| Treatment Room - Negative Pressure Wound Therapy, Surface Area Less Than Or Equal To 50 Square Centimeters, Per Session (1002928) | $241.00 | N/A | |
| Treatment Room - Negative Pressure Wound Therapy, Surface Area Greater Than 50 Square Centimeters, Per Session (1002929) | $307.00 | N/A | |
| Treatment Room - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes (1028030) | $226.00 | N/A | |
| Treatment Room - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes (1004719) | $128.00 | N/A | |
| Treatment Room - Application Of Vein Wound Compression System Lower Leg Below Knee Including Ankle And Foot (1010224) | $301.00 | N/A | |
| Trauma Response - Full Trauma Activation (1027810) | $235.00 | N/A | |
| Therapeutic Services - Therapeutic Removal Of Whole Blood To Correct Blood Level Imbalance (1004588) | $249.00 | N/A | |
| Therapeutic Services - Irrigation Of Implanted Venous Access Drug Delivery Device (1004718) | $154.00 | N/A | |
| Telemedicine - Fee For Remote Healthcare Service (1009851) | $42.00 | N/A | |
| Speech Therapy - Treatment Of Swallowing Or Oral Feeding Function (1002861) | $268.00 | N/A | |
| Speech Therapy - Treatment Of Speech, Language, Voice, Communication, Or Hearing Processing Disorder, Individual (1002858) | $260.00 | N/A | |
| Speech Therapy - Standardized Thought Processing Testing With Interpretation And Report, Per Hour Of Qualified Professional Time (1006830) | $340.00 | N/A | |
| Speech Therapy - Fluoroscopic And Video Recorded Motion Evaluation Of Swallowing Function (1002872) | $268.00 | N/A | |
| Speech Therapy - Evaluation Of Swallowing Function (1002860) | $260.00 | N/A | |
| Speech Therapy - Evaluation Of Speech Sound Production (1021037) | $285.00 | N/A | |
| Room & Board - Private (1000439) | $1,670.00 | N/A | |
| Room & Board - Private (1004313) | $777.00 | N/A | |
| Room & Board - Post Icu Intensive Care (1000440) | $1,815.00 | N/A | |
| Room & Board - Other (1008187) | $564.00 | N/A | |
| Room & Board - Other (1004310) | $454.00 | N/A | |
| Room & Board - Nursery (1004623) | $1,128.00 | N/A | |
| Room & Board - Nursery (1004622) | $1,128.00 | N/A | |
| Room & Board - Nursery (1004624) | $978.00 | N/A | |
| Room & Board - Nursery (1000438) | $978.00 | N/A | |
| Room & Board - Intensive Care (1000441) | $2,486.00 | N/A | |
| Respiratory Services - Ventilation Management In Hospital - Initial Day (1003236) | $1,159.00 | N/A | |
| Respiratory Services - Test For Exercise-Induced Lung Stress (1027651) | $312.00 | N/A | |
| Respiratory Services - Suction Removal Of Secretions From The Nose And Throat (1008256) | $111.00 | N/A | |
| Respiratory Services - Resuscitation In Delivery Or Birthing Room (1021613) | $785.00 | N/A | |
| Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1009222) | $110.00 | N/A | |
| Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1006731) | $110.00 | N/A | |
| Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1009221) | $110.00 | N/A | |
| Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1004474) | $79.00 | N/A | |
| Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1006717) | $79.00 | N/A | |
| Respiratory Services - Procedure To Improve Lung Function, Each 15 Minutes (1007537) | $96.00 | N/A | |
| Respiratory Services - Physician Attendance At Delivery And Stabilization Of Newborn (1021614) | $368.00 | N/A | |
| Respiratory Services - Overnight Measurement Of Oxygen Saturation In Blood Using Ear Or Finger Device (1002093) | $296.00 | N/A | |
| Respiratory Services - Multiple Measurements Of Oxygen Saturation In Blood Using Ear Or Finger Device (1003249) | $28.00 | N/A | |
| Respiratory Services - Measurement Of Oxygen Saturation In Blood Using Ear Or Finger Device (1003265) | $19.00 | N/A | |
| Respiratory Services - Measurement And Graphic Recording Of Total And Timed Exhaled Air Capacity (1003239) | $215.00 | N/A | |
| Respiratory Services - Measurement And Graphic Recording Of The Amount And Speed Of Breathed Air, Before And Following Medication Administration (1001533) | $338.00 | N/A | |
| Respiratory Services - Manual Maneuvers To Chest Wall To Assist Movement Of Lung Secretions (1003254) | $118.00 | N/A | |
| Respiratory Services - Initiation And Management Of Continuous Positive Airway Pressure (Cpap) Assistance By Mask Or Breathing Tube (1004468) | $198.00 | N/A | |
| Respiratory Services - Initiation And Management Of Continuous Positive Airway Pressure (Cpap) Assistance By Mask Or Breathing Tube (1003262) | $198.00 | N/A | |
| Respiratory Services - Inhaled Pneumonia Treatment (1004609) | $179.00 | N/A | |
| Respiratory Services - Exercise Test For Spasm Of Lung Airways (1027650) | $290.00 | N/A | |
| Respiratory Services - Demonstration Or Evaluation Of Manual Maneuvers To Chest Wall To Assist Movement Of Lung Secretions (1003278) | $154.00 | N/A | |
| Respiratory Services - Application Of Electrical Stimulation To 1 Or More Areas, Each 15 Minutes (1004481) | $58.00 | N/A | |
| Recovery Room Additional (1004671) | $131.00 | N/A | |
| Recovery Room (1004670) | $1,241.00 | N/A | |
| Recovery - Post Anesthesia Services (1001874) | $27.00 | N/A | |
| Radiopharmaceuticals - Technetium Sulfur Colloid (Radioactive Imaging Agent) (1003542) | $339.00 | N/A | |
| Radiopharmaceuticals - Technetium Sestamibi (Radioactive Imaging Agent) (1003575) | $338.00 | N/A | |
| Radiopharmaceuticals - Technetium Pentetate (Radioactive Imaging Agent) (1010432) | $296.00 | N/A | |
| Radiopharmaceuticals - Technetium Mertiatide (Radioactive Imaging Agent) (1005454) | $741.00 | N/A | |
| Radiopharmaceuticals - Technetium Medronate (Radioactive Imaging Agent) (1009453) | $188.00 | N/A | |
| Radiopharmaceuticals - Technetium Mebrofenin (Radioactive Imaging Agent) (1005436) | $273.00 | N/A | |
| Radiopharmaceuticals - Technetium Macroaggregated Albumin (Radioactive Imaging Agent) (1005439) | $311.00 | N/A | |
| Radiopharmaceuticals - Fluorodeoxyglucose F-18 (Radioactive Imaging Agent) (1005446) | $2,098.00 | N/A | |
| Pulmonary Rehabilitation - Pulmonary Rehabilitation Sesstion Including Exercise (1010220) | $341.00 | N/A | |
| Professional Services - Vaginal Removal Of Uterus (1003057) | $82.00 | N/A | |
| Professional Services - Urinary System Procedure (1003044) | $82.00 | N/A | |
| Professional Services - Upper Arm Bone And Shoulder Joint Procedure (1003101) | $82.00 | N/A | |
| Professional Services - Upper Arm And Elbow Procedure (1003109) | $82.00 | N/A | |
| Professional Services - Upper And Lower Gastrointestinal Procedure (1027675) | $82.00 | N/A | |
| Professional Services - Upper Abdominal Procedure (1003017) | $82.00 | N/A | |
| Professional Services - Upper Abdominal Hernia Repair (1003012) | $82.00 | N/A | |
| Professional Services - Subsequent Hospital Inpatient Care, Typically 15 Minutes Per Day (1010862) | $113.00 | N/A | |
| Professional Services - Skin Of Arms, Legs Or Trunk Procedure (1002978) | $82.00 | N/A | |
| Professional Services - Repair Or Removal Of Vagina And Urethral Procedure (1003056) | $82.00 | N/A | |
| Professional Services - Repair Of Incisional Hernia Or Wound Opening (1003013) | $82.00 | N/A | |
| Professional Services - Removal Of Uterus (1003031) | $82.00 | N/A | |
| Professional Services - Relocation Of Undescended Testicle Into Scrotum (1003052) | $82.00 | N/A | |
| Professional Services - Nerve, Muscle Or Tendon Procedure Of Forearm, Wrist, And Hand (1003115) | $82.00 | N/A | |
| Professional Services - Middle Or Incisional Abdominal Hernia Repair (1003026) | $82.00 | N/A | |
| Professional Services - Male Genitalia Procedure (1003048) | $82.00 | N/A | |
| Professional Services - Lower Abdominal Hernia Repair (1003025) | $82.00 | N/A | |
| Professional Services - Lower Abdominal Cavity Procedure (1003029) | $82.00 | N/A | |
| Professional Services - Lens Surgery (1002955) | $82.00 | N/A | |
| Professional Services - Large Intestine Procedure (1027673) | $82.00 | N/A | |
| Professional Services - Labor During Planned Vaginal Delivery (1003134) | $82.00 | N/A | |
| Professional Services - Insertion Of Needle Into Vein, Patient 3 Years Or Older (1008501) | $82.00 | N/A | |
| Professional Services - Insertion Of Needle Into Upper Leg Or Neck Vein, Patient Younger Than 3 Years (1007824) | $82.00 | N/A | |
| Professional Services - Injection Of Substance Into Spinal Canal Of Lower Back Or Sacrum Using Imaging Guidance (1026832) | $82.00 | N/A | |
| Professional Services - Head And Neck Procedure (1002973) | $82.00 | N/A | |
| Professional Services - Exam Of Uterus With Endoscope (1003059) | $82.00 | N/A | |
| Professional Services - Emergent Insertion Of Breathing Tube Into Windpipe (1002947) | $82.00 | N/A | |
| Professional Services - Division Of Fallopian Tubes (1003032) | $82.00 | N/A | |
| Professional Services - Diagnostic Exam Of Upper Gastrointestinal System (1027669) | $82.00 | N/A | |
| Professional Services - Diagnostic Exam Of Large Intestine (1027674) | $82.00 | N/A | |
| Professional Services - Continuous Spinal Drug Administration (1004387) | $82.00 | N/A | |
| Professional Services - Closed Lower Leg, Ankle Or Foot Procedure (1003088) | $82.00 | N/A | |
| Professional Services - Cesarean Delivery Following Labor (1004385) | $82.00 | N/A | |
| Professional Services - Cesarean Delivery (1003132) | $82.00 | N/A | |
| Professional Services - Central Venous Access (1002992) | $82.00 | N/A | |
| Professional Services - Bone Procedure Of Lower Leg, Ankle And Foot (1003092) | $82.00 | N/A | |
| Professional Services - Bone Procedure Of Forearm, Wrist, Or Hand (1003117) | $82.00 | N/A | |
| Professional Services - Bone Procedure Of Forearm, Wrist, Or Hand (1003116) | $82.00 | N/A | |
| Professional Services - Biopsy Of Female Genitalia (1003055) | $82.00 | N/A | |
| Professional Services - Anal And Rectal Procedure (1003041) | $82.00 | N/A | |
| Professional Services - Abdominal Wall Procedure (1003009) | $82.00 | N/A | |
| Preventive Services - Administration Of Vaccine By Injection, Each Additional Vaccine (1008507) | $32.00 | N/A | |
| Preventive Services - Administration Of Vaccine By Injection, Each Additional Vaccine (1007693) | $32.00 | N/A | |
| Preventive Services - Administration Of Vaccine By Injection, 1 Vaccine (1004368) | $62.00 | N/A | |
| Preventive Services - Administration Of Vaccine By Injection, 1 Vaccine (1007692) | $62.00 | N/A | |
| Preventive Services - Administration Of Vaccine By Injection, 1 Vaccine (1011896) | $61.00 | N/A | |
| Physical Therapy - Water Pool Therapy With Therapeutic Exercises To 1 Or More Areas, Each 15 Minutes (1002903) | $120.00 | N/A | |
| Physical Therapy - Walking Training To 1 Or More Areas, Each 15 Minutes (1002904) | $99.00 | N/A | |
| Physical Therapy - Training In Use Of Prosthesis For Arms Or Legs, Per 15 Minutes (1002911) | $107.00 | N/A | |
| Physical Therapy - Therapeutic Procedure To Re-Educate Brain-To-Nerve-To-Muscle Function, Each 15 Minutes (1002902) | $111.00 | N/A | |
| Physical Therapy - Repositioning Maneuvers For Treatment Of Vertigo, Per Day (1009796) | $130.00 | N/A | |
| Physical Therapy - Re-Evaluation Of Physical Therapy, Typically 20 Minutes (1026788) | $148.00 | N/A | |
| Physical Therapy - Evaluation Of Physical Therapy, Typically 30 Minutes (1026786) | $204.00 | N/A | |
| Physical Therapy - Evaluation Of Physical Therapy, Typically 20 Minutes (1026785) | $204.00 | N/A | |
| Physical Therapy - Application Of Ultrasound To 1 Or More Areas, Each 15 Minutes (1002900) | $53.00 | N/A | |
| Physical Therapy - Application Of Medication Through Skin Using Electrical Current, Each 15 Minutes (1002897) | $64.00 | N/A | |
| Physical Therapy - Application Of Mechanical Traction To 1 Or More Areas (1002885) | $62.00 | N/A | |
| Physical Therapy - Application Of Electrical Stimulation To 1 Or More Areas, Unattended By Physical Therapist (1002886) | $45.00 | N/A | |
| Pathology - Special Stained Specimen Slides To Examine Tissue Including Interpretation And Report (Group I For Microorganisms) (1006359) | $375.00 | N/A | |
| Pathology - Special Stained Specimen Slides To Examine Tissue (Initial Single Slide Or Stain) (1006381) | $263.00 | N/A | |
| Pathology - Special Stained Specimen Slides To Examine Tissue (Each Additional Slide Or Stain) (1024653) | $224.00 | N/A | |
| Pathology - Preparation Of Tissue For Exam By Removing Any Calcium Present (1006358) | $132.00 | N/A | |
| Pathology - Pap Smear (Thin Layer Prep With Automated Screening And Manual Rescreening) (1006967) | $113.00 | N/A | |
| Pathology - Microscopic Genetic Analysis Of Tumor Specimen (Manual Tumor Immunohistochemistry) (1010667) | $461.00 | N/A | |
| Pathology - Level Vi Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or High Complexity) (1006357) | $1,796.00 | N/A | |
| Pathology - Level V Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or Moderately High Complexity) (1006356) | $1,150.00 | N/A | |
| Pathology - Level Iv Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or Intermediate Complexity) (1006355) | $294.00 | N/A | |
| Pathology - Level Iii Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or Moderatley Low Complexity) (1006354) | $175.00 | N/A | |
| Pathology - Level Ii Pathology Exam Of Tissue Using Visual Inspection And Microscopic Examination (Specimen Specific Or Low Complexity) (1006353) | $126.00 | N/A | |
| Pathology - Flow Cytometry For Dna Or Cell Analysis (Technical Component, First Marker) (1006317) | $281.00 | N/A | |
| Pathology - Flow Cytometry For Dna Or Cell Analysis (Technical Component, Each Additional Marker) (1006323) | $177.00 | N/A | |
| Pathology - Chromosome Analysis For Genetic Defects (Interphase Ish, Analyze 100 To 300 Cells) (1006348) | $237.00 | N/A | |
| Pathology - Chromosome Analysis For Genetic Defects (Each Dna Probe) (1006341) | $127.00 | N/A | |
| Pathology - Cellular Exam Of Specimen Using Concentration Technique (Smears) (1006417) | $277.00 | N/A | |
| Pathology - Cellular Exam Of Non-Gynecologic Specimen Using Cellular Enhancement Technique (1009034) | $274.00 | N/A | |
| Pathology - Cellular Exam Of Fine Needle Aspirate (Physician Interpretation And Report) (1006424) | $572.00 | N/A | |
| Operating Room - Umbilical Hernia (1002407) | $3,108.00 | N/A | |
| Operating Room - Tying Of Fallopian Tubes Using Endoscope (1001520) | $4,311.00 | N/A | |
| Operating Room - Tying Of Fallopian Tubes (1002380) | $3,350.00 | N/A | |
| Operating Room - Suspension Of Vaginal Tissue Using Tape (1005121) | $2,626.00 | N/A | |
| Operating Room - Skin Lesion (1002086) | $1,639.00 | N/A | |
| Operating Room - Scraping Of Uterine Tissue Using Endoscope (1020856) | $4,910.00 | N/A | |
| Operating Room - Repair Of Hernia Using Endoscope (1001515) | $6,089.00 | N/A | |
| Operating Room - Removal Of Uterus, Ovaries And Fallopian Tubes (1000464) | $4,853.00 | N/A | |
| Operating Room - Removal Of Uterus Using Endoscope (1001508) | $7,519.00 | N/A | |
| Operating Room - Removal Of Uterus Through Vagina (1002447) | $4,372.00 | N/A | |
| Operating Room - Removal Of Tissue (1001019) | $2,670.00 | N/A | |
| Operating Room - Removal Of Recurring Cataracts Using Laser (1004380) | $1,161.00 | N/A | |
| Operating Room - Removal Of Ovaries Using Endoscope (1006752) | $3,133.00 | N/A | |
| Operating Room - Removal Of Large Intestine Using Endoscope (1001502) | $7,013.00 | N/A | |
| Operating Room - Removal Of Growth From Breast (1000719) | $2,411.00 | N/A | |
| Operating Room - Removal Of Gallbladder Using Endoscope (1001514) | $5,884.00 | N/A | |
| Operating Room - Removal Of Foreskin (1000880) | $2,763.00 | N/A | |
| Operating Room - Removal Of Fluid From Abdominal Cavity With Imaging Guidance (1007763) | $851.00 | N/A | |
| Operating Room - Removal Of Cataracts Using Fragmentation And Aspiration (1005017) | $4,257.00 | N/A | |
| Operating Room - Removal Of Appendix Using Endoscope (1001513) | $4,436.00 | N/A | |
| Operating Room - Removal Of Abnormal Growth (1001590) | $2,660.00 | N/A | |
| Operating Room - Rectal Procedure (1001343) | $2,944.00 | N/A | |
| Operating Room - Pain Clinic Procedure (1007581) | $870.00 | N/A | |
| Operating Room - Open Exploration Of Abdominal Cavity (1001521) | $4,053.00 | N/A | |
| Operating Room - Minor Amputation (1007759) | $2,519.00 | N/A | |
| Operating Room - Manipulation Of Broken Bone Or Dislocated Joint Without Incision (1000887) | $1,810.00 | N/A | |
| Operating Room - Introduction Of Saline Or X-Ray Contrast Material For Imaging Of The Uterus And Tubes (1001373) | $525.00 | N/A | |
| Operating Room - Insertion Of Catheter Into Central Vein (1006826) | $1,301.00 | N/A | |
| Operating Room - Insertion Of Catheter In Central Vein, Access Via Arm, Leg, Or Neck Vein, 5+ Years (1004760) | $1,019.00 | N/A | |
| Operating Room - Insertion Of Access Site Into Vein (1002469) | $2,070.00 | N/A | |
| Operating Room - Incision Into Bladder (1001004) | $2,189.00 | N/A | |
| Operating Room - Groin Hernia (1001412) | $4,040.00 | N/A | |
| Operating Room - Fluid Collection In Scrotum (1001371) | $3,093.00 | N/A | |
| Operating Room - Exam With Anesthesia (1005043) | $1,551.00 | N/A | |
| Operating Room - Drainage Or Aspiration Of Chest Cavity (1010488) | $1,030.00 | N/A | |
| Operating Room - Dilation And Scraping Of Uterus (1001009) | $3,588.00 | N/A | |
| Operating Room - Diagnostic Exam Of Uterus (1001374) | $2,643.00 | N/A | |
| Operating Room - Diagnostic Exam Of Bladder Using Flexible Endoscope (1004739) | $2,427.00 | N/A | |
| Operating Room - Diagnostic Exam Of Abdominal Cavity Using Endoscope (1001517) | $3,152.00 | N/A | |
| Operating Room - Cesarean Delivery With Tying Of Fallopian Tubes (1007070) | $6,174.00 | N/A | |
| Operating Room - Cesarean Delivery (1004275) | $5,583.00 | N/A | |
| Operating Room - Bladder Instillation Of Cancer Preventive, Inhibiting, Or Suppressive Agent (1006737) | $775.00 | N/A | |
| Operating Room - Biopsy Of Prostate With Trus (1002378) | $1,700.00 | N/A | |
| Operating Room - Aspiration Or Injection Of Large Joint Or Joint Capsule (1001416) | $508.00 | N/A | |
| Operating Room - Additional Urinary Procedure Using Endoscope (1000997) | $3,471.00 | N/A | |
| Operating Room - Additional Minutes (1005000) | $16.00 | N/A | |
| Operating Room - Abdominal Wall Hernia (1002476) | $3,591.00 | N/A | |
| Occupational Therapy - Therapeutic Exercise To Develop Strength, Endurance, Range Of Motion, And Flexibility, Each 15 Minutes (1002901) | $111.00 | N/A | |
| Occupational Therapy - Therapeutic Activities To Improve Function With One-On-One Contact Between Patient And Provider, Each 15 Minutes (1002912) | $109.00 | N/A | |
| Occupational Therapy - Sensory Technique To Enhance Processing And Adaptation To Environmental Demands, Each 15 Minutes (1002914) | $109.00 | N/A | |
| Occupational Therapy - Self-Care Or Home Management Training, Each 15 Minutes (1002915) | $111.00 | N/A | |
| Occupational Therapy - Re-Evaluation Of Occupational Therapy Established Plan Of Care, Typically 30 Minutes (1026792) | $167.00 | N/A | |
| Occupational Therapy - Physical Medicine Service Or Procedure (1004482) | $93.00 | N/A | |
| Occupational Therapy - One-On-One Therapeutic Interventions Focused On Thought Processing And Strategies To Manage Activities (1027626) | $101.00 | N/A | |
| Occupational Therapy - Manual Therapy Techniques To 1 Or More Regions, Each 15 Minutes (1002908) | $107.00 | N/A | |
| Occupational Therapy - Management And/or Training In Use Of Orthotics For Arms Legs And/or Trunk Per 15 Minutes (1027627) | $62.00 | N/A | |
| Occupational Therapy - Evaluation Of Occupational Therapy, Typically 45 Minutes (1026790) | $235.00 | N/A | |
| Occupational Therapy - Evaluation Of Occupational Therapy, Typically 30 Minutes (1026789) | $235.00 | N/A | |
| Occupational Therapy - Application Of Ultrasound To 1 Or More Areas, Each 15 Minutes (1002899) | $53.00 | N/A | |
| Occupational Therapy - Application Of Hot Wax Bath To 1 Or More Areas (1002890) | $15.00 | N/A | |
| Observation - Hospital Observation Care - Each Hour Of Service (1000442) | $59.00 | N/A | |
| Observation - Hospital Observation Care - Each Hour Of Service (1004317) | $59.00 | N/A | |
| Nuclear Medicine - Diagnostic Tomographic (Spect) Scan Of Heart, Multiple Studies (1003505) | $2,644.00 | N/A | |
| Nuclear Medicine - Diagnostic Tomographic (Spect) Scan Of Bones Or Joints (1003518) | $1,199.00 | N/A | |