULCER, INTRAMURAL HEMATOMA, OR TRAUMATIC DISRUPTION), RADIOLOGIC SUPERVISION AND INTERPRETATION"	"107,250.00"	"41,730.00"	"65,520.00"
75959	"PLACEMENT OF DISTAL EXTENSION PROSTHESIS(S) (DELAYED) AFTER ENDOVASCULAR REPAIR OF DESCENDING THORACIC AORTA, AS NEEDED, TO LEVEL OF CELIAC ORIGIN, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"107,250.00"	"41,730.00"	"65,520.00"
75960	"TRANSCATHETER INDUCTION OF INTRAVASCULAR STENT(S), (EXCEPT CORONARY, CAROTID, AND VERTEBRAL VESSEL), PERCUTANEOUS AND/ OR OPEN, RADIOLOGICAL SUPERVISION
AND INTERPRETATION"	"90,675.00"	"41,535.00"	"49,140.00"
75961	"TRANSCATHETER  RETRIEVAL, PERCUTANEOUS, OF INTRAVASCULAR FOREIGN BODY (E.G., FRACTURED VENOUS OR ARTERIAL CATHETER), RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"90,675.00"	"41,535.00"	"49,140.00"
75962	"TRANSLUMINAL BALLOON ANGIOPLASTY, PERIPHERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"45,435.00"	"20,865.00"	"24,570.00"
75966	"TRANSLUMINAL BALLOON ANGIOPLASTY, RENAL OR OTHER
VISCERAL ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"45,435.00"	"20,865.00"	"24,570.00"
75970	"TRANSCATHETER BIOPSY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"45,435.00"	"20,865.00"	"24,570.00"
75978	"TRANSLUMINAL BALLOON ANGIOPLASTY, VENOUS (E.G., SUBCLAVIAN STENOSIS) RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"45,435.00"	"20,865.00"	"24,570.00"
75980	"PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE WITH CONTRAST MONITORING, RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"73,710.00"	"32,760.00"	"40,950.00"
75982	"PERCUTANEOUS PLACEMENT OF DRAINAGECATHETER COMBINED INTERNAL AND EXTERNAL BILLIARY DRAINAGE OR OF A DRAINAGE STENT FOR INTERNAL BILLIARY DRAINAGE IN PATIENTS WITH AN INOPERABLE MECHANICAL BILLIARY OBSTRUCTION, RADIOLOGIC SUPERVISION AND INTERPRETATION."	"90,675.00"	"41,535.00"	"49,140.00"
75984	"CHANGE OF PERCUTANEOUS TUBE OR DRAINAGE  CATHETER WITH CONTRAST MONITORING (E.G., GASTROINTESTINAL SYSTEM, GENITOURINARY SYSTEM, ABSCESS),  RADIOLOGIC SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
75989	"RADIOLOGICAL GUIDANCE FOR PERCUTANEOUS DRAINAGE (ABSCESS, CYST, FLUID COLLECTION), WITH PLACEMENT OF CATHETER AND RADIOLOGICAL SUPERVISION AND
INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
75992	"TRANSLUMINAL ATHERECTOMY, PERIPHERAL ARTERY,
RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"45,435.00"	"20,865.00"	"24,570.00"
75994	"TRANSLUMINAL ATHERECTOMY, RENAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"45,435.00"	"20,865.00"	"24,570.00"
75995	"TRANSLUMINAL ATHERECTOMY, VISCERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"45,435.00"	"20,865.00"	"24,570.00"
76003	"FLUOROSCOPIC GUIDANCE FOR NEEDLE PLACEMENT (E.G.,
BIOPSY, ASPIRATION, INJECTION, LOCALIZATION DEVICE)"	"15,639.00"	"10,725.00"	"4,914.00"
76012	"RADIOLOGICAL SUPERVISION AND INTERPRETATION, PERCUTANEOUS VERTEBROPLASTY OR VERTEBRAL AUGMENTATION INCLUDING CAVITY CREATION; UNDER
FLUOROSCOPIC GUIDANCE"	"59,085.00"	"26,325.00"	"32,760.00"
76013	"RADIOLOGICAL SUPERVISION AND INTERPRETATION, PERCUTANEOUS VERTEBROPLASTY OR VERTEBRAL AUGMENTATION INCLUDING CAVITY CREATION; UNDER CT
GUIDANCE"	"59,085.00"	"26,325.00"	"32,760.00"
76080	"RADIOLOGIC EXAMINATION, ABSCESS, FISTULA OR SINUS TRACT
STUDY, INCLUDING CATHETERIZATION OF LESION AND RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
76086	"MAMMARY DUCTOGRAM OR GALACTOGRAM, 1 OR MULTIPLE
DUCT, INJECTION AND RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
76095	"STEREOTACTIC LOCALIZATION GUIDANCE FOR BREAST BIOPSY OR NEEDLE PLACEMENT (E.G.,  FOR WIRE LOCALIZATION OR FOR INJECTION), ONE OR MORE LESION, RADIOLOGICAL SUPERVISION
AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
76096	"MAMMOGRAPHIC GUIDANCE FOR NEEDLE PLACEMENT, BREAST (E.G.,  FOR WIRE LOCALIZATION OR FOR INJECTION), EACH LESION, RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
76355	"COMPUTED TOMOGRAPHY GUIDANCE FOR STEREOTACTIC
LOCALIZATION"	"15,639.00"	"10,725.00"	"4,914.00"
76360	"COMPUTED TOMOGRAPHY GUIDANCE FOR NEEDLE PLACEMENT (E.G., BIOPSY, ASPIRATION, INJECTION, LOCALIZATION DEVICE), RADIOLOGICAL SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
76362	"COMPUTED TOMOGRAPHY GUIDANCE FOR VISCERAL TISSUE
ABLATION"	"15,639.00"	"10,725.00"	"4,914.00"
76393	"MAGNETIC RESONANCE GUIDANCE FOR NEEDLE PLACEMENT (E.G., FOR BIOPSY, NEEDLE ASPIRATION, INJECTION, OR PLACEMENT OF LOCALIZATION DEVICE) RADIOLOGICAL
SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
76394	"MAGNETIC RESONANCE GUIDANCE FOR VISCERAL TISSUE
ABLATION"	"15,639.00"	"10,725.00"	"4,914.00"
76930	"ULTRASONIC GUIDANCE FOR PERICARDIOCENTESIS, IMAGING
SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
76932	"ULTRASONIC GUIDANCE FOR ENDOMYOCARDIAL BIOPSY,
IMAGING SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
76936	"ULTRASOUND GUIDED COMPRESSION REPAIR OF ARTERIAL PSEUDOANEURYSM OR ARTERIOVENOUS FISTULAE (INCLUDES DIAGNOSTIC ULTRASOUND EVALUATION, COMPRESSION OF
LESION AND IMAGING)"	"15,639.00"	"10,725.00"	"4,914.00"
76940	ULTRASONIC GUIDANCE FOR VISCERAL TISSUE ABLATION	"15,639.00"	"10,725.00"	"4,914.00"
76942	"ULTRASONIC GUIDANCE FOR NEEDLE PLACEMENT (E.G., BIOPSY,
ASPIRATION, INJECTION, LOCALIZATION DEVICE), IMAGING SUPERVISION AND INTERPRETATION"	"15,639.00"	"10,725.00"	"4,914.00"
76965	"ULTRASONIC GUIDANCE FOR INTERSTITIAL RADIOELEMENT
APPLICATION"	"15,639.00"	"10,725.00"	"4,914.00"
76986	"ULTRASONIC GUIDANCE, INTRAOPERATIVE"	"15,639.00"	"10,725.00"	"4,914.00"
77261	"THERAPEUTIC RADIOLOGY TREATMENT PLANNING; SIMPLE,
INTERMEDIATE OR COMPLEX, (ONLY ONE MAY BE REPORTED FOR A GIVEN COURSE OF THERAPY)"	"35,100.00"	"18,720.00"	"16,380.00"
77401	RADIATION TREATMENT DELIVERY (LINEAR ACCELERATOR)	"5,850.00"	"4,290.00"	"1,560.00"
77401	RADIATION TREATMENT DELIVERY (COBALT)	"3,900.00"	"2,340.00"	"1,560.00"
77418	"INTENSITY MODULATED TREATMENT DELIVERY, SINGLE OR MULTIPLE FIELDS/ARCS, VIA NARROW SPATIALLY AND TEMPORALLY MODULATED BEAMS, BINARY, DYNAMIC MLC PER
SESSION"	"11,076.00"	"7,800.00"	"3,276.00"
77421	STEREOSCOPIC X-RAY GUIDANCE FOR LOCALIZATION OF TARGET VOLUME FOR THE DELIVERY OF RADIATION THERAPY	"59,085.00"	"26,325.00"	"32,760.00"
77432	"STEREOTACTIC RADIATION TREATMENT MANAGEMENT  OF
CEREBRAL LESION(S)"	"59,085.00"	"26,325.00"	"32,760.00"
77600	"HYPERTHERMIA FOR TREATMENT OF MALIGNANCY, ONE OR MORE SESSIONS DURING THE COURSE OF THERAPY INCLUDING FOLLOW-UP CARE FOR 90 DAYS AFTER PROCEDURE"	"23,634.00"	"10,530.00"	"13,104.00"
77750	INFUSION OR INSTILLATION OF RADIOELEMENT SOLUTION	"11,076.00"	"7,800.00"	"3,276.00"
77761	"INTRACAVITARY RADIATION SOURCE APPLICATION, 1 OR MORE SOURCES/RIBBONS (BRACHYTHERAPY), ONE OR MORE SESSIONS DURING THE COURSE OF THERAPY INCLUDING FOLLOW-UP CARE FOR 90 DAYS AFTER PROCEDURE"	"35,100.00"	"18,720.00"	"16,380.00"
77776	"INTERSTITIAL RADIATION SOURCE APPLICATION, 1 OR MORE SOURCES/RIBBONS (BRACHYTHERAPY), ONE OR MORE SESSIONS DURING THE COURSE OF THERAPY INCLUDING FOLLOW-UP CARE FOR 90 DAYS AFTER PROCEDURE"	"35,100.00"	"18,720.00"	"16,380.00"
77781	"REMOTE AFTER LOADING HIGH INTENSITY BRACHYTHERAPY
(RAHIB); 1 OR MORE SOURCE POSITION OR CATHETERS PER SESSION"	"11,076.00"	"7,800.00"	"3,276.00"
77789	"SURFACE APPLICATION OF RADIATION SOURCE (BRACHYTHERAPY), ONE OR MORE SESSIONS DURING THE COURSE OF THERAPY INCLUDING FOLLOW-UP CARE FOR 90 DAYS
AFTER PROCEDURE"	"18,915.00"	"10,725.00"	"8,190.00"
79000	RADIOPHARMACEUTICAL (RADIOACTIVE IODINE) THERAPY	"7,098.00"	"5,460.00"	"1,638.00"
79005	RADIOPHARMACEUTICAL ABLATION OF GLAND FOR THYROID CARCINOMA OR METASTASES OF THYROID CARCINOMA	"15,639.00"	"10,725.00"	"4,914.00"
79200	"RADIOPHARMACEUTICAL THERAPY, BY INTRACAVITARY
ADMINISTRATION"	"18,915.00"	"10,725.00"	"8,190.00"
79300	"RADIOPHARMACEUTICAL THERAPY, BY INTERSTITIAL
RADIOACTIVE COLLOID ADMINISTRATION"	"18,915.00"	"10,725.00"	"8,190.00"
79403	"RADIOPHARMACEUTICAL THERAPY, BY RADIOLABELED
MONOCLONAL ANTIBODY BY INTRAVENOUS INFUSION"	"15,639.00"	"10,725.00"	"4,914.00"
79440	"RADIOPHARMACEUTICAL THERAPY, BY INTRA-ARTICULAR
ADMINISTRATION"	"15,639.00"	"10,725.00"	"4,914.00"
79445	"RADIOPHARMACEUTICAL THERAPY, BY INTRA-ARTERIAL
PARTICULATE ADMINISTRATION"	"15,639.00"	"10,725.00"	"4,914.00"
87207	OUTPATIENT MALARIA PACKAGE	"1,170.00"	"1,170.00"	-
88174	"EVALUATION OF ASPIRATE (CT-GUIDED BIOPSY) WITH OR WITHOUT PREPARATION OF SMEARS; IMMEDIATE CYTOLOGIC STUDY TO DETERMINE ADEQUACY OF SPECIMEN(S),
INTERPRETATION AND REPORT"	"11,076.00"	"7,800.00"	"3,276.00"
88331	"PATHOLOGY CONSULTATION DURING SURGERY; WITH FROZEN
SECTION(S), SINGLE BLOCK"	"11,076.00"	"7,800.00"	"3,276.00"
88332	"PATHOLOGY CONSULTATION DURING SURGERY; WITH FROZEN
SECTION(S), TWO (2) OR MORE BLOCKS"	"18,915.00"	"10,725.00"	"8,190.00"
89221	"DIRECTLY OBSERVED TREATMENT SHORT-COURSE; INTENSIVE
PHASE"	"4,875.00"	"4,875.00"	-
89222	"DIRECTLY OBSERVED TREATMENT SHORT-COURSE;
MAINTENANCE PHASE"	"2,925.00"	"2,925.00"	-
90375	ANIMAL BITE TREATMENT (ABT) PACKAGE	"5,850.00"	"5,850.00"	-
90945	"DIALYSIS PROCEDURE OTHER THAN HEMODIALYSIS (E.G.
PERITONEAL, HEMOFILTRATION)"	"5,070.00"	"4,387.50"	682.50
91034	"ESOPHAGUS, GASTROESOPHAGEAL REFLUX TEST; WITH NASAL
CATHETER PH ELECTRODE(S) PLACEMENT, RECORDING, ANALYSIS AND INTERPRETATION"	"16,107.00"	"9,555.00"	"6,552.00"
91037	"ESOPHAGEAL FUNCTION TEST, GASTROESOPHAGEAL REFLUX TEST WITH NASAL CATHETER INTRALUMINAL IMPEDANCE ELECTRODE(S) PLACEMENT, RECORDING, ANALYSIS AND
INTERPRETATION;"	"16,107.00"	"9,555.00"	"6,552.00"
91100	"INTESTINAL BLEEDING TUBE, PASSAGE, POSITIONING AND
MONITORING"	"16,107.00"	"9,555.00"	"6,552.00"
91105	"GASTRIC INTUBATION, AND ASPIRATION OR LAVAGE FOR
TREATMENT  (E.G., FOR INGESTED POISONS)"	"16,107.00"	"9,555.00"	"6,552.00"
92973	PERCUTANEOUS TRANSLUMINAL CORONARY THROMBECTOMY	"59,085.00"	"26,325.00"	"32,760.00"
92975	"THROMBOLYSIS, CORONARY; BY INTRACORONARY INFUSION,
INCLUDING CORONARY ANGIOGRAPHY"	"45,435.00"	"20,865.00"	"24,570.00"
92980	"TRANSCATHETER PLACEMENT OF AN INTRACORONARY STENT(S), PERCUTANEOUS, WITH OR WITHOUT OTHER THERAPEUTIC INTERVENTIONS, ANY METHOD; SINGLE VESSEL"	"59,085.00"	"26,325.00"	"32,760.00"
92981	"TRANSCATHETER PLACEMENT OF AN INTRACORONARY STENT(S), PERCUTANEOUS, WITH OR WITHOUT OTHER THERAPEUTIC INTERVENTIONS, ANY METHOD; EACH ADDITIONAL VESSEL"	"59,085.00"	"26,325.00"	"32,760.00"
92982	"PERCUTANEOUS TRANSLUMINAL CORONARY BALLOON
ANGIOPLASTY, ONE OR MORE VESSEL"	"59,085.00"	"26,325.00"	"32,760.00"
92986	PERCUTANEOUS BALLOON VALVULOPLASTY; AORTIC	"104,130.00"	"46,800.00"	"57,330.00"
92987	PERCUTANEOUS BALLOON VALVULOPLASTY; MITRAL	"104,130.00"	"46,800.00"	"57,330.00"
92990	PERCUTANEOUS BALLOON VALVULOPLASTY; PULMONARY VALVE	"104,130.00"	"46,800.00"	"57,330.00"
92992	"ATRIAL SEPTECTOMY OR SEPTOSTOMY; TRANSVENOUS METHOD, BALLOON (E.G., RASHKIND TYPE) (INCLUDES CARDIAC
CATHETERIZATION)"	"41,730.00"	"21,255.00"	"20,475.00"
92993	ATRIAL SEPTECTOMY OR SEPTOSTOMY; BLADE METHOD (PARK SEPTOSTOMY) (INCLUDES CARDIAC CATHETERIZATION)	"41,730.00"	"21,255.00"	"20,475.00"
92995	"PERCUTANEOUS TRANSLUMINAL CORONARY ATHERECTOMY, BY MECHANICAL OR OTHER METHOD, WITH OR WITHOUT BALLOON ANGIOPLASTY, ONE OR MORE VESSEL"	"59,085.00"	"26,325.00"	"32,760.00"
92997	"PERCUTANEOUS TRANSLUMINAL PULMONARY BALLOON
ANGIOPLASTY, ONE OR MORE VESSEL"	"25,155.00"	"12,870.00"	"12,285.00"
93501	RIGHT HEART CATHETERIZATION	"35,100.00"	"18,720.00"	"16,380.00"
93503	"INSERTION AND PLACEMENT OF FLOW DIRECTED CATHETER (E.G., SWAN-GANZ) FOR MONITORING PURPOSES"	"18,915.00"	"10,725.00"	"8,190.00"
93505	ENDOMYOCARDIAL BIOPSY	"45,435.00"	"20,865.00"	"24,570.00"
93508	"CATHETER PLACEMENT IN CORONARY ARTERY(S), ARTERIAL CORONARY CONDUITS AND/OR VENOUS CORONARY BYPASS GRAFTS FOR CORONARY ANGIOGRAPHY WITHOUT CONCOMITANT LEFT HEART CATHETERIZATION"	"18,915.00"	"10,725.00"	"8,190.00"
93510	"LEFT HEART CATHETERIZATION, RETROGRADE, FROM THE BRACHIAL ARTERY, AXILLARY ARTERY OR FEMORAL ARTERY;
PERCUTANEOUS"	"35,100.00"	"18,720.00"	"16,380.00"
93511	"LEFT HEART CATHETERIZATION, RETROGRADE, FROM THE BRACHIAL ARTERY, AXILLARY ARTERY OR FEMORAL ARTERY; BY
CUTDOWN"	"35,100.00"	"18,720.00"	"16,380.00"
93514	"LEFT HEART CATHETERIZATION BY LEFT VENTRICULAR
PUNCTURE"	"35,100.00"	"18,720.00"	"16,380.00"
93524	"COMBINED TRANSSEPTAL AND RETROGRADE LEFT HEART
CATHETERIZATION"	"45,435.00"	"20,865.00"	"24,570.00"
93526	"COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE
LEFT HEART CATHETERIZATION"	"45,435.00"	"20,865.00"	"24,570.00"
93527	"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH INTACT SEPTUM (WITH OR WITHOUT RETROGRADE LEFT HEART
CATHETERIZATION)"	"45,435.00"	"20,865.00"	"24,570.00"
93528	"COMBINED RIGHT HEART CATHETERIZATION WITH LEFT VENTRICULAR PUNCTURE (WITH OR WITHOUT RETROGRADE
LEFT HEART CATHETERIZATION)"	"45,435.00"	"20,865.00"	"24,570.00"
93529	COMBINED RIGHT HEART CATHETERIZATION AND LEFT HEART CATHETERIZATION  THROUGH EXISTING SEPTAL OPENING (WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION)	"45,435.00"	"20,865.00"	"24,570.00"
93530	"RIGHT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC
ANOMALIES"	"35,100.00"	"18,720.00"	"16,380.00"
93531	"COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC
ANOMALIES"	"45,435.00"	"20,865.00"	"24,570.00"
93532	"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH INTACT SEPTUM WITH OR WITHOUT RETROGRADE LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES"	"18,915.00"	"10,725.00"	"8,190.00"
93533	"COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION THROUGH EXISTING SEPTAL OPENING, WITH OR WITHOUT  RETROGRADE  LEFT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES"	"18,915.00"	"10,725.00"	"8,190.00"
93539	"INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION; FOR SELECTIVE OPACIFICATION OF ARTERIAL CONDUITS (E.G., INTERNAL MAMMARY), WHETHER NATIVE OR USED BYPASS"	"18,915.00"	"10,725.00"	"8,190.00"
93540	"INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION; FOR SELECTIVE OPACIFICATION OF AORTOCORONARY VENOUS BYPASS GRAFTS, ONE OR MORE CORONARY ARTERIES"	"18,915.00"	"10,725.00"	"8,190.00"
93541	"INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION;
FOR PULMONARY ANGIOGRAPHY"	"18,915.00"	"10,725.00"	"8,190.00"
93542	"INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION; FOR SELECTIVE RIGHT  VENTRICULAR OR RIGHT ATRIAL
ANGIOGRAPHY"	"18,915.00"	"10,725.00"	"8,190.00"
93543	INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION; FOR SELECTIVE CORONARY ANGIOGRAPHY (INJECTION OF RADIOPAQUE MATERIAL MAY BE BY HAND)	"18,915.00"	"10,725.00"	"8,190.00"
93544	"INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION;
FOR AORTOGRAPHY"	"45,435.00"	"20,865.00"	"24,570.00"
93545	INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION; FOR SELECTIVE CORONARY ANGIOGRAPHY (INJECTION OF RADIOPAQUE MATERIAL MAY BE BY HAND)	"18,915.00"	"10,725.00"	"8,190.00"
93555	"IMAGING SUPERVISION, INTERPRETATION AND REPORT FOR INJECTION PROCEDURE(S) DURING CARDIAC CATHETERIZATION; VENTRICULAR AND/OR ATRIAL ANGIOGRAPHY"	"18,915.00"	"10,725.00"	"8,190.00"
93556	"IMAGING SUPERVISION, INTERPRETATION AND REPORT FOR INJECTION PROCEDURE(S) DURING CARDIAC CATHETERIZATION; PULMONARY ANGIOGRAPHY, AORTOGRAPHY, AND/OR SELECTIVE CORONARY ANGIOGRAPHY INCLUDING VENOUS BYPASS GRAFTS AND ARTERIAL CONDUITS (WHETHER NATIVE OR USE"	"18,915.00"	"10,725.00"	"8,190.00"
93580	"PERCUTANEOUS TRANSCATHETER CLOSURE OF CONGENITAL INTERATRIAL COMMUNICATIONS (I.E., FONTAN FENESTRATION, ATRIAL SEPTAL DEFECT) WITH IMPLANT"	"107,250.00"	"41,730.00"	"65,520.00"
93581	PERCUTANEOUS TRANSCATHETER CLOSURE OF CONGENITAL VENTRICULAR SEPTAL DEFECT WITH IMPLANT	"107,250.00"	"41,730.00"	"65,520.00"
93600	BUNDLE OF HIS RECORDING	"18,915.00"	"10,725.00"	"8,190.00"
93602	INTRA-ATRIAL RECORDING	"18,915.00"	"10,725.00"	"8,190.00"
93603	RIGHT VENTRICULAR RECORDING	"18,915.00"	"10,725.00"	"8,190.00"
93610	INTRA-ATRIAL PACING	"18,915.00"	"10,725.00"	"8,190.00"
93612	INTRAVENTRICULAR PACING	"18,915.00"	"10,725.00"	"8,190.00"
93615	"ESOPHAGEAL RECORDING OF ATRIAL ELECTROGRAM  WITH OR
WITHOUT VENTRICULAR ELECTROGRAM(S);"	"18,915.00"	"10,725.00"	"8,190.00"
93616	ESOPHAGEAL RECORDING OF ATRIAL ELECTROGRAM  WITH OR WITHOUT VENTRICULAR ELECTROGRAM(S); WITH PACING	"18,915.00"	"10,725.00"	"8,190.00"
93618	INDUCTION OF ARRHYTHMIA BY ELECTRICAL PACING	"18,915.00"	"10,725.00"	"8,190.00"
93619	"COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH RIGHT ATRIAL PACING AND RECORDING, RIGHT VENTRICULAR PACING AND RECORDING, HIS BUNDLE RECORDING, INCLUDING INSERTION AND REPOSITIONING OF MULTIPLE ELECTRODE CATHETERS, WITHOUT INDUCTION OF ARRHYTHMIA"	"18,915.00"	"10,725.00"	"8,190.00"
93620	"COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION INCLUDING INSERTION AND REPOSITIONING OF MULTIPLE ELECTRODE CATHETERS WITH INDUCTION OR ATTEMPTED INDUCTION OF ARRHYTHMIA; WITH RIGHT ATRIAL PACING AND
RECORDING, HIS BUNDLE RECORDING"	"18,915.00"	"10,725.00"	"8,190.00"
93624	"ELECTROPHYSIOLOGIC FOLLOW-UP STUDY WITH PACING AND RECORDING TO TEST EFFECTIVENESS OF THERAPY, INCLUDING INDUCTION OR ATTEMPTED INDUCTION OF ARRHYTHMIA"	"18,915.00"	"10,725.00"	"8,190.00"
93631	INTRA-OPERATIVE EPICARDIAL AND ENDOCARDIAL PACING AND MAPPING TO LOCALIZE THE SITE TACHYCARDIA OR ZONE OF SLOW CONDUCTION FOR SURGICAL CORRECTION	"18,915.00"	"10,725.00"	"8,190.00"
93640	"ELECTROPHYSIOLOGIC EVALUATION OF SINGLE OR DUAL CHAMBER PACING CARDIOVERTER-DEFIBRILLATOR LEADS INCLUDING DEFIBRILLATION THRESHOLD EVALUATION (INDUCTION OF ARRHYTHMIA, EVALUATION OF SENSING AND PACING FOR ARRHYTHMIA TERMINATION) AT TIME OF INITIAL
IMPLANT"	"18,915.00"	"10,725.00"	"8,190.00"
93641	"ELECTROPHYSIOLOGIC EVALUATION OF SINGLE OR DUAL CHAMBER PACING CARDIOVERTER-DEFIBRILLATOR LEADS INCLUDING DEFIBRILLATION THRESHOLD EVALUATION (INDUCTION OF ARRHYTHMIA, EVALUATION OF SENSING AND PACING FOR ARRHYTHMIA TERMINATION) AT TIME OF INITIAL
IMPLANT"	"18,915.00"	"10,725.00"	"8,190.00"
93642	"ELECTROPHYSIOLOGIC EVALUATION OF SINGLE OR DUAL CHAMBER PACING CARDIOVERTER-DEFIBRILLATOR (INCLUDES DEFIBRILLATION THRESHOLD EVALUATION, INDUCTION OF ARRHYTHMIA, EVALUATION OF SENSING AND PACING FOR ARRHYTHMIA TERMINATION, AND PROGRAMMING OR
REPROGRAMMING"	"18,915.00"	"10,725.00"	"8,190.00"
93650	"INTRACARDIAC CATHETER ABLATION OF ATRIOVENTRICULAR NODE FUNCTION, ATRIOVENTRICULAR CONDUCTION FOR CREATION OF COMPLETE HEART BLOCK, WITH OR WITHOUT TEMPORARY PACEMAKER PLACEMENT"	"18,915.00"	"10,725.00"	"8,190.00"
93651	"INTRACARDIAC CATHETER ABLATION OF ARRHYTHMOGENIC FOCUS; FOR TREATMENT OF SUPRAVENTRICULAR TACHYCARDIA BY ABLATION OF FAST OR SLOW ATRIOVENTRICULAR PATHWAYS, ACCESSORY ATRIOVENTRICULAR CONNECTIONS OR OTHER ATRIAL FOCI, SINGLY OR IN COMBINATION"	"18,915.00"	"10,725.00"	"8,190.00"
93652	INTRACARDIAC CATHETER ABLATION OF ARRHYTHMOGENIC FOCUS; FOR  TREATMENT  OF VENTRICULAR TACHYCARDIA	"18,915.00"	"10,725.00"	"8,190.00"
93660	"EVALUATION OF CARDIOVASCULAR FUNCTION WITH TILT TABLE EVALUATION, WITH CONTINUOUS ECG MONITORING AND INTERMITTENT BLOOD PRESSURE MONITORING, WITH OR WITHOUT PHARMACOLOGICAL INTERVENTION"	"18,915.00"	"10,725.00"	"8,190.00"
96445	"CHEMOTHERAPY ADMINISTRATION INTO PERITONEAL CAVITY,
REQUIRING AND INCLUDING PERITONEOCENTESIS"	"15,639.00"	"10,725.00"	"4,914.00"
96450	"CHEMOTHERAPY ADMINISTRATION INTO CNS, REQUIRING AND
INCLUDING SPINAL PUNCTURE"	"10,842.00"	"8,385.00"	"2,457.00"
96542	"CHEMOTHERAPY INJECTION, SUBARACHNOID OR
INTERVENTRICULAR VIA SUBCUTANEOUS RESERVOIR"	"7,098.00"	"5,460.00"	"1,638.00"
96567	"PHOTODYNAMIC THERAPY BY EXTERNAL APPLICATION OF LIGHT TO DESTROY PREMALIGNANT AND/OR MALIGNANT LESIONS OF THE SKIN AND ADJACENT MUCOSA (E.G., LIP) BY ACTIVATION OF PHOTOSENSITIVE DRUG(S), 1 OR MORE PHOTOTHERAPY
EXPOSURE SESSION"	"15,639.00"	"10,725.00"	"4,914.00"
99246	OUTPATIENT HIV / AIDS PACKAGES	"14,625.00"	"14,625.00"	-
99460	EXPANDED NEWBORN CARE PACKAGE	"5,752.50"	"4,774.50"	978.00
58300	INSERTION OF INTRAUTERINE DEVICE (IUD)	"3,900.00"	"2,340.00"	"1,560.00"
96408*	CHEMOTHERAPY ADMINISTRATION	"14,196.00"	"10,920.00"	"3,276.00"
96440*	"CHEMOTHERAPY ADMINISTRATION INTO PLEURAL CAVITY,
REQUIRING AND INCLUDING THORACENTESIS"	"10,842.00"	"8,385.00"	"2,457.00"
96408**	CHEMOTHERAPY ADMINISTRATION	"10,920.00"	"8,400.00"	"2,520.00"
96440**	"CHEMOTHERAPY ADMINISTRATION INTO PLEURAL CAVITY,
REQUIRING AND INCLUDING THORACENTESIS"	"8,340.00"	"6,450.00"	"1,890.00"
ANC01	ANTENATAL CARE PACKAGE	"2,925.00"	"1,755.00"	"1,170.00"
ANC02	"ANTENATAL CARE SERVICES WITH INTRAPARTUM MONITORING
OR LABOR WATCH (WITHOUT DELIVERY)"	"4,192.50"	"2,515.50"	"1,677.00"
FP001	SUBDERMAL CONTRACEPTIVE IMPLANT	"5,850.00"	"3,510.00"	"2,340.00"
MCP01	"ROUTINE OBSTETRIC CARE INCLUDING PRENATAL, DELIVERY AND NEWBORN SERVICES OF HOSPITAL FACILITIES (MATERNITY CARE
PACKAGE)"	"12,675.00"	"7,605.00"	"5,070.00"
NSD01	"ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM CARE, VAGINAL DELIVERY AND/OR POSTPARTUM CARE (NORMAL SPONTANEOUS DELIVERY PACKAGE) FOR HOSPITALS"	"9,750.00"	"5,850.00"	"3,900.00"
P0000	RESUSCITATION PACKAGE	"7,800.00"	"5,460.00"	"2,340.00"
P0001	REFERRAL PACKAGE	"7,800.00"	"5,460.00"	"2,340.00"